Rounds in the General Hospital

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For hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms, Dr Stern discusses diagnosis and management with members of the Consultation Service at Massachusetts General Hospital. These rounds reports will prove useful for clinicians practicing at the interface of medicine and psychiatry.

PCC
Strategies for Documenting the Medical Record
Rounds in the General Hospital

May 7, 2026

Documentation should be objective and relevant, especially in psychosocially complex cases—too much information can interfere with establishing the correct diagnosis and treatment plan, while too little increases risk of…
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PCC
How to Document Complex Cases
Rounds in the General Hospital

April 9, 2026

Case presentations often drive differential diagnosis creation by what is said (and not said) and by whether information given is the “lead” or merely a (potentially interesting) tidbit.
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PCC
Strategies for Managing Dyspnea
Rounds in the General Hospital

April 2, 2026

Pharmacologic approaches and behavioral and psychological interventions such as mindfulness, relaxation, and CBT can mitigate dyspnea and associated anxiety.
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Administering ECT to Critically Ill Patients
Rounds in the General Hospital

March 5, 2026

ECT can be lifesaving for critically ill individuals with severe psychiatric and neuropsychiatric conditions; however, cardiac monitoring is essential.
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PCC
Understanding the Impact of Moral Injury
Rounds in the General Hospital

February 26, 2026

Healing of moral injuries requires truth-telling, communal recognition, and moral repair—not just medication or cognitive restructuring.
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PCC
Preventing Physician Burnout
Rounds in the General Hospital

February 10, 2026

The authors clarify misconceptions about burnout and depression and identify best practices and approaches for burnout at the individual and institutional level.
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Diagnosing and Treating Impulsivity
Rounds in the General Hospital

February 5, 2026

Impulsivity is a characteristic of many psychiatric and neuropsychiatric conditions throughout the lifespan; however, in older adults it frequently signals an emerging neurodegenerative process.
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PCC
Managing Grief and Bereavement
Rounds in the General Hospital

January 29, 2026

Risk factors that predispose to complicated grief include past psychiatric conditions, especially depression or substance use, unexpected death, the death of a child, and poor social support.
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Treatment and Referral for AUD in Primary Care
Rounds in the General Hospital

January 13, 2026

Explore which treatments are best for your patients with alcohol use disorders and when you should refer for specialized psychological or pharmacologic interventions.
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PCC
Diagnosis and Management of Rage
Rounds in the General Hospital

December 23, 2025

This article offers a practical framework for distinguishing rage from irritability and impulsivity, identifying underlying neuropsychiatric drivers, and guiding evidence-based management across conditions including PTSD, TBI, and mood disorders.
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PCC
Facilitating Academic Success for Clinicians
Rounds in the General Hospital

December 16, 2025

Many clinicians, experience “imposter syndrome,” which can foster the false belief that they are unqualified for promotion.
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PCC
Using Digital Technologies to Avoid Doctor’s Orders
Rounds in the General Hospital

December 2, 2025

The availability of portable technologies and application-based services can complicate caretaking in the hospital setting, as patients can circumvent medical recommendations.
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PCC
Sequelae of Toxic Exposures in Veterans
Rounds in the General Hospital

November 25, 2025

A 45-year-old veteran has ongoing symptoms likely related to past exposure to burn pits, dust storms, airborne industrial pollutants, and head trauma from hard parachute landings.
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PCC
Primary Care and Mental Health Collaboration
Rounds in the General Hospital

November 13, 2025

Since PCPs are often the first health care professionals to see patients with symptoms of a mental health disorder, they play a vital role in the identification, management, and…
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PCC
Talking to Pregnant Patients About Substance Use
Rounds in the General Hospital

November 11, 2025

A 33-year-old pregnant woman presented to the obstetric triage unit at 28 weeks. She and her partner reported that this pregnancy was going smoothly except for one thing: she…
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PCC
Talking to Patients About Inflammatory Bowel Diseases
Rounds in the General Hospital

November 6, 2025

Find out what triggers irritable bowel diseases and how your patients can manage their GI symptoms and utilize psychotropic agents in this comprehensive guide.
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Psychological Sequelae of Drone Attacks
Rounds in the General Hospital

November 6, 2025

Read about a newly emerging form of combat stress, one shaped by the relentless and psychologically corrosive nature of modern drone warfare.
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PCC
Choosing a Pharmacologic Strategy for Psychosis
Rounds in the General Hospital

October 28, 2025

Find out which antipsychotic agent to prescribe to your patient with psychosis and learn how to balance the concepts of efficacy, tolerability, and cost.
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Impact of Hypotension on Cognitive Function
Rounds in the General Hospital

October 23, 2025

Hypotension acts synergistically to affect mental status by compounding problems with gas exchange, neurovascular dynamics, neuronal metabolism, and neurotoxicity.
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PCC
Managing Somatic Delusions
Rounds in the General Hospital

October 16, 2025

Management of somatic delusions involves a multimodal treatment approach incorporating pharmacotherapy, somatic treatments, and psychotherapy.
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PCC
Talking to Your Patients About HSCT
Rounds in the General Hospital

September 30, 2025

If you have been unsure about what you should discuss with your patients who might undergo hematopoietic stem cell transplantation, then this case and discussion should prove useful.
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PCC
Diagnosing and Treating Dizziness
Rounds in the General Hospital

September 18, 2025

Psychiatric treatment of dizziness includes behavioral therapy to decrease arousal to the identified stimulus and pharmacologic interventions to decrease acute anxiety and prevent onset of downstream anxiety.
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Antihistamines: Indications, Interactions, and Adverse Effects
Rounds in the General Hospital

September 16, 2025

Many antihistamines share a propensity for muscarinic receptor antagonism at higher doses, leading to symptoms of anticholinergic toxicity.
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PCC
Management of Functional Neurological Disorder
Rounds in the General Hospital

August 19, 2025

Patients with functional neurological symptoms present to clinicians in a variety of clinical settings, although they are often seen in primary care settings before referral to specialty clinics.
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Gastrointestinal Complications of Clozapine
Rounds in the General Hospital

August 12, 2025

Clozapine-induced gastrointestinal hypomotility is common, and it can progress to severe and potentially life-threatening complications;
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PCC
PTSD Management in Primary Care
Rounds in the General Hospital

August 5, 2025

Individuals with PTSD are much more likely than those without to have at least 1 other psychiatric condition, and they are also prone to develop physical health problems.
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