Association between exposure to antidepressants and stimulants and age at onset of mania or psychosis: A retrospective population-based cohort study.

This study investigated the impact of prior antidepressant and stimulant exposure on the age at onset (AAO) of first episode mania (FEM) or psychosis (FEP). Patients with FEP and FEM born after 1985 in Olmsted County, Minnesota, were identified using the Rochester Epidemiology Project. Duration and peak dose of antidepressant and stimulant exposure were quantified by review of the electronic health record.

Adult Outcomes of Children With Reactive Attachment Disorder in a Non-Institutionalized Sample.

Research on reactive attachment disorder (RAD) has focused on institutionalized samples, and long-term outcomes have not been described. This study examines the natural history of RAD into adulthood in a US community sample The electronic medical record of a tertiary care center was reviewed for individuals who received an or diagnosis of RAD between 3-12 years old and were ≥ 18 years old at the start of the study; data were collected between February and June 2018. Children with RAD (n = 49) were identified and psychiatric, social, and medical outcomes were collected in childhood and adulthood.

A scoping review of social media in child, adolescents and young adults: research findings in depression, anxiety and other clinical challenges.

Background: Social media and other technologies are reshaping communication and health.

Aims: This review addresses the relationship between social media use, behavioural health conditions and psychological well-being for youth aged <25 years.

Method: A scoping review of 11 literature databases from 2000 to 2020 explored research studies in youth in five areas: clinical depression and anxiety, quantitative use, social media mode, engagement and qualitative dimensions and health and well-being.

Antecedents to first episode psychosis and mania: Comparing the initial prodromes of schizophrenia and bipolar disorder in a retrospective population cohort.

Objective: We aim to compare the psychiatric antecedents of schizophrenia (SZ) and bipolar disorder (BD).

Methods: Using the Rochester Epidemiology Project, we searched for residents of Olmsted County that had a diagnosis of SZ or BD. We confirmed each case using DSM-5 criteria and obtained the psychiatric antecedents.

National Trends in Mental Health-Related Emergency Department Visits Among Youth, 2011-2020.

Importance: There has been increasing concern about the burden of mental health problems among youth, especially since the COVID-19 pandemic. Trends in mental health-related emergency department (ED) visits are an important indicator of unmet outpatient mental health needs.

Objective: To estimate annual trends in mental health-related ED visits among US children, adolescents, and young adults between 2011 and 2020.

Development and Implementation of a Virtual Clinical Skills Examination in General Psychiatry.

Objective: During the COVID-19 pandemic, psychiatry programs have administered the Clinical Skills Evaluation (CSE) through videoconferencing. The authors evaluated the feasibility and appropriateness of administering virtual CSEs.

Methods: Virtual CSEs were administered to 11 general psychiatry residents on March 16, 2021.

Evidence for machine learning guided early prediction of acute outcomes in the treatment of depressed children and adolescents with antidepressants.

Background: The treatment of depression in children and adolescents is a substantial public health challenge. This study examined artificial intelligence tools for the prediction of early outcomes in depressed children and adolescents treated with fluoxetine, duloxetine, or placebo.

Methods: The study samples included training datasets (N = 271) from patients with major depressive disorder (MDD) treated with fluoxetine and testing datasets from patients with MDD treated with duloxetine (N = 255) or placebo (N = 265).

Psychiatry Residents as Medical Student Educators: a Review of the Literature.

Objective: Professional organizations and medical schools need trainees as medical student educators. There are limited data describing the training of residents and fellows as educators. There are also limited data describing the impact of trainee educators on medical student performance and clerkship experience.

Clinician Satisfaction with Rapid Adoption and Implementation of Telehealth Services During the COVID-19 Pandemic.

To examine clinician perspectives on the acceptability, appropriateness/suitability, and feasibility of video telehealth as a way to deliver mental health services during the COVID-19 pandemic. Mental health clinicians were surveyed with 27 Likert questions, using previously validated measures, on satisfaction and implementation experience with video telehealth visits between March and June 2020. A total of 112 of 193 clinicians completed the survey (58.

