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https://www.readbyqxmd.com/read/28732477/a-web-based-clinical-decision-tool-to-support-treatment-decision-making-in-psychiatry-a-pilot-focus-group-study-with-clinicians-patients-and-carers
#1
Catherine Henshall, Lisa Marzano, Katharine Smith, Mary-Jane Attenburrow, Stephen Puntis, Jakov Zlodre, Kathleen Kelly, Matthew R Broome, Susan Shaw, Alvaro Barrera, Andrew Molodynski, Alastair Reid, John R Geddes, Andrea Cipriani
BACKGROUND: Treatment decision tools have been developed in many fields of medicine, including psychiatry, however benefits for patients have not been sustained once the support is withdrawn. We have developed a web-based computerised clinical decision support tool (CDST), which can provide patients and clinicians with continuous, up-to-date, personalised information about the efficacy and tolerability of competing interventions. To test the feasibility and acceptability of the CDST we conducted a focus group study, aimed to explore the views of clinicians, patients and carers...
July 21, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28726526/integrated-care-coordination-by-an-interprofessional-team-reduces-emergency-department-visits-and-hospitalisations-at-an-academic-health-centre
#2
Anne H Gaglioti, Patrick Barlow, Kate DuChene Thoma, George R Bergus
People with chronic behavioural and physical health conditions have higher healthcare costs and mortality rates than patients with chronic physical conditions alone. As a result, there has been promotion of integrated care for this group. It is important to train primary care residents to practice in integrated models of care with interprofessional teams and to evaluate the effectiveness of integrated care models to promote high-quality care for this at-risk group. We implemented an integrated, interprofessional care management programme for adults with chronic mental and physical health needs as part of a curriculum for family medicine and family medicine psychiatry residents...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28720635/increased-public-accountability-for-hospital-nonprofit-status-potential-impacts-on-residency-positions
#3
Melanie C Raffoul, Robert L Phillips
BACKGROUND: The Institute of Medicine recently called for greater graduate medical education (GME) accountability for meeting the workforce needs of the nation. The Affordable Care Act expanded community health needs assessment (CHNA) requirements for nonprofit and tax-exempt hospitals to include community assessment, intervention, and evaluation every 3 years but did not specify details about workforce. Texas receives relatively little federal GME funding but has used Medicaid waivers to support GME expansion...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28702268/distressing-visual-hallucinations-after-treatment-with-trazodone
#4
Gustavo Santos, Ana Maria Moreira
Trazodone, a second-generation atypical antidepressant, is increasingly being used off-label, in the treatment of insomnia. Although generally well tolerated, trazodone treatment can be associated with some complications. We describe a case of a 60-year-old man who received trazodone for primary insomnia. He returned, to the emergency department, two days later with distressing visual hallucinations, which prompted inpatient treatment. Trazodone was discontinued, leading to a complete resolution of his visual hallucinations, and he was treated with mirtazapine for 6 months...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28699102/-the-concept-of-schizoidia-in-psychiatry-from-schizoidia-to-schizotypy-and-cluster%C3%A2-a-personality-disorders
#5
REVIEW
Hans-Peter Kapfhammer
From a perspective of conceptual evolution schizoidia was initially considered to describe features both of the premorbid personality of schizophrenic patients and of the personalities of non-psychotic family members (Bleuler, Kahlbaum, Kraepelin). On a psychopatholocial level a close link to the complex basic symptom of autism was stressed. From the very beginnings of modern psychiatry schizoidia was discussed within a conceptual frame of schizophrenia spectrum disorders (Kretschmer, Hoch, Polatin). Approaches to operationalize these conceptual works laid the basis for the cluster A personalities in DSM-III...
July 11, 2017: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
https://www.readbyqxmd.com/read/28688664/a-novel-flight-surgeon-training-model-at-a-joint-military-and-civilian-surgical-residency-program
#6
Erik S DeSoucy, Scott A Zakaluzny, Joseph M Galante
BACKGROUND: Graduating military preliminary interns are often required to fill flight surgeon billets. General surgery preliminary interns get experience evaluating surgical and trauma patients, but receive very little training in primary care and flight medicine. At a joint military and civilian training program, we developed a supplemental curriculum to help transition our interns into flight medicine. METHODS: From 2013 to 2016, we developed a lecture series focused on aerospace medicine, primary care, and specialty topics including dermatology, ophthalmology, orthopedics, pediatrics, psychiatry, and women's health...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28682527/issues-in-palliative-care
#7
Dean Schuyler
Through this column, we hope that practitioners in general medical settings will gain a more complete knowledge of the many patients who are likely to benefit from brief psychotherapeutic interventions. A close working relationship between primary care and psychiatry can serve to enhance patient outcome.
