Therapeutic Risk Management for Violence: Augmenting Clinical Risk Assessment With Structured Instruments
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 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 violent ideatio...
Source: Journal of Psychiatric Practice - September 1, 2020 Category: Psychiatry Tags: Columns Source Type: research
COVID-19: Preliminary Data on the Impact of Social Distancing on Loneliness and Mental Health
The COVID-19 pandemic and its need for social distancing as a response have the potential to increase the experience of loneliness in the population, with an associated increase in symptoms of mental disorders. As the world has largely adapted to remote platforms for employment, socializing, and health service delivery, the degree to which virtual opportunities for social engagement may offset the impact of limited in-person interactions on mental health functioning is unknown. This column offers preliminary data from an ongoing experience sampling study of the prevalence, course, and impact of loneliness on mental health ...
Source: Journal of Psychiatric Practice - September 1, 2020 Category: Psychiatry Tags: Columns Source Type: research
COVID-19: Why Has the Mortality Rate Declined?
This article explains how the mortality rate of an illness such as Coronavirus Disease 2019 (COVID-19) is calculated as well as how the definition of what is a “case” has changed from the earliest days of the pandemic to now. Many factors were not known about The Sudden Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) which causes COVID-19 at the beginning of the pandemic because it is a novel human pathogen. One key factor that was not known in the earliest days of the pandemic was that many patients are either asymptomatic or have symptoms so mild that they may not seek medical attention and hence these patients...
Source: Journal of Psychiatric Practice - September 1, 2020 Category: Psychiatry Tags: Columns Source Type: research
Pharmacological Treatment for Comorbid Bipolar Disorder and Obsessive-Compulsive Disorder in Adults
Comorbidity between bipolar disorder (BD) and obsessive-compulsive disorder (OCD) is fairly common, and the treatment of these conditions when comorbid is challenging. Serotonin reuptake inhibitors, the first option for treatment of OCD, can worsen BD symptoms, and mood stabilizers are generally not efficacious for OCD. Our goal in this article is to assess the clinical effectiveness of pharmacotherapies for comorbid BD-OCD in adults. We searched the Medline, Embase, and Cochrane Central Register of Controlled Trials databases on April 30, 2017, and we also searched the reference lists of identified articles. Studies publi...
Source: Journal of Psychiatric Practice - September 1, 2020 Category: Psychiatry Tags: Articles Source Type: research
A Systematic Review of Barriers Faced by Older Adults in Seeking and Accessing Mental Health Care
Older adults in the United States have lower rates of mental health care utilization than young adults. To understand these lower rates of mental health care, we performed a systematic review, in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, of barriers that prevent older adults from seeking and accessing treatment. We searched PubMed, PsycINFO, and Clinical Key to identify studies of barriers to mental health treatment in the older adult population (in individuals 50 y of age and older). Thirty-two articles met inclusion criteria (English language and focused on ...
Source: Journal of Psychiatric Practice - September 1, 2020 Category: Psychiatry Tags: Articles Source Type: research
Lithium Prescribing and Therapeutic Drug Monitoring in Bipolar Disorder: A Survey of Current Practices and Perspectives
Conclusion:
Shifts in prescribing practices, inconsistent interpretation of lithium levels, and concerns about safety and therapeutic drug monitoring highlight the need for evidence-informed guidelines reflective of current practice. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - September 1, 2020 Category: Psychiatry Tags: Articles Source Type: research
Assessing Mental Representation as an Indicator of Self and Interpersonal Functioning in Psychotherapy Patients
The goal of this study was to test in a clinical sample the interrater reliability and convergent validity of the Differentiation-Relatedness Scale (D-RS), a measure that evaluates mental representations based on open-ended descriptions of self and significant others. The study also investigated the ability of the D-RS to predict personality disorders (PDs) from Section II of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the dysfunctional trait domains presented in the Alternative DSM-5 Model for Personality Disorders Criterion B in Section III of the DSM-5. We also evaluated if the ...
Source: Journal of Psychiatric Practice - September 1, 2020 Category: Psychiatry Tags: Articles Source Type: research
Risk Assessment
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - September 1, 2020 Category: Psychiatry Tags: From the Editor Source Type: research
Lifestyle Psychiatry
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Book Review Source Type: research
Twelve-Month Analysis of Nonattendance for Initial Assessment in a Resident Outpatient Psychiatry Clinic
Conclusions:
Younger age, lack of insurance, major holidays, and longer waiting periods before the appointment were associated with nonattendance for the initial assessment in this outpatient resident clinic. This information can be helpful in developing interventions to improve attendance for the first step in engaging in psychiatric care. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research
Integration of Clozapine-associated Harm Obsessions into Cognitive Behavioral Conceptualization and Treatment Planning for Thought Broadcasting: A Case Study
Conclusions:
This report presents a means of conceptualizing the interplay between thought broadcasting and harm obsessions and discusses considerations in identifying and treating individuals with similar comorbid conditions, particularly in the context of clozapine treatment for medication-resistant psychosis. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research
Commentary on “Window to His World: Using a Patient’s YouTube Channel to Help Diagnose Chronic Mania”
We present the case of a manic patient who was hospitalized and subsequently found to have a YouTube channel that he had been using to promote his self-invented religion for over 2 years. Consent was obtained from the patient to review this YouTube channel for collateral information. From these videos, the patient was seen to be chronically circumstantial in his thought processes, grandiose in his ideas, highly energetic, distractible, preoccupied with religion, and talking with elaborate and rapid speech. A significant improvement in his symptoms was observed after administration of oral risperidone, with his scores on th...
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Window to His World: Using a Patient’s YouTube Channel to Help Diagnose Chronic Mania
We present the case of a manic patient who was hospitalized and subsequently found to have a YouTube channel that he had been using to promote his self-invented religion for over 2 years. Consent was obtained from the patient to review this YouTube channel for collateral information. From these videos, the patient was seen to be chronically circumstantial in his thought processes, grandiose in his ideas, highly energetic, distractible, preoccupied with religion, and talking with elaborate and rapid speech. A significant improvement in his symptoms was observed after administration of oral risperidone, with his scores on th...
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Reconsidering Rigidity in the Diagnosis of Neuroleptic Malignant Syndrome: A Case Report
In this report, we present a case in which a patient’s antipsychotic regimen during a psychotic episode (which involved both typical and atypical antipsychotics) subsequently led to NMS. During his stay, the patient developed an altered level of consciousness, elevation of creatine phosphokinase, hemodynamic instability, and a fever. However, the patient did not have signs of rigidity, the cardinal sign of this syndrome. The authors concluded that patients could develop NMS without rigidity while receiving an antipsychotic. Given this presentation, the authors suggest that clinicians have a high level of suspicion for NM...
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Therapeutic Risk Management for Violence: Clinical Risk Assessment
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 documenting) screening, assessment, and management of other-directed violence risk. In this 5-part series, we describe a model for achieving therapeutic risk management of the potentially violent patient, with essential elements involving a 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 violent ideation...
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Columns Source Type: research
