Psychosomatics最新文献

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IF 3.4 Q2 Medicine

Psychosomatics

Pub Date : 2020-11-01 DOI: 10.1016/j.psym.2020.01.010

Nicholas Kontos M.D.

引用次数: 0

Validation of the Ask Suicide-Screening Questions for Adult Medical Inpatients: A Brief Tool for All Ages 对成年住院病人自杀筛查问题的验证:一个适用于所有年龄段的简短工具

IF 3.4 Q2 Medicine

Psychosomatics

Pub Date : 2020-11-01 DOI: 10.1016/j.psym.2020.04.008

Lisa M. Horowitz Ph.D., M.P.H. , Deborah J. Snyder M.S.W. , Edwin D. Boudreaux Ph.D. , Jian-Ping He M.S. , Colin J. Harrington M.D. , June Cai M.D. , Cynthia A. Claassen Ph.D. , Joan E. Salhany M.B.A.H.C.M., R.N. , Tram Dao Psy.D. , John F. Chaves M.D. , David A. Jobes Ph.D. , Kathleen R. Merikangas Ph.D. , Jeffrey A. Bridge Ph.D. , Maryland Pao M.D.

Background

Few brief suicide risk screening instruments are validated for use in both adult and pediatric medical populations. Using the pediatric Ask Suicide-Screening Questions (ASQ) development study as a model, this study aimed to determine whether the ASQ is a valid suicide risk–screening instrument for use among adults medical patients, as well as to evaluate a set of other potential screening questions for use in adults.

Methods

Adult patients hospitalized on inpatient medical/surgical units from 4 hospitals were recruited to participate in a cross-sectional instrument-validation study. The 4-item ASQ and other candidate items were compared against the 25-item, previously validated Adult Suicidal Ideation Questionnaire as the criterion standard.

Results

A total of 727 adult medical inpatients completed the screening process. Compared with the Adult Suicidal Ideation Questionnaire, the ASQ performed best among the full set of candidate items, demonstrating strong psychometric properties, with a sensitivity of 100% (95% confidence interval = 90%–100%), a specificity of 89% (95% confidence interval = 86%–91%), and a negative predictive value of 100% (95% confidence interval = 99%–100%). A total of 4.8% (35/727) of the participants screened positive for suicide risk based on the standard criterion Adult Suicidal Ideation Questionnaire.

Conclusions

The ASQ is a valid and brief suicide risk–screening tool for use among adults. Screening medical/surgical inpatients for suicide risk can be performed effectively for both adult and pediatric patients using this brief, primary screener.

背景:很少有简短的自杀风险筛查工具被证实适用于成人和儿科医疗人群。本研究以儿科自杀筛查问题(ASQ)发展研究为模型，旨在确定ASQ是否是一种有效的成人医疗患者自杀风险筛查工具，并评估一组其他可能用于成人的筛查问题。方法选取4所医院内科/外科住院的成年患者进行横断面仪器验证研究。将4项ASQ和其他候选项目与先前验证的25项成人自杀意念问卷作为判定标准进行比较。结果共有727名成年住院患者完成了筛查。与成人自杀意念问卷相比，ASQ在所有候选项目中表现最好，表现出较强的心理测量特性，灵敏度为100%(95%置信区间= 90% ~ 100%)，特异性为89%(95%置信区间= 86% ~ 91%)，负预测值为100%(95%置信区间= 99% ~ 100%)。在成人自杀意念量表中，有4.8%(35/727)的被试有自杀倾向。结论ASQ是一种有效、简便的成人自杀风险筛查工具。筛选医疗/外科住院病人的自杀风险可以有效地为成人和儿童患者使用这个简短的，初级筛选。

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引用次数: 55

Diagnostic Challenges and Treatment of the Neuropsychiatric Symptoms of Adult-Onset Niemann-Pick Type C With Electroconvulsive Therapy 电休克治疗成人型尼曼-匹克C型神经精神症状的诊断挑战和治疗

IF 3.4 Q2 Medicine

Psychosomatics

Pub Date : 2020-11-01 DOI: 10.1016/j.psym.2020.06.011

Rachel Foels B.S. , Kimberly Hartney M.D. , Alexis Cohen-Oram M.D.

引用次数: 1

The Use of Security Dogs in De-escalation of Agitated Patients 安全犬在降低焦虑患者情绪升级中的应用

IF 3.4 Q2 Medicine

Psychosomatics

Pub Date : 2020-11-01 DOI: 10.1016/j.psym.2020.06.006

Janice Chung B.S. , Prudhvi Bandi B.S. , Daniel B. Janiczak M.D. , Jason P. Caplan M.D. , Curtis A. McKnight M.D.

