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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 12.

Shrink Notes: what does your doc think of you?
I've written before about shrink notes back in 2011.  See Here and Here.With the increasing transparency we're seeing with electronic records, there are now systems that allow patients to access their doctor's notes.  The first time one of my patients did this, he casually mentioned that the record included the wrong dose of a medication, and I suggested my patient might want to tell his doctor about this.  In psychiatry, we've been a bit touchy about this.  Patients might be distressed to see what we write about them, they may see some of the terms we use to describe them (like delusional?) as bei...
Source: Shrink Rap - July 9, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

Ailments are big business
Back when Prozac (fluoxetine) and Zoloft (sertraline) were new, I remember the mental acrobatics doctors made to justify giving these drugs to anxious patients. The drugs were approved for treating depression, but we knew they often seemed to help anxiety. The reason, we were told, was that some anxious patients were actually depressed, deep down, and we had just failed to recognize their depression. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - July 8, 2014 Category: Journals (General) Authors: Tags: Meds Primary care Psychiatry Source Type: blogs

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Great article on the Brazil vs. Columbia soccer game. (Source: a psychiatrist who learned from veterans)
Source: a psychiatrist who learned from veterans - July 8, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

3 innovations to improve mental health treatment
Our nation has recently witnessed another tragedy involving a young adult, with young adult victims. Facts often emerge slowly and it is important not to speculate about diagnoses through the news media; however, it seems clear in this case that mental illness is a factor — even though few people living with mental illness are violent. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - July 6, 2014 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Guest blogger Dr. Sana Johnson-Quijada on Freedom and Self Care
I met Dr. Sana Johnson-Quijada at the APA Annual Meeting this year in New York.   Sana has her own blog Friend to Yourself, and I invited her to do a guest blog on Shrink Rap.  In honor of Independence Day, she sent the following post.  Self-Care is Freedom, is Democracy, is Because We Are Accountableauthenticsociety.comSelf-Care Tip #159 – Be accountable for and to yourself.It was about 100 degrees Fahrenheit, which in my part of the world is considered hot.  But in Washington D.C., I considered that temperature general anesthesia.  I was breathing it in and trying hard to remain alert...
Source: Shrink Rap - July 6, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

The troubling deficiencies in our mental health system
Mental health patients and their families already pay a hefty price with the stigma of mental illness and the emotional roller coaster they often face dealing with symptoms. But insufficient mental health resources across the United States also means that they must pay a financial price as well in the form of lost productivity, out-of-pocket costs for treatment and sometimes periods of unemployment. A recent USA Today special report estimates that benefits for those who cannot support themselves, cost of care and lost productivity cost the U.S. economy more than $444 billion each year. Continue reading ... Your patien...
Source: Kevin, M.D. - Medical Weblog - July 4, 2014 Category: Journals (General) Authors: Tags: Policy Psychiatry Source Type: blogs

Football
As usual he avoids all videos of violence in his country (his country?) published in youtube.com. He starts listening to songs. In T.V. he starts watching an Arabic Lebanese series named لو (=If), which is about romantic relationships. He chooses to write a new article on an Arabic website about some old paintings about hypnosis. He opens the newspaper less often and prefers to see anything but the first three pages. The other day he liked this picture in the first page of his newspaper. But as he flips the first three pages to that page of culture he found this caricature.As he sees that caricature he remembers tha...
Source: psychiatry for all - July 3, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

Global Institute for Psychosocial, Palliative and End-of-Life Care (GIPPEC)
This week, the University of Toronto and the University Health Network (UHN) launched a new institute dedicated to end-of-life issues and the treatment of patients with life-threatening terminal diseases: the Global Institute for Psychosocial, Palliative and End-of-Life Care (GIPPEC).   GIPPEC will have its formal inauguration in October 2014, and will be functioning within the next year. It will include a core staff of about six people, and will have numerous Canadian and international researchers contributing part-time.  It will be an interdepartmental and interdivisional research centre devoted to promoting an...
Source: blog.bioethics.net - July 3, 2014 Category: Medical Ethics Authors: Thaddeus Mason Pope Tags: Health Care medical futility blog syndicated Source Type: blogs

