Clinical Psychiatry

 

 

 

Bipolar Disorder

Long-Term Treatment of Bipolar Disorder: Different Phases and the Problem of Non-Adherence

treatment non-adherence in bipolar disorder Outline:

  • Interactive animation: the different treatment phases of bipolar disorder
  • Treatment Non-Adherence: Its Importance and How to Avoid It
    • Extent of the problem
    • Definition
    • Complications
    • Types
    • Factors influencing non-adherence
    • Strategies to increase adherence

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Screening for Bipolar Disorder

bipolar disorder screening

Outline:

  • Why is an accurate diagnosis important?
  • Why do we miss the diagnosis of bipolar disorder?
  • Interviewing challenges
  • Three aspects to consider in a bipolar disorder screening
  • Screening instruments:
    • Mood Disorder Questionnaire
    • Bipolar Spectrum Diagnostic Scale
  • PDF: The MoodCheck

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Bipolar Disorder in DSM-5: Highlights of Changes from DSM-IV-TR to DSM-5

Bipolar disorder concept

Outline:

  • Increased activity was added to Criterion A for bipolar disorder
  • Mixed episode is now a specifier
  • Anxious distress is a new specifier
  • NOS was replaced by: other specified bipolar and related disorder and unspecified bipolar and related disorder
  • Antidepressant-induced mania can be now diagnosed as BD

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The Bipolar Disorder Concept: From Kraepelin to DSM-5

From Kraepelin (3)

This tutorial is a simplified review of the evolution of the bipolar disorder concept.

  • The “manic-depressive insanity” concept (Emil Kraepelin)
  • The unipolar vs bipolar distinction (Karl Leonhard)
  • From manic-depressive illness to bipolar subtypes (DSM-II to DSM-5)

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Critical Appraisal

 

Dr. Erick Turner: How to Read Papers in Psychiatry

Erick-Turner-profile

Dr. Turner is Assistant Professor in the Department of Psychiatry at Oregon Health and Science University (OHSU) in Portland. He has previously held positions at the US Food & Drug Administration and the National Institute of Mental Health.

He is here to help us understand clinical research and to improve our critical appraisal skills. One of his research interests is publication bias, or reporting bias. We’ll learn why this concept is important to interpret the medical literature and understand the limitations of the papers we read.

 Part 1

  • Facts you may not know about FDA’s approval process
    • Current limitations
  • Off-label prescribing
    • How to approach off-label prescribing of old drugs vs. new drugs
  • Types of reporting bias
    • Study publication bias
    • Outcome reporting bias
    • Delayed publication bias
    • Type of paper bias
    • Place of publication bias
    • Multiple publication bias

     

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Part 2

  • Facts you may not know about FDA’s approval process
    • Current limitations
  • Off-label prescribing
    • How to approach off-label prescribing of old drugs vs. new drugs
  • Types of reporting bias

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Insomnia

 

Insomnia Pharmacotherapy: Off-Label Antidepressants and Antipsychotic

Diapositiva6

Off-label agents used for primary insomnia: evidence of efficacy and clinical aspects of antidepressants and second-generation antipsychotics.

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Insomnia Pharmacotherapy: Low-Dose Doxepin and Ramelteon

Diapositiva5Insomnia Pharmacotherapy: Low-Dose Doxepin and Ramelteon

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 Insomnia Pharmacotherapy: Non-Benzodiazepine Hypnotics (Z drugs)

Diapositiva11Non-benzodiazepine hypnotics: zolpidem, zaleplon and eszopiclone. Discussion of ther mechanism of action, indications,available formulations, pharmacokinetics, side effects and dosing.

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Insomnia Pharmacotherapy Part 1: Introduction and Benzodiazepines

Benzodiazepines (14)An introduction to the pharmacotherapy of insomnia. A general approach is presented, followed by the pharmacology of hypnotic benzodiazepines.

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 Assessing Insomnia Effectively

Diapositiva13This video discusses a practical approach to the assessment of insomnia

 

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Neuropsychopharmacology of Sleep: Integrating Neurobiology and Drug Treatment

Diapositiva34This is an integration between the different neurotransmitters that regulate sleep physiology and pharmacological interventions commonly used in clinical practice.

 

 

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ADHD

 

Adult ADHD: Diagnosis and Clinical Features

Diapositiva13This video presents basic concepts regarding ADHD in adults . It is based mostly on DSM-5 criteria.

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Introduction to Drugs for the Treatment of ADHD

Diapositiva11This video discusses the role of the prefrontal cortex in ADHD and the mechanisms of action of amphetamines, methylphenidate, atomoxetine and alpha 2 agonists.

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Stimulants for ADHD: Summary of Formulations

ADHD formulationsThis presentation discusses clinical features of short, intermediate and long acting formulations of methylphenidate and amphetamines.

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 ADHD Pharmacotherapy: Side Effects

 

Diapositiva6This presentation discusses side effects associated with the use of ADHD medications.

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 ADHD Pharmacotherapy: Starting Treatment and Side Effects

Diapositiva5
Two videos discussing how to start drug treatment in ADHD and side effects monitoring.
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Generalized Anxiety Disorder

 

GAD Part 1: Diagnosis and Clinical Features

GADThis video presents basic concepts to diagnose generalized anxiety disorder in clinical practice. Based mostly on DSM V criteria.

Outline:

  • Introduction
  • Epidemiology
  • Diagnosis: DSM V
  • Rating scales
  • Differential diagnosis

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GAD Part 2: Pharmacotherapy

GAD PharmacotherapyThis presentation is based on the latest international guidelines for the treatment of GAD.

Outline:

  • First-line agents
  • Second-line agents
  • Adjunctive therapy
  • Treatment recommendations

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Obsessive-compulsive disorder

 

OCD Part 1: Diagnosis and Clinical Features

Obsessive Compulsive Disorder.pptxThis video presents the basic concepts to diagnose obsessive-compulsive disorder in clinical practice. It is based mostly on DSM V criteria.
Video outline:

    • DSM V criteria for OCD
    • Symptom clusters
    • Diagnostic issues
    • Epidemiology of OCD

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OCD Part 2: Pharmacotherapy of OCD

Pharmacotherapy of OCDThis video presents the basic concepts to treat obsessive-compulsive disorder in clinical practice.
Outline:

  • General concepts on treatment response
  • The use of SSRIs and clomipramine for the treatment of OCD
  • Considerations on the initial treatment plan
  • Introduction to treatment resistance and augmentation

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