引用次数: 2

End-Stage Anorexia Nervosa: When to Say “When”—A Literature Review of an Ethically Complicated Case 终末期神经性厌食症:何时说“何时”——一个伦理复杂案例的文献综述

IF 3.4 Q2 Medicine

Psychosomatics

Pub Date : 2020-11-01 DOI: 10.1016/j.psym.2020.05.011

Christine Sawhill D.O. , David C. Fipps D.O. , Jennifer V. Palomo M.S. , Melanie Miller M.D.

引用次数: 1

Neurocovid: Pharmacological Recommendations for Delirium Associated With COVID-19 神经covid:与COVID-19相关的谵妄的药理学建议

IF 3.4 Q2 Medicine

Psychosomatics

Pub Date : 2020-11-01 DOI: 10.1016/j.psym.2020.05.013

Erica B. Baller M.D., M.S. , Charlotte S. Hogan M.D. , Mark A. Fusunyan M.D. , Ana Ivkovic M.D. , James W. Luccarelli M.D., D.Phil. , Elizabeth Madva M.D. , Mladen Nisavic M.D. , Nathan Praschan M.D., M.P.H. , Nadia V. Quijije M.D. , Scott R. Beach M.D. , Felicia A. Smith M.D.

Background

The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as one of the biggest health threats of our generation. A significant portion of patients are presenting with delirium and neuropsychiatric sequelae of the disease. Unique examination findings and responses to treatment have been identified.

Objective

In this article, we seek to provide pharmacologic and treatment recommendations specific to delirium in patients with COVID-19.

Methods

We performed a literature search reviewing the neuropsychiatric complications and treatments in prior coronavirus epidemics including Middle Eastern respiratory syndrome and severe acute respiratory syndrome coronaviruses, as well as the emerging literature regarding COVID-19. We also convened a work group of consultation-liaison psychiatrists actively managing patients with COVID-19 in our hospital. Finally, we synthesized these findings to provide preliminary pharmacologic recommendations for treating delirium in these patients.

Results

Delirium is frequently found in patients who test positive for COVID-19, even in the absence of respiratory symptoms. There appears to be a higher rate of agitation, myoclonus, abulia, and alogia. No data are currently available on the treatment of delirium in patients with COVID-19. Extrapolating from general delirium treatment, Middle Eastern respiratory syndrome/severe acute respiratory syndrome case reports, and our experience, preliminary recommendations for pharmacologic management have been assembled.

Conclusions

COVID-19 is associated with neuropsychiatric symptoms. Low-potency neuroleptics and alpha-2 adrenergic agents may be especially useful in this setting. Further research into the pathophysiology of COVID-19 will be key in developing more targeted treatment guidelines.

由严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2)引起的2019冠状病毒病(COVID-19)大流行已成为我们这一代人最大的健康威胁之一。很大一部分患者表现为谵妄和该疾病的神经精神后遗症。独特的检查结果和对治疗的反应已经确定。目的在本文中，我们寻求提供针对COVID-19患者谵妄的药物和治疗建议。方法查阅文献，回顾中东呼吸综合征和严重急性呼吸综合征冠状病毒等冠状病毒既往流行的神经精神并发症和治疗情况，以及新出现的有关COVID-19的文献。我们还召集了一个会诊联络精神科医生工作组，积极管理我院的COVID-19患者。最后，我们综合这些发现，为治疗这些患者的谵妄提供初步的药理学建议。结果谵妄常见于COVID-19检测阳性的患者，即使没有呼吸道症状。躁动、肌阵挛、食欲不振和痛症的发生率似乎更高。目前没有关于治疗COVID-19患者谵妄的数据。从一般谵妄治疗、中东呼吸综合征/严重急性呼吸综合征病例报告和我们的经验推断，已经收集了药物管理的初步建议。结论新型冠状病毒肺炎与神经精神症状相关。在这种情况下，低效抗精神病药和α -2肾上腺素能药物可能特别有用。进一步研究COVID-19的病理生理学将是制定更有针对性的治疗指南的关键。

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引用次数: 61

Physical Health and Psychosocial Considerations During the Coronavirus Disease 2019 Outbreak 2019冠状病毒病爆发期间的身体健康和心理社会考虑

IF 3.4 Q2 Medicine

Psychosomatics

Pub Date : 2020-11-01 DOI: 10.1016/j.psym.2020.07.005

Andrea Giacalone Ph.D., Gennaro Rocco Ph.D., Enzo Ruberti Ph.D.