CNN anchor tries a "schizophrenia simulator" for a day (video)
CNN's Anderson Cooper tries to go through a normal day using a schizophrenia simulator: Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images - Blog)
Source: Clinical Cases and Images - Blog - July 2, 2014 Category: Universities & Medical Training Tags: CNN Psychiatry Source Type: blogs

People on Autism Spectrum at Increased Risk for Substance Abuse
Generally, people on the autism spectrum tend to be personally cautious and socially withdrawn. As you would expect, previous research shows that people with autism tend to have low rates of substance abuse – the preference for low risk and avoidance of social situations means less drinking or drug use. But new research from the Washington University School of Medicine found the opposite: in their study of 3,080 Australian twins, people with symptoms of autism were more likely than people without symptoms to abuse alcohol and marijuana. The interesting reason why and perhaps implications for protecting both autistic peop...
Source: Cliffside Malibu - July 1, 2014 Category: Addiction Authors: Richard Taite Tags: Richard Taite Source Type: blogs

The Myths that Society Holds About Mental Illness
It is an undisputed fact that individuals who experience mental health issues are often faced with discrimination that results from misconceptions of their illness. As a result, many people who would benefit from mental health services often don't seek treatment for fear that they will be viewed in a negative way. The World Health Organization agrees and says that in the 400 million people worldwide who are affected by mental illness, about twenty percent reach out for treatment.Take a look at the common myths society holds about mental illness. MYTH: Mental illness is not a true medical illness like heart d...
Source: Dr. Deborah Serani - July 1, 2014 Category: Psychiatrists and Psychologists Tags: stigma Source Type: blogs

Hospital Clowns meet the Boston Globe
Hearts & Noses The Hearts & Noses Hospital Clown Troupe, where I’m chairman of the board, is a great organization that provides professionally trained volunteer clowns to hospitalized children in Massachusetts, and trains other hospital clowns from around the US and the world. So I’m excited to see a feature article about the clowns (Getting silly where the work is serious) on the front cover of the Boston Globe’s “g” section. Author Joseph P. Kahn does an excellent job of explaining what the clowns do to empower children, and the amount of effort and training that goes into preparin...
Source: Health Business Blog - June 26, 2014 Category: Health Managers Authors: David Williams Tags: Announcements Hospitals Patients Michael Agus Source Type: blogs

Young children are silenced by psychiatric medication
Tom Insel, director of the National Institute of Mental Health (NIMH) in his recent blog post, “Are Children Overmedicated?” seems to suggest that perhaps more medication is in order. Comparing mental illness in children to food allergies, he dismisses the “usual” explanations given for the increase prescribing of medication.  In his view these explanations are; blaming psychiatrists who are too busy to provide therapy, parents who are too busy to provide a stable home environment, drug companies for marketing their products, and schools for lack of recess.  Concluding that perhaps the explanatio...
Source: Kevin, M.D. - Medical Weblog - June 26, 2014 Category: Journals (General) Authors: Tags: Physician ADHD Primary care Source Type: blogs

Finally, stigma rears it's ugly head.
I don't even want to write about this because I've cried enough and just don't want to think about it, push it out of my mind.I had been feeling really awful for several days. One night, I went to bed and got up about 5 times in 3 hours and drank an entire bottled water each time. I would still be thirsty but drinking so much water so quickly gave me a gagging feeling so I would go back to bed still thirsty. Then wake up and do it all over again.Finally around 1:30am I got tired of it and just stayed up. The longer I was up, the more extremely fatigued I felt, and it was extreme. Didn't matter if I drank coffee, took an en...
Source: bipolar.and.me - June 25, 2014 Category: Mental Illness Source Type: blogs

The progression of the Diagnostic Codes in Psychiatry and archaeological implications
All official diagnoses have a numeric code attached to them. It struck me a while back that there is a bit of history implied in those codes. Attention Deficit Hyperactivity Disorder, combined type is 314.01, inattentive type alone is 314.00, but hyperactive type alone is 314.01 which I suppose suggests that the original perception of the diagnosis was of something associated with hyperactivity and only later was it seen as useful to consider the criteria and make a diagnosis in the absence of hyperactivity. Perhaps there is a psychiatric resident's progress or the fields progress implied in the mood disorder codes. As a f...
Source: a psychiatrist who learned from veterans - June 25, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