June 29, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28679439/minor-depression-in-older-long-term-unemployed-people-seeking-vocational-support
#8
Sabrina Pfeil, Katrin Holtz, Kathrin-Andrea Kopf, Ulrich Hegerl, Christine Rummel-Kluge
BACKGROUND: Prevalence rates of minor and major depression vary from 0.7 to 6.8 (minor) and 3.8 to 10.9 (major) for the general population. Twenty-two percent of older, long-term unemployed people suffer from major depression. However, the prevalence rate of minor depression (depression on a subthreshold level with less than 5, but more than 1 depression symptom) in this population is unknown. The first aim of this study is to identify that prevalence rate, because we already know that minor depression increases the risk of developing a major depression and this in turn reduces the chances of reemployment what increases social and individual costs at the same time...
July 5, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28659013/-there-s-a-catch-22-the-complexities-of-pain-management-for-people-with-advanced-dementia-nearing-the-end-of-life-a-qualitative-exploration-of-physicians-perspectives
#9
Bannin De Witt Jansen, Kevin Brazil, Peter Passmore, Hilary Buchanan, Doreen Maxwell, Sonja J McIlfatrick, Sharon M Morgan, Max Watson, Carole Parsons
BACKGROUND: Pain management is a cornerstone of palliative care. The clinical issues encountered by physicians when managing pain in patients dying with advanced dementia, and how these may impact on prescribing and treatment, are unknown. AIM: To explore physicians' experiences of pain management for patients nearing the end of life, the impact of these on prescribing and treatment approaches, and the methods employed to overcome these challenges. DESIGN: Qualitative, semi-structured interview study exploring barriers to and facilitators of pain management, prescribing and treatment decisions, and training needs...
October 1, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/28647010/social-skills-training-for-children-and-adolescents-with-autism-spectrum-disorder-a-randomized-controlled-trial
#10
Nora Choque Olsson, Oskar Flygare, Christina Coco, Anders Görling, Anna Råde, Qi Chen, Katarina Lindstedt, Steve Berggren, Eva Serlachius, Ulf Jonsson, Kristiina Tammimies, Lars Kjellin, Sven Bölte
OBJECTIVE: Social skills group training (SSGT) for children and adolescents with autism spectrum disorder (ASD) is widely applied, but effectiveness in real-world practice has not yet been properly evaluated. This study sought to bridge this gap. METHOD: This 12-week pragmatic randomized controlled trial of SSGT compared to standard care alone was conducted at 13 child and adolescent psychiatry outpatient units in Sweden. Twelve sessions of manualized SSGT ("KONTAKT") were delivered by regular clinical staff...
July 2017: Journal of the American Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28641960/-involuntary-commitment-of-the-psychiatric-patient-legal-regulations-and-critical-aspects
#11
M Ibáñez Bernáldez, M Casado Blanco
Traditionally, medical care received by psychiatric patients involved their separation from the society through their isolation in closed institutions, thereby setting a stigmatising trend on the sick, and by extension on mental illness, a practice that somehow has remained until now. The profound changes in the field of psychiatry have been important and are reflected in the therapeutic field, as well as in the legislative one, and have contributed to establish changes concerning the social opinion about psychiatric patients...
June 19, 2017: Semergen
https://www.readbyqxmd.com/read/28622823/does-behavioral-health-integration-improve-primary-care-providers-perceptions-of-health-care-system-functioning-and-their-own-knowledge
#12
Leah Zallman, Robert Joseph, Colleen O'Brien, Emily Benedetto, Ellie Grossman, Lisa Arsenault, Assaad Sayah
OBJECTIVE: To examine the impact of behavioral health integration (BHI) on primary care providers' (PCPs') (1) perceptions of behavioral health (BH)-primary care (PC) system functioning and (2) perceptions of their own knowledge regarding how to manage, triage, and access help in caring for patients with mental health conditions and substance use disorders. METHODS: We implemented BHI based on evidence-based models consisting of seven elements: (1)Screening for mental health and substance use disorders, (2)Training of PC teams, (3)Integration of BH providers into PC teams, (4)Roll-out of unlicensed mental health care managers and establishment of a BH registry, (5)Psychiatry consult service, (6)Site-based BHI meetings, and (7)Site self assessments...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28617019/initial-examination-of-characteristics-of-patients-who-are-high-utilizers-of-an-established-primary-care-behavioral-health-consultation-service
#13
Meghan Fondow, Elizabeth Zeidler Schreiter, Chantelle Thomas, Ashley Grosshans, Neftali Serrano, Kenneth Kushner
Obective: Although much has been studied regarding high-utilizing patients of medical services, no studies have been published regarding high-utilizing patients of integrated primary care behavioral health (PCBH) services. The primary purpose of the current study was to examine characteristics of high-utilizing patients of PCBH services and model adherence. The secondary purpose was to describe the process of conducting this research by clinicians in integrated care. METHOD: Data were obtained from electronic health records retrospectively for the study's time period, 2007-2013, for the sample of all patients who met with the behavioral health consultation team during that time...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28608232/emotional-distress-among-physician-residents-and-fellows-an-observational-study-of-trainees-seeking-counseling-visits
#14
Anna Golob, Lauren A Beste, Mindy Stern, Kay Johnson
OBJECTIVE: Emotional distress, burnout, and depression occur frequently among graduate medical education (GME) trainees and may negatively affect patient care, education, and well-being. The authors aimed to characterize the causes and severity of distress among GME trainees seeking on-site counseling services at a large, multi-site, university-based training program in the USA. METHODS: The authors analyzed visits of all GME trainees seeking counseling from 2009 to 2012 and described trainee characteristics, level of distress, chief and secondary complaints, and initial visit outcomes...
