Dear Colleagues:
Welcome to the February 2011 issue of Innovations in Clinical Neuroscience. We start this issue with one of our regular columns, “The Interface,” by Sansone and Sansone. This month, the authors examine the literature regarding the link between certain types of sexual behavior and borderline personality disorder. Overall, it seems that certain types of sexual behavior in individuals with borderline personality disorder are related to impulsivity and victimization. Sansone and Sansone synthesize the data and discuss what these findings mean for clinicians in mental health and primary care settings.

Next, Yanofski provides us with another installment of our “Forensic Files” column. This month, he tackles the ethical, clinical, and legal challenges of taking on the psychiatric treatment of incarcerated individuals sentenced to death.

Following this, we are pleased to publish another commentary by our friend, Ronald Pies, who is Professor of Psychiatry at SUNY Upstate Medical University, Syracuse, New York, and Clinical Professor of Psychiatry at Tufts University School of Medicine, Boston, Massachusetts. Peppered with humor and insight, Dr. Pies serves us up some food for thought on the proposed elimination of the diagnosis of narcissistic personality disorder (NPD) in DSM-V. Whatever your current opinion is on the matter, Dr. Pies will no doubt get you to look at NPD in a new light.

Next, Kollins et al present their study on lisdexamfetamine dimesylate. The investigators evaluated the efficacy and safety of lisdexamfetamine dimesylate in participants with attention deficit hyperactivity disorder and a history of depression and/or substance use disorder in an exploratory, post-hoc analysis. The investigators found that the response to lisdexamfetamine dimesylate and the treatment-emergent adverse event profiles of participants with a history of depression and/or a history of substance use disorder were similar to those of participants with no history of these disorders. Because most ADHD clinical trials exclude individuals with concurrent psychiatric disorders, there is little information on treatment outcomes and safety of these individuals, which makes this study particularly interesting.

Make sure you check out this month’s “Psychotherapy Rounds” article. Collison and Correll review the treatment of panic attacks, which is a common complaint of patients seeking psychiatric care. In this article, the authors use a composite case to illustrate how psychodynamic psychotherapy can be utilized to treat panic disorder in a way that is rewarding for both the patient and the psychiatrist.

And finally, Alinejad et al present an interesting case of factitious disorder (FD) in a patient who regularly presented to the emergency room with diabetic ketoacidosis, which resulted from the patient deliberately withholding her exogenous insulin. The authors present a perspective on the treatment strategies of factitious disorder that clinicians may want to consider, especially when a patient exhibiting characteristics of FD does not wish to engage in psychiatric treatment. The authors also discuss the diagnostic criteria and other treatment strategies of FD, both of which are of considerable debate within the psychiatric community.

We hope you enjoy this issue of Innovations as much as we have!

Amir Kalali, MD
Editor, Innovations in Clinical Neuroscience