NIMBY: New Brunswick Sends Severely Autistic Adults to NB's Northern Border with Quebec and To Maine, Far From Most Families
NIMBY, Not In My Back Yard: Severely autistic NB youth and adults are sent out of the province to the Spurwink facility in Maine and to the Restigouche Regional Psychiatric Hospital in Campbellton on NB's northern border with Quebec far from families and communities in NB's more heavily populated south. The UK Daily Mail has reported the story of a family whose severely autistic  son who was sent 250 miles away for treatment including for severe self injurious behavior.  The distance involved during his stay of more than 2 years meant 500 mile round trips to visit their son who had never met his sister:Josh ...
Source: Facing Autism in New Brunswick - June 25, 2014 Category: Autism Authors: H L Doherty Source Type: blogs

99232 vs 99233 Coding Comparison (Subsequent Care Hospital Follow-Up).
This lecture will assist physicians and non-physician practitioners (NPP) determine if their inpatient hospital follow-up note documentation meets criteria for a level 2 (CPT® 99232 mid level subsequent care) or a level 3 (CPT® 99233 high level subsequent care) evaluation and management (E/M) code.  Recovery Audit Contractors will most likely continue to target E/M codes for improper payments.  Physicians and  NPP must pursue documentation education to prevent accusations of overbilling and to prevent underbilling for work provided.  I am an internal medicine physician with over 10 years experience as...
Source: The Happy Hospitalist - June 24, 2014 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs

Casey Kasem’s Living Will Did Not Work for Dementia: How to Make Sure Your Advance Directive Works
Discussion. How to get physicians to comply? (The "Ironclad Strategy") (Source: blog.bioethics.net)
Source: blog.bioethics.net - June 23, 2014 Category: Medical Ethics Authors: Thaddeus Mason Pope Tags: Health Care medical futility blog syndicated Source Type: blogs

Assistant Physicians Coming to Missouri
Missouri is planning to allow medical school graduates who have not completed residency to treat patients in underserved parts of the state. Bills that would allow medical school graduates to provide medical care have passed the General Assembly and are awaiting Governor Jay Nixon’s signature. The newly-minted physicians would receive “assistant physician” licenses and would be able to treat patients in collaboration with a licensed physician – much in the way a physician assistant does. However, the new graduates will be able to call themselves “doctor” while physician assistants will...
Source: WhiteCoat's Call Room - June 22, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Policy Source Type: blogs

Starting Again.
Just made my blog public again, so sure there aren't many who find this site or read it, but it has given me some clarity as to writing for myself. This was simply to be a type of diary that I could look back and see where I had become depressed/hypomanic and see if there was any triggers or long it could have been going on.  I guess it is what many bipolars would call a type of mood marker, although I guess it has turned into so much joy.I'm sure I mentioned it, but I made it public because  my husband asked me to.  He had applied for CIO job and didn't want it to be found since he is the only person that I...
Source: bipolar.and.me - June 22, 2014 Category: Mental Illness Source Type: blogs

NB'ers with Severe Autism Disorders Are Not Included in New Brunswick's "Inclusive Community"
New Brunswick's "inclusive" "community living" model is not a bridge to a better life for adults with autism disorders.  There are huge gaps in the model.  Group home staff are not autism trained and are not professionally supervised.  Those who don' fit in, including those with severe autism disorders are excluded, banished to live in psychiatric hospitals in New Brunswick and outside the country.New Brunswick tells the world that it is "inclusive" and talks incessantly about our "community living".   In fact if a child, youth or adult suffers from a severe autism disorder they are not included in a co...
Source: Facing Autism in New Brunswick - June 22, 2014 Category: Autism Authors: H L Doherty Source Type: blogs

Living with my son’s schizophrenia: From fear to hope
When my son Ben was 20-years-old, he was finally diagnosed with schizophrenia after five years of chaos and frustration — what I later came to know had been symptoms of the gradual onset of his illness. At the time, I’d thought he was just having a tough adolescence. I’d thought perhaps he needed more father figures (Ben’s father had deserted the family when Ben and his sister were little, and had been missing ever since). I tried everything to help: therapy, tough love, letting go, stepping in, humor, punishment, family time, letting him hit bottom so he’d learn his lessons, and almost a year in a teen wild...
Source: Kevin, M.D. - Medical Weblog - June 21, 2014 Category: Journals (General) Authors: Tags: Patient Psychiatry Source Type: blogs

