Impact of a Medical Student-Run Bingo Group on Psychiatry Inpatients and Students.

Medical students have few opportunities to lead patient groups during their clinical year. During the psychiatry clerkship, they are group observers and do not have the skills to lead psychotherapy or treatment groups. This report describes a bingo group led by medical students on an inpatient psychiatry unit. The group provides leadership opportunities for students lacking advanced group training, enables student integration into the ward, and reduces stigma. Patients find it easier to engage and benefit from socialization and improved cognitive and ego functioning. The group also provides continuity of care when staffing changes. Clerkship directors are encouraged to consider such a program.Prim Care Companion CNS Disord 2024;26(1):23m03576. Author affiliations are listed at the end of this article.

Rare Encounters: Medical Students Give Assertive Community Treatment Team Visits Rave Reviews.

OBJECTIVE: For 8 years, Albert Einstein College of Medicine students have worked with the Bronx Psychiatric Center Assertive Community Treatment (ACT) team. We relate the medical student ACT team experience using the ratings and words of the students themselves. We describe the history, evolution, and structure of this novel program. METHODS: Third-year medical students (N = 120) spent 1 day of their 6-week psychiatry clerkship visiting patients with the multidisciplinary ACT team. At the end of the clerkship, they were asked to complete a voluntary, anonymous survey of the entire clerkship experience, one component of which was the ACT team experience. A Likert scale of 1-5 was used (5 = excellent and 1 = unsatisfactory). The ACT program was initiated in October 2007, had a 3-year hiatus, and was restarted in 2011. RESULTS: Fifty-five of the students completed the survey. Seven of the students gave no numerical rating to the ACT team experience and wrote only very favorable comments. In the remaining 48 evaluations, 61% gave the ACT team experience an excellent rating; an additional 30% gave it a very good rating. The students expressed their enthusiasm for this program, calling it a "great" experience. Other student comments included the following: "Good example of how patients can have continuity of care and stability." "A MUST. It was worth seeing how patients live and interact in home environments." "Incredible experience seeing the role psychiatrists play in the community." "One-of-a-kind experience that is different from anything else in medical school." CONCLUSIONS: ACT teams are an underutilized medical student teaching tool. It is hoped that this review will encourage other schools and program directors to adopt an ACT team training model.

Exercise as a Treatment for Schizophrenia: A Review.

Schizophrenia is a mental disorder that is characterized by progressive cognitive impairment in areas of attention, working memory, and executive functioning. Although no clear etiology of schizophrenia has been discovered, many factors have been identified that contribute to the development of the disease, such as neurotransmitter alterations, decreased synaptic plasticity, and diminished hippocampal volume. Historically, antipsychotic medications have targeted biochemical alterations in the brains of patients with schizophrenia but have been ineffective in alleviating cognitive and hippocampal deficits. Other modalities, such as exercise therapy, have been proposed as adjuvant or primary therapy options. Exercise therapy has been shown to improve positive and negative symptoms, quality of life, cognition, and hippocampal plasticity, and to increase hippocampal volume in the brains of patients with schizophrenia. This article will briefly review the clinical signs, symptoms and proposed etiologies of schizophrenia, and describe the current understanding of exercise programs as an effective treatment in patients with the disease.

Bright Light Therapy: Seasonal Affective Disorder and Beyond.

Since the first description of Seasonal Affective Disorder (SAD) by Rosenthal et al. in the 1980s, treatment with daily administration of light, or Bright Light Therapy (BLT), has been proven effective and is now recognized as a first-line therapeutic modality. More recently, studies aimed at understanding the pathophysiology of SAD and the mechanism of action of BLT have implicated shifts in the circadian rhythm and alterations in serotonin reuptake. BLT has also been increasingly used as an experimental treatment in non-seasonal unipolar and bipolar depression and other psychiatric disorders with known or suspected alterations in the circadian system. This review will discuss the history of SAD and BLT, the proposed pathophysiology of SAD and mechanisms of action of BLT in the treatment of SAD, and evidence supporting the efficacy of BLT in the treatment of non-seasonal unipolar major depression, bipolar depression, eating disorders, and ADHD.

