-
Missouri Medicine 2024Technologies in the 21st century provide increasingly detailed and accurate maps of brain structure and function. So why don't psychiatrists order brain imaging on all... (Review)
Review
Technologies in the 21st century provide increasingly detailed and accurate maps of brain structure and function. So why don't psychiatrists order brain imaging on all our patients? Here we briefly review major neuroimaging methods and some of their findings in psychiatry. As clinicians and neuroimaging researchers, we are eager to bring brain imaging into daily clinical practice. However, to be clinically useful, any test in medicine must demonstrate adequate test statistics, and show proven benefits that outweigh its risks and costs. In 2024, beyond certain limited circumstances, we have no imaging tests that can meet those standards to provide diagnosis or guide treatment. This cold fact explains why for most psychiatric patients, neuroimaging is not currently recommended by professional organizations or the National Institute of Mental Health.
Topics: Humans; Mental Disorders; Brain; Neuroimaging; Psychiatry; Psychiatrists
PubMed: 38404436
DOI: No ID Found -
Journal of Cognitive Psychotherapy Nov 2020This invited commentary is the personal experience of a psychiatrist who assisted in Wuhan, China during the pandemic. From the personal perspective, it explains why...
This invited commentary is the personal experience of a psychiatrist who assisted in Wuhan, China during the pandemic. From the personal perspective, it explains why psychiatrists need to go to Wuhan, discusses the psychological problems faced by the front-line medical staff and confirmed COVID-19 patients and the corresponding psychological interventions provided to them, describes the particularity and coping methods of psychological issues related to COVID-19 epidemic.
Topics: Adult; COVID-19; China; Humans; Medical Staff, Hospital; Physician's Role; Psychiatry; Psychotherapy
PubMed: 33372123
DOI: 10.1891/JCPSY-D-20-00033 -
Psychosomatics 2020The purpose of this study was to describe the medical complications of anorexia nervosa (AN) to enable a consult-liaison psychiatrist to be familiar with these... (Review)
Review
OBJECTIVE
The purpose of this study was to describe the medical complications of anorexia nervosa (AN) to enable a consult-liaison psychiatrist to be familiar with these complications when involved with the care of a hospitalized patient with AN.
METHODS
Comprehensive PubMed search of English language publications of adult patients with AN was carried out using keywords, phrases, and medical subject headings of anorexia nervosa-medical complications, cardiac, osteoporosis, gastrointestinal, hematological, and endocrine. The database search was restricted by time of publication of studies from 2005 to 2020.
RESULTS
Every organ system can be adversely affected by AN. Most are fully reversible with time and informed medical care. A multidisciplinary team is needed to optimally care for patients who are hospitalized as a result of the medical complications of their AN.
CONCLUSIONS
Consult-liaison psychiatrists are asked to help in the care of patients with AN who are admitted to a hospital because of a medical complication of their illness. Being familiar with these complications and their treatments will optimize their hospital stays and the care provided. In addition, involving other relevant ancillary services is an important care consideration.
Topics: Adult; Anorexia Nervosa; Hospitalization; Humans; Osteoporosis; Referral and Consultation
PubMed: 32778424
DOI: 10.1016/j.psym.2020.06.020 -
Psychiatric Services (Washington, D.C.) May 2020Psychiatrists have been involved in seclusion and restraint (S-R) management and mitigating its abuses for 200 years. The emphasis on finding alternatives to S-R has... (Review)
Review
Psychiatrists have been involved in seclusion and restraint (S-R) management and mitigating its abuses for 200 years. The emphasis on finding alternatives to S-R has produced much of the recent success in decreasing its use. Nonetheless, patients continue to suffer from abuse and to die in S-R events, so a need for more assessments and interventions seems like a productive avenue to pursue. One approach is to involve psychiatrists more intensively in all S-R activities as is part of the widely used, rationale-based practice, Six Core Strategies to Prevent Conflict, Trauma, and Violence. These opportunities are reviewed.
