2024 ACLP Recommendations for Training Residents in Consultation-Liaison Psychiatry.

Background: Despite rapid shifts in consultation-liaison psychiatry (CLP) training in residency, including increasing general residency training requirements from the Accreditation Council for Graduate Medical Education, greater utilization of advanced practice providers, and effects of the coronavirus-2019 pandemic, the Academy of Consultation-Liaison Psychiatry has not updated recommendations for residency training in CLP since 2014. A national survey of residency program directors in 2021 suggested many changes to the structure of CLP rotations at individual programs over the past decade.

Objective: These recommendations are intended to guide residency program directors toward optimizing CLP training for all residents, including those who will eventually pursue CLP fellowship.

Annual Meeting Content Analysis: Leveraging Annual Meetings to Promote Diversity, Equity, Inclusion, and Belonging in the Academy of Consultation-Liaison Psychiatry.

Background: There is an increasing need to promote diversity, equity, and inclusion (DEI) in all aspects of academic medicine, including through continuing medical education. Although professional medical organizations' annual meetings play an instrumental role in continuing medical education for physicians, there are no studies describing DEI content in the annual meeting programming of professional medical organizations, including the Academy of Consultation-Liaison Psychiatry (ACLP), the primary professional organization for consultation-liaison psychiatrists.

Objective: To examine the ACLP annual meeting titles using Content Analysis.

A 10-Year Follow-up Survey of Psychiatry Resident Education in Consultation-Liaison Psychiatry.

Background: In 2010, the Academy of Consultation-Liaison (then Academy of Psychosomatic Medicine) surveyed US residency programs to understand training in consultation-liaison (CL) psychiatry, leading to recommendations in 2014. Since then, residency training in CL has evolved in the context of competing training demands, increased prioritization of electives, and reactions to coronavirus 2019.

Objective: To determine the current state of residency training in CL across the United States, including the structure of core and elective resident rotations in CL, attending physician staffing, presence of fellows and other trainees, didactic curriculum, and impact of coronavirus 2019.

Optimizing Fit: Targeting a Residency Psychiatry Consultation-Liaison Rotation to Various Levels of Training.

Background: Determining the optimal timing and structure for a core residency rotation in consultation-liaison psychiatry (CLP) remains a key challenge for program directors and rotation leaders. Previous surveys have been conducted regarding these questions, and guidelines from national organizations have been issued, but practices remain varied among institutions.

Methods: We conducted a narrative review of the literature related to the timing of CLP rotations and generated consensus recommendations based on our experience as program directors, rotation leaders, and residents.

The Educational Value of Outpatient Consultation-Liaison Rotations: A White Paper From the Academy of Consultation-Liaison Psychiatry Residency Education Subcommittee.

Background: As mental health services in outpatient medical clinics expand, psychiatrists must be trained to practice in these settings.

Objectives: The Academy of Consultation-Liaison Psychiatry residency education subcommittee convened a writing group with the goal of summarizing the current evidence about outpatient consultation-liaison psychiatry (CLP) training and providing a framework for CLP educators who are interested in developing outpatient CLP rotations within their programs.

Method: MEDLINE (via PubMed), Embase, and PsycINFO (via OVID) were reviewed each from inception to December 2019, for psychiatric CLP services in ambulatory settings that involved residents or fellows.

Psychopharmacology of COVID-19.

Background: With the rapid, global spread of severe acute respiratory syndrome coronavirus 2, hospitals have become inundated with patients suffering from coronavirus disease 2019. Consultation-liaison psychiatrists are actively involved in managing these patients and should familiarize themselves with how the virus and its proposed treatments can affect psychotropic management. The only Food and Drug Administration-approved drug to treat COVID-19 is remdesivir, and other off-label medications used include chloroquine and hydroxychloroquine, tocilizumab, lopinavir/ritonavir, favipiravir, convalescent plasma therapy, azithromycin, vitamin C, corticosteroids, interferon, and colchicine.

Psychopharmacological Decision Making in Bipolar Disorder During Pregnancy and Lactation: A Case-by-Case Approach to Using Current Evidence.