Glutamatergic Correlates of Bipolar Symptoms in Adolescents.

Prior studies demonstrate elevated cortical glutamate (Glu) in patients with bipolar disorder (BD). Studies assessing neurochemistry in early stages of bipolar illness before the emergence of manic symptoms are lacking. This study aimed to examine neurochemical correlates measured by proton magnetic resonance spectroscopy (H-MRS) and a dimensional measure of bipolarity in a sample of depressed adolescents.

Telehealth for rural diverse populations: telebehavioral and cultural competencies, clinical outcomes and administrative approaches.

Rural health care settings are challenged to provide timely and evidence-based care, particularly for culturally diverse patients with behavioral health disorders. Telepsychiatry and telebehavioral health improve access to care and leverage scarce resources. This scoping review from January 2000 - July 2019 was conducted to see if the literature had data for two related the research questions, "What are the components of culturally competent, telepsychiatric clinical care, and what approaches have clinicians and systems taken to implement and evaluate it?" The review focused on key words in four concept areas: (I) competencies; (II) telehealth in the form of telepsychiatry, telebehavioral or telemental health; (III) culture; and (IV) health.

Barriers to Use of Telepsychiatry: Clinicians as Gatekeepers.

Telepsychiatry is effective and has generated hope and promise for improved access and enhanced quality of care with reasonable cost containment. Clinicians and organizations are informed about clinical, technological, and administrative telepsychiatric barriers via guidelines, but there are many practical patient and clinician factors that have slowed implementation and undermined sustainability. Literature describing barriers to use of telepsychiatry was reviewed.

Rehospitalization to a child and adolescent psychiatry unit: Role of trauma and bullying.

Objective: Psychiatric rehospitalizations results in a significant burden to patients, families, and health care systems. Understanding psychiatric rehospitalizations offers an opportunity to identify weaknesses in current systems of care. The objective of this study was to test the hypothesis that a history of trauma or ongoing bullying increases the risk of psychiatric rehospitalization.

A case of a four-year-old child adopted at eight months with unusual mood patterns and significant polypharmacy.

Background: Long-term effects of neglect in early life are still widely unknown. Diversity of outcomes can be explained by differences in genetic risk, epigenetics, prenatal factors, exposure to stress and/or substances, and parent-child interactions. Very common sub-threshold presentations of children with history of early trauma are challenging not only to diagnose but also in treatment.

Code status discussions in psychiatric and medical inpatients.

Background: The Patient Self-Determination Act along with regulatory standards and institutional standards of care highlight the need for collaboration between care providers and patients with respect to goals of care and, in emergency situations, code status and measures to be taken in keeping with patients' wishes. Addressing code status may be lacking in patients who require psychiatric hospitalization due to the nature of psychiatric illness, relative medical stability, and a general expectation of survival. We sought to compare code status documentation and discussion between psychiatric and medical inpatients, as this knowledge will help shape future interventions for process improvement.

The importance of code status discussions in the psychiatric hospital: results of a single site survey of psychiatrists.

Objectives: Documentation of code status is a requirement with hospital admission, yet this discussion may present unique challenges with psychiatric inpatients. Currently, no standards exist on conducting these discussions with psychiatric inpatients. The authors surveyed psychiatry trainees and faculty regarding their perceptions and practice to gain further insight into the types of approaches used.

Analog-based free testosterone test results linked to total testosterone concentrations, not free testosterone concentrations.

Background: Analog-based free testosterone test results, sex hormone binding globulin (SHBG) concentrations, and total testosterone concentrations are somehow related. This study used new experiments to clarify these relationships.

Methods: An analog-based free testosterone immunoassay and a total testosterone immunoassay were applied to well-defined fractions of serum testosterone.