Psych Congress

Most commonly, depression severity is measured by instruments that focus on the symptoms of depression, said Mark Zimmerman, MD, director of outpatient psychiatry and the Partial Hospital Program at Rhode Island Hospital, and a professor of psychiatry at Brown Medical School.

There is a high prevalence of burnout, and maybe 2 or 3 factors contributing to that, explained W. Clay Jackson, MD, DipTh, clinical assistant professor of psychiatry, department of family medicine, University of Tennessee College of Medicine.

It isn’t often that a nurse practitioner is mobbed by audience members at the end of a session at a psychiatry conference, but Maria Mangini, PhD, FNP-BC, has hands-on, practical knowledge about using cannabis to bring relief to thousands of patients.

During a presentation at the US Psychiatric and Mental Health Congress in New Orleans, Louisiana, Mark Zimmerman, MD, said studies show that the presence of a comorbid disorder or specific symptom were the most important factors driving treatment decisions when clinicians picked an antidepressant, and anxiety was the symptom they cited most frequently.

With so many options for treatment-resistant depression, expert George Papakostas, MD, said all things being equal, the patient's preference counts.

Leslie Citrome, MD, MPH, of New York Medical College, discusses payer coverage of atypical antipsychotics with fewer metabolic side effects.

A survey of patients with ADHD showed that two-thirds of those who augment their morning medication do so because it stops working, and 42% have to plan their day around their medication fading.

There is a stigma that comes with being addicted to opioids, even if they are prescribed to manage pain, that can hurt the care patients need to receive, said Arwen Podesta, MD, ABPN, FASAM, ABIHM, of Tulane University.

Payers have made tremendous progress in improving oversight of opioids and other pain medications, but what is really needed is a shift to abuse-deterrent formulations, which are more expensive, said Thomas Kosten, MD, a psychiatrist with Baylor College of Medicine.

The debate over marijuana policy tends to be dominated by people with political "skin in the game," when what's needed is a balanced, evidenced-based review, said Kevin P. Hill, MD, MHS, of Beth Israel Deaconess Medical Center and Harvard Medical School.

Experts said that the frequency and quality of social relationships have a greater effect on mortality than obesity or drinking alcohol, and this commands attention from health systems.

Right now, state policy regarding medical marijuana use is out ahead of the science, which can lead to predicaments where cannabis is prescribed in situations where it is not needed, explained Kevin P. Hill, MD, MHS, of Beth Israel Deaconess Medical Center and Harvard Medical School.

Patients with childhood trauma may have reduced response to antidepressant agents, and physician need to be given more free rein to tailor treatment approaches to treat those with major depressive disorder, said Vladimir Maletic, MD, MS, clinical professor of neuropsychiatry and behavioral science at the University of South Carolina School of Medicine.

Changes under the DSM-5 mean that certain "mixed features" create a gray area of characteristics that could signal major depression or bipolar disorder, even if a patient has not exhibited hypomania.

Screening for depression in the primary care setting can take as little as 30 seconds, but screening is only effective if it actually leads to intervention, explained Michael E. Thase, MD, professor of psychiatry and director of the Mood and Anxiety Program at the University of Pennsylvania.

Studies show that the earlier a child with attention-deficit/hyperactivity disorder is treated with stimulants, the less likely he or she is to develop a substance abuse problem later in life.

The limited number of FDA approved medications indicated for bipolar depression makes treatment challenging, said Terence A. Ketter, MD. Several drugs that have been tested could not meet standards to receive an indication.

Becoming familiar with the subtle signs that a hallucination is fake can allow psychiatrists to keep patients out of the hospital when they have no business being there.

Presenters who have implemented telehealth to treat PTSD through the VA in Charleston, South Carolina, say it will help address shortages of mental health providers and offer care that is just as good as in-person treatment.

Studies show medication adherence in bipolar disorder is only about 40% to 45%, but this dangerous, progressive disease has a high suicide rate. Adherence is complicated by the fact that patients may miss the mild "high" that many associate with periods of creativity, says Kay Redfield Jamison, PhD.

Promising tests in animal models for an immunotherapy to control methamphetamine addiction have paved the way for human trials that could start in May 2016, according to Thomas Kosten, MD.

A 30-day intervention that includes exercise, nutrition, mindfulness, social connectedness, and sleep resulted in improved scores across a series of wellbeing measures for a small group of patients.

Peter Weiden, MD, says that psychiatrists have greater ability to address side effects from antipsychotics than they did 10 years ago. It's essential that clinicians take patient concerns seriously, because when they don't patients may react by stopping their medication.

Ten years of following patients who had a period of strong social supports after a first psychotic episode shows that the effects of that care wane over time once the help is removed. Joseph P. McEvoy, MD, of Georgia Regents University said the studies show the support should continue.

Michael E. Thase, MD, said that current antidepressants are "good, not great" but that there is interest in research into ketamine, even though researchers are not completely sure how it works.