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

{"title":"Using Discrete Form Data in the Electronic Medical Record to Predict the Likelihood of Psychiatric Consultation","authors":"Mark A. Oldham M.D. ,&nbsp;Beth Heaney D.N.P., P.M.H.N.P. ,&nbsp;Conrad Gleber M.D., M.B.A. ,&nbsp;Hochang B. Lee M.D. ,&nbsp;Daniel D. Maeng Ph.D.","doi":"10.1016/j.jaclp.2023.10.002","DOIUrl":"10.1016/j.jaclp.2023.10.002","url":null,"abstract":"<div><h3>Background</h3><p>Manually screening for mental health needs in acute medical-surgical settings is thorough but time-intensive. Automated approaches to screening can enhance efficiency and reliability, but the predictive accuracy of automated screening remains largely unknown.</p></div><div><h3>Objective</h3><p>The aims of this project are to develop an automated screening list using discrete form data in the electronic medical record that identify medical inpatients with psychiatric needs and to evaluate its ability to predict the likelihood of psychiatric consultation.</p></div><div><h3>Methods</h3><p>An automated screening list was incorporated into an existing manual screening process for 1 year. Screening items were applied to the year's implementation data to determine whether they predicted consultation likelihood. Consultation likelihood was designated high, medium, or low. This prediction model was applied hospital-wide to characterize mental health needs.</p></div><div><h3>Results</h3><p>The screening items were derived from nursing screens, orders, and medication and diagnosis groupers. We excluded safety or suicide sitters from the model because all patients with sitters received psychiatric consultation. Area under the receiver operating characteristic curve for the regression model was 84%. The two most predictive items in the model were “3 or more psychiatric diagnoses” (odds ratio 15.7) and “prior suicide attempt” (odds ratio 4.7). The low likelihood category had a negative predictive value of 97.2%; the high likelihood category had a positive predictive value of 46.7%.</p></div><div><h3>Conclusions</h3><p>Electronic medical record discrete data elements predict the likelihood of psychiatric consultation. Automated approaches to screening deserve further investigation.</p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667296023001325/pdfft?md5=2f1c6edb2e72af67e263014b7f52f22d&pid=1-s2.0-S2667296023001325-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684909","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":"A Prospective Study of Noncardiac Chest Pain-Related Disability in Emergency Department Patients With Comorbid Anxiety Disorders","authors":"Stéphanie Hamel Ph.D. ,&nbsp;Isabelle Denis Psy.D., Ph.D. ,&nbsp;Stéphane Turcotte M.Sc. ,&nbsp;Richard Fleet M.D., Ph.D. ,&nbsp;Patrick Archambault M.D. ,&nbsp;Clermont E. Dionne Ph.D. ,&nbsp;Guillaume Foldes-Busque Psy.D., Ph.D.","doi":"10.1016/j.jaclp.2023.04.007","DOIUrl":"10.1016/j.jaclp.2023.04.007","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to prospectively document the association between panic disorder (PD) or generalized anxiety disorder (GAD) and noncardiac chest pain (NCCP)-related disability. Its second objective was to validate an explanatory model of these associations.</p></div><div><h3>Methods</h3><p>This was a prospective cohort study of 124 emergency department patients with NCCP and comorbid PD or GAD. Anxiety sensitivity, heart-focused anxiety, and alexithymia were assessed at baseline. NCCP-related disability was assessed at baseline and at the 6-month follow-up. Mediation analysis was used to validate the explanatory model.</p></div><div><h3>Results</h3><p>The rate of NCCP-related disability was 54.8% (<em>n</em> = 68) at baseline and 34.7% (<em>n</em> = 43) at the 6-month follow-up. Patients with PD were significantly more likely to report NCCP-related disability at the 6-month follow-up than those with GAD alone (<em>P</em> = 0.021). A simplified model containing a causal chain between anxiety, anxiety sensitivity, heart-focused anxiety, and NCCP-related disability at the 6-month follow-up was a good fit for the data.