By |July 4th, 2020|Blog|Comments Off on NEW PATIENT FORM

New Cases of Mental Illness During Lifetime

Mental Ilness lifetime chart

By |May 6th, 2016|Blog|Comments Off on New Cases of Mental Illness During Lifetime

Hair Pulling Trichotillomania – Jerzy Grzebieluch MD Child and Adult Psychiatrist in Fort Walton Beach FL

People with trichotillomania pull hair on various parts of their bodies, including the scalp, face, arms, legs and pubic areas. They may not notice the hair pulling until they need to cover up bald patches with hair clips, a hat, wig or scarf. People with trichotillomania are not able stop pulling their hair.

As many as 1 person in 100 has the following signs and symptoms of trichotillomania:

  • recurrent hair pulling resulting in noticeable hair loss, unrelated to baldness or alopecia
  • pleasure, excitement, or relief when pulling out hair
  • embarrassment or shame resulting from hair loss
  • problems at home, school or work

The cause of trichotillomania is not known. For some children, trichotillomania becomes damaging and very difficult to control. Hair pulling can occur anytime but may become worse in stressful situations.

Most children with trichotillomania feel shame, embarrassment or guilt about their hair loss. Younger children may not notice or be bothered by hair loss. Older children and adolescents may be teased, have low self esteem, anxiety or depression.

Parents can become frustrated, as it is very difficult to understand that children with trichotillomania can’t simply stop pulling their hair. Neither parents nor children are to blame for the hair pulling behavior. Punishing children for pulling hair is unlikely to decrease the behavior and can lead to problems with self-esteem. In order to avoid punishment or embarrassment, children try to hide or deny they are pulling their hair.

Frequently used treatments for trichotillomania include:

  • cognitive behavioral therapy (CBT) is a specialized form of behavior therapy. It involves helping a child recognize thoughts, feelings and behaviors associated with hair pulling. The goal of this therapy is to increase the awareness of hair pulling and replace it with alternative behaviors
  • medication therapy is also used to […]
By |October 14th, 2015|Blog|Comments Off on Hair Pulling Trichotillomania – Jerzy Grzebieluch MD Child and Adult Psychiatrist in Fort Walton Beach FL

Read this before paying $100s for neurofeedback therapy

Read this before paying $100s for neurofeedback therapy

Neurofeedback therapy has promise, but it’s no shortcut to enlightenment

Last month, the Sunday Times published (pdf) a sensationalist article about a London clinic called Brainworks that offers therapy based on EEG feedback – “£1,320 for the standard 12 sessions”. Similar clinics can be found around the world. “Those who have tried it swear it offers inner transformation,” gasped the journalist Jini Reddy, “a profound lessening of anxieties, awakened states, feelings of elation and the focused, clear, calm mind more readily accessed through years of effortful practices.”EEG (electroencephalography) records the waves of electrical activity emitted by your brain, and the basic idea of neurofeedback therapy is that you have the frequency of these waves shown to you, via sounds or images, so that you can learn to exert some control over them.

Anyone reading the Sunday Times article could be forgiven for thinking they’d been transported to the 60s and 70s. Back then companies with futuristic names like Zygon Corporation cashed in on the discovery that experienced meditators show high levels of alpha brave-waves (8 to 12 hz) when they are in a meditative trance. You could buy a home EEG kit from one of these outfits and teach your brain to achieve this state of “alpha consciousness”.

Unfortunately, the logic is flawed, as the late psychologist and skeptic Barry Beyerstein explained in a series of essays and book chapters published in […]

By |December 30th, 2014|Blog|Comments Off on Read this before paying $100s for neurofeedback therapy

Neurocognitive effects of neurofeedback in adolescents with ADHD

Neurocognitive effects of neurofeedback in adolescents with ADHD

Although neurocognitive outcomes improved in all adolescents receiving treatment for ADHD, no additional value for neurofeedback over TAU was observed. Hence, this study does not provide evidence for using theta/sensorimotor rhythm neurofeedback to enhance neurocognitive performance as additional intervention to TAU for adolescents with ADHD symptoms.

J Clin Psychiatry. 2014 May;75(5):535-42. doi: 10.4088/JCP.13m08590.

Neurocognitive effects of neurofeedback in adolescents with ADHD: a randomized controlled trial.



