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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 2.

The Oklahoma University Conteoversy
Having graduated from Jesuit High School and seen my children graduate from Highland Park High School, even my limited experience assures me that there is no more a right wing group wanting to lynch black people than there is a left wing conspiracy to outlaw the NFL in favor of a national scrabble tournament. What we have is youths saying ‘bad words’ in response to the chanting of evidently ‘bad facts’ by others. The limited experience of the white youths did not let them see that the chanting of ‘bad facts’ was related to experiences which may have been true enough. But the privileged graduates also were not t...
Source: a psychiatrist who learned from veterans - March 23, 2015 Category: Psychiatry Source Type: blogs

Thoughts on Leaving Private Practice
The most surprising outrageous thing involved a Brother printer. We had trouble with a network connection; so someone called the helpline. They in turn were referred to someone else who did solve the problem but 'noticed some intrusions in our computer' and scared this HIPAA sensitive staff person who asked for authorizations of $600 and $300 to clear the matter up and 'have something placed on the computer to monitor.' A complete fraud from some outfit in India as it turned out. In printers I have appreciated the speed of the HP Officejet Pro 8600 which has some good HP support tools. RxNT is an excellent eprescribing sol...
Source: a psychiatrist who learned from veterans - March 20, 2015 Category: Psychiatry Source Type: blogs

Thoughts on Leaving Private Practice (Equipment and Business Methods)
The most surprising outrageous thing involved a Brother printer. We had trouble with a network connection; so someone called the helpline. They in turn were referred to someone else who did solve the problem but 'noticed some intrusions in our computer' and scared this HIPAA sensitive staff person who asked for authorizations of $600 and $300 to clear the matter up and 'have something placed on the computer to monitor.' A complete fraud from some outfit in India as it turned out. In printers I have appreciated the speed of the HP Officejet Pro 8600 which has some good HP support tools. The Samsung basic small rectangular b...
Source: a psychiatrist who learned from veterans - March 20, 2015 Category: Psychiatry Source Type: blogs

BRAIN Awareness
After what seems like an endless winter along the East Coast, we have reached what Emily Dickinson famously called the “month of expectation.” And, of course, March is also the time each year we celebrate Brain Awareness Week, the annual celebration of neuroscience with school visits, community lectures, and lab tours to talk about the brain. A list of Brain Awareness events can be found at (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - March 19, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Research and Reviews in the Fastlane 075
This study further defends the pathway of early discharge from the ED without evocative testing in subsets of patients with low risk chest pain.Recommended by Anand SwaminathanNeurology Edwards C, et al. Residency Training: A failed lumbar puncture is more about obesity than lack of ability. Neurology 2015; 84(10):e69-72. PMID: 25754807This is an interesting article exploring the reasons for LP failure. The authors reviewed all elective LPs done by Neurology residents in a LP clinic. They recorded all the demographic of the patient and the characteristics of the proceduralist. The overall LP failure rate was 19% and it w...
Source: Life in the Fast Lane - March 19, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Emergency Medicine Infectious Disease Neurology R&R in the FASTLANE Respiratory Toxicology and Toxinology literature recommendations research and reviews Source Type: blogs

Johnson and Johnson Continues to Pay For Risperdal
In August of 2012, Johnson & Johnson paid a $181 million multi-state consumer protection settlement to resolve charges that the company marketed its antipsychotic drug Risperdal for off-label uses. In November of 2013, J&J paid $2.2 billion to resolve False Claims Act allegations related to misbranding of a number of drugs, including Risperdal. In the past month, the company faced two further blows related to Risperdal. A Philadelphia jury awarded $2.5 million to the plaintiff over J&J’s “failure to warn” about Risperdal side effects. This was the first such case to be heard by a jury, though hundreds of cases ar...
Source: Policy and Medicine - March 18, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Eulogy for the doctor
No physician, however conscientious or careful, can tell what day or hour he may not be the object of some undeserved attack, malicious accusation, blackmail or suit for damages  … “ – Assaults Upon Medical Men. Journal of the American Medical Association, 1892 It’s happened again: A well-liked doctor is killed by his patient. Last year’s horrific death of a physician in our community, a valued colleague shot in his office by a disgruntled if not deranged patient, was a shock.  The recent physician slaying at Boston’s Brigham and Women’s Hospital echoed the senselessness of such an event.  Th...
Source: Kevin, M.D. - Medical Weblog - March 17, 2015 Category: Journals (General) Authors: Tags: Physician Hospital Psychiatry Source Type: blogs

