Human Trafficking: A Treatment Guide for Mental Health Professionals
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Book Review Source Type: research

Commentary: Diagnostic and Treatment Issues in Psychosis
The 3 cases presented in this issue highlight challenges in evaluating and treating patients with psychotic symptoms. The first case involved the rare but debilitating condition of periodic catatonia, the second case involved the use of intranasal oxytocin to augment an antipsychotic for a patient with worsening psychotic symptoms (and a prior diagnosis of schizophrenia) in the postpartum period, and the third case involved auto-enucleation (often referred to as “Oedipism”), a violent form of self-mutilation, in a patient presenting with first-episode schizophrenia. These case reports reinforce the need to cons...
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

The Vision of Blindness—Sight Versus Insight: A Case Report and Literature Review of Self-enucleation (Oedipism)
We present a case of bilateral self-enucleation by a young male patient in the context of his first episode of psychosis and review the literature on this clinical entity. Ocular damage interferes significantly with activities of daily living and is associated with decreased quality of life so that identifying risk factors is of major importance to prevent this dangerous behavior. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Add-on Oxytocin in the Treatment of Postpartum Acute Schizophrenia: A Case Report
An increasing body of research has been published concerning the potential impact of oxytocin (OT) in the pathophysiology of neuropsychiatric disorders that affect social functioning, such as schizophrenia. The possible therapeutic effect of OT in promoting mother-child bonding could be valuable in the management of postpartum psychosis. Studies on the efficacy of OT as an add-on therapy in the treatment of schizophrenia have found reductions in both positive and negative symptoms. The patient in the case reported here developed her second psychotic episode at the age of 22, a month after delivering her first child. Four w...
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Periodic Catatonia: Long-term Treatment With Lamotrigine: A Case Report
Periodic catatonia is a rare form of catatonia, characterized by episodes occurring in a cyclic pattern with clinical features of combined stupor and excitement, with intervals of remission. Although periodic catatonia is not common, it is an urgent condition, requiring hospitalization for evaluation and treatment. The management of periodic catatonia is quite challenging, mainly because of the unknown pathophysiological mechanisms involved in the onset of this clinical entity, which are less clear than in other forms of catatonia. Although positive trials of several medications in the acute phase of periodic catatonia hav...
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Treatment of Cannabinoid Hyperemesis With Olanzapine: A Case Series
The use and availability of cannabis for recreational and medical purposes has become more widespread with increased legalization. Adverse health outcomes of this increased use include cannabinoid hyperemesis syndrome (CHS), which is underrecognized in medical settings. Cessation of substance use is the recommendation of choice for the complete resolution of CHS. However, interventions that provide rapid relief may be necessary in treatment-refractory cases. Little evidence is available to guide care in these cases. Here we report 4 cases of treatment-refractory CHS, all of which remitted after treatment with olanzapine. O...
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research

Evaluating a Multicomponent Strategy to Address Burnout, Job Engagement, and Job Satisfaction Among Telepsychiatrists
Conclusions: Given the risk for social, professional, and academic isolation among telepsychiatrists, organizational engagement efforts are advisable, feasible, and may be associated with significant improvement in satisfaction and retention among telepsychiatrists. Our findings have important implications for enhancing the performance and job satisfaction of telepsychiatrists and potentially reducing burnout rates in this population of providers. Practical Applications: Effective strategy efforts included: (1) enhancing and standardizing recruitment efforts to ensure proper matching of the psychiatrist with org...
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research

Therapeutic Risk Management for Violence: Safety Planning for Other-directed Violence
Therapeutic management of risk for other-directed violence (ODV) involves screening, assessment, and clinically appropriate intervention. In this 5-part series, effective screening and assessment for ODV have been described as a combination of clinical interviewing and the use of structured tools to inform clinical impressions of both acute and chronic risk for violence. Once risk of violence is identified, therapeutic management of the risk throughout the course of treatment is best achieved by determining the function of the violent ideation and behavior. This can be achieved through the use of functional chain analysis....
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

