首页 > 最新文献

Journal of the Academy of Consultation-Liaison Psychiatry最新文献

英文 中文
A Survey of Consultation Liaison Psychiatrists on the Assessment of Maternal Capacity 关于产妇行为能力评估的咨询联络精神科医生调查。
IF 2.3 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-05-01 DOI: 10.1016/j.jaclp.2024.02.005
Laura Renee Warning B.S., Nicholas David Hollman M.P.H., B.S., Ondria Chris Gleason M.D.
{"title":"A Survey of Consultation Liaison Psychiatrists on the Assessment of Maternal Capacity","authors":"Laura Renee Warning B.S., Nicholas David Hollman M.P.H., B.S., Ondria Chris Gleason M.D.","doi":"10.1016/j.jaclp.2024.02.005","DOIUrl":"10.1016/j.jaclp.2024.02.005","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 3","pages":"Pages 322-324"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013743","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
Delirium and Near-Death Experience: A Case of Surviving a Complicated Delivery 谵妄与濒死体验:一个难产幸存的案例。
IF 2.3 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-05-01 DOI: 10.1016/j.jaclp.2023.12.004
Sean E. Oldak M.D., Omar Muñoz-Abraham M.D., Lujain Alhajji M.D., Vanessa L. Padilla M.D.
{"title":"Delirium and Near-Death Experience: A Case of Surviving a Complicated Delivery","authors":"Sean E. Oldak M.D., Omar Muñoz-Abraham M.D., Lujain Alhajji M.D., Vanessa L. Padilla M.D.","doi":"10.1016/j.jaclp.2023.12.004","DOIUrl":"10.1016/j.jaclp.2023.12.004","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 3","pages":"Pages 313-314"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886589","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
Diabetes-Related Posttraumatic Stress Symptoms in Adolescents and Young Adults With Type 1 Diabetes: A Pilot Study 1 型糖尿病青少年患者中与糖尿病相关的创伤后应激症状 (PTSS):试点研究。
IF 2.3 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-05-01 DOI: 10.1016/j.jaclp.2024.01.003
Tamaki Hosoda-Urban Ph.D. , Ellen H. O'Donnell Ph.D.

Background

Posttraumatic stress symptoms (PTSS) may adversely affect glycemic control. Yet no studies have focused on trauma and PTSS induced by diabetes-related events in adolescents and young adults (AYA) with type 1 diabetes.

Objective

This study explores PTSS arising from diabetes-related events (e.g., severe symptoms or emergency room visits due to complications) among AYA with type 1 diabetes.

Methods

In this cross-sectional pilot study, self-reported measures (Posttraumatic Diagnostic Scale for DSM-5, Child Posttraumatic Stress Disorder Symptom Scale 5) were employed to assess trauma experiences and PTSS in AYA with type 1 diabetes at a pediatric diabetes clinic within a large hospital/academic medical center.

Results

Fifty AYA with type 1 diabetes completed questionnaires assessing trauma and PTSS. Of the sample, 82% (n = 41) reported experiencing at least one form of general trauma (e.g., physical abuse, witnessing violence, or serious injuries). Among those who reported trauma, 22% (n = 9) indicated that the most distressing event was specifically diabetes-related. Over a quarter of participants exhibited clinically relevant levels of PTSS related to diabetes events. Females assigned at birth and those with a higher frequency of emergency room visits due to diabetes had an elevated risk of developing clinically relevant levels of diabetes-related PTSS.

Conclusions

Our results suggest that diabetes itself can serve as a traumatic stressor for some individuals. Therefore, interventions should be designed to prevent or mitigate PTSS starting from the time of diagnosis.

