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.

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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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Facilitating Smoking Cessation in Primary Care
Rounds in the General Hospital

May 17, 2022

Here, the authors discuss the importance of tobacco cessation, best practices involving pharmacologic agents and counseling techniques, and strategies to address myths related to smoking cessation.
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Challenging a Surrogate Decision-Maker
Rounds in the General Hospital

May 12, 2022

When a proxy medical decision-maker is not acting as the patient wished or in the best interest of the patient, the decision-making of the surrogate can be challenged. Read…
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Managing Clozapine in Primary Care
Rounds in the General Hospital

February 17, 2022

In this article, gain insight into the management of patients taking clozapine. The authors also provide critical steps for early detection and management of life-threatening complications of clozapine, including…
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Rounds in the General Hospital

January 27, 2022

Have you been unsure about how racial discrimination can contribute to anxiety, depression, or poor health? Have you been unsure about how to intervene with patients who experience acculturative…
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Rounds in the General Hospital

December 23, 2021

Have you have been uncertain about how to make a diagnosis of multiple sclerosis by reviewing signs and symptoms, laboratory test results, and brain imaging or wondered about treatment…
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Rounds in the General Hospital

December 16, 2021

There are multiple reasons why childhood sexual abuse can be difficult to diagnose; therefore, it often goes underreported. Read on to find out how to properly identify and report…
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Rounds in the General Hospital

October 14, 2021

Have you ever wondered whether, and why, Wernicke’s encephalopathy can develop in someone without an alcohol use disorder? Have you been uncertain about treatment? If you have, then this…
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Rounds in the General Hospital

September 16, 2021

In this article, the authors present the case of a patient with concerns about cognitive decline. They also discuss the evaluation, diagnosis, and treatment of such patients as well…
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Rounds in the General Hospital

September 2, 2021

Have you encountered veterans with PTSD and been uncertain about how to intervene? Have you been undecided about how, or whether, to work with military families? If you have,…
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Patient-Centered Approach to Opioid Use Disorder
Rounds in the General Hospital

April 8, 2021

Explore the neurobiological, psychological, psychosocial, and cultural determinants of opioid use disorder and review approaches to integrated, culturally competent care.
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Rounds in the General Hospital

April 1, 2021

Here, the authors provide primary care providers a foundation for understanding pediatric hyperkinetic movement disorders, including tips on creation of a differential diagnosis, assessment of risk factors, and guidance…
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Rounds in the General Hospital

February 18, 2021

Have you ever wondered what is responsible for an altered mental status with agitated behaviors or how to evaluate a patient with such symptoms? If so, then this article…
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Rounds in the General Hospital

January 21, 2021

Have you wondered why people act impulsively or compulsively? Have you been frustrated when strategies to change behaviors are unsuccessful? If so, then this article may prove useful by…
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Rounds in the General Hospital

December 17, 2020

In this issue’s Rounds in the General Hospital, the authors discuss the risks and benefits of polypharmacy and strategies for tapering and discontinuing antipsychotics in those with schizophrenia.
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Rounds in the General Hospital

October 1, 2020

Have you ever seen a toddler who ingested a toxic agent, been uncertain about the dangers of psychotropics in children, or wondered if antidotes exist to reverse such toxidromes?…
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Rounds in the General Hospital

July 16, 2020

In this Rounds in the General Hospital article, the authors discuss commonly used sedative-analgesic agents and protocols and the management of acute withdrawal phenomenon that may arise when weaning…
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Rounds in the General Hospital

June 27, 2019

Have you ever wondered what criteria need to be satisfied before a patient can be involuntarily admitted to a psychiatric hospital? Read this article to explore the clinical, legal,…
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Rounds in the General Hospital

November 8, 2018

Have you ever wondered whether physicians have the right to restrict patients’ behavior when they are voluntary inpatients? As a health care provider, have you been afraid to be…
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Rounds in the General Hospital

October 4, 2018

Have you ever wondered if and how often an electrocardiogram should be obtained to monitor the QTc? Have you been unclear about which medical and metabolic conditions and medications…
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Rounds in the General Hospital

May 31, 2018

Have you ever wondered whether you could facilitate better collaboration with a patient who appears to reject your help during an acute medical event? Have you ever had trouble…
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Rounds in the General Hospital

January 4, 2018

Have you ever wondered what is responsible for an altered mental status with abnormal movements? Have you been uncertain about when and how to evaluate a patient with such…
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Rounds in the General Hospital

November 30, 2017

First-line treatments for bipolar disorder are associated with multisystem side effects, especially weight gain, that predispose patients to obstructive sleep apnea among other complications. This article provides up-to-date information…
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Rounds in the General Hospital

October 5, 2017

Have you ever wondered how common bowel and bladder dysfunction are postpartum? Have you ever felt ill-prepared to make a decision with regard to further workup or treatment? Have…
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Rounds in the General Hospital

September 15, 2016

Have you ever wondered whether the presence of myoclonus helped to create or narrow your differential diagnosis? Have you ever been uncertain about whether or how to treat focal…
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