Journal of Psychiatric Practice最新文献

{"title":"A Cardiovascular Risk Optimization Program in People With Schizophrenia: A Pilot Randomized Controlled Clinical Trial.","authors":"Núria Riera-Molist, Montse Assens-Tauste, Pere Roura-Poch, Marta Guimerà-Gallent, Josep Manel Santos-López, Montserrat Serra-Millas, Neus Frau-Rosselló, Estefania Gallego-Peña, Quintí Foguet-Boreu","doi":"10.1097/PRA.0000000000000743","DOIUrl":"10.1097/PRA.0000000000000743","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease is one of the leading causes of premature death in people with schizophrenia. Some modifiable factors that have been implicated include unhealthy lifestyle, medication side effects, and physical comorbidities. The goal of this study was to assess the efficacy of a 6-month, multifactorial cardiovascular risk intervention to reduce cardiovascular risk (CVR) in people with schizophrenia.</p><p><strong>Methods: </strong>We conducted a 2-arm, parallel, randomized clinical trial in a regional mental health center. Participants with at least 1 poorly controlled cardiovascular risk factor (CVRF) (hypertension, diabetes mellitus, hypercholesterolemia, or tobacco smoking) were randomly assigned to the intervention group or to a control group. The subjects in the intervention group received a patient-centered approach that included promoting a healthy lifestyle, pharmacological management of CVRFs, psychotropic drug optimization, and motivational follow-up [Programa d'optimització del RISc CArdiovascular (PRISCA)]. The main outcome was change in CVR as assessed using the Framingham-REGICOR function, after 6 months compared with the baseline in both groups.</p><p><strong>Results: </strong>Forty-six participants were randomly assigned to the PRISCA group (n=23) or the control group (n=23). The most prevalent CVRFs at baseline were hypercholesterolemia (84.8%) and tobacco smoking (39.1%). The PRISCA group showed a significant reduction in the REGICOR score (-0.96%; 95% CI: -1.60 to -0.32, P=0.011) after 6 months (relative risk reduction of 20.9%), with no significant changes in the control group (0.21%; 95% CI: -0.47 to 0.89, P=0.706). In the PRISCA group, low-density lipoprotein cholesterol also decreased significantly (-27.14 mg/dL; 95% CI: -46.28 to -8.00, P=0.008).</p><p><strong>Conclusion: </strong>A patient-centered, multifactorial cardiovascular risk intervention improved CVR in people with schizophrenia after 6 months, which was achieved mainly by improving the lipid profile.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"29 6","pages":"456-468"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catatonia as the Presentation of Encephalopathy Associated With Autoimmune Thyroiditis: A Case Report and Literature Review.","authors":"Hossam Tharwat Ali, Farah Riyad Mohamed, Ahmed Khaled Al-Ghannami, Ana Leticia Fornari Caprara, Jamir Pitton Rissardo","doi":"10.1097/PRA.0000000000000751","DOIUrl":"10.1097/PRA.0000000000000751","url":null,"abstract":"<p><p>Encephalopathy can be associated with autoimmune disorders such as autoimmune thyroiditis, and it can present with a wide range of neuropsychiatric manifestations. However, it rarely presents with catatonia. We present the case of a middle-aged female with Hashimoto's thyroiditis presenting with catatonia. A literature review of previous similar cases highlighting significant points is also included. A 48-year-old female presented to the emergency department with catatonic symptoms that had worsened over the previous 5 days. A similar condition was reported to have occurred and resolved spontaneously 3 months earlier. On examination, the patient appeared uncooperative and unresponsive. She showed typical symptoms of catatonia, with a score of 21 points on the Bush-Francis Catatonia Rating Scale. Routine tests were within normal ranges except for an elevated level of C-reactive protein and an elevated erythrocyte sedimentation rate. Computed tomography, magnetic resonance imaging, and cerebrospinal fluid analysis were all normal. An electroencephalogram showed diffuse delta-theta range slowing with no epileptiform discharges. Lorazepam was initiated but did not control the catatonic symptoms. Re-evaluation revealed thyroid swelling and elevated levels of thyroperoxidase antibodies. IV methylprednisolone was therefore initiated and produced complete resolution of the catatonic symptoms in 4 hours. The patient was discharged and prescribed prednisone 1 mg/kg daily. At follow-up, the patient continued to show complete resolution of the catatonic symptoms. It is noteworthy that the patient developed hypothyroidism 6 months after this catatonic episode for which levothyroxine 50 mcg/d was prescribed. Encephalopathy associated with autoimmune thyroiditis can initially present with catatonic symptoms in euthyroid cases. The mainstay of treatment is steroids which result in complete resolution of the catatonic symptoms.