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August 6, 1999
Looking for Websites on psychiatry can be overwhelming. Just doing a search for "psychiatry" in Yahoo as this article was written yielded 188 sites and 16 categories. How does one narrow down the search?
The first step is to "use as many specific words as possible. Psychiatry is too broad a term under which to search. Instead, choose a specific topic such as 'obsessive-compulsive disorder treatment,' " advised Russell Lim, M.D., who recommends using the metasearch engine Dogpile at www.dogpile.com.
Secondly, "pay attention to the date the site was last modified and who wrote the site," explained Lim. "If it's a general citizen, then I consider it a personal page and the information not reliable. I look for sites written by M.D.s; experts; and those associated with foundations, organizations, universities, and hospitals," said Lim, author of one of the first articles on the Internet and mental health, "The Internet: Applications for Mental Health Clinicians and Clinical Settings Training and Research," which was published in the June 1996 issue of the APA journal Psychiatric Services. Lim is also an assistant clinical professor of psychiatry at the University of California at Davis and medical director of Northgate Point Regional Support Team.
When asked what features make a site useful, Lim responded, "Those sites that have references, or links, directly to articles and links to other sites. Overall, the Internet can be a great source of information primarily because of the speed with which things can be put on line. Thus, it can be much more current than a textbook.
APA's Web site provides a wealth of information on a variety of topics aimed at APA members, patients, and the general public. While information on some of the features of APA's Web site appears below, an extensive update on the site will be published in Psychiatric News in the fall.
The following are recommendations of Web sites of interest to psychiatrists from recognized experts in their respective fields. Of course, readers should evaluate the content of all Web sites (and their links) for themselves in terms of accuracy, validity, and usefulness.
Mark Levy, M.D., a forensic psychiatrist and expert in posttraumatic stress disorder, is the chair of the San Francisco Foundation for Psychoanalysis and a faculty member at the University of California, San Francisco.
To find the latest clinical and research literature on PTSD from major journals, Levy searches on Medline at www.ncbi.nlm.nih.gov/PubMed/medline.html For psychiatrists who would like to browse a site dedicated to PTSD, he suggests visiting the Veterans Affairs' National Center for PTSD at www.dartmouth.edu/dms/ptsd. On the homepage, click on "Information about PTSD for Clinicians" and then "Publications for Researchers and Clinicians."
"This is an excellent clearinghouse for information on all aspects of PTSD diagnosis, public information, research, treatment, studies, and so on," said Levy, who has his own Web site at www.levymd.com. The selection "PTSD Research Quarterly" on the homepage "includes articles on topics ranging from trauma assessment to epidemiology and is searchable by subject, author, or date."
Asite to which he frequently refers patients is APA's "Let's Talk Facts About PTSD" at www.psych.org/public_info/ptsd.html. It provides general information that can be printed out for further reference, he noted.
Mary Susan Hansen, M.D., medical director of Citywide Case Management at San Francisco General Hospital, doesn't hesitate to recommend www.schizophrenia.com for information on schizophrenia. This is a not-for-profit site begun by the brother of a schizophrenia patient who committed suicide in 1995. The goal of the site is to provide "valuable and accurate information" about this tragic disease.
"The site is incredibly comprehensive, easy to use, and has an unusual search engine," Hansen commented. Its search engine can search 200 Web sites-53,000 documents-on schizophrenia.
To make searching as easy as possible, the site also features a list of the most commonly requested searches, such as "Possible Medication Side Effects" and "Schizophrenia Research Organizations," explained Hansen, who is an associate clinical professor of psychiatry at the University of California at San Francisco.
Another site Hansen recommended is www.mentalhealth.com, sponsored by Canadian psychiatrist Phillip W. Long, M.D. The site has a particularly useful section on schizophrenia (choose "Disorders" then "Schizophrenia" from the left column of the site). The "Research" section, designed for professionals, has Medline citations on a wide variety of relevant topics. Other sections have full-text articles suitable for patients and the public from such publications as the Schizophrenia Bulletin and Harvard Health Letter. The site also features articles on recovery, easy-to-read booklets, recommended books, and links to other sites, she said.
To catch up on public policy, legislative, and other news related to mental health, Hansen uses the site of the National Alliance on Mental Illness at www.nami.org, which is geared toward those with chronic and serious mental illnesses. She recommends looking in the left-hand column and then clicking on "What's New" for NAMI's information on topical mental health issues or clicking on "Policy" for current legislation and policy papers.
