Psychiatric services最新文献_第2页

Sensitivity and Specificity of Cognitive Health Screening in a Coordinated Specialty Care Setting. 认知健康筛查在协调专科护理中的敏感性和特异性

IF 3.2 3区医学

Psychiatric services Pub Date : 2025-08-01 Epub Date: 2025-05-14 DOI: 10.1176/appi.ps.20240524

Alice M Saperstein, Cale N Basaraba, Melanie M Wall, Lisa B Dixon, Ilana Nossel, Iruma Bello, Alice Medalia

{"title":"Sensitivity and Specificity of Cognitive Health Screening in a Coordinated Specialty Care Setting.","authors":"Alice M Saperstein, Cale N Basaraba, Melanie M Wall, Lisa B Dixon, Ilana Nossel, Iruma Bello, Alice Medalia","doi":"10.1176/appi.ps.20240524","DOIUrl":"10.1176/appi.ps.20240524","url":null,"abstract":"Objective: Cognitive health should be addressed as part of routine clinical care for people with schizophrenia spectrum disorder, including those with early psychosis. Providers need an efficient workflow that includes screening tools with adequate sensitivity and specificity to facilitate appropriate cognitive symptom management. This study aimed to examine the utility of a cognitive health screening protocol by analyzing data from 102 participants in OnTrackNY, a specialized network of programs for people experiencing early psychosis.Methods: Screening elicited participants' perceptions of the usefulness of better memory, attention, and critical thinking skills and aimed to detect the presence of cognitive difficulties via participant and clinician reports. The screening protocol's sensitivity and specificity for detecting cognitive impairment, as defined by scores on a brief cognitive assessment, were evaluated.Results: About half the sample had global cognitive impairment, whereas more than 90% demonstrated impairment in at least one cognitive domain. Screening items demonstrated high sensitivity to detect global (≥0.80) and specific cognitive impairment (≥0.74), such that individuals with objectively measured cognitive impairment were likely to be correctly identified, although specificity remained low (≤0.34).Conclusions: The screening protocol may best be considered as a means to initiate shared decision making for next steps, which may include brief cognitive assessment or more resource-intensive evaluation, and to inform appropriate treatment recommendations.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"729-735"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implications of Clozapine Monitoring During the COVID-19 Pandemic. COVID-19大流行期间氯氮平监测的意义

IF 3.2 3区医学

Psychiatric services Pub Date : 2025-08-01 Epub Date: 2025-04-30 DOI: 10.1176/appi.ps.20240456

Allison L Little, Ashley J Maister, Lauren R Ash, Anuja Vallabh, Tamara J Bystrak, Justin C Ellison, Yinglin Xia, Leah M Rickert, Martin Cruz, Chelsea L Khaw, Brittany L Spitznogle, Rebecca Milovac

{"title":"Implications of Clozapine Monitoring During the COVID-19 Pandemic.","authors":"Allison L Little, Ashley J Maister, Lauren R Ash, Anuja Vallabh, Tamara J Bystrak, Justin C Ellison, Yinglin Xia, Leah M Rickert, Martin Cruz, Chelsea L Khaw, Brittany L Spitznogle, Rebecca Milovac","doi":"10.1176/appi.ps.20240456","DOIUrl":"10.1176/appi.ps.20240456","url":null,"abstract":"Objective: Clozapine is the drug of choice for treatment-resistant schizophrenia. Routine monitoring of an absolute neutrophil count (ANC) is required to detect severe neutropenia, which is a black box warning for clozapine. However, during the COVID-19 pandemic, laboratory monitoring became less frequent because of decreased access to health care services and concern about increased viral exposure. The purpose of this study was to evaluate the discontinuation rate of clozapine due to severe neutropenia during the COVID-19 pandemic.Methods: This 16-month retrospective study included all adult patients within the Veterans Health Administration who had a clozapine prescription at least 12 months before March 2020. Demographic data included indication for use, concomitant antipsychotic prescriptions, age, and race-ethnicity. Descriptive statistics were performed to analyze study objectives and demographic data.Results: In total, 2,106 patients were included in this study. No patients discontinued clozapine because of severe neutropenia, and only one patient had severe neutropenia during the study period. All-cause clozapine discontinuation occurred for 96 patients (5%). Significant differences were found between individuals who discontinued clozapine and those who did not for the longest ANC gap category (p<0.001), neutropenia category (p=0.042), and duration of clozapine use (p=0.001).Conclusions: Less frequent ANC monitoring as a consequence of the COVID-19 pandemic did not lead to increased incidence of clozapine discontinuation due to severe neutropenia. These results demonstrate the feasibility and safety of extended-interval laboratory monitoring (i.e., every 90 days) for patients receiving clozapine treatment for at least 1 year.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"714-719"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Empowering Youths and Their Families: Educational Discharge Resources for a Pediatric Psychiatric Emergency Department. 授权青少年和他们的家庭：儿童精神科急诊科的教育出院资源。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-07-01 Epub Date: 2025-04-30 DOI: 10.1176/appi.ps.20240601

Sijia Zhang, Christine Novotny, Ekta Patel

引用次数: 0

Medicaid Expansion and County-Level Suicide: Disparities Based on Rurality and Mental Health Provider Shortages. 医疗补助扩张和县级自杀：基于农村和心理健康提供者短缺的差异。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-07-01 Epub Date: 2025-04-11 DOI: 10.1176/appi.ps.20240444

