Mary Woesner - Academia.edu (original) (raw)
Papers by Mary Woesner
The primary care companion for CNS disorders, Jan 10, 2024
A psychiatrist attempts to stay positive while facing her parents' and loved ones' premat... more A psychiatrist attempts to stay positive while facing her parents' and loved ones' premature deaths—ever reminding us that hope springs eternal.
Psychiatric Services, Apr 1, 1984
The primary care companion for CNS disorders, Jan 5, 2017
PubMed, 2017
Since the first description of Seasonal Affective Disorder (SAD) by Rosenthal et al. in the 1980s... more Since the first description of Seasonal Affective Disorder (SAD) by Rosenthal et al. in the 1980s, treatment with daily administration of light, or Bright Light Therapy (BLT), has been proven effective and is now recognized as a first-line therapeutic modality. More recently, studies aimed at understanding the pathophysiology of SAD and the mechanism of action of BLT have implicated shifts in the circadian rhythm and alterations in serotonin reuptake. BLT has also been increasingly used as an experimental treatment in non-seasonal unipolar and bipolar depression and other psychiatric disorders with known or suspected alterations in the circadian system. This review will discuss the history of SAD and BLT, the proposed pathophysiology of SAD and mechanisms of action of BLT in the treatment of SAD, and evidence supporting the efficacy of BLT in the treatment of non-seasonal unipolar major depression, bipolar depression, eating disorders, and ADHD.
PubMed, Feb 15, 2019
Schizophrenia is a mental disorder that is characterized by progressive cognitive impairment in a... more Schizophrenia is a mental disorder that is characterized by progressive cognitive impairment in areas of attention, working memory, and executive functioning. Although no clear etiology of schizophrenia has been discovered, many factors have been identified that contribute to the development of the disease, such as neurotransmitter alterations, decreased synaptic plasticity, and diminished hippocampal volume. Historically, antipsychotic medications have targeted biochemical alterations in the brains of patients with schizophrenia but have been ineffective in alleviating cognitive and hippocampal deficits. Other modalities, such as exercise therapy, have been proposed as adjuvant or primary therapy options. Exercise therapy has been shown to improve positive and negative symptoms, quality of life, cognition, and hippocampal plasticity, and to increase hippocampal volume in the brains of patients with schizophrenia. This article will briefly review the clinical signs, symptoms and proposed etiologies of schizophrenia, and describe the current understanding of exercise programs as an effective treatment in patients with the disease.
Preventive Medicine, 2020
Now, when I think back O.P's plight and isolation, I marvel that he could remain standing. He... more Now, when I think back O.P's plight and isolation, I marvel that he could remain standing. He reminds me of many other courageous young men—the writer, the newly graduated physician, and all the others whom I treated and who died of AIDS. He also reminds me of the vibrant gay community that was destroyed by a microscopic retrovirus.
The primary care companion for CNS disorders, Jul 17, 2014
Physical diseases are difficult to treat in psychiatric patients, whether they are comorbid disor... more Physical diseases are difficult to treat in psychiatric patients, whether they are comorbid disorders or mental disorders due to a general medical condition. The psychiatric symptoms are difficult to treat in a medical ward or clinic, and the physical symptoms are difficult to treat in a psychiatric ward or clinic. For this reason, medicalpsychiatric units have been developed but remain uncommon. It has been suggested that assertive community treatment (ACT) teams are a way in which to integrate medical and psychiatric treatments. We review the case of a woman with psychiatric symptoms caused by Graves disease that went untreated due to medication noncompliance and unmanageable irritability, aggression, and mood variability. We make a case for the use of the assertive community treatment team in the treatment of patients with mental disorders due to a general medical condition when the psychiatric manifestations are severe and cannot be managed in a medical ward or clinic.
Psychiatric Services, Jul 1, 1983
Psychiatric Services, Aug 1, 1984
Psychiatric Services, Sep 1, 2017
because of suffering related to a mental disorder involves active intervention to end a life that... more because of suffering related to a mental disorder involves active intervention to end a life that would otherwise continue. That is not a small difference, legally or morally. For the reasons suggested in the column, including the possibility that physician-assisted death would serve as a substitute for ongoing commitment to patients with difficultto-treat disorders, it would be most unfortunate for the United States and Canada to follow in the footsteps of those European countries that have legalized that option.
