Faculty Bibliography

OBJECTIVE:Mental health providers experience inappropriate sexual behavior from patients. It is unclear if training programs adequately prepare trainees to respond to such behaviors. Additionally, trainees may not seek support and guidance from supervisors after an incident. This is an exploratory study to document the prevalence of and assess the preparedness of trainees to deal with inappropriate sexual behavior. METHODS:A survey was administered to 58 psychiatry residents and 14 psychology interns at the NYU School of Medicine. A total of 22 questions were asked regarding participants' experiences with inappropriate sexual behavior, including prevalence of, and preparedness during, and support received after the behavior. RESULTS:Of those who completed the survey, 89% of respondents had experienced inappropriate sexual behavior. Seventy percent said they had no training in responding to inappropriate sexual behavior, and 95% wanted more training. A minority of respondents consistently sought support after these events, and of those who did, only 60% of trainees did so with a supervisor. CONCLUSION/CONCLUSIONS:Experiences involving inappropriate sexual behavior are prevalent among the mental health trainees surveyed, but most trainees did not feel that they received adequate training in preparation for or supervision after their experiences. Creating training or establishing protocols to respond to inappropriate sexual behavior may help trainees feel more capable and safer. Further studies are needed to understand inappropriate sexual behavior's impact on trainees and patient care, as well as to assess the efficacy of training and protocols developed to manage inappropriate sexual behavior.

Mr. J, age 54, is agitated, disruptive, and claims to be the 'son of Jesus Christ.' He left his job and family to travel to the Middle East to be baptized. What could be causing his symptoms?

OBJECTIVE: The teaching hospitals of the New York University psychiatry residency program were evacuated and then closed for a minimum of 3 months in the aftermath of Superstorm Sandy. Faculty and residents were deployed to alternate clinical sites. The authors examine the consequences of Superstorm Sandy and its implications for the New York University psychiatry residency training program. METHODS: A survey was administered to faculty and residents. RESULTS: The authors tabulated 98 surveys, for which 24 % of faculty and 84 % of residents responded. Among respondents, 61 % believed that being involved in the evacuation of the hospitals was a positive experience. During deployment, most (85 %) found being placed with peers and supervisors to be beneficial, but there were significant disruptions. CONCLUSION: Despite facing multiple challenges including closed facilities, deployment to nonaffiliated hospitals, and exhausted personal resources, the training program continued to provide accredited clinical experiences, a core curriculum, and supervision for psychiatry residents during and after Superstorm Sandy.

INTRODUCTION: Increased mortality in people with schizophrenia, compared to the general population, has been consistently reported worldwide. This mortality has been attributed predominantly to "unnatural" deaths-suicide, accidents, and homicide. Recent studies have shown an increase in natural causes of death. Our objective is to compare the mortality of schizophrenic and schizoaffective subjects to the general US population. METHODS: 319 Olmsted County residents meeting DSM-IV-TR criteria for schizophrenia or schizoaffective disorder seen at the Mayo Clinic between 1950 and 1980 were followed until February 2005 for a median of 23.5 years. RESULTS: At the end of follow-up, 44% of patients were deceased. Mortality was significantly (p<0.001) increased compared to the Caucasian population in the US for persons of like age, gender, and calendar year of birth. The median survival following diagnosis was 36.2 years. Death certificate cited cause of death was cardiac (29%), cancer--including lung (19%), and pulmonary disease (17%). Concerningly, there was no association with the year of diagnosis to survival. CONCLUSIONS: Tsuang and colleagues showed in 1975 that mortality in schizophrenics and later, those with schizoaffective disorder was significantly increased compared to the US general population. Thirty years later, with a demographically similar population, we have found the same pattern of increased mortality. In light of continued improvements in the general population's lifespan, the survival gap in schizophrenia/schizoaffective disorder appears to be increasing.