Benson S Ku, Maria Dieci, Qingyue Yuan, Benjamin G Druss

{"title":"Medicaid Expansion and County-Level Suicide: Disparities Based on Rurality and Mental Health Provider Shortages.","authors":"Benson S Ku, Maria Dieci, Qingyue Yuan, Benjamin G Druss","doi":"10.1176/appi.ps.20240444","DOIUrl":"10.1176/appi.ps.20240444","url":null,"abstract":"Objective: Prior research has shown that Medicaid expansion is linked with slightly reduced suicide rates at the state level. This study aimed to investigate the association between Medicaid expansion and suicide rates at the county level, as well as disparities based on rurality and areas with a shortage of mental health professionals.Methods: In this cross-sectional study, the authors conducted a difference-in-differences analysis, with regression-adjusted ordinary least squares and fixed effects of county and year, to compare changes in county-level suicide mortality rates among nonelderly adults before and after Medicaid expansion. Whether these changes differed by rurality and by mental health professional availability was also examined.Results: Among 3,068 unique counties included in the analysis, on average, 50.0% of residents were male, 17.1% ages ≥65 years, 34.8% high school graduates, and 76.8% non-Hispanic White. The estimated suicide incidence rate per 100,000 population was 17.2 across all counties from 2007 to 2021. Medicaid expansion was not significantly associated with suicide rates. However, the three-way interaction term indicated a significant decrease in suicide rates after Medicaid expansion in metropolitan counties without mental health professional shortages (adjusted coefficient=-1.32, 95% CI=-2.37 to -0.28, p=0.014).Conclusions: These findings suggest that Medicaid expansion may have a greater impact in areas with more resources and infrastructure to provide mental health care. Further investigation is needed into the mechanisms that drive these differences.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"620-627"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical Malpractice: Coming Changes and Their Impact on Psychiatry. 医疗事故：未来的变化及其对精神病学的影响。

IF 3.2 3区医学

Psychiatric services Pub Date : 2025-07-01 Epub Date: 2025-05-28 DOI: 10.1176/appi.ps.20250230

Neil S Kaye, Paul S Appelbaum

引用次数: 0

Transitioning Out of Coordinated Specialty Care: Exploration of Service Users' and Families' Goals and Needs. 从协调的专科护理过渡：服务使用者和家庭目标和需求的探索。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-07-01 Epub Date: 2025-04-23 DOI: 10.1176/appi.ps.20240199

Elizabeth R Fraser, Karina Silva Garcia, Oladunni Oluwoye

{"title":"Transitioning Out of Coordinated Specialty Care: Exploration of Service Users' and Families' Goals and Needs.","authors":"Elizabeth R Fraser, Karina Silva Garcia, Oladunni Oluwoye","doi":"10.1176/appi.ps.20240199","DOIUrl":"10.1176/appi.ps.20240199","url":null,"abstract":"Objective: This study aimed to describe the goals of service users with first-episode psychosis who enrolled in coordinated specialty care (CSC), along with the goals their family members have for them, and to understand service users' and family members' perceived needs for recovery after discharge from the program.Methods: The authors conducted 32 in-depth interviews in English or Spanish with service users and their family members recruited between September 2021 and December 2022. Transcripts were analyzed to determine the common concerns and expectations of service users and family members.Results: Most service users described wanting financial and social independence from their families of origin, including an education that would allow them to obtain well-paid, stable employment; transportation; and an independent residence. Service users described hoping to replace some of the support they received from CSC with friends they would make in the future; some family members hoped their loved one would be able to develop and sustain romantic relationships. Most family members described not feeling ready to leave CSC at the 2-year mark, whereas service users expressed mixed opinions about their readiness to exit the program.Conclusions: Although service users were excited about the prospect of discharge, they, along with their family members, agreed that ongoing support was needed after CSC. On the basis of the findings, the authors delineate supports that service users and family members believe are necessary for a successful step-down.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"635-641"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Well-Being Model for Young Black Adults: Applying Coproduction Principles and Practices. 年轻黑人成年人的幸福模型：应用合作生产原则和实践。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-07-01 Epub Date: 2025-05-07 DOI: 10.1176/appi.ps.20240335

Crystal L Brandow, Hakim Asadi, Alexander Gamble, Margaret Swarbrick

引用次数: 0

A Wellness Model Developed by and for Individuals With Lived Experience. 由有生活经验的个人开发的健康模型。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-07-01 Epub Date: 2025-05-07 DOI: 10.1176/appi.ps.20240257

Margaret Swarbrick, Lasheema Sanders-Edwards, Rita Cronise

引用次数: 0

Adapting the Project ECHO Model for Providers Treating Trauma-Related Problems: Evaluation and Lessons Learned. 为治疗创伤相关问题的提供者调整项目ECHO模型：评估和经验教训。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-07-01 Epub Date: 2025-04-11 DOI: 10.1176/appi.ps.20240101

Kristen P Lindgren, Emily R Dworkin, Sophia Robinson, Laura Merchant, Minu Ranna-Stewart, Rebecca C Hendrickson, Jonathan W Reeves, Michele A Bedard-Gilligan

引用次数: 0

An Employer's View of Recovery. 雇主对复苏的看法。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-07-01 Epub Date: 2025-04-11 DOI: 10.1176/appi.ps.20250029

Robert E Drake

引用次数: 0