A Survey of American and Canadian Psychiatry Residents on Their Training, Teaching Practices, and Attitudes Toward Teaching.

OBJECTIVE: Formal training for residents-as-teachers in psychiatry is increasingly emphasized. However, little is known about the quantity and content of residents' teaching, their attitudes toward teaching, or the training received on how to teach. METHODS: An online survey was disseminated to American and Canadian psychiatry residents. RESULTS: Three hundred eighty-two residents from all postgraduate years (PGY) responded, representing about 7 % of all trainees. About half of PGY-1 have not received residents-as-teachers training, but by PGY-3 most have. The majority of respondents reported teaching, most commonly 1-5 h. Most found teaching enjoyable or rewarding (n = 304; 87 %); however, 40 % (n = 138) found teaching burdensome, 43 % (n = 151) lacked sufficient time to teach, and many (n = 226; 64 %) reported insufficient feedback from supervisors. CONCLUSIONS: Although the sampling methodology and low response rate limit the generalizability of findings, respondents typically seemed to value teaching, though the majority felt that they lacked feedback on their teaching skills.

Autophagy and Schizophrenia: A Closer Look at How Dysregulation of Neuronal Cell Homeostasis Influences the Pathogenesis of Schizophrenia.

Autophagy, the process of degrading intracellular components in lysosomes, plays an important role in the central nervous system by contributing to neuronal homeostasis. Autophagic failure has been linked to neurologic dysfunction and a variety of neurodegenerative diseases. Recent investigation has revealed a novel role for autophagy in the context of mental illness, namely in schizophrenia. This article summarizes the phenomenology, genetics, and structural/histopathological brain abnormalities associated with schizophrenia. We review studies that demonstrate for the first time a connection between autophagy malfunction and schizophrenia. Transcriptional profiling in schizophrenia patients uncovered a dysregulation of autophagy-related genes spatially confined to a specific area of the cortex, Brodmann Area 22, which has been previously implicated in the positive symptoms of schizophrenia. We also discuss the role of autophagy activators in schizophrenia and whether they may be useful adjuvants to the traditional antipsychotic medications currently used as the standard of care. In summary, the field has progressed beyond the basic concept that autophagy impairment predisposes to neurodegeneration, to a mechanistic understanding that loss of autophagy can disrupt neuronal cell biology and predispose to mood disorders, psychotic symptoms, and behavioral change.

The assertive community treatment team: an appropriate treatment for medical disorders that present with prominent psychiatric symptoms.

Physical diseases are difficult to treat in psychiatric patients, whether they are comorbid disorders or mental disorders due to a general medical condition. The psychiatric symptoms are difficult to treat in a medical ward or clinic, and the physical symptoms are difficult to treat in a psychiatric ward or clinic. For this reason, medical-psychiatric units have been developed but remain uncommon. It has been suggested that assertive community treatment (ACT) teams are a way in which to integrate medical and psychiatric treatments. We review the case of a woman with psychiatric symptoms caused by Graves disease that went untreated due to medication noncompliance and unmanageable irritability, aggression, and mood variability. We make a case for the use of the assertive community treatment team in the treatment of patients with mental disorders due to a general medical condition when the psychiatric manifestations are severe and cannot be managed in a medical ward or clinic.

A case of acute renal failure in a patient recently treated with clozapine and a review of previously reported cases.

Clozapine has been reported to cause acute renal failure due to acute interstitial nephritis. We discuss a case of clozapine-induced acute renal failure and compare it to 7 other cases reported in the literature. We review the signs and symptoms of the hypersensitivity response, such as fever and eosinophilia, caused by clozapine and make recommendations for early detection. Early detection and prompt discontinuation of clozapine can prevent renal damage, as can the avoidance of other nephrotoxic drugs like antibiotics.