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Current psychiatry最新文献

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Agitated and depressed with a traumatic brain injury. 情绪激动,情绪低落,脑外伤
Q4 Medicine Pub Date : 2023-09-01 DOI: 10.12788/cp.0390
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?
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引用次数: 0
Climate change and mental illness: What psychiatrists can do 气候变化与精神疾病:精神病医生能做些什么
Q4 Medicine Pub Date : 2023-09-01 DOI: 10.12788/cp.0389
Oliver Freudenreich
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引用次数: 0
Infested with worms, but are they really there? 感染了蠕虫,但它们真的在那里吗?
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.12788/cp.0376
D. Wong
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引用次数: 1
Off-label medications for addictive disorders 成瘾障碍的标签外药物
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.12788/cp.0384
Tyler Vanderhoof
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引用次数: 1
Brain damage from recurrent relapses of bipolar mania: A call for early LAI use 双相躁狂症复发引起的脑损伤:早期使用LAI的呼吁
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.12788/cp.0385
H. Nasrallah
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
正如我一直主张通过在第一次躁狂发作后立即使用长效注射(LAI)抗精神病药物来预防精神分裂症复发,以防止精神病复发和进行性脑损伤一样,3我强烈建议在第一次躁狂发作出院后立即使用LAI。考虑到多发发作的严重后果,这是双相躁狂最合理的治疗方法,由于药物依从性差,多发发作在这种精神病性情绪障碍中很常见。与BD I的抑郁发作不同,在BD I中,患者可以洞察自己的抑郁并寻求精神治疗,而在躁狂发作期间,患者通常没有意识到自己患有严重的大脑疾病(嗅觉缺失),并拒绝治疗。4此外,患有BD I的年轻患者经常停止口服情绪稳定剂或第二代抗精神病药物(已被批准用于治疗躁狂),因为他们错过了躁狂发作时的幸福快感和旺盛的身心能量。他们完全没有意识到(也不知道)进一步躁狂发作对神经生物学的严重损害,这可能会导致他们的临床、功能和认知退化。这些患者也可能对治疗产生耐药性,这被称为“双相情感障碍的恶性转化”。5进行性脑组织丢失、临床恶化、功能下降的证据,6我是第一项报告双相躁狂患者心室扩张(代表皮质萎缩)的研究的首席研究员,7这一发现随后被20多名研究人员复制。随后进行了大量神经影像学研究,报告了包括额叶在内的多个大脑区域的体积损失。在双相情感障碍I中早期使用长效注射型抗精神病药物可以预防严重后果Henry a.Nasrallah,医学博士,DLFAPA主编
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引用次数: 0
Perinatal psychiatry: 5 key principles 围产期精神病学:5个关键原则
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.12788/cp.0386
L. LaPlante
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引用次数: 0
Burnout among surgeons: Lessons for psychiatrists 外科医生的职业倦怠:给精神科医生的教训
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.12788/cp.0383
Harshavardhan Bollepalli
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。
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引用次数: 0
Diagnosing borderline personality disorder: Avoid these pitfalls 诊断边缘型人格障碍:避免这些陷阱
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.12788/cp.0388
Theodore J. Wilf
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引用次数: 0
Extended-release injectable naltrexone for opioid use disorder 纳曲酮缓释注射治疗阿片类药物使用障碍
Q4 Medicine Pub Date : 2023-08-01 DOI: 10.12788/cp.0387
Ashmeer Ogbuchi
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引用次数: 1
Risk Evaluation and Mitigation Strategy programs: How they can be improved 风险评估和缓解战略方案:如何改进它们
Q4 Medicine Pub Date : 2023-07-01 DOI: 10.12788/cp.0375
C. Cooke
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引用次数: 0
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Current psychiatry
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