介入精神病学:下一步是什么?

Q4 Medicine
K. Vincent
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引用次数: 0

摘要

精神病学未能解决这些变化将是一个可怕的错误,因为精神病学家可能会失去对我们领域进步和发展的控制。但这就产生了一个更大的问题:我们接下来需要采取什么措施?我们认为,介入精神病学必须被公认为其自己的精神病学亚专业,在精神病学住院医师培训中得到更大的重视,并接受专业组织的标准化。精神病学将程序纳入患者护理已有近100年的历史,从20世纪30年代的电休克疗法(ECT)和胰岛素休克疗法开始。3,4然而,在过去的10年里,美国食品药品监督管理局对神经调控治疗精神疾病程序的批准迅速扩大(包括2005年的迷走神经刺激、2008年的经颅磁刺激和2009年批准的使用脑深部刺激的设备例外),为这一非官方的精神病亚专科带来了“介入精神病学”的绰号。5,6如果我们要将介入精神病学作为一个公认的亚专业,创建一个普遍接受的定义是很重要的。我们建议该术语指的是可能具有或不具有侵入性但需要特殊训练才能执行的治疗技术或过程。此外,介入精神病学甚至应该包括微创手术,如氯胺酮输注、药物植入、长效注射(LAI)药物,以及需要风险评估和缓解策略(REMS)的过程,如氯氮平、氯胺酮,或奥氮平用于缓释注射混悬剂7(参见“风险评估和缓解策略计划:如何改进”,第14页)。开具氯氮平(7%)8或LAI(32.1%至77.7%,取决于患者群体)的临床医生比例对本社论或其他感兴趣的主题发表评论:henry.nasrallah@currentpsychiatry.com客座社论
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Interventional psychiatry: What are the next steps?
Psychiatry’s failure to address these changes would be a dire error, as psychiatrists could lose control of our field’s advances and growth. But this creates an even larger question: what are the next steps we need to take? We believe interventional psychiatry must be recognized as its own psychiatric subspeciality, receive greater emphasis in psychiatry residency training, and be subject to standardization by professional organizations. Psychiatry has incorporated procedures into patient care for almost 100 years, starting with electroconvulsive therapy (ECT) and insulin shock therapy in the 1930s.3,4 However, in the last 10 years, the rapid expansion of FDA approvals of neuromodulation procedures to treat psychiatric conditions (including vagus nerve stimulation in 2005, transcranial magnetic stimulation [TMS] in 2008, and the device exception granted for the use of deep brain stimulation in 2009) has produced the moniker “interventional psychiatry” for this unofficial psychiatric subspeciality.5,6 If we are to establish interventional psychiatry as a recognized subspeciality, it is important to create a universally accepted definition. We propose the term refer to therapeutic techniques or processes that may or may not be invasive but require special training to perform. Additionally, interventional psychiatry should include even minimally invasive procedures, such as ketamine infusions, medication implants, long-acting injectable (LAI) medications, and processes that require a Risk Evaluation and Mitigation Strategy (REMS), such as those utilized with clozapine, esketamine, or olanzapine for extended-release injectable suspension7 (see “Risk Evaluation and Mitigation Strategy programs: How they can be improved,” page 14). The proportions of clinicians who prescribe clozapine (7%)8 or LAIs (32.1% to 77.7%, depending on the patient population being To comment on this editorial or other topics of interest: henry.nasrallah @currentpsychiatry.com Guest Editorial
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来源期刊
Current psychiatry
Current psychiatry Medicine-Psychiatry and Mental Health
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0.50
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