Providing a Routine Medical Necessity Letter to Improve Access to Care for Our Patients
This column explains the value of developing routine medical necessity letters to help patients maximize the likelihood of securing insurance approval for medically necessary services for the treatment of mental and substance use disorders, including psychotherapeutic treatment. The structure proposed for such medical necessity letters is based on the terms of the Mental Health Parity and Addiction Equity Act and the landmark verdict in the federal class action known as Wit v. United Behavioral Health/Optum. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

Charting and Handling Therapeutic Drug Monitoring Results: How they Differ From Most Laboratory Results
Therapeutic drug monitoring (TDM) results are a biological measure of the ability of the patient to clear a drug as long as the patient is adhering to the prescribed dosage. If the patient is not adherent, then TDM can provide evidence of such nonadherence. To properly interpret TDM results, several variables must be considered. First and foremost is the dose the patient is supposed to be taking. The second variable is whether the patient should have achieved a steady-state condition, which means that the amount of drug the patient is taking in a day is equal to the amount the patient is eliminating in the same day so that...
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

Exercise Prescription Practices to Improve Mental Health
Conclusions: Exercise is recognized by most clinicians as a therapeutic option for psychiatric conditions. Despite this recognition, only a small proportion provide recommendations consistent with national guidelines or empirical research. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Resident Paper Winner Source Type: research

Can Nonoffending Pedophiles Be Reached for the Primary Prevention of Child Sexual Abuse by Addressing Nonoffending Individuals Who Are Attracted to Minors in the United States? New Strategies With The Global Prevention Project
This paper introduces a new prevention strategy against child sexual abuse (both offline and online) in the United States. The Global Prevention Project is a supportive treatment program designed for nonoffending minor-attracted persons who reside in the community. Attraction to minors and the underlying scientific terms (pedophilia/hebephilia) are discussed and a framework is provided for how to implement such a program in the United States. Our treatment modality is described to provide transparency in our clinical work. We discuss challenges encountered in this domain with possible solutions and the legal ramifications ...
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

Mental Health and COVID-19: Challenges and Multimodal Clinical Solutions
The Coronavirus Disease 2019 (COVID-19) pandemic has led to an exponential rise in mental health issues. Studies have shown that, in times of increased unemployment rates and economic downturn, rates of mental health issues, suicide, substance use, and domestic violence tend to increase. Barriers to care, including stigma and decreased access to providers, contribute to morbidity and mortality. Telehealth services are being utilized to help increase access to care, and economic stimulus packages have been created to help with the financial burden that is often associated with increased mental health stressors. Efforts to p...
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

Using a Patient Safety/Quality Improvement Model to Assess Telehealth for Psychiatry and Behavioral Health Services Among Special Populations During COVID-19 and Beyond
Telehealth has been rapidly deployed in the environment of the Coronavirus 2019 (COVID-19) pandemic to help meet critical mental health needs. As systems of care use telehealth during the pandemic and evaluate the future of telehealth services beyond the crisis, a quality and safety framework may be useful in weighing important considerations for using telehealth to provide psychiatric and behavioral health services within special populations. Examining access to care, privacy, diversity, inclusivity, and sustainability of telehealth to meet behavioral and psychiatric care needs in geriatric and disadvantaged youth populat...
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

Exercise
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2021 Category: Psychiatry Tags: From the Editor Source Type: research

Clinical Manual of Youth Addictive Disorders
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Book Review Source Type: research