The safety of pharmacotherapy for bipolar disorder during pregnancy and lactation remains a subject of debate and uncertainty. Clinicians must balance concerns about anatomical and behavioral teratogenicity, maternal mental health, exposure to multiple drugs, and heightened risks for peripartum mood episodes. Risk-benefit analyses must consider factors such as illness severity, past pregnancy treatment outcomes, known drug responsivity, psychosocial supports, and key windows during fetal development.

Core Concepts Involving Adverse Psychotropic Drug Effects: Assessment, Implications, and Management.

Adverse effects from psychiatric drugs can profoundly influence treatment adherence and outcomes. Good care involves addressing adverse effects no differently than any other component of treatment. Knowledge about adverse effect assessment and management fosters a proper context that helps clinicians not sacrifice a drug's potential therapeutic benefits because of greater concerns about its tolerability.

What to Do When Your Depressed Patient Develops Mania.

When does mania signal bipolar disorder, another medical illness, or the adverse effects of a prescribed antidepressant? And what are the next steps to manage this development?

Recommendations for training psychiatry residents in psychosomatic medicine.

Background: The Accreditation Council of Graduate Medical Education (ACGME) mandates that residents in psychiatry training programs learn to provide psychiatric consultation to other medical and surgical services. The ACGME, however, offers little information to instruct academic faculty and institutions to what constitutes a quality educational experience in psychosomatic medicine/consultation-liaison psychiatry for the resident trainee.

Methods: These recommendations were developed through a collaborative process between educators in C-L psychiatry and members of the Academy of Psychosomatic Medicine's Residency Education Subcommittee.

The prescription of psychotropic medications for patients discharged from a psychiatric emergency service.

Objective: Considerable debate exists about the value and wisdom of initiating "definitive" pharmacotherapies, particularly antidepressants, in the psychiatric emergency setting. We evaluated the nature and prevalence of medication prescriptions for patients discharged from an urban psychiatric emergency service and the extent to which pharmacotherapy initiation was predictive of follow-through with aftercare.

Method: Records were reviewed for 675 consecutive individuals evaluated and discharged from a community-based psychiatric emergency service over a 3-month period (January 2003-March 2003).

A metabolic basis for impaired muscle force production and neuromuscular compensation during sprint cycling.

For both different individuals and modes of locomotion, the external forces determining all-out sprinting performances fall predictably with effort duration from the burst maximums attained for 3 s to those that can be supported aerobically as trial durations extend to roughly 300 s. The common time course of this relationship suggests a metabolic basis for the decrements in the force applied to the environment. However, the mechanical and neuromuscular responses to impaired force production (i.

Neuroscience in psychiatry training: how much do residents need to know?

Objective: With the explosion of research in psychiatric neuroscience, the extent and means by which neuroscientific progress will translate into clinical care remains largely uncertain. The authors sought to determine how this dilemma is currently being played out in residency training programs, in which training directors must decide how best to integrate neuroscience teaching in a rapidly changing clinical landscape.

Method: The authors surveyed U.

Clinical correlates of childhood and adolescent adjustment in adult patients with bipolar disorder.

Impaired psychosocial functioning has been well documented in bipolar disorder, although there is little information linking premorbid adjustment with adult functional outcome. Childhood and adolescent functioning in school, peer relations, and personal interests was evaluated by standardized interviews with 56 adult-onset DSM-IV bipolar I (N = 46), II (N = 7), or not otherwise specified (N = 3) patients, with collaboration by collateral historians, and assessed relative to current work functioning and overall illness features. Poor childhood or adolescent adjustment was associated with subsequent alcohol or drug abuse or dependence (p <.

Antidepressant properties of anticonvulsant drugs for bipolar disorder.

A growing number of anticonvulsant drugs are receiving attention as possible mood stabilizers. This attention is based mainly on the assumption that the antimanic efficacy of anticonvulsants makes them suitable as mood stabilizers. However, their antidepressant properties have received less scrutiny.

The reproductive safety profile of mood stabilizers, atypical antipsychotics, and broad-spectrum psychotropics.

There has been growing concern about the potential iatrogenic effects of several newer psychotropic drugs on reproductive health safety in women. Areas of particular concern in this regard include (1) controversies about a potential association between the use of valproate and development of polycystic ovary syndrome (PCOS), (2) the safety of use of newer psychotropic medications during pregnancy, and (3) safety issues with these medications in women while breastfeeding. This review summarizes current information about each of these areas.