背景:创伤后应激症状(PTSS)可能会对血糖控制产生不利影响。然而,还没有研究关注 1 型糖尿病青少年和年轻成人(AYA)因糖尿病相关事件引起的创伤和 PTSS:本研究探讨了 1 型糖尿病青少年患者因糖尿病相关事件(如严重症状或因并发症就诊急诊室)而产生的 PTSS:在这项横断面试验性研究中,我们采用了自我报告量表(DSM-5创伤后诊断量表、儿童创伤后应激障碍症状量表5)来评估一家大型医院/学术医疗中心儿科糖尿病门诊的1型糖尿病亚健康患者的创伤经历和PTSS:结果:50 名 1 型糖尿病青少年完成了创伤和 PTSS 评估问卷。在这些样本中,82%(n = 41)的人表示至少经历过一种形式的一般创伤(如身体虐待、目睹暴力、严重受伤)。在报告创伤的参与者中,22%(n = 9)表示最痛苦的事件与糖尿病有关。超过四分之一的参与者表现出与糖尿病事件相关的临床相关水平的创伤后应激障碍。出生时即被分配的女性和因糖尿病而去急诊室就诊频率较高的女性患与糖尿病相关的临床相关水平的PTSS的风险较高:我们的研究结果表明,糖尿病本身对某些人来说就是一种创伤应激源。因此,应从诊断开始就设计干预措施来预防或减轻 PTSS。
{"title":"Diabetes-Related Posttraumatic Stress Symptoms in Adolescents and Young Adults With Type 1 Diabetes: A Pilot Study","authors":"Tamaki Hosoda-Urban Ph.D. ,&nbsp;Ellen H. O'Donnell Ph.D.","doi":"10.1016/j.jaclp.2024.01.003","DOIUrl":"10.1016/j.jaclp.2024.01.003","url":null,"abstract":"<div><h3>Background</h3><p>Posttraumatic stress symptoms (PTSS) may adversely affect glycemic control. Yet no studies have focused on trauma and PTSS induced by diabetes-related events in adolescents and young adults (AYA) with type 1 diabetes.</p></div><div><h3>Objective</h3><p>This study explores PTSS arising from diabetes-related events (e.g., severe symptoms or emergency room visits due to complications) among AYA with type 1 diabetes.</p></div><div><h3>Methods</h3><p>In this cross-sectional pilot study, self-reported measures (Posttraumatic Diagnostic Scale for DSM-5, Child Posttraumatic Stress Disorder Symptom Scale 5) were employed to assess trauma experiences and PTSS in AYA with type 1 diabetes at a pediatric diabetes clinic within a large hospital/academic medical center.</p></div><div><h3>Results</h3><p>Fifty AYA with type 1 diabetes completed questionnaires assessing trauma and PTSS. Of the sample, 82% (n = 41) reported experiencing at least one form of general trauma (e.g., physical abuse, witnessing violence, or serious injuries). Among those who reported trauma, 22% (n = 9) indicated that the most distressing event was specifically diabetes-related. Over a quarter of participants exhibited clinically relevant levels of PTSS related to diabetes events. Females assigned at birth and those with a higher frequency of emergency room visits due to diabetes had an elevated risk of developing clinically relevant levels of diabetes-related PTSS.</p></div><div><h3>Conclusions</h3><p>Our results suggest that diabetes itself can serve as a traumatic stressor for some individuals. Therefore, interventions should be designed to prevent or mitigate PTSS starting from the time of diagnosis.</p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 3","pages":"Pages 248-253"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266729602400003X/pdfft?md5=07609978cdb48357ea98e4759821893a&pid=1-s2.0-S266729602400003X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Meaningful Engagement in Depression and Anxiety Collaborative Care: Associations With Systematic Case Review 有意义地参与抑郁和焦虑协作护理:与系统性病例回顾的关联。
IF 2.3 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-05-01 DOI: 10.1016/j.jaclp.2024.01.006
Heather Huang M.D. , Brandon Huynh M.D. , Nichole Nidey Ph.D. , Hsiang Huang M.D., M.P.H.

Background

Collaborative care (CC) is an evidence-based model of care for treating behavioral health conditions in primary care settings. The CC team consists of a primary care provider, behavioral health care manager (CM), and a consultant psychiatrist who collaborate to create treatment plans. To date, there is limited data on factors associated with meaningful engagement in CC programs.

Objective

To identify the proportion of patients who were meaningfully engaged and to investigate the factors associated with meaningful engagement in a CC program.

