Persisting Popularity of the Sweet 16 Saga

The continuing popularity of the Sweet 16 posts on this blog is starting to provoke a little wonder. They are consistently among the top posts and pages second usually only to the home page. I'm not sure what to make of it yet. Briefly, this story is probably about copyright law conflicts surrounding a brief … Continue reading Persisting Popularity of the Sweet 16 Saga

Can We Prevent Delirium Using Auricular Acupuncture?

  Hey, lend me your ears. I just read an article on preventing postoperative agitation using acupuncture. The authors checked for delirium using the Delirium Observation Screening Scale (DOS) and used press needles to prevent agitation after surgery in 4 elderly demented patients [1]. DOS scores were higher than 3 pre-op but much lower with … Continue reading Can We Prevent Delirium Using Auricular Acupuncture?

Testing for Executive Dysfunction, with Video

http://vimeo.com/5004177 This very thorough video can also be found at the link on the right hand side of this page. It was produced by the Hartford Institute. Testing for cognitive impairment doesn't have to take a lot of time. As a psychiatric consultant,  I frequently find it helpful to use some very brief tests for … Continue reading Testing for Executive Dysfunction, with Video

Has Anyone Been to the APA Free Workshops on Maintenance of Certification?

I've noticed that my blog post from April 21, 2011 about the free sessions on Maintenance of Certification (MOC) in Psychiatry that were to be presented at the American Psychiatric Association (APA) annual meeting held in Honolulu are suddenly again very popular. I think it's interesting because it's just a notice about the sessions being … Continue reading Has Anyone Been to the APA Free Workshops on Maintenance of Certification?

Is Delirium a Mental Illness and What Do Attorneys Think?

I've had some interesting interactions with attorneys about delirious patients in the emergency room, intensive care units, and in the general hospital over years. Frequently, medically ill patients who are delirious need admission to hospital to manage both the inciting medical problems and the behavioral disturbances that make them potentially dangerous to themselves and others. … Continue reading Is Delirium a Mental Illness and What Do Attorneys Think?

A Scale for Predicting Imminent Suicide On the Horizon

I'm a psychiatric hospitalist essentially and I'm called to the intensive care units daily to assess suicide risk for patients who have already attempted suicide or who've talked about thoughts, plans, or intentions for doing so. Although I was on duty and didn't get an opportunity to go to the American Psychiatric Association (APA) meeting … Continue reading A Scale for Predicting Imminent Suicide On the Horizon

Is Hepatic Encephalopathy A Synonym for Delirium?

I'm on an email list serve for transplant psychiatry and I saw a question from a PhD research assistant about "assessment of hepatic encephalopathy".  The question was about tests for this neuropsychological syndrome caused by liver disease. They include the Hepatic Encephalopathy Scaling Algorithm (HESA) and the Clinical Hepatic Encephalopathy Staging Scale (CHESS). These instruments … Continue reading Is Hepatic Encephalopathy A Synonym for Delirium?