Topics: Humans; Hospitals, Psychiatric; Patient Isolation; Psychiatry; Restraint, Physical; Violence
PubMed: 32019431
DOI: 10.1176/appi.ps.201900321 -
The Journal of the American Academy of... Mar 2021
Topics: Databases, Factual; Humans; Physician's Role; Psychiatry; Societies, Medical; Suicide, Assisted; United States
PubMed: 33731486
DOI: 10.29158/JAAPL.200100-20 -
Journal of the American Academy of... Apr 2024As child and adolescent psychiatrists, it is our job to identify factors that influence the behaviors seen in front of us. Often the question is asked whether these...
As child and adolescent psychiatrists, it is our job to identify factors that influence the behaviors seen in front of us. Often the question is asked whether these factors are primarily due to nature or nurture: Is someone born a "bad kid," or are there environmental exposures that lead to less than ideal behaviors? Factors such as racism, poverty, bullying, social isolation, and even where we grow up could play a part in the behaviors seen. This is one of the most rewarding, but at times can be one of the most frustrating, parts of our job as child and adolescent psychiatrists. Hopefully we can explore the factors influencing behaviors seen by the children we work with, highlighting the good in them and the situations that have led to the concerns seen. At the same time, we can become frustrated knowing that some of these factors are difficult for us to change as an individual child and adolescent psychiatrist, such as racism, poverty, inequalities in education, or family support. Bearing witness to these societal issues and their impact on our patients hopefully sparks advocacy efforts toward larger system changes.
PubMed: 38575058
DOI: 10.1016/j.jaac.2024.03.014 -
Child and Adolescent Mental Health Feb 2022Child and Adolescent Psychiatrists have stressful jobs and huge caseloads, and are ideally placed to play an influential and meaningful role in responding to 'the...
Child and Adolescent Psychiatrists have stressful jobs and huge caseloads, and are ideally placed to play an influential and meaningful role in responding to 'the biggest global health threat of the 21st Century': the eco-crisis. This article describes how a group of child and adolescent psychiatrists responded to the awareness that the impacts of the eco-crisis will increasingly undermine their daily work in the clinic. The article lists the progress this small group of committed individuals have made in raising awareness of the issues and what steps they have taken to guide and support other practitioners who want to play their part. Their future plans are set out with an invitation to join the crucial endeavour.
Topics: Adolescent; Child; Family; Global Health; Humans; Psychiatry
PubMed: 34964543
DOI: 10.1111/camh.12539 -
Australasian Psychiatry : Bulletin of... Dec 2022To comment upon the evidence-base regarding psychiatrist and trainee burnout and provide recommendations on management.
OBJECTIVE
To comment upon the evidence-base regarding psychiatrist and trainee burnout and provide recommendations on management.
CONCLUSIONS
Burnout has been conceptualised as a specific stress-related response, primarily related to work. There is a high prevalence of burnout amongst both trainees and psychiatrists internationally, with substantial consequences for personal and family wellbeing, organisational efficiency and patient care. We summarise the evidence on organisational and individual approaches to addressing burnout.
Topics: Humans; Burnout, Professional; Psychiatry; Prevalence
PubMed: 36112911
DOI: 10.1177/10398562221124798 -
Current Psychiatry Reports Jun 2024We review current literature related to the clinical assessment of Mild Cognitive Impairment (MCI). We compile recommendations related to the evaluation of MCI and... (Review)
Review
PURPOSE OF REVIEW
We review current literature related to the clinical assessment of Mild Cognitive Impairment (MCI). We compile recommendations related to the evaluation of MCI and examine literature regarding the use of clinical biomarkers in this assessment, the role of non-pharmacologic therapy in the prevention of cognitive decline, and recent approval of anti-amyloid therapy in the treatment of MCI.
RECENT FINDINGS
The role of imaging and plasma biomarkers in the clinical assessment of MCI has expanded. There is data that non-pharmacologic therapy may have a role in the prevention of neurocognitive decline. Anti-amyloid therapies have recently been approved for clinical use. Clinical assessment of MCI remains multifactorial and includes screening and treating for underlying psychiatric and medical co-morbidities. The use of biomarkers in clinical settings is expanding with the rise of anti-amyloid therapies. These new diagnostics and therapeutics require nuanced discussion of risks and benefits. Psychiatrist's skillset is uniquely suited for these complex evaluations.
PubMed: 38856858
DOI: 10.1007/s11920-024-01514-3 -
BJPsych Bulletin Oct 2021
PubMed: 34556201
DOI: 10.1192/bjb.2021.78