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"29 6","pages":"499-504"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209744","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 Relationship of Self-identified Weight Status With Perceived Mental and Physical Health.","authors":"Antonia Hamilton, Shannon R Smith, Janet A Lydecker","doi":"10.1097/PRA.0000000000000744","DOIUrl":"10.1097/PRA.0000000000000744","url":null,"abstract":"<p><strong>Objective: </strong>This study examined whether individuals with higher weight (body mass index in the overweight or obesity range) self-identified as having overweight or obesity (Ow/Ob). The study also examined whether self-identifying as having Ow/Ob was associated with perceived mental health, perceived physical health, depression, and eating disorder psychopathology.</p><p><strong>Methods: </strong>Four study groups were created: those with Ow/Ob who self-identified as having Ow/Ob (Ow/Ob+), those with Ow/Ob who did not self-identify as having Ow/Ob (Ow/Ob-), those with core features of binge-eating disorder (BED) and Ow/Ob, and those with bulimia nervosa (BN) and Ow/Ob. Analyses of variance compared study groups on perceived health, depression, and eating disorder psychopathology.</p><p><strong>Results: </strong>The BED and BN groups were more likely to self-identify as having overweight/obesity compared with Ow/Ob groups without eating disorders. The Ow/Ob- group had the best-perceived health and the lowest levels of eating disorder psychopathology and depression compared with the other groups. The Ow/Ob+ group had better perceived mental health than the BED and BN groups but did not differ significantly from the Ow/Ob- group in perceived mental health. Perceived physical health in the Ow/Ob+ group was better than in the BED group and worse than in the Ow/Ob- group. The Ow/Ob+ group had higher levels of eating disorder psychopathology than the Ow/Ob- group.</p><p><strong>Conclusions: </strong>Self-identifying as having obesity is associated with eating disorder psychopathology as well as poorer perceived mental and physical health. Providers should engage patients in discussions about their weight with the understanding that self-identifying as having overweight or obesity might indicate the presence of eating disorder psychopathology. Future clinical research should investigate the directionality or possible bidirectionality of this relationship.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"29 6","pages":"430-438"},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Affective Temperament, Pain Catastrophizing, and Anxiety Sensitivity on Pain Severity in Patients With Chronic Pelvic Pain: A Pilot Study.","authors":"Özlem Kayacik Günday, Hatice Harmanci, Yiğit Şenol","doi":"10.1097/PRA.0000000000000742","DOIUrl":"10.1097/PRA.0000000000000742","url":null,"abstract":"<p><strong>Objective: </strong>The goals of this study were to investigate whether there was a dominant temperament type, and to assess the effect of temperament, pain catastrophizing, and anxiety sensitivity on pain severity, in female patients diagnosed with chronic pelvic pain (CPP) compared with healthy controls.</p><p><strong>Methods: </strong>This cross-sectional study involved 51 patients 18 to 65 years of age who were diagnosed with CPP without a history of psychiatric treatment and 97 healthy volunteer women with sociodemographic characteristics similar to those of the study group. A sociodemographic form prepared by the researchers, the Anxiety Sensitivity Index, the Pain Catastrophizing Scale, a temperament scale (Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire), and a visual analog pain scale (VAS) were completed. The results were compared between the patient and control groups. Multiple regression analyses were performed to examine the predictive effects of temperament characteristics, pain catastrophizing, and anxiety sensitivity on pain severity.