Family Murder: Pathologies of Love and Hate
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Book Review Source Type: research

Bringing Psychiatry into the Mosque: Analysis of a Community Psychoeducation Intervention
Conclusions: The findings of this study suggest the potential effectiveness of coordinated interventions by religious leaders and mental health professionals to address the reluctance of Muslims to use psychotropic medication treatment when indicated. Limitations of this study include the self-selection of a highly-educated subset of the greater Muslim population that may already have been interested in a mental health symposium. For the future, research should consider the use of psychoeducation in general religious services to reach a more representative sample of practicing Muslims. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research

Clinical Use of Prazosin in a Patient With Acute Stress Disorder: A Case Report
We present the case of a 51-year-old man who was experiencing symptoms of ASD following a motor vehicle accident that occurred a few days earlier. He was reporting flashbacks and nightmares of the accident, but after being treated with prazosin, his symptoms completely resolved. Prazosin may be effective in treating the symptoms of ASD and, by doing this, it may also play a role in inhibiting the progression of ASD to PTSD. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Pseudologia Fantastica: An Elaborate Tale of Combat-related PTSD
We describe the patient’s presentation and the careful process of confrontation and acquisition of collateral information used to reach the diagnosis, along with the patient’s efforts to avoid accepting the truth by constructing a series of even more elaborate stories. Finally, we underscore the importance of maintaining a therapeutic alliance in caring for patients with PF through frequent displays of uniform positive regard, and we describe the approach to treatment used during the patient’s hospital stay. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Therapeutic Risk Management: Suicide Postvention
When considering critical elements involved in suicide prevention, dialogs are often dominated by suicide assessment, management, and intervention themes. Proactive consideration on what to do if a patient dies by suicide is often overlooked, which can be especially detrimental to our practice and those we serve. In this article, we extend the philosophy of the therapeutic risk management model to consider ways in which we can take good care of the extended community of suicide loss survivors, including providers. We begin by briefly describing the widespread impact of suicide loss and the lack of suicide postvention educa...
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Columns Source Type: research

The Mental Health Crisis in America: Recognizing Problems; Working Toward Solutions: Part 3. Access to Care
This column is the third in a series summarizing the 2-day Centennial Conference of the Austen Riggs Center. The conference framed problems in access to care and in the nature of care provided that are part of a mental health crisis in America and then worked to propose solutions. This column addresses problems with access to care and summarizes the conference’s closing keynote by Peter Fonagy, PhD, OBE, addressing issues both of access to care and of the nature of care provided. These issues play roles in ultimately “bending the curve” to improve outcomes for those struggling with mental and substance us...
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Columns Source Type: research

The 5% of the Population at High Risk for Severe COVID-19 Infection Is Identifiable and Needs to Be Taken Into Account When Reopening the Economy
The goal of this column is to help mental health care professionals understand coronavirus disease 2019 (COVID-19) so that they can better explain the complexities of the current crisis to their patients. The bottom-line of this column is that, while COVID-19 can infect virtually everyone in the human population, only about 5% are susceptible to severe infection requiring admission to an intensive care unit and/or causing a fatal outcome and this population can be identified on the basis of comorbid medical illness and/or age. These numbers are based on experience in China, the United States, and Europe. Table 1 presents a...
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Columns Source Type: research

Mental Health Care Providers Dealing With Coronavirus Disease 2019 (COVID-19): What Is the Definition of a Case, How Is That Changing, and What Kinds of Tests Are Available?
The goal of this column is to inform mental health care professionals about the evolving way the diagnosis of Coronavirus Disease 2019 (COVID-19) is being made, with emphasis on tests to assist in making the diagnosis and to determine the presence of antibodies to the virus. This column also provides some general information about the disease, its relative risks, and efforts to develop effective treatments. Links to credible websites that are being continuously updated are also provided for readers who want more information and to stay current with ongoing developments. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Columns Source Type: research

