Faculty Bibliography

Post-traumatic stress disorder (PTSD) induced by life-threatening medical events has been associated with adverse physical and mental health outcomes, but it is unclear whether early interventions to prevent the onset of PTSD after these events are efficacious. We conducted a systematic review to address this need. We searched six biomedical electronic databases from database inception to October 2018. Eligible studies used randomized designs, evaluated interventions initiated within 3 months of potentially traumatic medical events, included adult participants, and did not have high risk of bias. The 21 included studies (N = 4,486) assessed a heterogeneous set of interventions after critical illness (9), cancer diagnosis (8), heart disease (2), and cardiopulmonary surgery (2). Fourteen psychological, 2 pharmacological, and 5 other-type interventions were assessed. Four of the psychological interventions emphasizing cognitive behavioral therapy or meaning-making, 1 other-type palliative care intervention, and 1 pharmacological-only intervention (hydrocortisone administration) were efficacious at reducing PTSD symptoms relative to control. One early, in-hospital counseling intervention was less efficacious at lowering PTSD symptoms than an active control. Clinical and methodological heterogeneity prevented quantitative pooling of data. While several promising interventions were identified, strong evidence of efficacy for any specific early PTSD intervention after medical events is currently lacking.

OBJECTIVE:This is a pilot study which assesses the beliefs of psychiatric professionals regarding obtaining patient information via the Internet as well as the frequency with which they do it in a variety of clinical settings. METHODS:Psychiatry faculty and residents were asked to participate in an anonymous online survey about their use of the search engine Google to find information about their patients. Data were analyzed with Microsoft Excel. RESULTS:The participants included 48 faculty and 34 residents (118 faculty and 44 residents were surveyed) with response rates of 41% and 77%, respectively. Majority of attending physicians and residents reported engaging in patient-targeted googling with no significant difference between the groups. Residents were most likely to search for patient information online in the psychiatric emergency room (45%). Psychiatric emergency room (36.8%) and private practice (31.6%) were notable clinical settings for obtaining further patient information on the Internet for the faculty. When describing reasons for engaging in patient-targeted googling, "patient care" was cited about twice as often as "curiosity" in the psychiatric emergency room, whereas "curiosity" and "patient care" were reasons mentioned in other clinical settings. In general, neither faculty nor residents report informing their patients of their Internet searches either before or after engaging in patient-targeted googling. CONCLUSION:This study raises important questions about education for trainees and faculty regarding patient-targeted googling.

The increasing prevalence of cannabis use in the United States requires awareness of cannabis-related disorders and familiarity with treatment options. We present a case of cannabinoid hyperemesis syndrome that required psychiatric consultation for diagnostic clarification and effective treatment with intravenous haloperidol. Literature from emergency medicine, toxicology, and gastroenterology is reviewed, including proposed diagnostic criteria for cannabinoid hyperemesis syndrome and reported off-label treatment options, with a specific focus on clinical questions facing the practicing psychiatrist regarding this emerging disorder.