Publications, Videos, Blog

Selected Publications, Videos, and Blog from Merry Noel Miller, M.D.

Psychiatric Times
Strategies to Avoid Burnout in Professional Practice: Some Practical Suggestions.

Miller MN and McGowen KR (2010). “Avoiding burnout in professional practice”, Psychiatric Times 27 (2): 25

Southern Medical Journal
The Painful Truth: Physicians Are Not Invincible

Physicians are not immune to psychosocial problems but may face unique impediments to attending to them. Self-care among physicians is not a topic generally included as a part of professional training, nor is it a topic that readily receives consideration in professional practice. The stresses of professional practice can exact a great toll, however, and self-neglect can lead to tragic consequences. In some areas, particularly suicide rates, physicians have increased vulnerability, and in other areas problems may be unrecognized (depression, substance abuse, marital problems, and other stress-related concerns). Female physicians show some particular areas of risk. In this paper, we raise questions about how and why physicians may be particularly vulnerable, review the available literature about the extent and nature of such problems in physicians, discuss possible factors related to the development of these problems in physicians, and suggest a variety of solutions to improve physician self-care.

Miller MN, McGowen KR. (2000). "The Painful Truth: Physicians Are Not Invincible", Southern Medical J 93 (10): 966-973.

Academic Psychiatry
Insights About Psychotherapy Training and Curricular Sequencing: Portal of Discovery

The authors discuss the curricular implications of a research project originally designed to evaluate the instructional strategy of using standardized patients in a psychotherapy training seminar.

McGowen KR, Miller MN, Floyd MR, Miller BE, and Coyle B (2009). “Portal of Discovery: Insights about Psychotherapy Training and Curricular Sequencing”, Academic Psychiatry 33 (1), 67-70.

Depression and Anxiety
Increased premenstrual dosing of nefazodone relieves premenstrual magnification of depression

We report on 3 subjects with premenstrual magnification of major depression (PMMD) treated with nefazodone who benefited from a supplement of additional nefazodone premenstrually. During the 6-month study, subjects were given supplements of either additional nefazodone or placebo prior to the expected onset of menses (double-blind crossover design). Symptoms were assessed during the late luteal and follicular phases. All subjects showed significant improvement for the months in which they received nefazodone supplements, but not when given placebo. Premenstrual dose increase is a clinically promising intervention for women who experience PMMD.

Miller MN, McGowen KR, Miller BE, Coyle B, and Hamdy R. (1999). “Lessons learned about research on premenstrual syndrome”. Journal of Women’s Health 8 (7): 989-993.

Psychiatry: Interpersonal and Biological Processes
Culture and Eating Disorders: A Historical and Cross-Cultural Review

Cultural beliefs and attitudes have been identified as significant contributing factors in the development of eating disorders. Rates of these disorders appear to vary among different racial/ethnic and national groups, and they also change across time as cultures evolve. Eating disorders are, in fact, more prevalent within various cultural groups than previously recognized, both within American ethnic minorities and those in other countries. This review examines evidence for the role of culture as an etiological factor for the development of eating disorders. Historical and cross-cultural experiences suggest that cultural change itself may be associated with increased vulnerability to eating disorders, especially when values about physical aesthetics are involved. Such change may occur across time within a given society, or on an individual level, as when an immigrant moves into a new culture. Further research into the cultural factors that promote the development of eating disorders is much needed. Understanding how cultural forces contribute to the development of disorders is needed so that preventive interventions can be created.

Miller MN and Pumariega AJ (2001). “Culture and Eating Disorders: a Historical and Cross-Cultural Review”. Psychiatry 64(2): 93-110.