Another Step Toward Implementing Mental Health Parity
This column describes a recent $14.3 million settlement in a case brought against United Behavioral Health by the Department of Labor and New York State Attorney General Letitia James. United Behavioral Health agreed to stop 2 practices that were in violation of the Mental Health Parity and Addiction Equity Act. One of the practices involved systematic underpayment of nonphysician therapists and the other involved systematic use of targeted utilization review to end behavioral treatment after 20 sessions in a year. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Columns Source Type: research
Subtypes of Major Depressive Disorder Based on Pharmacological Responsiveness
Major depressive disorder (MDD) is a descriptive, syndromic diagnosis which will likely be discovered to be more than a single disorder when understood from a pathobiological or pathoetiological perspective. To date, attempts to divide this disorder into more homogenous phenotypes on the basis of signs and symptoms have not yielded more information on the pathobiological or pathoetiological factors that can cause a major depressive episode. This column proposes a new way of dividing MDD into 3 subtypes based on responsiveness to pharmacological treatments that are pharmacologically quite different from each other: type 1, ...
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Columns Source Type: research
How Are Attention-deficit Hyperactivity and Internet Gaming Disorders Related in Children and Youth?
Conclusions:
C-Y with ADHD are at increased risk for developing IGD compared with C-Y without ADHD, but it has not been determined at what developmental stage IGD is likely to emerge. Since IGD and ADHD are strongly associated, it is imperative to consider ADHD as a significant risk factor for IGD and vice versa, which can help psychiatrists be alert for early signs of IGD and manage them accordingly. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Articles Source Type: research
Insight in Obsessive-Compulsive Disorder: Relationship With Sociodemographic and Clinical Characteristics
The objective was to evaluate various aspects of insight using these scales to identify the relationships between different aspects of insight and clinical and sociodemographic variables to assess which scale or scales might possess greater efficiency in clinical practice. For this purpose, a descriptive, observational, and cross-sectional study of 81 patients in treatment in a mental health center was conducted. Patients were evaluated using the Brown Assessment of Beliefs Scale, the Overvalued Ideas Scale, the Scale of Unawareness of Mental Disorders, the Yale-Brown Obsessive Compulsive Scale, the Clinical Global Impress...
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Articles Source Type: research
Psychosocial and Pharmacological Approaches for Improving Treatment Adherence and Outcomes in People With Severe Schizophrenia: A 10-Year Follow-up
The objective of this study was to understand the psychosocial and pharmacological approaches linked to better treatment adherence and outcomes (psychiatric hospitalizations, clinical severity, and suicide attempts) among patients with schizophrenia receiving the standard treatment in mental health units (MHUs) compared with patients in a community-based, case-managed program (CMP). An observational, prospective (10 y) study was conducted involving patients with severe schizophrenia (N=688). The treatment adherence of patients in the CMP was higher than among those in the MHUs (12.2% vs. 84.3% abandoning treatment; P (So...
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Articles Source Type: research
Demographic and Clinical Correlates of High-lethality Suicide Attempts: A Retrospective Study in Psychiatric Inpatients
In conclusion, patients who used more lethal methods differed from those who used less lethal methods. Identification of these differences may be necessary to implement specific suicide prevention strategies in patients with psychiatric conditions. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: Articles Source Type: research
Gun Safety
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2021 Category: Psychiatry Tags: From the Editor Source Type: research
Social (In)Justice and Mental Health
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - September 1, 2021 Category: Psychiatry Tags: Book Review Source Type: research
Commentary: Psychiatric Presentations of Nonpsychiatric Illness or Treatment
Patients presenting with psychiatric symptoms, even in cases where there is no clear psychiatric history, are often labeled as having “psychogenic” symptoms or a psychosomatic reaction, and a tendency does exist to mislabel and/or misdiagnose certain patients in medical settings. The 3 cases presented in this issue of the Journal provide examples of patients presenting with psychotic or manic symptoms in the context of an underlying nonpsychiatric medical disorder. Kim and colleagues describe the case of a 65-year-old man with no psychiatric history who presented with acute visual hallucinations 1 day after starting om...
