What is the difference between a Psychiatrist and a Psychologist?

“Elderly Lady in Training” commented that she had some difficulty rating the blog. She didn’t realize that the comment which you entered had to be verified vía your email. This prevents spammers going in and making false positive or negative ratings. I missed that part too. So I went back and checked. Sure enough, this is what it says:   Your e-mail address is used only for verification purposes only and will not be sold, or shown publicly.

The more I think about it, I like the idea of verification. You’d be surprised to know that since I started the blog, there have been 1752 spammers trying to make comments about the blog. 95% of them either take you to an XXX rated site using foul sexually explicit language or trying to sell things such as Viagra, etc. I almost approved one of the XXX comments last week. To think that you would have seen that on the blog………Lord have mercy!

To cast your vote click here or to subscribe to the blog click here. Both links are also on the top right hand side of the blog.

I started working on the Boys and Sports logic puzzle. So far, so good.

One of the most popular question I have received from people during my medical career is this.

What’s the Difference Between a Psychologist and a Psychiatrist?

By Kendra Van Wagner, About.com

It’s an important difference to understand, whether you are a student of psychology or a consumer searching for a mental health provider. The terms “psychologist” and “psychiatrist” are often used interchangeably to describe anyone who provides therapy services. While psychologists and psychiatrists both conduct psychotherapy and research, there are significant differences between the two professions.

Education, Training, and Credentials

The simple answer is that a psychiatrist is a medical doctor, while a psychologist is not. Educational background is the most obvious difference between psychiatrists and psychologists.

Psychologists receive graduate training in psychology and pursue either a Ph.D. or Psy.D. in clinical or counseling psychology. Doctorate programs typically take five to seven years to complete and most states require an additional one or two year long internship in order to gain licensure. Other states require an addition year or two of supervised practice before granting full licensure.

The title of “psychologist” can only be used by an individual who has completed the above education, training, and state licensure. Informal titles such as “counselor” or “therapist” are often used as well, but other mental health care professionals such as licensed social workers can also claim these titles.

Psychiatrists are physicians to have specific training in the assessment, diagnosis, treatment, and prevention of mental illnesses. Psychiatrists attend medical school and receive an M.D. After completing medical training, they complete an additional four years of residency training in mental health. In addition to this, some receive additional training in a specific area of interest such as geriatric psychiatry, child and adolescent psychiatry, addictions and other areas.

Prescribing Medications

A second important distinction between the two careers is that psychiatrists can prescribe medication, while psychologists cannot. There has been a recent push to grant prescribing powers to psychologists, with states such as New Mexico and Louisiana now allowing psychologists to write prescriptions after consulting with a psychiatrist.

Which is Better?

If you are considering a career as a therapist, you will need to determine which career path is best for you. Are you interested in conducting psychotherapy, administering psychological tests, and conducting research? If so, a career as a psychologist may be the best choice for you.

If you have an interest in medicine and want to be able to prescribe medications to your patients, a career in psychiatry might be your ideal choice. If you don’t want to invest five to eight years in graduate training, consider pursuing a career as a licensed social worker or counselor, which typically requires two or three years of graduate study. Psychiatric nursing is another great career option for students interested in medicine. Advanced Psychiatric Nurses hold a Master’s degree or higher in psychiatric-mental health nursing and are able to assess patients, diagnose disorders, provide psychotherapy and prescribe medications.

Fettucine Alfredo is macaroni and cheese for adults.

Warmly………David

Boys and Sports

First of all, I’d like to thank those of you who’ve already voted for the blog, for all those who’ve made comments and to those of you who like the new blog look. I keep experimenting with different themes………I think I’ll stick with this one. It gives me a few more options which I can use over time. Plus it just seems easier to read.

I thought I’d post a little review on the symptoms of Lewy Body Dementia.

Lewy Body Dementia Symptoms as explained by the Lewy Body Dementia Association

In this section we’ll discuss each of the symptoms, starting with the key word: dementia. Dementia is a process whereby the person becomes progressively confused. The earliest signs are usually memory problems, changes in their way of speaking, such as forgetting words, and personality problems. Cognitive symptoms of dementia include poor problem solving, difficulty with learning new skills and impaired decision making.