The Safety Nets Have Gaping Holes – Our Sewing Kit!
Anne Klee & Laurie Harkness In our country, two words that should never be spoken or written in the same sentence are Veteran and homelessness.  Yet all too frequently we hear this is the case.   Ten years ago there were estimated to be 250,000 homeless Veterans on the streets of America each night.  Today through the multi-pronged efforts of the U.S. Department of Veterans Affairs (VA), the Department of Housing and Urban Development (HUD), many state Governor’s, state agencies, and community agencies and partners, there are now less than 50,000 homeless Veterans each night.  Veterans are about 50 percent more ...
Source: Disruptive Women in Health Care - March 17, 2015 Category: Consumer Health News Authors: dw at Tags: Women Veterans Source Type: blogs

Increasing Bad Press for Today's Healthcare Information Technology - Deserved and Overdue
Here are three candid, quite revealing articles about the distaste for today's health IT that appeared recently.  I will address each,The first seems like pure deja vu (see my June 4, 2009 post "If The Military Can't Get Electronic Health Records Right, Why Would We Think Conflicted EHR Companies And IT-Backwater Hospitals Can?" at  Forbes:  Pentagon's $11 Billion Healthcare Record System Will Be Obsolete Before It's Even Built -  March 3, 2015
Source: Health Care Renewal - March 16, 2015 Category: Health Management Tags: forbes health affairs healthcare IT difficulties healthcare IT risks Source Type: blogs

Should Medical Staff ‘Google’ Patients?
Note: The Bioethics Program blog will be moving to its new home on April 1, 2015. Be sure to change your bookmarks to   by Brandon Hamm, Bioethics Program Alum (MSBioethics 2012) On several occasions, a new admission or psychiatric consultation has been accompanied by patient information that was “googled” by nursing or consulting practitioners. On some […] (Source:
Source: - March 16, 2015 Category: Medical Ethics Authors: The Bioethics Program Tags: Health Care Privacy Clinical Care paternalism syndicated Source Type: blogs

Last week we had our annual House appropriations subcommittee hearing to discuss next year’s budget for NIH. The bipartisan enthusiasm for NIH and its mission was striking, so striking that ranking member Rosa DeLauro (D-CT) ended the hearing by suggesting a “group hug.” Amidst the rare bipartisan romance, there were a few challenging questions, including one about how NIH sets priorities. Dr. Andy Harris (R-MD), the only member of Congress who has been an NIH grantee, put it this way: “Eighty-four million Americans have heart disease, and yet the amount we spend per death is a hundred times less on heart disease t...
Source: NIMH Directors Blog - March 14, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Destruction of Lives with the Stroke of a Pen
Protect Our Defenders is a non-profit human rights organization that honors, supports and gives voice to the brave women and men in uniform who have been raped or sexually assaulted by fellow service members.  Nancy Parrish Paula Coughlin Men and women serving in our military who are raped or sexually assaulted face overwhelming obstacles in order to receive adequate health care. Instead of assuring victims that their distress about their attacks is a normal response, the Department of Defense (DoD) has a record of mistreating victims by labeling them with errant diagnoses of personality or adjustment disorders. Based on ...
Source: Disruptive Women in Health Care - March 10, 2015 Category: Consumer Health News Authors: dw at Tags: Women Veterans Source Type: blogs

Depression: Why not START with a nutritional solution?
If you experience depression, you will typically be prescribed an antidepressant, an SSRI or other agent. If you consult a psychologist or counselor, the underlying psychological underpinnings (if any) are explored, strategies devised to cope. But there will almost never be talk about your diet, nutritional deficiencies that amplify dark moods, the life habits that allow demons to emerge. Yet there are some very powerful strategies available that have potential to substantially lift mood. Such solutions won’t, of course, erase the effects of childhood trauma or grieving from personal loss, but they can help smooth th...
Source: Wheat Belly Blog - March 9, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle anxiety Depression gluten grains Weight Loss Source Type: blogs

