Literature Review
All posts tagged with “Clinical News | Mental Illness.”
What the experiences of young persons can teach us about medical aid in dying for psychiatric illness
01/11/25 at 03:20 AMWhat the experiences of young persons can teach us about medical aid in dying for psychiatric illnessJAMA Psychiatry; Brent Kious, MD, PhD; 1/25Medical aid in dying (MAID) is becoming ever more available. While it is most often used by persons with terminal illnesses, it is also becoming more accessible to those with a primary psychiatric illness. Some countries, including the Netherlands, have long allowed MAID for persons experiencing unbearable and irremediable suffering due to a mental illness. In Canada, Quebec’s Superior Court ruled in 2019 that restricting MAID to persons with a “reasonable foreseeable natural death” violates key sections of the Canadian Charter, implying that MAID must be made available to persons with nonterminal conditions, including psychiatric illness. Meanwhile, while only persons with terminal illness can access MAID in those parts of the US that have legalized it, some physicians have argued that certain psychiatric illnesses, especially anorexia nervosa, can be terminal, opening the door to MAID for persons with a primary psychiatric illness.
Palliative care for mental illness: A podcast with Dani Chammas and Brent Kious
01/08/25 at 03:00 AMPalliative care for mental illness: A podcast with Dani Chammas and Brent KiousGeriPal Podcast; by Eric Widera, Alex Smith, Dani Chammas, Brent Kious; 12/19/24We’ve talked a lot before about integrating psychiatry into palliative care. Still, we haven’t talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. On this week’s podcast, we talk with two experts about palliative psychiatry. We invited Dani Chammas, a palliative care physician and psychiatrist at UCSF (and a frequent guest to the GeriPal podcast), as well as Brent Kious, a psychiatrist at the Huntsman Mental Health Institute, focusing on the management of severe persistent mental illnesses.
[Australia] Why mental health clinicians are not engaging in advance care planning with older people with schizophrenia and other psychotic illnesses
12/21/24 at 03:50 AM[Australia] Why mental health clinicians are not engaging in advance care planning with older people with schizophrenia and other psychotic illnessesPsychology Research and Behavior Management; Anne P F Wand, Aspasia Karageorge, Yucheng Zeng, Roisin Browne, Megan B Sands, Daniella Kanareck, Vasi Naganathan, Anne Meller, Carolyn M Smith, Carmelle Peisah; 12/24These clinician-identified attitudes, experiences, and barriers to engagement in ACP [advance care planning] with older people with psychotic illnesses highlight avenues of potential intervention to facilitate ACP in this cohort. Given the complexity of issues, clinicians need education and training in ACP combined with clear processes and policies to support practice. Clinician insights should be combined with the perspectives of older consumers with psychotic illnesses and their families to inform implementation of ACP.
Our unrealized imperative: Integrating mental health care into hospice and palliative care
12/14/24 at 03:00 AMOur unrealized imperative: Integrating mental health care into hospice and palliative careJournal of Palliative Medicine; Susan Block; 12/24The field of Hospice and Palliative Medicine (HPM) has its roots in the principles, promulgated by Dame Cicely Saunders, that patient and family are the unit of care and that comprehensive integration of physical, psychological, social, and spiritual care is necessary to address suffering in all its dimensions. Although we aspire to provide comprehensive care for our patients, most hospice and palliative care (HPM) physicians lack basic competencies for identifying and managing patients with psychological distress and mental health distress and disorders, a growing segment of our clinical population. I propose strategies to address these challenges focused on enhancing integration between psychiatry/psychology and HPM, changes in fellowship education and faculty development, addressing the stigma against people with mental health diagnoses, and addressing system and cultural challenges that limit our ability to provide the kind of comprehensive, integrative care that our field aspires to.
