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Clinical Manual of Child and Adolescent Psychopharmacology, Third Edition
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: Book Review Source Type: research

Examining the Feasibility and Acceptability of an Online Yoga Class for Mood Disorders: A MoodNetwork Study
Discussion: These preliminary data support the utility of online yoga tailored specifically for people with mood disorders as a possible adjunctive intervention that warrants further investigation. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: Practitioner's Corner Source Type: research

Ketamine Use for Suicidal Ideation in the General Hospital: Case Report and Short Review
We report on the use of ketamine as an efficient, well-tolerated treatment for persistent suicidal ideation in a patient hospitalized in a general hospital after a severe suicide attempt. Based on data in the literature, we suggest that the benefit-risk ratio for ketamine use in such a context is highly favorable. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Cannabinoid Hyperemesis Syndrome and the Consulting Psychiatrist: A Case Study of Diagnosis and Treatment for an Emerging Disorder in Psychiatric Practice
We present a case of cannabinoid hyperemesis syndrome that required psychiatric consultation for diagnostic clarification and effective treatment with intravenous haloperidol. Literature from emergency medicine, toxicology, and gastroenterology is reviewed, including proposed diagnostic criteria for cannabinoid hyperemesis syndrome and reported off-label treatment options, with a specific focus on clinical questions facing the practicing psychiatrist regarding this emerging disorder. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

The Mask of Happiness: Unmasking Coercive Control in Intimate Relationships
This article defines and exemplifies the dynamic of coercive control, a more insidious and difficult to identify process of domination and exploitation that victims have a hard time labeling on their own. Further reading and resources are also provided. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: Columns Source Type: research

Two New Psychotherapy Studies: Back to the Future?
This column reviews 2 recent high-quality psychotherapy research studies. One study by Steinert and colleagues suggests that psychodynamic therapy is equivalent to cognitive behavioral therapy (CBT) (or medication when this was the comparator) for a range of disorders. A second study by Barlow and colleagues finds Unified Protocol CBT targeting underlying emotional dysregulation to be equivalent to single disorder-specific CBT for a range of anxiety disorders. Taken together, these studies help bridge the gap between CBT and psychodynamic therapy and refocus us on the realities of clinical settings, where most patients pre...
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: Columns Source Type: research

A Brief Interview to Detect Panic Attacks and Panic Disorder in Emergency Department Patients with Cardiopulmonary Complaints
Conclusions: Patients with panic attacks or panic disorder commonly present to the ED, but often go unrecognized. A brief 7-item clinician rating scale accurately identifies these patients among those ED patients presenting with cardiopulmonary complaints. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: Articles Source Type: research

Reducing the Risk of Type 2 Diabetes in Nonselected Outpatients With Schizophrenia: A 30-Month Program
Conclusion: The study found that positive outcomes were associated with female sex and a longer duration of illness. Negative outcomes with worsening of risk factors were associated with being newly diagnosed with schizophrenia and male sex. It was possible to produce improvements in some risk factors through individual health-oriented lifestyle interventions, especially in LT patients. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: Articles Source Type: research

Botulinum Toxin as a Treatment for Depression in a Real-world Setting
Objectives: A series of randomized controlled trials have shown the efficacy of glabellar botulinum toxin (BTX) injection as a treatment for depression in women. We wanted to extend these findings and assess how they may be translated to a real-world setting. Methods: For that purpose, 42 patients with severe, in most cases chronic and treatment-resistant depression received adjunctive treatment with BTX in private practice. Depression severity was rated before and 3 weeks after the treatment using the Hamilton Depression Rating Scale, the Montgomery Åsberg Depression Rating Scale, and the Beck Depression Invent...
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: Articles Source Type: research

An Examination of Fluoxetine for the Treatment of Selective Mutism Using a Nonconcurrent Multiple-Baseline Single-Case Design Across 5 Cases
This study examined the utility of fluoxetine in the treatment of 5 children, aged 5 to 14 years, diagnosed with selective mutism who also demonstrated symptoms of social anxiety. A nonconcurrent, randomized, multiple-baseline, single-case design with a single-blind placebo-controlled procedure was used. Parents and the study psychiatrist completed multiple methods of assessment including Direct Behavior Ratings and questionnaires. Treatment outcomes were evaluated by calculating effect sizes for each participant as an individual and for the participants as a group. Information regarding adverse effects with an emphasis on...
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: Articles Source Type: research

Out of the Box
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2018 Category: Psychiatry Tags: From the Editor Source Type: research

Becoming Mindful: Integrating Mindfulness Into Your Psychiatric Practice
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: Book Review Source Type: research

