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Acute Onset or Worsening of Psychiatric Symptoms Following Breastfeeding Cessation: An Illustrative Case and Literature Review. 停止母乳喂养后精神症状的急性发作或恶化:例证与文献综述。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-10-18 DOI: 10.1016/j.jaclp.2024.10.001
Katherine A Meidl, Bailey N Brooks, Stacey A Pawlak, Melissa B Ludgate

Background: Breastfeeding shares a complex, occasionally contradictory relationship with maternal mental health. Both positive and negative mood impacts have been noted in relation to breastfeeding initiation as well as cessation. Though popular magazines and online forums discuss the onset of psychiatric symptoms following weaning, there is limited medical literature detailing this relationship.

Methods: We describe the case of a patient who developed psychiatric symptoms shortly after weaning, including acute-onset insomnia and worsening anxiety. A literature review of psychiatric symptom development following breastfeeding cessation was conducted using the search engines PubMed, PsycINFO (EBSCOhost), and Embase. Search terms included controlled vocabulary, keywords (within title and abstract fields), synonyms, and related concepts for: postpartum period, postpartum depression, postpartum anxiety, breastfeeding cessation, breastfeeding weaning, lactation, dysphoric milk ejection reflex, and insomnia. Relevant case reports were reviewed and compared to this case. Information including the patient's age, psychiatric symptoms, past psychiatric history, medical work-up, treatment, and outcome was extracted from each article.

Results: Nine patients who developed psychiatric symptoms following breastfeeding cessation were identified in six case reports. Three patients experienced recurrent symptoms in multiple pregnancies. This led to documentation of 13 discrete post-weaning syndromes. All cases involved either first-time parents, those new to breastfeeding, or those experiencing symptoms during multiple weaning periods. Table 1 synthesizes data from article review. As with our case, 11 clinical cases describe sleep changes (primarily insomnia) and 4 discuss anxiety symptoms. Treatment varied based upon symptoms experienced, with no consistently effective treatments identified across cases.

Conclusions: This case of unspecified insomnia and anxiety disorders following abrupt weaning adds to the limited literature in the field and suggests that physiologic and psychologic factors associated with breastfeeding cessation may play a role in the development or worsening of postpartum mood disorders. Intensive psychiatric treatment resulted in resolution of the patient's symptoms. The relationship between weaning and psychiatric disorders is evident in the lay press but is underrepresented in medical literature. Additional research is needed to better understand this relationship so that physicians can counsel, diagnose, and treat patients more effectively.

背景:母乳喂养与产妇的心理健康有着复杂的关系,有时甚至是相互矛盾的。人们注意到,母乳喂养的开始和停止都会对情绪产生积极和消极的影响。尽管流行杂志和在线论坛讨论了断奶后精神症状的出现,但详细阐述这种关系的医学文献却很有限:我们描述了一例断奶后不久即出现精神症状的患者,包括急性失眠和焦虑加重。我们使用 PubMed、PsycINFO (EBSCOhost) 和 Embase 等搜索引擎对停止母乳喂养后出现精神症状的文献进行了综述。检索词包括控制词汇、关键词(在标题和摘要字段内)、同义词和相关概念:产后时期、产后抑郁、产后焦虑、停止母乳喂养、断母乳喂养、泌乳、排乳反射障碍和失眠。我们查阅了相关病例报告,并与本病例进行了比较。从每篇文章中提取了包括患者年龄、精神症状、既往精神病史、医学检查、治疗和结果在内的信息:结果:在六篇病例报告中发现了九名在停止母乳喂养后出现精神症状的患者。其中有三位患者在多次妊娠中反复出现症状。由此记录了 13 种不同的断奶后综合征。所有病例均涉及初次为人父母者、刚开始母乳喂养者或在多次断奶期间出现症状者。表 1 综合了文章综述中的数据。与我们的病例一样,11 个临床病例描述了睡眠变化(主要是失眠),4 个病例讨论了焦虑症状。根据症状的不同,治疗方法也不尽相同,在不同病例中没有发现一致有效的治疗方法:本病例在突然断奶后出现不明原因的失眠和焦虑症,为该领域有限的文献资料增添了新的内容,并表明与停止母乳喂养相关的生理和心理因素可能在产后情绪障碍的发展或恶化中起作用。强化精神治疗后,患者的症状得到了缓解。断奶与精神障碍之间的关系在非专业媒体中很明显,但在医学文献中却很少见。需要进行更多的研究来更好地了解这种关系,以便医生能更有效地为患者提供咨询、诊断和治疗。
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引用次数: 0
Reversible Lithium-induced Bradycardia in a Patient With Wolff-Parkinson-White Syndrome. 一名沃尔夫-帕金森-怀特综合征患者因锂引起的可逆性心动过缓。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-10-10 DOI: 10.1016/j.jaclp.2024.09.007
Kristen Dzeda, Yang Liu, Rocksheng Zhong
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引用次数: 0
Nonprescribed Substance Use in the General Hospital: A Retrospective Study. 综合医院的非处方药物使用情况:一项回顾性研究。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-10-05 DOI: 10.1016/j.jaclp.2024.09.006
Lee M Dockery, Kristopher A Kast, Mariah Smith, Lisa S Stewart, Thomas Reese, Andrew D Wiese, Mauli V Shah, David E Marcovitz

