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Journal of Psychiatric Practice

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https://www.readbyqxmd.com/read/27824786/an-open-trial-of-a-smartphone-assisted-adjunctive-intervention-to-improve-treatment-adherence-in-bipolar-disorder
#1
Susan J Wenze, Michael F Armey, Lauren M Weinstock, Brandon A Gaudiano, Ivan W Miller
We evaluated the feasibility and acceptability of a novel, 12-week, adjunctive, smartphone-assisted intervention to improve treatment adherence in bipolar disorder. Eight participants completed 4 in-person individual therapy sessions over the course of a month, followed by 60 days of twice-daily ecological momentary intervention (EMI) sessions, with a fifth in-person session after 30 days and a sixth in-person session after 60 days. Perceived credibility of the intervention and expectancy for change were adequate at baseline, and satisfaction on completion of the intervention was very high...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824785/commentary-on-3-unusual-cases-involving-electroconvulsive-therapy
#2
David A Kahn
Well-established practice guidelines and a solid body of evidence underpin the safe and effective use of electroconvulsive therapy (ECT), primarily in mood disorders. In this issue of the journal, 3 case reports deal with situations that fall outside of the usual guidelines: treatment resistance to ECT overcome by combined use with antidepressant medication; use of ECT in the presence of polymyositis; and use of ECT for an unusually severe case of neuroleptic malignant syndrome, assisted by consultation from an online expert resource...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824784/use-of-expert-consultation-in-a-complex-case-of-neuroleptic-malignant-syndrome-requiring-electroconvulsive-therapy
#3
Justine Wittenauer Welsh, A Umair Janjua, Steven J Garlow, Laurie McCormick, Mustafa M Husain, Daniel F Maixner, Richard D Weiner, Adriana P Hermida
Our team at Emory University Hospital contacted experts at the National Network of Depression Centers (NNDC) for clinical guidance concerning a patient with schizophrenia hospitalized in the intensive care unit with a complex case of prolonged delirium secondary to neuroleptic malignant syndrome (NMS). Through the NNDC, leading psychiatrists across the United States with expertise in electroconvulsive therapy (ECT) provided us with treatment strategies based on experience in our area of concern. This report describes our use of ECT to treat severe NMS in this patient with schizophrenia, utilizing the recommendations made by the NNDC's ECT experts concerning electrode position, number and frequency of treatments, and selection of anesthetic induction agents...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824783/cpk-measurements-and-ect-in-polymyositis-a-case-report
#4
Benjamin Delucia, Rachit Patel, Adeeb Yacoub, Andrew Francis
Inflammatory myopathies, including polymyositis (PM), may add risk to electroconvulsive therapy (ECT) due to muscle sensitivity to depolarizing neuromuscular agents. In addition, previously published case series have shown elevations in creatine phosphokinase (CPK), an index of PM disease severity, in patients without muscle disease receiving ECT. We report the case of a 74-year-old female who developed initial onset of depression after steroid treatment for biopsy-proven PM. After she failed to respond to trials of antidepressant medications, she was treated with 21 inpatient and outpatient sessions of ECT over 2 years...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824782/possible-synergy-between-electroconvulsive-therapy-and-imipramine-a-case-report
#5
Tom K Birkenhäger, Esther M Pluijms
This report describes a 63-year-old woman, who had experienced 3 previous episodes of severe major depressive disorder. The first 2 episodes responded to treatment with antidepressants, whereas the third episode was accompanied by psychotic features and responded well to treatment with electroconvulsive therapy (ECT). After a severe relapse, the patient responded very slowly to a second course of ECT and failed to achieve full remission. Within a few weeks, she had another severe relapse and responded very rapidly to a combination of ECT and imipramine...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824781/practical-aspects-of-discussing-marijuana-in-a-new-era
#6
Sean R Lenoue, Narin Wongngamnit, Christian Thurstone
The use of marijuana for the treatment of medical conditions is a highly controversial topic. Misconceptions by both patients and providers concerning the safety of and evidence-based indications for marijuana can complicate treatment planning and outcomes. Maintaining skills such as motivational interviewing, providing evidence-based informed consent, and increasing access to care remain top priorities for providing quality patient care. The goal of this article is to offer guidance to clinical providers who are adapting to the changing realities of medical marijuana and legalized recreational marijuana...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824780/an-introduction-from-the-new-psychotherapy-columnist
#7
Eric M Plakun