Methods

Data was collected from a CC program implemented across 27 adult primary care clinics in a Midwestern, U.S. academic medical system. Logistic regression (n = 5218) was used to estimate the odds of receiving meaningful engagement.

Results

Data was collected from 6437 individuals with 68% being female and a mean age of 45 years old (standard deviation 17.6). Overall, 57% of patients were meaningfully engaged; however, this proportion differed based on demographic and clinical factors. Among modifiable clinical factors, systematic case reviews between the CM and psychiatrist (odds ratio: 10.2, 95% confidence interval: 8.6–12.1) and warm handoffs (odds ratio: 1.3, 95% confidence interval: 1.1–1.5) were associated with a higher likelihood of receiving meaningful engagement.

Conclusions

The presence of systematic case reviews between the behavioral health CM and the consultant psychiatrist was highly associated with meaningful engagement. When implementing such programs, high fidelity to the core principles including regularly scheduled systematic case reviews should be pursued.

背景:协作护理(CC)是一种以证据为基础的护理模式,用于在初级保健环境中治疗行为健康问题。协作护理(CC)团队由初级保健提供者(PCP)、行为健康护理经理(CM)和精神科顾问组成,他们共同合作制定治疗计划。迄今为止,关于有意义地参与 CC 计划的相关因素的数据还很有限:目标:确定有意义参与的患者比例,并调查与有意义参与 CC 项目相关的因素:从美国中西部一个学术医疗系统的 27 个成人初级保健诊所实施的 CC 项目中收集数据。采用逻辑回归法(n=5218)估算有意义参与的几率:共收集到 6437 人的数据,其中 68% 为女性,平均年龄为 45 岁(SD 17.6)。总体而言,57%的患者进行了有意义的参与,但这一比例因人口统计学和临床因素而异。在可改变的临床因素中,CM 和精神科医生之间的系统性病例回顾(OR:10.2,95% CI:8.6-12.1)和温馨交接(OR:1.3,95% CI:1.1-1.5)与获得有意义参与的更高可能性相关:结论:行为健康护理经理和精神科顾问之间的系统性病例审查与有意义的参与密切相关。在实施此类项目时,应严格遵守核心原则,包括定期进行系统性病例回顾。
{"title":"Meaningful Engagement in Depression and Anxiety Collaborative Care: Associations With Systematic Case Review","authors":"Heather Huang M.D. ,&nbsp;Brandon Huynh M.D. ,&nbsp;Nichole Nidey Ph.D. ,&nbsp;Hsiang Huang M.D., M.P.H.","doi":"10.1016/j.jaclp.2024.01.006","DOIUrl":"10.1016/j.jaclp.2024.01.006","url":null,"abstract":"<div><h3>Background</h3><p>Collaborative care (CC) is an evidence-based model of care for treating behavioral health conditions in primary care settings. The CC team consists of a primary care provider, behavioral health care manager (CM), and a consultant psychiatrist who collaborate to create treatment plans. To date, there is limited data on factors associated with meaningful engagement in CC programs.</p></div><div><h3>Objective</h3><p>To identify the proportion of patients who were meaningfully engaged and to investigate the factors associated with meaningful engagement in a CC program.</p></div><div><h3>Methods</h3><p>Data was collected from a CC program implemented across 27 adult primary care clinics in a Midwestern, U.S. academic medical system. Logistic regression (n = 5218) was used to estimate the odds of receiving meaningful engagement.</p></div><div><h3>Results</h3><p>Data was collected from 6437 individuals with 68% being female and a mean age of 45 years old (standard deviation 17.6). Overall, 57% of patients were meaningfully engaged; however, this proportion differed based on demographic and clinical factors. Among modifiable clinical factors, systematic case reviews between the CM and psychiatrist (odds ratio: 10.2, 95% confidence interval: 8.6–12.1) and warm handoffs (odds ratio: 1.3, 95% confidence interval: 1.1–1.5) were associated with a higher likelihood of receiving meaningful engagement.</p></div><div><h3>Conclusions</h3><p>The presence of systematic case reviews between the behavioral health CM and the consultant psychiatrist was highly associated with meaningful engagement. When implementing such programs, high fidelity to the core principles including regularly scheduled systematic case reviews should be pursued.</p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 3","pages":"Pages 254-260"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681885","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
Change in Neuropsychological Test Performance Seen in a Longitudinal Study of Patients With Post-acute Sequelae of COVID-19: A 6-Month Follow-up Study COVID-19 急性后遗症患者神经心理测试成绩变化的纵向研究:6个月随访研究
IF 2.3 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-05-01 DOI: 10.1016/j.jaclp.2023.12.005
Sean T. Lynch M.D. , Rhea Dornbush Ph.D., M.P.H. , Sivan Shahar M.D. , Rayah Mansour M.P.H. , Lidia Klepacz M.D. , Louis H. Primavera Ph.D. , Stephen J. Ferrando M.D.