Commentary: Diagnostic Challenges in Evaluating Adolescents
Three cases presented in this issue highlight diagnostic challenges in evaluating adolescents, in particular those with a constellation of symptoms that includes hallucinations. These cases raise the question of the accuracy of patient reports and the importance of further exploring symptoms before rushing to a diagnosis or treatment. The first case involved an 18-year-old female patient with Cotard syndrome. She had the syndrome’s typical delusions and hallucinations, but her case was unusual because this syndrome is more common in adults and usually involves prominent mood symptoms. The second case involved a 14-ye...
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Hearing Voices and Seeing Things: Symptoms of Anxiety Misconstrued as Evidence of Schizophrenia in an Adolescent
We report the case of a 16-year-old whose cartoon-like hallucinations had led to the diagnosis of schizophrenia and had directed attention of the patient, her parents, and her clinicians away from critical issues of anxiety, depression, learning difficulties, and traumatic school experiences. This case illustrates how the diagnosis of schizophrenia can be driven by the prominence and vividness of psychotic-like symptoms reported by a patient, the expectation that patients’ chief complaints must be directly and immediately addressed, insufficient attention to collateral information, and the distortions of a “che...
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Sexually Predatory Behavior in an Adolescent Female
This report describes a rare case of an adolescent female with a history of unspecified depressive disorder, disinhibited social engagement disorder, and significant history of sexual trauma at an early age, who initially presented with suicidal ideation. During the initial evaluation, the patient was found to have engaged in sexually predatory behavior toward younger boys, including solicitation and inappropriate sexual behavior. This report discusses relevant literature on the prevalence, risk factors, and treatment for this behavior among female adolescent sexual predators, as sex offenders are primarily thought to be m...
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Cotard Syndrome in an Adolescent With a First Episode of Psychosis
This report describes a unique presentation of full Cotard syndrome in an adolescent patient experiencing first-episode psychosis without reported mood symptoms. The patient displayed limited improvement over the first week of treatment with quetiapine but improved rapidly during the second week of hospitalization after a medication change to risperidone. The patient’s rapid response to risperidone is unique, as most existing evidence suggests that electroconvulsive therapy is the most effective treatment for Cotard syndrome. This response indicates an opportunity for the implementation of a second-generation antipsy...
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Feasibility of a Manualized Mindful Yoga Intervention for Patients With Chronic Mood Disorders
Chronic mood disorders pose an important mental health problem. Individuals with these disorders experience a significant impairment, often fail to seek help, and their illnesses frequently do not respond to treatment. It is therefore important to develop innovative and attractive treatments for these disorders. Mindful yoga represents a promising treatment approach. This pilot study tested the feasibility of a 9-week manualized mindful yoga intervention for patients with chronic mood disorders. Eleven patients receiving standard treatment were recruited to complete a 9-week mindful yoga intervention. Qualitative methods w...
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research

Therapeutic Risk Management for Violence: Chain Analysis of Other-directed Violent Ideation and Behavior
Violence risk assessment is a requisite component of mental health treatment. Adhering to standards of care and ethical and legal requirements necessitates a cogent process for conducting, and then documenting, other-directed violence (ODV) risk screening, assessment, and management. In this 5-part series, we describe a model for achieving therapeutic risk management of the potentially violent patient, with essential elements involving: clinical interview augmented by structured screening or assessment tools; risk stratification in terms of temporality and severity; chain analysis to intervene on the functions of ODV ideat...
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

Improving Access to Psychotherapy: Implications of Wit Versus United Behavioral Health
This column summarizes the verdict in the federal class action known as Wit v United Behavioral Health (UBH)/Optum, highlighting the verdict’s implications for increasing access to care, implementing the mental health parity law, and reducing health disparities. Achieving these results requires recognition of the verdict as more than simply a nice news story, but as a decision that actually offers individual clinicians, their professional organizations, as well as patients, families, and their consumer organizations, a powerful tool for implementing change if they take up the task of learning how to use it. The verdi...
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

Charting and Handling Genetic Test Results: How They Differ From Most Laboratory Results
Genetic tests, unlike most other laboratory tests, are trait rather than state tests. That means the results almost always stay the same. Exceptions to this rule are discussed in this column. Trait tests require documentation in such a way that they are not buried in the chart and forgotten, as usually happens with state (or point-in-time tests) such as serum potassium levels. Genetic test results and their implications should be explained to the patient in as much detail as possible and also shared and discussed with all health care providers treating the patient. This column explains the rationale for and the means to ac...
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

