From the Pages of Psychiatric Times: April 2024

In the April issue of Psychiatric Times®, we worked with experts from multiple psychiatric areas to bring you thoughtful articles about a wide variety of psychiatric topics, from managing borderline personality disorder in obstetrics units to the assessment and treatment of insomnia in older adults. Here are some highlights from the issue.

Managing Suicidal Thoughts, Behaviors, and Risk in Treatment-Resistant Depression

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Suicidal thoughts and behaviors (STBs) are among the most dreaded complications of treatment-resistant depression (TRD), which is associated with elevated risk of death from suicide as well as from other conditions, even when compared with nonresistant depression.

According to 1 meta-analysis, the overall incidence of suicide and suicide attempts among adults with TRD is between 2 and 10 times that of individuals with nonresistant depression. Approximately 30% of individuals with TRD attempt suicide at least once in their lifetime, compared with about 15% of those with nonresistant depression. Even when compared with individuals with unipolar depression, patients with a history of TRD should be considered at high risk for STBs. Continue Reading

Management of Borderline Personality Disorder in an Obstetric Unit

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Providing care to individuals with borderline personality disorder (BPD) within inpatient medical settings can bring unique challenges for patients and medical teams. Individuals with BPD are more likely to have limited medical literacy, engage in challenging behavior and verbal altercations with their medical team, and be psychiatrically misdiagnosed.

They also often are considered high-risk patients in hospital settings due to the increased possibility of intentional or unintentional self-harm behaviors. These include overdoses, impulsive verbal arguments, unprotected sexual activity, poor medication and treatment adherence, nonsuicidal self-injurious behaviors, and suicide attempts. Continue Reading

Assessing and Treating Insomnia in Older Adults

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In humans, sleep is divided into nonrapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. The non-REM sleep consists of 3 stages (N1-N3), with N1 and N2 being considered lighter stages of sleep, and N3 being considered as deep sleep. In healthy adults, sleep starts with NREM sleep and is then followed shortly by REM sleep. During a normal night’s sleep, there are 4 to 5 alterations between NREM and REM sleep.

Electroencephalogram (EEG) recordings show increasing voltage and decreasing frequency as NREM sleep progresses into deeper stages. The heart rate and blood pressure also decline during NREM sleep, whereas gastrointestinal motility and parasympathetic activities increase. In REM sleep, there are bursts of rapid eye movements, but there is significant loss of muscle tone. Continue Reading

Unraveling Minds: The Impact of Global Climate Change on Mental Health

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Climate change presents a global public emergency with drastic impact on human physical and mental health. As most research has been happening in Western countries, there is a lack of information from developing countries… Climate change is considered a destructive reality with severe consequences for the future. The World Health Organization estimates an increase of 250,000 excess deaths per year between 2030 and 2050 due to the “well-understood impacts of climate change.”

The connection between climate change and mental health is still underresearched, primarily because of the heterogeneity of studies to measure the impact of climate change on mental health. Explanatory models have proposed direct and indirect effects of climate change on mental health. Continue Reading

See the full April issue of Psychiatric Times here. And be sure to stay up-to-date by subscribing to the Psychiatric Times E-newsletter.

Do you have a comment on any of these or other articles? Have a good idea for an article and want to write? Interested in sharing your perspectives? Write to us at PTeditor@mmhgroup.com.