Other causes of dementia should be ruled out first, such as alcoholism, overuse of medication, thyroid or metabolic problems. Strokes can also cause dementia. If these reasons are ruled out then the person is said to have a degenerative dementia. Lewy Body Dementia is second only to Alzheimer’s disease as the most common form of dementia.

Fluctuations in cognition will be noticeable to those who are close to the person with LBD, such as their partner. At times the person will be alert and then suddenly have acute episodes of confusion. These may last hours or days. Because of these fluctuations, it is not uncommon for it to be thought that the person is “faking”. This fluctuation is not related to the well-known “sundowning” of Alzheimer’s. In other words, there is no specific time of day when confusion can be seen to occur.

Hallucinations are usually, but not always, visual and often are more pronounced when the person is most confused. They are not necessarily frightening to the person. Other modalities of hallucinations include sound, taste, smell, and touch.

Parkinsonism or Parkinson’s Disease symptoms, take the form of changes in gait; the person may shuffle or walk stiffly. There may also be frequent falls. Body stiffness in the arms or legs, or tremors may also occur. Parkinson’s mask (blank stare, emotionless look on face), stooped posture, drooling and runny nose may be present.

REM Sleep Behavior Disorder (RBD) is often noted in persons with Lewy Body Dementia. During periods of REM sleep, the person will move, gesture and/or speak. There may be more pronounced confusion between the dream and waking reality when the person awakens. RBD may actually be the earliest symptom of LBD in some patients, and is now considered a significant risk factor for developing LBD. (One recent study found that nearly two-thirds of patients diagnosed with RBD developed degenerative brain diseases, including Lewy body dementia, Parkinson’s disease, and multiple system atrophy, after an average of 11 years of receiving an RBD diagnosis. All three diseases are called synucleinopathies, due to the presence of a mis-folded protein in the brain called alpha-synuclein.)

Sensitivity to neuroleptic (anti-psychotic) drugs is another significant symptom that may occur. These medications can worsen the Parkinsonism and/or decrease the cognition and/or increase the hallucinations. Neuroleptic Malignancy Syndrome, a life-threatening illness, has been reported in persons with Lewy Body Dementia. For this reason, it is very important that the proper diagnosis is made and that healthcare providers are educated about the disease.

Other Symptoms

Visuospatial difficulties, including depth perception, object orientation, directional sense and illusions may occur.

Autonomic dysfunction, including blood pressure fluctuations (e.g. postural/orthostatic hypotension) heart rate variability (HRV), sexual disturbances/impotence, constipation, urinary problems, hyperhidrosis (excessive sweating), decreased sweating/heat intolerance, syncope (fainting), dry eyes/mouth, and difficulty swallowing which may lead to aspiration pneumonia.

Other psychiatric disturbances may include systematized delusions, aggression and depression. The onset of aggression in LBD may have a variety of causes, including infections (e.g., UTI), medications, misinterpretation of the environment or personal interactions, and the natural progression of the disease.

All right now. Enough of some serious material. Now it’s time to play. These are the kind of puzzles which make me feel really smart. The more I do, the smarter I feel. I hope they help you just as much.

Boys and Sports
by Shelly Hazard

Wilma and three other women were comparing notes about the achievements of their sons. Each son had a favorite sport and each was a star player. The boys ranged in age from 10 years old to 13 years old. Determine the full name of each mother, the name of her son, the sport each son played, and how old each son was.

1. Sara Copper’s son, who wasn’t Brian, didn’t play soccer.

2. The boy who played basketball was the youngest. Mrs. Green’s son was a year younger than the boy who played baseball but a year older than Sara’s son.

3. The oldest boy, who wasn’t Mark, was Sharon’s son but he didn’t play hockey.

4. The boy who played baseball was a year older than the boy who played hockey.

5. From youngest to oldest, the boys were Mark, Teresa’s son, Mrs. Silver’s son, and Eric.

6. Mrs. Wild’s son was two years older than Chris.

Click here for the Solution

Warmly………David

Sarcasm and Satire

Happy Thursday to all! First of all, I found a new tool which rates blogs. If you notice, it’s on the right column. The star ratings go from 1 through 5 with 5 being the best. The higher the rating, the more people on the net will learn about dementias and LBD. By clicking on the link, it will take you to another website where you can vote anonymously. Consider doing your part to help spread the word about the aspects of dementia. I’m also posting a link to that page here.

