Annals of Clinical Psychiatry最新文献_第2页

Protest behaviors among patients placed in seclusion in a psychiatric emergency service. 被隔离在精神病紧急服务中心的病人的抗议行为。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-11-01 DOI: 10.12788/acp.0124

Tyler Q Ruch, Chelsea Hoops, Rif S El-Mallakh, Christina Terrell

{"title":"Protest behaviors among patients placed in seclusion in a psychiatric emergency service.","authors":"Tyler Q Ruch, Chelsea Hoops, Rif S El-Mallakh, Christina Terrell","doi":"10.12788/acp.0124","DOIUrl":"10.12788/acp.0124","url":null,"abstract":"Background: Patients placed in seclusion for behavioral dyscontrol often perceive that the health care team is treating them inappropriately. These patients may express their indignation in many ways. To better characterize these behaviors, we conducted a study of protest behaviors in a psychiatric emergency service.Methods: Video surveillance of seclusion room occupants is routinely reviewed as part of our safety protocol. For 1 month in 2022, we noted the frequency and timing of potential protest behaviors such as disrobing and evacuation. Descriptive statistics were applied.Results: A total of 41 seclusion events (8.1%) occurred over the surveillance period, which included 504 initial emergency psychiatric evaluations. Six patients (14.6%) engaged in protest behaviors (all within 5 minutes of being placed in seclusion), including 3 (7.3%) who urinated and 3 (7.3%) who disrobed. One patient urinated almost immediately (2.4%), and another urinated 25 minutes after entering seclusion; the latter was not interpreted as a protest behavior.Conclusions: Immediate behaviors in seclusion that are different from behaviors that led to seclusion can be interpreted as protest behaviors. The 2 most often observed protest behaviors were urination and disrobing.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 4","pages":"234-237"},"PeriodicalIF":1.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240652","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}

引用次数: 0

The role of psychiatry in bariatric care. 精神病学在减肥护理中的作用。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-11-01 DOI: 10.12788/acp.0122

Richard Balon

引用次数: 0

Methamphetamine-associated catatonia: Case series and systematic review of the literature from 1943-2020. 甲基苯丙胺相关紧张症:1943-2020年的病例系列和文献系统回顾。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0116

Bojan Slavnic, Brian S Barnett, Seth McIntire, Robert Becker, Sindhu Saba, Krishna D Vellanki, Lindsay Honaker, Jeremy Weleff, Brendan T Carroll

{"title":"Methamphetamine-associated catatonia: Case series and systematic review of the literature from 1943-2020.","authors":"Bojan Slavnic, Brian S Barnett, Seth McIntire, Robert Becker, Sindhu Saba, Krishna D Vellanki, Lindsay Honaker, Jeremy Weleff, Brendan T Carroll","doi":"10.12788/acp.0116","DOIUrl":"https://doi.org/10.12788/acp.0116","url":null,"abstract":"Background: Catatonia due to a general medical condition may result from a variety of causes, including substance intoxication and withdrawal. Stimulants are occasionally associated with catatonia, though there has been little investigation of methamphetamine's relationship to catatonia. Here we present 5 cases of catatonia associated with methamphetamine use and a systematic review of the associated literature from 1943 to 2020.Methods: We performed a systematic review of the literature and present 5 cases of catatonia evaluated using the Bush-Francis Catatonia Rating Scale and KANNER catatonia rating scale.Results: Methamphetamine use was associated with catatonia in a small number of cases in the literature. However, some of these reports included other possible etiologies. The patients in our case series met DSM-5 criteria for catatonia due to a general medical condition, with all reporting recent methamphetamine use and testing positive for amphetamines on urine drug screen.Conclusions: Given the ongoing rise in methamphetamine use in the United States, it is important that clinicians understand that methamphetamine use can be associated with catatonia. Patients with methamphetamine-associated catatonia may respond favorably to lorazepam and require shorter hospital stays than other catatonic patients. Lastly, methamphetamine-associated catatonia highlights how alteration in dopamine function and projections may be a critical neural mechanism underlying catatonia in general.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 3","pages":"167-177"},"PeriodicalIF":1.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960664","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}

引用次数: 0

Incongruous approach to addictions? 不协调的成瘾方法?

