From the Pages of Psychiatric Times: December 2022

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In the December issue of Psychiatric Times^TM, we worked with experts from multiple psychiatric areas to bring you thoughtful articles about a wide variety of psychiatric topics, from the risk of tardive dyskinesia in antipsychotic use to updates on the biggest issues in mental health and psychiatric practice from 2022. Here are some highlights from the issue.

Assessing 2022: What’s the Prognosis in Psychiatry?

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Psychiatric issues continued to take center stage as the world stepped out of the depths of the COVID-19 pandemic. Was progress made, or did we stall? Psychiatric Times™ looked at some of the most pressing topics in psychiatry and mental health care as featured on our covers and asked leaders in the field to be the judge.

SDOMH: Time to Walk the Walk

What is the most important issue in mental health? In an online Psychiatric Times™ poll, 30.7% of respondents felt that social determinants of mental health (SDOMH) were the top issue of 2022. Notably, SDOMH landed on the first cover of the year and were a focus of discussion during the 2022 American Psychiatric Association (APA) Annual Meeting in May. Have things changed? Continue Reading

Beyond “Bad Behavior”: ADHD in Clinical Practice

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In this installment of Tales From the Clinic: The Art of Psychiatry, we look at a bread-and-butter case of attention-deficit/hyperactivity disorder (ADHD) from a child psychiatry clinic. Although very common, this disorder is surrounded by multiple questions that research is just beginning to unravel. It is subject to gender-norming and differential referral and diagnosis rates in females versus males, and even though it is highly heritable, ADHD is still labeled as “bad behavior” in many families.

Resistance to initiating psychotropic ADHD medications is prevalent despite extensive proof that treatment can successfully alter a child’s life trajectory in terms of academic achievements, interpersonal relationships, substance use, and criminal history. Continue Reading

Use of Antipsychotics: Risks of Tardive Dyskinesia

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A recent study found a 5.1% prevalence rate of tardive dyskinesia (TD) in patients with bipolar disorder (n = 1074) treated at Mayo Clinic and other sites in the Bipolar Disorder Biobank research collaborative. Investigators considered this rate a likely underestimate because milder cases may not have been diagnosed or reported. This study served as a sobering reminder of the significant frequency of this disfiguring and sometimes disabling adverse effect, which can be irreversible.

The study results were consistent with previously identified TD rates from second-generation antipsychotics (SGAs) found in meta-analyses—for example, a study by Carbon and colleagues that found an annualized rate of 2.6% per year. Risk factors that increase the rate include use in mood disorders, older individuals, women, those with alcohol use disorder, those with diabetes and cigarette dependence, and those who use anticholinergic drugs. Continue Reading

Eight Best Practices for Medical Malpractice Defense

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The best way to prevent a malpractice lawsuit is to prepare for the likelihood of being sued, experts say. The more prepared a physician is, the better the chances of a successful outcome. Although no physician can manage all the possible risks that lead to malpractice lawsuits, we asked experts to share their best practices and tips.

1. Acquire good malpractice insurance.

The least expensive insurance is not always best, said attorney Christopher J. Ryan, counsel and cochair of the health care litigation task force at Dickinson Wright in Ann Arbor, Michigan. Clinicians should look for insurance that comes with risk management tools that can add value to a practice. Physicians also should make sure they have a policy in place with an admitted carrier in their state, according to Tom Benvenuto, a senior trial attorney with Benvenuto & Slattery in Roslyn, New York. Continue Reading

See the full December issue of Psychiatric Times^TM here. And be sure to stay up-to-date by subscribing to the Psychiatric Times^TM 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.