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

{"title":"Preliminary Characteristics of Telephone-Based Psychiatric Consultations for General Adults Within the CHAMP Program in Indiana","authors":"Alyssa C. Smith M.D., Jon Agley Ph.D., M.P.H., Camila L. Arnaudo M.D., Michael S. Metrick M.D.","doi":"10.1016/j.jaclp.2025.08.014","DOIUrl":"10.1016/j.jaclp.2025.08.014","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"67 1","pages":"Pages 85-87"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016638","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}

{"title":"Quality Indicators in Psychological Care for Patients With Serious Illness: A Systematic Review","authors":"Takaaki Hasegawa M.D., Ph.D. ,&nbsp;Toru Okuyama M.D., Ph.D. ,&nbsp;Ryoichi Sadahiro M.D., Ph.D. ,&nbsp;Yu Uneno M.D., Ph.D. ,&nbsp;Yoshiaki Okamoto Ph.D. ,&nbsp;Yusuke Kanno R.N., Ph.D. ,&nbsp;Saho Wada M.D., Ph.D. ,&nbsp;Shuji Inada M.D., Ph.D. ,&nbsp;Yuri Igarashi Ph.D. ,&nbsp;Hitoshi Tanimukai M.D., Ph.D. ,&nbsp;Daisuke Fujisawa M.D., Ph.D.","doi":"10.1016/j.jaclp.2025.09.002","DOIUrl":"10.1016/j.jaclp.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Psychological care for patients with serious illness is recommended; however, established quality indicators for this care are lacking.</div></div><div><h3>Objective</h3><div>This study aimed to review clinical quality indicators to evaluate the quality of psychological care for patients with serious illnesses.</div></div><div><h3>Methods</h3><div>This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched 6 databases, including MEDLINE, EMBASE, and PsycINFO. Our review included studies on the development of quality indicators for psychological care in patients with serious illness. Study selection and data extraction were conducted independently, and methodological quality was evaluated using the Appraisal of Indicators through Research and Evaluation instrument. The study protocol was registered with the University Hospital Medical Information Network (UMIN000051290).</div></div><div><h3>Results</h3><div>Among the identified 2119 reports, 345 reports were reviewed in detail and 12 studies met the eligibility criteria. From these, 24 quality indicators were identified, some of which overlapped conceptually or in content: 1 structure, 14 process, and 9 outcome indicators. According to the Appraisal of Indicators through Research and Evaluation instrument, most studies satisfied the category 1 criteria (clarity of purpose, relevance, and organizational context); however, formal validation of the developed indicators in practice was rarely conducted.</div></div><div><h3>Conclusions</h3><div>There is an urgent need for a comprehensive set of validated quality indicators to assess the quality of psychological care across multiple components. Increasing the incorporation of evidence-based psychological care practices for patients with serious illnesses would support the development of valid and useful clinical quality indicators.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"67 1","pages":"Pages 35-47"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253774","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}

{"title":"Pazopanib-induced Neuropsychiatric Symptoms","authors":"Wendi Zhao BBiomed, M.D.,&nbsp;Soumitra Das M.B.B.S., M.D., FRANZCP., M.P.H.,&nbsp;Lokesh Sekharan M.D., FRANZCP","doi":"10.1016/j.jaclp.2025.09.001","DOIUrl":"10.1016/j.jaclp.2025.09.001","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"67 1","pages":"Pages 79-81"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240409","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}