引用次数: 21

An Intravenous Lorazepam Infusion for Dissociative Amnesia: A Case Report 劳拉西泮静脉输注治疗游离性遗忘1例

IF 3.4 Q2 Medicine

Psychosomatics

Pub Date : 2020-11-01 DOI: 10.1016/j.psym.2020.01.009

Shixie Jiang M.D. , Steven Gunther M.D. , Kimberly Hartney M.D. , Theodore A. Stern M.D.

引用次数: 0

CASPR2-IgG–Associated Autoimmune Encephalitis: Unusual Cause of Delirium caspr2 - igg相关的自身免疫性脑炎:谵妄的不寻常原因

IF 3.4 Q2 Medicine

Psychosomatics

Pub Date : 2020-11-01 DOI: 10.1016/j.psym.2020.05.017

Qi Sun M.D. , Tara Davidson M.D. , Jennifer Kleinman Sween M.D. , Christopher Klein M.D. , Thomas McLeod M.D. , Teresa Rummans M.D.

引用次数: 2

The Feasibility and Impact of a Suicide Risk Screening Program in Rural Adult Primary Care: A Pilot Test of the Ask Suicide-Screening Questions Toolkit 农村成人初级保健自杀风险筛查项目的可行性和影响:自杀筛查问题询问工具包的试点测试

IF 3.4 Q2 Medicine

Psychosomatics

Pub Date : 2020-11-01 DOI: 10.1016/j.psym.2020.05.002

Mary A. LeCloux Ph.D. , Mathew Weimer M.D. , Stacey L. Culp Ph.D. , Karissa Bjorkgren B.S. , Samantha Service M.S. , John V. Campo M.D.

Objective

The purpose of this study was to evaluate the feasibility and impact of a suicide risk screening program in a rural West Virginia primary care practice.

Methods

Patients presenting for routine and sick visits were asked to participate in electronic suicide risk screening using the Ask Suicide-Screening Questions tool; screen positive individuals were assessed with the Ask Suicide-Screening Questions Brief Suicide Safety Assessment. Screening program feasibility was evaluated by the proportion of patients consenting to participate, participant Ask Suicide-Screening Questions and Brief Suicide Safety Assessment completion rates, and response to a question asking whether primary care providers should ask about suicide. Screening impact was evaluated quasi-experimentally by comparing electronic medical record documentation of suicide risk screening, assessment, and risk determination in practice patients before and after implementing the screening program.

Results

Over half of the patients approached agreed to participate in a research study about suicide (N = 196; 57.7%). Feasibility of the screening program was demonstrated by the high completion rates for the Ask Suicide-Screening Questions (99.0%) and the Brief Suicide Safety Assessment (100.0%) among study participants. Additionally, 95.4% (N = 187) of participants agreed primary care providers should screen patients for suicide. Suicide screening rates rose significantly between the baseline and intervention phases (5.8% to 61.0%; X² = 200.61, P < 0.001), as did suicide risk detection rates (0.7% to 6.2%; X² = 12.58, P < 0.001).

Conclusion

Suicide risk screening was feasible and well accepted by adult patients in rural primary care and has potential to improve suicide risk detection in this setting.

目的本研究的目的是评估自杀风险筛查项目在西弗吉尼亚州农村初级保健实践中的可行性和影响。方法采用“询问自杀筛查问题”(Ask suicide screening Questions)工具，要求就诊的患者参与电子自杀风险筛查;对筛查阳性个体进行自杀筛查问题简要自杀安全评估。筛选方案的可行性通过同意参与的患者比例、参与者询问自杀筛选问题和简要自杀安全评估完成率以及对初级保健提供者是否应该询问自杀问题的回答来评估。通过比较实施筛查计划前后患者自杀风险筛查、评估和风险确定的电子病历文件，对筛查的影响进行准实验评估。结果超过一半的患者同意参加一项关于自杀的研究(N = 196;57.7%)。筛选方案的可行性通过研究参与者自杀筛选问题的高完成率(99.0%)和简要自杀安全评估(100.0%)得到证明。此外，95.4% (N = 187)的参与者同意初级保健提供者应该对患者进行自杀筛查。自杀筛查率在基线和干预阶段之间显著上升(5.8%至61.0%;X2 = 200.61, P <0.001)，自杀风险检出率也是如此(0.7%至6.2%;X2 = 12.58, P <0.001)。结论自杀风险筛查在农村初级保健成人患者中是可行的，且被广泛接受，具有提高自杀风险检测水平的潜力。

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引用次数: 11

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