ABSTRACT
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.Prim Care Companion CNS Disord 2024;26(3):23f03680. Author affiliations are listed at the end of this article.
Subject(s)
Mental Disorders , Humans , Mental Disorders/therapy , Mental Disorders/diagnosis , Female , Male , Vitamin D , Middle AgedABSTRACT
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.
Subject(s)
Wernicke Encephalopathy , Humans , Inpatients , Wernicke Encephalopathy/diagnosis , Wernicke Encephalopathy/etiology , Wernicke Encephalopathy/therapyABSTRACT
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.
Subject(s)
Mental Disorders , Psychiatry , Hospitals, General , Humans , Inpatients , Mania , Referral and ConsultationABSTRACT
OBJECTIVE: To determine the incidence and predictors of delirium after cardiac surgery. METHOD: A prospective, observational study of postcardiotomy surgical patients was conducted during a 5 month period at the Minneapolis, MN, VAMC. RESULTS: Of the 53 patients who completed the study, 12 patients (23%) met criteria for postoperative delirium and 18 patients (34%) met criteria for postoperative subsyndromal delirium. Significant predictors of postoperative delirium included a history of cerebrovascular disease (Charlson Index item, VA CICSP), high medical comorbidity (VA morbidity risk score, Charlson Index), increased preoperative creatinine level, and an increased preoperative pain rating. When delirium and subsyndromal delirium patients were combined, a history of cerebrovascular disease, left ventricular dysfunction, or diabetes predicted the development of delirious symptoms. CONCLUSIONS: Incident delirium occurred in 23% of patients after cardiac surgery and incident delirium symptoms, in 57%. The strongest predictor of both incident delirium and delirium symptoms was a history of cerebrovascular disease.
Subject(s)
Cardiac Surgical Procedures/adverse effects , Delirium/epidemiology , Aged , Cerebrovascular Disorders/epidemiology , Comorbidity , Delirium/etiology , Humans , Incidence , Middle Aged , Minnesota/epidemiology , Prospective Studies , Regression Analysis , Risk FactorsSubject(s)
Antipsychotic Agents/therapeutic use , Bipolar Disorder/drug therapy , Bipolar Disorder/etiology , Brain Injuries/psychology , Dibenzothiazepines/therapeutic use , Adult , Antipsychotic Agents/administration & dosage , Citalopram/therapeutic use , Dibenzothiazepines/administration & dosage , Drug Administration Schedule , Humans , Male , Quetiapine FumarateABSTRACT
PRIMARY OBJECTIVE: To examine demographic factors, childhood experiences and behaviour problems and adult psychopathology associated with a history of adult traumatic brain injury (TBI) with unconsciousness in patients with substance use disorders (SUD). DESIGN AND METHODS: Voluntary patients (n = 550) undergoing treatment for SUD were compared for clinical and demographic variables based on report of TBI. RESULTS: Among the 218 (40%) patients reporting TBI, 61% were men. Childhood conduct problems and loss of a parent were strongly associated with adult TBI. Patients with TBI had more severe SUD and higher rates of depressive and anxiety symptoms, somatic concerns, physical trauma, attempted suicide and Antisocial Personality Disorder. CONCLUSIONS: Men have a higher rate of TBI than women, but women with SUD have an increased relative risk of TBI compared to women in the general population. Childhood conduct problems and loss of a parent in childhood may predict adult risk-taking behaviour that leads to TBI in patients with SUD. TBI is associated with higher rates of psychopathology in patients with SUD.
