Partial hospitalization programs represent a midpoint along the treatment intensity continuum bet... more Partial hospitalization programs represent a midpoint along the treatment intensity continuum between an inpatient and an outpatient service. Partial hospitalization programs can be used in place of an inpatient unit for patients who need crisis stabilization and amelioration of their acute symptoms, but who are not imminently homicidal or suicidal. Partial hospitalization programs can also manage adjustments in pharmacotherapy, conduct skills classes, and engage patients in group psychotherapy. In this article, the authors describe the roles and functions of partial hospitalization programs in today's spectrum of psychiatric services and describe the process of transition from an acute inpatient unit to a partial hospitalization programs.
Sleep disturbances are common in pregnancy. Insomnia is a frequent sleep disturbance experienced ... more Sleep disturbances are common in pregnancy. Insomnia is a frequent sleep disturbance experienced by pregnant women which can be primary or due to co-morbid conditions. The differential diagnosis of insomnia in pregnancy includes anxiety disorders, mood disorders, breathing related sleep disorders and restless legs syndrome. Early interventions to treat the sleep disturbance are recommended to avoid adverse pregnancy outcomes. Management strategies include improving sleep hygiene, behavioral therapies, and pharmacotherapy. The risks of pharmacotherapy must be weighed against their benefits due to the possible risk of teratogenicity associated with some medications. We searched PubMed and Google Scholar employing a combination of key words: pregnancy, sleep disturbances, Obstructive Sleep Apnea, Sleep disorders and insomnia. We included original studies, review articles, meta-analysis and systematic reviews in our search prioritizing articles from the last 10-15 years. Articles older than 15 years were only included if their findings had not been superseded by more recent data. Further selection of articles was done from bibliographies and references of selected articles. Sleep disturbances in pregnancy are common and cause considerable morbidity. Management includes a combination of non-pharmacological and pharmacological treatments carefully weighing the risks and benefits of each for the expectant mother and fetus.
... Letter. Herbal Medicines as a Factor in Delirium. Imran Shuja Khawaja, MD, Rocco F. Marotta, ... more ... Letter. Herbal Medicines as a Factor in Delirium. Imran Shuja Khawaja, MD, Rocco F. Marotta, MD, Ph.D. and Steven Lippmann, MD ... References. Linde K, Ramirez G, Mulrow CD, et al: St John's wort for depression: an overview and meta-analysis of randomised clinical trials. ...
In this article, the authors provide an overview of the declining role of the psychiatrist in gro... more In this article, the authors provide an overview of the declining role of the psychiatrist in group psychotherapy. They surveyed 18 psychiatry residency training programs and found an overall decreased focus on group therapy training. The authors opine on the causes for this decline and why group therapy training is important for psychiatry residents, as well as provide several recommendations to encourage the inclusion of group psychotherapy training in residency programs. The authors believe that acquiring group therapy skills and providing group therapy can be an enjoyable experience for psychiatrists and beneficial to the patients.
THE ALMOST INEVITABLE EXPERIENCES OF LIFE-THREATENING TRAUMATA AND THE UBIQUITOUS CONFLICTS THAT ... more THE ALMOST INEVITABLE EXPERIENCES OF LIFE-THREATENING TRAUMATA AND THE UBIQUITOUS CONFLICTS THAT PROMOTE THESE EVENTS HAVE left countless survivors with persisting cognitive, autonomic, and behavioral sequelae. Known in previous ...
Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine
American Academy of Sleep Medicine (AASM) practice parameters indicate that split-night polysomno... more American Academy of Sleep Medicine (AASM) practice parameters indicate that split-night polysomnograms (SN-PSG) may be performed when the apnea hypopnea index (AHI) is > or = 20 to 40, depending on clinical factors. The aim of this study was to determine the diagnostic accuracy of SN-PSG, including at the lower range of AHIs. We reviewed 114 consecutive full-night PSGs (FN-PSG) performed at our center between August 2006 and November 2008 on subjects enrolled in studies in which obstructive sleep apnea (OSA) was the sleep disorder of interest. We compared the AHI from the first 2 hours (2 hr-AHI) and 3 hours (3 hr-AHI) of sleep with the "gold standard" AHI from FN-PSG (FN-AHI), considering OSA present if FN-AHI > or = 5. The 2 hr-AHI and 3 hr-AHI correlated strongly with the FN-AHI (concordance correlation coefficient [CCC] = 0.93 and 0.97, respectively). After adjusting for percentage of sleep in stage REM sleep and in supine position, the correlation of 2 hr- and 3...
