Wilson Disease

Wilson disease is a rare autosomal recessive inherited disorder of copper metabolism in which excessive amounts of copper accumulate in the body.  The buildup of copper leads to damage in the liver, brain, and eyes.  Although copper accumulation begins at birth, symptoms of the disorder only appear later in life.   Presentation Clinical symptoms vary significantly, but… Read more »

Major Depression

First-degree relatives of depressed individuals are about 3 times as likely to develop depression as the general population. Late-onset depression (after age 60 years) is an etiologically and clinically distinct syndrome from Major Depression genetically passed through generations.  A family history of depression is less common among patients with late-onset depression than in younger adults with… Read more »

Anxiety Disorders

Anxiety disorders are a worldwide problem with panic disorder having a 12-month prevalence of 2 to 3%. Generalized anxiety disorder’s prevalence is 3%, and the phobias occur in 10 to 15% of adults. Panic disorder: Recurrent unexpected panic attacks, typically with anticipatory anxiety and avoidance behavior. Generalized anxiety disorder: Excessive anxiety and worry, not meeting the criteria for other… Read more »

Suicide Risk & Evaluation

Suicide means killing oneself. The act constitutes a person willingly, perhaps ambivalently, taking his or her own life. Several forms of suicidal behavior fall within the self-destructive spectrum. A completed suicide means the person has died. A suicide attempt involves a serious act, such as taking a fatal amount of medication and someone intervening accidentally…. Read more »


Schizophrenia is diagnosed based on the presence of delusions, hallucinations, and disorganized speech and behavior, often accompanied by apathy and social withdrawal and resulting in major impairment in functioning for at least 6 months.   Schizophrenia, the prototypical psychotic disorder, necessarily includes symptoms of psychosis (“positive” symptoms) and also often includes “negative symptoms” such as… Read more »

Post Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a specific manifestations of symptoms referable to an extremely traumatic event. The event by definition must involve exposure to actual or threatened death, serious injury, or sexual violence, as reported directly by the patient or by family or friends. Patients suffer from repeated or extreme exposure to aversive details of… Read more »

Bipolar disorder / Manic-Depressive

Bipolar disorder is defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, irritability, and mood with one or more deep depressive episodes. The disease is characterized by distinct episodes of major depression contrasted with episodes of mania, which lead to severe impairment in function. First-degree relatives of people with Bipolar… Read more »

Eating Disorders

Anorexia Nervosa Diagnostic criteria for anorexia nervosa in the DSM-V include the following : Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents,… Read more »

Alcohol Abuse

Alcoholism (alcohol dependence) and alcohol abuse are two different forms of problem drinking. Alcoholism: signs of physical addiction to alcohol and continued consumption (despite problems with physical health, mental health, and social, family, or job responsibilities). These patients have: tolerance, withdrawal, & overwhelming involvement in getting alcohol. Alcohol abuse: drinking leads to “problems” (social, work,… Read more »