Strategies for Implementing an Electronic Patient-Reported Outcomes-Based Symptom Management Program Across Six Cancer Centers.

Background: Electronic patient-reported outcome (ePRO)-based symptom management improves cancer patients' outcomes. However, implementation of ePROs is challenging, requiring technical resources for integration into clinical systems, substantial buy-in from clinicians and patients, novel workflows to support between-visit symptom management, and institutional investment.

Methods: The SIMPRO Research Consortium developed eSyM, an electronic health record-integrated, ePRO-based symptom management program for medical oncology and surgery patients and deployed it at six cancer centers between August 2019 and April 2022 in a type II hybrid effectiveness-implementation cluster randomized stepped-wedge study.

Childhood maladaptive coping mechanisms and the subsequent development of depression.

Background: Depression is a major source of symptoms and disability. In adults, maladaptive coping (usually characterized as personality dysfunction) has been shown to be associated with a depression diagnosis and poorer depression outcome. As adults with maladaptive coping difficulties are more prone to depression, we hypothesized that children with childhood disorders that involve poor coping would increase the risk of later developing depressive disorders.

Prevalence, Factor Structure, and Heritability of Avoidant Personality Disorder.

To review the community prevalence, factor structure, and heritability of avoidant personality disorder (AVPD), we reviewed the literature of empirical studies reported between years 1980 and 2020. Community point prevalence rates ranged from 0.8% to 5%, with one study of women older than 25 years finding a lifetime rate of 9.

Empirical findings of fitness-for-duty evaluations.

This article was migrated. The article was marked as recommended. :The ability of physicians to practice appropriately is often evaluated by a fitness for duty exam.

Empirical evidence of the effect of personality pathology on the outcome of panic disorder.

Background: Treatment resistant disorders are a significant clinical problem. Impediments to good outcome need to be identified and addressed. Personality pathology has been hypothesized to be one such factor in panic disorder.

An empirical data comparison of regulatory agency and malpractice legal problems for psychiatrists.

Background: Our objective is to compare legal difficulties that psychiatrists encounter in regulatory agency and malpractice (insurance) settings.

Methods: Data sources included a literature search of malpractice and medical board discipline from 1990 to 2009 (rates and types of discipline); publicly available insurance data (malpractice frequency and type); and data from the National Practitioner Data Bank (NPDB) (required reports of malpractice settlements and hospital discipline).

Results: Medical board discipline findings indicate that psychiatrists are at increased risk of disciplinary action compared with other specialties.

Empirical findings on legal difficulties among practicing psychiatrists.

Background: This article reviews the published literature on areas of legal difficulty among practicing psychiatrists.

Methods: A literature search using PubMed identified studies of malpractice lawsuits or medical board discipline of psychiatrists between 1990 and 2009. Eight studies of physician discipline in the United States and one from the United Kingdom were identified.

Personality traits and medical outcome of cardiac illness.

Objective: Our goal was to examine the empirical literature on the effect of personality traits on the medical outcome of cardiac illness.

Method: Pub Med and Psychological Abstracts were searched for the years 1990 to September 2009 using the terms personality, personality traits, personality disorder, health, recovery from illness, cardiac illness and surgical recovery. Articles were then selected that were prospective, had a peer review published measure of personality, a standardized measure of outcome of physical illness and at least one year follow up.

Avoidant personality disorder and its relationship to social phobia.

This review summarizes past and recent findings in the empiric literature and the evolution of the concepts of avoidant personality disorder (APD) and social phobia (SP). APD is an internally consistent dimensional personality pathology that causes dysfunction that appears to be dimensional rather than a sudden jump in impairment after a certain number of criteria have been met. It has state and trait personality components.

State and trait in personality disorders.

Background: The current definitions of personality disorder indicate early onset, long duration and disorders of relatively stable severity. It has been noticed by a number of authors and researchers that at times personality pathology can be quite variable and not fit that model.

Methods: This report examines the possibility that there is a valid psychiatric disorder whose key feature is episodic personality dysfunction.

State personality disorder in social phobia.

To examine the effects of state on personality disorder characteristics, we compared individuals with social phobia before and after psychological intervention. Administration of the Personality Disorder Questionnaire (PDQ-4) before and after treatment allowed for the identification of three groups of patients: (1) individuals who showed elevated PDQ-4 scores but little changes from intake to post treatment (Trait PD group; n = 28); (2) individuals who showed a decrease in PDQ-4 scores from intake to post treatment (State group; n = 33); and (3) a group with no significant personality disorder characteristics at pre or post-treatment (No PD group; n = 32). There were trend differences between the Trait, State and No PD groups for being single, never married (81.

The effect of Axis II disorders on the outcome of treatment of anxiety and unipolar depressive disorders: a review.

Psychiatric and other clinicians have often speculated on whether the presence of a personality disorder would indicate a poorer course of treatment for an Axis I disorder. Starting around 1990, the standardized criteria of the DSM increased interest in examining this area empirically. This report updates my previous reviews and examines other writing in this area.

Predictors of alkalosis after liver transplantation.

Background: Metabolic alkalosis (MA) is common after orthotopic liver transplantation (OLT).

Methods: The study was conducted to identify factors associated with MA after 285 OLTs. MA, defined as total carbon dioxide content of 30 mEq/L or greater, developed in 115 patients (40%) within the first 3 postoperative days.