RESUMO
OBJECTIVE: Interpersonal and social rhythm therapy (IPSRT) is an evidence-based psychotherapy for mood disorders. The goal of this quality improvement initiative was to demonstrate feasibility of implementing IPSRT across the continuum of outpatient and inpatient care within an academic medical center. METHODS: A multidisciplinary work group was convened to implement IPSRT in outpatient (N=48), inpatient (N=602), and intensive outpatient (N=68) programs of an academic medical center. Quality improvement performance markers (including symptoms and group attendance rates) were collected. RESULTS: Institutional preference for group treatments required adaptation of IPSRT from an individual to group psychotherapy format. Iterative problem solving and protocol development resulted in models of group IPSRT appropriate for each level of care. Performance outcome markers were favorable, indicating feasibility of implementation. CONCLUSIONS: At a single, multisite, urban, academic medical center, IPSRT proved a feasible evidence-based psychotherapy for implementation across levels of care in routine practice.
Assuntos
Centros Médicos Acadêmicos , Continuidade da Assistência ao Paciente , Transtornos do Humor/terapia , Avaliação de Processos e Resultados em Cuidados de Saúde , Psicoterapia de Grupo/métodos , Melhoria de Qualidade , Atividades Cotidianas , Adulto , Ritmo Circadiano , Competência Clínica , Medicina Baseada em Evidências , Estudos de Viabilidade , Feminino , Humanos , Relações Interpessoais , MasculinoRESUMO
The effects of acute lorazepam administration on 1H magnetic resonance spectroscopy (MRS) in vivo brain spectra were examined in the left dorsolateral prefrontal cortex (L-DLPFC) of healthy human subjects. We wanted to examine whether lorazepam administration would result in significant changes in the levels of 1H-MRS metabolites in this brain region. Ten healthy controls underwent a short echo-time 1H-MRS session immediately before, and a second one 1 h after lorazepam administration (2mg/orally). The measured 1H-metabolites included N-acetyl-aspartate, phosphocreatine+creatine, trimethylamines, myo-inositol, glutamate, and glutamine, which were expressed as absolute values and ratios. No significant differences were found after lorazepam administration for any of the measured metabolite levels or ratios (paired t-tests, p >.05). This study demonstrated that lorazepam can potentially be utilized to acutely sedate psychiatric subjects during in vivo 1H-MRS sessions, as it does not appear to produce significant changes in the 1H-MRS spectra in this specific brain region.