Top stories in health and medicine, June 20, 2014
From MedPage Today: The Uninsured: 33 Million and Counting. In the last full year before the Affordable Care Act went into effect, more than 33 million Americans had been without health insurance for more than a year, according to CDC survey. Gross Anatomy: A Real Twisted Heart. It’s nothing but heartache for a 48-year-old Italian man, who presented to the emergency department with dextrocardia after a motorcycle accident crushed his chest, and spun his heart right round. Antidepressants Not Tied to Heart Defects. Antidepressant use during the first trimester of pregnancy was not associated with a greater risk of c...
Source: Kevin, M.D. - Medical Weblog - June 20, 2014 Category: Journals (General) Authors: Tags: News Heart Obesity Pediatrics Psychiatry Source Type: blogs

Tired. Just Tired.
For years, I've absolutely loved having  Shrink Rap.  I've loved having a place to write, to vent, to share something cool I've learned, and I've learned so very much from readers who have really changed my life.  What a great experience from a thought at the kitchen table that started, "I want a blog.  What's a blog?"  Shrink Rap has inspired me to keep current with psychiatry and to learn about things to write about that I might otherwise just skip.  I love having a place to ask questions, especially when they're about things that make my brain start doing somersaults (--well, not really, I ...
Source: Shrink Rap - June 20, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

Why aren't 2nd term presidents popular?
Megan McCardle asks. Of course, notpresidents aren't all that popular either. It's like playing poker. You've got to put together a hand that wins you the office. Recently this has been harder for a Republican candidate though Bush drew into a straight almost busted by his past alcoholism in light of Clinton's misbehavior and our desire for propriety. What might be considered an anti-Republican constraint affected Bush later in the game though in that he effectively was told he had to sell a casus belli on Iraq to the U.N.; so he emphasized the likelihood of present WMD in Iraq. Ever after, 'he lied;' actually he presented...
Source: a psychiatrist who learned from veterans - June 19, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

Memory Aging and Known Influences on Longevity
This open access review paper looks over some of the better known ways to modestly slow aging and extend healthy life in laboratory animals and their relationship with the progressive degeneration of memory with advancing age: The aging process has been associated with numerous pathologies at the cellular, tissue, and organ level. Decline or loss of brain functions, including learning and memory, is one of the most devastating and feared aspects of aging. During the past century, age-related memory impairments have emerged as one of the top public health threats. Both psychiatric and neurodegenerative disorders comprising...
Source: Fight Aging! - June 19, 2014 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Exploring the mind of a mass murderer
Mass murders are becoming a depressingly familiar routine in the United States — we can now expect to experience a media grabbing shooting about once a month. And the frequency can only increase as future cohorts of copycat killers are spawned by the seductive opportunity to temporarily gain the spotlight. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 18, 2014 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Drama Club: What I Learned About Creativity and Aging
And as evening twilight fades away The sky is filled with stars, invisible by day–Longfellow We admire the arts and those who share their creative expression for the  entertainment, insight, reflection, shared humanity and genius of imagination. But in the realm of health, medicine, and aging, there may be more practical reasons to be an artist or an art-lover: an artist—Creativity is good for you (and better than broccoli). The arts enhance not only experience, but health. During the first-ever international conference of the National Center for Creative Aging (NCCA), I  enjoyed an array of cross-disciplinary pr...
Source: Disruptive Women in Health Care - June 18, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Uncategorized Source Type: blogs

Putain
I was training my French language by reading La Putain Respectueuse, and Morts sans Sepulture, in French since I have also the Arabic translation by Suhail Idriss. Both are pieces of theatre written by Sartre. La Putain Respectueuse talks about a prostitute which came down to one of the southern states from New York. She was asked to give false testimony against a black man. She was bribed to do so. The man who was trying to bribe her chose first to sleep with her that night, then the next morning he offered to bribe her so that she give a false testimony. The black man visits her and asks her to give the right testimony. ...
Source: psychiatry for all - June 18, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

