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Ictal Aphemia, Not Aphasia: Focal Frontal Seizures Misdiagnosed as Functional Neurological (Conversion) Mutism 布罗卡缺血症,而非失语症:局灶性额叶癫痫被误诊为功能性神经(转换)缄默症。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2025-01-01 DOI: 10.1016/j.jaclp.2024.08.005
Xavier F. Jimenez M.D., M.A., Maria Vasconez Narvaez M.D., Fred A. Lado M.D.
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引用次数: 0
Serotonin Toxicity Associated With Electroconvulsive Therapy: A Case Report 与电休克疗法相关的羟色胺中毒:病例报告。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2025-01-01 DOI: 10.1016/j.jaclp.2024.08.002
Kylie Calderon B.S., Melissa K. Cutshaw M.D., M.P.H. , Elana Horwtiz M.D. , Ryan D. Slauer M.D. , Ryan A. Duffy M.D.
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引用次数: 0
Associations of Mild Behavioral Impairment Domains with Brain Volumes: Cross-sectional Analysis of Atherosclerosis Risk in Community (ARIC) Study 轻度行为障碍领域与老年人脑容量的关联。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2025-01-01 DOI: 10.1016/j.jaclp.2024.11.003
Lisa Young B.S., B.A. , Lisa N. Richey B.A. , Connor A. Law B.S. , Aaron I. Esagoff B.S. , Zahinoor Ismail M.D. , Matthew L. Senjem M.S. , Clifford R. Jack Jr. M.D. , Srishti Shrestha Ph.D. , Rebecca F. Gottesman M.D., Ph.D. , Khaled Moussawi M.D., Ph.D. , Matthew E. Peters M.D. , Andrea L.C. Schneider M.D., Ph.D.

Background

Mild behavioral impairment (MBI) has been associated with global brain atrophy, but the regional neural correlates of MBI symptoms are less clear, particularly among community-dwelling older individuals without dementia.

Objective

Our objective was to examine the associations of MBI domains with gray matter (GM) volumes in a large population-based sample of older adults without dementia.

Methods

We performed a cross-sectional study of 1445 community-dwelling older adults in the Atherosclerosis Risk in Communities Study who underwent detailed neurocognitive assessment and brain magnetic resonance imaging in 2011–2013. MBI domains were defined using an established algorithm that maps data collected from informants on the Neuropsychiatric Inventory Questionnaire to the 5 MBI domains of decreased motivation, affective dysregulation, impulse dyscontrol, social inappropriateness, and abnormal perception/thought content. We performed voxel-based morphometry analyses to investigate associations of any MBI domain symptoms with GM volumes. We additionally performed region-of-interest analyses using adjusted linear regression models to examine associations between individual MBI domains with a priori–hypothesized regional GM volumes.

Results

Overall, the mean age of participants was 76.5 years; 59% were female, 21% were of Black race, and 26% had symptoms in at least one MBI domain. Participants with normal cognition comprised 60% of the population, and 40% had mild cognitive impairment. Compared to individuals without any MBI domain symptoms, voxel-based morphometry analyses showed that participants with symptoms in at least one MBI domain had consistently lower GM volumes in the cerebellum and bilateral temporal lobes, particularly involving the hippocampus. In adjusted region-of-interest models, affective dysregulation domain symptoms were associated with lower GM volume in the inferior temporal lobe (β = −0.34; 95% confidence interval = −0.64, -0.04), and impulse dyscontrol domain symptoms were associated with lower GM volume in the parahippocampal gyrus (β = −0.06; 95% confidence interval = −0.11, 0.00).