Estimates are that 50-70 million Americans suffer from chronic disorder of sleep and wakefulness,... more Estimates are that 50-70 million Americans suffer from chronic disorder of sleep and wakefulness, hindering daily functioning and affecting health. Psychiatric illness is common among people who have a sleep disorder. The relationship between psychiatric illness and sleep disorders is bidirectional: People with mental illness often have sleep complaints, and a primary sleep disorder often resulting in neuropsychiatric complications. Obstructive sleep apnea is a comorbid disorder and patients with mental illness should be screened for OSA and treated if they have it.
This paper reviews the current knowledge of cardiovascular effects of the most commonly used nove... more This paper reviews the current knowledge of cardiovascular effects of the most commonly used novel antidepressants and their possible interactions with cardiovascular medications. The literature was reviewed through Medline 1980-2001. Materials were located by using terms such as SSRIs, individual names of novel antidepressants matched with terms like cardiovascular effects, cardiovascular diseases, cardiovascular risk factors, etc. Drug compendiums from 1998-2001 and some psychopharmacology texts were also used. The article focuses on the cardiovascular effects of the newer antidepressants, their use in patients with cardiovascular disease, and interactions with various commonly used cardiovascular drugs.
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, Jan 15, 2010
American Academy of Sleep Medicine (AASM) practice parameters indicate that split-night polysomno... more American Academy of Sleep Medicine (AASM) practice parameters indicate that split-night polysomnograms (SN-PSG) may be performed when the apnea hypopnea index (AHI) is > or = 20 to 40, depending on clinical factors. The aim of this study was to determine the diagnostic accuracy of SN-PSG, including at the lower range of AHIs. We reviewed 114 consecutive full-night PSGs (FN-PSG) performed at our center between August 2006 and November 2008 on subjects enrolled in studies in which obstructive sleep apnea (OSA) was the sleep disorder of interest. We compared the AHI from the first 2 hours (2 hr-AHI) and 3 hours (3 hr-AHI) of sleep with the "gold standard" AHI from FN-PSG (FN-AHI), considering OSA present if FN-AHI > or = 5. The 2 hr-AHI and 3 hr-AHI correlated strongly with the FN-AHI (concordance correlation coefficient [CCC] = 0.93 and 0.97, respectively). After adjusting for percentage of sleep in stage REM sleep and in supine position, the correlation of 2 hr- and 3...
ABSTRACT The category of sleep disorders known as parasomnias includes behavioral disturbances oc... more ABSTRACT The category of sleep disorders known as parasomnias includes behavioral disturbances occurring during sleep or states of mixed sleep and wakefulness. They can be minimal and confined to vocalizations or minor movements or of a magnitude that can lead to serious injury, disruption of relationships, and diagnostic ambiguity. Many can be mistakenly thought to represent manifestations of psychiatric disorders. Careful evaluation and therapy can prevent inappropriate psychiatric diagnosis, avoid ineffective treatment, and ameliorate the sleep disorders. Herein, many parasomnias will be brought to the attention of practicing psychiatrists who can learn to recognize enough of the most important clinical features to ensure appropriate consultation with a sleep medicine specialist.
... Letter. Herbal Medicines as a Factor in Delirium. Imran Shuja Khawaja, MD, Rocco F. Marotta, ... more ... Letter. Herbal Medicines as a Factor in Delirium. Imran Shuja Khawaja, MD, Rocco F. Marotta, MD, Ph.D. and Steven Lippmann, MD ... References. Linde K, Ramirez G, Mulrow CD, et al: St John's wort for depression: an overview and meta-analysis of randomised clinical trials. ...
