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"Doctor I would like to die. Please help.".
Psychodyn Psychiatry
January 2025
Professor of Psychiatry, Columbia University Irving Medical Center; Senior Consultant, Consultation-Liaison Psychiatry, New York Presbyterian Hospital-Milstein Hospital.
The request for hastened death by patients with psychiatric disorders poses a professional conundrum for psychiatrists. Issues of transference and countertransference loom large in such situations. Primitive defense mechanisms, particularly projective identification need to be addressed in understanding the request.
View Article and Find Full Text PDFMedicaid Spending in Coordination-Only Dual-Eligible Special Needs Plans.
JAMA Netw Open
January 2025
Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.
Importance: More than 4 million Medicare beneficiaries have enrolled in dual-eligible Special Needs Plans (D-SNPs), and coordination-only D-SNPs are common. Little is known about the impact of coordination-only D-SNPs on Medicaid-covered services and spending, including long-term services and supports, which are financed primarily by Medicaid.
Objective: To evaluate changes in Medicaid fee-for-service (FFS) spending before and after new enrollment in coordination-only D-SNPs vs new enrollment in non-D-SNP Medicare Advantage (MA) plans among community-living beneficiaries enrolled in both Medicare and North Carolina Medicaid.
Depressive Symptoms and Amyloid Pathology.
JAMA Psychiatry
January 2025
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
Importance: Depressive symptoms are associated with cognitive decline in older individuals. Uncertainty about underlying mechanisms hampers diagnostic and therapeutic efforts. This large-scale study aimed to elucidate the association between depressive symptoms and amyloid pathology.
View Article and Find Full Text PDFRavulizumab demonstrates long-term efficacy, safety and favorable patient survival in patients with paroxysmal nocturnal hemoglobinuria.
Ann Hematol
January 2025
Division of Hematology-Oncology, Hanyang University Seoul Hospital, Seoul, Republic of Korea.
Ravulizumab is a second-generation complement component 5 (C5) inhibitor (C5i) approved for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) following positive results from two pivotal trials in patients with PNH originally naive to C5i treatment and eculizumab-experienced patients with PNH. In both trials, after the 26week primary evaluation period, all patients received ravulizumab for up to 6 years. To report ravulizumab treatment outcomes in patients with PNH originally naive to C5i treatment and eculizumab-experienced patients with PNH treated for up to 6 years.
View Article and Find Full Text PDFBackground: Medical Assistance in Dying (MAID) on psychiatric grounds is a subject of increasing relevance to Dutch mental health care. In addition to different advantages, there are disadvantages.
Aim: To highlight some consequences of MAID on psychiatric grounds and to offer solutions to mitigate these.
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