Journal of Psychiatric Practice最新文献

{"title":"Association of Thyroid Function With Depression: A Historical Cohort Study.","authors":"Junting Liu, Brooke Ellen Delgoffe, Rachel Gabor, Shivy Sharma, Ajay K Parsaik","doi":"10.1097/PRA.0000000000000840","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000840","url":null,"abstract":"<p><strong>Background: </strong>There is inconsistent evidence concerning the association between thyroid dysfunctions and depression. Therefore, we conducted this population-based study to investigate the relationship between thyroid-stimulating hormone (TSH) and depression using the Patient Health Questionnaire-9 (PHQ-9).</p><p><strong>Method: </strong>We included patients (≥18 y) who received care at the Marshfield Clinic Health System and completed a TSH level and a PHQ-9 within 2 weeks, between 2015 and 2020. We used a logistic regression model adjusted for covariates to estimate the effect of TSH level on clinically relevant depression (PHQ-9 score ≥10).</p><p><strong>Results: </strong>Our cohort included 31,099 patients, mean age 50.9±19.5 years, 73.5% females, and 96.3% White, 39.7% of whom had clinically relevant depression. The patients with clinically relevant depression had higher TSH levels compared with those without such depression (P=0.01). In this cohort, we found that low TSH levels (<0.5 mIU/L) and very elevated TSH levels (≥10 mIU/L) both had increased odds of being associated with clinically relevant depression: [1.30 (95% CI: 1.15-1.46) and OR 1.50 (95% CI: 1.25-1.81), respectively]. Subgroup analysis showed similar findings in patients with mood disorders, females, younger adults (<65 y), and those with untreated thyroid disorders. In males, only low TSH was associated with clinically relevant depression, whereas in patients with treated thyroid disorders, only very elevated TSH was associated with clinically relevant depression.</p><p><strong>Conclusions: </strong>In this large cross-sectional study, we found that low TSH and very elevated TSH levels were both associated with higher odds of depression. Similar trends were observed in patients with mood disorders, females, younger adults (<65 y), and those with untreated thyroid disorders. Large prospective population-based studies are needed to further investigate the relationship between TSH levels and clinical depression.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 2","pages":"74-81"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis-induced Catatonia: A Case Study.","authors":"Darby Herkert, Matthew Majeske","doi":"10.1097/PRA.0000000000000849","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000849","url":null,"abstract":"<p><p>Catatonia is a diagnosis characterized by a combination of abnormal movements, behaviors, and withdrawal. It has been linked to mental health diagnoses such as schizophrenia and mood disorders. Catatonia is both traumatic for the patient and linked to multiple negative downstream medical diagnoses. Marijuana is a frequently utilized recreational drug that has been shown to have various neuropsychiatric effects in recent years. This report describes the case of a young adult male presenting with catatonia in the setting of cannabis use without other predisposing factors. It adds to the growing evidence of cannabis-associated catatonia, and it highlights the need for further research and increased counseling regarding the neuropsychiatric effects of marijuana.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 2","pages":"105-106"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Washington University (or Feighner) Psychiatric Diagnostic Criteria to DSM-III and Subsequent Versions: A Personal Perspective.","authors":"Sheldon H Preskorn","doi":"10.1097/PRA.0000000000000841","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000841","url":null,"abstract":"<p><p>The goal of this column is to give an autobiographical perspective on what I saw and learned as a trainee about the origins and the people behind the development of criteria-based psychiatric diagnosis. These individuals' own words are used to explain their rationale and goals. I further explain the transition from the Washington University (or Feighner) criteria to the Research Diagnostic Criteria to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III). The column ends with an example of how research inclusion and exclusion criteria added to DSM-III diagnoses can result in positive results by making the populations being studied both more homogenous and discrete from one another.