Evolving Roles and Needs of Psychiatry Chief Residents During the COVID-19 Pandemic and Beyond.

Psychiatry chief residents have diverse leadership roles within psychiatry residency programs. Chief residents have historically been viewed as "middle managers", and other leadership roles include administrative work, teaching, and advocacy for residents. Chief residents also help in managing the logistics of complex healthcare systems and mediating between many groups with conflicting needs and perspectives.

C-L Case Conference: Chronic Psychosis Managed in Collaborative Care.

We present the case of a 60-year-old woman who presented to primary care with chronic mixed depressive and hypomanic symptoms consistent with schizoaffective disorder. Patients with serious mental illness such as psychotic disorders are ideally referred for treatment in specialty psychiatric settings; however, many patients with serious mental illness receive their care in primary care settings due to patient preference or unavailability of psychiatric services. Top experts in the CL field provide guidance for this commonly encountered clinical case based on their experience and a review of the available literature.

Indirect psychiatric consultation for perinatal bipolar disorder: A scoping review.

Objective: To synthesize the literature and develop guidance on supports needed for primary care and perinatal providers in screening, initial management, triage, and bridging treatment for perinatal bipolar disorder.

Methods: We conducted a scoping review by searching six electronic databases using keywords related to perinatal bipolar disorder. We summarized descriptive statistics on settings and extracted information on care approaches.

Psychiatrist and Psychologist Experiences with Telehealth and Remote Collaborative Care in Primary Care: A Qualitative Study.

Purpose: Availability of mental health services is limited in the rural United States. Two promising models to reach patients with limited access to care are telehealth referral and collaborative care. The objective of this study was to assess telepsychiatrist- and telepsychologist-level facilitators and barriers to satisfaction with and implementation of these 2 telehealth models in rural settings.

The Relationship Between Medication Attitudes and Medication Adherence Behavior in Adults With Bipolar Disorder.

The relationship between medication attitudes and adherence as well as reliable measures of medication attitudes need further study. This study examined the psychometric properties of the Attitudes Toward Mood Stabilizers Questionnaire (AMSQ) in bipolar participants and the relationship between medication attitudes and adherence, measured by the self-reported Tablets Routine Questionnaire (TRQ). Inclusion criteria included mood stabilizer treatment and 20% or more medication nonadherence.

Race analysis in an African American sample with serious mental illness and comorbid diabetes.

Objectives: Targeted Training in Illness Management (TTIM) focuses on enhancing care engagement for people living with serious mental illness and diabetes. This secondary analysis from a 60-week, randomized controlled trial of TTIM versus treatment as usual evaluated racial subgroup outcomes.

Method: Demographics, clinical characteristics, and diabetes status were evaluated for those self-identifying as non-Hispanic White, African American, and Hispanic.

Evaluating PROMIS Physical Function Measures in Older Adults at Risk for Alzheimer's Disease.

Activities of daily living can be affected by cognitive decline. Self-report measurement of functioning is attractive due to ease of data collection, low cost, and accessibility via technology-assisted means, and for understanding patient perspective. A concern is with reliability of such measurement as cognitive decline occurs.

Patient-rated versus proxy-rated cognitive and functional measures in older adults.

Objectives: Patients with cognitive impairment may have difficulty reporting their functional and cognitive abilities, which are important clinical outcomes. Health care proxies may be able to corroborate patient self-reports. Several studies reported discrepancy between patient and proxy ratings, though the literature is sparse on changes over time of these ratings.

Evaluating PROMIS(®) applied cognition items in a sample of older adults at risk for cognitive decline.

PROMIS(®) Applied Cognition is a short self-assessment of cognitive abilities and concerns that eliminates the need for a trained rater and provides online question banks that can be uniformly used across health care providers. This 12-month prospective study of 281 elderly individuals evaluates self-perceptions of cognitive functioning in relation to objective cognition, or assessment by an external rater, and compares PROMIS® Applied Cognition Abilities and Concerns subsets with commonly used "legacy" instruments. PROMIS® correlated with objective legacy measures (the Mini-Mental State Examination [MMSE] and Saint Louis University Mental Status [SLUMS] examination), depression (measured with the Geriatric Depression Scale [GDS]), anxiety, and activities of daily living.

Patients' perceptions of barriers to self-managing bipolar disorder: A qualitative study.

Background: Self-management of bipolar disorder (BD) is challenging for many individuals.

Material: Interviews were used to assess perceived barriers to disease self-management among 21 high-risk patients with BD. Content analysis, with an emphasis on dominant themes, was used to analyze the data.

Mixed-methods analysis of internalized stigma correlates in poorly adherent individuals with bipolar disorder.

Background: Internalized stigma, which occurs when stigmatized individuals accept society's assessment and incorporate this assessment into their sense of self, is prevalent in individuals with bipolar disorder (BD). This study explored the correlates of internalized stigma in a research sample of patients with BD who were poorly adherent to their medications.

Methods: Both quantitative and qualitative analyses were performed.

Medication Adherence in Patients with Bipolar Disorder: A Comprehensive Review.

Poor medication adherence is a pervasive problem that causes disability and suffering as well as extensive financial costs among individuals with bipolar disorder (BD). Barriers to adherence are numerous and cross multiple levels, including factors related to bipolar pathology and those unique to an individual's circumstances. External factors, including treatment setting, healthcare system, and broader health policies, can also affect medication adherence in people with BD.

Detecting Change over Time: A Comparison of the SLUMS Examination and the MMSE in Older Adults at Risk for Cognitive Decline.

Aims: To directly compare the 1-year stability of Mini-Mental State Examination (MMSE) score and Saint Louis University Mental Status (SLUMS) examination score and correlate score changes with demographic variables, clinical factors, and functional domains.

Methods: A sample of 304 study participants was recruited from residential and clinical settings in Ohio. Follow-up assessments were administered after 1 year with a retention rate of 92% (n = 281).