</p></div><div><h3>Conclusions</h3><p>PD appears to be more closely associated with NCCP-related disability than GAD. Among patients with NCCP and comorbid PD or GAD, heart-focused anxiety was the main psychological determinant of the development or maintenance of NCCP-related disability in the 6 months following an emergency department visit.</p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667296023000824/pdfft?md5=71cca7973f4826ffcaa61cd97643e5a2&pid=1-s2.0-S2667296023000824-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83965548","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":"Polypharmacologic Toxicity Involving Deutetrabenazine in a Patient With Renal Insufficiency","authors":"Harish S. Pudukodu M.D.,&nbsp;Varsha Radhakrishnan M.D.,&nbsp;Jordan H. Rosen M.D.","doi":"10.1016/j.jaclp.2023.08.004","DOIUrl":"10.1016/j.jaclp.2023.08.004","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667296023001118/pdfft?md5=2abfd1768b687271e3e59601008732cf&pid=1-s2.0-S2667296023001118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10334813","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":"A Systematic Review of Neuropsychiatric Symptoms in Idiopathic Intracranial Hypertension","authors":"Natalia Kosyakova B.S. ,&nbsp;Jacob S. Shaw B.S. ,&nbsp;Anne Reisch M.D. ,&nbsp;Lisa N. Richey B.A ,&nbsp;Sabrina Kentis B.A ,&nbsp;Barry R. Bryant M.D. ,&nbsp;Aaron I. Esagoff B.S. ,&nbsp;Jacob White M.L.S. ,&nbsp;Matthew E. Peters M.D.","doi":"10.1016/j.jaclp.2023.10.005","DOIUrl":"10.1016/j.jaclp.2023.10.005","url":null,"abstract":"<div><h3>Background</h3><p>There is limited characterization of neuropsychiatric symptoms (NPS) in patients with idiopathic intracranial hypertension (IIH). Along with commonly presenting symptoms of IIH, including headache and papilledema, NPS may have a significant impact on IIH outcomes.</p></div><div><h3>Objective</h3><p>We completed a systematic review of the literature to characterize the most common noncognitive NPS in IIH patients and examine associations between noncognitive NPS and IIH outcomes.</p></div><div><h3>Methods</h3><p>A Preferred Reporting Items for Systemic Reviews and Meta-Analysis compliant literature search was conducted in Ovid Medline, PubMed, PsycInfo, Embase, Web of Science, Cochrane, CINAHL, and Scopus databases. The initial query yielded 1688 unique articles. These articles were narrowed to those including empirical analyses of noncognitive NPS in adult patients with IIH.</p></div><div><h3>Results</h3><p>A final cohort of eight articles comprised 724 individuals with IIH and 257 healthy controls. Noncognitive NPS, specifically anxiety and depression, were more common in IIH patients compared to controls. Patients with IIH also reported increased headache, visual disturbances, and overall poorer quality of life. Limitations included heterogeneous sample characteristics along with variability in measurement of noncognitive NPS between studies.</p></div><div><h3>Conclusions</h3><p>A greater understanding of the most prevalent noncognitive NPS such as depression and anxiety in IIH patients, particularly among females who are obese and facing social and economic marginalization, may help to reduce IIH-associated morbidity. In particular, improved screening and timely management of psychiatric conditions using a multidisciplinary approach may improve IIH outcomes.