Academic Medicine, May 1, 1997
A longitudinal study to ascertain the attitudes toward, and habits of, substance use among a sing... more A longitudinal study to ascertain the attitudes toward, and habits of, substance use among a single class of medical students. A single class from a northeastern medical school was surveyed in both its first year (February 1991, 176 students) and its third year (May 1993, 170 students). The students were asked to report how frequently during the prior year they had used drugs or alcohol, and whether their use of each substance had increased, decreased, or remained the same since entering medical school; to identify any family members with histories of alcohol or drug problems; and to report any incidence during the prior year of ten behaviors associated with substance dependence. The students were also asked to indicate their agreement or disagreement with 11 attitudinal statements. Additional attitudinal items asked the students to identify three major deterrents to the abuse of drugs and alcohol, and what they had done if they had become aware of a classmate with a drug or alcohol problem. Chi-square analysis and two-tailed t-tests were used to compare data from the two surveys. The response rates in the first and second surveys were 96.9% and 81.8%, respectively. Use of licit and illicit substances was comparable to that of chronological peers and prior national studies of medical trainees. Most of the students admitted to using alcohol at least once in the prior year (91.8% and 95%, respectively). In both years marijuana was the illicit drug used most often. Although there was a slight increase over time in the use of benzodiazepines (2.4% to 5.8%) and a decrease in the use of marijuana (29.4% to 21.7%), these changes were not significant. Few of the students in their third year reported using any substance other than alcohol more than once a month. In general, a greater percentage of the students reported a decrease rather than an increase in the use of a substance since entering medical school; the primary exception was for wine. As they progressed in their training, the students became less concerned about the effect of substance use on their performance and more likely to be embarrassed about admitting to an addiction. Although in each year a few of the students appeared to be at risk for substance dependence (8.9% and 3.5%, respectively), no student came to the attention of the administration because of problems related to substance use. While most of the students were unaware of any classmate who had a problem, half of those who were aware had done nothing, and the balance had rarely sought assistance from the faculty or administration. Although there was no evidence that substance use was a major problem, a few of the students appeared to be at risk for drug or alcohol dependence. Appropriate intervention, support, and referral systems should be identified for the few who may be at risk, and increased educational efforts are needed to help all students address this issue with their peers and, ultimately, with their patients.
Psychiatric Services, Jun 1, 1985
Psychiatric Services, Apr 1, 1984
Psychiatric Services, Aug 1, 1984
Psychiatric Services, Dec 1, 1982
Psychiatric Services, Dec 1, 1982
Psychiatric Services, Mar 1, 1987
Psychiatric Services, Jul 1, 1983
Families arc asking to be included in the treatment of their mentally ill relatives. They arc ask... more Families arc asking to be included in the treatment of their mentally ill relatives. They arc asking for more information from professionals, specifically information on the nature of the mental illness and on "practical" techniques for coping with it. In my opinion, the best books for families are those that provide practical information and that also attempt to bridge the historical rift between the mental health professional and the family. Both Coping With Schizophrenia and Living and Working With Schizophrenia achieve these goals, to different degrees. Coping With Schizophrenia, by Mona Wasow, is the more emotional and controversial of the two books. Ms. Wasow has drawn on hen experience as a social worker and the parent of a schizophrenic child to write a "how-to manual and reference book" for other parents of individuals with "chronic schizophrenia.
The primary care companion for CNS disorders, Jan 10, 2024
A psychiatrist attempts to stay positive while facing her parents' and loved ones' premat... more A psychiatrist attempts to stay positive while facing her parents' and loved ones' premature deaths—ever reminding us that hope springs eternal.
Psychiatric Services, Apr 1, 1984
The primary care companion for CNS disorders, Jan 5, 2017
PubMed, 2017
Since the first description of Seasonal Affective Disorder (SAD) by Rosenthal et al. in the 1980s... more Since the first description of Seasonal Affective Disorder (SAD) by Rosenthal et al. in the 1980s, treatment with daily administration of light, or Bright Light Therapy (BLT), has been proven effective and is now recognized as a first-line therapeutic modality. More recently, studies aimed at understanding the pathophysiology of SAD and the mechanism of action of BLT have implicated shifts in the circadian rhythm and alterations in serotonin reuptake. BLT has also been increasingly used as an experimental treatment in non-seasonal unipolar and bipolar depression and other psychiatric disorders with known or suspected alterations in the circadian system. This review will discuss the history of SAD and BLT, the proposed pathophysiology of SAD and mechanisms of action of BLT in the treatment of SAD, and evidence supporting the efficacy of BLT in the treatment of non-seasonal unipolar major depression, bipolar depression, eating disorders, and ADHD.
PubMed, Feb 15, 2019
Schizophrenia is a mental disorder that is characterized by progressive cognitive impairment in a... more Schizophrenia is a mental disorder that is characterized by progressive cognitive impairment in areas of attention, working memory, and executive functioning. Although no clear etiology of schizophrenia has been discovered, many factors have been identified that contribute to the development of the disease, such as neurotransmitter alterations, decreased synaptic plasticity, and diminished hippocampal volume. Historically, antipsychotic medications have targeted biochemical alterations in the brains of patients with schizophrenia but have been ineffective in alleviating cognitive and hippocampal deficits. Other modalities, such as exercise therapy, have been proposed as adjuvant or primary therapy options. Exercise therapy has been shown to improve positive and negative symptoms, quality of life, cognition, and hippocampal plasticity, and to increase hippocampal volume in the brains of patients with schizophrenia. This article will briefly review the clinical signs, symptoms and proposed etiologies of schizophrenia, and describe the current understanding of exercise programs as an effective treatment in patients with the disease.
