Tales From the Clinic: Leading by Case Example

Have you missed the latest episodes of the series Tales From the Clinic: The Art of Psychiatry?

One of our most popular series is Tales From the Clinic: The Art of Psychiatry, curated by Series Editor Nidal Moukaddam, MD, PhD. If you have not been keeping up, check out the articles below for case example-led clinical advice and practical tips.

“I Want to Do This for My Baby”: The Woes of Pregnancy and Addiction

One study showed that between 1999 and 2019, opioid-related deaths among persons aged 15 to 64 increased over 402%. Women accounted for 32.9% of those reported deaths. As such, there is an increasing need for a women-centered approach to opioid use disorder treatment. Out of 13,000 substance abuse treatment facilities across the United States, only 40% offered women-centered opioid use disorder care.

Opioid use disorder is a complex condition to treat. How can you help these women? Kristen Laster, MD, and Andres Ojeda, MD, walk us through.

Headaches and Psychiatric Illness

Headaches are a very common neuropsychiatry comorbidity. Patients with anxiety (25%), depression (23%), and posttraumatic/stressor and trauma-related stress disorder (15%) are the most likely to have comorbid headaches. Patients may worry about having their physical symptoms dismissed, and it can be a difficult condition to manage due to overlap with somatization. The most important triggering events for primary headaches are distress and sleep issues.

How can you help patients manage this condition? Afroz Shamim, MD, shares more in this episode.

Trust, Patience, and Communication: Treating Bulimia Nervosa When Residential Programs are Unavailable

Managing bulimia nervosa (BN) in outpatient care can be challenging. Research shows that weight changes may prove to be insignificant in this disorder, which can allow BN to go undiagnosed for longer periods of time when compared to anorexia nervosa and other eating disorders. Three things that are necessary components to the early treatment process include (1) safety planning, (2) the instillation of hope, and (3) immediate introduction of adaptive coping skills.

What other considerations and screening methods are available? In this episode, learn more from Ronnie Lee, PsyD, and Jonathan C. Blassingame III, PhD.

“I Have No One”: Understanding Homelessness and Trauma

Over 80% of homeless individuals have experience life-altering trauma. Challenges in working with this patient group include, the aforementioned trauma, substance use, mental illness, medical illness, and difficult meeting basic needs. Furthermore, homeless patients may experience more setbacks than the average patient, and professionals helping them may be 2 to 3 times more likely to experience PTSD.

Why is working with this patient group so rewarding? Julie Williams, MD, shares more.

My Patient Overdosed and Now I Feel Guilty…

While patient death by suicide can greatly impact psychiatrists, overdose death’s impact is less researched. However, the rate of synthetic opioid-involved deaths increased by 1040% from 2013 to 2019. One of the most helpful things to do is to acknowledge and normalize the fear of disclosure of relapses amongst patients with substance use disorder. Subconscious criticism on the part of the clinician can lead to patient denial or dishonesty, and may lead to poorer treatment outcomes.

How can you better help patients with substance use disorder while also protecting yourself? Benjamin Li, MD; Burhan Khan, MBBS; and Nidal Moukaddam, MD, PhD, explore this challenging situation.

What topics do you want to see covered in this series? Let us know via email at PTEditor@MMHGroup.com.