Harnessing the Synergy Between Mindfulness and Psychotherapy
This column explores mindfulness as one part of Buddhist teaching and practice that has attracted attention in the treatment of mental and substance use disorders. Cognitive neuroscientific correlates of mindfulness are presented. Mindfulness is offered as a potentially valuable technique that can not only help patients in individual psychotherapies endure the painful emotions that are part of psychotherapy sessions and of managing life between sessions but also help patients and clinicians across modalities move beyond adherence to particular techniques that focus primarily on symptom reduction, to better meet patient nee...
Source: Journal of Psychiatric Practice - March 1, 2022 Category: Psychiatry Tags: Columns Source Type: research
How Loading Dose Strategies for Depot Paliperidone Can Go Wrong
This column presents a real-life case of a patient who developed severe and prolonged Parkinsonism secondary to the loading dose strategy recommended in the prescribing information (package insert) for paliperidone palmitate (Invega Sustenna). This column presents 2 major points. First, the case illustrates what the practitioner must do before following the general guidelines for a loading dose approach to the administration of paliperidone palmitate as outlined in the package insert to decrease the likelihood of a serious and potentially fatal consequence. Second, the case illustrates how therapeutic drug monitoring can b...
Source: Journal of Psychiatric Practice - March 1, 2022 Category: Psychiatry Tags: Columns Source Type: research
Financial Worry and Psychological Distress Among Immigrants in the United States, 2013-2018
The coronavirus disease 2019 (COVID-19) pandemic has highlighted links among economic stability, health outcomes, and migration. The facets of financial worry and their associated psychological burden have been understudied among the immigrant population. The goal of this study was to determine the specific facets of financial worry and associated psychological burden in immigrants. This cross-sectional study, which used data from the 2013 to 2018 National Health Interview Survey (NHIS), examined patient-reported measures of worry regarding financial strain. The NHIS is a household survey of noninstitutionalized, nonmilita...
Source: Journal of Psychiatric Practice - March 1, 2022 Category: Psychiatry Tags: Articles Source Type: research
Electrocardiogram Monitoring Practices for Hospitalized Adults Receiving Antipsychotics: A Retrospective Cohort Study
Objective:
Antipsychotics are frequently used for managing both acute and chronic neuropsychiatric disorders. While antipsychotics are known to be associated with increased mortality due to cardiac arrhythmia, there is a lack of consensus on the timing and frequency of electrocardiogram (ECG) monitoring. The goal of this study was to examine current ECG monitoring practices for adults receiving antipsychotics, specifically during hospital admission.
Methods:
The study involved a multisite retrospective chart review of adults admitted across 8 hospitals between January 2010 and December 2015 who received ant...
Source: Journal of Psychiatric Practice - March 1, 2022 Category: Psychiatry Tags: Articles Source Type: research
Similar Outcomes in Treating Major Depressive Disorder With 10 Hz Repetitive Transcranial Magnetic Stimulation (rTMS) Versus Intermittent Theta Burst Stimulation (iTBS): A Naturalistic Observational Study
Conclusions:
Findings in an observational, real-world clinical sample showed no significant differences in outcomes between 10 Hz rTMS and iTBS targeted at the left dorsolateral prefrontal cortex in the treatment of MDD. Because of the shorter treatment time involved, the choice of iTBS may reduce hospital exposure and increase savings and the treatment capacity of clinics without sacrificing effectiveness. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2022 Category: Psychiatry Tags: Articles Source Type: research
Current Understanding of the Effects and Potential Clinical Utility of Kratom: A Review
Conclusions:
Historically, kratom has been used for medical purposes and for the treatment of alcohol and substance use disorders. The currently available literature suggests a potential for similar clinical applications. However, without controlled research studies or regulation, kratom poses numerous health risks to consumers. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2022 Category: Psychiatry Tags: Articles Source Type: research
Eudaimonia
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2022 Category: Psychiatry Tags: From the Editor Source Type: research
Professional Well-Being: Enhancing Wellness Among Psychiatrists, Psychologists, and Mental Health Clinicians
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Book Review Source Type: research
Anti-NMDA Receptor Encephalitis Associated With an Ovarian Teratoma Presenting as First-episode Psychosis: A Case Report
We report an unusual case of a 27-year-old previously healthy female who presented with a 15-day history of psychotic, cognitive, and unspecified somatic symptoms. She was admitted to the psychiatric ward of an early intervention in psychosis team and medicated with aripiprazole. The young age of onset, the rapid onset, the absent history of psychiatric disease, and the persistence of a marked memory deficit after the psychotic symptoms remitted strongly suggested a nonpsychiatric etiology and led us to hypothesize autoimmune encephalitis as the most probable diagnosis. An investigation was carried out for anti-N-methyl-D-...