Partial hospitalization programs represent a midpoint along the treatment intensity continuum bet... more Partial hospitalization programs represent a midpoint along the treatment intensity continuum between an inpatient and an outpatient service. Partial hospitalization programs can be used in place of an inpatient unit for patients who need crisis stabilization and amelioration of their acute symptoms, but who are not imminently homicidal or suicidal. Partial hospitalization programs can also manage adjustments in pharmacotherapy, conduct skills classes, and engage patients in group psychotherapy. In this article, the authors describe the roles and functions of partial hospitalization programs in today's spectrum of psychiatric services and describe the process of transition from an acute inpatient unit to a partial hospitalization programs.
Sleep disturbances are common in pregnancy. Insomnia is a frequent sleep disturbance experienced ... more Sleep disturbances are common in pregnancy. Insomnia is a frequent sleep disturbance experienced by pregnant women which can be primary or due to co-morbid conditions. The differential diagnosis of insomnia in pregnancy includes anxiety disorders, mood disorders, breathing related sleep disorders and restless legs syndrome. Early interventions to treat the sleep disturbance are recommended to avoid adverse pregnancy outcomes. Management strategies include improving sleep hygiene, behavioral therapies, and pharmacotherapy. The risks of pharmacotherapy must be weighed against their benefits due to the possible risk of teratogenicity associated with some medications. We searched PubMed and Google Scholar employing a combination of key words: pregnancy, sleep disturbances, Obstructive Sleep Apnea, Sleep disorders and insomnia. We included original studies, review articles, meta-analysis and systematic reviews in our search prioritizing articles from the last 10-15 years. Articles older than 15 years were only included if their findings had not been superseded by more recent data. Further selection of articles was done from bibliographies and references of selected articles. Sleep disturbances in pregnancy are common and cause considerable morbidity. Management includes a combination of non-pharmacological and pharmacological treatments carefully weighing the risks and benefits of each for the expectant mother and fetus.
... Letter. Herbal Medicines as a Factor in Delirium. Imran Shuja Khawaja, MD, Rocco F. Marotta, ... more ... Letter. Herbal Medicines as a Factor in Delirium. Imran Shuja Khawaja, MD, Rocco F. Marotta, MD, Ph.D. and Steven Lippmann, MD ... References. Linde K, Ramirez G, Mulrow CD, et al: St John's wort for depression: an overview and meta-analysis of randomised clinical trials. ...
In this article, the authors provide an overview of the declining role of the psychiatrist in gro... more In this article, the authors provide an overview of the declining role of the psychiatrist in group psychotherapy. They surveyed 18 psychiatry residency training programs and found an overall decreased focus on group therapy training. The authors opine on the causes for this decline and why group therapy training is important for psychiatry residents, as well as provide several recommendations to encourage the inclusion of group psychotherapy training in residency programs. The authors believe that acquiring group therapy skills and providing group therapy can be an enjoyable experience for psychiatrists and beneficial to the patients.
THE ALMOST INEVITABLE EXPERIENCES OF LIFE-THREATENING TRAUMATA AND THE UBIQUITOUS CONFLICTS THAT ... more THE ALMOST INEVITABLE EXPERIENCES OF LIFE-THREATENING TRAUMATA AND THE UBIQUITOUS CONFLICTS THAT PROMOTE THESE EVENTS HAVE left countless survivors with persisting cognitive, autonomic, and behavioral sequelae. Known in previous ...
Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine
American Academy of Sleep Medicine (AASM) practice parameters indicate that split-night polysomno... more American Academy of Sleep Medicine (AASM) practice parameters indicate that split-night polysomnograms (SN-PSG) may be performed when the apnea hypopnea index (AHI) is > or = 20 to 40, depending on clinical factors. The aim of this study was to determine the diagnostic accuracy of SN-PSG, including at the lower range of AHIs. We reviewed 114 consecutive full-night PSGs (FN-PSG) performed at our center between August 2006 and November 2008 on subjects enrolled in studies in which obstructive sleep apnea (OSA) was the sleep disorder of interest. We compared the AHI from the first 2 hours (2 hr-AHI) and 3 hours (3 hr-AHI) of sleep with the "gold standard" AHI from FN-PSG (FN-AHI), considering OSA present if FN-AHI > or = 5. The 2 hr-AHI and 3 hr-AHI correlated strongly with the FN-AHI (concordance correlation coefficient [CCC] = 0.93 and 0.97, respectively). After adjusting for percentage of sleep in stage REM sleep and in supine position, the correlation of 2 hr- and 3...