{"title":"Psychiatric Care Checklist: A Novel Aid to Improve Psychiatric Care in the Emergency Department","authors":"Obert Xu M.B.B.S., B.S.N. ,&nbsp;Miriam R. Elman M.S., M.P.H. ,&nbsp;Kenneth DeVane M.S., M.B.A. ,&nbsp;Kendra Henderson M.D. ,&nbsp;Manny Gonzalez M.D., M.B.A. ,&nbsp;Haley Manella M.D., M.B.A.","doi":"10.1016/j.jaclp.2025.08.013","DOIUrl":"10.1016/j.jaclp.2025.08.013","url":null,"abstract":"<div><h3>Background</h3><div>Emergency department (ED) patients requiring inpatient psychiatric admission experience prolonged boarding times due to a nationwide deficit in inpatient bed capacity. These extended boarding times, which can last hours to days, introduce additional risks of harm, including missed home medications and omissions in care essential to chronic disease management. The overall aim is to reduce missed care components in ED patients with psychiatric illness awaiting inpatient psychiatry admission by using our novel checklist and mnemonic, sugar control, home medications, expiration time, documentation, social work, and psychiatry consults, coupled with an educational campaign.</div></div><div><h3>Objective</h3><div>The primary goal of this study was to determine whether the proportion of patients given one or more clinically significant home medications during their ED stay increased after the implementation of the sugar control, home medications, expiration time, documentation, social work, and psychiatry consults checklist and educational interventions.</div></div><div><h3>Methods</h3><div>We performed a retrospective prepost study to evaluate the sugar control, home medications, expiration time, documentation, social work, and psychiatry consults checklist among patients in the ED awaiting placement in an inpatient psychiatric unit. We implemented our psychiatric care checklist as part of a quality improvement campaign through educational messaging and integration into our intradepartmental transition of care note template.</div></div><div><h3>Results</h3><div>We utilized electronic medical record data to compare the proportion of patients with psychiatric illness who received more than one clinically significant home medication before and after the implementation of our interventions. A total of 245 patients were included, consisting of 124 patients seen between March 2022 and February 2023 (preintervention period) and 121 patients between March 2023 and February 2024 (postintervention period). The proportion of patients who received at least one clinically significant home medication in the pre–sugar control, home medications, expiration time, documentation, social work, and psychiatry consults intervention period was 46.0% (95% confidence interval: 37.4–54.8%), compared to 58.7% (95% confidence interval: 49.7–67.1) in the postintervention period. This represents a statistically significant increase in the administration of home medications during the intervention compared to baseline (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>This study evaluated the use of a novel psychiatric care checklist in reducing missed home medications in ED patients awaiting inpatient psychiatric admission. The improvement was statistically and clinically significant. Our findings could offer value to other institutions facing significant boarding times for patients with psychiatric illness.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"67 1","pages":"Pages 4-13"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994375","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}

{"title":"Catatonia and Delirium in a General Medical Setting: Prevalence and Naturalistic Treatment Outcome","authors":"Charles Mormando D.O. ,&nbsp;Samuel Reinfeld D.O. ,&nbsp;Nicholas Genova M.D. ,&nbsp;Aimy Rehim M.D. ,&nbsp;Ilana Yel D.O. ,&nbsp;Andrew Francis M.D., Ph.D. ,&nbsp;Adeeb Yacoub M.D.","doi":"10.1016/j.jaclp.2025.10.334","DOIUrl":"10.1016/j.jaclp.2025.10.334","url":null,"abstract":"<div><h3>Background</h3><div>Catatonia is prevalent in the general hospital yet remains under-recognized. Of particular interest is the relationship between delirium and catatonia as recent studies have shown catatonia may co-occur with delirium. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision posits that catatonia does not exist in delirium, although studies have questioned this exclusion.</div></div><div><h3>Objective</h3><div>To assess the co-occurrence of catatonia and delirium in hospitalized general medical patients and to describe naturalistic treatment outcomes with lorazepam.</div></div><div><h3>Methods</h3><div>Data from a naturalistic quality improvement project were retrospectively analyzed. All consecutive admissions to 4 general medical units at the University Hospital at Stony Brook were screened within 48 h using the Bush-Francis Catatonia Screening Instrument and the Confusion Assessment Method. The diagnostic threshold on the Bush-Francis Catatonia Screening Instrument was set to 4 signs to increase specificity. The Bush-Francis Catatonia Rating Scale was utilized to monitor severity of positive screens. The quality improvement project included 718 consecutive patient admissions that are reviewed and analyzed in this report.</div></div><div><h3>Results</h3><div>Approximately 2.2% of the 718 patients met criteria for catatonia. Of the patients with catatonia, 93% also met criteria for co-occurring delirium. The prevalence of delirium in the sample was 24.8%, and 8.4% of patients with delirium also had catatonia. Of those with catatonia and delirium, 43.8% received treatment for catatonia with benzodiazepines. Of those treated, the clinical features of catatonia and delirium remitted in 43% of cases, whereas the signs of catatonia responded to treatment (&gt;50% reduction in Bush-Francis Catatonia Rating Scale) in 57% of cases. All 16 cases of catatonia had 5 or more signs of catatonia, while the majority of the remaining 702 patients had 0–2 signs.</div></div><div><h3>Conclusions</h3><div>These data provide further evidence that catatonia coexists with delirium, and may respond to lorazepam. We found a bimodal distribution in the number of catatonic signs, suggesting catatonia may be a distinct syndrome among medical patients. Our results suggest that prospective treatment studies are warranted.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"67 1","pages":"Pages 26-34"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472228","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}