Maitham Rathie Caricatures in Al-Mada
Since some time I noticed a new cartoonist publishing clever caricatures in Al Made paper. His name is Matham Rathie. I chose for you these four cartoons that I like the most, if we can use the word "like" in this context !! (Source: psychiatry for all)
Source: psychiatry for all - June 18, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

Dear Mr Alward, Cardy, Coon, Gallant: New Brunswick Still Needs A Permanent Residential Care and Treatment Centre For Severely Autistic Adults
Photo of my son Conor from a few years ago submitted to the Aquinian for an article by then Aquinian journalism student Karissa Donkin. No progress in residential care and treatment for severely autistic adults in New Brunswick has been made since that article or since Conor's autism diagnosis 16 years ago at age 2June 18, 2014Dear Mr Alward, Mr Cardy, Mr Coon and Mr Gallant:A provincial election will soon be held and one of you will be premier, once again if it is Mr Alward, for the first time if it is Mr Cardy, Mr Coon or Mr Gallant.  I respectfully ask each of you to consider this request for adult a...
Source: Facing Autism in New Brunswick - June 18, 2014 Category: Autism Authors: H L Doherty Source Type: blogs

Healthcare Update Satellite — 06-17-2014
Read more healthcare-related news from around the web on my other blog at DrWhitecoat.com Oklahoma University Medical Center joins the growing ranks of hospitals that are requiring patients to pay a fee of $200 to be treated for non-emergency complaints. That amounts to an estimated 40% of OU’s emergency department visits. If patients do not want to pay for non-emergent care, they will be referred to nearby urgent care clinics. This “triage out” protocol will eventually become a standard throughout US emergency departments. Count on it. Emergency physician writes about how she almost diagnosed Lou Gehrig&...
Source: WhiteCoat's Call Room - June 17, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs

More on gun violence
Lawrence Gostin, writing for the JAMA forum, makes many of the same points I did recently about the framing of gun violence as a mental health issue. Sure, most mass shooters have diagnosable mental illness but a) most mentally ill people are not violent, b) most gun violence is not mass murder (in fact it's only a tiny fraction), and c) the only good predictor of future violence is past violence. To remind us:Although most mass killers are mentally ill, only a small minority of persons with mental illness is violent. Overall, only about 4% to 5% of overall violent crime can be attributed to persons with mental illness. At...
Source: Stayin' Alive - June 17, 2014 Category: American Health Source Type: blogs

Have ADHD diagnoses reached a tipping point?
I have been blogging and tweeting about ADHD a lot lately because I believe that change is in the air. This is the worst of times for ADHD diagnosis because statistics show it is wildly overdiagnosed and overtreated. This is possibly the best of times for ADHD diagnosis because I think we have reached the tipping point and feel hopeful that the ADHD fad will soon begin to fade. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 13, 2014 Category: Journals (General) Authors: Tags: Conditions ADHD Psychiatry Source Type: blogs

Psychiatry's contract with society
Mental Health Foundation (MHF) - This survey is part of a larger piece of research looking at the unwritten but implicit ‘contract’ that exists between psychiatrists and patients, carers, fellow professionals, service managers and commissioners and wider society. Views are being sought from patients, carers, family and staff until 27th June 2014. Survey MHF news (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - June 12, 2014 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Consultations Mental Health Regulation, governance and accountability Workforce and employment Source Type: blogs

Isn't there anything we can do about this shit?
I'm guessing you're probably like me, and you're starting to get a little bit tired of wackos committing random acts of mass murder. Yeah, it's a bad thing.So everybody's got a diagnosis and a prescription. Better mental health services. Rooting out misogyny and delusional extremism from the culture. Making it harder for nutcases to get guns. All that sounds good, if not necessarily evidently possible, but . . .Here's the problem, looking at this from a public health perspective. We really don't know how to predict that somebody is going to be violent. Well, that's not quite true -- past violent behavior is a useful predic...
Source: Stayin' Alive - June 9, 2014 Category: American Health Source Type: blogs

Is it Ok to Shrink your Sister in an Emergency?
I'd like to bend your ear with a hypothetical situation and see what you think.  This one is for the docs, and I'm going to start and end it with a simple question: is it okay to prescribe for a family member?  Is it okay to prescribe a psychotropic medication for oneself or a family member?  Before you jump on me, let me tell you that to the best that I am aware, docs have always written prescriptions for themselves and for their family members.  An antibiotic, an allergy medication, I think this has been par for the course for straightforward things.  When I was an intern, one of the nurses ...
Source: Shrink Rap - June 9, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

