Attention to body mass index by child psychiatry providers when prescribing second-generation antipsychotic medication to children: a survey study using a clinical vignette.

AIM: We sought to determine whether weight and body mass index measurement were taken into consideration when prescribing second-generation antipsychotic (SGA) medication to a child. METHODS: Two hundred clinicians were surveyed using a hypothetical clinical case vignette at a child psychopharmacology, postgraduate medical education course. The vignette described an overweight 10-year-old boy who was about to be prescribed an SGA medication to control psychotic symptoms. The reference to the patient's being 'overweight' was purposefully included to determine if providers would assess the patient's risk of morbidity from the metabolic side effects of the SGAs at the time of prescribing. RESULTS: Only 7.0% of prescribers listed either 'body mass index' or a combination of 'height' and 'weight' as part of their next treatment steps for an overweight child before prescribing an SGA. CONCLUSIONS: These results suggest the need for education as to the importance of body mass index monitoring when prescribing second-generation antipsychotic medications to children.

Web-based simulation in psychiatry residency training: a pilot study.

BACKGROUND: Medical specialties, including surgery, obstetrics, anesthesia, critical care, and trauma, have adopted simulation technology for measuring clinical competency as a routine part of their residency training programs; yet, simulation technologies have rarely been adapted or used for psychiatry training. OBJECTIVE: The authors describe the development of a web-based computer simulation tool intended to assess physician competence in obtaining informed consent before prescribing antipsychotic medication to a simulated patient with symptoms of psychosis. METHOD: Eighteen residents participated in a pilot study of the Computer Simulation Assessment Tool (CSAT). Outcome measures included physician performance on required elements, pre- and post-test measures of physician confidence in obtaining informed consent, and levels of system usability. RESULTS: Data suggested that the CSAT increased physician confidence in obtaining informed consent and that it was easy to use. CONCLUSIONS: The CSAT was an effective educational tool in simulating patient-physician interactions, and it may serve as a model for use of other web-based simulations to augment traditional teaching methods in residency education.

Over-the-counter medication and herbal or dietary supplement use in college: dose frequency and relationship to self-reported distress.

OBJECTIVE: A growing number of researchers have examined the use of over-the-counter (OTC) medications and herbal or dietary supplements among college students. There is concern about the efficacy and safety of these products, particularly because students appear to use them at a higher rate than does the general public. PARTICIPANTS AND METHODS: The authors administered surveys to college students (N = 201) to assess the frequency of use in the past week. RESULTS: A substantial percentage reported using OTC medications (74.1%), herbal or dietary supplements (70.6%), or both concurrently (61.2%). Dose frequency of OTC medications was the best predictor of self-reported emotional distress in the past week. Higher doses of products containing pseudoephedrine or valerian were associated with self-reported anxiety. CONCLUSIONS: These data further reflect an increasing trend toward self-medication among college students. Investigators must conduct reliability and validity studies to evaluate the clinical utility of the measurement tool developed in this study.