</p><p><strong>Results: </strong>Scores on the Pain Catastrophizing Scale and the VAS were statistically significantly higher in the CPP group ( P <0.001). The frequency of depressive, cyclothymic, and irritable temperaments was found to be significantly higher in the CPP group (CPP: 7.78±3.32 vs. controls: 6.54±3.19; P =0.027; CPP:10.61±4.41 vs. controls: 8.82±4.21; P =0.017; CPP: 5.22±4.29 vs. controls: 3.75±3.41; P =0.025). According to the model established by temperament traits, anxiety sensitivity, and pain catastrophizing level, pain catastrophizing level explained 11.6% of the variance in pain severity. A 1-unit change in the score for pain catastrophizing level caused a 0.278-point change in the VAS total score ( P <0.01).</p><p><strong>Conclusions: </strong>Cyclothymic, depressive, and irritable temperament types that increase the risk of affective disease are more common in patients with CPP. The level of pain catastrophizing in patients with CPP affects their perception of the severity of the pain.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":" ","pages":"447-455"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41141654","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":"Extreme Risk Protection Orders: Legislative Intent and Clinician Guidance.","authors":"Hal S Wortzel, Joseph A Simonetti, Christopher E Knoepke, Joseph R Simpson, Leah Brar, Patricia Westmoreland, Bridget B Matarazzo","doi":"10.1097/PRA.0000000000000749","DOIUrl":"10.1097/PRA.0000000000000749","url":null,"abstract":"<p><p>In this second column of a 2-part series exploring extreme risk protections orders, we utilize recent events in Colorado, including legislative efforts to expand the list of eligible petitioners to include clinicians, as an opportunity to explore questions and challenges faced by mental health and medical professionals serving in this capacity. Clinicians are in need of more clear guidance, given an emerging role that comes without clear evidence or practice standards to inform individualized clinical decision-making, and which potentially pits public safety interests against patient care needs, especially those pertaining to therapeutic relationships. In the interim, clinicians will best serve their patients by continuing to practice in a fashion that is analogous to decision-making around other interventions with serious implications for patient autonomy such as involuntary hospitalization. Ongoing collaboration with legislators is needed to arrive at laws that are informed by the limitations inherent in clinical risk assessment and that can be translated into clinical practices that simultaneously support patient needs and community safety.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"29 6","pages":"480-488"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209746","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":"Psychedelics, With a Focus on Psilocybin: Issues for the Clinician.","authors":"Amir Garakani,&nbsp;Jeanne L Alexander,&nbsp;Calvin R Sumner,&nbsp;Janet H Pine,&nbsp;Lawrence S Gross,&nbsp;Charles L Raison,&nbsp;Scott T Aaronson,&nbsp;David A Baron","doi":"10.1097/PRA.0000000000000729","DOIUrl":"10.1097/PRA.0000000000000729","url":null,"abstract":"<p><p>There has been a burgeoning interest in psychedelics among the public, state legislatures, psychiatrists and other clinical providers, and within the research community. Increasing numbers of studies evaluating psychedelics for depression, anxiety, posttraumatic stress disorder, and substance use disorders have been conducted or are underway. While discussing psychedelics in general, the focus of this paper is on psilocybin and its mechanism, how it exerts a psychedelic effect, dosing, and a review of the treatment studies of psilocybin, which were primarily for treatment-resistant depression and cancer-related anxiety. Future directions and potential limitations of studying and regulating psilocybin and other psychedelics are also discussed.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"29 5","pages":"345-353"},"PeriodicalIF":1.