A Survey of Psychiatry Course Offerings for Fourth-Year Medical Students.

Objective: Fourth-year course offerings seem to vary widely among psychiatry departments with some offering a wide selection while others offer little or unspecified opportunity. The purpose of this study was to learn the distribution and diversity of fourth-year medical school psychiatry courses and identify unique course offerings that may inspire other departments.

Methods: The authors compiled a list of US allopathic medical schools accredited by the Liaison Committee on Medical Education (LCME) using the LCME website.

Decisional Capacity and Personality Disorders: Substantially Unable or Substantially Unwilling?

Capacity assessments are performed when there is suspicion that a person is unable to adequately care for their physical, medical, or financial well-being. The purpose of these assessments is to inform the legal system as to whether or not guardianship may be necessary. It is well established that certain mental illnesses, such as neurocognitive disorders (dementia) or psychotic disorders (like schizophrenia), may diminish capacity and, in some cases, lead to the need for establishment of a legal guardian.

Hallucinogens and Their Therapeutic Use: A Literature Review.

The exploration of possible therapeutic benefits of hallucinogenic substances has undergone a revitalization in the past decade. This literature review investigated the published literature regarding the psychotherapeutic uses of hallucinogens in psychiatric disorders. The results showed that a variety of substances have been evaluated in the treatment of psychiatric disorders, including ayahuasca, ibogaine, ketamine, lysergic acid diethylamide, 3,4-methylenedioxymethamphetamine, and psilocybin.

Development of Evaluations to Assess the Quality of Residency Program Directors.

Objective: The objective was to develop residency program director specific evaluation tools with face validity for identifying areas of excellence and opportunities for improvement.

Methods: Investigators conducted standardized interviews with graduate medical education (GME) leadership, department chairs, program directors, and senior residents assessing their perspectives on the desirable qualities of program directors. Responses were categorized by theme to create benchmarked evaluation tools.

Neurobiological Mediators of Squalor-dwelling Behavior.

Squalor-dwelling behavior has been characterized as living in conditions so unsanitary that feelings of revulsion are elicited among visitors. This behavior is commonly associated with an insensitivity to distress/disgust and a failure to understand the direness of one's living situation, which leads to social isolation and impairment in quality of life. Etiologically, several associations have been described in the literature, including age-related decline, lower socioeconomic status, and rural dwelling status.

Postpartum depression in adolescent mothers.

Background: Postpartum depression has been extensively studied in adults but is less understood in adolescent mothers, despite a prevalence that is double that observed in adult mothers. The purpose of this review was to describe the epidemiology, risk factors, treatment and prognosis for adolescents with postpartum depression. We also sought to identify limitations of the available literature and propose areas for future study targeting postpartum depression in this vulnerable population.

Clock Copying Predicts Mortality in Adult Protective Services Clients.

Objective: The objective of this study was to determine if a clock copying task predicts 18-month mortality in an Adult Protective Services (APS) sample referred for a decision-making capacity assessment.

Methods: The authors performed a retrospective medical record review of clients (N = 233) referred by APS for a decision-making capacity assessment during a 3-year time period. Information extracted included demographic data and neuropsychological performance on a battery sensitive to executive function, visuospatial ability, depression, memory, and general cognition.

The Best of Both Worlds: Psychiatry Training at Combined Civilian-Military Programs.

Air Force psychiatry faces the task of training competent military psychiatrists in an era of continuing reductions. Beginning in the 1980s, the Air Force started collaborating with University partners to create hybrid training programs, civilian-military psychiatry residencies. These mergers provide stability for Air Force psychiatry training in the face of increased operational missions and uncertain military recruiting.

Executive function impairment and recidivism in adult protective services clients referred for a decision making capacity assessment.

The objective of this study was to determine if recidivistic Adult Protective Services (APS) cases referred for a decision-making capacity assessment were more cognitively impaired than nonrecidivistic cases. A retrospective medical record review of neuropsychological and demographic data was gathered during decisional capacity assessments. Recidivistic clients were those referred to APS more than once; those with a single open case were nonrecidivistic.

Quantifying publication scholarly activity of psychiatry residency training directors.

Objective: The authors quantify the number of PubMed-indexed publications by psychiatry program directors during a 5-year observation period.

Methods: The authors obtained the names of general adult, child and adolescent, and geriatric psychiatry program directors from the ACGME website and entered them into a PubMed.gov database search.

Cognitive profiles of elder adult protective services clients living in squalor.

The purpose of this study was to determine whether squalor-dwelling Adult Protective Services (APS) clients were more cognitively impaired than non-squalor-dwelling APS clients referred for decision-making capacity assessments. The authors performed a retrospective medical record review of neuropsychological and demographic data gathered during decisional capacity assessments. Squalor dwelling was defined by unsanitary living conditions that posed a danger to the occupant's health or safety.

Informing evidence-based practice: a review of research analyzing adult protective services data.

The mission of Adult Protective Services (APS) is to protect older and vulnerable adults from abuse, neglect, and exploitation. The complexity of APS cases and the potential for life-changing interventions point to the need for research that examines and evaluates APS practices. A literature review identified 50 studies published during a 16-year period that used APS agencies, clients, data, or resources to test hypotheses regarding elder abuse.

Prazosin for military combat-related PTSD nightmares: a critical review.

Military combat is a common trauma experience associated with posttraumatic stress disorder (PTSD). Trauma-related nightmares are a hallmark symptom of PTSD. They can be resistant to label-pharmacological PTSD treatment, and they are associated with a variety of adverse health outcomes.

The Women's Health Objective Structured Clinical Exam: a multidisciplinary collaboration.

