Journal of the Academy of Consultation-Liaison Psychiatry最新文献

{"title":"Dexmedetomidine in the Intensive Care Unit for Extreme Aggression in a Child With Catatonia.","authors":"Samuel Warn, Barrington Hwang, Joshua Smith","doi":"10.1016/j.jaclp.2024.12.006","DOIUrl":"10.1016/j.jaclp.2024.12.006","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonprescribed Substance Use in the General Hospital: A Retrospective Study","authors":"Lee M. Dockery M.D.,&nbsp;Kristopher A. Kast M.D.,&nbsp;Mariah Smith M.D.,&nbsp;Lisa S. Stewart M.S.N., M.Ed.,&nbsp;Thomas Reese Pharm.D., Ph.D.,&nbsp;Andrew D. Wiese Ph.D.,&nbsp;Mauli V. Shah M.P.H.,&nbsp;David E. Marcovitz M.D.","doi":"10.1016/j.jaclp.2024.09.006","DOIUrl":"10.1016/j.jaclp.2024.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Nonprescribed substance use (NPSU) is a recognized phenomenon exhibited by patients with substance use disorders while admitted to inpatient hospitals. What factors distinguish patients who engage in NPSU, or how their hospitalizations and outcomes differ, remains to be understood in full.</div></div><div><h3>Objectives</h3><div>Our study describes a cohort of medically admitted patients with substance use disorders with behaviors concerning for NPSU during their hospitalization.</div></div><div><h3>Methods</h3><div>We extracted electronic health record data for all hospital encounters when an addiction consult was documented (n = 3100). We defined NPSU cases during a clinical, interdisciplinary case review in which patients were deemed high risk based on team members' observations of one or more behaviors described in the NPSU Checklist. These individuals were placed on a “NPSU Protocol,” which was implemented for optimization of care, destigmatization, and risk mitigation (n = 61). We compared clinical characteristics, resource utilization, and treatment outcomes among the NPSU cohort to addiction consult patients without suspicion of NPSU but with stimulant or opioid use disorder diagnoses.</div></div><div><h3>Results</h3><div>Patients on the NPSU protocol were younger and had higher rates of infectious disease diagnoses reported during hospitalization than patients without concern for NPSU. Hospitalizations for individuals suspected of NPSU were longer, had higher rates of before medically advised discharge, as well as discharges without medications for opioid use disorder. These outcome differences were also observed when analysis was restricted to hospitalizations in which an infectious disease was diagnosed.</div></div><div><h3>Conclusions</h3><div>Our study characterizes a population of people who exhibited behaviors concerning for NPSU and highlights key outcome disparities. To our knowledge, this study is the first to show a direct correlation between infectious disease diagnosis and NPSU, as well as a direct correlation between suspected NPSU and outcomes such as before medically advised discharge and discharge without medications for opioid use disorder, irrespective of infectious disease diagnosis. Further study is necessary to determine interventions to reduce poor outcomes among hospitalized patients with NPSU.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"66 1","pages":"Pages 27-36"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Commentary on “Delirium in the United States: Results From the 2023 Cross-Sectional World Delirium Awareness Day Prevalence Study” by Lindroth et al. (2024)","authors":"José Lucas Sena da Silva M.D.,&nbsp;Juliana Caldas M.D., Ph.D.","doi":"10.1016/j.jaclp.2024.12.002","DOIUrl":"10.1016/j.jaclp.2024.12.002","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"66 1","pages":"Pages 110-111"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-L Case Conference: The Interaction Between Emotional Dysregulation and Chronic Critical Illness in a Patient With a Terminal Personality Disorder","authors":"Nathan C. Praschan M.D., M.P.H. ,&nbsp;Jordan H. Rosen M.D. ,&nbsp;Melissa P. Bui M.D. ,&nbsp;O. Joseph Bienvenu M.D., Ph.D.","doi":"10.1016/j.jaclp.2024.08.004","DOIUrl":"10.1016/j.jaclp.2024.08.004","url":null,"abstract":"<div><div>We present a case of a patient who presented for endocarditis and subsequently had a prolonged and challenging hospital course, with much of it spent in the intensive care unit (ICU). Throughout their hospitalization, personality factors, combined with impaired communication and pain in severe medical illness, led to challenging behaviors of disengagement, impulsivity, splitting, agitation, and suicidal statements. Experts in critical care psychiatry review the case and its key elements, including principles of critical care psychiatry and pharmacologic management of ICU patients; communication problems in ICU patients and associated psychiatric distress; the benefits of proactive consultation for challenging patients; and the construct of post-intensive care syndrome. Patients with personality disorders often struggle to cope with severe medical illness, leading to challenging, self-defeating behaviors. Such acts are even more difficult to manage in intensive care, where a patient's tenuous medical status depends on smooth interactions between them and the medical team. We address how these challenges may be mitigated in collaboration with a psychiatric consult team.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"66 1","pages":"Pages 90-98"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Substance Use Disorders Among Patients With Psoriasis and Comorbid Major Depressive Disorder","authors":"Xiaofeng Yan M.D., Ph.D.,&nbsp;Kevin J. Varghese M.D.,&nbsp;James Alan Bourgeois O.D., M.D.","doi":"10.1016/j.jaclp.2024.08.008","DOIUrl":"10.1016/j.jaclp.2024.08.008","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"66 1","pages":"Pages 112-114"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Artificial Intelligence in Consultation-Liaison Psychiatry","authors":"Hochang B. Lee M.D., F.A.C.L.P.","doi":"10.1016/j.jaclp.2025.01.007","DOIUrl":"10.1016/j.jaclp.2025.01.007","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"66 1","pages":"Pages 1-2"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic and Endocrine Correlates of Subclinical Hypothyroidism in Young Adults With First-Episode and Drug-Naive Major Depressive Disorder","authors":"ZhaoXuan Shang MSc ,&nbsp;ChunQing Fang MSc ,&nbsp;XiaoE. Lang MD, PhD ,&nbsp;Xiangyang Zhang MD, PhD","doi":"10.1016/j.jaclp.2024.10.003","DOIUrl":"10.1016/j.jaclp.2024.