Since starting this blog, I’ve learned more about dementia than I did during my entire medical career. I am astounded by what I read. There are so many hypotheses regarding the causes of dementia, how to prevent dementia and how to treat it.

Isn’t it funny that over the years, the do’s and don’ts of what we should and should not do, what we shoud and should not eat constantly change. One month, coffee is bad for you. The next month suddenly it’s OK to drink coffee. Now it’s been said that coffee and tea will prevent dementia. Of course, most of us wouldn’t balk about eating rich dark chocolate which is also claimed to help. So here are some of the latest “things” which I’ve read on the internet in the past 4 months.

Hypnosis now helps to prevent dementia. Well, hypnosis can help with a lot of problems. But some people are against hypnosis for personal reasons.  And of course the coffee. No drinka da coffee. Oh, now’s there are new studies…….drinka da coffee. Hello~~~      There’s also the gingko stuff. For years, we were taught that gingko would help most anything including dementia. Oh now. Not now. Why waste your money on gingko—it doesn’t do anything to help to prevent dementia. Ah, yes. The wine. Drink wine, don’t drink wine, avoid alcohol. Now they’re saying a little bit of wine or alcohol is good for you.

Of course there are the standard positive ideas such as relaxation, exercise, music and weight loss. Socialization is also good. Lord, have mercy! Next month there will be an article saying, “Be by yourself more. Don’t be around so many people. It’s not good for you.” “Don’t take any vitamins especially B12.

Now for the real kickers! I just recently read that mild smoking can help prevent dementia. What??? Isn’t that kind of counter-intuitive? And the one that nearly made me orgiastic — smoke some marijuana. It’ll help to prevent dementia as well as to keep it controlled if you already have it. Bring it on! Let me go score some “good weed.” Now, I’m not Bill Clinton. I have tried smoking marijuana when I was much younger and I did inhale it. Personally speaking, I felt as though I was demented after I  did it. And of course, the munchies, the red eyes and the dry mouth. Not to mention constipation. No, I didn’t continue to smoke marijuana. I just didn’t like it (and I still wonder how others crave it). I felt more demented after smoking that 1 joint than I do now when I actually have some dementia.

Where to go from here? I think we should just live a life of hedonism…eat, drink and be merry. Get drunk everyday, smoke a couple packs of cigarettes all day as you sip that java. Of couse, don’t exercise and don’t speak to anyone more than you have to. Remember, smiling and laughter can make you get Alzheimer’s disease. Eat cookes, cakes, pies, ice cream and all the candy you can. The sugar makes you feel good and happy. After all, we’re all taught that the brain needs a lot of glucose to function. Please, don’t take any vitamins. We get all we need in this day and age of processed food. Did I mention brain games, training and puzzles. Avoid these at all costs. They make you work your brain too much which causes it to wear out which then makes the brain start to rot and to degenerate. And isn’t dementia just a pretty name for rotting of the brain?

Oh, I’ve learned so much. I will not take any more daily showers. Eat plenty of maple leaves deep fried in rich trans fats covedred with plenty of uniodized salt. And I will avoid healthy fiber at any cost!

Oops! How did I forget the vitamin D?

Warmly………David

Blogging to do list:

• Post on delusions and hallucinations
• Do book review on “Could it be Dementia“
• Do book review on “Behind the Mask“
• Do book review on “Living with Lewys“

Better diagnosis vital for seniors with dementia

In terms of driving, this article is scary. I certainly can relate to it. I got ticked off when I read, “What’s more, Ontario does not pay family doctors extra to do the lengthy assessments that determine if a senior is fit to drive.” It makes me wonder how many seniors are driving here in the US who probably shouldn’t be. It’s a tough call for all. Taking away someone’s driving privileges is a real blow to the senior!