{"title":"Anorexia Nervosa in Older Adults: A Case Series and Systematic Review of Clinical and Systems-Level Challenges","authors":"Victoria P. Schulte M.D. ,&nbsp;Lyan Chung MSN, PMHNP-BC ,&nbsp;Jennie Davidow M.D. ,&nbsp;Danilo Rojas-Velasquez M.D.","doi":"10.1016/j.jaclp.2025.11.003","DOIUrl":"10.1016/j.jaclp.2025.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Anorexia nervosa (AN) in older adults presents with medical complexity, psychiatric comorbidity, and diagnostic ambiguity, often overlapping with depression, cognitive decline, or anorexia of aging. A literature base dominated by case reports limits practical guidance for consultation-liaison (C-L) psychiatry.</div></div><div><h3>Objective</h3><div>To describe key clinical features of AN in older adults, integrating systems-level barriers that shape diagnosis, care transitions, and prognosis.</div></div><div><h3>Methods</h3><div>We describe 2 late-life AN cases and conducted a systematic review of studies including adults aged ≥60 years with AN defined by the <em>Diagnostic and Statistical Manual of Mental Disorders</em>. Two reviewers independently screened and extracted data and appraised quality using Joanna Briggs Institute tools. Extracted variables included demographics, <em>Diagnostic and Statistical Manual of Mental Disorders</em> diagnostic criteria, psychiatric and medical comorbidities, care setting, and outcomes. We used narrative synthesis with descriptive statistics like n/N, %, median (interquartile range), and ranges to summarize case reports. The AN course was categorized as late-onset (≥60 years), chronic diagnosed, chronic undiagnosed, or recurrence.</div></div><div><h3>Results</h3><div>Forty publications met criteria: 31 case reports/series, eight cross-sectional studies, and one cohort. Cross-sectional studies showed 3–6% prevalence of disordered eating behaviors with rare AN. Across 47 individually described patients, most were women in their early seventies with severe undernutrition and multimorbidity. Care most commonly occurred on medical units. Nutritional rehabilitation (e.g., supervised meals, enteral feeding) was the most common intervention. Outcomes were mixed, with many patients achieving weight gain, but mortality remained substantial. System-level barriers, such as insurance coverage and access constraints, were not reported in the literature but were prominent in our 2 cases.</div></div><div><h3>Conclusions</h3><div>In older adults, AN is rare in population samples but severe when clinically detected. The review highlights diagnostic complexity, medical risk, limited psychotherapy/medication detail, and systems barriers central to consultation-liaison practice. Consultation-liaison psychiatrists play a key role in identifying and coordinating treatment for this complex population.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"67 1","pages":"Pages 48-60"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641850","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}