Source: Journal of Psychiatric Practice - September 1, 2021 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Omeprazole-induced Visual Hallucinations: A Case Report
In this report, we present a case of visual hallucinations secondary to PPI usage and propose possible mechanisms. In this case, a 65-year-old man with no psychiatric history developed acute visual hallucinations following initiation of omeprazole, in the absence of delusions, paranoia, and other psychotic symptoms. The visual hallucinations began after the patient started treatment with omeprazole and resolved almost immediately upon discontinuation of omeprazole. To treat symptoms of gastroesophageal reflux disease, omeprazole was replaced with famotidine, and the visual hallucinations did not recur after the omeprazole ...
Source: Journal of Psychiatric Practice - September 1, 2021 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Subdural Hematoma Presenting as Psychogenic Nausea
Psychogenic nausea refers to nausea symptoms that are experienced outside of the context of obvious general medical pathology and presumably as a result of psychiatric etiology. Although this dichotomy between general medical and psychiatric pathology is somewhat dated according to the focus of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) Somatic Symptom Disorders, the psychogenic description of a medically unexplained symptom is still commonly used in the general medical vernacular. This case report involved a 74-year-old man who was presumed to have “psychogenic” nausea symptoms afte...
Source: Journal of Psychiatric Practice - September 1, 2021 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Improvement in Memory Deficits With Memantine in Mania Secondary to Traumatic Brain Injury and Preexisting Perinatal Birth Injury
We present the case of a patient who presented to the hospital with symptoms suggestive of mania with psychotic features that had started after a recent TBI, with the brain scan also revealing the presence of a preexisting perinatal birth injury. When the patient recovered from the psychiatric symptoms, he still appeared to have memory problems that improved with the use of add-on memantine, an N-methyl-D-aspartate receptor antagonist. To date, there is some literature supporting the off-label use of memantine as a cognitive enhancer in patients with TBIs and other psychiatric illnesses, such as bipolar disorder. (Source: ...
Source: Journal of Psychiatric Practice - September 1, 2021 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Practical Steps Towards Identifying and Assisting Victims of Domestic Violence
Domestic violence is prevalent among psychiatric patients; however, utilization of screening, safety, and legal interventions is low among mental health practitioners. In this column, the authors review interventions that can assist with the identification of victims of domestic violence in daily practice and provide an overview of steps that can be taken to aid these victims and reduce the chance of future violence. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - September 1, 2021 Category: Psychiatry Tags: Columns Source Type: research
Fundamental Pharmacokinetic Concepts and Their Clinical Relevance: Clearance, Zero Versus First Order and Nonlinear Pharmacokinetics
In response to a question posed by a valued colleague, this column will discuss 4 fundamental pharmacokinetic concepts: (1) What does the term clearance encompass? (2) What do the terms first order and second order pharmacokinetics mean? (3) What does the term nonlinear pharmacokinetics mean and is it just a synonym for zero order pharmacokinetics? (4) What is the clinical relevance, if any, of these concepts and why? In addition, this column cites several earlier columns that are relevant to aspects of each of the answers. Thus, readers interested in more details can refer to these earlier publications that include case e...
Source: Journal of Psychiatric Practice - September 1, 2021 Category: Psychiatry Tags: Columns Source Type: research
Impact of CYP2D6 Polymorphism on Equilibrium Concentration of Fluoxetine in Patients Diagnosed With Major Depressive Disorder and Comorbid Alcohol Use Disorders
The objective of the study was to investigate the influence of the 1846G>A polymorphism of the CYP2D6 gene on the concentration/dose indicator of fluoxetine in patients diagnosed with major depressive disorder and comorbid alcohol use disorder.
Methods:
Our study included 101 patients with major depressive disorder and alcohol use disorder (average age: 41.3±14.5 y) who were treated with fluoxetine at an average dose of 26.1±8.7 mg/d. Treatment efficacy was assessed using validated psychometric scales, and the safety/tolerability of the therapy was assessed using the Udvalg for Kliniske Undersogelser Side-Effe...
Source: Journal of Psychiatric Practice - September 1, 2021 Category: Psychiatry Tags: Articles Source Type: research