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 2","pages":"85-88"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 16-minute Hour: Combining Abbreviated Psychotherapy With Medication Visits. Part 1: Introduction.","authors":"Samuel Dotson, John C Markowitz, David Mintz, Michael E Thase","doi":"10.1097/PRA.0000000000000838","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000838","url":null,"abstract":"<p><p>Psychiatrists increasingly practice psychotherapy by integrating their therapeutic training into brief medication visits. Insurance companies reimburse this approach using the 90833 Current Procedural Terminology code, which corresponds to 16-37 minutes of add-on psychotherapy combined with pharmacotherapy. As scholarship focused on such short-form combined therapy is scarce, this 4-part series addresses this practice gap, providing guidance to practicing professionals. This introductory installment reviews recent evolutions in psychotherapy training, the existing literature on abbreviating psychotherapy techniques, and some general guidelines and principles for adapting psychotherapy to shortened visits and selecting a specific therapeutic modality.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 2","pages":"89-94"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Patient With Schizophrenia's Journey to an Autoimmune Encephalitis Diagnosis: Shedding Light on Common Clinical Biases.","authors":"Daniel Carmona-Farres, Ricardo Lopez-Escribano, Mercè Aubareda-Magriñà, Marta Serrallonga-Mercader, Iluminada Corripio Collado","doi":"10.1097/PRA.0000000000000848","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000848","url":null,"abstract":"<p><p>The interplay between psychiatric and neurological disorders often complicates diagnostic processes, leading to significant challenges in distinguishing between mental illnesses and neurological conditions. This complexity is further exacerbated by diagnostic overshadowing, a phenomenon where symptoms of one disorder may mask or alter the perception of the other. Through the lens of a nuanced case, we chronicle the journey of a 73-year-old male with longstanding schizophrenia whose later development of motor symptoms was initially attributed to side effects of his psychiatric medication. As his general condition tended to worsen over time, a more in-depth investigation revealed a more profound neurological underpinning, illustrating the perilous path of misdiagnosis that persisted for several months. We also interweave a brief review of analogous cases in the literature that underscore the impact of decision-making errors in medical practice, highlighting the necessity for critical thinking, continuous vigilance, and the implementation of strategies to mitigate diagnostic errors.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 2","pages":"100-104"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketamine: The Story of Modern Psychiatry's Most Fascinating Molecule.","authors":"Joseph McCullen Truett","doi":"10.1097/PRA.0000000000000839","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000839","url":null,"abstract":"","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 2","pages":"113-114"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Group Interpersonal Psychotherapy for Adolescents With Non-suicidal Self-injury: A Randomized Controlled Study.","authors":"Yingqi Yin, Shufang Zhang, Lan Yu, Fan Shi, Guilin Yu","doi":"10.1097/PRA.0000000000000846","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000846","url":null,"abstract":"<p><p>Non-suicidal self-injury (NSSI) is a significant clinical concern in adolescents. The goal of this study was to evaluate the efficacy of group interpersonal psychotherapy (G-IPT) combined with treatment as usual (TAU) compared with TAU alone in treating adolescents with NSSI. A randomized controlled trial was conducted in a psychiatric outpatient clinic in Hubei Province, China, involving 52 adolescents 12 to 17 years of age diagnosed with NSSI. Participants were randomly assigned to either the G-IPT combined with TAU group (n=26), who received 12 additional G-IPT sessions, or the TAU-alone group (n=26). Outcomes were assessed using the Ottawa Self-Injury Inventory (OSI), 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Interpersonal Disturbances Scale (IDS), and Interpersonal Communication Scale (ICS) at pre-treatment [Time Zero (T0)], immediately after completion of G-IPT, or 12 weeks after baseline assessment in the TAU group [Time 1 (T1)], and 3 months after treatment [Time 2 (T2)]. Forty-eight participants completed all assessments. The primary outcomes included a reduction in NSSI frequency and an increase in participants' ability to resist NSSI. Results demonstrated reductions in the OSI item \"NSSI in the last month\" at T1 (P<0.001) and T2 (P=0.008), as well as significant improvements in the OSI item \"Strength to resist NSSI\" (P<0.001 at T1; P=0.001 at T2). Significant between-group and interaction effects were observed, indicating that G-IPT combined with TAU was more effective than TAU alone in reducing NSSI behaviors. These findings underscore the potential of G-IPT as an effective adjunct to TAU in clinical settings for adolescent NSSI intervention.