Estimates are that 50-70 million Americans suffer from chronic disorder of sleep and wakefulness,... more Estimates are that 50-70 million Americans suffer from chronic disorder of sleep and wakefulness, hindering daily functioning and affecting health. Psychiatric illness is common among people who have a sleep disorder. The relationship between psychiatric illness and sleep disorders is bidirectional: People with mental illness often have sleep complaints, and a primary sleep disorder often resulting in neuropsychiatric complications. Obstructive sleep apnea is a comorbid disorder and patients with mental illness should be screened for OSA and treated if they have it.
This paper reviews the current knowledge of cardiovascular effects of the most commonly used nove... more This paper reviews the current knowledge of cardiovascular effects of the most commonly used novel antidepressants and their possible interactions with cardiovascular medications. The literature was reviewed through Medline 1980-2001. Materials were located by using terms such as SSRIs, individual names of novel antidepressants matched with terms like cardiovascular effects, cardiovascular diseases, cardiovascular risk factors, etc. Drug compendiums from 1998-2001 and some psychopharmacology texts were also used. The article focuses on the cardiovascular effects of the newer antidepressants, their use in patients with cardiovascular disease, and interactions with various commonly used cardiovascular drugs.
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, Jan 15, 2010
American Academy of Sleep Medicine (AASM) practice parameters indicate that split-night polysomno... more American Academy of Sleep Medicine (AASM) practice parameters indicate that split-night polysomnograms (SN-PSG) may be performed when the apnea hypopnea index (AHI) is > or = 20 to 40, depending on clinical factors. The aim of this study was to determine the diagnostic accuracy of SN-PSG, including at the lower range of AHIs. We reviewed 114 consecutive full-night PSGs (FN-PSG) performed at our center between August 2006 and November 2008 on subjects enrolled in studies in which obstructive sleep apnea (OSA) was the sleep disorder of interest. We compared the AHI from the first 2 hours (2 hr-AHI) and 3 hours (3 hr-AHI) of sleep with the "gold standard" AHI from FN-PSG (FN-AHI), considering OSA present if FN-AHI > or = 5. The 2 hr-AHI and 3 hr-AHI correlated strongly with the FN-AHI (concordance correlation coefficient [CCC] = 0.93 and 0.97, respectively). After adjusting for percentage of sleep in stage REM sleep and in supine position, the correlation of 2 hr- and 3...
ABSTRACT The category of sleep disorders known as parasomnias includes behavioral disturbances oc... more ABSTRACT The category of sleep disorders known as parasomnias includes behavioral disturbances occurring during sleep or states of mixed sleep and wakefulness. They can be minimal and confined to vocalizations or minor movements or of a magnitude that can lead to serious injury, disruption of relationships, and diagnostic ambiguity. Many can be mistakenly thought to represent manifestations of psychiatric disorders. Careful evaluation and therapy can prevent inappropriate psychiatric diagnosis, avoid ineffective treatment, and ameliorate the sleep disorders. Herein, many parasomnias will be brought to the attention of practicing psychiatrists who can learn to recognize enough of the most important clinical features to ensure appropriate consultation with a sleep medicine specialist.
... Letter. Herbal Medicines as a Factor in Delirium. Imran Shuja Khawaja, MD, Rocco F. Marotta, ... more ... Letter. Herbal Medicines as a Factor in Delirium. Imran Shuja Khawaja, MD, Rocco F. Marotta, MD, Ph.D. and Steven Lippmann, MD ... References. Linde K, Ramirez G, Mulrow CD, et al: St John's wort for depression: an overview and meta-analysis of randomised clinical trials. ...
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