Psychiatry

Whether revisions to the bible of mental illness should be carried out in secret might seem like an academic question. But the issue carries real weight for parents desperate to address children's difficult behavior or people in distress over their mental state. It also speaks to citizens' concerns over news accounts of an overmedicated America and of the troubling financial links between some psychiatric researchers and the pharmaceutical industry.

Over the summer, a wrangle between eminent psychiatrists that had been brewing for months erupted in print. Startled readers of Psychiatric News saw the spectacle unfold in the journal's normally less-dramatic pages.

People with otherwise untreatable depression improved in a small clinical trial after receiving continuous electrical stimulation of a part of the brain that scientists believe regulates sadness. A report this week in the journal Biological Psychiatry said 12 of 20 patients with chronic major depression benefited from the electronic device. For seven of the 12, the disease went into remission. The benefits were sustained over the course of the one-year study, researchers said.

In the early 1980s, a profound shift in psychiatry set the stage for the growth of psychiatric diagnoses in kids. In a third revision of the manual often called the profession's bible (the Diagnostic and Statistical Manual of Mental Disorders, or DSM), the American Psychiatric Assn. began adding descriptions of newly recognized anxiety disorders. The new entries set forth symptoms of extreme shyness, worry or fear.

Katie's middle child "has always had a lot going on in her head," says her mother. And much of it has been a mystery to Katie, who has coped with her daughter's escalating tantrums, combative behavior, bouts of fearfulness and just-plain-oddity since the 11-year-old was a toddler. A month ago, Katie, a 38-year-old L.A.-area mother of three, brought the child to a psychiatrist.

A persecution complex. Paranoid schizophrenia. Psychotic depression, with both homicidal and suicidal characteristics. Severe bipolar disorder. Though no one can now diagnose Virginia Tech gunman Seung-Hui Cho, mental health experts who watched his videotaped message about Monday's rampage say there was evidence of all of those mental disorders. His desire to kill others as well as himself is "not an unusual combination for a school shooter," said Dr.

A psychiatrist instructs a patient on his couch: "I'll say a normal word, then you say the first sick thing that pops into your head." Another phones his wife to say: "I'm going to be late, dear. It's total craziness here."

Kanuri Qawi's unlikely 2004 court victory has had a lasting impact on California mental hospitals, adding to what one doctor calls a "culture of refusal," as more patients reject their medication. In the aftermath of Qawi's lawsuit, hospital officials are now required to hold what are known as Qawi hearings and must demonstrate clearly that a patient paroled to the hospital is dangerous before they can force medication.

ON a crisp afternoon last fall, a police officer responding to a 911 call pulled onto an abandoned military base on the eastern edge of San Francisco Bay. Six dreary naval housing blocks, converted into apartments for down-on-their-luck veterans, had been painted with labels meant to inspire: Hope, Resolve. The door to Apartment B, in the building called Courage, was open. The man who had summoned police, Kanuri Qawi, was waiting casually in the doorway, a glass of soda in his hand.

NASA astronauts undergo a psychological assessment when they join the space agency, but they face no further evaluations during their careers unless issues arise during their annual flight physicals, the space agency said Tuesday. "No other psychological assessments are done for shuttle astronauts after that initial one unless a concern is raised," said NASA public affairs officer Katherine Trinidad. Navy Capt.