Background: Nonprescribed substance use (NPSU) is a recognized phenomenon exhibited by patients with substance use disorders while admitted to inpatient hospitals. What factors distinguish patients who engage in NPSU, or how their hospitalizations and outcomes differ, remains to be understood in full.

Objectives: Our study describes a cohort of medically admitted patients with substance use disorders with behaviors concerning for NPSU during their hospitalization.

Methods: We extracted electronic health record data for all hospital encounters when an addiction consult was documented (n = 3100). We defined NPSU cases during a clinical, interdisciplinary case review in which patients were deemed high risk based on team members' observations of one or more behaviors described in the NPSU Checklist. These individuals were placed on a "NPSU Protocol," which was implemented for optimization of care, destigmatization, and risk mitigation (n = 61). We compared clinical characteristics, resource utilization, and treatment outcomes among the NPSU cohort to addiction consult patients without suspicion of NPSU but with stimulant or opioid use disorder diagnoses.

Results: Patients on the NPSU protocol were younger and had higher rates of infectious disease diagnoses reported during hospitalization than patients without concern for NPSU. Hospitalizations for individuals suspected of NPSU were longer, had higher rates of before medically advised discharge, as well as discharges without medications for opioid use disorder. These outcome differences were also observed when analysis was restricted to hospitalizations in which an infectious disease was diagnosed.

Conclusions: Our study characterizes a population of people who exhibited behaviors concerning for NPSU and highlights key outcome disparities. To our knowledge, this study is the first to show a direct correlation between infectious disease diagnosis and NPSU, as well as a direct correlation between suspected NPSU and outcomes such as before medically advised discharge and discharge without medications for opioid use disorder, irrespective of infectious disease diagnosis. Further study is necessary to determine interventions to reduce poor outcomes among hospitalized patients with NPSU.

背景和目的:非处方药物使用(NPSU)是公认的药物使用障碍患者在住院期间表现出的一种现象。非处方药物使用患者的区别因素是什么,他们的住院情况和治疗结果有何不同,这些问题仍有待全面了解。我们的研究描述了一组在住院期间有非处方药物使用(NPSU)行为的药物使用障碍住院患者:我们提取了有成瘾咨询记录的所有住院病例的电子健康记录数据(n=3100)。我们在临床跨学科病例审查期间定义了 NPSU 病例,根据小组成员对 NPSU 检查表中描述的一种或多种行为的观察,患者被视为高风险患者。这些患者被纳入 "NPSU 协议",以优化护理、消除耻辱感和降低风险(n=61)。我们将 NPSU 群组的临床特征、资源利用率和治疗结果与未怀疑 NPSU 但诊断为兴奋剂或阿片类药物使用障碍的成瘾咨询患者进行了比较:与未被怀疑患有非典型肺炎的患者相比,接受非典型肺炎治疗方案的患者更年轻,住院期间报告的传染病诊断率更高。疑似 NPSU 患者的住院时间更长,在医疗建议出院前出院的比例更高,且出院时未服用阿片类药物使用障碍 (MOUD) 药物。当分析仅限于确诊为传染病的住院患者时,也观察到了这些结果差异:我们的研究描述了表现出非典型肺炎相关行为的人群的特征,并强调了主要的结果差异。据我们所知,这项研究首次显示了传染病诊断与 NPSU 之间的直接相关性,以及疑似 NPSU 与医疗建议出院前和无 MOUD 出院等结果之间的直接相关性,无论传染病诊断与否。有必要开展进一步研究,以确定减少 NPSU 住院患者不良预后的干预措施。
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引用次数: 0
Medical Psychiatry Units: A Delphi Consensus Approach to Defining Essential Characteristics. 内科精神科病房:采用德尔菲共识法确定基本特征。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-10-05 DOI: 10.1016/j.jaclp.2024.09.004
Susan L Padrino, Aubrey C Chan, Maarten van Schijndel, Marsha N Wittink