Assisted physician suicide: Are doctors killing doctors?
Standing on the edge of his hotel balcony, a doctor describes the rolling hills. He tells me, “It’s a beautiful place to die.” Ten minutes later, he agrees not to injure himself — for now. I’m not running a physician suicide hotline. But doctors keep calling me. It’s midnight, and I’m speaking to a psychiatry intern. Bullied by residents and her attending, she cries, “I’ve lost my self-confidence. I’m depressed. On psych meds now. But I don’t feel better.” Then a fourth-year medical student shares a similar story. “I was normal before med school. Now I’m so afraid. I can’t go on,” she so...
Source: Kevin, M.D. - Medical Weblog - March 9, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Facebook Launches Suicide Prevention Initiative - WSJ video
Facebook is partnering with suicide prevention organizations on a new tool to identify people in distress. Forefront research scientist Ursula Whiteside discusses the project with Sara Murray. 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 - March 8, 2015 Category: Universities & Medical Training Tags: Depression Facebook Psychiatry Source Type: blogs

Delirium and Physostigmine: ECG helps in Management
This patient took an unknown overdose and was delirious.  The axillae were dry.  Due to delirium and dry skin, there was suspicion of anticholinergic toxicity.Here is his ECG:There is sinus tachycardia.  There is also some QRS widening and a large R-wave in aVR, and an rSR' (RV conduction delay) in lead V1.  The QRS duration is 107 ms.  There is QT prolongation as well, with a computerized (Bazett) QTc of 480 ms (prolonged).The prolonged QRS and RV conduction delay make this very suspicious for Na channel blockade, and, most worrisome, for tricyclic antidepressant overdose (TCA).Do we treat the del...
Source: Dr. Smith's ECG Blog - March 7, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

An alcoholic patient, and his effect on a medical student
This article originally appeared in uvm medicine. 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 - March 6, 2015 Category: Journals (General) Authors: Tags: Education Emergency Hospital Medical school Source Type: blogs

Does medical student debt lead to suicide?
Every year 300 to 400 physicians commit suicide. More than 10 percent of doctors are thought to have depression, a frequent precursor to suicide. Rates of depression and suicide among physicians are higher than in the general population. Many reasons including stress, heavy workload, sleep deprivation, lack of autonomy, and lack of outlets for personal care may contribute to higher vulnerability in doctors. High-profile suicides this past year by medical residents have led to a slew of articles on depression and suicide in physician. Curiously missing from the conversation is financial strain, particularly debt. Co...
Source: Kevin, M.D. - Medical Weblog - March 6, 2015 Category: Journals (General) Authors: Tags: Education Medical school Psychiatry Source Type: blogs

Top stories in health and medicine, March 6, 2015
From MedPage Today: Trends in Teen, Young Adult Suicide Differ by Gender. Patterns of suicides among adolescents and young adults changed dramatically from 1994 to 2012, with major gender differences in these 19-year trends. Early Hot Flashes May Predict Heart Disease. Early-onset and frequent hot flashes and night sweats in women were associated with poorer endothelial function. Hepatitis E Vaccine Has Lasting Effect. A vaccine against hepatitis E (HEV) provided protection against the virus for more than 4 years. Getting Inspired About the Lean, Mean PCMH. As we continue planning our first patient-centered medical home ...
Source: Kevin, M.D. - Medical Weblog - March 6, 2015 Category: Journals (General) Authors: Tags: News GI OB/GYN Psychiatry Source Type: blogs

Collaborative Care
When asked about how NIMH research can change mental health care, I have a short list of “best hits” that I offer as examples. High up on that short list is collaborative care. Developed initially for treating depression, collaborative care integrates mental health and primary care to provide patient-centered, comprehensive, accountable care. To ensure that patients receive comprehensive and evidence-based care, each patient has a team, including primary care providers and mental health specialists, monitoring progress, with clinical and community support for reaching treatment goals. Not only does each patient’s tre...
Source: NIMH Directors Blog - March 5, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Increase the minimum wage for better mental health
There are many good reasons for Congress to enact President Obama’s proposal to raise the Federal minimum wage to $9 per hour.  Many of these reasons, from economic stimulus to possible reductions in gaping income inequality to much-needed financial relief for working families, have been extensively discussed in the public sphere.  However, one important benefit of increasing wages has not received enough attention: improving mental health. 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 - March 4, 2015 Category: Journals (General) Authors: Tags: Policy Psychiatry Source Type: blogs

