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Journal of Psychiatric Practice

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
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
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
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
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
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
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
Ester Camprodon-Rosanas, Santiago Batlle, Xavier Estrada-Prat, Marta Aceña-Díaz, Araitz Petrizan-Aleman, Elena Pujals, Luis M Martin-López, Víctor Pérez-Solá, Núria Ribas-Fitó
Sluggish cognitive tempo (SCT) symptoms have largely emerged from investigations of attention-deficit/hyperactivity disorder (ADHD). Recent research has demonstrated the relevance of SCT symptoms in the field of clinical child and adolescent psychiatry. The goal of this research was to study the symptoms of SCT in a clinical child and adolescent sample and to define its features and comorbid conditions. We reviewed 834 clinical records of patients referred to Child and Adolescent Mental Health Services and examined SCT symptoms and their relation with sociodemographic data, clinical diagnosis, comorbid conditions, Child Behavior Checklist dimensions, and intelligence quotient...
September 2016: Journal of Psychiatric Practice
John M Oldham
No abstract text is available yet for this article.
September 2016: Journal of Psychiatric Practice
Deepa Pawar, Ramin Mojtabai, Aviva Goldman, Donna Batkis, Kathleen Malloy, Bernadette Cullen
The objective of this study was to assess the subjective responses of patient and staff to the provision of health-related information in an outpatient psychiatric clinic. Simple educational information on healthy eating, exercising, and smoking cessation was provided in the waiting area of a clinic over the course of a year. This information took the form of educational handouts, educational DVDs, and monthly "special events" such as a poster competition for smoking cessation. In addition, patients were given an opportunity to attend free nutritional counseling sessions...
July 2016: Journal of Psychiatric Practice
David A Kahn
Two cases of unusual situations are discussed: one involving feigned suicide detected as false only after a comparison of surveillance systems, and one involving monozygotic triplets who all developed psychosis with shared delusions. Although these 2 cases involve presentations most of us will never encounter as clinicians, they nevertheless serve to highlight fundamental questions about the nature of psychopathology. Both cases also have compelling parallels in literature and film.
July 2016: Journal of Psychiatric Practice
Artemis Papanastasiou, Gerasimos Konstantinou, Themistocles Vlachos
We present a case of folie à trois with schizoaffective and negative symptoms in monozygotic triplets, which to our knowledge is unique. For 4 years starting in their late teens, the 3 male siblings withdrew socially, adopted a primitive lifestyle, and exhibited poor self-care with increasing aggression, which led to their admission to the hospital at the age of 22 years. Over the subsequent 8 years, 1 brother recovered fully with treatment, resumed academic and social functioning, and does not need medication therapy currently...
July 2016: Journal of Psychiatric Practice
M Justin Coffey, Brian K Ahmedani
The authors describe a case of "pseudocide" in which the patient appears to have feigned his own suicide. This case was identified as a result of a routine reconciliation of internally collected suicide data with government-collected mortality data. The authors discuss the evolution of the concept of pseudocide in the clinical literature and consider issues related to deceitful and factitious behaviors and suicide surveillance and measurement.
July 2016: Journal of Psychiatric Practice
Yakov Shapiro, Nicholas John, Rowan Scott, Nadia Tomy
In the first article in this 2-part series, we outlined a psychobiological model of psychiatric treatment and reviewed the evidence showing psychotherapy to be a form of biological intervention that induces lasting alterations in brain structure and function. In this second article, we focus on the adaptive model of psychopathology, the effectiveness of psychotherapeutic interventions, the synergistic effects of combined psychotherapy and psychopharmacology treatments, and attention to the patient's subjective experience and the doctor-patient alliance to complement an "objective" case formulation...
July 2016: Journal of Psychiatric Practice
Patricia Westmoreland, Phillip S Mehler
Anorexia nervosa is a serious mental illness with a high mortality rate. The body image distortion inherent to this disorder and the impaired judgment and cognition due to malnutrition frequently result in patients refusing treatment. Treatment is most effective if patients are treated early in the course of their illness and undergo a full course of treatment. Involuntary treatment may therefore be both life-saving and critical to recovery. Between April 2012 and March 2016, 109 patients (5.2% of patients admitted to the Eating Recovery Center in Denver, CO) were certified, 39% of whom were transferred from the ACUTE Center for Eating Disorders at Denver Health Medical Center...
July 2016: Journal of Psychiatric Practice
Sheldon H Preskorn
In recent years, a significant upsurge in the development of new laboratory tests for use in psychiatric practice has occurred. This column discusses salient questions about those tests to help mental health practitioners better understand the potential role of such tests in their clinical practices. These issues are particularly relevant for mental health professionals who prescribe psychotropic medications. The column does not provide an exhaustive list of tests nor does it review the pros and cons of any specific company's tests...
July 2016: Journal of Psychiatric Practice
Christian G Widschwendter, Alex Hofer, Susanne Baumgartner, Monika Edlinger, Georg Kemmler, Maria A Rettenbacher
OBJECTIVE: The quality of the patient-psychiatrist relationship can be seen as a cornerstone of adherence to medications in patients with chronic psychiatric disorders. Although therapeutic alliance in psychotherapy has been investigated broadly, it has received little attention in the context of medication adherence. The goal of this study was to develop and validate a user-friendly questionnaire for the assessment of therapeutic alliance in clinically stable outpatients with schizophrenia...
July 2016: Journal of Psychiatric Practice
Glorimar Ortiz, Vera Hollen, Lucille Schacht
OBJECTIVES: The goal of this study was to explore antipsychotic medication prescribing practices in a sample of 86,034 patients discharged from state psychiatric inpatient hospitals and to find the prevalence of patients discharged with no antipsychotic medications, on antipsychotic monotherapy, and on antipsychotic polypharmacy. For patients discharged on antipsychotic polypharmacy, the study explored the adjusted rates of antipsychotic polypharmacy, the reasons patients were discharged on antipsychotic polypharmacy, the proportion of antipsychotic polypharmacy by mental health disorder, and the characteristics associated with being discharged on antipsychotic polypharmacy...
July 2016: Journal of Psychiatric Practice
Eric Lis, Gail Myhr
Cognitive behavioral therapy (CBT) is an evidence-based psychotherapeutic approach which has been shown to be an effective intervention for most psychiatric disorders. There are conflicting data in the literature regarding whether a comorbid personality disorder worsens the prognosis of CBT for depression, anxiety, and other complaints. This study examined data collected before and after courses of CBT for patients with significant borderline (n=39, 11.5%) or obsessive-compulsive (n=66, 19.4%) personality pathology or no personality disorder (n=235, 69...
July 2016: Journal of Psychiatric Practice
Anne L Bailey, Eugene H Makela, Kia Asberg
OBJECTIVE/BACKGROUND: Because restless legs syndrome (RLS) is a problematic syndrome, demonstrating an association between use of selective serotonin reuptake inhibitors (SSRIs)/serotonin-norepinephrine reuptake inhibitors (SNRIs) and RLS may help direct patient care. The goals of this study were (1) to establish the incidence of RLS in mental health patients being treated with SSRIs or SNRIs in a local Veterans Affairs medical center and (2) to evaluate the frequency with which certain SSRIs or SNRIs are associated with RLS and the trend in frequency of the diagnosis since the revision of the criteria for RLS offered by the International Restless Leg Syndrome Study Group (IRLSSG), the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the International Classification of Sleep Disorders, Revised (ICSD-3)...
July 2016: Journal of Psychiatric Practice
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