Postpartum Mental Health Care for Mothers of Multiples: A Qualitative Study of New Mothers’ Treatment Preferences
Conclusions: This study lays the groundwork for the development of a targeted psychosocial intervention to address mental health concerns among new mothers of multiples, particularly those who are already engaged and seeking support and community online. This report also suggests myriad ways in which providers can best address the needs of this population (eg, utilize providers with expertise in multiples, deliver care in the home, use e-health approaches, and normalize unique stressors and negative moods). (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

Panic Disorder Correlates With the Risk for Sexual Dysfunction
Conclusions: Although the results were mixed, it appears that patients with panic disorder tended to be more susceptible to sexual dysfunction than the general population. Further trials with larger sample sizes and rigorous research designs are needed to establish the relationship between sexual dysfunction and panic disorder. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

Obsessive-Compulsive Disorder in Older Adults: A Comprehensive Literature Review
We reviewed English-language articles concerning obsessive-compulsive disorder (OCD) in older adults. PubMed was searched using key words that included obsessive-compulsive disorder, geriatric, elderly, aging, and older. Of the 644 articles identified, we included 78 that were relevant to the topic. Articles that were excluded as irrelevant included studies that were not focused on OCD in older adults, animal studies, and older case reports if we identified similar more recent case reports. The literature contains very little information about the epidemiology, diagnosis, psychopathology, and treatment of OCD in older adul...
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

The Impact of Personality Pathology on Treatment Outcome in Late-life Panic Disorder
Conclusions: Cluster B pathology had a detrimental effect on CBT treatment outcome for panic disorder in both age groups. In late-life panic disorder with comorbid personality pathology, CBT may be preferred over treatment with paroxetine. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

Finding the Best Balance
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2020 Category: Psychiatry Tags: From the Editor Source Type: research

Acknowledgment of Peer Reviewers
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Acknowledgment of Peer Reviewers Source Type: research

Handbook of Mentalizing in Mental Health Practice, Second Edition
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Book Review Source Type: research

Documentation Practices for Transgender Youth Admitted to an Inpatient Psychiatric Unit
Conclusions: Findings from this study suggest that inpatient treatment teams show inconsistency in documentation practices for youth transgender inpatients. Further work is necessary to understand the implications of these findings for patient satisfaction and clinical outcomes. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Practitioner's Corner Source Type: research

Parent-led Behavioral Intervention for a Treatment-refusing Adult With Obsessive-Compulsive Disorder With Poor Insight and Extreme Family Accommodation
Obsessive-compulsive disorder (OCD) with poor insight can contribute to the refusal to receive treatment, leaving the burden of care on parents or other caregivers. The case presented here involved a young adult with OCD with delusional levels of insight paired with extreme family-accommodating behaviors that had resulted in impaired quality of life and functioning for the young adult and his parents. A parent-led behavioral intervention [The Supportive Parenting for Anxious Childhood Emotions (SPACE)] that was developed for children with anxiety was adapted and utilized for a young adult with severe OCD. The case presents...
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Tianeptine Abuse Leading to an Episode of Psychosis: A Case Report and Literature Review
Tianeptine is an atypical mu-opioid receptor agonist. It is available as an antidepressant outside the United States, but it is also classified as a controlled substance in many other countries. It is not approved by the United States Food and Drug Administration for the treatment of depression but it can be obtained online without a prescription. The case described in this article involved a patient who developed symptoms of psychosis on supratherapeutic doses of tianeptine, highlighting the importance of inquiring into all supplements taken by patients when conducting an initial psychiatric evaluation. (Source: Journal o...
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Blackout Versus Pass Out in Allegations of Alcohol-involved Sexual Assault: Why Knowing the Difference Matters
It is common for not only laypersons but also courts, witnesses, attorneys, and even some experts involved in a criminal sexual assault investigation to confuse the terms “blackout” and “pass out” when referring to the memory, consciousness, and other behavioral ramifications of alcohol intoxication. A typical alcohol-involved sexual assault allegation often includes the partial or total absence of memory for events of the alleged incident. The etiology and behavioral presentations of the types of alcohol-induced memory deficiency evidenced are not all created equal and understanding the differences...
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Columns Source Type: research

