This week, Psychiatric times discussed a wide variety of psychiatric issues and industry updates, from noninvasive brain stimulation techniques for catatonia to the concurrent treatment of eating disorders and PTSD. Here are some highlights from the week.
A year 988: the first step of a long journey
A year ago, the National Suicide Prevention Lifeline switched to its new 3-digit number, 988. Since its launch, the Lifeline has received an astonishing number of hits: over 5 million, including more than 1.43 million calls, 416,000 chats and 281,000 SMS. But is it effective in saving lives?
The move to the 988 Suicide & Crisis Lifeline has triggered a transformative moment in behavioral health care in this country. For the first time in my 26-year career, every state and territory is talking about improving their behavioral health crisis systems, said Monica Johnson, MA, director of the 988 & Behavioral Health Crisis Coordinating Office at Substance Abuse and Mental Health Services Administration (SAMHSA). Keep reading
Noninvasive brain stimulation techniques for catatonia
A recent study evaluated the role of 3 common noninvasive brain stimulation (NIBS) techniques, electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS) in catatonic treatment.
This is the first systematic review of NIBS techniques for the treatment of catatonia; The study included 13 systematic reviews and 1 meta-analysis of ECT, 2 systematic reviews and 12 case reports of rTMS, and 7 studies and 14 cases of tDCS. The studies included patients diagnosed with catatonia; age and diagnostic specificities were not considered. Studies included treatment with ECT, rTMS, tDCS, alone or in combination with pharmacotherapy or other treatments; the frequency and duration of treatment were not limited. Keep reading
Treatment of eating disorders and PTSD simultaneously leads to long-term recovery
Eating disorders (ED), including anorexia nervosa, bulimia nervosa, binge eating disorder, other specific eating and eating disorders, and avoidant-restrictive food intake disorder are estimated to , affect more than 28.8 million Americans at some point in their lives. They have the second highest mortality rate of all mental illnesses, making them serious but treatable mental and physical illnesses. Concomitant disorders, such as anxiety, mood disorders, substance use disorders, and post-traumatic stress disorder (PTSD), are often present in individuals with ED.
Indeed, research shows an undeniable connection between PTSD and ED. Individuals with significant traumatic histories and/or PTSD have more severe ED symptoms, more suicidality, and more symptoms of anxiety and depression.Keep reading
Treatment of the objection: ethical and legal principles
Psychiatrists and consultation liaison residents are often consulted to assess capacity in medically hospitalized patients who have a history of psychiatric illness. Subsequent decisions about the provision of medical and psychiatric care upon objection (TOO) may involve hospital ethics committees and legal counsel.
We present a case in which the question of TOO for an incapacitated patient remained incompletely resolved due to a conflict between the ethically most appropriate treatment and the legally most appropriate treatment. This conflict, coupled with uncertainty about the ethical and legal principles themselves and the role of each team, has caused considerable moral distress to both the medical and psychiatry teams. Keep reading
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