Medical psychiatry units (MPUs), also known as complexity intervention units, represent an important innovation for integrating medical and behavioral health care in the hospital setting, thereby reducing the need for sequential medical and psychiatric hospitalization. As US hospitals face an increased demand for mental health services, interest in the MPU model is gaining momentum. However, there is no shared definition for what constitutes an MPU, and significant variation exists among units across the United States that have been designated as an MPU. The lack of a unified definition for MPUs results in significant variability and poses challenges for creating new MPUs and studying existing MPUs. To address this gap, the Medical-Psychiatry Unit Consortium recruited a panel of MPU experts to conduct a consensus study. The consortium used a survey to assess the relative importance of various characteristics of MPUs within the following categories: structural organization, environment and design, spectrum of care, staffing, and culture of care. After two rounds of a modified Delphi process, consensus was achieved with regard to which characteristics are necessary or preferred vs. not necessary or harmful. The necessary or preferred characteristics include those that would be expected on a general medical unit, such as having cardiac telemetry monitoring capabilities, as well as characteristics typical of a psychiatric unit, such as locked unit doors, locked cabinets for patient belongings, and common area or milieu. Overall, this suggests that an ideal MPU combines the ability to provide acute medical care with acute psychiatric care. Notably, staffing and culture of care emerged as categories with the highest ranking of necessary characteristics, outweighing environment, design, or the breadth of services offered. These findings suggest that MPU experts feel teamwork and having a shared mission are critical components of effective MPUs and highlight the importance of staff recruitment and training.

精神科医疗单元(MPUs),又称复杂性干预单元,是在医院环境中整合医疗和行为保健的一项重要创新,从而减少了医疗和精神科连续住院的需求。随着美国医院对心理健康服务的需求不断增加,人们对 MPU 模式的兴趣也日益高涨。然而,对于什么是 MPU 并没有一个共同的定义,美国各地被指定为 MPU 的单位之间也存在着很大的差异。缺乏对 MPU 的统一定义导致了巨大的差异,为创建新的 MPU 和研究现有 MPU 带来了挑战。为了填补这一空白,医疗-精神病学单位联盟招募了一个由多学科综合单位专家组成的小组来开展一项共识研究。联合会通过一项调查来评估多学科综合病房在以下类别中各种特征的相对重要性:结构组织、环境和设计、护理范围、人员配备和护理文化。经过两轮修改后的德尔菲程序,就哪些特征是必要的或首选的,哪些特征是不必要的或有害的达成了共识。必要或首选的特征包括普通医疗单元应有的特征,如具备心电遥测监控功能,以及精神科单元的典型特征,如单元门上锁、病人物品柜上锁、公共区域或环境上锁。总体而言,这表明理想的重症监护病房应兼具提供急症医疗护理和急症精神病护理的能力。值得注意的是,人员配备和护理文化是必要特征中排名最高的类别,超过了环境、设计或所提供服务的广度。这些研究结果表明,多学科综合病房专家认为团队合作和共同的使命是有效的多学科综合病房的重要组成部分,并强调了人员招聘和培训的重要性。
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引用次数: 0
First Suicide Attempts in Early Adolescents: A Descriptive Outcomes Study. 青少年首次自杀未遂:一项描述性结果研究。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-10-05 DOI: 10.1016/j.jaclp.2024.09.003
Alastair J McKean, Chaitanya Pabbati, Tanner J Bommersbach, Jennifer R Geske, J Michael Bostwick

Background: In 2021, suicide was the second leading cause of death in early adolescent Americans ages 10-14. Research into suicidal behavior in this age group is limited. We report on prior psychiatric care, attempt method, and attempt outcomes in a cohort of 164 early adolescents accrued by first suicide attempt coming to medical attention.