Conclusions

In this community-dwelling population of older adults without dementia, MBI symptoms were associated with lower GM volumes in regions commonly implicated in early Alzheimer's disease pathology. These findings lend support to the notion that MBI symptoms may be useful in identifying individuals at risk for future dementia.
背景:轻度行为障碍(MBI)与整体脑萎缩有关,但MBI症状的区域神经相关性却不太清楚,尤其是在社区居住的无痴呆症老年人中。我们的目的是在一个基于人群的无痴呆症老年人大样本中研究 MBI 领域与灰质(GM)体积的关联:我们对 "社区动脉粥样硬化风险(ARIC)研究 "中的 1,445 名社区老年人进行了横断面研究,他们在 2011-2013 年期间接受了详细的神经认知评估和脑磁共振成像(MRI)检查。我们采用一种既定算法对 MBI 领域进行了定义,该算法将从信息提供者处收集的神经精神量表问卷数据映射到五个 MBI 领域,即动机减退、情感调节障碍、冲动控制障碍、社交不当和感知/思维内容异常。我们进行了体素形态计量(VBM)分析,以研究任何 MBI 领域症状与 GM 体积之间的关联。此外,我们还使用调整线性回归模型进行了兴趣区域分析,以研究单个 MBI 领域与先验假设的区域 GM 体积之间的关联:总体而言,参与者的平均年龄为 76.5 岁;59% 为女性,21% 为黑人,26% 在至少一个 MBI 领域有症状。认知能力正常的参与者占总人数的 60%,40% 有轻度认知障碍。与没有任何 MBI 领域症状的人相比,VBM 分析显示,至少有一个 MBI 领域症状的参与者的小脑和双侧颞叶的 GM 体积一直较低,尤其是海马体。在调整后的兴趣区模型中,情感调节障碍领域症状与颞叶下部较低的GM体积有关(β=-0.34,95%CI=-0.64,-0.04),冲动控制障碍领域症状与海马旁回较低的GM体积有关(β=-0.06,95%CI=-0.11,0.00):在社区居住的无痴呆症老年人群中,MBI症状与阿尔茨海默病早期病理常见区域较低的GM体积有关。这些发现支持了MBI症状可能有助于识别未来痴呆症高危人群的观点。
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引用次数: 0
Cognitive, Behavioral, and Functional Outcomes of Suspected Mild Traumatic Brain Injury in Community-Dwelling Older Persons Without Mild Cognitive Impairment or Dementia. 无轻度认知障碍或痴呆的社区居住老年人疑似轻度外伤性脑损伤的认知、行为和功能结局
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-12-31 DOI: 10.1016/j.jaclp.2024.12.004
Dylan X Guan, Matthew E Peters, G Bruce Pike, Clive Ballard, Byron Creese, Anne Corbett, Ellie Pickering, Pamela Roach, Eric E Smith, Zahinoor Ismail

Background: Traumatic brain injury is associated with greater risk and earlier onset of dementia.

Objective: This study investigated whether later-life changes in subjective cognition and behavior - potential markers of Alzheimer disease - could be observed in cognitively unimpaired older persons with a history of suspected mild traumatic brain injury (smTBI) earlier in life and whether changes in cognition and behavior mediated the link between smTBI and daily function.

Methods: Data for 1392 participants from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behaviour, Function, and Caregiving in Aging were analyzed. A validated self-reported brain injury screening questionnaire was used to determine the history of smTBI. Outcomes were measured using the Everyday Cognition scale (for subjective cognitive decline [SCD]), Mild Behavioral Impairment (MBI) Checklist, and Standard Assessment of Global Everyday Activities (for function). Inverse probability of treatment weighted logistic and negative binomial regressions were used to model smTBI (exposure) associations with SCD and MBI statuses, and Everyday Cognition-II and MBI Checklist total scores, respectively. Mediation analyses were conducted using bootstrapping.

Results: History of smTBI was linked to higher odds of SCD (odds ratio = 1.45, 95% confidence interval: [1.14-1.84]) or MBI (odds ratio = 1.75, 95% confidence interval: [1.54-1.98]), as well as 24% (95% confidence interval: [18%-31%]) higher Everyday Cognition-II and 52% (95% confidence interval: [41%-63%]) higher MBI Checklist total scores. Finally, SCD and MBI mediated approximately 45% and 56%, respectively, of the association between smTBI history and poorer function, as indicated by higher Standard Assessment of Global Everyday Activities total scores.

Conclusions: smTBI at any point in the life course is linked to poorer cognition and behavior even in community-dwelling older persons without MCI or dementia. Older persons with smTBI may benefit from early dementia risk assessment using tools that measure changes in cognition and behavior. Interventions for declining cognition and behavior may also be beneficial in this population to address functional impairment.