Better diagnosis vital for seniors with dementia

By Pauline Tam, Ottawa Citizen January 27, 2009 OTTAWA —

Doctors’ failure to detect and to treat dementia in many seniors has thousands of them driving when they shouldn’t be, says Dr. William Dalziel, chief of the Regional Geriatric Program of Eastern Ontario. At a meeting Tuesday of the Alzheimer Society of Ottawa and Renfrew County, Dalziel warned that in Ottawa alone, about 10,000 seniors have been diagnosed with dementia, but that number could reach 50,000 over the next two decades. Estimates suggest 100,000 elderly Ontarians with dementia — or about two per cent of the province’s seniors — are on the road even though they may be unfit to drive. In Ottawa, 2,500 elderly drivers have some form of dementia, he said. The problem persists because family doctors either are not trained to spot the warning signs, or are reluctant to report their patients to licensing authorities, said Dalziel. What’s more, Ontario does not pay family doctors extra to do the lengthy assessments that determine if a senior is fit to drive. “Just a diagnosis of dementia doesn’t mean someone can’t drive. You have to look at the disabilities they have related to that,” said Dalziel. “We need to equip physicians with the tools to decide if someone with dementia is safe or unsafe. And then we need to pay them properly to do that.” Often, seniors with dementia are diagnosed only after they reach the advanced stages, making it more difficult for them to be treated, he added. This also increases their chances of developing other illnesses or injuries that can land them in a hospital or nursing home, which can be a financial drain on families and on the health-care system, said Dalziel. He advocates the creation of more screening programs that would catch such warning signs as memory loss, changes in mood and behaviour and apathy. Treating risk factors such as high-blood pressure, depression and stroke also would slow the onset of dementia. “If you’re trying to get a middle-aged man to take his pills for hypertension, you don’t talk to him about a heart attack because he thinks he’s invincible,” said Dalziel. “Talk to him about dementia and you’re probably going to get a lot more (compliance).” Meantime, a new screening program is being launched in Eastern Ontario this month that will teach pharmacists how to spot seniors who may be at high risk of developing dementia. For example, it alerts pharmacists to watch for customers who purchase dosettes or pill organizers that remind people to take their medications daily. It then directs pharmacists to offer those customers a standardized memory test and to notify their family doctors should warning signs of dementia emerge. “There’s a bunch of red flags that health professionals, if they’re awake and alert and think of them, could easily utilize to recognize someone who is at greater risk,” said Dalziel, architect of the screening program. “The purchase of a dosette should come with memory screening because if someone is having trouble taking their medication, maybe they have memory troubles.” The program, expected to be tested at a half-dozen pharmacies across Eastern Ontario, is part of a broader regional effort to improve the detection of dementia. Another program being rolled out next month trains nurses working in community health centres and family health teams to assess elderly patients for signs of dementia, before being treated by a physician.

Well, now. Let’s go back to the Fast Food puzzle from last week — Burger, fries, small drink and cookie. The answer is $2.75.

• If a burger and fries cost $3.50, and a small drink and cookie cost $2.25, then all four cost a total of $5.00. Take away the fries and small drink, which cost $2.25, and the remaining burger and cookie cost $2.75.

I made it a whole lot harder that it needed to be. I resorted to algebra and still didn’t get it correct. I came up with $2.85. Maybe I subtracted wrong. When I think that I minored in math in college, I couldn’t  believe that I couldn’t even do the simple algebra. Shameful. But I guess it’s a reminder that the brain is challenged these days. I think I need to get back to those logic puzzles again. They seem to help me the most—they actually make me feel smarter.

Congratulations to these great folks for solving it correctly! In order of posting are:

1. Willa
2. Laura
3. Kat
4. Lynn M.
5. Pam
6. Lynn
7. Raquel
8. Freda

I hope I didn’t forget anyone. Ladies, check for your email on how to receive your gift!!

Wasn’t able to get a post out yesterday. I got up early, but for some reason just couldn’t pull it together to concentrate on writing.

Some humor —

“Good morning,” I said to a coworker in the parking lot. She mumbled something back and continued to the front door, distracted. As we walked, I couldn’t help but notice that she was muttering to herself: “It pays the bills, it pays the bills, it pays the bills…”

Blogging to do list:

• Post my sarcastic thoughts
• Post on delusions and hallucinations
• Do book review on “Could it be Dementia“
• Do book review on “Behind the Mask“
• Do book review on “Living with Lewys“

This is the 28th day of the year, with 337 days remaining in 2009.

Fact of the Day: pancake

The oldest surviving pancake recipe in the English language dates from the 15th century. It describes a thin flat cake of batter, fried on both sides in a pan and usually served either flat or with several stacked. Blin (as in blini and blintze) is Russian for ‘pancake’ and blintz(e) is from Russian blinets ‘little pancake.’ Cake itself first meant ’small flat bread roll baked on both sides by being turned – as in pancake.

Warmly………David