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 2","pages":"65-73"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Analysis of Ethical Complexities Underlying Psychiatric Decision-making Capacity Evaluations: Prevalence and Cooccurrence of Contributing Factors.","authors":"Brandon Hamm, Rohan M Shah, Olivia Hogue, Xavier Jimenez","doi":"10.1097/PRA.0000000000000844","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000844","url":null,"abstract":"<p><strong>Objective: </strong>The ethical complexity within psychiatric evaluations of decision-making capacity (DMC) often involves more than determining whether a patient retains DMC. Some psychiatrists propose that DMC evaluation may be requested due to distress regarding additional ethical dilemmas, even when capacitation status is not questioned. The present study quantitatively illustrates this additional ethical complexity and provides greater transparency regarding additional areas that may require psychiatric facilitation of care when consulted for the evaluation of DMC.</p><p><strong>Methods: </strong>A total of 145 DMC evaluation case encounters were retrospectively analyzed for the presence of 27 total additional ethical context factors. Factor prevalence and number of factors per case were calculated. Cooccurrence of ethical context factors was determined through Fisher exact test pairwise comparisons.</p><p><strong>Results: </strong>Almost all cases (93.1%) featured ≥1 additional ethical context factor (range = 0 to 13 factors/case). The most common factors included inpatient treatment refusal or nonadherence (34.5%), leaving against medical advice (26.2%), concerns about nonadherence to outpatient treatment (25.7%), surrogate determination (22.1%), palliative care and hospice consideration (20.7%), and disposition conflict (20.7%). Several ethical context factors demonstrated significant pairwise cooccurrence, many of which involved mandatory reporting of abuse and neglect.</p><p><strong>Conclusions: </strong>Clinical scenarios encountered in DMC evaluations often contain ethical complexities beyond clarifying capacitation status. Often, consultation with psychiatrists to evaluate DMC may reflect the underlying desire for management of additional ethical context factors. The unique skillset of consultation liaison psychiatrists can help both patients and medical teams navigate these complicated clinical trajectories. Screening for additional ethical context factors in DMC evaluations may enable the facilitation of optimal care.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 2","pages":"95-99"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race and Ethnicity.","authors":"John M Oldham","doi":"10.1097/PRA.0000000000000842","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000842","url":null,"abstract":"","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 2","pages":"55"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Disparities in Administration of Transcranial Magnetic Stimulation at an Academic Center.","authors":"Alyssa C Smith, Mohannad Abu-Sultanah, Emily G Holmes, Susan K Conroy","doi":"10.1097/PRA.0000000000000843","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000843","url":null,"abstract":"<p><strong>Objective: </strong>The authors sought to examine the racial and ethnic makeup of patients treated with transcranial magnetic stimulation (TMS) for treatment-resistant depression at an urban, Midwestern academic center.</p><p><strong>Methods: </strong>This retrospective chart review study examined patients treated with TMS at the academic center from July 2018 to February 2024. Symptom scores were recorded before TMS initiation and following the course of treatment. Associations of gender, insurance status, and race with response or remission were compared using chi-squared tests. Association of age with response or remission was compared using paired t-tests.</p><p><strong>Results: </strong>Of the 71 patients treated, roughly half responded, and a third of the total sample remitted. Only 6 patients (9%) identified as a racial minority, all of whom responded. There was no statistically significant association of age or insurance status with response or remission.</p><p><strong>Conclusions: </strong>Racial and ethnic minorities were underrepresented in this treatment population. Our work suggests efforts are needed to address this disparity.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"31 2","pages":"82-84"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}