The ACA’s Hospital Tax-Exemption Rules And The Practice Of Medicine
The Affordable Care Act (ACA) and related regulations include obligations for nonprofit (and some government) hospitals to provide benefits, such as free care, to their communities. On their face, these new obligations seem a valuable response to longstanding concerns of some legislators, litigators, and scholars that some nonprofit hospitals are really ‘for-profits in disguise’ and to the related calls to eliminate tax-deductions for gifts to nonprofit hospitals. Moreover, the requirements have been lauded for their potential to improve public health, particularly in leading to better consultation and collaboration wi...
Source: Health Affairs Blog - March 3, 2015 Category: Health Management Authors: Jill Horwitz and David Cutler Tags: All Categories Business of Health Care Health Law Health Reform Hospitals Policy Source Type: blogs

Is Internal Medicine MOC necessary?
Maintenance of certification is, in my opinion, a good idea. While I had significant concerns about the structure that the ABIM was using, the idea that we have an obligation to maintain our knowledge. I believe that the only legitimate argument is in the definition of how one documents maintenance. The ABIM had two major problems to address. The first issue that they are working vigorously to improve is the criteria for MOC. I have written often about how I would document maintenance. I hope the performance improvement concept is taken out of MOC because we are subject to too many performance report cards already. While ...
Source: DB's Medical Rants - March 2, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Just in the Nic o’ tine
A 21-year-old man presented with palpitations, tremulousness, nausea, and vomiting. He reported ingesting one 14 mg nicotine patch in a suicide attempt. Initial vital signs include heart rate 132 bpm, blood pressure 140/80 mm Hg, temperature 37°C, respiratory rate 26 bpm, and pulse oximetry 100% on room air. Physical examination is remarkable for agitation, fine resting tremor, tachycardia, and pressured speech.   The lethal dose of nicotine is estimated to range from 1 mg/kg to 10 mg/kg. Reports of nicotine toxicity have occurred with the ingestion of as little as one whole cigarette or three cigarette butts in children...
Source: The Tox Cave - March 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Things we might have done differently: High School
#1 is finishing High School. Some good things have happened in High School, but if we could rerun the tape we’d have tried something different — perhaps a local charter school that specializes in autism disorders.The Junior and Senior years have been remarkably weak. I think this is partly due to local conditions; we’ve seen problems with leadership, policies, and funding — particularly funding and support for class aides.I don’t think that’s the whole story though — I suspect very few schools or school districts have figured out how to manage special education for ages 16-19, particularly in integrated setti...
Source: Be the Best You can Be - March 2, 2015 Category: Disability Tags: adolescence adult education school Source Type: blogs

Crowd Sourced Suckers
“What do you think of this?” writes a friend: …[A]n untraditional approach to medical diagnosis that is helping solve the country’s most difficult medical mysteries and creating real miracles. This is the description of something called CrowdMed, the latest version of getting doctors to provide services for free. Thus my short answer about what I think of it: not much. To be fair, and because I had a few minutes of free time, I went and checked it out. Patients submit questions about their medical condition(s), accompanied by varying levels of supporting detail, and “medical detectives”...
Source: Musings of a Dinosaur - February 27, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs

Promoting Amphetamines for Over-Eating - What Could Possibly Go Wrong?
In this study, about 5% of patients given any dosage of Vyvanse had to discontinue its use because of adverse effects.  3/196 patients initially randomized to Vyvanse had serious adverse effects, and one patient died, apparently of an amphetamine overdose.  Oddly, the article declared that the one death, due to methamphetamine overdose, was thought by a study investigator not to be related to treatment with another amphetamine, lisdexamfetamine.  That makes little sense, given that in a randomized controlled trial, the presumption is that differences in groups given different treatments were caused by these ...
Source: Health Care Renewal - February 26, 2015 Category: Health Management Tags: clinical trials conflicts of interest deception evidence-based medicine FDA marketing Shire stealth marketing Source Type: blogs

Mortality and Mental Disorders
It’s easy to overlook the most important health statistic of the past century. Life expectancy has increased dramatically in the U.S., from 51 years in 1910 to nearly 79 years (81 years in women, 76 years in men) in 2010.1 (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - February 26, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Preventing deaths in detention of adults with mental health conditions
Equality and Human Rights Commission (EHRC) - This publication is the final report of an inquiry into non-natural deaths of adults with mental health conditions who have been detained in England and Wales. It focuses on prisons, police custody and psychiatric hospitals, as every year hundreds of deaths occur in these settings and these deaths are later deemed to have been preventable. Report Supplementary documents EHRC inquiry (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - February 23, 2015 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Mental Health Patient safety Source Type: blogs

