Evaluation of mood disorder patients in a primary care practice: measures of affective temperament, mental health risk factors, and functional health in a retrospective, descriptive study of 35 patients.

Objective: THE PURPOSE OF THIS RETROSPECTIVE, DESCRIPTIVE STUDY WAS TO EVALUATE PRIMARY CARE PATIENTS DIAGNOSED WITH A MOOD DISORDER ON THE BASIS OF THE FOLLOWING: (1) comorbid medical illnesses, (2) risk factors for mood disorders and longitudinal presence of symptoms, (3) presence of affective temperament, and (4) functional status and quality of life.

Method: Patients (N = 35) were a convenience sample diagnosed in the Mood Disorder Clinic (MDC), a family practice site-based mental health treatment consultation service. All study patients were assessed using a semistructured interview and diagnosed according to DSM-IV-TR criteria.

Improving patient safety: patient-focused, high-reliability team training.

Healthcare systems are recognizing "human factor" flaws that result in adverse outcomes. Nurses work around system failures, although increasing healthcare complexity makes this harder to do without risk of error. Aviation and military organizations achieve ultrasafe outcomes through high-reliability practice.

Vulnerable populations: drug court program clients.

Substance abuse and addiction are chronic conditions characterized by an inability to control one's urge to use mood- or mind-altering drugs. Recognition of the association between addictions and crime to support the addiction, along with the relapsing nature of addictions, presents treatment and management challenges for clinicians and frustration for patients and their families. Pressures to reduce the burgeoning jail population have resulted in collaboration between the treatment community and the court--a diversion program called drug court.

Safeguarding patients: complexity science, high reliability organizations, and implications for team training in healthcare.

Serious events within healthcare occur daily exposing the failure of the system to safeguard patient and providers. The complex nature of healthcare contributes to myriad ambiguities affecting quality nursing care and patient outcomes. Leaders in healthcare organizations are looking outside the industry for ways to improve care because of the slow rates of improvement in patient safety and insufficient application of evidenced-based research in practice.

Sustained remission with lamotrigine augmentation or monotherapy in female resistant depressives with mixed cyclothymic-dysthymic temperament.

Background: The treatment of bipolar depression remains problematic. Lamotrigine has been shown in randomized controlled studies to be efficacious in preventing bipolar depression and rapid cycling states.

Methods: Twenty-four women with cyclothymic temperament and refractory depression were recruited from four outpatient sites (three primary care and one psychiatric) and treated with lamotrigine in a naturalistic, open-label study.

The Psychiatric Family Nurse Practitioner: A Collaborator in Family Practice.

The potential of the psychiatric family nurse practitioner (Psych.F.N.