Sarah Dinegar, Edwin Meresh, Hera Tang, Victoria Nobari
Mr. N, age 46, has a history of alcohol use disorder, insomnia, anxiety, and depression. He is brought to the ED with a TBI after repeatedly beating his head into a table. How can you help him?
N 先生，46 岁，有酗酒、失眠、焦虑和抑郁病史。他因多次将头撞向桌子导致创伤性脑损伤而被送到急诊室。您能如何帮助他？
{"title":"Agitated and depressed with a traumatic brain injury.","authors":"Sarah Dinegar, Edwin Meresh, Hera Tang, Victoria Nobari","doi":"10.12788/cp.0390","DOIUrl":"10.12788/cp.0390","url":null,"abstract":"<p><p>Mr. N, age 46, has a history of alcohol use disorder, insomnia, anxiety, and depression. He is brought to the ED with a TBI after repeatedly beating his head into a table. How can you help him?</p>","PeriodicalId":10971,"journal":{"name":"Current psychiatry","volume":" ","pages":"44-48"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46814599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Climate change and mental illness: What psychiatrists can do","authors":"Oliver Freudenreich","doi":"10.12788/cp.0389","DOIUrl":"https://doi.org/10.12788/cp.0389","url":null,"abstract":"","PeriodicalId":10971,"journal":{"name":"Current psychiatry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44866600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Infested with worms, but are they really there?","authors":"D. Wong","doi":"10.12788/cp.0376","DOIUrl":"https://doi.org/10.12788/cp.0376","url":null,"abstract":"","PeriodicalId":10971,"journal":{"name":"Current psychiatry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48673900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Just as I have always advocated preventing recurrences in schizophrenia by using long-acting injectable (LAI) antipsychotic formulations immediately after the first episode to prevent psychotic relapses and progressive brain damage,3 I strongly recommend using LAIs right after hospital discharge from the first manic episode. It is the most rational management approach for bipolar mania given the grave consequences of multiple episodes, which are so common in this psychotic mood disorder due to poor medication adherence. In contrast to the depressive episodes of BD I, where patients have insight into their depression and seek psychiatric treatment, during a manic episode patients often have no insight (anosognosia) that they suffer from a serious brain disorder, and refuse treatment.4 In addition, young patients with BD I frequently discontinue their oral mood stabilizer or second-generation antipsychotic (which are approved for mania) because they miss the blissful euphoria and the buoyant physical and mental energy of their manic episodes. They are completely oblivious to (and uninformed about) the grave neurobiological damage of further manic episodes, which can condemn them to clinical, functional, and cognitive deterioration. These patients are also likely to become treatment-resistant, which has been labeled as “the malignant transformation of bipolar disorder.”5 The evidence for progressive brain tissue loss, clinical deterioration, functional decline, and treatment resistance is abundant.6 I was the lead investigator of the first study to report ventricular dilatation (which is a proxy for cortical atrophy) in bipolar mania,7 a discovery that was subsequently replicated by 2 dozen researchers. This was followed by numerous neuroimaging studies reporting a loss of volume across multiple brain regions, including the frontal lobe, Early use of a longacting injectable antipsychotic in bipolar I disorder can prevent grave consequences Henry A. Nasrallah, MD, DLFAPA Editor-in-Chief
{"title":"Brain damage from recurrent relapses of bipolar mania: A call for early LAI use","authors":"H. Nasrallah","doi":"10.12788/cp.0385","DOIUrl":"https://doi.org/10.12788/cp.0385","url":null,"abstract":"Just as I have always advocated preventing recurrences in schizophrenia by using long-acting injectable (LAI) antipsychotic formulations immediately after the first episode to prevent psychotic relapses and progressive brain damage,3 I strongly recommend using LAIs right after hospital discharge from the first manic episode. It is the most rational management approach for bipolar mania given the grave consequences of multiple episodes, which are so common in this psychotic mood disorder due to poor medication adherence. In contrast to the depressive episodes of BD I, where patients have insight into their depression and seek psychiatric treatment, during a manic episode patients often have no insight (anosognosia) that they suffer from a serious brain disorder, and refuse treatment.4 In addition, young patients with BD I frequently discontinue their oral mood stabilizer or second-generation