Suicide deaths among adolescent and young adult patients with cancer
11/23/24 at 03:20 AMSuicide deaths among adolescent and young adult patients with cancerJAMA Network Open; Koji Matsuo, MD, PhD; Christina J. Duval, BA; Briana A. Nanton, BS; Jennifer A. Yao, BA; Erin Yu, BS; Christian Pino, MD; Jason D. Wright, MD; 11/24The overall cancer incidence among adolescent and young adult (AYA) patients is increasing at an alarming rate in the US largely driven by thyroid cancer. Although cancer mortality continues to decrease among AYA patients, those who survive cancer are at elevated risk for emotional distress, mental health problems, and suicide. Together with the population-level increase in the US suicide death rate, the results of this assessment call for attention focused on the increasing suicide death rate among AYA patients with cancer, particularly male individuals. The proportion of AYA patients with cancer of thyroid, testis, or cutaneous melanoma who had a suicide death was greater than 2%, and they most benefit from a psychosocial and mental health evaluation. Because this study noted that many suicide deaths among these AYA patients with cancer occur years after the cancer diagnosis, long-term care and support for cancer survivors is recommended.
Comorbid depression in patients with head and neck cancer compared with other cancers
11/16/24 at 03:35 AMComorbid depression in patients with head and neck cancer compared with other cancersJAMA Otolaryngology-Head Neck Surgery; Marina C. Martinez,; Andrey Finegersh, MD, PhD; Fred M. Baik, MD; F. Chris Holsinger, MD; Heather M. Starmer, PhD, CCC-SLP, BCS-S; Lisa A. Orloff, MD; John B. Sunwoo, MD; Davud Sirjani, MD; Vasu Divi, MD; Michelle M. Chen, MD, MHS; 10/24This cohort study found that patients with HNC were twice as likely to screen positive for depression on a validated survey than those with other cancers, despite having similar rates of self-reported depression and depression medication use. These findings suggest that self-reporting of depression may result in underreporting and undertreatment in this population and, thus, a need for further work in developing interventions to improve identification of and optimize treatment for patients with HNC and comorbid depression.
[UK] Large language models for mental health applications: Systematic review
11/09/24 at 03:00 AM[UK] Large language models for mental health applications: Systematic reviewZhijun Guo, Alvina Lai, Johan H Thygesen, Joseph Farrington, Thomas Keen, Kezhi Li; 10/24The study identifies several issues: the lack of multilingual datasets annotated by experts, concerns regarding the accuracy and reliability of generated content, challenges in interpretability due to the "black box" nature of LLMs [large language models], and ongoing ethical dilemmas. These ethical concerns include the absence of a clear, benchmarked ethical framework; data privacy issues; and the potential for overreliance on LLMs by both physicians and patients, which could compromise traditional medical practices. As a result, LLMs should not be considered substitutes for professional mental health services. However, the rapid development of LLMs underscores their potential as valuable clinical aids, emphasizing the need for continued research and development in this area.
Clinician perspectives on palliative care for older adults with serious mental illnesses: A multisite qualitative study
10/26/24 at 03:15 AMClinician perspectives on palliative care for older adults with serious mental illnesses: A multisite qualitative studyThe American Journal of Geriatric Psychiatry; by Daniel Shalev, Maureen Ekwebelem, Lilla Brody, Karolina Sadowska, Sanam Bhatia, Dania Alvarez, Catherine Riffin, M Carrington Reid; 9/24Approximately 5.5% of the population live with serious mental illnesses (SMI). Older adults with SMI experience a high burden of serious medical illnesses and disparities in advance care planning, symptom management, and caregiver support. The objectives of this study are to explore interdisciplinary clinician perspectives on the palliative care needs of older adults with SMI and serious medical illnesses... Major themes identified were: (1) Current paradigms of palliative care do not meet the needs of patients with SMI; (2) Clinicians are motivated to care for this population but require more training and interdisciplinary practice; (3) There is a need for structural integration of psychiatric and palliative care services. The study underscores the inadequacy of current palliative care models in meeting the unique needs of older adults with SMI. Models of integrated psychiatric and serious illness care and enhanced training are needed to improve the delivery of palliative care. Integrated care models and workforce development at the interface of serious illness care and psychiatric have the potential to improve outcomes for this vulnerable population.