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0111

Richard Balon

引用次数: 0

Better than we think: Is the treatment of depressed patients more effective than we think? 比我们想象的好:抑郁症患者的治疗比我们想象的更有效吗?

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0117

Mark Zimmerman, Sin-Ying Lin

{"title":"Better than we think: Is the treatment of depressed patients more effective than we think?","authors":"Mark Zimmerman, Sin-Ying Lin","doi":"10.12788/acp.0117","DOIUrl":"https://doi.org/10.12788/acp.0117","url":null,"abstract":"Background: Most studies of depression treatment rely on measures of symptom severity to evaluate outcome. We hypothesized that many patients would consider themselves to have benefitted significantly from treatment despite not being considered a responder according to a measure of depression symptom severity (ie, 50% reduction in symptom score).Methods: In our study, 854 patients with major depressive disorder completed the Remission from Depression Questionnaire, a self-report measure that assesses several constructs patients consider to be relevant for assessing treatment outcome. At discharge, patients completed the Patient Global Rating of Improvement (PGI) to gauge effectiveness of treatment.Results: Less than 40% of patients were responders on the depressive symptom subscale, whereas two-thirds of the sample were PGI responders. Among patients who were PGI responders but nonresponders on the depression symptoms scale, more than one-half were responders on at least 1 of 4 nonsymptom domains (functioning, quality of life, coping ability, positive mental health).Conclusions: A patient-centered approach to evaluating outcome goes beyond an assessment of symptoms. When viewed from a broader perspective, the results of our study suggest that patients with depression benefit more from treatment than is suggested by only examining outcome from a symptom-based perspective.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 3","pages":"188-194"},"PeriodicalIF":1.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960665","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}

引用次数: 0

Psychiatry Update 2023 Spring Abstract Compendium. 精神病学2023春季更新摘要纲要。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01

引用次数: 0

Concurrent Cotard and Koro syndromes in psychotic depression: Case report and literature review. 精神病性抑郁症并发Cotard和Koro综合征:病例报告和文献复习。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0114

Matthew C Castellana, Preksha Arora-Hughes, Abigail S Green

引用次数: 0

Differences in clinical presentations of patients seeking care for treatment-resistant depression across sexual orientations and gender identities. 不同性取向和性别认同的难治性抑郁症患者寻求治疗的临床表现差异

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0112

Isabel Benjamin, Rachel Hershenberg, Kate D Dorrell, Amanda C Tan, Patricio Riva-Posse, William M McDonald, Adriana P Hermida, Andrea Crowell, Brian A Feinstein

{"title":"Differences in clinical presentations of patients seeking care for treatment-resistant depression across sexual orientations and gender identities.","authors":"Isabel Benjamin, Rachel Hershenberg, Kate D Dorrell, Amanda C Tan, Patricio Riva-Posse, William M McDonald, Adriana P Hermida, Andrea Crowell, Brian A Feinstein","doi":"10.12788/acp.0112","DOIUrl":"https://doi.org/10.12788/acp.0112","url":null,"abstract":"Background: Sexual and/or gender minority (SGM) individuals experience higher rates and greater severity of depressive disorders than non-SGM persons. SGM individuals are more likely than non-SGM individuals to seek mental health treatment and to present to treatment with unique characteristics that should be accounted for when considering treatment recommendations. Patients seeking care for treatment-resistant depression (TRD) are offered a variety of evidence-based interventions ranging in modality and invasiveness (eg, psychotherapy and neuromodulation).Methods: The current study used data from a TRD clinical research program to examine whether SGM (N = 52) and non-SGM (N = 202) patients differed in their clinical presentations and the treatment recommendations offered to them.Results: We found that SGM patients were younger, had a more severe history of childhood trauma, and reported greater current suicidality than non-SGM patients. There were no significant differences in treatment recommendations between groups.Conclusions: This study adds to nascent literature investigating clinical characteristics of SGM populations seeking mental health care and provides foundational evidence for the unique treatment considerations necessary for SGM individuals seeking treatment for TRD. Research into whether treatment outcomes differ for SGM and non-SGM individuals with TRD is encouraged, given clinical differences in trauma history and suicidality.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 3","pages":"199-208"},"PeriodicalIF":1.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960662","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}