外伤性脑损伤(TBI)与痴呆的高风险和早期发病相关。本研究调查了在早期疑似轻度脑损伤(smTBI)的认知功能未受损的老年人中,是否可以观察到主观认知和行为的晚年变化(AD的潜在标志物),以及认知和行为的变化是否介导了smTBI与日常功能之间的联系。方法:分析来自加拿大健康、生活质量、认知、行为、功能和老年护理在线研究平台(CAN-PROTECT)的1392名参与者的数据。一个有效的自我报告的脑损伤筛查问卷被用来确定smTBI的历史。使用日常认知量表(ECog-II)(主观认知能力下降- SCD)、MBI检查表(MBI- c,轻度行为障碍- MBI)和全球日常活动标准评估(SAGEA,功能)来测量结果。使用治疗加权logistic逆概率和负二项回归分别对smTBI(暴露)与SCD+和MBI+状态以及ECog-II和MBI- c总分的关系进行建模。采用自举法进行中介分析。结果:smTBI病史与SCD+ (OR=1.45, 95%CI:[1.14-1.84])或MBI+ (OR=1.75, 95%CI:[1.54-1.98])的较高几率相关,以及24% (95%CI:[18%-31%])的ECog-II和52% (95%CI:[41%-63%])的MBI- c总分较高。最后,SCD+和MBI+状态分别介导了smTBI病史和较差功能之间约45%和56%的关联,这表明了较高的SAGEA总分。讨论:smTBI在生命过程中的任何时候都与较差的认知和行为有关,即使在没有轻度认知障碍或痴呆的社区老年人中也是如此。患有smTBI的老年人可能受益于使用测量认知和行为变化的工具进行早期痴呆风险评估。对认知能力和行为能力下降的干预措施也可能有利于解决这一人群的功能障碍。
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引用次数: 0
Palliative Electroconvulsive Therapy: A Descriptive Cohort Study. 姑息性电痉挛治疗:一项描述性队列研究。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-12-09 DOI: 10.1016/j.jaclp.2024.12.001
Gregg A Robbins-Welty, Ryan D Slauer, Madeline M Brown, Morgan M Nakatani, Dan Shalev, Jacob Feigal

Background: Palliative care (PC) is the standard of care for patients with serious medical illnesses, or those conditions associated with high risk of mortality and negative impact on quality of life (QOL). Electroconvulsive therapy (ECT) is the gold standard treatment for certain psychiatric conditions, which may co-occur with serious medical illnesses. However, the use of "palliative ECT" (PECT) in this context is understudied.

Methods: We conducted a descriptive retrospective cohort study reviewing the indications, outcomes, and regimens of PECT. We included patients who had an ECT consultation, in addition to either a PC consultation or a do-not-attempt-resuscitation code status between 2018 and 2023.

Results: Thirty-one patients met our inclusion criteria, and 21 received ECT. The cohort was predominantly female (70%) with a mean age of 67.6 (range 25-90). Catatonia (64.5%) and treatment-resistant depressive disorder (35.5%) were the most common indications for ECT. At the time of ECT consultation, 16 patients (51.6%) had a serious medical illness, including cancer (19.4%) or end-organ disease (22.6%). Fourteen patients had major neurocognitive disorder (MNCD) (45.2%). Surrogate decision-makers consented for ECT in 64.5% of cases. All 21 patients who received ECT experienced psychiatric symptom improvement. ECT was associated with reduced mortality risk in 5 (23.8%) cases. Five patients initially misdiagnosed with MNCD experienced recovery in cognitive function after ECT, and the diagnosis was revised to depression-related cognitive dysfunction. Eight patients retained a comorbid MNCD diagnosis but experienced a mean Montreal Cognitive Assessment (MoCA) improvement of 5 points (range 0 to 17) with ECT.

Discussion: This work highlights the use of ECT among patients with serious medical illnesses, identifying cases when ECT was beneficial or deemed unsuitable. Patients with serious medical illnesses who also had an indication for ECT experienced improved QOL with ECT. Misdiagnoses, such as confusing depression-related cognitive dysfunction and catatonia for MNCD, were effectively addressed through ECT. The findings underscore the importance of cross-specialty collaboration between C-L psychiatry and PC.