Background

Post-acute sequelae of COVID-19 may include physical, psychiatric, and neurocognitive symptoms. Few studies of cognitive symptoms have been longitudinal, with many following participants briefly after infection and relying on subjective complaints, screening instruments, or computerized testing. This group previously reported diminished neuropsychological (NP) test performance in over half of 60 individuals tested in-person 7 months post-COVID-19, particularly those seeking care for cognitive complaints. The current study describes the initial and 6-month follow-up results of an expanded cohort of 75 participants.

Objective

To measure longitudinal changes in neuropsychological test performance, as well as medical and psychiatric changes, post-COVID-19.

Methods

Participants underwent NP, psychiatric, and medical assessments approximately 7 months after acute COVID-19 infection. Sixty-three (84%) returned approximately 6 months later for repeat evaluation.

Results

At the initial visit, 29 (38.7%) met criteria for low NP performance, and 16 (21.3%) met criteria for extremely low NP performance. At 6-month follow-up, several NP domains that were significantly below normative values at the initial visit were no longer abnormal, with the exception of language. Only measures of delayed memory and fatigue showed significant improvements between the 2 time points.

Conclusions

A substantial proportion of individuals recovered from acute COVID-19 infection have persistent neuropsychiatric symptoms over 1 year after infection. While the overall sample in this study showed some improvement in NP test performance relative to norms, only fatigue and delayed memory improved significantly between times 1 and 2. No individual declined in NP test performance, though relatively few individuals made significant clinical improvement, indicating the need for serial neuropsychiatric assessment and treatment supports. Longitudinal follow-up of this cohort is in progress.

