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Guest Editorial
Palliative Care: An Opportunity for Mental Health Professionals
Harvey Max Chochinov
(PDF)

In Review
Structured Interview Assessment of Symptoms and Concerns in Palliative Care
Keith G Wilson, Ian D Graham, Raymond A Viola, Susan Chater, Barbara J de Faye, Lynda A Weaver, Julie A Lachance
(PDF)

Palliative Care for Families: Remembering the Hidden Patients
Linda J Kristjanson, Samar Aoun
(PDF)

Psychotherapeutic Interventions at the End of Life: A Focus on Meaning and Spirituality
William Breitbart, Christopher Gibson, Shannon R Poppito, Amy Berg
(PDF)

Review Paper
Prevalence Studies of Substance-Related Disorders: A Systematic Review of the Literature
Julian M Somers, Elliot M Goldner, Paul Waraich, Lorena Hsu
(PDF)

Original Research
Stress and Psychological Impact on SARS Patients During the Outbreak
Siew E Chua, Vinci Cheung, Grainne M McAlonan, Charlton Cheung, Josephine WS Wong, Erik PT Cheung, Marco TY Chan, Teresa KW Wong, Khai M Choy, Chung M Chu, Peter WH Lee, Kenneth WT Tsang
(PDF)

Brief Communication
Psychological Effects of the SARS Outbreak in Hong Kong on High-Risk Health Care Workers
Siew E Chua, Vinci Cheung, Charlton Cheung, Grainne M McAlonan, Josephine WS Wong, Erik PT Cheung, Marco TY Chan, Michael MC Wong, Siu W Tang, Khai M Choy, Meng K Wong, Chung M Chu, Kenneth WT Tsang
(PDF)

Schizophrenia: The Quest for a Minimum Sense of Identity to Ward Off Delusional Disorder
Marie-Christine Noël-Jorand, Max Reinert, Sébastien Giudicelli, Daniel Dassa
(PDF)

Diabetes, Tardive Dyskinesia, Parkinsonism, and Akathisia in Schizophrenia: A Retrospective Study Applying 1998 Diabetes Health Care Guidelines to Antipsychotic Use
Emmanuelle Lévy, Howard C Margolese, Lawrence Annable, Guy Chouinard
(PDF)

The Psychosocial Effects of Being Quarantined Following Exposure to SARS: A Qualitative Study of Toronto Health Care Workers
Emma Robertson, Karen Hershenfield, Sherry Lynn Grace, Donna Eileen Stewart
(PDF)

Hard Times and Good Friends: Negative Life Events and Social Support in Patients With Seasonal and Nonseasonal Depression
Erin E Michalak, Edwin M Tam, Chinnapalli V Manjunath, Lakshmi N Yatham, Anthony J Levitt, Robert D Levitan, Raymond W Lam
(PDF)

Letters to the Editor
(PDF)

Combined Transcranial Magnetic Stimulation and Right Unilateral Electroconvulsive Therapy in Patients With Treatment-Refractory Depression

Re: Treatment Noncompliance With Orally Disintegrating Olanzapine Tablets

Reply: Treatment Noncompliance With Orally Disintegrating Olanzapine Tablets

Quetiapine in the Management of Psychosis Secondary to Huntington's Disease: A Case Report

Ziprasidone-Induced Lupus Erythematosus

Lorazepam-Induced Prolongation of the QT Interval in a Patient With Schizoaffective Disorder and Complete AV Block

Letters to the Editor

Reply: Treatment Noncompliance With Orally Disintegrating Olanzapine Tablets

My letter describing a patient with olanzapine wafer noncompliance had one purpose: to alert clinicians to the possibility of “cheeking” wafers. Dr Citrome describes 2 more “cheeking” techniques and offers an easy remedy. I did not suggest that parenteral drug administration is always (or even usually) the answer to medication non-adherence. I agree with Dr Citrome that persistence with oral atypical antipsychotics (ensuring swishing and swallowing) is preferable to forced parenteral haloperidol, particularly if it leads to a better outcome.

In some cases, however, benefit might never materialize from the patient’s perspective, regardless of the medication administered or the route of administration and regardless of clinical response by objective criteria. How prudent and promising is it to insist on repeating daily the drama of drug administration with its checks and obvious coercive element? I would argue that a fail-safe route of infrequent drug administration (for example, with intramuscular haloperidol decanoate) should remain an option to stabilize patients who have little insight into drug benefit. There is no question that these patients present us with complex issues regarding competency, civil rights, and our duties as physicians.

Oliver Freudenreich, MD
Boston, Massachusetts