[Canada] Cognitive symptoms across diverse cancers
09/21/24 at 03:00 AM[Canada] Cognitive symptoms across diverse cancersJAMA Network Open; Samantha J. Mayo, RN, PhD; Kim Edelstein, PhD; Eshetu G. Atenafu, MSc, PStat; Rand Ajaj, HBSc; Madeline Li, MD, PhD; Lori J. Bernstein, PhD; 8/24In this cross-sectional study of 5078 survey respondents with cancer seeking psychosocial support, over half of these patients reported having cognitive symptoms of any severity. A third of these patients reported moderate to severe cognitive symptoms, which were associated with disease, treatment, and other symptoms. Findings of this study suggest that higher severity of cognitive symptoms was consistently associated with higher symptom burden; these findings could be used to inform decision-making regarding access to cognitive screening, assessment, and supportive care in outpatient oncology clinics.
Psychological trauma can worsen symptom burden at end-of-life
05/17/24 at 03:00 AMPsychological trauma can worsen symptom burden at end-of-life Hospice News; by Holly Vossel; 5/15/24 Recent research has found that traumatic experiences can lead to increased pain and symptom burden at the end of life, along with a greater likelihood of emotional suffering and isolation. Collective trauma experiences have been associated with higher instances of pain and dyspnea among more than half of seniors nationwide, a recent study found, published in the Journal of Pain and Symptom Management. Traumatized seniors are also more likely to experience loneliness, dissatisfaction with their life and depression. ... Hospices need a greater understanding of both the depth of these patients’ suffering and the scope of their unique needs to improve trauma-informed care delivery, [Dr. Ashwin] Kotwal said, assistant professor of medicine at the University of California San Francisco’s (UCSF) Division of Geriatrics.
Few hospitals follow recommended practices for evidence-based suicide care
03/14/24 at 03:00 AMFew hospitals follow recommended practices for evidence-based suicide care Pew, by Farzana Akkas; 3/12/24 In 2022, suicide claimed the lives of an estimated 49,449 people in the United States. ... Research has shown that almost half of those who die by suicide interact with the health care system within four weeks of their deaths. And those who are hospitalized for suicide risk face an elevated risk of dying by suicide post-discharge, making this a critical time for these patients to have access to resources, support, and care that can keep them safe in the event of a suicidal crisis. But new research shows that only 8% of hospitals in the U.S. have instituted all the key components of evidence-based, best-practice interventions to help at-risk patients who are discharged after receiving care. In fact, more than 1 in 4 are not conducting any of these interventions.
Rising suicide risk among seniors due to loneliness, mobility, financial insecurity, study finds
03/07/24 at 02:00 AMRising suicide risk among seniors due to loneliness, mobility, financial insecurity, study finds McKnights Home Care, by Adam Healy; 3/5/24As the number of adults over 65 continues to grow, suicide rates among older adults have also been rising, according to data from the National Center for Health Statistics. Between 2008 and 2017, the share of suicide-related emergency department visits among adults 65 years and older more than doubled. These older adults face age-related stressors that can negatively affect mental health, such as declining physical health, reduced mental sharpness, or the loss of friends or loved ones, which can heighten the risk of suicide.
Death by Doctor May Soon Be Available for the Mentally Ill in Canada
12/29/23 at 03:50 AMDeath by Doctor May Soon Be Available for the Mentally Ill in CanadaNew York TimesDecember 27, 2023Canada already has one of the most liberal assisted death laws in the world, offering the practice to terminally and chronically ill Canadians. But under a law scheduled to take effect in March assisted dying would also become accessible to people whose only medical condition is mental illness, making Canada one of about half a dozen countries to permit the procedure for that category of people. That move has divided Canadians, some of whom view it as a sign that the country’s public health care system is not offering adequate psychiatric care, which is notoriously underfunded and in high demand.
Palliative-Behavioral Health Collaborations Benefit Patients with Serious Mental Illnesses
12/17/23 at 04:00 AMPalliative-Behavioral Health Collaborations Benefit Patients with Serious Mental IllnessesPalliative Care NewsDecember 15, 2023Palliative care providers have opportunities to bridge gaps of unmet needs among patients who have serious mental illnesses and their families. ... Building up community-based palliative and mental health care collaborations will be crucial to supporting a growing population of seniors with SMIs with complex needs, he [Dr. Andrew Esch, palliative care physician and senior education advisor at the Center to Advance Palliative Care] said. ... Some of the most common SMIs among seniors include bipolar disorder, schizophrenia, borderline personality disorder and post traumatic stress and major depression, among others.