Conclusions: Patients who receive PECT experience reduced suffering and improved QOL. PECT may be helpful in scenarios of life-threatening psychiatric illnesses, terminal medical illnesses with comorbid treatment-refractory psychiatric illnesses, and diagnostic uncertainty with MNCD.

简介姑息治疗(PC)是重症患者或死亡风险高且对生活质量(QOL)有负面影响的患者的标准治疗方法。电休克疗法(ECT)是治疗某些精神疾病的金标准,这些疾病可能与严重的内科疾病同时存在。然而,在这种情况下使用 "姑息性电休克疗法"(PECT)的情况还未得到充分研究:我们进行了一项描述性回顾性队列研究,回顾了 PECT 的适应症、结果和治疗方案。我们纳入了在2018年至2023年期间接受过ECT会诊的患者,此外还纳入了PC会诊或DNAR代码状态的患者:31名患者符合我们的纳入标准,其中21人接受了ECT治疗。患者以女性为主(70%),平均年龄为 67.6 岁(25-90 岁不等)。紧张症(64.5%)和耐药抑郁症(35.5%)是最常见的 ECT 适应症。就诊时,16 名患者(51.6%)患有严重的内科疾病,包括癌症(19.4%)或内脏疾病(22.6%)。14名患者患有严重神经认知障碍(MNCD)(45.2%)。64.5%的病例的代理决策者同意接受电痉挛疗法。所有21名接受电痉挛疗法的患者的精神症状均有所改善。5例(23.8%)患者接受电痉挛疗法后降低了死亡风险。五名最初被误诊为MNCD的患者在接受电痉挛疗法后认知功能得到恢复,诊断结果被修正为抑郁相关认知功能障碍(DRCD)。8名患者仍合并有MNCD诊断,但在接受ECT治疗后,蒙特利尔认知评估(MoCA)的平均值提高了5分(范围为0至17分):这项研究强调了在患有严重内科疾病的患者中使用电痉挛疗法的情况,确定了电痉挛疗法有益或不适合的病例。重症内科疾病患者如果也有接受电痉挛疗法的指征,那么他们在接受电痉挛疗法后的生活质量会得到改善。通过电痉挛疗法有效地解决了误诊问题,例如将 DRCD 和紧张症混淆为 MNCD。研究结果强调了C-L精神科和PC跨专科合作的重要性:结论:接受 PECT 治疗的患者可以减轻痛苦,提高 QOL。在危及生命的精神疾病、合并难治性精神疾病的终末期内科疾病以及 MNCD 诊断不确定的情况下,PECT 可能会有所帮助。
{"title":"Palliative Electroconvulsive Therapy: A Descriptive Cohort Study.","authors":"Gregg A Robbins-Welty, Ryan D Slauer, Madeline M Brown, Morgan M Nakatani, Dan Shalev, Jacob Feigal","doi":"10.1016/j.jaclp.2024.12.001","DOIUrl":"10.1016/j.jaclp.2024.12.001","url":null,"abstract":"<p><strong>Background: </strong>Palliative care (PC) is the standard of care for patients with serious medical illnesses, or those conditions associated with high risk of mortality and negative impact on quality of life (QOL). Electroconvulsive therapy (ECT) is the gold standard treatment for certain psychiatric conditions, which may co-occur with serious medical illnesses. However, the use of \"palliative ECT\" (PECT) in this context is understudied.</p><p><strong>Methods: </strong>We conducted a descriptive retrospective cohort study reviewing the indications, outcomes, and regimens of PECT. We included patients who had an ECT consultation, in addition to either a PC consultation or a do-not-attempt-resuscitation code status between 2018 and 2023.</p><p><strong>Results: </strong>Thirty-one patients met our inclusion criteria, and 21 received ECT. The cohort was predominantly female (70%) with a mean age of 67.6 (range 25-90). Catatonia (64.5%) and treatment-resistant depressive disorder (35.5%) were the most common indications for ECT. At the time of ECT consultation, 16 patients (51.6%) had a serious medical illness, including cancer (19.4%) or end-organ disease (22.6%). Fourteen patients had major neurocognitive disorder (MNCD) (45.2%). Surrogate decision-makers consented for ECT in 64.5% of cases. All 21 patients who received ECT experienced psychiatric symptom improvement. ECT was associated with reduced mortality risk in 5 (23.8%) cases. Five patients initially misdiagnosed with MNCD experienced recovery in cognitive function after ECT, and the diagnosis was revised to depression-related cognitive dysfunction. Eight patients retained a comorbid MNCD diagnosis but experienced a mean Montreal Cognitive Assessment (MoCA) improvement of 5 points (range 0 to 17) with ECT.</p><p><strong>Discussion: </strong>This work highlights the use of ECT among patients with serious medical illnesses, identifying cases when ECT was beneficial or deemed unsuitable. Patients with serious medical illnesses who also had an indication for ECT experienced improved QOL with ECT. Misdiagnoses, such as confusing depression-related cognitive dysfunction and catatonia for MNCD, were effectively addressed through ECT. The findings underscore the importance of cross-specialty collaboration between C-L psychiatry and PC.</p><p><strong>Conclusions: </strong>Patients who receive PECT experience reduced suffering and improved QOL. PECT may be helpful in scenarios of life-threatening psychiatric illnesses, terminal medical illnesses with comorbid treatment-refractory psychiatric illnesses, and diagnostic uncertainty with MNCD.</p>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814838","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
Implementation of the California End of Life Option Act at UCSF: Examining the Utility of the Mandatory Mental Health Assessment in Medical Aid in Dying. 加州大学旧金山分校的加州生命终结选择法案:检查强制性心理健康评估的效用。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-11-29 DOI: 10.1016/j.jaclp.2024.11.006
Michael T Dinh, Brieze Bell, James A Bourgeois, Eric Weaver, Jordie Martin, David L O'Riordan, Michael Rabow, Lawrence Kaplan, Brian Anderson