{"title":"Advancing Emotional and Behavioral Health in Pediatric Acute and Chronic Medical Illness: A Role for Pediatric Consultation-Liaison Psychiatry in the Academy of Consultation-Liaison Psychiatry","authors":"Maryland Pao M.D., F.A.C.L.P., D.F.A.A.C.A.P., D.F.A.P.A., F.A.P.O.S.","doi":"10.1016/j.jaclp.2026.01.005","DOIUrl":"10.1016/j.jaclp.2026.01.005","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"67 1","pages":"Pages 1-3"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991667","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}

{"title":"Consultation-Liaison Case Conference: Management of Demoralization in the Medical Setting","authors":"Alyssa C. Smith M.D. ,&nbsp;Jonathan S. Gerkin M.D. ,&nbsp;Diana M. Robinson M.D. ,&nbsp;Emily G. Holmes M.D., M.P.H.","doi":"10.1016/j.jaclp.2025.06.006","DOIUrl":"10.1016/j.jaclp.2025.06.006","url":null,"abstract":"<div><div>Demoralization has important implications for patients' health, but consultation-liaison psychiatrists may be less familiar with diagnosis and management due to limited inclusion in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. We present the case of a multivisceral transplant patient who experienced demoralization due to complications from her posttransplant course. We discuss the diagnosis of demoralization, including differential diagnoses to consider, followed by a discussion of management of demoralization in the inpatient setting using acceptance and commitment therapy. We then discuss the consultation-liaison psychiatrist's role in assisting with management of teams' counter-transference to difficult patient cases, including the possibility of teams experiencing their own demoralization.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"67 1","pages":"Pages 71-78"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486913","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}

{"title":"Illness Perceptions and Emotional Experiences in Heart Failure: Qualitative Insights to Inform Personalized Psychosocial Care","authors":"Laura Suarez M.D. ,&nbsp;Christine Hughes B.S. ,&nbsp;Shawna Ehlers Ph.D., L.P. ,&nbsp;Shannon M. Dunlay M.D., M.S. ,&nbsp;Jeffrey P. Staab M.D., M.S.","doi":"10.1016/j.jaclp.2025.10.330","DOIUrl":"10.1016/j.jaclp.2025.10.330","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) affects over 6 million US adults, especially older individuals, and is a leading cause of hospitalization with high readmission rates. Psychological distress, particularly depression, is common and linked to negative outcomes.</div></div><div><h3>Objective</h3><div>This study explored illness perceptions and psychosocial experiences in patients with HF, with attention to differences by etiology and sex.</div></div><div><h3>Methods</h3><div>This was a qualitative research study of patients with HF that collected information through semistructured phone interviews and a mailed survey assessing demographic and mental health history. From February 2021 to May 2022, thirty-five patients were recruited and completed the interview. All interviews were audio-recorded, transcribed, and coded using NVivo.</div></div><div><h3>Results</h3><div>The mean participant age was 71.8 years (standard deviation 11.1), with 22 (63%) males. Eight had a history of depression, and 5 reported anxiety; most linked their symptoms partly to HF. Three major psychosocial themes emerged: <em>(1) Living with Heart Failure, (2) Emotional Experience and Coping, and (3) Personal and Community</em> <em>Support</em>. Emotional responses included depression, anxiety, anger, and frustration. Although many reported strong family support, caregiver stress was noted. Women showed higher rates of depression, anxiety, and antidepressant use, with differences also seen by illness etiology.</div></div><div><h3>Conclusions</h3><div>This qualitative analysis found that patients with HF adapt to a “new normal” through lifestyle changes, with 4 key themes emerging. Variability within each theme suggests that a one-size-fits-all approach to assessing and managing psychosocial distress may be insufficient, highlighting opportunities for more individualized care in primary and specialty settings.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"67 1","pages":"Pages 14-25"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369342","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}

{"title":"Comments on ‘Proactive Addiction Consultation for Hospitalized Patients’ by Karol et al.: Methodological Insights","authors":"Parth Aphale,&nbsp;Himanshu Shekhar,&nbsp;Shashank Dokania","doi":"10.1016/j.jaclp.2025.10.331","DOIUrl":"10.1016/j.jaclp.2025.10.331","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"67 1","pages":"Pages 88-89"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369336","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}