Methods: Our cohort constitutes a subsample from a previously reported retrospective-prospective study identified through the Rochester Epidemiology Project that recruited individuals making first suicide attempts coming to medical attention (index attempt [IA]) during a 22-year period (1/1/1986-31/12/07). Among 1490 all-age index attempters followed until 12/31/2010, 164 (11.0%) were aged 10-14.

Results: 3/164 died on IA (1.8% of the cohort; two females, one male). Nearly half (72/164, 43.9%) had no prior psychiatric history. Females were less likely than males to have seen a mental health provider (P = 0.029) or been prescribed psychiatric medications (P < 0.001) prior to IA. Medication overdose was the most common attempt method in females (81/128, 63.3%), while cutting or piercing wounds were the most common method in males (13/36, 36.1%). Females were significantly more likely than males to overdose (P = 0.001). Of IA survivors, 19.9% (32/161) were initially medically hospitalized, 52.8% (85/161) were psychiatrically hospitalized-initially or in transfer-and 37.2% (60/161) were discharged without hospitalization.

Conclusion: Medication overdoses accounted for over half of all IAs and were significantly more common in females. While IA mortality was low relative to older patients from the all-age-cohort, morbidity was substantial with nearly a fifth of attempts severe enough to warrant medical hospitalization and more than half initial or eventual psychiatric hospitalization. These findings emphasize the importance of both means restriction and identification of early adolescents at risk before they make their first attempt.

目标:2021 年,自杀是导致 10-14 岁美国青少年死亡的第二大原因。对这一年龄组自杀行为的研究十分有限。我们报告了一个由 164 名青少年组成的队列中之前的精神科治疗、自杀尝试方法和自杀尝试结果,该队列由首次自杀未遂并就医的青少年组成:我们的队列是从之前报道的罗切斯特流行病学项目(Rochester Epidemiology Project)所确定的回顾性-前瞻性研究中的一个子样本,该项目招募了在 22 年内(1986 年 1 月 1 日至 2007 年 12 月 31 日)首次企图自杀并就医的人(指数企图,IA)。在追踪至 2010 年 12 月 31 日的 1490 名全年龄段自杀未遂者中,164 人(11.0%)的年龄在 10-14 岁之间:3/164人死于自杀未遂(占队列的1.8%;2名女性,1名男性)。近一半的患者(72/164,43.9%)之前没有精神病史。女性比男性更不可能看过心理健康提供者(P=0.029)或开过精神科处方药(P结论:女性比男性更不可能看过心理健康提供者(P=0.029)或开过精神科处方药(P=0.029):用药过量占所有内科病例的一半以上,而且在女性中更为常见。虽然与全年龄组的老年患者相比,药物滥用的死亡率较低,但发病率却很高,近五分之一的药物滥用严重到需要住院治疗,一半以上的药物滥用患者最初或最终被送入精神病院。这些研究结果表明,在青少年首次尝试自杀之前,对他们进行手段限制和识别高危青少年非常重要。
{"title":"First Suicide Attempts in Early Adolescents: A Descriptive Outcomes Study.","authors":"Alastair J McKean, Chaitanya Pabbati, Tanner J Bommersbach, Jennifer R Geske, J Michael Bostwick","doi":"10.1016/j.jaclp.2024.09.003","DOIUrl":"10.1016/j.jaclp.2024.09.003","url":null,"abstract":"<p><strong>Background: </strong>In 2021, suicide was the second leading cause of death in early adolescent Americans ages 10-14. Research into suicidal behavior in this age group is limited. We report on prior psychiatric care, attempt method, and attempt outcomes in a cohort of 164 early adolescents accrued by first suicide attempt coming to medical attention.</p><p><strong>Methods: </strong>Our cohort constitutes a subsample from a previously reported retrospective-prospective study identified through the Rochester Epidemiology Project that recruited individuals making first suicide attempts coming to medical attention (index attempt [IA]) during a 22-year period (1/1/1986-31/12/07). Among 1490 all-age index attempters followed until 12/31/2010, 164 (11.0%) were aged 10-14.</p><p><strong>Results: </strong>3/164 died on IA (1.8% of the cohort; two females, one male). Nearly half (72/164, 43.9%) had no prior psychiatric history. Females were less likely than males to have seen a mental health provider (P = 0.029) or been prescribed psychiatric medications (P < 0.001) prior to IA. Medication overdose was the most common attempt method in females (81/128, 63.3%), while cutting or piercing wounds were the most common method in males (13/36, 36.1%). Females were significantly more likely than males to overdose (P = 0.001). Of IA survivors, 19.9% (32/161) were initially medically hospitalized, 52.8% (85/161) were psychiatrically hospitalized-initially or in transfer-and 37.2% (60/161) were discharged without hospitalization.</p><p><strong>Conclusion: </strong>Medication overdoses accounted for over half of all IAs and were significantly more common in females. While IA mortality was low relative to older patients from the all-age-cohort, morbidity was substantial with nearly a fifth of attempts severe enough to warrant medical hospitalization and more than half initial or eventual psychiatric hospitalization. These findings emphasize the importance of both means restriction and identification of early adolescents at risk before they make their first attempt.</p>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Consultation Liaison Case Conference: Inpatient Psychiatric Consultation for Patients With Sickle Cell Disease. 咨询联络病例会议:镰状细胞病患者的住院精神病咨询。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-10-05 DOI: 10.1016/j.jaclp.2024.09.005
Lauren E Fields, Elizabeth Leimbach, Adrienne D Mishkin, C Patrick Carroll, Elizabeth J Prince

