TagGeneral Hospital Psychiatry

Reading of the Week: When Physical Medicine Met Mental Health; New Papers from General Hospital Psychiatry and JAMA Neurology

From the Editor

In my last hospital job, an afternoon might involve seeing a gentleman with poorly controlled diabetes, a woman who wasn’t participating in her post-hip physiotherapy, and an ICU patient with multiple problems. The common thread: they all had psychiatric diagnoses (PTSD, depression, and delirium, respectively).

Patients with physical and mental health problems can be costly and complicated. They also pose a challenge for a health care system that is designed for the simplicity of tackling one problem at a time.

This week, we look at a couple of papers on this interface between mental and physical health.

In the first paper, the University of Rochester’s Mark A. Oldman and his co-authors wonder if proactive psychiatric consultations can reduce hospital length of stay. With a systematic review, they conclude: “Our review indicates that proactive models of CL psychiatry whose screening is enriched by clinical expertise in mental health care and that deliver enhanced, proactive mental health services appear to reduce LOS, with preliminary cost-benefit analyses reporting favorable returns on investment that more than offset the increased costs of providing this level of enhanced care.”

hospitalGood Hospital, Good CL Service?

In the second paper, the University of Toronto’s Matthew J. Burke, a neurologist, considers patients who present with symptoms unexplained by medical disease. “The irony of ‘it’s all in your head’ is that although this phrase is often used inappropriately and dismissively, it is technically correct.”

DG

  Continue reading

Reading of the Week: Schizophrenia & Diabetes: The Gap in Care; Also, Swedish Health Care

From the Editor 

“The pain in my feet. It’s killing me.”

That’s what John told me when I asked him what he needed help with. It’s not quite the answer I thought he’d give – John has schizophrenia and he has significant side effects from his medications. But, like many people with mental illness, he also struggles with physical illness (diabetes and the accompanying neuropathy).

Many of our patients have both physical and mental illnesses. When faced with these twin challenges, how do they fair?

In this week’s first selection, we look at a new paper that considers people with schizophrenia and diabetes. The study authors find a significant gap between the care received by those with and without mental illness.

insulinAn old drug, an old illness, and a big problem for those with mental illness

In our second selection, drawing from a lively blog written by medical student Ali Damji, we look at Swedish health care.

DG
Continue reading

Reading of the Week: Physician, Heal Thyself? The Gold et al. Study on Docs and Disclosure (and Mental Illness)

From the Editor

If you had depression, would you tell people?

This week’s Reading is a paper from General Hospital Psychiatry that considers just this question. In it, the authors surveyed American female physicians, asking about mental disorders and why they would or wouldn’t choose to get help – and to tell people.

Would you share your mental health history?

This paper is paired with an essay written by Dr. Nathaniel P. Morris, a Stanford resident of psychiatry, who mulls mental illness and disclosure – and has a big disclosure of his own.

DG Continue reading