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A Novel Approach to Morbidity and Mortality Analysis in Psychiatry ResidencyRegulatory bodies that oversee hospitals and graduate medical education have begun to place an ever growing importance on patient safety and quality improvement, from which psychiatry is not immune. More in this case study.
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Treating Complex Trauma SurvivorsThis CME outlines distinguishing features of PTSD, complex trauma, and the dissociative subtype of PTSD (DPTSD), with an explanation of the distinctive neurobiological subtype of DPTSD.
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Pediatric Major Depressive Disorder: Questions to ConsiderWhat are the options for treating major depressive disorder in children and adolescents? This case offers readers a chance to give their feedback and to interact with the authors, who will present teaching points based on your comments.
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Preparing an Advanced Beneficiary NoticeAn ABN is a written communication given to a Medicare beneficiary by a physician prior to providing a service that is expected to be denied by Medicare Part B.
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15 Steps to Helping Psychiatric Patients Achieve and Maintain a Healthy WeightWhile psychotropic medications for schizophrenia, bipolar disorder, and other psychiatric disorders can cause weight gain, patients can take small steps to improve their health.
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Strategies to Reduce and Prevent Restraint and Seclusion in Pediatric PopulationsHere's compelling reason for judicious use of restraint and seclusion, and a review of various alternative approaches.
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Mini Quiz: Alcohol and SleepWhich sleep parameters are increased in alcohol use disorders? Take the quiz and learn more.
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Group Visit CodesBilling 99213 for individual patients seen together in a group visit is fraud.
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Troubleshooting Delirium in Elderly InpatientsDelirium is characterized by an altered level of consciousness, decreased attention span, acute onset, and fluctuating course. Approximately 15% of elderly patients admitted to the hospital have delirium as a presenting or associated symptom. Delirium will develop in another 15% of elderly patients during hospitalization.
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The Interplay of Mood Disorders and Eating DisordersA 20-year-old college sophomore with “depression and anxiety,” who is exercising ferociously and who is literally dying to lose more weight sets the stage.
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Borderline Personality Disorder in AdolescentsBPD appears to be a neurodevelopmental disorder, influenced by the person’s genetics and brain development and shaped by early environment, including attachment and traumatic experiences.
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Debate: Is It Worth Saving the Bereavement Exclusion in DSM-5?Ringing the Bell to Save the Bereavement Exclusion.
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Can You Be Forced to Buy Burial Insurance?Tuesday's oral arguments on the Affordable Care Act produced at least one truly riveting exchange.
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Cross-National Research: Caregiver ConsequencesComparing the consequences of caregiving across countries for a person with a serious mental illness needs to take into account not only different languages, but also different cultures, quality of mental health services and standards of living. So far, one questionnaire has shown the most validity and become the exemplar in cross-national research; yet it is still not free from possible cultural bias or criticism from its creators who acknowledge that much more research needs to be done.
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Metabolic Syndrome in Patients With Major Depressive DisorderAssociated Risk FactorsAlthough most studies have focused on the risk of metabolic syndrome for patients with schizophrenia exposed to atypical antipsychotics, other psychiatric patients appear to be at risk for metabolic disturbances as well.7-9 Major depressive disorder (MDD) may be of particular interest because it is much more common than schizophrenia and is treated with a broad range of psychotropics.
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Common Issues in Female Sexual Dysfunction"I've lost my interest in sex." As psychiatrists, we hear this concern (if we ask) from women in a variety of situations: those who are depressed, postpartum, menopausal, traumatized, and those who have been treated with psychotropic medications. Thankfully, we have many interventions, both behavioral and pharmacological, to use in addressing sexual issues.
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Social Media Use: A Closer Look at the Real Meaning of FriendsPeople feel free to post comments on social media sites that they would never dare say to someone’s face. The cure, if only a partial one, is to get out of social media and to start living a real life. What is your opinion on this issue?
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Psychiatric Malpractice: Basic Issues in Evolving ContextsThis article focuses on 4 issues in psychiatric malpractice: prescribing, liability for suicide, informed consent, and duty to protect under the Tarasoff v Regents of the University of California ruling. Malpractice is a civil wrong actionable by law. There are 2 goals of malpractice suits: the first is to make an injured plaintiff whole by an award of money, and the second is to inform the profession how courts will decide similar cases in the future.
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Cognitive Behavioral Treatment for Obsessive-Compulsive DisorderPatients with OCD generally respond best to cognitive-behavioral therapy (CBT). At the core of the behavior therapy program is a technique known as exposure and ritual prevention (ERP).
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Introduction: Why Does Psychiatry Need the Humanities?Bringing the arts and humanities to psychiatry requires bringing these areas of study into our education, our research and our practice models.
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The Bipolar Handbook: Real-Life Questions With Up-to-Date Answers by Wes BurgessBipolar disorder is often seen as a perplexing illness by patients and clinicians alike. In recent years, there has been a growing appreciation in psychiatric circles of the disorder's prevalence. This increased attention has filtered its way down to the general public, which, in turn, has produced sometimes sensationalistic media portrayals of manic depression, a number of speculative books about historic figures and noted artists who purportedly had the illness, and an array of self-help books marketed to individuals (and their families) afflicted with the disorder.
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Mentalization-Based Treatment: A Common-Sense Approach to Borderline Personality DisorderMBT presents a compromise to bridge the valuable history of psychoanalytic ideas to both modern psychiatric research as well as present public health needs and practice.
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4 Warning Signs of Illness FalsificationMedical, psychiatric, and/or developmental disorders can be falsified in a variety of ways. Know the warning signs often missed by clinicians.
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Bipolar Disorder: Increasing the Effectiveness and Decreasing the Side Effects of TreatmentStudies have shown that many pharmacologic agents are effective in the treatment of acute mania and bipolar relapse education.
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A New Approach: Using Virtual Reality Psychotherapy in Panic Disorder With AgoraphobiaWith the advent of computer technology, new forms of therapy have emerged that can help patients. How can a virtual reality environment enable patients to overcome panic disorder and agoraphobia, and what are the advantages to such forms of therapy?
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Depression Management in Cancer PatientsDepressive disorders and symptoms are common in cancer patients (up to 58% have depressive symptoms and up to 38% have major depression), worsen over the course of cancer treatment, persist long after cancer therapy, recur with the recurrence of cancer, and significantly impact quality of life.
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Let’s Ask the Right Questions About Medical Aid in DyingSome patients are intractably and maybe even irredeemably ill. What should be done for them?
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Dementia: The Epidemic of Our TimeIf we don't find a cure or adequate treatments, the number of individuals impacted by dementia could skyrocket to nearly 14 or 15 million Americans by 2050.
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PTSD in Late Life: An Update on Clinical IssuesTrauma-related psychiatric disorders such as PTSD and grief often go undetected and untreated in older adults. Here's how to help.