June 12, 2017: Academic Psychiatry
https://www.readbyqxmd.com/read/28606419/the-evolving-practice-of-psychiatry-in-the-era-of-integrated-care
#15
REVIEW
Robert Joseph, Rachel Kester, Colleen O'Brien, Hsiang Huang
BACKGROUND: Integrating behavioral health care into the primary care setting is increasingly recognized as an effective way to manage mental illness and substance use disorders on a population level in the United States. The term "integrated care," however, is used in many ways and encompasses several different models. OBJECTIVES: The aim of this article is to provide a conceptual framework to understand the landscape of models of integrated care and to use this framework to contrast the roles of behavioral health providers in integrated settings with those in traditional behavioral health delivery models...
April 13, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28599626/factors-associated-with-general-practitioners-awareness-of-depression-in-primary-care-patients-with-heart-failure-baseline-results-from-the-observational-recode-hf-study
#16
Marion Eisele, Anja Rakebrandt, Sigrid Boczor, Agata Kazek, Nadine Pohontsch, Magdalena Okolo-Kulak, Eva Blozik, Jens-Martin Träder, Stefan Störk, Christoph Herrmann-Lingen, Martin Scherer
BACKGROUND: Depression is more prevalent in patients with heart failure (HF) than in those without, but its detection is complicated by the symptom overlap between the two diseases. General practitioners (GPs) are the first point of contact for patients with HF. Therefore, this study aims to investigate GPs' awareness of depression in their HF patients and factors associated with this awareness. METHODS: In this cross-sectional, observational study 3224 primary care patients with HF were screened for depressive symptomatology using an algorithm based on the Hospital Anxiety and Depression Scale, the 9-item subscale on Depression of the Patient Health Questionnaire, and selected items from the PROMIS Depression and Anxiety scales...
June 9, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28543089/treatments-for-people-living-with-schizophrenia-in-sub-saharan-africa-an-adapted-realist-review
#17
REVIEW
S Chidarikire, M Cross, I Skinner, M Cleary
AIM: To identify the treatments and interventions available and their impact on people living with schizophrenia in Sub-Saharan Africa. BACKGROUND: Help-seeking behaviour and the choice of treatment are largely influenced by socio-cultural factors and beliefs about the causes of mental illness. This review addresses the gap in knowledge regarding the treatment options available to people living with schizophrenia in Sub-Saharan Africa. DESIGN: Adapted realist literature review...
May 25, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28498090/world-federation-of-societies-of-biological-psychiatry-wfsbp-guidelines-for-biological-treatment-of-schizophrenia-a-short-version-for-primary-care
#18
Alkomiet Hasan, Peter Falkai, Thomas Wobrock, Jeffrey Lieberman, Birte Glenthøj, Wagner F Gattaz, Florence Thibaut, Hans-Jürgen Möller
OBJECTIVE: Schizophrenia is a severe mental disorder and many patients are treated in primary care settings. Apart from the pharmacological management of disease-associated symptoms, the detection and treatment of side effects is of the utmost importance in clinical practice. The purpose of this publication is to offer relevant evidence-based recommendations for the biological treatment of schizophrenia in primary care. METHODS: This publication is a short and practice-oriented summary of Parts I-III of the World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia...
June 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28492425/identifying-patient-and-provider-specific-gaps-in-care-among-patients-with-hepatitis-b
#19
Tatyana Kushner, Robert Lam, Daniel L Gray, David E Kaplan, Marina Serper
GOALS: To examine patient, provider, and health system barriers to clinical follow-up among US veterans with chronic hepatitis B virus (HBV). BACKGROUND: Studies have demonstrated deficiencies in clinical care and follow-up in HBV; however, patient, provider, and health-system barriers in non-Asian populations are understudied. STUDY: A retrospective cohort of 517 US veterans with chronic HBV at 3 diverse Veterans Affairs sites from 1999 to 2015...
May 10, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28479895/referral-letters-to-the-psychiatrist-in-nigeria-is-communication-adequate
#20
Oluyomi Esan, Oluremi Oladele
OBJECTIVE: Over half of patients with psychiatric disorders are first seen by primary care physicians before referral to the psychiatrist. An efficient referral system is, therefore, important to offering quality care to such patients. Communication between physicians is often sub-optimal and referral letters to specialists sometimes provide inadequate information. The current study's aim was to observe the prevalence of deficiencies in the referral letters to a department of psychiatry in a Nigerian teaching hospital...
December 2016: African Health Sciences
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