There are many more psychiatric difficulties that we see in clinical practice.  I will be adding to these files over the next few months.  At the present, just make your choices above if any look of interest.  My section on melatonin under sleep disorders and insomnia is my favorite.

Hypochondriacal Disorder Treated with 6 Sessions of Cognitive Behavioral Counseling: In a random assignment study, one group of 102 patients participated in an experimental, six-session cognitive behavioral treatment (CBT) program. The primary care physicians assigned to these patients also received a special letter that outlined treatment recommendations and offered the physicians advice on how to care for and approach the patient during upcoming office visits. A control group of 80 patients was followed for the same period of time, but this group did not undergo the CBT therapy and their doctors did not receive the letter. After one year, the group undergoing therapy showed a significant improvement in symptoms compared to the patients who received the usual medical care. They reported feeling better and had fewer symptoms and less anxiety about their health. They were also found to have improved social functioning and improved functioning in their daily activities, such as doing errands and working around the house. J Amer Med Assoc 3/24/04 Harvard.

Prader-Willi Syndrome Often Had Low Bone Density: PWS is a chromosome 15 disorder characterized by hypotonia, hypogonadism, hyperphagia, and obesity. Musculoskeletal manifestations, including scoliosis, hip dysplasia, and lower limb alignment abnormalities. In a study of 31 PWS patients, chromosome 15q abnormality was confirmed in 18; scoliosis in 21 of 30 patients with an average primary curve of 27 degrees; 3 were braced, and 2 underwent spinal fusion; 14 had a total of 58 fractures, with 6 patients sustaining multiple fractures; of 14 with bone density testing, 8 patients had osteopenia, and 4 had osteoporosis based on lumbar spine z scores. Twenty-six patients had Axis I psychiatric diagnoses including impulse control disorder (7), organic personality disorder (6), oppositional defiant disorder (5), dysthymic disorder (4), depressive disorder not otherwise specified (3), attention-deficit/hyperactivity disorder (2), and obsessive-compulsive disorder (2). Nine patients exhibited self-mutilating behaviors. The treating orthopaedic surgeon must plan carefully and proceed with caution when treating children and adults with PWS. Prader-Willi Syndrome: clinical concerns for the orthopaedic surgeon. Kroonen LT, et al. Naval Medical Center San Diego. . J Pediat Orthop 2006 Sep-Oct;26(5):673-9.