Background: The End of Life Option Act (EOLOA) legalized medical aid in dying (MAID) in California in 2015. University of California, San Francisco Health initially implemented a policy requiring a mandatory mental health assessment of all patients seeking MAID, though this was not required by the EOLOA. State-level statistics on EOLOA are available, but less is known about outcomes at individual institutions and how institutional policy affects outcomes for patients seeking MAID.

Objectives: Investigators examined the factors contributing to patients' decisions to request MAID and how the mandatory mental health assessment impacted determinations of decisional capacity and access to MAID.

Methods: Retrospective chart review was conducted on a sample of patients who had pursued MAID or been prescribed MAID medications between June 2016 and May 2020 obtained by a combination of purposive sampling (n = 78) and systematic electronic health record sampling (n = 22). Descriptive statistics were used to examine demographic factors, neuropsychiatric diagnoses and rating scales, factors contributing to patients' decision to request MAID, and outcomes of the psychiatric evaluation process.

Results: Of the 78 patients in the purposive sample who had initiated EOLOA requests, 67% had MAID medications prescribed. Zero patients were found to lack decisional capacity due to a current psychiatric condition. Many patient records were missing relevant data including neuropsychiatric rating scale scores and factors contributing to patients' decision to request MAID. The neuropsychiatric rating scale scores and diagnoses that were present did not suggest a high prevalence of severe psychiatric illness in the sample.

Conclusions: The findings from this study suggest that mandatory mental health assessments for all patients requesting MAID at a single academic medical center did not identify patients who lacked decisional capacity to pursue MAID, and potentially created access barriers to seriously ill patients seeking this intervention. Generalizability of findings may be limited by the fact that mental illness burden was low in the studied sample. Results from this study contributed to changes in EOLOA institutional policy at University of California, San Francisco, including elimination of the mandatory mental health assessment for EOLOA candidates in favor of a conditional mental health assessment based on certain clinical criteria.