Neurofeedback aims to reduce symptoms of attention-deficit/hyperactivity disorder (ADHD), mainly attention problems. However, the additional influence of neurofeedback over treatment as usual (TAU) on neurocognitive functioning for adolescents with ADHD remains unclear.


By using a multicenter parallel randomized controlled trial (RCT) design, male adolescents with a DSM-IV-TR diagnosis of ADHD (mean age = 16.1 years; range, 12-24) were randomized to receive either a combination of TAU and neurofeedback (n = 45) or TAU (n = 26). Randomization was computer generated and stratified by age group (ages 12 through 15, 16 through 20, and 21 through 24 years). The neurofeedback intervention consisted of approximately 37 sessions over a period of 25 weeks of theta/sensorimotor rhythm training on the vertex (Cz). Primary neurocognitive outcomes included performance parameters derived from the D2 Test of Attention, the Digit Span backward, the Stroop Color-Word Test and the Tower of London, all assessed preintervention and postintervention. Data were collected between December 2009 and July 2012.


At postintervention, outcomes of attention and/or motor […]

By |December 26th, 2014|Blog|Comments Off on Neurocognitive effects of neurofeedback in adolescents with ADHD

Neurofeedback Versus Stimulant Medication


Our study supports effects for stimulants, but not for NF. Effects of NF may require thorough patient selection, frequent training sessions, a system for excluding nonresponders, and active transfer training. The P3 no go ERP component may be a marker for treatment response.

Jerzy Grzebieluch MD Psychiatrist in Fort Walton Beach , Destin FL biofeedback versus stimulants in ADHD
J Child Adolesc Psychopharmacol. Sep 2013; 23(7): 448–457.
PMCID: PMC3779016
 EFFECTS of Neurofeedback versus Stimulant Medication in ADHD : A Randomized Pilot Study



The purpose of this pilot study was to compare the effects of 30 sessions of neurofeedback (NF) with stimulant medication on attention-deficit/hyperactivity disorder (ADHD) patients.


Thirty-two medication-naïve ADHD patients, ages 7–16, from a neuropsychiatric clinic, were randomized to NF (n=16) or drug treatment (n=16). Other actions, such as parent management training, information, or support in school were given as needed, with no differences between the groups. All participants were assessed before treatment on two rating scales, each with parent and teacher forms. In addition, quantitative electroencephalogram (QEEG) and event-related potentials (ERPs), which included behavioral data from a go/no go test were administered. NF […]

By |December 23rd, 2014|Blog|Comments Off on Neurofeedback Versus Stimulant Medication

EEG neurofeedback for ADHD treatment – effectiveness


Overall, the existing literature and this study fail to support any benefit of neurofeedback on neurocognitive functioning in ADHD, possibly due to small sample sizes and other study limitations.

J Child Psychol Psychiatry. 2014 May;55(5):460-72. doi: 10.1111/jcpp.12143. Epub 2013 Oct 30.

Does EEG-neurofeedback improve neurocognitive


functioning in children with attention-


deficit/hyperactivity disorder?


A systematic review and a double-blind


placebo controlled study.

Erratum in

  • J Child Psychol Psychiatry. 2014 Aug;55(8):954-5.



The number of placebo-controlled randomized studies relating to EEG-neurofeedback and its effect on neurocognition in attention-deficient/hyperactivity disorder (ADHD) is limited. For this reason, a double blind, randomized, placebo-controlled study was designed to assess the effects of EEG-neurofeedback on neurocognitive functioning in children with ADHD, and a systematic review on this topic was performed.


Forty-one children (8-15 years) with a DSM-IV-TR diagnosis of ADHD were randomly allocated to EEG-neurofeedback or placebo-neurofeedback treatment for 30 sessions, twice a week. Children were stratified by age, electrophysiological state of arousal, and medication use. Neurocognitive tests of attention, executive functioning, working memory, and time processing were administered before and after treatment. Researchers, teachers, children and their parents, with the exception of the neurofeedback-therapist, were all blind to treatment assignment. Outcome measures were the changes in neurocognitive performance before and after treatment.



No significant treatment effect on any of the neurocognitive variables was found. A systematic review of the current literature also did not find any systematic beneficial effect of EEG-neurofeedback on neurocognitive functioning.