Reasons for Participation and Nonparticipation in Psychological Relapse Prevention for Anxiety and Depression: A Qualitative Study
Conclusions: Psychoeducation on relapse should be provided to patients to help them relate recurrence risks to themselves. RPIs should also be individually tailored. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

The Interface of COVID-19 and Inpatient Psychiatry: Our Experience and Lessons Learned
We present our experience, lessons learned, and recommendations should a resurgence of the pandemic or a similar crisis occur. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

Objective and Subjective Perspectives on Implementation of a Violence Risk Screening Program in an Emergency Department
Conclusions: The providers indicated that they believed the violence risk screening and suicide screening procedures helped improve clinical thoroughness and documentation. Ongoing feedback between providers and program developers was beneficial. The implementation of the universal suicide screening process was relatively seamless for these providers. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

Crisis Intervention Psychotherapy in the Age of COVID-19
This article reviews the history of critical incident stress management and the use of its replacement, psychological first aid. The history and core principles of crisis psychotherapy and 8 core elements of treatment are described. The use of digital and virtual technology has enabled the delivery of crisis psychotherapy during the COVID-19 pandemic. A case study of a family impacted by COVID-19 is reported as an illustration. The use of a 6-week timeline, an ecological map, and a problem-solving wheel-and-spoke treatment plan are demonstrated. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

The New Normal
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2021 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, 2021 Category: Psychiatry Tags: Acknowledgment of Peer Reviewers Source Type: research

The American Opioid Epidemic: From Patient Care to Public Health
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Book Review Source Type: research

Commentary on 2 Cases of Neuropsychiatric Symptoms Occurring in Association With COVID-19
Two cases are presented involving neuropsychiatric symptoms occurring in the context of coronavirus disease 2019 (COVID-19) infections. The first case involved a middle-age man with no known psychiatric history who presented with acute psychotic symptoms (delusions, hallucinations, disorganization) after recovery from a recent respiratory illness. This patient tested positive for COVID-19 on admission. The patient’s symptoms were not consistent with delirium and testing did not suggest a neurological etiology. The patient’s psychosis eventually resolved 6 weeks after its abrupt onset with treatment with antipsy...
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Suspected Recurrence of Symptomatic COVID-19: Management During Inpatient Psychiatric Treatment
We report a case of recurrence of respiratory symptoms and positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) testing in a patient on an inpatient psychiatric unit occurring 42 days after the initial positive SARS-CoV-2 RT-PCR test, 38 days after initial symptom resolution, and 30 days after the first of 3 negative SARS-CoV-2 RT-PCR tests. Over the course of the admission, the patient was safely initiated on clozapine. Recent literature on COVID-19’s potential recurrence and neuropsychiatric effects is reviewed and implications for the manage...
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Abrupt Late-onset Psychosis as a Presentation of Coronavirus 2019 Disease (COVID-19): A Longitudinal Case Report
We present a longitudinal case of COVID-19 psychosis in a patient who underwent comprehensive diagnostic evaluation. This case is a contribution to the inchoate characterization of neuropsychiatric manifestations of COVID-19 infection. Case Report: We present a case of late-onset psychosis in a middle-aged man with no psychiatric history who tested positive for COVID-19 on admission following a recently resolved upper respiratory illness. His acute presentation—characterized by delusions, hallucinations, and disorganized thought and behavior, for which he required inpatient medical admission and subsequent inp...
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Postviral Depression
A previously healthy 68-year-old man rapidly developed a severe melancholic depression following influenza infection. There is an evolving understanding of the complex and possibly bidirectional relationship between depression and inflammation. We review the literature concerning this relationship in the context of viral infection and discuss possible implications for treatment. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Moving Forward While Standing Still: A Case of Mental Health Advocacy Evolving in the Time of COVID-19
There have been shifts over time in the value placed on long-term psychotherapeutic modalities even though they can be life-saving. For example, the province of Ontario in Canada has been dealing with a government proposal put forward in 2019 to limit the length of psychotherapy treatment. In response, stakeholders from numerous groups came together to advocate for the importance of continuing unrestricted access to long-term psychotherapy. Approaches to this advocacy then had to unexpectedly adapt to the Coronavirus Disease 2019 (COVID-19) pandemic that came to the forefront in 2020 and will continue to develop in respons...
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