antipsychotic (which are approved for mania) because they miss the blissful euphoria and the buoyant physical and mental energy of their manic episodes. They are completely oblivious to (and uninformed about) the grave neurobiological damage of further manic episodes, which can condemn them to clinical, functional, and cognitive deterioration. These patients are also likely to become treatment-resistant, which has been labeled as “the malignant transformation of bipolar disorder.”5 The evidence for progressive brain tissue loss, clinical deterioration, functional decline, and treatment resistance is abundant.6 I was the lead investigator of the first study to report ventricular dilatation (which is a proxy for cortical atrophy) in bipolar mania,7 a discovery that was subsequently replicated by 2 dozen researchers. This was followed by numerous neuroimaging studies reporting a loss of volume across multiple brain regions, including the frontal lobe, Early use of a longacting injectable antipsychotic in bipolar I disorder can prevent grave consequences Henry A. Nasrallah, MD, DLFAPA Editor-in-Chief","PeriodicalId":10971,"journal":{"name":"Current psychiatry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45976303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vol. 22, No. 8 23 Burnout is an occupational phenomenon and a syndrome resulting from unsuccessfully managed chronic workplace stress. The characteristic features of burnout include feelings of exhaustion, cynicism, and reduced professional efficacy.1 A career in surgery is associated with demanding and unpredictable work hours in a high-stress environment.2-8 Research indicates that surgeons are at an elevated risk for developing burnout and mental health problems that can compromise patient care. A survey of the fellows of the American College of Surgeons found that 40% of surgeons experience burnout, 30% experience symptoms of depression, and 28% have a mental quality of life (QOL) score greater than one-half an SD below the population norm.9,10 Surgeon burnout was also found to compromise the delivery of medical care.9,10 To prevent serious harm to surgeons and patients, it is critical to understand the causative factors of burnout among surgeons and how they can be addressed. We conducted this systematic review to identify factors linked to burnout across surgical specialties and to suggest ways to mitigate these risk factors.
职业倦怠是一种职业现象，是由于长期工作压力管理不成功而导致的一种综合症。职业倦怠的特征包括疲惫、玩世不恭和职业效率降低外科的职业生涯与高压力环境中要求高和不可预测的工作时间有关。2-8研究表明，外科医生出现职业倦怠和精神健康问题的风险较高，这可能会影响对患者的护理。一项针对美国外科医师学会(American College of Surgeons)研究员的调查发现，40%的外科医师经历过职业倦怠，30%的外科医师经历过抑郁症状，28%的外科医师的精神生活质量(QOL)得分比总体标准低1.5个标准差以上。9,10外科医生的职业倦怠也会影响医疗服务的提供。9,10为了防止对外科医生和患者造成严重伤害，了解外科医生职业倦怠的致病因素以及如何解决这些因素至关重要。我们进行了这项系统综述，以确定与外科专业的职业倦怠相关的因素，并提出减轻这些风险因素的方法。
{"title":"Burnout among surgeons: Lessons for psychiatrists","authors":"Harshavardhan Bollepalli","doi":"10.12788/cp.0383","DOIUrl":"https://doi.org/10.12788/cp.0383","url":null,"abstract":"Vol. 22, No. 8 23 Burnout is an occupational phenomenon and a syndrome resulting from unsuccessfully managed chronic workplace stress. The characteristic features of burnout include feelings of exhaustion, cynicism, and reduced professional efficacy.1 A career in surgery is associated with demanding and unpredictable work hours in a high-stress environment.2-8 Research indicates that surgeons are at an elevated risk for developing burnout and mental health problems that can compromise patient care. A survey of the fellows of the American College of Surgeons found that 40% of surgeons experience burnout, 30% experience symptoms of depression, and 28% have a mental quality of life (QOL) score greater than one-half an SD below the population norm.9,10 Surgeon burnout was also found to compromise the delivery of medical care.9,10 To prevent serious harm to surgeons and patients, it is critical to understand the causative factors of burnout among surgeons and how they can be addressed. We conducted this systematic review to identify factors linked to burnout across surgical specialties and to suggest ways to mitigate these risk factors.","PeriodicalId":10971,"journal":{"name":"Current psychiatry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42102410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risk Evaluation and Mitigation Strategy programs: How they can be improved","authors":"C. Cooke","doi":"10.12788/cp.0375","DOIUrl":"https://doi.org/10.12788/cp.0375","url":null,"abstract":"","PeriodicalId":10971,"journal":{"name":"Current psychiatry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45142350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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