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10188663","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":"Incels: An Introduction for Mental Health Clinicians.","authors":"Camille A Tastenhoye,&nbsp;Juliette Dupré,&nbsp;Nina E Ross,&nbsp;Tanya V Bodnar,&nbsp;Susan Hatters Friedman","doi":"10.1097/PRA.0000000000000738","DOIUrl":"10.1097/PRA.0000000000000738","url":null,"abstract":"<p><p>Involuntary celibates (\"incels\") refers to a group consisting mostly of heterosexual men that exists predominantly in online spaces. These men are united by a belief that they are victimized by a postfeminist society, leading to an inability to engage in sexual intimacy with women. Recent acts of mass violence have been linked to self-identified incels, leading to an increased need for awareness of incel worldviews, argot, and demographics among psychiatrists. Limited research exists to describe this heterogenous group, with existing data suggesting higher rates of depression, anxiety, and suicidal ideation within the demographic. This column reviews the incel worldview, existing literature, how to identify an individual with incel beliefs based on vocabulary and internet usage, and treatment modalities.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"29 5","pages":"384-389"},"PeriodicalIF":1.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10196959","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":"Textbook of Autism Spectrum Disorders (2nd Edition).","authors":"Teresa Daly","doi":"10.1097/PRA.0000000000000730","DOIUrl":"https://doi.org/10.1097/PRA.0000000000000730","url":null,"abstract":"","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"29 5","pages":"428"},"PeriodicalIF":1.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10567232","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":"Digital Collateral Information Through Electronic and Social Media in Psychotherapy: Comparing Clinician-reported Trends Before and During the COVID-19 Pandemic.","authors":"Ipsit V Vahia, Rachel N Sava, Hailey V Cray, Heejung J Kim, Rebecca A Dickinson, Kerry J Ressler, Ana F Trueba","doi":"10.1097/PRA.0000000000000727","DOIUrl":"10.1097/PRA.0000000000000727","url":null,"abstract":"<p><strong>Background: </strong>Patient clinical collateral information is critical for providing psychiatric and psychotherapeutic care. With the shift to primarily virtual care triggered by the COVID-19 pandemic, psychotherapists may have received less clinical information than they did when they were providing in-person care. This study assesses whether the shift to virtual care had an impact on therapists' use of patients' electronic and social media to augment clinical information that may inform psychotherapy.</p><p><strong>Methods: </strong>In 2018, we conducted a survey of a cohort of psychotherapists affiliated with McLean Hospital. We then reapproached the same cohort of providers for the current study, gathering survey responses from August 10, 2020, to September 1, 2020, for this analysis. We asked clinicians whether they viewed patients' electronic and social media in the context of their psychotherapeutic relationship, what they viewed, how much they viewed it, and their attitudes about doing so.</p><p><strong>Results: </strong>Of the 99 respondents, 64 (64.6%) had viewed at least 1 patient's social media and 8 (8.1%) had viewed a patient's electronic media. Of those who reported viewing patients' media, 70 (97.2%) indicated they believed this information helped them provide more effective treatment. Compared with the 2018 prepandemic data, there were significantly more clinicians with>10 years of experience reporting media use in therapy. There was also a significant increase during the pandemic in the viewing of media of adult patients and a trend toward an increase in viewing of media of older adult patients.</p><p><strong>Conclusions: </strong>Review of patients' electronic and social media in therapy became more common among clinicians at a large psychiatric teaching hospital during the COVID-19 pandemic. These findings support continuing research about how reviewing patients' media can inform and improve clinical care.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"29 5","pages":"367-372"},"PeriodicalIF":1.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10798232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10188660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eight Clinical Cases and the Lessons They Taught.","authors":"Sheldon H Preskorn","doi":"10.1097/PRA.0000000000000736","DOIUrl":"10.1097/PRA.0000000000000736","url":null,"abstract":"<p><p>Eight different cases are presented in this column, along with the lessons and principles that can be learned from each. The lessons and principles are general in nature and hence they are applicable to patients that readers will likely encounter.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"29 5","pages":"373-377"},"PeriodicalIF":1.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10240873","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}