The Mental Health Crisis in America: Recognizing Problems; Working Toward Solutions: Part 2. Offering Hope Through Engagement
This column is the second in a series summarizing the 2-day Centennial Conference of the Austen Riggs Center. The conference framed problems in access to care and in the nature of the care being provided that are part of a mental health crisis in America, and then worked to propose solutions. This column addresses problems with the nature of care provided, proposing psychodynamic perspectives that offer hope through engagement. Such approaches play a role in “bending the curve” to improve mental health outcomes. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Columns Source Type: research

Drug-Drug Interactions (DDIs) in Psychiatric Practice, Part 9: Interactions Mediated by Drug-metabolizing Cytochrome P450 Enzymes
This column is the ninth in a series exploring drug-drug interactions (DDIs) with a special emphasis on psychiatric medications. The first 3 columns in this DDI series discussed why patients being treated with psychiatric medications are at increased risk for taking multiple medications and thus experiencing DDIs, how to recognize such DDIs, strategies for avoiding and/or minimizing adverse outcomes from such DDIs, and pharmacokinetic considerations concerning DDIs in psychiatric practice. The fourth and fifth columns in this series presented a pair of parallel tables, one of which outlined the primary, known mechanism(s) ...
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Columns Source Type: research

Group Intervention for Young Adults With Mood and Anxiety Disorders Transitioning to College
Young adults with chronic mood and anxiety disorders may receive a range of services in pediatric care (eg, psychiatry, therapy) and within the school system (eg, individualized education plans). Such services rely on the involvement of parents or guardians to support youth (eg, attending appointments, administering medications). However, in college, young adults are often on their own and need to assume responsibility for scheduling appointments, obtaining and taking medications, and seeking out additional services (eg, accommodations). Unfortunately, many young adults may not have developed the skills needed to navigate ...
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

Obsessive-Compulsive Symptoms in Obsessive-Compulsive Disorder and in Generalized Anxiety Disorder: Occurrence and Correlations
Conclusions: The study revealed that patients with GAD often have coexisting obsessive-compulsive symptoms, which may not be identified during routine psychiatric examination. Obsessive-compulsive symptoms observed in patients with GAD may show a different structure than obsessive-compulsive symptoms in patients with OCD. The results of this study suggest that compulsions are more specific for the diagnosis of OCD than obsessions. Compulsions, such as counting related to the need for order and symmetry, may be associated with some cognitive dysfunctions and male sex, a finding that requires further research. (Source: Jou...
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

The Efficacy of PowerPoint-based CBT Delivered Through Email: Breaking the Barriers to Treatment for Generalized Anxiety Disorder
Conclusions: Delivery of PowerPoint e-CBT modules via email was found to be a viable method for delivering CBT to individuals with GAD and a simple method for overcoming language, cultural, and travel barriers to accessing mental health resources. This simplified approach to the individualization and delivery of treatment modules has the potential to improve access to CBT as a treatment option throughout the world. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

Digital Opportunities for Outcomes in Recovery Services (DOORS): A Pragmatic Hands-On Group Approach Toward Increasing Digital Health and Smartphone Competencies, Autonomy, Relatedness, and Alliance for Those With Serious Mental Illness
This article introduces the need and theoretical foundation for and the experience of running the resulting Digital Opportunities for Outcomes in Recovery Services (DOORS) group in the setting of 2 programs: a first-episode psychosis program and a clubhouse for individuals with serious mental illness. The experience of running these 2 DOORS groups resulted in 2 publicly available, free training manuals to empower others to run such groups and adapt them for local needs. Future work on DOORS will expand the curriculum to best support digital health needs and increase equity of access to and knowledge and skills related to t...
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

Digital Psychiatry
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2020 Category: Psychiatry Tags: From the Editor Source Type: research

Silent Virtues: Patience, Curiosity, Privacy, Intimacy, Humility, and Dignity
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Book Review Source Type: research

