An Individual With 2 Distinct Nonpathologic Identities
This article presents the case of a Vietnamese-American medical student who had 2 distinct identities which were not due to a pathologic process but rather were the result of learning. This case illustrates the complexity of brain function which is fundamental to psychiatry. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Columns Source Type: research
Family Accommodation of Symptoms in Adults With Obsessive-Compulsive Disorder: Factor Structure and Usefulness of the Family Accommodation Scale for OCD–Patient Version
This study investigated the factor structure of the FAS-PV and clinical variables associated with patient-reported family accommodation in a sample of 151 treatment-seeking adults with OCD. A confirmatory factor analysis suggested that a 4-factor model best characterized the scale, with the following factors: (1) participation in symptoms, (2) avoidance of OCD triggers, (3) taking on responsibilities, and (4) modifying responsibilities. Internal consistency was high for the total score and for scores on the 4 subscales of the FAS-PV. Approximately 87% of the sample reported accommodation behaviors at some level. Family acc...
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Articles Source Type: research
Inpatient Early Intervention for Serious Mental Illnesses Is Associated With Fewer Rehospitalizations Compared With Treatment as Usual in a High-volume Public Psychiatric Hospital Setting
This study examined the influence of an early intervention program for serious mental illnesses (SMI) on readmissions at 6 and 12 months postdischarge at a high-volume, urban public inpatient psychiatric hospital.
Methods:
The Early Onset Treatment Program (EOTP) is a cost-free, 90-day inpatient multidisciplinary service intervention program for uninsured patients who are within 5 years of SMI onset, funded as a pilot program by the Texas state legislature. Rehospitalization rates at 6 and 12 months were extracted from electronic medical records for EOTP participants (n=165) and comparison patients matched on demogr...
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Articles Source Type: research
Evaluating Clinician Attitudes After Local Implementation of the Veterans Affairs Predictive Analytic Model for Suicide Prevention
Conclusions:
Results demonstrate the need for educational interventions and improved communication between local coordinators and clinicians. Clinicians rarely discussed fears about the algorithmic approach, but they highlighted concerns about the value that this approach added to their role. Future evaluations are needed to examine additional sustainment issues. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Articles Source Type: research
A Plausible Explanation of Increased Suicidal Behaviors Among Transgender Youth Based on the Interpersonal Theory of Suicide (IPTS): Case Series and Literature Review
The objective of this study was to examine the pathologic basis of treatment-resistant suicidality in transgender youth despite favorable environments using the theoretical framework of the IPTS, supported by a literature review and case series.
Methods:
We conducted a literature review using PubMed and PsycInfo with key words suicidal ideation, suicidality, transgender, transgender youth, gender dysphoria, and interpersonal theory of suicide. Seventy-eight articles were retrieved, which were then narrowed down to 30 articles after non-English articles and irrelevant topics were excluded. The clinical presentations ...
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: Articles Source Type: research
What’s a Family Member to do?
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2022 Category: Psychiatry Tags: From the Editor Source Type: research
American Psychiatric Association Publishing Textbook of Suicide Risk Assessment and Management, Third Edition
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Book Review Source Type: research
Commentary: Treatment-resistant Depression: Considerations Related to ECT and Ketamine
Treatment-resistant depression (TRD) may be responsive to interventions beyond antidepressants including brain stimulation such as electroconvulsive therapy (ECT) or to ketamine or esketamine, the latter of which is approved for TRD in an intranasal form. The 3 cases presented in this issue deal with an array of clinical considerations in treating patients with TRD, including the use of ECT in a patient with a history of liver transplantation, the use of heated yoga in a patient nonresponsive to ECT, and intranasal ketamine abuse in a patient with comorbid migraines. Gunther and colleagues described the case of a 73-year-o...
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
A Case of Intranasal Ketamine Misuse: Considerations for Clinical Practice
We present a case of a patient who presented with paranoia and personality changes attributed to ketamine misuse, which illustrates the need for more robust screening and systematic monitoring with this medication. Continued evaluation of the abuse potential of ketamine in long-term treatment as well as restricted access and in-office administration are important, to develop a better understanding of the risk-benefit profile of this drug. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
A Patient With Electroconvulsive Therapy–resistant Major Depressive Disorder With a Full Response to Heated Yoga: A Case Report
Depression remains difficult to treat as a result of less than optimal efficacy and troublesome side effects of antidepressants. The authors present the case of a patient with treatment-resistant depression with melancholic features who had previously been unresponsive to electroconvulsive therapy (ECT) plus an antidepressant regimen but whose condition fully remitted with the addition of a standardized form of heated hatha yoga (HY; Bikram yoga) practiced in a room heated to 105°F. The patient was a 28-year-old woman who underwent 8 weeks of HY as part of a randomized controlled trial of HY for depression while continuin...
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Electroconvulsive Therapy in a Patient With a Liver Transplant
We describe a patient who had undergone a successful orthotopic liver transplant 26 years previously, who developed severe major depression. The patient tolerated an index course of ECT well and responded robustly. There were no complications pertinent to the graft or otherwise. Liver transplantation is not a contraindication to ECT, and clinicians should not hesitate to proceed when necessary. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
A Case Series of Very Late-onset Schizophrenia-like Psychosis: Is It a Dimension of Dementia?
Conclusions:
It remains unclear if VLOSLP is a unique disorder, a prodrome to dementia, or a different condition that is not yet understood. Further research is needed to develop comprehensive treatment for patients with VLOSLP. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research
Targeting 3 Tiers of Psychiatric Problems in Patient-focused Psychiatric Practice: Diagnostic Signs, Symptoms, and Impairments; Specific Complex Subjective Complaints; and Contributing Meta-problems
Conclusions:
Diagnostic or not, specific problems expressed by patients and families and contributing meta-problems should be integrated into initial formulations and tracked during treatment. Whereas only some of these problems may fall within a clinician’s scope of responsibilities, all should fall within the scope of concern, some to be referred to others, and some exceeding caregivers’ capacities. Periodic review of problem lists for patients’ and families’ most distressing concerns can contribute to the therapeutic alliance, increase patient satisfaction, and perhaps improve outcomes. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research
Assessing Self-reported Recovery in a Community Psychiatry Setting
Conclusions:
While certain demographic and diagnostic groups were associated with higher RAS-R scores, study results suggest that time in treatment is itself associated with higher self-reported recovery among all demographic groups. Age, race, and diagnosis were all associated with higher scores on the Personal Confidence and Hope subscale, highlighting the need for individualized treatment that takes multiple patient characteristics into account. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Practitioner’s Corner Source Type: research
Therapeutic Risk Management and Firearm-related Lethal Means Safety
Safety planning to reduce suicide or other-directed violence risk involves efforts toward “making the environment safe,” including working collaboratively with at-risk patients to encourage voluntary changes in their firearm storage decisions [ie, lethal means safety (LMS) counseling]. This column provides a conceptual framework and real-world evidence to support the delivery of LMS counseling to at-risk patients, as well as guidance on asking about firearm access and making individualized safety recommendations. It also reviews important elements related to documenting LMS discussions and legal considerations related ...
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Columns Source Type: research