引用次数: 0

High-dose armodafinil in treatment-refractory bipolar depression. 大剂量阿莫达非尼治疗难治性双相抑郁症。

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0113

Wan Y Kwok, Victoria Stephens, Henry A Nasrallah

{"title":"High-dose armodafinil in treatment-refractory bipolar depression.","authors":"Wan Y Kwok, Victoria Stephens, Henry A Nasrallah","doi":"10.12788/acp.0113","DOIUrl":"https://doi.org/10.12788/acp.0113","url":null,"abstract":"Background: Bipolar depression is a serious neuropsychiatric disorder associated with a high risk of morbidity and suicidality. Standard antidepressants approved for treating major depressive disorder fail to exert efficacy in bipolar depression. Although 5 agents have been developed for the treatment of bipolar depression, treatment resistance is still observed in some patients, and requires off-label pharmacotherapy. Modafinil and armodafinil have been reported to improve treatment-resistant bipolar depression, but with inconsistent results.Methods: We present a case of a 65-year-old woman with severe bipolar depression who failed to respond to electroconvulsive therapy and IV ketamine but later responded to high-dose armodafanil.Results: The patient responded to high-dose armodafinil (gradually titrated to 1,000 mg/d) and achieved remission with good tolerability for 5 years. Recently, she contracted COVID-19 and developed muscular weakness. After a lengthy workup, we became concerned for myopathy as an adverse effect from armodafinil. The patient's dose of armodafinil was significantly reduced and she subsequently became very depressed and functionally disabled before improving again when armodafinil 1,000 mg/d was reinstated.Conclusions: We propose that some of the negative results seen in research of armodafinil for bipolar depression may be due to the use of low doses (100 to 200 mg/d), and higher doses may be needed for adequate response in treatment-resistant bipolar depression.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 3","pages":"195-198"},"PeriodicalIF":1.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960663","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}

引用次数: 0

Characteristics and experiences of professionals providing 9/11 mental health services. 9/11心理健康服务专业人员的特点与经验

IF 1.3 4区医学

Annals of Clinical Psychiatry Pub Date : 2023-08-01 DOI: 10.12788/acp.0118

Carol S North, Samina Mahesar, Karen J Meltzer, David E Pollio

{"title":"Characteristics and experiences of professionals providing 9/11 mental health services.","authors":"Carol S North, Samina Mahesar, Karen J Meltzer, David E Pollio","doi":"10.12788/acp.0118","DOIUrl":"https://doi.org/10.12788/acp.0118","url":null,"abstract":"Background: After disasters, mental health professionals might be called upon to help address the emotional consequences of the disaster among survivors and other affected groups, but the clinicians themselves could be affected. This exploratory study examined the experiences of 60 mental health professionals, most of whom provided mental health care to individuals affected by the September 11, 2001 terrorist attacks (9/11), and/or experienced 9/11 sequelae themselves.Methods: Participants completed structured interviews 3 and/or 6 years after the disaster, with full diagnostic assessment of psychiatric disorders and questions specific to their personal and professional post-9/11 experience.Results: Providing postdisaster care was somewhat stressful initially, but long-term effects were more positive than negative, with overall benefit to many personal lives. Most found their clients' 9/11 stories emotionally upsetting, yet characterized their 9/11 mental health work as positive. Work satisfaction increased by 3-fold, but this effect was transitory. One-third had postdisaster psychopathology, but most was pre-existing and therefore not a product of disaster-related stressors.Conclusions: Although most mental health professionals initially found the emotional difficulty of their work increased after 9/11, this negative effect had largely dissipated over the years. Opportunities for disaster mental health training and initial logistical support could benefit these professionals.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"35 3","pages":"178-187"},"PeriodicalIF":1.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9958591","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}

引用次数: 0