背景:2015年,美国加州《生命终结选择法案》(EOLOA)将临终医疗援助(MAID)合法化。加州大学旧金山分校(UCSF)卫生部最初实施了一项政策,要求对所有寻求MAID的患者进行强制性心理健康评估,尽管EOLOA没有要求这样做。州一级的EOLOA统计数据是可用的,但对个别机构的结果以及机构政策如何影响寻求MAID的患者的结果知之甚少。目的:调查影响患者决定申请MAID的因素,以及强制性心理健康评估如何影响决定能力和获得MAID的决定。方法:采用目的抽样(n=78)和系统电子健康记录(EHR)抽样(n=22)相结合的方法,对2016年6月至2020年5月期间接受MAID治疗或处方MAID药物治疗的患者样本进行回顾性图表分析。描述性统计用于检验人口学因素、神经精神病学诊断和评分量表、影响患者决定要求MAID的因素以及精神病学评估过程的结果。结果:在目的样本中提出EOLOA请求的78例患者中,67%的患者处方了MAID药物。没有发现患者由于目前的精神状况而缺乏决策能力。许多患者记录缺少相关数据,包括神经精神评定量表得分和影响患者决定请求MAID的因素。神经精神评定量表得分和诊断结果并不表明样本中存在严重精神疾病的高患病率。结论:本研究的结果表明,在单一学术医疗中心对所有要求MAID的患者进行强制性心理健康评估,并不能识别出缺乏追求MAID的决策能力的患者,并可能为寻求这种干预的重症患者创造准入障碍。研究结果的普遍性可能受到研究样本中精神疾病负担较低这一事实的限制。这项研究的结果有助于改变加州大学旧金山分校的EOLOA制度政策,包括取消对EOLOA候选人的强制性心理健康评估,转而采用基于某些临床标准的有条件心理健康评估。
{"title":"Implementation of the California End of Life Option Act at UCSF: Examining the Utility of the Mandatory Mental Health Assessment in Medical Aid in Dying.","authors":"Michael T Dinh, Brieze Bell, James A Bourgeois, Eric Weaver, Jordie Martin, David L O'Riordan, Michael Rabow, Lawrence Kaplan, Brian Anderson","doi":"10.1016/j.jaclp.2024.11.006","DOIUrl":"10.1016/j.jaclp.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>The End of Life Option Act (EOLOA) legalized medical aid in dying (MAID) in California in 2015. University of California, San Francisco Health initially implemented a policy requiring a mandatory mental health assessment of all patients seeking MAID, though this was not required by the EOLOA. State-level statistics on EOLOA are available, but less is known about outcomes at individual institutions and how institutional policy affects outcomes for patients seeking MAID.</p><p><strong>Objectives: </strong>Investigators examined the factors contributing to patients' decisions to request MAID and how the mandatory mental health assessment impacted determinations of decisional capacity and access to MAID.</p><p><strong>Methods: </strong>Retrospective chart review was conducted on a sample of patients who had pursued MAID or been prescribed MAID medications between June 2016 and May 2020 obtained by a combination of purposive sampling (n = 78) and systematic electronic health record sampling (n = 22). Descriptive statistics were used to examine demographic factors, neuropsychiatric diagnoses and rating scales, factors contributing to patients' decision to request MAID, and outcomes of the psychiatric evaluation process.</p><p><strong>Results: </strong>Of the 78 patients in the purposive sample who had initiated EOLOA requests, 67% had MAID medications prescribed. Zero patients were found to lack decisional capacity due to a current psychiatric condition. Many patient records were missing relevant data including neuropsychiatric rating scale scores and factors contributing to patients' decision to request MAID. The neuropsychiatric rating scale scores and diagnoses that were present did not suggest a high prevalence of severe psychiatric illness in the sample.</p><p><strong>Conclusions: </strong>The findings from this study suggest that mandatory mental health assessments for all patients requesting MAID at a single academic medical center did not identify patients who lacked decisional capacity to pursue MAID, and potentially created access barriers to seriously ill patients seeking this intervention. Generalizability of findings may be limited by the fact that mental illness burden was low in the studied sample. Results from this study contributed to changes in EOLOA institutional policy at University of California, San Francisco, including elimination of the mandatory mental health assessment for EOLOA candidates in favor of a conditional mental health assessment based on certain clinical criteria.</p>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774625","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
