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Introduction

Happy July! This month we feature some of our foremost thought leaders in psychiatry and faculty for Psychiatry Update Spring 2023 sharing their most memorable cases. Our last issue featured Part 2 “5 Minutes With” with Dr. Christoph Correll, Dr. Margaret Sibley, Dr. Ann Childress, Dr. Holly Swartz, and Dr. Donald Black. Topics included the best tool in their clinical arsenals, mental health therapies that are safe and easy to incorporate but may be underutilized, and specific advances on the horizon that will greatly improve their treatment armamentarium. If you missed it, you can find that interview here.

Don’t miss!— Psychiatry Update Journal Club 

Monday, July 26 at 10am

“Long-acting Injectable Antipsychotics in Early-Phase Schizophrenia: Preventing a Relapse Today Can Make a Difference for a Lifetime”

A discussion of using long-acting injectable antipsychotics in early-phase schizophrenia and the potential benefits of a more proactive approach

  • During this live event, Dr. Leslie Citrome will interview Dr. Jose Rubio, Assistant Professor of Psychiatry at Zucker School of Medicine, Hofstra/Northwell, NY. Dr. Rubio co-authored a study that examined claims data to evaluate predictors of initiation of atypical LAIs among patients with newly diagnosed schizophrenia. 
  • Oral antipsychotic agents, a mainstay of schizophrenia treatment for 60 years, may not be taken consistently, resulting in higher relapse rates than long-acting injectable (LAI) antipsychotics. Thus, there is compelling evidence for the use of LAI antipsychotics, especially in the early phase of the disease, when patients have the most to lose. 
  • Dr. Rubio’s study examined claims data from the IBM MarketScan Commercial and Medicare Supplemental databases.
  • Dr. Citrome and Dr. Rubio will discuss the results and potential benefits of a more proactive LAI approach. 
  • We hope you can join us. There will be targeted questions and valuable interaction! 
  • Click here to register! 

This month’s Psych Resource section will keep you updated with articles from Clinical Psychiatry News, Current Psychiatry, MDedge Psychiatry, New England Journal of Medicine, and JAMA Psychiatry—check them out below. 

Thank you to our participants for their interesting case perspectives this month. Please contact me at colleen@cmhadvisors.com with any comments and/or suggestions. Thanks for reading! —Colleen Hutchinson

Most Memorable Cases with Psych Update Spring 2023 Faculty

  • Christoph Correll, MD, is Professor of Psychiatry and Molecular Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; and Investigator, Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York.
  • Margaret H. Sibley, Ph.D. is Associate Professor of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Licensed Clinical Psychologist at Seattle Children’s Hospital and a researcher who specializes in the diagnosis and treatment of ADHD in adolescence and adulthood, having published over 100 scientific works on this topic, as well as a book on the psychosocial treatment of adolescent ADHD.
  • Ann Childress, MD, is President of the Center for Psychiatry and Behavioral Medicine, Clinical Associate Professor, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas and Adjunct Associate Professor, Touro University Nevada College of Osteopathic Medicine.
  • Holly A. Swartz, MD, is Professor of Psychiatry at the University of Pittsburgh; Editor-in-Chief, American Journal of Psychotherapy; and Treasurer of the International Society for Bipolar Disorders, Pittsburgh, PA.
  • Donald W. Black is Past-President of the American Academy of Clinical Psychiatrists (AACP) and Professor of Psychiatry at University of Iowa Carver College of Medicine in Iowa City, Iowa.

What was your most memorable case of the past year?

Dr. Correll: My most memorable case of the past year was treatment-resistant schizophrenia with non-response to adult maximum doses of several first-line antipsychotics and only partial response to clozapine, including several different augmentation options, in a girl 9 years of age.


Dr. Sibley: My most memorable case of the past year is one in which I worked with a mother and her 9th grader with ADHD to help them through some rocky times. He ended up honestly acknowledging he has no interest in graduating high school and would rather pursue a trade. His mom finally accepted this and supported it, which was a breakthrough moment for their relationship.


Dr. Freeman: My most memorable case of the past year was severe postpartum OCD.


Dr. Black: My most memorable case over the past year was a man with severe auditory hallucinations who had been misdiagnosed with having multiple personalities. Fortunately, he is responding well to antipsychotics.


Dr. Childress: My most memorable case of the past year was a 4-year-old male with severe generalized anxiety disorder who responded to escitalopram. Once anxiety was under control, it became clear that he also had ADHD and predominantly inattentive presentation and was struggling academically. He is now responding well to methylphenidate and escitalopram, and he made all-state band and was able to travel to another city for a competition!



Psychiatry Resource Section

Medscape AAIC 2023 Conference Coverage: Finger-Prick Blood Test Promising for Alzheimer's Diagnosis, Monitoring

https://www.medscape.com/viewarticle/994523

JAMA Psychiatry Viewpoint: Open Notes Use in Psychiatry—The Need for Multilevel Efforts in Research and Practice

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2806891

MDEdge Clinical Psychiatry News Article: Most Americans in favor of regulated therapeutic psychedelics 

https://www.mdedge.com/psychiatry/article/264222/major-depressive-disorder/most-americans-favor-regulated-therapeutic

APA Learning Center July Free Members Course: Anxiety Disorders Treatment: Current State and Future Promise —CME:1.5, COP:1.5

https://education.psychiatry.org/Public/Catalog/Details.aspx?id=UxSrtyz9YckBlZg0zyPouQ%3d%3d

New England Journal of Medicine Perspective: Empowered or Traumatized? A Call for Evidence-Informed Armed-Assailant Drills in U.S. Schools

https://www.nejm.org/doi/full/10.1056/NEJMp2301804

Current Psychiatry Evidence-Based Reviews: Interventional Psychiatry (Part 2)

https://www.mdedge.com/psychiatry/article/263896/depression/interventional-psychiatry-part-2?channel=133

JAMA Psychiatry Viewpoint: The Intricate Interaction Between Expectations and Therapeutic Outcomes of Psychedelic Agents

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2806880?widget=personalizedcontent&previousarticle=0