Purpose: To determine the preliminary benefits of a Women's Health Objective Structured Clinical Exam (OSCE) which integrates psychiatry and obstetrics and gynecology principles into communication-focused doctor-patient paradigms.

Method: The authors extracted medical student survey data from pre- and post-OSCE program evaluations (n = 193). Using McNemar's tests, the authors compared pre- and post-OSCE proportions of students reporting comfort levels with interactions involving terminally diagnosed patients, domestic violence, breast feeding, and other areas relevant to women's health.

Neuropsychological correlates of performance based functional status in elder adult protective services referrals for capacity assessments.

We have previously described high rates of executive function impairment in clients referred by Adult Protective Services (APS) to geriatric psychiatry for decision-making capacity assessments. The purpose of this study was to determine the independent relationship between neuropsychological screening instruments, particularly instruments sensitive to executive function, and performance-based functional tasks in elder referrals. Our retrospective medical review (n = 75/157 referrals completed all neuropsychological and functional assessments) revealed that only the Executive Interview (EXIT25) contributed independent variance to money management performance (R(2) = 0.

Academic performance in the context of a "three excused absences" psychiatry clerkship policy.

Objective: In order to better manage medical student absences during the psychiatry clerkship, a policy allowing students to miss up to 3 days without penalty was developed. The purpose of this study was to describe absence patterns and compare academic performance between students with and without absences.

Method: Authors reviewed the academic record of 3rd-year medical students rotating through the psychiatry clerkship between July 1, 2009 and June 30, 2011.

Improving student comfort with death and dying discussions through facilitated family encounters.

Objective: The purpose of this study was to explore the educational potential for a collaboration between palliative medicine and psychiatry designed to improve first-year medical students' knowledge and comfort with end-of-life issues through a facilitated small-group discussion with family members of recently-deceased loved ones.

Methods: A group of 222 first-year medical students were divided into 14 small groups. Each group also consisted of two mental-health providers, one palliative-medicine interdisciplinary team member, and one family member of a recently-deceased hospice patient.

Executive clock drawing correlates with performance-based functional status in people with combat-related mild traumatic brain injury and comorbid posttraumatic stress disorder.

Executive Clock Drawing Tasks (CLOX parts 1 and 2) can predict functional impairment. This study determined the correlation between CLOX and other psychometric screening instruments with the Structured Assessment of Independent Living Skills (SAILS)-defined performance-based functional status in people with combat-related mild traumatic brain injury (TBI) and comorbid posttraumatic stress disorder (PTSD). We hypothesized that CLOX would correlate significantly with functional performance.

Documented combat-related mental health problems in military noncombatants.

Although combat-related posttraumatic stress disorder (PTSD) has been documented for military combatants, little is known about PTSD in noncombatants. Active-duty U.S.

Psychopharmacological treatment for cognitive impairment in survivors of traumatic brain injury: a critical review.

Traumatic brain injury (TBI) is a growing national health issue that commonly results in clinically significant cognitive impairments. This article reviews and evaluates the many proposed psychopharmacological treatments for TBI-related cognitive impairment. A literature review was utilized to focus on stimulant and nonstimulant dopamine enhancing agents, acetylcholinesterase inhibitors, antidepressant agents, mood stabilizers, antipsychotics, and benzodiazepines.

Executive function in self-neglecting adult protective services referrals compared with elder psychiatric outpatients.

Objective: Psychometric performance, with an emphasis on executive function, was compared between adult protective services (APS) clients referred for a decision-making capacity consultation and elders seen in an outpatient geriatric psychiatry clinic.

Methods: The authors performed a retrospective medical records review extracting general, executive, and visuospatial cognitive performance and depression symptom burden in APS referrals (N = 63) and geriatric psychiatry outpatients (N = 58).

Results: After adjusting for age and education, APS clients had worse mean executive performance as measured by the Executive Interview (24.

Depression, disability and intermediate pathways: a review of longitudinal studies in elders.

Cross-sectional studies demonstrate depression is associated with disability in elders. These studies also report that disability in depressed elders is associated with greater medical illness burden, cognitive impairment, and behavioral changes. Only longitudinal studies, however, can determine the impact of depression and its comorbidities on functional decline.

Prospective evaluation of pretreatment executive cognitive impairment and depression in patients referred for radiotherapy.

Purpose: Cancer patients are at risk of cognitive impairment and depression. We sought to ascertain the prevalence of executive, visuospatial, memory, and general cognitive performance deficits before radiotherapy in a radiation oncology clinic referral population and correlate the neurocognitive measures with the depression symptom burden.

Methods And Materials: A total of 122 sequential patients referred for radiotherapy evaluation were administered a test battery composed of the Executive Interview (EXIT25), Executive Clock Drawing Task (CLOX1 and CLOX2), Mini Mental State Examination (MMSE), Memory Impairment Screen (MIS), and Geriatric Depression Scale (GDS).

Clock drawing phenotypes in community-dwelling African Americans and Caucasians: results from the University of Alabama at Birmingham study of aging.

Background: Two dementia patterns have been described: 'type 1' dementia is characterized by executive function impairment and posterior cortical impairment, and 'type 2' dementia is characterized by executive impairment and relatively preserved posterior cortical function. The Executive Clock Drawing Task (CLOX) has been used to discriminate between type 1, type 2, and normal cognitive phenotypes. The aim of this study was to describe the prevalence of these phenotypes in community-dwelling African American and Caucasian elders.

Depression and mortality in elders referred for geriatric psychiatry consultation.

Objective: The association between depressive symptoms and mortality was assessed in a 7-year longitudinal follow-up of subjects referred for geropsychiatric consultation.

Methods: The medical records of 89 referrals were reviewed. Survival analysis was performed on subjects stratified by Geriatric Depression Scale (GDS) and residential status.