An Inpatient Psychiatric Program Targeting Opioid Overdoses
The United States is currently experiencing an opioid epidemic, as drug overdose deaths have become a leading cause of death. According to the Centers for Disease Control, in 2017, opioids were responsible for 47,000 deaths, which involved both illicit and prescription opioids. A multifaceted public health approach that utilizes public health authorities, health care providers, local hospitals, and affected communities is required to effectively reduce opioid-related morbidity and mortality. The authors of this paper developed an inpatient program on the dual-diagnosis unit at Gracie Square Psychiatric Hospital in New York...
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Practitioner's Corner Source Type: research

Adapting Dialectical Behavior Therapy for Treating Problematic Interactive Media Use
This article documents the therapeutic benefit of dialectical behavior therapy (DBT) adapted to treat PIMU and applied to a 15-year-old male individual with a history of dysregulated use of the Internet in the categories of gaming, pornography, information-bingeing, and social media. Outcomes were measured by diary cards, documenting the patient’s affective states, urges to engage in PIMU, the number of times he acted upon these urges, and collateral information provided by both parents and teachers from his school. Over the course of a 7-module DBT intervention covered during 14 sessions, the patient showed improvem...
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Commentary on “Bosch-Boonstra-Schaaf Optic Atrophy Syndrome Presenting as New-Onset Psychosis in a 32-Year-Old Man: A Case Report and Literature Review”
Bosch-Boonstra-Schaaf optic atrophy syndrome (BBSOAS) is a recently described autosomal dominant disorder caused by mutations in the nuclear receptor subfamily 2 group F member 1 (NR2F1) gene. Its common features include optic atrophy and/or hypoplasia, developmental delay, intellectual disability, attention deficit disorder, autism spectrum disorder, seizures, hearing defects, spasticity, hypotonia, and thinning of the corpus callosum. Mitochondrial involvement has also been described with BBSOAS. Currently, 31 cases of BBSOAS have been described in the literature. Here we report a case of undiagnosed BBSOAS presenting as...
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Bosch-Boonstra-Schaaf Optic Atrophy Syndrome Presenting as New-Onset Psychosis in a 32-Year-Old Man: A Case Report and Literature Review
Bosch-Boonstra-Schaaf optic atrophy syndrome (BBSOAS) is a recently described autosomal dominant disorder caused by mutations in the nuclear receptor subfamily 2 group F member 1 (NR2F1) gene. Its common features include optic atrophy and/or hypoplasia, developmental delay, intellectual disability, attention deficit disorder, autism spectrum disorder, seizures, hearing defects, spasticity, hypotonia, and thinning of the corpus callosum. Mitochondrial involvement has also been described with BBSOAS. Currently, 31 cases of BBSOAS have been described in the literature. Here we report a case of undiagnosed BBSOAS presenting as...
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

The Mental Health Crisis in America: Recognizing Problems; Working Toward Solutions: Part 1. Defining the Crisis
This column is the first in a series summarizing the 2-day Centennial Conference of the Austen Riggs Center. The conference framed problems in access to care and in the nature of care provided that are part of a mental health crisis in America, and then worked to propose solutions. This column focuses on framing the problems and on beginning to address what it might take to “bend the curve” in mental health outcomes. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Columns Source Type: research

Drug-Drug Interactions (DDIs) in Psychiatric Practice, Part 8: Relative Receptor Binding Affinity as a Way of Understanding the Differential Pharmacology of Currently Available Antidepressants
This column is the eighth in a series exploring drug-drug interactions (DDIs) with a special emphasis on psychiatric medications. The first 3 columns in this DDI series discussed why patients being treated with psychiatric medications are at increased risk for taking multiple medications and thus experiencing DDIs, how to recognize such DDIs, strategies for avoiding and/or minimizing adverse outcomes from such DDIs, and pharmacokinetic considerations concerning DDIs in psychiatric practice. The fourth and fifth columns in this series presented a pair of parallel tables, one of which outlined the primary, known mechanism(s)...
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Columns Source Type: research