背景:COVID-19 急性后遗症 (PASC) 可能包括身体、精神和神经认知症状。有关认知症状的纵向研究很少,许多研究都是在感染后对参与者进行短暂跟踪,依赖于主观主诉、筛查工具或计算机化测试。该研究小组曾报告称,在 COVID-19 病毒感染后 7 个月进行的亲身测试中,60 多人中有一半人的神经心理学(NP)测试成绩下降,尤其是那些因认知症状而寻求治疗的人。本研究描述了由 75 名参与者组成的扩大队列的初始和 6 个月随访结果:参与者在急性 COVID-19 感染约 7 个月后接受了 NP、精神和医疗评估。约 6 个月后,63 名参与者(84%)再次接受评估:初次就诊时,有 29 人(38.7%)符合低 NP 表现标准,16 人(21.3%)符合极低 NP 表现标准。在 6 个月的随访中,除语言能力外,初次就诊时明显低于常模值的几个 NP 领域已不再异常。在两个时间点之间,只有延迟记忆和疲劳的测量值有明显改善:讨论/结论:有相当一部分急性 COVID-19 感染者在感染一年后仍有持续的神经精神症状。虽然本研究中的总体样本的 NP 测试表现与常模相比有所改善,但只有疲劳和延迟记忆在第一和第二个时间点之间有明显改善。没有人在 NP 测试中成绩下降,但有明显临床改善的人相对较少,这表明需要进行连续的神经精神评估和治疗支持。对这一群体的纵向跟踪研究正在进行中。
{"title":"Change in Neuropsychological Test Performance Seen in a Longitudinal Study of Patients With Post-acute Sequelae of COVID-19: A 6-Month Follow-up Study","authors":"Sean T. Lynch M.D. ,&nbsp;Rhea Dornbush Ph.D., M.P.H. ,&nbsp;Sivan Shahar M.D. ,&nbsp;Rayah Mansour M.P.H. ,&nbsp;Lidia Klepacz M.D. ,&nbsp;Louis H. Primavera Ph.D. ,&nbsp;Stephen J. Ferrando M.D.","doi":"10.1016/j.jaclp.2023.12.005","DOIUrl":"10.1016/j.jaclp.2023.12.005","url":null,"abstract":"<div><h3>Background</h3><p><span>Post-acute sequelae of COVID-19 may include physical, psychiatric, and neurocognitive </span>symptoms. Few studies of cognitive symptoms have been longitudinal, with many following participants briefly after infection and relying on subjective complaints, screening instruments, or computerized testing. This group previously reported diminished neuropsychological (NP) test performance in over half of 60 individuals tested in-person 7 months post-COVID-19, particularly those seeking care for cognitive complaints. The current study describes the initial and 6-month follow-up results of an expanded cohort of 75 participants.</p></div><div><h3>Objective</h3><p>To measure longitudinal changes in neuropsychological test performance, as well as medical and psychiatric changes, post-COVID-19.</p></div><div><h3>Methods</h3><p>Participants underwent NP, psychiatric, and medical assessments approximately 7 months after acute COVID-19 infection. Sixty-three (84%) returned approximately 6 months later for repeat evaluation.</p></div><div><h3>Results</h3><p>At the initial visit, 29 (38.7%) met criteria for low NP performance, and 16 (21.3%) met criteria for extremely low NP performance. At 6-month follow-up, several NP domains that were significantly below normative values at the initial visit were no longer abnormal, with the exception of language. Only measures of delayed memory and fatigue showed significant improvements between the 2 time points.</p></div><div><h3>Conclusions</h3><p>A substantial proportion of individuals recovered from acute COVID-19 infection have persistent neuropsychiatric symptoms over 1 year after infection. While the overall sample in this study showed some improvement in NP test performance relative to norms, only fatigue and delayed memory improved significantly between times 1 and 2. No individual declined in NP test performance, though relatively few individuals made significant clinical improvement, indicating the need for serial neuropsychiatric assessment and treatment supports. Longitudinal follow-up of this cohort is in progress.</p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 3","pages":"Pages 231-247"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089303","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
Palliative ECT for Catatonia in a Terminal Cancer Patient: A Case Report 姑息性电疗治疗晚期癌症患者的紧张症:病例报告。
IF 2.3 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-05-01 DOI: 10.1016/j.jaclp.2024.01.005
Arushi Mahajan B.S., Thanvi Vatti M.P.H., Andrew Coulter M.D., Elias Khawam M.D., Molly Howland M.D.
{"title":"Palliative ECT for Catatonia in a Terminal Cancer Patient: A Case Report","authors":"Arushi Mahajan B.S.,&nbsp;Thanvi Vatti M.P.H.,&nbsp;Andrew Coulter M.D.,&nbsp;Elias Khawam M.D.,&nbsp;Molly Howland M.D.","doi":"10.1016/j.jaclp.2024.01.005","DOIUrl":"10.1016/j.jaclp.2024.01.005","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 3","pages":"Pages 315-316"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673640","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
C-L Case Conference: Insomnia Disorder C-L病例会议:失眠障碍。
IF 2.3 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-05-01 DOI: 10.1016/j.jaclp.2023.11.684
Vanessa Aversa M.D. , Raed Hawa M.D. , Elliott K. Lee M.D. , Michael S.B. Mak M.D.