Popular art in Dallas
Marc Ramirez recently reported on salvaged elements of Dallas history, appealing decorative sculpture. When I moved here many years ago, I realized in the summer heat I wasn't in Chicago, mostly a loss, but the gigantic tableaux picture of the Mexican woman in the land at the El Chico on a large open wall was intriguing and reassuring. This I believe still is at the Lovers lane location now near the Tollway. One author has called the regional culture El Norte, and for me this picture better represents the ongoing issues of adaptation that the imposing Amercan culture faces than did the hitching stake did at the DMA. (Sourc...
Source: a psychiatrist who learned from veterans - June 8, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

Bad financial management at Kings College London means VC Rick Trainor is firing 120 scientists
This article, by Bruce Alberts, Marc W. Kirschner, Shirley Tilghman, and Harold Varmus, should be read by everyone. They observe that ” . . . little has been done to reform the system, primarily because it continues to benefit more established and hence more influential scientists”. I’d be more impressed by the senior people at Kings if they spent time trying to improve the system rather than firing people because their research is not sufficiently expensive. 10 June 2014 Progress on the cull, according to an anonymous correspondent “The omnishambles that is KCL management 1) We were told we would ...
Source: DC's goodscience - June 7, 2014 Category: Science Authors: David Colquhoun Tags: Academia assessment HEFCE management bollocks managerialism metrics Rick Trainor science UUK Anne Greenough bibliometrics Karen O’Brien Robert Lechler Shitij Kapur Simon Howell Universities UK vice-chancellors Source Type: blogs

Bad financial management at Kings College London means VC Rick Trainor is firing 120 scientists
This article, by Bruce Alberts, Marc W. Kirschner, Shirley Tilghman, and Harold Varmus, should be read by everyone. They observe that ” . . . little has been done to reform the system, primarily because it continues to benefit more established and hence more influential scientists”. I’d be more impressed by the senior people at Kings if they spent time trying to improve the system rather than firing people because their research is not sufficiently expensive. 10 June 2014 Progress on the cull, according to an anonymous correspondent “The omnishambles that is KCL management 1) We were told we would ...
Source: DC's goodscience - June 7, 2014 Category: Science Authors: David Colquhoun Tags: Academia assessment HEFCE management bollocks managerialism metrics Rick Trainor science UUK Anne Greenough bibliometrics Karen O’Brien Robert Lechler Shitij Kapur Simon Howell Universities UK vice-chancellors Source Type: blogs

In the Works, "Committed: The Battle Over Forced Psychiatric Care."
Good morning, I've missed you.  Blogging has not been the same lately and I've let some great topics go by.  Let me tell you what I've been up to.There have been so many things to write about lately, and I will tell you that my brain is just bursting with all the work Clink and I are doing on our new book: Committed: The Battle Over Forced Psychiatric Care.  ClinkShrink is doing some of the background stuff, she's being (as always) the forensic expert, she's sweeping up after my grammatical carelessness, and correcting the forensically idiotic things I say.  She's focusing on legal cases and a chap...
Source: Shrink Rap - June 7, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

Help! My Patient Got Arrested. What Do I Do?
Today over on Clinical Psychiatry News I give advice to mental health practitioners about what to do when you need to make sure your patient is taken care of when he ends up in jail. This is never the kind of stuff they teach you in residency, so I end up fielding phone calls from friends and colleagues about it sometimes.Hopefully you'll never have to deal with this, but if you do you'll know where to begin. Read the column here.----- Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail dot com Our book is out now. (Source: Shrink Rap)
Source: Shrink Rap - June 6, 2014 Category: Psychiatrists and Psychologists Authors: ClinkShrink Source Type: blogs

