Canadian Psychiatric Association
 

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Guest Editorial
Needed: Clinical Research in Mood Disorders

Martin Alda, Michael Bauer

(PDF)


In Review
The Antisuicidal and Mortality-Reducing Effect of Lithium Prophylaxis: Consequences for Guidelines in Clinical Psychiatry

Bruno Müller-Oerlinghausen, Anne Berghöfer, Bernd Ahrens

(PDF)

Lithium Augmentation Therapy in Refractory Depression: Clinical Evidence and Neurobiological Mechanisms
Michael Bauer, Mazda Adli, Christopher Baethge, Anne Berghöfer, Johanna Sasse, Andreas Heinz, Tom Bschor

(PDF)

Prophylaxis Latency and Outcome in Bipolar Disorders
Christopher Baethge, Leonardo Tondo, Irene M Bratti, Tom Bschor, Michael Bauer, Adele C Viguera, Ross J Baldessarini

(PDF)


Review Paper
Clinical Features of Bipolar Disorder With and Without Comorbid Diabetes Mellitus

Martina Ruzickova, Claire Slaney, Julie Garnham, Martin Alda

(PDF)


The Cortisol Awakening Response in Bipolar Illness: A Pilot Study

Dorian Deshauer, Anne Duffy, Martin Alda, Eva Grof, Joy Albuquerque, Paul Grof

(PDF)


Implementing Quality Management in Psychiatry: From Theory to Practice—Shifting Focus From Process to Outcome

Brent M McGrath, Raymond P Tempier

(PDF)


Original Research
Mental Disorders and Reasons for Using Complementary Therapy

Badri Rickhi, Hude Quan, Sabine Moritz, Heather L Stuart, Julio Arboleda-Flórez

(PDF)

Readiness to Participate in Psychiatric Research Daniele Zullino, Philippe Conus, François Borgeat, Charles Bonsack
(PDF)

Toward Benchmarks for Tertiary Care for Adults With Severe and Persistent Mental Disorders
Alain D Lesage, Daniel Gélinas, David Robitaille, Éric Dion, Diane Frezza, Raymond Morissette

(PDF)


Brief Communication
Patient Attitudes Regarding Causes of Depression: Implications for Psychoeducation

Janaki Srinivasan, Nicole L Cohen, Sagar V Parikh

(PDF)


Book Reviews
(PDF)

Helping the Helpers Not to Harm: Iatrogenic Damage and Community Mental Health.
Reviewed by
Peter Moore, MD, FRCPC

L’Homme de Vérité.
Revue par
Maurice Dongier, MD, FRCPC


Letters to the Editor
(PDF)

Re: The Combined Use of Atypical Antipsychotics and Cognitive-Behavioural Therapy in Schizophrenia

Reply: The Combined Use of Atypical Antipsychotics and Cognitive-Behavioural Therapy in Schizophrenia

Re: Should Psychologists Be Granted Prescription Privileges? A Review of the Prescription Privilege Debate for Psychiatrists

Reply: Should Psychologists Be Granted Prescription Privileges? A Review of the Prescription Privilege Debate for Psychiatrists

Re: Should Psychologists Be Granted Prescription Privileges? A Review of the Prescription Privilege Debate for Psychiatrists

Reply: Should Psychologists Be Granted Prescription Privileges? A Review of the Prescription Privilege Debate for Psychiatrists

Breath-Holding in Anxiety Disorders

Bright Light, Serotonin Turnover, and Psychological Well-Being

Letters to the Editor

Re: Should Psychologists Be Granted Prescription Privileges? A Review of the Prescription Privilege Debate for Psychiatrists

Dear Editor:

According to its objective, the article by Lavoie and Fleet is “informational” (1). However, while cogently written with regard to some pivotal events in psychology’s developmental history, it also contains some flagrant inaccuracies.

The authors allege that the clinical psychological subspecialty of clinical psychopharmacology is currently undeveloped, restricted to the prescription of psychotropic drugs (rather than also encompassing other medicines and the provision of medical care in general), and deviates from psychology’s theoretical approach to mental illness.

On the contrary, the specialty’s development has progressed substantially: the American Psychological Association has established strict standards for the psychopharmacological and medical education and training of psychologists, and this has been followed by the establishment of similar North American guidelines published by the Association of State and Provincial Psychology Boards (2). Further, a postdoctoral education and training program, along with a credentialling body (that is, the International Collee of Prescribing Psychologists [ICPP]), has been established to board certify psychologists in the medical evaluation and management of serious mental illness and related medical disorders (for example, hypothyroidism- induced depression, side effects of drugs, and adverse drug interactions), consistent with psychology’s theoretical approach to mental illness (3). Psychiatrist board members consistently note that the pharmacologic training of their student psychologists surpasses training provided within traditional medical schools, and legislation has been passed to allow duly qualified psychologists to prescribe medicine in US federal hospitals, in the US territory of Guam, and most recently, in New Mexico. In the case of New Mexico, after all the evidence both for and against was reviewed, legislation that consigned autonomous prescribing authority to duly qualified psychologists passed with a vast majority of favourable votes and with the support of both the New Mexico Medical Association and a psychiatrist who provided expert medical testimony. In Canada, the province of Alberta has reportedly modified its health care legislation to allow duly qualified health care professionals to request prescribing authority.

In sum, clinical psychopharmacology is a well-established clinical psychological subspecialty (and hence, well past the “debating” stage of development) with a wealth of data from both psychiatrists and psychologists documenting the qualifications of practitioners within this specialty to prescribe medicine competently and safely. Psychiatrists should question why 2 psychologists, neither of whom is board certified to practice this specialty, are attempting to “stimulate the interest” of psychiatrists and to “educate” them so that they may become involved in this discussion—a discussion about whether duly qualified specialists within another discipline should be allowed to provide health care services within their scope of practice.

References

1. Lavoie KL, Fleet RP. Should psychologists be granted prescription privileges? A review of the prescription privilege debate for psychiatrists. Can J Psychiatry 2002;47:443–8.

2. Melnyk WT, Allen MF, Nutt RL, Connor T, Robiner B, Pacht A. Guidelines for prescriptive authority. Montgomery (AL): ASPPB Committee on Education and Training for Credentialing, Association of State and Provincial Psychology Boards (ASPPB); July 2001.

3. Litman LC. Differences is prescribing practice between board-certified prescribing psychologists and psychiatrists. UWO Med J 2001;71(2):59–60.

Larry C Litman, PhD, Cpsych, FACAPP, FPPR, FSMI, FICPP, FSICPP
London, Ontario




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