Repetitive Transcranial Magnetic Stimulation in the Treatment of Bipolar Depression: Experience From a Clinical Setting
Conclusions: Our data suggest that rTMS may be equally effective and safe for patients with both unipolar and bipolar depression. Patients with bipolar TRD showed a similar response profile over treatment time compared with patients with unipolar TRD. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

A Randomized Study Comparing the Short-Term Neurocognitive Outcome of Electroconvulsive Therapy Versus Repetitive Transcranial Magnetic Stimulation in the Treatment of Patients With Depression
Conclusions: rTMS was well tolerated with less negative impact on cognitive functioning than ECT. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

Availability of Buprenorphine Treatment in the 10 States With the Highest Drug Overdose Death Rates in the United States
The objective of this study was to assess the accuracy of the Substance Abuse and Mental Health Services Administration (SAMHSA) database for patients who use it to seek buprenorphine treatment. Design and Measurements: Buprenorphine providers within a 25-mile radius of the county with the highest drug-related death rates within the 10 states with the highest drug-related death rates were identified and called to determine whether the provider worked there, prescribed buprenorphine, accepted insurance, had appointments, or charged for visits. Results: The number of providers listed in each county ranged from 1 to 166...
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

Personality Factors and Attachment Styles as Predictors of the Therapeutic Efficacy of a Short-Term Ambulatory Intervention for Depression
In this study, we evaluated sociodemographic factors, and scores on the Global Assessment of Functioning Scale, the Big Five Inventory personality assessment, the Montgomery-Åsberg Depression Rating Scale, and the Adult Attachment Scale. Results: Mean scores on the Montgomery-Åsberg Depression Rating Scale decreased significantly from 26.3 (SD=9.0) at admission to 10.6 (SD=8.1) at the end of the CIn (t=23.9; P (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: Articles Source Type: research

Opioids
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2020 Category: Psychiatry Tags: From the Editor Source Type: research

Physician Suicide: Cases and Commentaries
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Book Reviews Source Type: research

The Diagnosis and Management of Agitation
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Book Reviews Source Type: research

Categorizing Cannabis and Alcohol Use Patterns of Emerging Adults in Psychiatric Partial Hospitalization Treatment
Background: Emerging adulthood is a common and problematic time for alcohol and cannabis use. Emerging adulthood also represents a vulnerable time period for anxiety and depression. Substance use and mental health issues are highly comorbid, yet substance use is commonly neglected in psychiatric care. Objective: The goal of this study was to categorize the cannabis and alcohol use patterns of emerging adults in psychiatric care and to evaluate relationships with use-related problems, psychiatric symptomatology, and motives for use. Methods: Participants were emerging adults who were consecutive admissions to a youn...
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Practitioner's Corner Source Type: research

Psychotic Disorders in Patients Who Use Synthetic Cannabinoids
Conclusions: Our study revealed that psychotic symptoms are typical manifestations in association with intoxication with synthetic cannabinoids, and we identified several nonspecific characteristics of the psychoses that may occur in patients intoxicated with synthetic cannabinoids. We also identified a number of signs that may indicate the presence of substance-induced psychoses. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Practitioner's Corner Source Type: research