Another excellent source of information on mental health legislation and public policy is APA's Web site. APA posts "Action Alerts" concerning mental health legislation about which members and other advocates can contact their legislators; fact sheets; information on regulatory issues; and in-depth information on important topics, such as patient confidentiality and parity coverage of mental health. There is even a feature that allows users to identify quickly their members of Congress and send them an e-mail message.
"Every psychiatrist should be interested in Supreme Court decisions because those decisions tend to shape the climate in which we practice," said Harold Bursztajn, M.D., an associate professor of psychiatry and codirector of the Program in Psychiatry and the Law at Harvard Medical School. "These are decisions about confidentiality, managed care, and the Americans With Disabilities Act."
His recommendation for such information is a site that reports the latest Supreme Court decisions, www.findlaw.com. To search there, click on "Supreme Court" and then enter the topic. Having the name of the case is also helpful, he added.
Those psychiatrists who would prefer to have forensic experts do this research for them, however, can proceed directly to Bursztajn's site at www.forensic-psych.com/. This site features the combined work of several Harvard faculty specializing in psychiatry, law, ethics, and allied medical and mental health specialties. The latest forensic articles and cases are posted at "What's New" on the homepage.
While at his site, Bursztajn suggests that psychiatrists click on "Managed Health Care and Malpractice" for articles on emerging trends in such areas as managed care organizational liability. Information on clinical risk management strategies is posted on "Risk Management" on the homepage.
For psychiatrists who would like to learn the latest research findings on addiction, Steve Adelman, M.D., recommended the following: The Center for Disease Control and Prevention's Tobacco Information and Prevention Source (TIPS) at www.cdc.gov./nccdphp/osh. This site includes information on smoking cessation, educational materials aimed at specific age groups, and a database on smoking and health. Adelman is the medical director of substance abuse services for Harvard Vanguard Medical Associates.
The National Institute on Alcohol Abuse and Alcoholism site at www.niaaa.nih.gov/ includes the comprehensive Alcohol and Alcohol Problems Science Database, known as "ETOH." This is an online bibliographic database containing more than 100,000 records on alcohol abuse and alcoholism. Also at this site is "Quick Facts," which offers information on a variety of alcohol-related topics.
The National Institute on Drug Abuse site at www.nida.nih.gov contains excellent information on various drugs of abuse, along with lists and summaries of scientific meetings on drug abuse and topical updates on important discoveries, according to Adelman.
Adelman also modestly recommends his site for information on addiction: "Ask drsteve-The Real Story About Smoking, Drinking, and Getting High" at www.drsteve.org. This site contains background information on major addictive substances: tobacco, illicit and prescription drugs, and alcohol. The site also contains a growing Q&A archive with answers to more than 150 questions on addiction on a range of topics from Internet addiction to chewing tobacco.
"Most of the questions are from patients, although occasionally professionals also write in. Many psychiatrists would find the answers interesting because the level of detail I include goes beyond what most folks encounter in everyday practice," he said.
As the director of the Institute of Cybermedicine in the department of psychiatry at Harvard Medical School, Steven Locke, M.D., is immersed in the latest technological research. In fact, one of his projects is to develop computer programs for managing depression that will be used by primary care doctors and patients.
Besides directing the institute, Locke maintains a private practice, teaches at Harvard and the Massachusetts Institute of Technology, and is director of Psychiatric Informatics and the Center for Clinical Computing at the Beth Israel Deaconess Medical Center. In addition, he is the chief of behavioral medicine at Harvard Pilgrim Health Care.
One site on depression that Locke recommends to his patients is mentalhelp.net/depression. "This site explains the symptoms and treatment of depression. The page design is excellent, and it's easy to use," said Locke. The site includes an area specifically for professionals.
For biological information and the latest research findings, Locke refers to the psychiatric section of Medscape at psychiatry.medscape.com/home/topics/psychiatry/psychiatry.html. For information on psychotherapy, he visits www.behavior.net. In the area "Join Ongoing Discussions Now," treating clinicians chat on such topics as "Gestalt Therapy" and "Evolutionary Psychology," explained Locke, who shares responsibility for overseeing the discussion in the area "Outcome Assessment."