Director’s Blog It’s difficult to overstate the impact that genomic medicine is having on biomedical research and practice. For cancer diagnostics, rare disease therapeutics, and fields like microbiomics and infectious diseases, the advent of cheap, fast, precise genomic sequencing has been a game changer. What about mental disorders
Abstract: Background: The psychopathological and clinical characteristics of adult patients with epilepsy attending our neurology clinic was evaluated to determine prevalence of psychopathology and its associated factors towards improving services and initiating collaborative care which is currently non-existent.Methods: The study was a 2 stage procedure conducted over one year using the General Health Questionnaire (GHQ-12) in the first stage and Schedule for Clinical Assessment in Neuropsychiatry (SCAN) in the second stage. Diagnosis of psychiatric disorders was based on ICD-10 criteria.Results: Sixty-three patients were interviewed. Mean age was 34.43±13.7 years; more than half of the patients had less than one seizure episode per month
Abstract: Objective: The present study aimed to extract discriminating indicators for diagnosis of autism spectrum disorder (ASD) from personal backgrounds and past history among depressed adult outpatients.Methods: Subjects were 430 depressed adults, consisting of patients with ASD (n=70) and those without ASD (n=360). Group comparison and discriminant analysis was conducted with regard to backgrounds (age, gender, education, marriage, living alone, physical diseases and family history of mood disorders) and past history (school non-attendance, bullied experience, psychotic-like experiences, conduct problems, suicide-related behaviors and interpersonal friction).Results: Six discriminating indicators (interpersonal friction, bullied experience, psychotic-like experiences, age under 32 years, school non-attendance and university educational level) were identified by stepwise discriminant analysis (P
Abstract: Objective: To test the feasibility and efficacy of a psychosocial intervention to address high-risk substance use in patients scheduled for elective surgery.Method: A group-format intervention, based in motivational interviewing principles, was provided prior to elective surgery to 107 participants with at-risk substance use, identified using the AUDIT-C and self-report of illicit drug use. Patient satisfaction was assessed with an anonymous survey. Within-subject comparisons of substance use at baseline and at a postoperative follow-up evaluation were conducted
Abstract: Objective: Cardiovascular side effects of lithium have been reported to occur mainly at higher-than-therapeutic serum levels. We aimed to investigate the impact of the long-term lithium use on electrocardiogram (ECG) parameters in association with the serum levels in patients with bipolar disorder (BD) and in healthy controls (HCs) serving as the reference group.Methods: The study sample consisted of 53 euthymic BD type I patients on lithium monotherapy at therapeutic serum levels (M=0.76, S.D.=0.14, range=0.41–1.09 mmol/l) for at least 12 months and 45 HCs.
Abstract: Objective: To understand collaborative care psychiatric consultants’ views and practices on making the diagnosis of and recommending treatment for bipolar disorder in primary care using collaborative care.Method: We conducted a focus group at the University of Washington in December 2013 with nine psychiatric consultants working in primary care-based collaborative care in Washington State. A grounded theory approach with open coding and the constant comparative method revealed categories where emergent themes were saturated and validated through member checking, and a conceptual model was developed.Results: Three major themes emerged from the data including the importance of working as a collaborative care team, the strengths of collaborative care for treating bipolar disorder, and the need for psychiatric consultants to adapt specialty psychiatric clinical skills to the primary care setting. Other discussion topics included gathering clinical data from multiple sources over time, balancing risks and benefits of treating patients indirectly, tracking patient care outcomes with a registry, and effective care.Conclusion: Experienced psychiatric consultants working in collaborative care teams provided their perceptions regarding treating patients with bipolar illness including identifying ways to adapt specialty psychiatric skills, developing techniques for providing team-based care, and perceiving the care delivered through collaborative care as high quality.
Ten to 15% of the population use benzodiazepines in any given year, and 2% use benzodiazepines chronically. However, benzodiazepine use disorder is more prevalent in individuals who abuse other substances .
Abstract: Objective: The aims of this study were 1) to assess the long-term effects of a collaborative care intervention for patients with depression on process of care outcomes, and 2) to describe whether case management was continued after the end of the original one-year intervention.Methods: This 24-month follow-up of a randomized controlled trial took place 12months after the end of the 1-year intervention. Data collection occurred by means of self-rating questionnaires and from medical records.
Abstract: Objective: Pain and depression are prevalent and treatable symptoms among patients with cancer yet they are often undetected and undertreated. The Indiana Cancer Pain and Depression (INCPAD) trial demonstrated that telecare management can improve pain and depression outcomes.
Jayashri Kulkarni, MBBS, MPM, FRANZCP, PhD
Director, Monash Alfred Psychiatry Research Centre, Melbourne, Australia