Preventive Medicine, 2020
Now, when I think back O.P's plight and isolation, I marvel that he could remain standing. He... more Now, when I think back O.P's plight and isolation, I marvel that he could remain standing. He reminds me of many other courageous young men—the writer, the newly graduated physician, and all the others whom I treated and who died of AIDS. He also reminds me of the vibrant gay community that was destroyed by a microscopic retrovirus.
The primary care companion for CNS disorders, Jul 17, 2014
Physical diseases are difficult to treat in psychiatric patients, whether they are comorbid disor... more Physical diseases are difficult to treat in psychiatric patients, whether they are comorbid disorders or mental disorders due to a general medical condition. The psychiatric symptoms are difficult to treat in a medical ward or clinic, and the physical symptoms are difficult to treat in a psychiatric ward or clinic. For this reason, medicalpsychiatric units have been developed but remain uncommon. It has been suggested that assertive community treatment (ACT) teams are a way in which to integrate medical and psychiatric treatments. We review the case of a woman with psychiatric symptoms caused by Graves disease that went untreated due to medication noncompliance and unmanageable irritability, aggression, and mood variability. We make a case for the use of the assertive community treatment team in the treatment of patients with mental disorders due to a general medical condition when the psychiatric manifestations are severe and cannot be managed in a medical ward or clinic.
Psychiatric Services, Jul 1, 1983
Psychiatric Services, Aug 1, 1984
Psychiatric Services, Sep 1, 2017
because of suffering related to a mental disorder involves active intervention to end a life that... more because of suffering related to a mental disorder involves active intervention to end a life that would otherwise continue. That is not a small difference, legally or morally. For the reasons suggested in the column, including the possibility that physician-assisted death would serve as a substitute for ongoing commitment to patients with difficultto-treat disorders, it would be most unfortunate for the United States and Canada to follow in the footsteps of those European countries that have legalized that option.
Academic Medicine, May 1, 1997
A longitudinal study to ascertain the attitudes toward, and habits of, substance use among a sing... more A longitudinal study to ascertain the attitudes toward, and habits of, substance use among a single class of medical students. A single class from a northeastern medical school was surveyed in both its first year (February 1991, 176 students) and its third year (May 1993, 170 students). The students were asked to report how frequently during the prior year they had used drugs or alcohol, and whether their use of each substance had increased, decreased, or remained the same since entering medical school; to identify any family members with histories of alcohol or drug problems; and to report any incidence during the prior year of ten behaviors associated with substance dependence. The students were also asked to indicate their agreement or disagreement with 11 attitudinal statements. Additional attitudinal items asked the students to identify three major deterrents to the abuse of drugs and alcohol, and what they had done if they had become aware of a classmate with a drug or alcohol problem. Chi-square analysis and two-tailed t-tests were used to compare data from the two surveys. The response rates in the first and second surveys were 96.9% and 81.8%, respectively. Use of licit and illicit substances was comparable to that of chronological peers and prior national studies of medical trainees. Most of the students admitted to using alcohol at least once in the prior year (91.8% and 95%, respectively). In both years marijuana was the illicit drug used most often. Although there was a slight increase over time in the use of benzodiazepines (2.4% to 5.8%) and a decrease in the use of marijuana (29.4% to 21.7%), these changes were not significant. Few of the students in their third year reported using any substance other than alcohol more than once a month. In general, a greater percentage of the students reported a decrease rather than an increase in the use of a substance since entering medical school; the primary exception was for wine. As they progressed in their training, the students became less concerned about the effect of substance use on their performance and more likely to be embarrassed about admitting to an addiction. Although in each year a few of the students appeared to be at risk for substance dependence (8.9% and 3.5%, respectively), no student came to the attention of the administration because of problems related to substance use. While most of the students were unaware of any classmate who had a problem, half of those who were aware had done nothing, and the balance had rarely sought assistance from the faculty or administration. Although there was no evidence that substance use was a major problem, a few of the students appeared to be at risk for drug or alcohol dependence. Appropriate intervention, support, and referral systems should be identified for the few who may be at risk, and increased educational efforts are needed to help all students address this issue with their peers and, ultimately, with their patients.
Psychiatric Services, Jun 1, 1985
Psychiatric Services, Apr 1, 1984
Psychiatric Services, Aug 1, 1984
Psychiatric Services, Dec 1, 1982
Psychiatric Services, Dec 1, 1982
Psychiatric Services, Mar 1, 1987
Psychiatric Services, Jul 1, 1983
Families arc asking to be included in the treatment of their mentally ill relatives. They arc ask... more Families arc asking to be included in the treatment of their mentally ill relatives. They arc asking for more information from professionals, specifically information on the nature of the mental illness and on "practical" techniques for coping with it. In my opinion, the best books for families are those that provide practical information and that also attempt to bridge the historical rift between the mental health professional and the family. Both Coping With Schizophrenia and Living and Working With Schizophrenia achieve these goals, to different degrees. Coping With Schizophrenia, by Mona Wasow, is the more emotional and controversial of the two books. Ms. Wasow has drawn on hen experience as a social worker and the parent of a schizophrenic child to write a "how-to manual and reference book" for other parents of individuals with "chronic schizophrenia.