We present the case of a 67-year-old male with a history of major depressive disorder, panic disorder, treatment refractory hypertension, dyslipidemia, benign prostatic hypertrophy, and environmental allergies who was initially brought to medical attention following an unwitnessed fall. He subsequently developed symptoms of insomnia disorder. Experts in consultation-liaison psychiatry and sleep medicine provide guidance for this clinical scenario based on their experience and a review of current literature, exploring the epidemiology of insomnia disorder and comorbidities in relation to this case. Furthermore, we offer a review of current treatment for insomnia disorder, including non-pharmacologic methods such as cognitive behavioral therapy for insomnia and pharmacotherapy.

我们报告一例67岁男性患者,有重度抑郁症、恐慌症、难治性高血压、血脂异常、良性前列腺肥大和环境过敏史,在一次未被目击的跌倒后被送往医院。他随后出现失眠障碍的症状。会诊联络精神病学和睡眠医学专家根据他们的经验和对当前文献的回顾,为这一临床场景提供指导,探讨与本病例相关的失眠障碍和合并症的流行病学。此外,我们还回顾了目前失眠障碍的治疗方法,包括非药物方法,如失眠认知行为疗法(CBT-i)和药物治疗。
{"title":"C-L Case Conference: Insomnia Disorder","authors":"Vanessa Aversa M.D. ,&nbsp;Raed Hawa M.D. ,&nbsp;Elliott K. Lee M.D. ,&nbsp;Michael S.B. Mak M.D.","doi":"10.1016/j.jaclp.2023.11.684","DOIUrl":"10.1016/j.jaclp.2023.11.684","url":null,"abstract":"<div><p><span><span><span><span>We present the case of a 67-year-old male with a history of major depressive disorder<span>, panic disorder, treatment refractory hypertension, </span></span>dyslipidemia<span>, benign prostatic hypertrophy, and </span></span>environmental allergies who was initially brought to medical attention following an unwitnessed fall. He subsequently developed </span>symptoms of insomnia disorder. Experts in consultation-liaison psychiatry and </span>sleep medicine<span> provide guidance for this clinical scenario based on their experience and a review of current literature, exploring the epidemiology of insomnia<span> disorder and comorbidities in relation to this case. Furthermore, we offer a review of current treatment for insomnia disorder, including non-pharmacologic methods such as cognitive behavioral therapy for insomnia and pharmacotherapy.</span></span></p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 3","pages":"Pages 293-301"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453026","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
A Qualitative Assessment of Barriers and Proposed Interventions to Improve Acute Agitation Management for Children With Mental and Behavioral Health Conditions in the Emergency Department 定性评估急诊科对患有精神和行为健康问题的儿童进行急性躁动管理的障碍和干预建议
IF 2.3 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-03-01 DOI: 10.1016/j.jaclp.2023.12.001
Jennifer A. Hoffmann M.D., M.S. , Anisha Kshetrapal M.D., M.S.Ed. , Alba Pergjika M.D., M.P.H. , Ashley A. Foster M.D. , Julia H. Wnorowska R.N., B.S.N. , Julie K. Johnson M.S.P.H., Ph.D.

Background

Mental health visits to the emergency department (ED) by children are rising in the United States, and acute agitation during these visits presents safety risks to patients and staff.

Objective

We sought to assess barriers and strategies for providing high-quality care to children who experience acute agitation in the ED.

Methods

We conducted semistructured interviews with 6 ED physicians, 6 ED nurses, 6 parents, and 6 adolescents at high risk for developing agitation. We asked participants about their experiences with acute agitation care in the ED, barriers and facilitators to providing high-quality care, and proposed interventions. Interviews were coded and analyzed thematically.

Results

Participants discussed identifying risk factors for acute agitation, worrying about safety and the risk of injury, feeling moral distress, and shifting the culture toward patient-centered, trauma-informed care. Barriers and facilitators included using a standardized care pathway, identifying environmental barriers and allocating resources, partnering with the family and child, and communicating among team members. Nine interventions were proposed: opening a behavioral observation unit with dedicated staff and space, asking screening questions to identify risk of agitation, creating personalized care plans in the electronic health record, using a standardized agitation severity scale, implementing a behavioral response team, providing safe activities and environmental modifications, improving the handoff process, educating staff, and addressing bias and inequities.