When patients’ anger leads to murder
When we perceive any object of a familiar kind, much of what appears subjectively to be immediately given is really derived from past experience. – Bertrand Russell, The Analysis of Mind I’ve learned a few more things about Stephen Pasceri, the man who murdered a cardiovascular surgeon in Boston recently.  He had money troubles involving credit card debt.   He declared bankruptcy at one point.  He tried to get John Kerry, the senator, to fix an $8,000 hospital bill.  He also has family troubles.  He sued his own aunt and uncle over a property dispute.  He seems to have been an angry and impulsive man. Conti...
Source: Kevin, M.D. - Medical Weblog - February 17, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Karl Bonhoeffer
Many years ago I read a lot about Dietrich Bonhoeffer, the minister and theologian.  His ideas about the church and Christianity I found interesting, and I was also interested in his involvement in plots to kill Hitler.  He was executed in 1945 for that involvement.  And so I discovered that his father, Karl (1868-1948) was a psychiatrist.  And because at the time I worked at the Royal Society of Medicine Library in London, which was (and is) a research library of historical record which kept all sorts of things, and we had Index Medicus in print and Medline on CD Rom, I could find material about h...
Source: Browsing - February 15, 2015 Category: Databases & Libraries Tags: medical history Nazi Germany psychiatry Source Type: blogs

The $5.3 Million a Year Government Bureaucrat - The Top Administrator, or CEO of a "Government Entity," Charlotte-Mecklenburg Hospital Authority, "Doing Business as" Carolinas Healthcare Gets a Raise
The pay given to top managers of health care organizations continues its seemingly inexorable rise, and the justifications for it seem to be increasingly perfunctory.  However, a closer look at individual cases can generate even more questions about how we got to this pass.  Our latest example arises from a recent news article about the compensation of top managers at Carolinas Healthcare.   CEO Pay Levitating Since 2009 In 2011, we started following executive compensation at the hospital system now known as Carolinas Healthcare. Our posts in 2011, 2012, and 2013 all fit the same pattern.The total compensati...
Source: Health Care Renewal - February 12, 2015 Category: Health Management Tags: Carolinas HealthCare Charlotte-Mecklenburg Hospital Authority executive compensation government managers ' coup d etat public hospitals Source Type: blogs

Can use of an occupational justice model in an American context result in accusations of professional misconduct?
Conceptual practice models are interrelated bodies of theory, research, and practice resources that are used by OTs to guide practice (Kielhofner, 2009). One such conceptual practice model is the Occupational Justice Model (Townsend, 1993; Townsend and Nillson, 2010).  According to these sources, the Occupational Justice Model is framed around the concept that injustice occurs due to inherent governance and social structures that allegedly restrict the occupational performance of some populations and individuals.Concepts associated with occupational justice models have filtered into some official documents of the Amer...
Source: ABC Therapeutics Occupational Therapy Weblog - February 12, 2015 Category: Occupational Health Tags: OT Education OT practice philosophy Source Type: blogs

Medtronic Settles $2.8 Million Off-Label Suit Over Neurostimulator Promotion
Minnesota-based medtech company, Medtronic Inc., has agreed to pay $2.8 million to resolve allegations that the company promoted its neurostimulator device for unapproved chronic pain treatment. According to the complaint, originally filed by former Medtronic sales rep Jason Nickell, Medtronic sales staff were directed to sell the device at discounted prices to pain management doctors. Nickell also alleged that sales reps promised physicians could “make upward of $10,000 profit on each patient, while adding only minutes to the procedure" by using a billing code meant for an FDA-approved use. Neurostimulation provides pai...
Source: Policy and Medicine - February 11, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs

In times of stress, remember who is behind the mask
As clinicians, we often forget or become desensitized to the image that society has of medicine and doctors. Alongside teachers and scientists, we are seen to be among the most trustworthy of professionals, yet our morale is low, with almost 50 percent describing it as “low” or “very low.” You can imagine, then, why I often describe medicine as a forest: beautiful, scenic and picturesque from afar but potentially hostile, and even lethal, inside. From a distance, the forest is amazing to behold, but inside, from time to time, its inhabitants — and we all know this feeling far too well — grow tired of be...
Source: Kevin, M.D. - Medical Weblog - February 10, 2015 Category: Journals (General) Authors: Tags: Physician Hospital Psychiatry Residency Source Type: blogs

