Faculty Bibliography

The widespread prevalence of coronavirus disease 2019 (COVID-19) means that inpatient psychiatric units will necessarily manage patients who have COVID-19 that is comorbid with acute psychiatric symptoms. We report a case of recurrence of respiratory symptoms and positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) testing in a patient on an inpatient psychiatric unit occurring 42 days after the initial positive SARS-CoV-2 RT-PCR test, 38 days after initial symptom resolution, and 30 days after the first of 3 negative SARS-CoV-2 RT-PCR tests. Over the course of the admission, the patient was safely initiated on clozapine. Recent literature on COVID-19's potential recurrence and neuropsychiatric effects is reviewed and implications for the management of COVID-19 on inpatient psychiatric units are discussed. In the era of COVID-19 and our still-developing understanding of this illness, psychiatrists' role as advocates and collaborators in our patients' physical health care has become even more critical.

OBJECTIVE:To determine the rate of healthcare utilization for older primary care patients by depression status. DESIGN/METHODS:Cross-sectional data analysis. SETTING/METHODS:Primary care practices, western New York state. PARTICIPANTS/METHODS:753 patients aged 65 years and older. MEASURES/METHODS:Diagnostic depression categories were determined using the Structured Clinical Interview for DSM-IV (SCID). The Cornell Services Index (CSI) measured outpatient medical visits. Demographic, clinical, and functional variables were obtained from medical records and interview data. RESULTS:41.23% had subsyndromal or minor depression (M/SSD) and 53.15% had no depression. The unadjusted mean number of outpatient medical visits was greater in those with M/SSD (3.96 visits within 3 months) compared to those without depression (2.84), with a significant difference after adjusting for demographic, functional, and clinical factors. CONCLUSION/CONCLUSIONS:Those with M/SSD had higher rates of healthcare utilization compared with those without depressive symptoms. Future research should examine whether interventions for older adults with M/SSD reduce healthcare utilization.