Psychotherapy in the Post-COVID-19 Era
This column anticipates challenges likely to be faced by psychotherapists and their patients after the coronavirus disease 2019 (COVID-19) pandemic subsides. It looks beyond the current impact of loneliness, isolation, thwarted belongingness, and loss toward the longer term impact of moral injury and blocked opportunities for mourning. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Columns Source Type: research
Two Clinically Important but Underutilized and Misunderstood Tools: Formulas to Estimate Creatinine Clearance and Therapeutic Drug Monitoring
This column first reviews 2 key equations that are central to clinical pharmacology. Clinicians can use the first equation to predict the effect of a specific dose of a specific drug in specific circumstances on the basis of 3 variables: (1) the drug’s pharmacodynamics, (2) the drug’s pharmacokinetics, and (3) biological variance in the individual patient. Clinicians can use the second equation to determine the concentration of a drug that a patient will achieve on a given dose depending on the patient’s ability to clear the drug from the body. These 2 equations allow prescribers to predict whether the dose of a drug...
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Columns Source Type: research
Race, History of Abuse, and Homelessness Are Associated With Forced Medication Administration During Psychiatric Inpatient Care
Objective:
Although previous research has suggested that racial disparities exist in the administration of forced medication (FM) in psychiatric inpatients, data remain scarce regarding other contributing variables. Therefore, this study examined sociodemographic and clinical variables associated with FM administration in psychiatric inpatients.
Methods:
Electronic medical records from 57,615 patients admitted to an academic psychiatric hospital between 2010 and 2018 were reviewed to identify patients who received FM. These records indicated that FM petitions were requested and approved for ∼6200 patients. Patients ...
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Winner of Resident Paper Award 2019 Source Type: research
Promoting Medication Adherence Among Psychiatric Patients With a History of Nonadherence: A Clinical Practice Improvement Program
Conclusions:
Quality improvement methodologies can be used to solve common problems with context-specific solutions. The implementation of person-centered medication adherence counseling led by an advanced practice nurse in concert with optimization of medication regimens appears to be a promising strategy for improving adherence in nonadherent patients admitted to the psychiatric ward. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Articles Source Type: research
Cognitive Remediation for Outpatients With Recurrent Mood Disorders: A Feasibility Study
Current first-line treatments for mood disorders often improve mood symptoms but do little to reduce cognitive and functional impairment. This 10-week, uncontrolled, feasibility study evaluated a cognitive remediation (CR) intervention for individuals with recurrent mood disorders. Adults with recurrent major depressive disorder or bipolar disorder, who had recently been treated and discharged from specialized mental health services, were eligible for inclusion. Twenty patients completed the CR intervention, which involved weekly individual sessions with a therapist, as well as the practice of computerized CR exercises bet...
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Articles Source Type: research
Mental Health and Social Care Professionals After a Patient Suicide: Interrelation Between Support Needed, Sought, and Received
This article investigates the support needed, sought, and received by professionals following a patient suicide. A self-administered questionnaire about the consequences of patient suicide and support issues was completed by 704 professionals. Profiles of support were defined using a 3-dimensional, 8-fold typology based on need for, search for, and sufficiency of support. Stress reactions, professionals’ characteristics, relationship with the patient, training, and providers of support were used to characterize the profiles. Most professionals acknowledged receiving sufficient support to manage the aftermath of patient s...
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: Articles Source Type: research
A Turbulent World
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - July 1, 2020 Category: Psychiatry Tags: From the Editor Source Type: research
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 use disorders....
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