Overall, the […]

By |December 19th, 2014|Blog|Comments Off on EEG neurofeedback for ADHD treatment – effectiveness

PTSD treatment : Psychiatrist is Fort Walton Beach, Jerzy Grzebieluch MD

Posttraumatic Stress Disorder (PTSD)

All children and adolescents experience stressful events which can affect them both emotionally and physically. Their reactions to stress are usually brief, and they recover without further problems. A child or adolescent who experiences a catastrophic event may develop ongoing difficulties known as posttraumatic stress disorder (PTSD). The stressful or traumatic event involves a situation where someone’s life has been threatened or severe injury has occurred (ex. they may be the victim or a witness of physical abuse, sexual abuse, violence in the home or in the community, automobile accidents, natural disasters (such as flood, fire, earthquakes), and being diagnosed with a life threatening illness). A child’s risk of developing PTSD is related to the seriousness of the trauma, whether the trauma is repeated, the child’s proximity to the trauma, and his/her relationship to the victim(s).

Following the trauma, children may initially show agitated or confused behavior. They also may show intense fear, helplessness, anger, sadness, horror or denial. Children who experience repeated trauma may develop a kind of emotional numbing to deaden or block the pain and trauma. This is called dissociation. Children with PTSD avoid situations or places that remind them of the trauma. They may also become less responsive emotionally, depressed, withdrawn, and more detached from their feelings.

A child with PTSD may also re-experience the traumatic event by:

  • having frequent memories of the event, or in young children, play in which some or all of the trauma is repeated over and over
  • having upsetting and frightening dreams
  • acting or feeling like the experience is happening again
  • developing repeated physical or emotional symptoms when the child is reminded of the event
  • Jerzy Grzebieluch MD PTSD treatment in Fort [...] 
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By |October 17th, 2014|Blog|Comments Off on PTSD treatment : Psychiatrist is Fort Walton Beach, Jerzy Grzebieluch MD

Belsomra – new sleeping pill: insomnia treatment by Psychiatrist in Fort Walton Beach Jerzy Grzebieluch MD

The U.S. Food and Drug Administration  approved Belsomra (suvorexant) tablets for use as needed to treat difficulty in falling and staying asleep (insomnia).

Belsomra is an orexin receptor antagonist and is the first approved drug of this type. Orexins are chemicals that are involved in regulating the sleep-wake cycle and play a role in keeping people awake. Belsomra alters the signaling (action) of orexin in the brain.

By |October 12th, 2014|Blog|Comments Off on Belsomra – new sleeping pill: insomnia treatment by Psychiatrist in Fort Walton Beach Jerzy Grzebieluch MD

Autism Treatment in Fort Walton Beach, Destin by Psychiatrist Jerzy Grzebieluch MD

What Is Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is characterized by:

  • Persistent deficits in social communication and social interaction across multiple contexts;
  • Restricted, repetitive patterns of behavior, interests, or activities;
  • Symptoms must be present in the early developmental period (typically recognized in the first two years of life); and,
  • Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

The term “spectrum” refers to the wide range of symptoms, skills, and levels of impairment or disability that children with ASD can have. Some children are mildly impaired by their symptoms, while others are severely disabled. The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) no longer includes Asperger’s syndrome; the characteristics of Asperger’s syndrome are included within the broader category of ASD.

Information on ASD can also be found on the Eunice Kennedy Shriver National Institute of Child Health and Human Development website  and the Centers for Disease Control and Prevention website .


Scientists don’t know the exact causes of autism spectrum disorder (ASD), but research suggests that both genes and environment play important roles.

Genetic factors

In identical twins who share the exact same genetic code, if one has ASD, the other twin also has ASD in nearly 9 out of 10 cases. If one sibling has ASD, the other siblings have 35 times the normal risk of also developing the disorder. Researchers are starting to identify particular genes that may increase the risk for ASD.

Still, scientists have only had some success in finding exactly which genes are involved. For more information about such cases, see the information below about Fragile X syndrome and tuberous sclerosis.

Most people who develop […]

By |September 7th, 2014|Blog|Comments Off on Autism Treatment in Fort Walton Beach, Destin by Psychiatrist Jerzy Grzebieluch MD