</p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667296023001350/pdfft?md5=2fec9ec22201a2d26c4fd3dc9b06addc&pid=1-s2.0-S2667296023001350-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136127301","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":"Repeated Cerebellar Symptoms Post-ECT in a Geriatric Patient","authors":"Tuna Hasoglu M.D.,&nbsp;Brian J. Lee M.D., Ph.D.,&nbsp;Irving M. Reti M.B.B.S.","doi":"10.1016/j.jaclp.2023.08.006","DOIUrl":"10.1016/j.jaclp.2023.08.006","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667296023001234/pdfft?md5=9704151ba9bceb3d042e3f16af241ed0&pid=1-s2.0-S2667296023001234-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10541800","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":"Successful Continuation of Clozapine Treatment During Liver Transplantation: Case Report","authors":"Karanbir Padda M.D.,&nbsp;Junona Elgudin M.D.,&nbsp;David Salerno Pharm.D.,&nbsp;Mashal Khan M.D.","doi":"10.1016/j.jaclp.2023.08.003","DOIUrl":"10.1016/j.jaclp.2023.08.003","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266729602300112X/pdfft?md5=e883c81160a17cb224173a44f2d37c40&pid=1-s2.0-S266729602300112X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10168962","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":"Association of the Stanford Integrated Psychosocial Assessment for Transplant and 1-Year Outcome of Living Kidney Transplantation in Japan","authors":"Kosuke Takano M.A. ,&nbsp;Sayaka Kobayashi Ph.D. ,&nbsp;Hidehiro Oshibuchi M.D., Ph.D. ,&nbsp;Junko Tsutsui Ph.D. ,&nbsp;Nano Mishima M.A. ,&nbsp;Satoko Ito M.D., Ph.D. ,&nbsp;Rumiko Kamba M.D. ,&nbsp;Rie Akaho M.D., Ph.D. ,&nbsp;Katsuji Nishimura M.D., Ph.D.","doi":"10.1016/j.jaclp.2023.09.003","DOIUrl":"10.1016/j.jaclp.2023.09.003","url":null,"abstract":"<div><h3>Background</h3><p>Because most kidney transplantations in Japan are performed on the basis of living donors, after-transplant outcomes should achieve optimum results, overcoming participants' possible reduced adherence.</p></div><div><h3>Objective</h3><p>To investigate the association between the Japanese version of the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT-J) and outcomes, 1 year after the patient's living kidney transplant (LKT).</p></div><div><h3>Methods</h3><p>The prospective cohort study was undertaken at Tokyo Women's Medical University Hospital from January 2020 to July 2021, with a 1-year follow-up period. The SIPAT-J assesses 18 psychosocial risk factors: (1) Patient's Readiness Level and Illness Management (SIPAT A), (2) Social Support System Level of Readiness (SIPAT B), (3) Psychological Stability and Psychopathology (SIPAT C), and (4) Lifestyle and Effect of Substance Use (SIPAT D). The evaluators, a psychiatrist and 3 clinical psychologists, conducted an independent, blinded application of the SIPAT-J using participants' medical records. The study focused on physical composite outcomes, psychiatric outcomes, and nonadherent behaviors.</p></div><div><h3>Results</h3><p>The participants were 173 LKT recipients (median age [interquartile range], 51 [38–59]); 67.1% were male and 67.1% were employed. The median (interquartile range) SIPAT scores were SIPAT A [7 (5–9)], SIPAT B [7 (5–9)], SIPAT C [2 (0–4)], SIPAT D [3 (3–4)], and SIPAT total [20 (16–23)]. The physical composite outcome was 25 (14.5%), psychiatric outcome 9 (5.2%), and nonadherent behavior 17 (9.8%). SIPAT C (odds ratio = 1.34, 95% confidence interval = 1.06–1.72, <em>P</em> = 0.02) was significantly associated with the psychiatric outcome. SIPAT B (odds ratio = 1.49, 95% confidence interval = 1.12–1.98, <em>P</em> = 0.01) and SIPAT total (odds ratio = 1.13, 95% confidence interval = 1.03–1.24, <em>P</em> = 0.01) were significantly associated with nonadherent behaviors. There was no significant association between the SIPAT and physical composite outcomes.</p></div><div><h3>Conclusion</h3><p>This study is the first to examine the association between SIPAT and physical and psychiatric outcomes 1 year after LKT, controlling for follow-up periods and factors other than SIPAT. Comprehensive psychosocial assessment before LKT and early identification of factors that may negatively affect transplant success can allow targeted interventions to be implemented and increase the likelihood of favorable recipient outcomes.