Recurrent Hypothermia After Risperidone Therapy in an Elderly Patient With Alzheimer's Dementia and Psychotic Features. 利培酮治疗阿尔茨海默氏痴呆症和精神病特征老年患者的复发性低体温症:罕见病例报告。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-11-15 DOI: 10.1016/j.jaclp.2024.11.002
Shrinjay Vyas, Shubham Garg
{"title":"Recurrent Hypothermia After Risperidone Therapy in an Elderly Patient With Alzheimer's Dementia and Psychotic Features.","authors":"Shrinjay Vyas, Shubham Garg","doi":"10.1016/j.jaclp.2024.11.002","DOIUrl":"10.1016/j.jaclp.2024.11.002","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644685","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
Milieu Therapy in the Treatment of a Medically Complex Patient Receiving Care on a Medical-Psychiatry Unit and Consultation-Liaison Psychiatry Service: A Case Report 在医疗精神病科和会诊联络精神病科接受治疗的病情复杂病人的环境疗法:病例报告。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-11-01 DOI: 10.1016/j.jaclp.2024.07.002
Norman R. Greenberg M.D., Erika Jakobson D.O., Anna L. Dickerman M.D.
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引用次数: 0
“I'm Not Crazy”: Responding to Perceived Mental Health Stigma "我没疯"--对心理健康污名化的回应。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-11-01 DOI: 10.1016/j.jaclp.2024.08.001
John R. Peteet M.D.
{"title":"“I'm Not Crazy”: Responding to Perceived Mental Health Stigma","authors":"John R. Peteet M.D.","doi":"10.1016/j.jaclp.2024.08.001","DOIUrl":"10.1016/j.jaclp.2024.08.001","url":null,"abstract":"","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 6","pages":"Pages 590-591"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005857","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: Explicit, Implicit, and Tacit Consultation Questions for a Patient With Idiopathic Thrombocytopenic Purpura and Agitation C-L 病例会议:针对特发性血小板减少性紫癜和躁动患者的显性、隐性和隐性咨询问题。
IF 2.7 4区 心理学 Q2 PSYCHIATRY Pub Date : 2024-11-01 DOI: 10.1016/j.jaclp.2024.07.001
Flannery Merideth M.D. , Joseph B. Jabaily D.O. , Daniel Daunis M.D. , Nicholas Kontos M.D., F.A.C.L.P.
We present the case of a 23-year-old man with a complex psychiatric history who was transferred from a community hospital for management of agitation and severe thrombocytopenia. Experts in consultation-liaison psychiatry deconstruct the consultation question in this case. The importance of addressing superficial and hidden aspects of a consultation is reviewed via the concepts of explicit, implicit, and tacit consultation questions.
我们介绍的病例是一名 23 岁的男子,他有复杂的精神病史,因躁动不安和严重血小板减少症从社区医院转院接受治疗。会诊联络精神病学专家解构了本病例中的会诊问题。通过显性、隐性和隐性会诊问题的概念,回顾了解决会诊中表面和隐性问题的重要性。
{"title":"C-L Case Conference: Explicit, Implicit, and Tacit Consultation Questions for a Patient With Idiopathic Thrombocytopenic Purpura and Agitation","authors":"Flannery Merideth M.D. ,&nbsp;Joseph B. Jabaily D.O. ,&nbsp;Daniel Daunis M.D. ,&nbsp;Nicholas Kontos M.D., F.A.C.L.P.","doi":"10.1016/j.jaclp.2024.07.001","DOIUrl":"10.1016/j.jaclp.2024.07.001","url":null,"abstract":"<div><div>We present the case of a 23-year-old man with a complex psychiatric history who was transferred from a community hospital for management of agitation and severe thrombocytopenia. Experts in consultation-liaison psychiatry deconstruct the consultation question in this case. The importance of addressing superficial and hidden aspects of a consultation is reviewed via the concepts of explicit, implicit, and tacit consultation questions.</div></div>","PeriodicalId":52388,"journal":{"name":"Journal of the Academy of Consultation-Liaison Psychiatry","volume":"65 6","pages":"Pages 562-569"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617653","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
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Journal of the Academy of Consultation-Liaison Psychiatry
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