Conclusions

Understanding barriers can inform solutions to improve care for children who experience acute agitation in the ED. The perspectives of families and patients should be considered when designing interventions to improve care.

背景在美国,儿童到急诊科(ED)就诊的人数不断增加,而就诊期间的急性躁动给患者和工作人员带来了安全风险。方法我们对 6 名急诊科医生、6 名急诊科护士、6 名家长和 6 名躁动高危青少年进行了半结构式访谈。我们询问了参与者在急诊室急性躁动护理方面的经验、提供高质量护理的障碍和促进因素以及建议的干预措施。结果参与者讨论了识别急性躁动的风险因素、担心安全和受伤风险、感到精神痛苦以及向以患者为中心、创伤知情护理的文化转变等问题。障碍和促进因素包括使用标准化护理路径、识别环境障碍和分配资源、与家庭和儿童合作以及团队成员之间的沟通。提出了九项干预措施:开设行为观察室并配备专门人员和空间、提出筛查问题以确定躁动风险、在电子病历中创建个性化护理计划、使用标准化躁动严重程度量表、实施行为反应小组、提供安全活动和环境改造、改进交接流程、教育员工以及解决偏见和不平等问题。在设计改善护理的干预措施时,应考虑家属和患者的观点。
{"title":"A Qualitative Assessment of Barriers and Proposed Interventions to Improve Acute Agitation Management for Children With Mental and Behavioral Health Conditions in the Emergency Department","authors":"Jennifer A. Hoffmann M.D., M.S. ,&nbsp;Anisha Kshetrapal M.D., M.S.Ed. ,&nbsp;Alba Pergjika M.D., M.P.H. ,&nbsp;Ashley A. Foster M.D. ,&nbsp;Julia H. Wnorowska R.N., B.S.N. ,&nbsp;Julie K. Johnson M.S.P.H., Ph.D.","doi":"10.1016/j.jaclp.2023.12.001","DOIUrl":"10.1016/j.jaclp.2023.12.001","url":null,"abstract":"<div><h3>Background</h3><p><span>Mental health visits to the </span>emergency department (ED) by children are rising in the United States, and acute agitation during these visits presents safety risks to patients and staff.</p></div><div><h3>Objective</h3><p>We sought to assess barriers and strategies for providing high-quality care to children who experience acute agitation in the ED.</p></div><div><h3>Methods</h3><p>We conducted semistructured interviews with 6 ED physicians, 6 ED nurses, 6 parents, and 6 adolescents at high risk for developing agitation. We asked participants about their experiences with acute agitation care in the ED, barriers and facilitators to providing high-quality care, and proposed interventions. Interviews were coded and analyzed thematically.</p></div><div><h3>Results</h3><p>Participants discussed identifying risk factors for acute agitation, worrying about safety and the risk of injury, feeling moral distress, and shifting the culture toward patient-centered, trauma-informed care. Barriers and facilitators included using a standardized care pathway<span>, identifying environmental barriers and allocating resources, partnering with the family and child, and communicating among team members. Nine interventions were proposed: opening a behavioral observation unit with dedicated staff and space, asking screening questions to identify risk of agitation, creating personalized care plans in the electronic health record, using a standardized agitation severity scale, implementing a behavioral response team, providing safe activities and environmental modifications, improving the handoff process, educating staff, and addressing bias and inequities.</span></p></div><div><h3>Conclusions</h3><p>Understanding barriers can inform solutions to improve care for children who experience acute agitation in the ED. The perspectives of families and patients should be considered when designing interventions to improve care.</p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 2","pages":"Pages 167-177"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138626062","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: Overcoming Bias in the Differential Diagnosis of Psychosis 咨询联络案例会议:克服精神病鉴别诊断中的偏见。
IF 2.3 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-03-01 DOI: 10.1016/j.jaclp.2023.09.001
Joshua B. Franklin M.D., Ph.D. , Bruce Leewiwatanakul D.O. , Adrienne D. Taylor M.D. , Erica B. Baller M.D., M.S. , Samantha J. Zwiebel M.D., M.A.