Despite psychiatry's shift toward a biomedical model, emerging research suggests that psychosocial factors make major contributions to the etiology of mental disorders of all kinds and that several types of psychotherapy have been shown to be effective forms of treatment for a range of disorders. Notwithstanding these findings, psychiatrists are doing less psychotherapy and attending less to psychosocial factors in their work with patients. The author surveys some of the underpinnings of this problem and discusses the value of psychotherapy as part of psychiatric practice and training...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824779/use-of-an-analog-scale-in-the-treatment-of-patients-with-major-depressive-disorder-to-optimize-assessment-and-clinical-outcome
#8
Sheldon H Preskorn
This column explains how a clinician can use an analog scale (1) to elucidate the course of major depressive disorder in a specific patient and (2) to assess response to treatment. This scale complements other standardized rating scales, such as the Montgomery-Asberg Depression Rating Scale (MADRS), because its anchors are tailored to each specific patient in terms of his or her worst depressive episode (ie, episode rated a 10) and how it has responded to treatment in the past, including whether the patient ever has achieved a full remission (ie, score of 0) following the initial onset of the disorder...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824778/use-of-orally-disintegrating-olanzapine-during-electroconvulsive-therapy-for-prevention-of-postictal-agitation
#9
Adriana P Hermida, A Umair Janjua, Yilang Tang, Sharyn R Syre, Gregory Job, William M McDonald
A major medical problem for patients undergoing electroconvulsive therapy (ECT) is the occurrence of postictal agitation (PIA). This phenomenon is associated with confusion and disorientation that can have severe clinical implications for the safety of the patient and health care professionals. Many different pharmacological strategies have been used to prevent PIA. We present data on 40 patients who suffered from PIA after a course of ECT and evaluate the prophylactic use of orally disintegrating olanzapine in the prevention of PIA in subsequent ECT treatments...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824777/antipsychotic-selection-for-acute-agitation-and-time-to-repeat-use-in-a-psychiatric-emergency-department
#10
Seth Gomez, Julie Dopheide
BACKGROUND: Early recognition and treatment of agitated patients is essential to avoid violence in the psychiatric emergency department (ED). Antipsychotics have established efficacy in managing agitation, yet little is known about how the choice of initial antipsychotic impacts time to repeat use and length of stay (LOS) in the psychiatric ED. OBJECTIVE: To describe the impact of initial antipsychotic selection on time to repeat use and LOS in the psychiatric ED...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824776/hopes-and-expectations-regarding-genetic-testing-for-schizophrenia-among-young-adults-at-clinical-high-risk-for-psychosis
#11
Phoebe Friesen, Ryan E Lawrence, Gary Brucato, Ragy R Girgis, Lisa Dixon
Genetic tests for schizophrenia could introduce both risks and benefits. Little is known about the hopes and expectations of young adults at clinical high-risk for psychosis concerning genetic testing for schizophrenia, despite the fact that these youth could be among those highly affected by such tests. We conducted semistructured interviews with 15 young adults at clinical high-risk for psychosis to ask about their interest, expectations, and hopes regarding genetic testing for schizophrenia. Most participants reported a high level of interest in genetic testing for schizophrenia, and the majority said they would take such a test immediately if it were available...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824775/evaluation-of-bipolar-disorder-in-children-and-adolescents-referred-to-a-mood-service-diagnostic-pathways-and-manic-dimensions
#12
Ana P Ferreira-Maia, Alexandre C Boronat, Miguel A Boarati, Lee Fu-I, Yuan-Pang Wang
OBJECTIVES: Few studies have examined pediatric mental health services for early-onset bipolar disorder (BD). The goal of this study was to describe diagnostic pathways and manic dimensions in BD among referred children and adolescents. METHODS: Data were obtained from a review of the charts of 814 subjects, 2 to 17 years of age, with a complaint of mood disturbances who were referred between 2003 and 2012 to a university-based child and adolescent clinic that specializes in mood disorders...
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27824774/smoke
#13
John M Oldham
No abstract text is available yet for this article.
November 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27648507/content-area-framework-for-conducting-family-meetings-for-acutely-ill-psychiatric-patients
#14
Natalie C Pon, Mollie R Gordon, John Coverdale, Phuong T Nguyen
Family meetings are a critically important component of managing acutely psychiatrically ill patients, and learning how to conduct such a meeting is critically important in the training of psychiatrists. Because we found no published comprehensive tools that dealt with the biopsychosocial content areas to be covered in family meetings in acute psychiatric settings, we developed and present such a comprehensive tool that is based in part on a review of existing tools utilized by other disciplines. This article describes the specific steps involved in premeeting planning, the formal topic areas that might be canvassed during the meeting, and postmeeting documentation and debriefing...