Immune to Stress?
Some of us seem to cope better with life’s hard knocks than others. One might assume that the secrets to understanding these individual differences in resilience must be sought in the brain. Maybe not. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - February 10, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Prescribing off-label: It’s gotten out of control
Doctors prescribe way too many medicines for patients who don’t really need them. A lot of the pressure comes from intense drug company marketing. Some comes from patients who aren’t happy leaving the office without a pill. And doctors have too little time with each patient to explain non-pill solutions to problems. Wild prescribing is not new. For thousands of years, doctors have given patients useless (and often quite harmful) drugs and patients have taken them. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source...
Source: Kevin, M.D. - Medical Weblog - February 6, 2015 Category: Journals (General) Authors: Tags: Meds Medications Psychiatry Source Type: blogs

Precision Medicine for Mental Disorders
Precision medicine seems to be the new hot topic in the research world. President Obama spoke about precision medicine in his State of the Union speech (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - February 3, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Psychiatry is devalued: And patients suffer because of it
This past week I spoke with a patient who noted that since his wife’s death six months ago, he had lost 40 pounds, slept a maximum of four hours nightly, and stopped enjoying activities he used to take pleasure in. He found it difficult to concentrate at work, and getting out of bed each morning was described as his greatest struggle. While relaying this story, the man was on the verge of tears. His voice was soft and pleading; he needed help. While the exact line between a “normal” grief reaction and new-onset major depression is controversial, my attending explained to this patient that — given the length and...
Source: Kevin, M.D. - Medical Weblog - February 2, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Always Err on the Side of Compassion
The best piece of marital advice I’ve ever heard came from an ex-priest, a kind and gentle man who has been married to his bride for longer than I’ve been alive. “Always err on the side of compassion,” he told me when I called him up all upset one afternoon after my husband and I got into a fight. I don’t even remember what the fight was about. Something stupid. But I remembered his advice and I’ve been trying to apply it not only to my marriage but to my life, in general. In fact, it has become my mantra. Always err on the side of compassion. It sounds so easy, but is so difficult to execute. The mo...
Source: World of Psychology - February 1, 2015 Category: Psychiatrists and Psychologists Authors: Therese J. Borchard Tags: Depression Disorders General Health-related Motivation and Inspiration Personal Bipolar Disorder Cognitive Behavioral Therapy Intrusive Thoughts Major Depressive Disorder Mood Disorder Psychomotor retardation Seasonal Affective Dis Source Type: blogs

The APA and The Helping Families in Mental Health Crisis Act
If you are not familiar with Representative Tim Murphy's legislation to overhaul America's broken mental health system, this post isn't for you.  The legislation died when congress convened, but Rep. Murphy is planning to reintroduce the legislation to this congress, and he has 115 co-sponsors for the bill.  In the last session, APA took no stance on the bill; they wrote a letter supporting the idea of legislative change and said they looked forward to working with Murphy on this.  Rep. Murphy has said that the new legislation to be proposed will have some changes, changes that APA finds more in alignment wi...
Source: Shrink Rap - January 31, 2015 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

Doctor Evil
This is extremely disgusting. Doctors in California, who receive payments and other benefits from drug companies, have been prescribing anti-psychotics to kids in foster care -- kids who are not psychotic at all, but who are being drugged into a stupor in lieu of properly addressing their behavioral problems. According to the investigation by the San Jose Mercury News, drug companies spent $14 million from 2010 to 2013 to bribe doctors into making these prescriptions.According to the investigation, nearly 25% of California foster children age 10-18 were prescribed antipsychotic drugs. I have written about these drugs here ...
Source: Stayin' Alive - January 30, 2015 Category: American Health Source Type: blogs

The day the music died and how a hospital lost its joy
There’s a great song by Don McLean called “American Pie.” The chorus talks about “the day the music died.” I thought about that song in my hospital a couple years ago, when the music died there, too. I’ve noticed that our physician burnout and nurse frustration have increased in the years since the music died. Could it be a coincidence? 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 - January 30, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

It’s All In Your Head
The following post originally ran on Disruptive Woman to Watch Lisa Suennen’s blog Venture Valkyrie on January 26th. “Mental health needs a great deal of attention. It’s the final taboo and it needs to be faced and dealt with.” That quote is from the great philosopher and clinician, oh wait I mean 80’s post-punk rocker Adam Ant. Seriously. But he is so right on. Back in 1998 I was part of the management team of a company called Merit Behavioral Care, also once known as American Biodyne. The company was the first of its kind: a company that delivered what we now know as population health for people with menta...
Source: Disruptive Women in Health Care - January 30, 2015 Category: Consumer Health News Authors: dw at Tags: Mental Health Source Type: blogs