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Anti-NMDA Receptor Encephalitis: A Challenge in Psychiatric Settings
We present a case that highlights the typical presentation of anti-NMDA receptor encephalitis in a young woman and discuss management and outcome. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Anti-NMDA Receptor Encephalitis Masquerades as Psychosis: A Case Report
A 28-year-old male patient with an unclear history of psychosis was admitted to the inpatient psychiatric unit. He presented with auditory hallucinations, agitation, and bizarre and disorganized behavior. He was treated with antipsychotic medications without improvement. Magnetic resonance imaging of the brain showed hyperintensities throughout the brain parenchyma. Investigations for infectious, metabolic, autoimmune, and malignant etiologies were negative. Anti–N-methyl-D-aspartate (NMDA) receptor encephalitis was suspected. Cerebrospinal fluid (CSF) and serum NMDA receptor antibody testing were performed. Both tests w...
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Patients‘ Rights and the Texas Mental Health Law
A series of court cases between the 1960s and the 1980s focusing on patient autonomy changed the approach to mental health treatment in the United States. The process of involuntary psychiatric treatment can vary greatly between states; thus, all mental health practitioners need to have a strong grasp of their respective state and institutional policies. In this article, we examine the Texas mental health law regarding consent to psychoactive medications and involuntary medications. The Texas Health and Safety Code requires the use of a legally authorized representative to consent to psychoactive medications when patients ...
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research
First Use of Clozapine Point of Care Testing in Acute Inpatient Psychiatry: Preliminary Report
Clozapine is the antipsychotic of choice in treatment-resistant schizophrenia. Serum clozapine concentration testing is essential to monitor adherence, adjust dosing, and ensure treatment safety. However, patients who are acutely unwell are frequently reluctant to undergo blood testing requiring venipuncture. Also, conventional laboratory-based measurement of clozapine plasma levels can take days, thus contributing to the suboptimal use of clozapine when it is most needed. We pioneered clozapine whole-blood point of care (POC) testing in the acute inpatient setting in the treatment of a group of actively psychotic patients...
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research
Suicide and Life Insurance
Much has been written about the history of suicide and, notably, about societies that condemned both the act and the actor, resulting in a perpetuation of suicide being stigmatized in many cultures. One aspect of this perceived stigmatization involves exclusionary clauses in life insurance policies that reject paying benefits to survivor-beneficiaries of the decedent if the decedent has died by suicide within a prescribed time frame. From the perspective of the individual, life insurance is designed to protect the estate of a decedent from a significant financial burden. From the insurer’s perspective, there are essentia...
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Columns Source Type: research
Do Patients With Treatment-resistant Disorders Recover?
This column describes the challenge posed by patients with treatment-resistant disorders. It then reviews a recently published study demonstrating that with adequate treatment and enough time—over a decade—even patients with conditions that were previously considered treatment-resistant and who have high degrees of comorbidity, suicide risk, and a significant number of prior hospitalizations can achieve full recovery in terms of measures of psychodynamic conflicts, symptoms, and overall functioning. These areas of improvement converge and thus appear to be linked, suggesting the transdiagnostic relevance of psychodynam...
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Columns Source Type: research