The military is off-track when dealing with mental health problems
The headline reads, “Study: Mental illness rate higher in soldiers.” The article goes on to offer alarming statistics: The rate of major depression is five times as high among soldiers as civilians; intermittent explosive disorder, which results in episodes of extreme anger, is six times as high; and post-traumatic stress disorder was nearly 15 times higher than among civilians, the study found. This would be pretty scary if true — but it isn’t. Psychiatric epidemiology is done in a way that leads to systematic bias and inflated rates of reported psychiatric disorder. And there has also been systema...
Source: Kevin, M.D. - Medical Weblog - June 4, 2014 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Pfizer Publicly Undermines and Refutes Black Box Warning for Chantix; Should Face Penalties or Removal of Drug from Market
The black box warning for Chantix, which is required by the FDA to be placed on this smoking cessation drug made by Pfizer, notes the following:"All patients being treated with CHANTIX should be observed for neuropsychiatric symptoms including changes in behavior, hostility, agitation, depressed mood, and suicide-related events, including ideation, behavior, and attempted suicide. These symptoms, as well as worsening of pre-existing psychiatric illness and completed suicide, have been reported in some patients attempting to quit smoking while taking CHANTIX in the postmarketing experience. ... Advise patients and caregiver...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - June 2, 2014 Category: Addiction Source Type: blogs

Service models in adult psychiatry
This report discusses the separation of care between in-patient and community and within the community. It argues that decisions about the best model of service delivery should be based on evidence that it will deliver better care for patients. It also highlights the need for more responsive crisis services and more access to necessary resources. Report RCP news (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - June 2, 2014 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Changing configuration of health services Integrated care Mental Health Source Type: blogs

Feeling Mighty Unreal: Derealization in Kleine-Levin Syndrome
I went on this trip once, back to my hometown after a long absence. Have you ever felt that your surroundings seem odd and distant, and that you're completely detached from them? That the things and places around you aren't real? This can happen to me, on occasion.It did on this trip, perhaps because I've dreamed about those places so many times that the real places and the dream places are blurred in memory.Of course time marches on. The stores in the strip mall have changed, and you go to Starbucks with your father. But sometimes new and surprising things appear in the landscape.Or maybe old and unexpected things pop up ...
Source: The Neurocritic - June 1, 2014 Category: Psychiatrists and Psychologists Authors: The Neurocritic Source Type: blogs

And now for something warm and fuzzy!
Psychiatry these days --- I could do link after link and commentary after commentary about guns and violence and mass shootings and can we prevent all this?  But why?  Let's go for something sweet and warm and fuzzy and ducky today.  I hope you enjoy the video above.----- Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail dot com Our book is out now. (Source: Shrink Rap)
Source: Shrink Rap - May 31, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

Lessons from the VA – bad performance measures and insufficient primary care
This article delineates the problem beautifully. As a former VA physician (part time for 20 years and only inpatient the last 10 years) I can tell you that the patients who frequent the VA require intense primary care. They often have multiple medical problems and often psychiatric problems. Now the electronic medical record is the best I have seen, but it still takes time to type notes, and review the charts. The VA has great benefits, and often reasonable hours, but the salaries are not great from primary care. And the US has a shortage of primary care physicians, especially internists (who the VA seems to favor). Primar...
Source: DB's Medical Rants - May 30, 2014 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Cases: Legacy Projects at the End of Life
Discussion:Suffering, both physical, psychological and existential, is an important topic for seriously ill patients (1). The 2005 National Consensus Project on Quality Palliative Care highlighted the importance of understanding and addressing patients’ emotional and spiritual needs (2). Emotional and spiritual suffering are important factors that can contribute to the development of patients’ and caregivers’ depression and anxiety (3,6).  Various interventions are available to address emotional and spiritual distress.  One example is legacy project. These projects provide meaning-based coping through the c...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 30, 2014 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs

Top stories in health and medicine, May 27, 2014
From MedPage Today: Temporary Fee on Big Business Funds Obamacare. The world of healthcare, like any, is full of haves and have nots. Grassroots Group Aims to Renew Primary Care. “Change is HERE. The future of primary care has arrived.” The motto of Primary Care Progress, a 4-year-old grassroots organization advocating for interprofessional teamwork and a brighter landscape for primary care in the U.S., is echoed throughout the organization’s rhetoric, blog posts, leadership summits, and the voices of its members. War Wounds: Hearing Loss Tracks Gulf War Vets. Do you routinely ask your patients if they ...
Source: Kevin, M.D. - Medical Weblog - May 27, 2014 Category: Journals (General) Authors: Tags: News Primary care Psychiatry Source Type: blogs