The Practice of Psychiatric E-Consultation: Current State and Future Directions.

OBJECTIVE: This article summarizes the existing literature on psychiatric electronic consultation (e-consultation or e-consult) to provide guidance on psychiatric e-consult practice and suggest next steps in research on psychiatric e-consults. METHOD: A narrative review was conducted using relevant search terms in PubMed and Google Scholar. RESULTS AND DISCUSSION: The psychiatric e-consult is a method of asynchronous consultation between primary care providers and psychiatric specialists that is associated with primary care provider satisfaction and promotes access to specialist guidance in mental health care. Major themes in the literature include contextual factors that affect implementation of psychiatric e-consult services, outcomes associated with psychiatric e-consults, and specific practical considerations that may affect psychiatric e-consult technique. CONCLUSIONS: Psychiatric e-consults may help address the widespread lack of access to specialty psychiatric care. Further studies are needed to examine clinical outcomes based on psychiatry e-consults.

Impact of motor stroke on novel and conventional action metaphor comprehension.

Previous studies indicate that damage to motor brain regions impacts comprehension of literal action-related language. However, whether such damage also impacts comprehension of action-metaphors remains unknown. Such a finding would support the notion that metaphors are grounded in sensorimotor representations. Here we tested this hypothesis by comparing comprehension of novel, conventional, and frozen action and non-action metaphors in 14 right-handed adults with right-sided mild to moderate paresis following left hemisphere motor stroke and 23 neurotypical participants. Consistent with our hypothesis, results indicated that only in the stroke group, accuracy for action metaphors was significantly lower than for non-action metaphors. Further, in the stroke group, accuracy was significantly worse in the following pattern: novel < conventional < frozen action metaphors. These results strongly support the notion that motor-related brain regions are important not only for literal action-related language comprehension, but also for action-related metaphor comprehension, especially for less familiar metaphors.