Reward Dysfunction in the Manic Spectrum: Unable to Win? The Use of Biographical Information to Refine Neurobiological Modeling
Conclusions: The experience and neural correlates of hedonic processing may be impaired in the manic spectrum. Possible mechanisms for this impairment and its dissociation from the earlier stage of reward processing characterized by hyperactive reward pursuit are considered. Clinical reports and longitudinal, life-based follow-up can provide important data to supplement more experimentally based neurobiological models of reward dysfunction in bipolar disorders. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Voltage-gated Potassium Channel Antibody Autoimmune Encephalopathy Presenting With Isolated Psychosis in an Adolescent
Antibody-mediated encephalopathies associated with serum or cerebrospinal fluid antibodies directed against neuronal structures may present with a multitude of neuropsychiatric syndromes. Although some of the antibody-driven conditions are now well recognized in adults (eg, N-methyl-D-aspartate receptor antibody encephalitis), the spectrum of neuropsychiatric manifestations in the pediatric population is less clear. Psychosis, confusion, catatonia, and additional behavioral changes, along with seizures, encephalopathy, and movement disorders, may be initial manifestations or concurrent features in all age groups. Psychosis...
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Why Suicide Risk Assessment Still Matters
Both public awareness of suicide and professional efforts directed at suicide prevention have increased considerably in recent years. Unfortunately, rates of death by suicide have remained relatively stable over the past decade despite these enhanced efforts. Some have argued that “suicide risk assessment doesn’t work” and have called into question the utility of devoting clinical time and energy to risk assessment. In this column, the authors first present an overview of the argument against suicide risk assessment and the data supporting that argument, followed by an alternate argument as to why suicide...
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: Columns Source Type: research

A “Trans-Dyadic” Perspective on the Goldwater Rule
The Goldwater Rule has been debated, redefined, and debated further since the election of Donald Trump as President of the United States. This column offers a perspective on the Goldwater Rule that moves beyond psychiatry’s current preoccupation with precision DSM-5 diagnosis of individuals, which ethically requires consent or other legal authorization for release of diagnostic information to others, and into the realm of leadership as seen through the “trans-dyadic” lens of psychoanalytic understanding of large group processes on a societal level. Concepts from large group psychology are introduced to il...
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: Columns Source Type: research

CNS Drug Development, Lessons Learned, Part 4: The Role of Brain Circuitry and Genes—Tasimelteon as an Example
This is the fourth in a series of columns discussing the rational and targeted development of drugs to affect specific central nervous system (CNS) circuits in specific ways based on knowledge gained by molecular biology and the human genome project. The first column in this series described 6 CNS drugs with novel mechanisms of action developed over the last 25 years. The second column discussed differences between syndromic diagnoses as exemplified by the third through the fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM III through DSM-5) and the new approach to psychiatric diagnoses champ...
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: Columns Source Type: research

Psychosis Risk Syndrome: What Now?
Conclusions: “Attenuated psychosis syndrome” is a clinically useful concept. It identifies help-seeking individuals with mental health problems who need an intervention and who, if no treatment strategy is proposed, present a higher likelihood of developing a psychosis spectrum disorder in the years following their first contact with a mental health facility. In parallel with the clinical utility of this concept, additional research focused on this group of patients is warranted to further understand the emerging phase of psychotic disorders and to develop effective and efficient evidence-based prevention strat...
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Cognitive Behavioral Therapy for Chronic Pain—One Therapeutic Approach for the Opioid Epidemic
Opioids are frequently prescribed for chronic pain. For the past 2 decades, long-term opioid analgesic therapy was considered the cornerstone of effective pain management for chronic nonmalignant conditions, despite a lack of documented effectiveness and safety, with the attendant risk of addiction, overdose, and death. Cognitive behavioral therapy (CBT) may be used effectively to treat chronic pain, either as a stand-alone treatment or with other nonopioid pharmacological treatments. CBT improves pain-related outcomes along with mobility, quality of life, and disability and mood outcomes. Compared with long-term use of op...
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Outcomes of Acute Partial Hospital Treatment: Comparison of Two Programs and a Waiting List Control
Conclusions: Across 2 different acute PHPs, significant reductions in symptom severity and improvements in elements of cognitive functioning were observed. Findings indicate that acute PHP treatment may produce moderate-sized treatment effects in a 1-week period that seem unrelated to specific psychotherapeutic methods. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Use of Rapid Response Teams in Psychiatry: Variables that Impact Safety
Conclusions: We propose the acronym SCHEME to refer to a tool that can be used to quickly and easily assess medical risk in prospective psychiatric inpatients at the time of admission, which can help reduce the use of RRTs and CTs. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Disasters
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2017 Category: Psychiatry Tags: From the Editor Source Type: research

Ordinarily Well: The Case for Antidepressants
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: Book Review Source Type: research

