Director’s Blog Released today, the World Health Organization (WHO)'s report, ” Preventing Suicide: A global imperative ,” provides the first global view of how often suicide attempts and deaths occur, and how suicide-related behaviors affect all ages, nationalities, economic levels, and cultures. Every year around the world more than 800,000 people die by suicide. Globally, suicide is the second leading cause of death in 15- to 20-year-olds.
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.
Abstract: Objective: Eating disorder (ED) symptoms have gone mostly unexamined among veterans. The current study assessed rates of bulimia nervosa (BN) and binge eating disorder (BED) symptoms and diagnoses and their associations with common comorbidities among male and female veterans.Method: Participants were US military veterans who screened positive for trauma histories and/or a probable Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) posttraumatic stress disorder (PTSD) diagnosis (n=499). Symptoms of PTSD were assessed using the Clinician-Administered PTSD Scale, and symptoms of EDs, mood, and substance use disorders were assessed using the Structured Clinical Interview for the DSM-IV.Results: Lifetime rates of BN and BED diagnoses were comparable to civilian populations, and a considerable range of lifetime and current BN and BED symptoms were identified
Abstract: Objective: To report a case of cycloserine-induced acute psychosis in a young female while on second line antitubercular treatment (ATT) for tubercular meningitis.Method: Case report.Results: A 20-year-old female, known case of tubercular meningitis on ATT since 8 months, presented with a 10-days history of headache, vomiting, and photophobia. A provisional diagnosis of drug-resistant tuberculosis was made, and second-line ATT including cycloserine (750 mg/day) and levofloxacin (750 mg/day) was added.
Abstract: Objective: To report a case of paranoid psychosis and cognitive impairment associated with Hepatitis C virus (HCV) antiviral therapy.Methods: Case report.Results: A 55-year-old male presented with paranoid psychosis and cognitive impairment, 4 months after initiating interferon-based HCV antiviral therapy. His psychosis resolved with discontinuation of therapy and initiation of risperidone, but his cognitive impairment persisted.
Abstract: Objective: This study investigates the prevalence of lithium use, monitoring practice and associated effects on renal function in a large UK community sample.Method: A large population-based renal function database was cross-referenced with a general practitioner database of 404, 673 patients. The renal function of patients prescribed lithium during the 2-year period was compared with that of matched controls. The renal monitoring patterns of these cases were investigated in a naturalistic observational study
Abstract: Hashimoto’s thyroiditis (HT) is an autoimmune thyroiditis that occurs frequently in middle-aged women. To date, there is no formally reported association between acute mania and hypothyroidism due to HT. We report a case of acute mania associated with hypothyroidism resulting from HT.
Abstract: Objective: Constipation is often overlooked in patients with schizophrenia. We examined their awareness of constipation and whether they reported it to their psychiatrists.Method: Five hundred three inpatients with schizophrenia (International Classification of Diseases, 10th Revision) were interviewed about their recent bowel movements and evaluated for the diagnostic criteria for functional constipation. If constipation was present, patients were asked if they were aware of it and had reported it to their psychiatrists in charge.
Considerable progress has been made in understanding how neural circuits contribute to mental processing and psychiatric disorders. This research has highlighted the importance of network dysfunction, particularly changes in the balance between excitatory and inhibitory transmission within and across brain regions that underlie cognition, emotion, and motivation.
Abstract: The present article reports the case of a delusional pregnancy that developed in a drug-naïve young woman affected by paranoid schizophrenia and Hashimoto-related hyperprolactinemia. The literature in this field has addressed the phenomenon of distorted thoughts of pregnancy being elicited by physical changes due to drug-induced hyperprolactinemia. The present report gives account of a case of delusional pregnancy that developed in a schizophrenic patient with concurrent hyperprolactinemia induced by a primary endocrine disease