</p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266729602300126X/pdfft?md5=1c85a538a2fac0dbc05f973d55b5a26f&pid=1-s2.0-S266729602300126X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41147177","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":"Corrigendum to “The Dual Roles of the JACLP: Leading the Field of C-L Psychiatry and Serving the Members of Our Academy” [Journal of the Academy of Consultation-Liaison Psychiatry 64 (2023) 1-2]","authors":"Hochang Benjamin Lee M.D. ,&nbsp;Joseph M. Cerimele M.D., M.P.H. ,&nbsp;Maryland Pao M.D. ,&nbsp;Mark A. Oldham M.D.","doi":"10.1016/j.jaclp.2023.09.005","DOIUrl":"10.1016/j.jaclp.2023.09.005","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667296023001283/pdfft?md5=a11fe2d3a736de70ad1f847f09fea907&pid=1-s2.0-S2667296023001283-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693816","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":"Pediatric Consultation-Liaison (C-L) Psychiatry Training Pathways","authors":"Maryland Pao M.D.,&nbsp;GenaLynne C. Mooneyham M.D., M.S.,&nbsp;Haniya Raza D.O., M.P.H.","doi":"10.1016/j.jaclp.2023.11.271","DOIUrl":"10.1016/j.jaclp.2023.11.271","url":null,"abstract":"<div><p>This perspective piece reviews the current training pathways for pediatric consultation-liaison psychiatry. Significant workforce shortages of child and adolescent psychiatry over the past 3 decades have led to the creation of new training pathways between pediatrics and child and adolescent psychiatry training programs to care for children whose medical and psychiatric management has become increasingly complex. There are now several options available to receive excellent training in pediatric consultation-liaison. Efforts to foster continued interactions and shared education between adult and pediatric consultation-liaison providers are likely to be beneficial to both disciplines given the astonishing advances in technology over the years that have allowed many patients with complex childhood medical disorders to survive into adulthood today.</p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667296023004329/pdfft?md5=eca58a3f62cd7f9ed3016b720325ed7e&pid=1-s2.0-S2667296023004329-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300566","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":"Consultation-Liaison Case Conference: Systemic Challenges in Management of Aggression in a Pediatric Patient With Seronegative Autoimmune Encephalitis","authors":"Tucker Hickox B.S. ,&nbsp;Khyati Brahmbhatt M.D. ,&nbsp;Joshua R. Smith M.D. ,&nbsp;Catherine Fuchs M.D. ,&nbsp;Yasas Tanguturi M.D., M.P.H.","doi":"10.1016/j.jaclp.2023.08.005","DOIUrl":"10.1016/j.jaclp.2023.08.005","url":null,"abstract":"<div><p>We present the case of a 9-year-old girl who presented to a tertiary-care academic children's hospital with acute onset of severe obsessive-compulsive symptoms, perseveration, grimacing, and personality changes with resultant agitation. Extensive multidisciplinary workup led to a diagnosis of seronegative autoimmune encephalitis. The clinical course included multiple general pediatric and inpatient psychiatric unit admissions that were complicated by severe affective dysregulation with physical aggression towards staff and family. Top experts in the consultation-liaison field provide guidance for this commonly encountered clinical case based on their experience and a review of available literature. Key teaching points include assessment and management of seronegative autoimmune encephalitis and catatonia. We discuss the system-level challenges of management of aggression in health care settings and ways to improve care for patients presenting with behavioral manifestations (aggression) of physical illness.</p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667296023001222/pdfft?md5=1cdb34d5ebfa998a5b1285d0bb3d2c9e&pid=1-s2.0-S2667296023001222-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10307217","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}