An Unusual Case of Acute Psychosis With Obsessive-Compulsive Features Following Arsenic Poisoning
In this report, we present the case of a patient who developed acute psychosis with hallucinations, disorganized thinking, and obsessive-compulsive symptoms following chronic occupational arsenic exposure. The patient was treated with the combination of an antipsychotic and an antidepressant and he responded well with significant improvement in both the acute psychosis and obsessive-compulsive symptoms. The authors concluded that patients can develop atypical symptoms, including acute psychosis, following arsenic poisoning. In the case described in this report, the patient also presented with a new onset of obsessive-compu...
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Neurobiological Mediators of Squalor-dwelling Behavior
Squalor-dwelling behavior has been characterized as living in conditions so unsanitary that feelings of revulsion are elicited among visitors. This behavior is commonly associated with an insensitivity to distress/disgust and a failure to understand the direness of one’s living situation, which leads to social isolation and impairment in quality of life. Etiologically, several associations have been described in the literature, including age-related decline, lower socioeconomic status, and rural dwelling status. Primary neuropsychiatric disorders, such as psychosis, alcoholism, dementia, personality disorders, develo...
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Contending With Preplanned Death: Questions for Clinicians
Conclusions: Considerations regarding preplanned deaths merit greater professional and public discussion. Many options exist for improving how professionals address the quality of human experiences surrounding death. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: Columns Source Type: research

Bias Toward Psychodynamic Therapy: Framing the Problem and Working Toward a Solution
Although psychodynamic therapy (PDT) is an evidence-based intervention for a broad spectrum of psychiatric conditions, there is often notable bias in the way PDT is depicted both in the popular media and in the scientific literature. This has contributed to a negative view of PDT, which hampers both patient access to this treatment and researcher access to funding for further research on PDT. The adverse effects of these distortions and biases are detrimental not only to PDT but also to the overall field of psychotherapy, raising questions about its credibility. Here we summarize current evidence for PDT, describe existing...
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: Columns Source Type: research

CNS Drug Development: Lessons Learned Part 3: Psychiatric and Central Nervous System Drugs Developed Over the Last Decade—Implications for the Field
This column reviews the divergence between the approach to drug development in infectious disease, oncology, and immunology versus psychiatry. Between 2009 and 2016, 254 new drugs were approved. Of those, only 9 were for a psychiatric indication; another 5 were labeled to treat central nervous system disorders that are not considered psychiatric per se but are frequently found in individuals with psychiatric illnesses (eg, substantial weight gain). There were 2 additional new products for psychiatric indications that involved either a combination product (Contrave) or a prodrug for the production of aripiprazole (Aristada)...
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: Columns Source Type: research

Predictors of Length of Stay in a Psychiatric Adolescent Treatment Program
Understanding predictors of adolescent inpatient length of stay (LOS) is important in informing treatment outcomes for this age group. The current literature on adolescent LOS remains limited and has been characterized by methodological limitations. In the study described here, we examined a wide range of predictors for LOS in a psychiatric unit for adolescents (N=285), including severity of disorder (previous hospitalizations, self-harm, cognitive impairment and thought disorder, severe depression, history of trauma), types of psychotropic medication, and diagnoses. Our results indicated that LOS is associated with predic...
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Major Depressive Disorder in Patients With Doctoral Degrees: Patient-reported Depressive Symptom Severity, Functioning, and Quality of Life Before and After Initial Treatment in the STAR*D Study
Conclusions: Findings from this study indicated that, following citalopram monotherapy, the participants in the DOCS group achieved greater reductions in depressive symptom severity (based on effect sizes) than the participants in the non-DOCS group. For both treatment groups, the findings also showed the positive effect that remission status from MDD can have on QOL and functioning. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Blister Packaging Medication Increases Treatment Adherence in Psychiatric Patients
Conclusions: Psychiatric patients adhere better to prescription medication regimens when receiving their medications in BP. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Patient-reported Outcomes in Practice: Clinicians’ Perspectives From an Inpatient Psychiatric Setting
The use of patient-reported outcomes (PROs) has become increasingly common. They have been used to assess quality of care and to support policy decisions, but the evidence concerning their utility to improve patient outcomes is inconsistent. A better understanding of clinicians’ experience with PROs has the potential to improve their effectiveness. This exploratory, quantitative, and qualitative study investigated the perspectives of clinicians (N=70) from multiple disciplines (psychiatrists, psychologists, social workers, and psychiatric nurses) on the utility of PROs in an inpatient psychiatric setting. During sche...
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Death with Dignity
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - September 1, 2017 Category: Psychiatry Tags: From the Editor Source Type: research

DBT Principles in Action: Acceptance, Change and Dialectics
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: Book Reviews Source Type: research

Transference-focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: Book Reviews Source Type: research

