What gets resident physicians stressed and how would they prefer to be supported? A best-worst scaling study.

Introduction: Physician burnout has severe consequences on clinician well-being. Residents face numerous work-stressors that can contribute to burnout; however, given specialty variation in work-stress, it is difficult to identify systemic stressors and implement effective burnout interventions on an institutional level. Assessing resident preferences by specialty for common wellness interventions could also contribute to improved efficacy.

Self-Reported Preferences for Help-Seeking and Barriers to Using Mental Health Supports Among Internal Medicine Residents: Exploratory Use of an Econometric Best-Worst Scaling Framework for Gathering Physician Wellness Preferences.

Background: Burnout interventions are limited by low use. Understanding resident physician preferences for burnout interventions may increase utilization and improve the assessment of these interventions.

Objective: This study aims to use an econometric best-worst scaling (BWS) framework to survey internal medicine resident physicians to establish help-seeking preferences for burnout and barriers to using wellness supports by quantifying selections for 7 wellness support options and 7 barriers.

Illness Anxiety Disorder: Psychopathology, Epidemiology, Clinical Characteristics, and Treatment.

Illness anxiety disorder is a primary disorder of anxiety about having or developing a serious illness. The core feature is the cycle of worry and reassurance seeking regarding health, as opposed to a focus on relief of distress caused by somatic symptoms (as in Somatic Symptom Disorder). Clinically significant health anxiety is common, with estimates ranging up to 13% in the general adult population.

Effect of call organization on burnout and quality of life in psychiatry residents.

We aimed to measure the effects of a residency program's mid-year shift from 24-h call to night float on resident burnout and quality of life. At the end of the year, residents who started the year with 24-h call had worse burnout and quality of life, with statistical significance and large effect sizes. Exposure to a twenty-four hour call system, when compared to a full year of night float, may be associated with increased burnout and decreased quality of life, though measuring this effect is not straightforward.

Case report: Improvement in dissociative symptoms with mixed amphetamine salts.

Symptoms of dissociation, including dissociative amnesia, depersonalization, and derealization, commonly develop in individuals subject to chronic and repeated trauma during development. This includes the trauma of environmental inability to facilitate development of adequate cognitive strategies for coping with strong negative emotions. Dissociation likely involves dysregulated balance of prefrontal inhibition of limbic structures and inadequate regulation of attentional bias by both prefrontal and limbic systems.

The Relationship of Hypochondriasis to Anxiety, Depressive, and Somatoform Disorders.

Background: Though the phenotype of anxiety about medical illness has long been recognized, there continues to be debate as to whether it is a distinct psychiatric disorder and, if so, to which diagnostic category it belongs.

Objective: Our objective was to investigate the pattern of psychiatric comorbidity in hypochondriasis (HC) and to assess the relationship of health anxiety to anxiety, depressive, and somatoform disorders.

Methods: Data were collected as part of a clinical trial on treatment methods for HC.