We present the case of a 34-year-old Black patient with no significant psychiatric history who presented with catatonia and psychotic symptoms following a recent severe acute respiratory syndrome coronavirus-2 infection, whose diagnosis of coronavirus disease 2019 encephalitis was delayed by premature attribution of his symptoms to a primary psychiatric etiology. Top experts in the consultation-liaison field provide guidance for this commonly encountered clinical case based on their experience and a review of the available literature. Key teaching topics include the diagnosis and management of coronavirus disease 2019 encephalitis, cognitive bias, and racial bias. Specifically, this case illustrates the role of the consultation-liaison psychiatrist in identifying medical conditions that may overlap with psychiatric presentations and in advocating for marginalized patients.

我们报告了一名34岁的黑人患者,他没有明显的精神病史,在最近感染了严重急性呼吸系统综合征冠状病毒2型后出现了紧张症和精神病症状,由于过早将其症状归因于主要的精神病因,他对2019年冠状病毒病脑炎的诊断被推迟。咨询联络领域的顶级专家根据他们的经验和对现有文献的审查,为这一常见的临床病例提供指导。主要教学主题包括2019冠状病毒病脑炎的诊断和管理、认知偏见和种族偏见。具体而言,本案例说明了咨询联络精神病学家在识别可能与精神病表现重叠的医疗状况以及为边缘化患者辩护方面的作用。
{"title":"Consultation-Liaison Case Conference: Overcoming Bias in the Differential Diagnosis of Psychosis","authors":"Joshua B. Franklin M.D., Ph.D. ,&nbsp;Bruce Leewiwatanakul D.O. ,&nbsp;Adrienne D. Taylor M.D. ,&nbsp;Erica B. Baller M.D., M.S. ,&nbsp;Samantha J. Zwiebel M.D., M.A.","doi":"10.1016/j.jaclp.2023.09.001","DOIUrl":"10.1016/j.jaclp.2023.09.001","url":null,"abstract":"<div><p><span>We present the case of a 34-year-old Black patient with no significant psychiatric history<span> who presented with catatonia and psychotic </span></span>symptoms<span> following a recent severe acute respiratory syndrome coronavirus-2 infection, whose diagnosis of coronavirus disease 2019 encephalitis was delayed by premature attribution of his symptoms to a primary psychiatric etiology. Top experts in the consultation-liaison field provide guidance for this commonly encountered clinical case based on their experience and a review of the available literature. Key teaching topics include the diagnosis and management of coronavirus disease 2019 encephalitis, cognitive bias, and racial bias. Specifically, this case illustrates the role of the consultation-liaison psychiatrist in identifying medical conditions that may overlap with psychiatric presentations and in advocating for marginalized patients.</span></p></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 2","pages":"Pages 195-203"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10288784","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
Anti-N-Methyl-D-Aspartate Receptor Encephalitis—Are We Missing a Treatable Illness in the Elderly That Is Causing Severe Disability and Death? 抗NMDA受体脑炎-我们是否错过了一种可治疗的老年疾病,这种疾病会导致严重残疾和死亡?
IF 2.3 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-03-01 DOI: 10.1016/j.jaclp.2023.10.003
Joshua Kontrobarsky M.B.B.S. (Hons), Joshua Laing BBiomedSci M.B.B.S., F.R.A.C.P., Ph.D., Brett Coulson F.R.A.N.Z.C.P.
{"title":"Anti-N-Methyl-D-Aspartate Receptor Encephalitis—Are We Missing a Treatable Illness in the Elderly That Is Causing Severe Disability and Death?","authors":"Joshua Kontrobarsky M.B.B.S. (Hons),&nbsp;Joshua Laing BBiomedSci M.B.B.S., F.R.A.C.P., Ph.D.,&nbsp;Brett Coulson F.R.A.N.Z.C.P.","doi":"10.1016/j.jaclp.2023.10.003","DOIUrl":"10.1016/j.jaclp.2023.10.003","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 2","pages":"Pages 214-215"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684908","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
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1