We present the fictional case of a 29-year-old man with sickle cell disease referred to psychiatry for evaluation of depression during an acute pain episode. Consultation-liaison psychiatrists with expertise in sickle cell disease provide guidance for this commonly encountered clinical case based on their experience and a review of the available literature. Key teaching points include the high prevalence of mood and cognitive disorders in this population, as well as pertinent issues related to chronic pain, opioids, and stigma.

我们介绍了一个虚构的病例:一名 29 岁的镰状细胞病患者在一次急性疼痛发作中因抑郁而被转诊到精神科进行评估。具有镰状细胞病专业知识的会诊联络精神科医生根据他们的经验和对现有文献的回顾,为这个常见的临床病例提供了指导。教学要点包括该人群中情绪和认知障碍的高发病率,以及与慢性疼痛、阿片类药物和耻辱感相关的问题。
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引用次数: 0
Novel Use of a Tricyclic Antidepressant to Address Depression and Quality of Life in a Case of Radiation Proctitis. 在一例放射性直肠炎病例中使用三环类抗抑郁药解决抑郁和生活质量问题的新方法。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-10-04 DOI: 10.1016/j.jaclp.2024.09.002
Elizabeth Hale, Patrick Buckley
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引用次数: 0
Proposing Antipsychotic Stewardship Programs to Regulate Antipsychotic Use in the Treatment of Delirium. 提出抗精神病药物监管计划,规范抗精神病药物在治疗谵妄中的使用。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-09-05 DOI: 10.1016/j.jaclp.2024.08.007
Abdulaziz Alkhayyat, Sean Oldak
{"title":"Proposing Antipsychotic Stewardship Programs to Regulate Antipsychotic Use in the Treatment of Delirium.","authors":"Abdulaziz Alkhayyat, Sean Oldak","doi":"10.1016/j.jaclp.2024.08.007","DOIUrl":"10.1016/j.jaclp.2024.08.007","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Development of a Pediatric Catatonia Clinical Roadmap for Clinical Care at Vanderbilt University Medical Center. 为范德比尔特大学医学中心的临床护理制定儿科卡他性精神障碍临床路线图。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-09-05 DOI: 10.1016/j.jaclp.2024.08.003
Joshua Ryan Smith, Tasia York, Sarah Hart, Anuj Patel, Heather L Kreth, Katherine Spencer, Karisa Bree Grizzle, Jo Ellen Wilson, Lindsay Pagano, Nadia Zaim, Catherine Fuchs

Background: Pediatric catatonia is associated with a high degree of morbidity and mortality in children. However, pediatric catatonia is highly responsive to treatment if rapidly identified and appropriate interventions are administered. To our knowledge, there are no current publications which propose a systematic approach for the management of pediatric catatonia.