A Model for Incident Review Committees in Behavioral Health Settings
We present a model for an incident review committee that has been implemented in 2 large, academic acute care psychiatric hospitals. We believe the model not only permitted us to efficiently and effectively review untoward incidents, but that it also provided an approach to calibrating standards of care for the institution, engaging physicians in an interdisciplinary effort, promulgating a culture of quality review and improvement throughout the organization, promoting continuity and sustainability of the incident review process, and, most importantly, driving beneficial change in clinical practice. Demonstration of the ef...
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: Practitioner's Corner Source Type: research

Transgender Youth in the Inpatient Psychiatric Setting: A Literature Review and Case Report
Once considered pathological, transgenderism is now accepted as a variant of normal sexuality. As society has become more accepting of transgenderism, increasing numbers of transgender patients have begun to seek psychiatric care, and younger populations are embracing their gender differences. There is a paucity of literature on how best to serve transgender youth in psychiatric inpatient units. In this article, we share our experience and discuss the need for practical guidelines to help the inpatient psychiatrist navigate key topics related to this population. We then present a case report to illustrate several of these ...
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Clinical Barriers to Effective Treatment of Eating Disorders and Co-occurring Psychiatric Disorders in Transgendered Individuals
Eating disorders (EDs) are complex and difficult to treat illnesses that are often chronic and disabling on their own accord or due to comorbidity with other psychiatric conditions. Historically, EDs have been viewed as illnesses of heterosexual, affluent white females. This stereotype increases the likelihood that these disorders will be underrecognized in the lesbian, gay, bisexual, and transgender community, as well as in different gender, socioeconomic, and ethnic populations. Our case report illustrates the clinical difficulties of managing a patient who presented to inpatient treatment with complaints of depression a...
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Politics in the Consulting Room
The recent presidential campaign and election have had a strong impact on many patients and clinicians. This guest column and its introduction by Dr Eric Plakun, who edits the psychotherapy section of the journal, note the inevitability that we will all self-disclose, while describing some of the pros and cons and impacts of self-disclosure of a clinician’s political perspectives. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: Columns Source Type: research

Targets for the Treatment of Insomnia in Veterans With Serious Mental Illness
Conclusions: Similar to insomnia among individuals without SMI, insomnia in Veterans with SMI is associated with dysfunctional sleep-related behaviors and cognitions. Many of the Veterans also lacked access to settings and resources conducive to healthy sleep. Veterans with SMI should be regularly assessed for insomnia. Research is needed concerning optimal evidence-based insomnia interventions for addressing behaviors and cognitions in this population in the context of these challenges. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Characteristics of Patients Involved in Physical Assault in an Acute Inpatient Psychiatric Setting
Conclusions: Clinicians should take extra precautions for involuntarily admitted young patients with a history of substance use, as they are more likely to exhibit assaultive behavior. A diagnosis of schizophrenia spectrum disorder in itself is not significantly associated with assaultive behavior. Screening instruments such as the Dynamic Appraisal of Situational Aggression may be useful in assessing risk of assault. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

The Presence of Childhood Attention Deficit/Hyperactivity Disorder May Be Associated With Interpersonal Sensitivity in Patients With Social Anxiety Disorder
The goal of this study was to evaluate a possible association between childhood attention deficit/hyperactivity disorder (ADHD) and interpersonal sensitivity in patients with social anxiety disorder (SAD). The study involved 125 adult outpatients with a primary diagnosis of SAD. To evaluate childhood ADHD, the ADHD module of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL) was used. Clinical and sociodemographic data were collected and clinical rating scales were completed. Mean total scores on the Interpersonal Sensitivity Measure were significantly hi...
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Therapists’ Metacognitive Monitoring of the Psychotherapeutic Process With Patients With Borderline Personality Disorder
Conclusions: Reflection on the psychotherapeutic process with patients with BPD induced in therapists a self-focused, emotionally intense linguistic style dominated by references to themselves and their experience of intense emotional states. These results suggest that, when describing their work with patients with BPD, therapists experience metacognitive challenges and mentalization processes that may parallel the challenges therapists face when thinking and working during the psychotherapy sessions themselves. The results underscore the important role of supervision in assisting therapists to organize their reflective pr...
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: Articles Source Type: research

Incident Review
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2017 Category: Psychiatry Tags: From the Editor Source Type: research

The Psychoanalytic Model of the Mind
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2017 Category: Psychiatry Tags: Book Review Source Type: research

Impact of an Alcohol Withdrawal Treatment Pathway on Hospital Length of Stay: A Retrospective Observational Study Comparing Pre and Post Pathway Implementation
Conclusions: This study demonstrates the successful implementation of an alcohol withdrawal treatment pathway in a medical-surgical population hospitalized in a large tertiary care facility with significant impact on hospital LOS. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2017 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research