The primary care companion for CNS disorders最新文献

Importance: When patients present with cognitive impairment, consults to neuropsychology can assist internists and psychiatrists in diagnosis, treatment planning, and determination of functional status. Neuropsychological evaluation and treatment have been shown to improve health outcomes and patient and family satisfaction. The objective of this narrative review is to explore the role of neuropsychologists in their collaboration with care teams to improve patient outcomes.

Observations: Neuropsychologists have specialized education and training in brain behavior relationships and neurocognitive functioning. The consultation process for neuropsychology can be made more efficient by the referring physician clearly delineating the reason for the referral, ordering relevant laboratory tests and imaging studies, performing screenings for treatable conditions, and providing historical records to the neuropsychologist prior to the consult. Neuropsychological assessment can assist in diagnosis, identification of neuropsychological status, establishing a baseline, treatment planning, determination of functional ability, and monitoring the effectiveness of treatments.

Conclusions and Relevance: Primary care teams and psychiatrists can benefit from collaboration with neuropsychologists. The most effective process for engaging neuropsychologists in the care of patients is through full communication, including properly placed consults.

Prim Care Companion CNS Disord 2024;26(5):24nr03766.

Author affiliations are listed at the end of this article.

Importance: Amid and following the COVID-19 pandemic, there has been a growing focus on understanding the underlying etiology of the mental health crisis in children and youth. However, there remains a dearth of empirically driven literature to comprehensively explore these issues. This narrative review delves into current mental health challenges among children and youth, examining perspectives from both pre-pandemic and pandemic periods.

Observations: Research highlights reveal concerning statistics, such as 1 in 5 children experience mental health disorders. The pandemic exacerbated these issues, introducing stressors such as job losses and heightened anticipatory anxiety. Race relations have emerged as a significant public health concern, with biases impacting students, particularly affecting Asian, black, and multiracial individuals. Substance use trends indicate a rise in overdose deaths, particularly among adolescents, with cannabis use linked to adverse outcomes. Increased screen time and income disparities further compound mental health challenges.

Conclusions and Relevance: Proposed public health mitigation strategies include improving access to evidence based treatments, implementing legislative measures for early identification and treatment of developmental disorders, and enhancing suicide prevention efforts. School-based interventions and vocational-technical education are crucial, alongside initiatives targeting sleep hygiene, social media usage, nutrition, and physical activity. Educating health care professionals about both physical and mental health is essential to address workforce burnout and effectively manage clinical complexities.

Prim Care Companion CNS Disord 2024;26(5):24nr03747.

Author affiliations are listed at the end of this article.

Objective: To examine the prevalence and key correlates of psychological resilience in Ukrainian mental health workers (MHWs), using a novel discrepancy-based psychiatric resilience (DBPR) analytic approach.

Methods: A total of 178 Ukrainian MHWs, recruited via convenience sampling from July to August 2023, completed a survey assessing their war-related exposures, occupational stress, and mental health symptoms and sociodemographic and psychosocial characteristics. DBPR scores were computed by regressing composite distress scores onto measures of war- and work-related stressors. Psychological resilience was defined as lower actual, relative to predicted, composite distress scores. Multivariable and relative importance analyses were conducted to identify and quantify factors associated with greater resilience.

Results: A total of 55.6% of MHWs were classified as resilient. Greater levels of close social relationships, presence of meaning in life, and optimism were independently associated with greater resilience.

Conclusion: A slight majority of Ukrainian MHWs exhibit psychological resilience in the face of ongoing conflict and occupational stressors. Clinical interventions to bolster social connectedness, meaning in life, and optimism may help promote resilience in this population.

Prim Care Companion CNS Disord 2024;26(5):24m03761.

Author affiliations are listed at the end of this article.

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss the diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Prim Care Companion CNS Disord 2024;26(5):24f03763.

Author affiliations are listed at the end of this article.

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Prim Care Companion CNS Disord 2024;26(5):24f03783.

Author affiliations are listed at the end of this article.