September 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27648506/pyrotherapy-for-the-treatment-of-psychosis-in-the-21st-century-a-case-report-and-literature-review
#15
Zachary D Zuschlag, Callie J Lalich, Edward B Short, Mark Hamner, David A Kahn
The concept that fevers can improve the condition of patients with certain medical and psychiatric diseases dates back to Hippocrates. Over the centuries, it has been observed that fevers and infectious agents have been beneficial for a broad spectrum of diseases, including neurologic conditions such as epilepsy and psychiatric illnesses including melancholy and psychosis. Interest in the concept of fever as a treatment for disease, termed pyrotherapy or pyretotherapy, peaked in the late 1800s and early 1900s thanks to the Nobel Prize winning work of Julius Wagner-Jauregg for his studies with malaria therapy for general paralysis of the insane, now more commonly referred to as neurosyphilis...
September 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27648505/atypical-findings-in-massive-bupropion-overdose-a-case-report-and-discussion-of-psychopharmacologic-issues
#16
Yuanjia Zhu, Tiwalola Kolawole, Xavier F Jimenez
Bupropion is an atypical antidepressant that is structurally similar to amphetamines. Its primary toxic effects include seizure, sinus tachycardia, hypertension, and agitation; however, at higher amounts of ingestion, paradoxical cardiac effects are seen. We report the case of a 21-year-old woman who ingested 13.5 g of bupropion, a dose higher than any other previously reported. The patient presented with seizure, sinus tachycardia with prolonged QTc and QRS intervals, dilated pupils, and agitation. Four days after overdose, the patient's sinus tachycardia and prolonged QTc and QRS intervals resolved with symptomatic management, but she soon developed sinus bradycardia, hypotension, and mild transaminitis...
September 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27648504/national-initiative-to-prevent-suicide-nips-a-new-proposal-to-improve-the-understanding-and-prevention-of-suicide
#17
Sheldon H Preskorn
Suicide is a staggering, tragic, and growing cause of death in the United States. Despite a government-led 20-year effort, the suicide rate increased by 25% between 1999 and 2014. To prevent suicide, it is essential to understand the biological factors-genetic and epigenetic-and environmental factors that underlie it. To gain this increased understanding, the equivalent of the "War on Cancer" initiative is needed. The War on Cancer initiative, which began in the 1970s, has transformed the treatments and outcomes of cancer, and the same could occur with a similar initiative on suicide...
September 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27648503/factors-associated-with-high-frequency-of-suicidal-ideation-in-medically-ill-veterans
#18
Joel Wendell, Chelsea G Ratcliff, Elizabeth Price, Nancy J Petersen, Elizabeth A Dinapoli, Jeffrey A Cully
Suicide is a leading cause of death, and rates are especially high among medically ill, older individuals. Health-related psychosocial correlates of suicidal ideation (SI) may be particularly important for medically ill older adults as they may clarify who may benefit from interventions to reduce SI. This study examined whether demographic, physical health, and/or health-related psychosocial factors were associated with high frequency of SI in older, medically ill Veterans experiencing elevated anxiety or depression...
September 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27648502/constant-observation-of-suicidal-patients-the-intervention-we-love-to-hate
#19
Mark J Russ
Constant observation (CO) of psychiatric inpatients at risk for suicidal behavior has been criticized in the literature because of the absence of demonstrable effectiveness, associated costs, staff and patient acceptance, and related issues. Our inability to demonstrate effectiveness, however, is an ethical conundrum that cannot readily be solved. Frequent and often vociferous references in the literature to the absence of an evidence base for this intervention carries the risk that CO may be underutilized in particular clinical circumstances with untoward results...
September 2016: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27648501/risks-benefits-and-recommendations-for-pastoral-care-on-inpatient-psychiatric-units-a-systematic-review
#20
Steven Pennybaker, Patrick Hemming, Durga Roy, Blair Anton, Margaret S Chisolm
OBJECTIVE: A systematic review was conducted of the biomedical literature regarding pastoral care (PaC) providers on inpatient psychiatric units with the aim of answering 3 questions: (1) What are the risks and benefits of PaC providers' presence on inpatient psychiatric units? (2) What are current recommendations for integration of PaC providers into a psychiatric team? and (3) What gaps exist in the literature? METHODS: PubMed, PsycInfo, Embase, CINAHL, and Scopus were searched from the start of each database to July 9, 2014 using terms related to PaC providers and inpatient psychiatry...
September 2016: Journal of Psychiatric Practice
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