Consistency of the Antidepressant Effect of Intranasal Esketamine in Phase 3 Clinical Trials
This column reviews the development of intranasal esketamine with particular emphasis on the consistency of the clinical trial results. In the process, it illustrates methodological issues important in the approval process by an agency such as the United States Food and Drug Administration. Topics covered include the importance of study design, the nature of the comparator, and the prespecified statistical analysis plan. The column also discusses what is considered a positive versus a supportive study and the differences between phase 2 and phase 3 studies and the rationale for including both in the development process. Wh...
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

Pilot Study of a Brief Sleep Intervention for Suicidal Ideation in Bipolar Disorder
Objective: We investigated the feasibility and acceptability of a brief sleep intervention and sleep monitoring device in bipolar disorder (BD), as well as the intervention’s effectiveness in reducing suicidal ideation through improved sleep quality and duration. Methods: Participants (N=13) with BD received 4 sessions of cognitive-behavioral therapy for sleep disturbance and completed assessments of the intervention and sleep device acceptability, mood, suicidal ideation, and sleep at pretreatment and posttreatment. Results: Feasibility and acceptability of the intervention were high at both pretre...
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

The Psychiatric Inpatient Multidisciplinary Team Meeting: A Model for Current Practice
The multidisciplinary treatment team meeting (MTTM) has been the central forum for treatment planning and clinical decision-making on many psychiatric inpatient units for decades. While the principles underlying MTTMs were described in the distant past, a detailed model for how these meetings are structured and how they function has not been well presented. In an era of very brief hospital lengths of stay, collaborative, thoughtful, comprehensive, and efficient team meetings have become increasingly important. The goal of this article is to describe a highly structured, successful MTTM model that borrows heavily from an in...
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

Improving Psychiatric Care Through Integrated Digital Technologies
This manuscript provides an overview of our efforts to implement an integrated electronic monitoring and feedback platform to increase patient engagement, improve care delivery and outcome of treatment, and alert care teams to deterioration in functioning. Patients First utilizes CareSense, a digital care navigation and data collection system, to integrate traditional patient-reported outcomes monitoring with novel biological monitoring between visits to provide patients and caregivers with real-time feedback on changes in symptoms such as stress, anxiety, and depression. The next stage of project development incorporates ...
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

A Naturalistic Study of Outcomes for Durable Remission in Patients With Bipolar Disorder
The objective of the current study was to determine the status of the patients after 3 additional years, as well as the medications associated with remission. Methods: Data were extracted from clinical records. The criteria for remission in both the original study and the follow-up were 12 continuous months of euthymia, mild symptoms, and no clinical relapse. Active illness was defined as (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: Articles Source Type: research

A Study in Contrasts: Technology Versus “Humanology”
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2021 Category: Psychiatry Tags: From the Editor Source Type: research

Rational Psychopharmacology: A Book of Clinical Skills
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2021 Category: Psychiatry Tags: Book Review Source Type: research

Multidisciplinary Management of a Frequent Attender With Pyrexia of Unknown Origin and Psychotic Symptoms
This case report details the multidisciplinary management of a frequent attender in his early 50s with no fixed abode who presented with pyrexia of unknown origin, complicated by his noncooperation with intervention and treatment because of the development of psychotic symptoms. The case required the involvement of liaison psychiatry, anesthesia, cardiology, radiology, gastroenterology, rheumatology, respiratory, hematology, and social services, highlighting not just multidisciplinary intervention but the benefits of working with a multispeciality team. The patient had previously presented to the emergency department 47 ti...
Source: Journal of Psychiatric Practice - January 1, 2021 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research

