Research: Long‐Acting Injectables: A Strategy to Mitigate Nonadherence in Bipolar Disorder
Despite our best efforts, partial or nonadherence to treatment is common in bipolar disorder. Varying definitions of nonadherence make a clear prevalence difficult to determine, but a recent nationwide bipolar disorder cohort study identified rates of nonadherence to treatment to be as high as 60%, with a mean prevalence of 40% [1]. The study included > 33,000 individuals with bipolar disorder, and approximately 60% were nonadherent at least once during the monitoring period. This begs the question, why? Nonadherence to pharmacologic treatment is not unique to bipolar disorder, but rates are notoriously high in mental health conditions. Reasons are multifactorial but include the number of comorbidities, young age, co‐occurring substance use disorders, limited primary support system, psychotic symptoms, intensity of manic symptoms, and limited insight, amongst others [1, 2].
A Different Perspective on ADHD Evaluations
In his New York Times bestselling book “The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness,” social psychologist Jonathan Haidt writes about the impact of smartphones (really, all internet-connected personal electronics) on child development. He describes a phone-based childhood replacing the play-based childhood that existed prior to the rise of smartphones.
Haidt identifies four foundational harms of a phone-based childhood—social deprivation, sleep deprivation, attention fragmentation, and addiction—then proposes four foundational reforms: no smartphones before high school, no social media before 16, phone-free schools, and far more unsupervised play. For many people who are raising or working with children, the book stirs up concerning dilemmas and meaningful solutions. As a mother, I was alarmed and experienced the book as a call to action.
Responding to the Crisis in Israel: Focus on What We Can Control
As a Jewish immigrant to the United States whose family fled religious persecution, it’s difficult to formulate a cogent response to the horrific events now occurring in Israel and Palestine. The slow and complicated process and the confusing and arduous journey from Latvia in the Soviet Union to the United States is still a subject I speak about often as I try to teach my children to understand why people behave in certain ways.
The events that are still unfolding have triggered thoughts of “this could have been me,” as I envision myself both as the person gruesomely attacked for being a certain religion and as the fleeing Palestinian civilian trapped in a horrific scenario beyond my control. Integrating one’s personal feelings can make patient care even more complex. Many of my Muslim and Jewish patients are suffering. So are many others with their own past traumas.
Physician Burnout; Letter to the editor response
I am writing in reference to “Burnout among surgeons: Lessons for psychiatrists” (Current Psychiatry, August 2023, p. 23-27,34-35,35a-35c, doi:10.12788/cp.0383). I have spent the last 8 years caring primarily for medical students and residents from osteopathic and allopathic medical schools. While I have collected data on rates of depression, anxiety, attention-deficit/hyperactivity disorder, and stress, this article hit upon a more nuanced set of observations.
Mothers in medicine: What can we learn when worlds collide?
Across all industries, studies by the U.S. Department of Labor have shown that women, on average, earn 83.7 percent of what their male peers earn. While a lot has been written about the struggles women face in medicine, there have been decidedly fewer analyses that focus on women who choose to become mothers while working in medicine.
I’ve been privileged to work with medical students and residents for the last 8 years as the director of graduate and medical student mental health at Rowan-Virtua School of Osteopathic Medicine in Mt. Laurel, N.J. Often, the women I see as patients speak about their struggles with the elusive goal of “having it all.” While both men and women in medicine have difficulty maintaining a work-life balance, I’ve learned, both personally and professionally, that many women face a unique set of challenges.
Pandemic May Have Caused Havoc for Trainees but Also Taught Unexpected Lessons
COVID-19 meant a lot of different things to different people. In the world of medicine and medical education, the ripple effects of COVID-19 live on. Lives were lost and shattered. Those in medicine saw firsthand how the medical system was overtaxed.
Physicians across many specialties, who previously would have been mentors to medical students and residents, were burnt out. Medical students and residents were left with permanent scars as they sometimes understood the pandemic and the virus, along with the precautions they had to follow, in a way that was often very different from that of friends and family. They were oversaturated with death and negativity by the media. At its worst, those training to save lives and alleviate suffering felt the frustration of joining a broken medical system. The already overburdened system was unable to provide fair, equitable medical help and support to people impacted by COVID-19. Trainees experienced a major shift in curriculum and training as programs attempted to meet everyone’s needs. Physicians and staff pivoted constantly to allow training to progress, all while already being spread thin.
Lessons Learned in Caring for Residents During COVID-19 Pandemic
Because of the pandemic, many psychiatry residents have been thrust into stressful new roles and situations. Here are ways to support them and ensure they feel free to seek help when needed.
Resident physicians serve a unique and important role in hospitals nationwide, as they are responsible for providing patient care while simultaneously furthering their own medical education. The overlapping responsibilities present a complex set of mental health concerns. While residency is often a time filled with self-doubt related to competency, added pressures and increased responsibilities related to COVID-19 are exacerbating these fears.
5 questions: How Rowan is helping medical students deal with mental health issues
Studies have found that while physicians and physicians-to-be generally have physically healthy lifestyles, the stress and long hours notwithstanding, they are prone to more mental health issues than the general public.
Mental health issues among college students have been an increasing concern of health officials.
However, one subset of college students has risen to the top of many experts’ concerns: medical students.
Studies have found that while physicians and physicians-to-be generally have physically healthy lifestyles, the stress and long hours notwithstanding, they are prone to more mental health issues than the general public.
In September, Cornell University drew attention to the issue by holding a national conference billed as the first comprehensive, multidisciplinary forum to examine the mental health needs of medical students.
A year ago, Elina Maymind, an associate professor in the department of psychiatry at Rowan School of Osteopathic Medicine, founded the Rowan University Medical Student and Graduate Student Mental Health Program. She is now its director.