The power of the specialist physician — and stewardship
My latest column over at discusses the disordered balance of power in the doctor-patient relationship. As most of you know, I harbor strong biases about the quality of medical decisions, especially in the elderly. Attached. Yes, I am attached to the issue of decision quality. Nearly all of electrophysiology, and much of cardiology, involves preference-sensitive decisions. This means doctors are called to align treatments with the goals of the patient. We hold great power; we must use it justly and wisely. My latest essay arose from an unusual source. The prominent medical journal Circulation Outcomes publishes...
Source: Dr John M - January 30, 2015 Category: Cardiology Authors: Dr John Source Type: blogs

The Ignorance Project
Attending the World Economic Forum this past week, I was struck by two trends. The first was that brain research has emerged as a hot topic. Not only was brain science or brain health a new theme at the meeting, research on the brain emerged in discussions about next generation computing, global cooperation, and even models of economic development as well as being linked to mental health or mindfulness. In a meeting frequented largely by economists and business leaders, I was surprised by the number of non-scientists who have become enchanted by brain science. Clearly this is the era of the brain, with mental health now pa...
Source: NIMH Directors Blog - January 29, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Wall Street Journal readers weigh in on PAS
Last Saturday, the Wall Street Journal carried an excellent op-ed piece, “Dr. Death Makes a Comeback” (subscription required), by Dr. Paul McHugh, former chief psychiatrist at Johns Hopkins Hospital.  In it, Dr. McHugh opposes physician-assisted suicide (PAS), making three key points: The practice will tend to spread beyond terminally ill people to those who are “treatable but mentally troubled.”  He appeals to the experience in... // Read More » (Source:
Source: - January 29, 2015 Category: Medical Ethics Authors: Jon Holmlund Tags: Health Care Allocation / Access / Public Health bioethics end of life Health Care Practice syndicated Source Type: blogs

Top 10 PTSD Blogs of 2014
Post-traumatic stress disorder (PTSD) often is linked to military veterans, but it can affect anyone following a traumatic event. There are five subtypes: normal stress response, acute stress disorder, uncomplicated PTSD, comorbid PTSD and complex PTSD. Sleep disturbances and flashbacks, where the sufferer relives the trauma, are hallmarks of the disease. PTSD has several other symptoms, some of which overlap with other disorders. These include a loss of interest in regular activities, feeling depressed, anxious and difficulty concentrating. A person with PTSD may find it difficult to relate to loved ones. Instead they are...
Source: World of Psychology - January 29, 2015 Category: Psychiatrists and Psychologists Authors: Kim Lyon Tags: Best of the Web Brain and Behavior Disorders General Mental Health and Wellness Military Psychology PTSD Stress Trauma Violence and Aggression abuse best ptsd blogs combat veterans Complex post-traumatic stress disorder Postt Source Type: blogs

Research and Reviews in the Fastlane 068
Welcome to the 68th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out the...
Source: Life in the Fast Lane - January 29, 2015 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Cardiology Education Emergency Medicine Infectious Disease Intensive Care LITFL Microbiology Psychiatry and Mental Health critical care examination LITFL R/V R&R in the FASTLANE recommendations Review Source Type: blogs

Infestation Anxiety: The Enemy Within
As Ebola fears wane, don’t be fooled. The next great threat is always upon us. There is a little-known psychological disorder called “Ekbom syndrome” in which a person believes that insects are crawling underneath their skin. Patients often tear their skin off in an attempt to extract the invisible vermin. Even though it’s a rare disorder affecting about 100,000 Americans, somehow we can all relate to the maddening anxiety of those afflicted. There is something universally cringe-worthy about the experience of infestation. I was reminded of this during the Ebola scare that swept the nation over the past few...
Source: World of Psychology - January 28, 2015 Category: Psychiatrists and Psychologists Authors: Evan Fisher Tags: Brain and Behavior General Green and Environment Health-related Psychology anxiety Collective Unconscious ebola Fear Foreign Policy Immune System infestation News Media Object Relations Sensationalism social media Source Type: blogs