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Major depressive disorder is often associated with subclinical hypothyroidism (SCH), but the clinical and biochemical characteristics in young, first-episode, drug-naive patients remain unclear. This study aims to examine the prevalence and clinical correlates of SCH in this population to enhance screening and management strategies.</div></div><div><h3>Method</h3><div>A cross-sectional study included 917 young Chinese patients (aged 18–35 years) diagnosed with first-episode, drug-naive Major depressive disorder. Comprehensive clinical assessments were conducted, involving demographic data, psychiatric evaluations using the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Positive and Negative Syndrome Scale, alongside biochemical measurements such as thyroid stimulating hormone, thyroid peroxidase antibodies, fasting blood glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, and diastolic blood pressure. Binary logistic regression identified clinical correlates of SCH.</div></div><div><h3>Results</h3><div>The prevalence of SCH among the study population was 58%. Logistic regression analysis identified significant predictors of SCH, including higher Hamilton Depression Rating Scale scores (odds ratio [OR] = 1.26), thyroid peroxidase antibodies (OR = 1.003), fasting blood glucose (OR = 2.28), total cholesterol (OR = 1.66), systolic blood pressure (OR = 1.11), and diastolic blood pressure (OR = 1.07). In contrast, lower high-density lipoprotein cholesterol levels (OR = 0.28) were inversely associated with SCH.</div></div><div><h3>Conclusion</h3><div>The high prevalence of SCH in young, first-episode, drug-naive Major depressive disorder patients emphasizes the need for comprehensive metabolic and endocrine evaluations. Regular monitoring of thyroid function, glucose levels, blood pressure, and lipid profiles is crucial for early detection and intervention, potentially improving clinical outcomes in this vulnerable group.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"66 1","pages":"Pages 13-26"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversible Lithium-induced Bradycardia in a Patient With Wolff-Parkinson-White Syndrome","authors":"Kristen Dzeda M.D.,&nbsp;Yang Liu B.A.,&nbsp;Rocksheng Zhong M.D., M.H.S.","doi":"10.1016/j.jaclp.2024.09.007","DOIUrl":"10.1016/j.jaclp.2024.09.007","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"66 1","pages":"Pages 106-107"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Use of a Tricyclic Antidepressant to Address Depression and Quality of Life in a Case of Radiation Proctitis","authors":"Elizabeth Hale M.D.,&nbsp;Patrick Buckley M.D., MBA","doi":"10.1016/j.jaclp.2024.09.002","DOIUrl":"10.1016/j.jaclp.2024.09.002","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"66 1","pages":"Pages 104-105"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2024 ACLP Recommendations for Training Residents in Consultation-Liaison Psychiatry","authors":"Scott R. Beach M.D. ,&nbsp;Carrie L. Ernst M.D. ,&nbsp;David C. Fipps D.O. ,&nbsp;Thomas M. Soeprono M.D. ,&nbsp;Mallika Lavakumar M.D. ,&nbsp;Samuel P. Greenstein M.D. ,&nbsp;Thomas W. Heinrich M.D. ,&nbsp;Ann C. Schwartz M.D.","doi":"10.1016/j.jaclp.2024.11.001","DOIUrl":"10.1016/j.jaclp.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Despite rapid shifts in consultation-liaison psychiatry (CLP) training in residency, including increasing general residency training requirements from the Accreditation Council for Graduate Medical Education, greater utilization of advanced practice providers, and effects of the coronavirus-2019 pandemic, the Academy of Consultation-Liaison Psychiatry has not updated recommendations for residency training in CLP since 2014. A national survey of residency program directors in 2021 suggested many changes to the structure of CLP rotations at individual programs over the past decade.</div></div><div><h3>Objective</h3><div>These recommendations are intended to guide residency program directors toward optimizing CLP training for all residents, including those who will eventually pursue CLP fellowship.</div></div><div><h3>Methods</h3><div>We convened a workgroup of 8 Academy of Consultation-Liaison Psychiatry members holding leadership positions in residency and fellowship education on local and national levels. The project was approved by the Academy of Consultation-Liaison Psychiatry Executive Council and conducted via a three-stage iterative process.</div></div><div><h3>Results</h3><div>Consensus was reached on 34 recommendations across four domains, including structural issues, faculty supervision, formal curriculum and evaluations, and elective experiences. Residents must spend sufficient time on CLP rotations to achieve relevant milestones. Given that consultants are expected to offer unique insight, the ideal placement of core CLP rotations comes at a time in residency where residents are able to provide expert opinion and lead teams. Faculty expertise in CLP and availability to provide direct supervision and oversight to trainees are essential. A separate and formal CLP didactic curriculum should exist, and elective opportunities should be offered to supplement training.</div></div><div><h3>Conclusions</h3><div>Establishing a strong CLP foundation for all residents is essential for ensuring competency in providing psychiatric care for medically complex patients and collaborating with our colleagues in other specialties, as well as fostering trainee interest in pursuing a career in CLP.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"66 1","pages":"Pages 80-89"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}