A Pilot Study of Transdiagnostic Group Cognitive-behavior Therapy for Anxiety: An Intensive Weekend Intervention
Anxiety disorders are highly prevalent and can cause serious functional impairment. Cognitive-behavioral treatments are effective but they are not always readily available. One factor contributing to this problem is the large number of disorder-specific treatments that require a high level of clinician training and resources, despite the similarity in the mechanisms underlying the various anxiety disorders and their treatments. Group-based, transdiagnostic cognitive-behavioral therapy (TCBT) has been shown to reduce the burden on clinicians while maintaining strong positive treatment outcomes. Furthermore, long courses of ...
Source: Journal of Psychiatric Practice - January 1, 2021 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research

Switch to Hypomania After Discontinuation of Tamoxifen: A Case Report
We describe the case of a 48-year-old woman who entered a hypomanic state after discontinuation of tamoxifen while remaining on unopposed venlafaxine prescribed for depression. This case highlights the risk of misdiagnosing unipolar depression in breast cancer patients with undiagnosed bipolar disorder who are being treated with tamoxifen and subsequently started on antidepressants. The use of antidepressants in this population should be carefully monitored to avoid the development of manic, hypomanic, or mixed symptoms in patients with underlying bipolar disorder once tamoxifen is discontinued. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2021 Category: Psychiatry Tags: Clinical Case Discussion Source Type: research

Facilitating Successful Reentry Among Justice-involved Veterans: The Role of Veteran and Offender Identity
Reentry courts facilitate successful offender reintegration into the community following release from incarceration, and many justice-involved veterans may benefit from such services given their elevated risk for deleterious outcomes postrelease. However, effectively engaging court participants is a crucial foundation to achieve the goals of recidivism reduction and global psychosocial improvement. This conceptual article presents an overview of factors that may interfere with a veteran’s engagement in reentry court through the lens of both veteran and offender identity. Recommendations for reentry court personnel ba...
Source: Journal of Psychiatric Practice - January 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

Afterword to “Working on the Frontlines From Home: Residents’ Experiences With Telepsychiatry During the COVID-19 Pandemic”
The coronavirus disease 2019 (COVID-19) pandemic thrust health care professionals around the globe to the frontlines to care for those affected by this medical crisis. While many surgical and procedural medical subspecialties experienced drastic declines in patient visits during this time, the demand for psychiatric services was more stable. In response to statewide stay at home orders, third-year residents in the psychiatry outpatient clinic described in this article quickly transitioned to telepsychiatry to continue providing care to their patients. While providing care from home, these residents experienced a number of ...
Source: Journal of Psychiatric Practice - January 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

Working on the Frontlines From Home: Residents’ Experiences With Telepsychiatry During the COVID-19 Pandemic
The coronavirus disease 2019 (COVID-19) pandemic thrust health care professionals around the globe to the frontlines to care for those affected by this medical crisis. While many surgical and procedural medical subspecialties experienced drastic declines in patient visits during this time, the demand for psychiatric services was more stable. In response to statewide stay at home orders, third-year residents in the psychiatry outpatient clinic described in this article quickly transitioned to telepsychiatry to continue providing care to their patients. While providing care from home, these residents experienced a number of ...
Source: Journal of Psychiatric Practice - January 1, 2021 Category: Psychiatry Tags: Columns Source Type: research

QTc, the Multitude of Ways It Is Calculated and Implications for Clinical Practice: A Case Example
QTc stands for heart-rate corrected QT interval on the electrocardiogram and is a measure of the efficiency of repolarization of the left ventricle. Excessive prolongation, generally considered to be>500 ms, can result in a potentially fatal ventricular arrhythmia known as torsade de pointes. Some psychiatric medications can cause this arrhythmia and, therefore, this issue is important to all prescribers of psychiatric medications. It is also important to keep in mind that there are multiple algorithms used to calculate the QTc. The Bazett’s algorithm, one of the most commonly used algorithms on electrocard...
Source: Journal of Psychiatric Practice - January 1, 2021 Category: Psychiatry Tags: Columns Source Type: research