Objective: The aim of our report was to create multidisciplinary clinical care roadmap for catatonia in the inpatient pediatric setting within Vanderbilt University Medical Center (VUMC).

Methods: At VUMC, we formed a team of pediatric providers from child and adolescent psychiatry, rheumatology, neurology, pediatric hospital medicine, and pediatric psychology. Our team met on a regular basis over the course of 2022-2024 to review the current literature on pediatric catatonia and develop a consensus for clinical assessment and management.

Results: We determined consensus recommendations from our VUMC multidisciplinary team for the following domains of pediatric catatonia inpatient clinical care: initial assessment of pediatric catatonia in the inpatient pediatric settings, medical and psychiatric work up for pediatric catatonia, the lorazepam challenge in pediatric populations, behavioral and environmental considerations, and the use of electroconvulsive therapy and alternative psychopharmacologic interventions in pediatric catatonia.

Conclusion: Pediatric catatonia is a condition associated with a high degree of morbidity and mortality but is responsive to treatment if diagnosed and treated early. The inpatient pediatric medical setting provides a unique opportunity for identification and treatment. Our clinical care roadmap provides tools for inpatient clinicians at VUMC to identify pediatric catatonia and initiate an evidence-based approach to medical workup, management, and clinical care. This approach has the potential to significantly improve longitudinal outcomes and quality of life improvements for children at VUMC with catatonia and their families.

导言:小儿紧张症与儿童的高发病率和高死亡率有关。然而,如果能迅速识别并采取适当的干预措施,小儿紧张症对治疗的反应非常快。据我们所知,目前还没有任何出版物提出治疗小儿紧张症的系统方法。我们的报告旨在为范德比尔特大学医学中心(VUMC)儿科住院病人的紧张症制定多学科临床护理路线图:在范德比尔特大学医学中心,我们组建了一个由来自儿童与青少年精神病学、风湿病学、神经病学、儿科医院医学和儿科心理学的儿科医疗人员组成的团队。我们的团队在 2022 年至 2024 年期间定期举行会议,回顾当前有关小儿紧张症的文献,并就临床评估和管理达成共识:我们确定了弗吉尼亚大学医学院多学科团队就儿科紧张症住院患者临床护理的以下领域提出的共识建议:儿科紧张症住院患者的初步评估、儿科紧张症的医学和精神病学检查、劳拉西泮在儿科人群中的挑战、行为和环境因素、电惊厥治疗和其他精神药物干预在儿科紧张症中的应用:结论:小儿紧张症是一种发病率和死亡率都很高的疾病,但如果及早诊断和治疗,其治疗效果还是不错的。儿科住院医疗环境为识别和治疗提供了独特的机会。我们的临床护理路线图为 VUMC 的住院临床医生提供了识别儿科紧张症的工具,并启动了循证医学检查、管理和临床护理方法。这种方法有可能显著改善VUMC患有紧张症的儿童及其家人的纵向治疗效果和生活质量。
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引用次数: 0
Prevalence of Substance Use Disorders Among Patients With Psoriasis and Comorbid Major Depressive Disorder. 银屑病合并重度抑郁症患者的药物使用障碍患病率。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-09-03 DOI: 10.1016/j.jaclp.2024.08.008
Xiaofeng Yan, Kevin J Varghese, James Alan Bourgeois
{"title":"Prevalence of Substance Use Disorders Among Patients With Psoriasis and Comorbid Major Depressive Disorder.","authors":"Xiaofeng Yan, Kevin J Varghese, James Alan Bourgeois","doi":"10.1016/j.jaclp.2024.08.008","DOIUrl":"10.1016/j.jaclp.2024.08.008","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of the Academy of Consultation-Liaison Psychiatry
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