Catatonia Due to Tacrolimus Toxicity 16 Years After Renal Transplantation: Case Report and Literature Review
We report a novel case of tacrolimus-induced encephalopathy that developed 16 years after renal transplantation while the drug was at a therapeutic level. Discontinuation of tacrolimus and switching to an alternative immunosuppressant resulted in significant clinical improvement over 1 week. Our experience illustrates the possibility of acute neurotoxicity from tacrolimus even when the patient has tolerated the drug for 16 years and drug levels are within the therapeutic range. This case also highlights the importance of collaboration between psychiatry and transplant clinicians. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Commentary on “Synchrony Between Bipolar Mood Cycles and Lunar Tidal Cycles Ended After Initiation of Light Treatment and Treatment of Hypothyroidism”
According to a recent report, mood cycles in a group of patients with rapid cycling bipolar disorder oscillated in synchrony with lunar gravimetric tides. Mood switches in a 67-year-old woman with rapid cycling bipolar II disorder on lithium maintenance treatment were assessed with a χ2 periodogram and a χ2 analysis of the mood switches in relation to the lunar tidal cycle. During a period when she was treated with nortriptyline and her thyroid-stimulating hormone levels were elevated, her mood switches had a significant (P (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Synchrony Between Bipolar Mood Cycles and Lunar Tidal Cycles Ended After Initiation of Light Treatment and Treatment of Hypothyroidism
According to a recent report, mood cycles in a group of patients with rapid cycling bipolar disorder oscillated in synchrony with lunar gravimetric tides. Mood switches in a 67-year-old woman with rapid cycling bipolar II disorder on lithium maintenance treatment were assessed with a χ2 periodogram and a χ2 analysis of the mood switches in relation to the lunar tidal cycle. During a period when she was treated with nortriptyline and her thyroid-stimulating hormone levels were elevated, her mood switches had a significant (P (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Welfare Checks and Therapeutic Risk Management
In clinical practice, welfare checks have become a fairly common aspect of suicide prevention. At the same time, the medical literature provides almost no guidance to inform clinicians under what circumstances welfare checks should be requested, how best to go about placing those requests, or how to document decision-making related to this important subject. Literature searches spanning both PubMed and Google Scholar failed to yield any applicable results. Performed correctly, welfare checks have the potential to be life-saving interventions for persons in suicidal crises. Performed incorrectly, welfare checks may become a...
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Columns Source Type: research

Psychotherapy in Psychiatry: Fighting Alternative Facts
In the Canadian province of Ontario, the Ministry of Health and Long-Term Care is proposing to impose arbitrary limits on access to psychotherapy provided by physicians. This column presents and debunks 3 myths associated with this ill-conceived proposal: (1) that long-term psychotherapy costs the health care system too much money, making it necessary for the government to curb this spending; (2) that long-term psychotherapy is a non–evidence-based treatment being needlessly spent on the worried well; and (3) that we need to focus on quick treatments, not long ones. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Columns Source Type: research

Drug-Drug Interactions (DDIs) in Psychiatric Practice, Part 7: Relative Receptor Binding Affinity as a Way of Understanding the Differential Pharmacology of Currently Available Antipsychotics
This column is the seventh in a series exploring drug-drug interactions (DDIs) with a special emphasis on psychiatric medications. The first 3 columns in this DDI series discussed why patients being treated with psychiatric medications are at increased risk for taking multiple medications and thus experiencing DDIs, how to recognize such DDIs, strategies for avoiding and/or minimizing adverse outcomes from such DDIs, and pharmacokinetic considerations concerning DDIs in psychiatric practice. The fourth and fifth columns in this series presented a pair of parallel tables, one of which outlined the primary, known mechanism(s...
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Columns Source Type: research

Feasibility and Acceptability of a Lifestyle Intervention For Individuals With Bipolar Disorder
Individuals with bipolar disorder are at greater risk for cardiovascular disease and are less likely to adhere to lifestyle interventions than the general population. To decrease cardiovascular risk and improve adherence to lifestyle interventions, we developed the Nutrition Exercise and Wellness Treatment (NEW Tx). NEW Tx is an 18-session, 20-week cognitive behavioral therapy–based treatment comprising 3 modules: Nutrition, Exercise, and Wellness. To evaluate the feasibility and acceptability of this intervention as well as predictors of treatment satisfaction and expectations, 38 adult outpatients with bipolar diso...
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Articles Source Type: research

Psychological Function, Iyengar Yoga, and Coherent Breathing: A Randomized Controlled Dosing Study
Conclusions: Improvement in psychological symptoms correlated with cumulative yoga practice. Both interventions reduced symptoms of depression and anxiety and increased feelings of positivity. The time commitment for yoga practice needs to be weighed against benefits when designing yoga interventions. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2019 Category: Psychiatry Tags: Articles Source Type: research