Deep Brain Stimulation for Treatment-Refractory Depression

: Depression has a high lifetime prevalence and recurrence rate, with more than one-third of affected patients experiencing treatment-refractory depression. These individuals should benefit from additional treatment options such as deep brain stimulation (DBS), a research-grade intervention. DBS is being investigated for its efficacy in treatment-refractory cases. We reviewed...

Pharmacogenomics Can Enhance Prescribing of Psychiatric Medications

Many psychiatric patients experience pharmaceutical intolerances, and some of them do not derive optimal efficacy from their pharmacotherapies. Clinical problems such as these may result in prolonged dysfunction, adverse consequences, and repeated changes in medication treatment regimens. Pharmacogenomics is a laboratory method that aids individualized medication selection by predicting...

Mental Health Impact of Hosting Disaster Refugees: Analyses from a Random Sample Survey Among Haitians Living in Miami

Objectives: Studies on the mental health of families hosting disaster refugees are lacking. This study compares participants in households that hosted 2010 Haitian earthquake disaster refugees with their nonhost counterparts. Methods: A random sample survey was conducted from October 2011 through December 2012 in Miami-Dade County, Florida. Haitian participants...

Homelessness and Emergency Psychiatric Evaluations

To the Editor: Homelessness is associated with increased illness burden and increased utilization of emergency health services.1,2 Mental illness and substance abuse are both common in the homeless population.2 Major societal distress from events such as Superstorm Sandy has been associated with increased rates of homelessness and emergency department...

Special Series on Mental Health

Featured in this issue of the Southern Medical Journal is a short series of articles on mental health, a clinical care challenge in the United States. The articles address a range of mental health issues, identifying the characteristics of certain disorders and proposing interventions of promise. The purpose of...

Commentary on “Impact of Nutrition on Neurocognition”

We live in the information age. In this month’s issue of the Southern Medical Journal, Yeh and Kaliebe1 clearly explicate this flood of information and the ease of obtaining data--it is now the song that sticks in our heads. I am dating myself with the introductory quote, but this...

Commentary on “One-Visit Behavioral Intervention for Older Primary Care Patients with Mild to Moderate Depressive Symptoms”

Everyone wants to feel well. Doctors try to mitigate illness and promote health. Patients and physicians optimally strive to achieve a team approach to a partnership that promotes...

Conversion Disorder in an Appalachian Community

Objectives: Conversion disorder (CD) is believed to be the manifestation of physical and/or neurological symptoms for primary gain without an identifiable organic cause. Although it is believed to be more common in rural areas, the literature examining this claim is sparse. To our knowledge, no study has been published...

One-Visit Behavioral Intervention for Older Primary Care Patients with Mild to Moderate Depressive Symptoms

Objectives: We pilot tested a one-visit behavioral intervention with telephone follow-up for older primary care patients with mild to moderate depressive symptoms. Methods: A total of 16 English-speaking primary care patients aged 60 years and older who scored 5 to 14 on the Patient Health Questionnaire-9 (PHQ-9) engaged in...

Impact of Nutrition on Neurocognition

Today’s media-saturated environment bombards us with a constant stream of information about the latest diet ‘‘do’s and don’ts.’’ The 2015-2020 US Department of Agriculture and Department of Health and Human Services’ Dietary Guidelines for Americans have generated much online attention for both stated and unstated recommendations. Simply described, these...

Relation Between Physicians’ Work Lives and Happiness

Objectives: Although we know much about work-related physician burnout and the subsequent negative effects, we do not fully understand work-related physician wellness. Likewise, the relation of wellness and burnout to physician happiness is unclear. The purpose of this study was to examine how physician burnout and wellness contribute to...

Feasibility of Canine Therapy Among Hospitalized Pre–Heart Transplant Patients

Objectives: Canine-assisted therapy (CAT) has been used in many settings with much success, yet no study has assessed its feasibility and receptiveness in hospitalized patients awaiting heart transplantation. Methods: Patients admitted to our institution with a status I for heart transplantation during a 12-month period (April 2014–April 2015) were...

Depression in Heart Failure: Is It Well Recognized?

To the Editor: Heart failure (HF) is a serious entity affecting not only the physical health but also the mental health of individuals. Approximately 5 million people in the United States have HF.1 In the midst of guideline-directed therapy and prevention of hospital readmission for HF, depression often is...

Plane-Assisted Suicide

To the Editor: The March 2015 crash of the Germanwings jetliner has brought the term “plane-assisted suicide” into the popular lexicon. Certainly, the role of mental health treatment in preventing such tragedies will be considered. What role can psychiatrists and other mental health providers play in...

Differentiating Bipolar Disorder from Attention-Deficit/Hyperactivity Disorder in Children

To the Editor: Bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD) are two mental health conditions of childhood with high degrees of comorbidity. BD is a recurrent, familial ailment that occurs in 1% to 3% of youth, particularly in adolescents.1 The persistence and rapid change in symptoms at crucial stages...

Effects of Cocaine-Positive Urine Screens on Serum Thyrotropin Levels in Patients Admitted to an Inpatient Mental Health Unit

Objective: To assess the effect of a positive urine screen for cocaine on thyrotropin (TSH, also thyroid-stimulating hormone) concentrations. Methods: In this retrospective cohort study, patients admitted to the mental health unit at an academic inpatient setting with a diagnosis of cocaine dependence or cocaine intoxication were routinely screened...

Implementation of a CIWA-Ar Alcohol Withdrawal Protocol in a Veterans Hospital

Objectives: The South Texas Veterans Health Care System (STVHCS) implemented a Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)–based alcohol-withdrawal protocol in June 2013. The aim of this study was to determine the efficacy and safety of the new protocol. The primary objective was the evaluation of whether...

VHA Chaplaincy Contact with Veterans at Increased Risk of Suicide

Objectives: To examine the extent to which chaplains interact with military veterans at increased risk of suicide and select characteristics related to those at-risk veterans who present for chaplaincy services. Methods: The nationwide network of chaplains affiliated with the Veterans Health Administration (n = 990) was e-mailed a letter...

Commentary on “VHA Chaplaincy Contact with Veterans at Increased Risk of Suicide”

As America’s wars overseas wind down, military veterans are faced with stressors beyond those of combat dangers. Depression, substance abuse, and posttraumatic stress disorder contribute to the increasing rate of suicide among veterans. According to the data, 22 veterans commit suicide every day in the United States.1 Suicidality disproportionately...

Depression, Somatic Symptoms, and Perceived Neighborhood Environments Among US-Born and Non-US-Born Free Clinic Patients

Objectives: The study’s purpose was to examine the impact of somatic symptoms and perceived neighborhood environment on depression using a comparison among US-born and non–US-born free clinic patients. Methods: US-born English speakers (n = 99), non–US-born English speakers (n = 89), and non–US-born Spanish speakers (n = 158) 18...