XYou may have noticed, we have just launched our new website. We will be adding more features over the upcoming weeks that you will like, so there may be a few hiccups along the way. If this is your first time visiting since our relaunch, please reset your password so you can still access our journals and CME activities that we have been providing for over 80 years. If you have any questions or comments please contact us at webadmin@psychiatrist.com.
XYou may have noticed, we have just launched our new website. We will be adding more features over the upcoming weeks that you will like, so there may be a few hiccups along the way. If this is your first time visiting since our relaunch, please reset your password so you can still access our journals and CME activities that we have been providing for over 80 years. If you have any questions or comments please contact us at webadmin@psychiatrist.com.
In this issue of our regular column, Dr Schuyler discusses the case of Mr A, a 77-year-old man who was being managed by a hospice when he started regular psychotherapy sessions more than 3 years ago. Mr A tended to think about what he used to be able to do and what he could not do now. Then, Mr A changed his way of thinking, and he adapted to this life stage.
Here, Dr Coker illustrates the benefits of inpatient hospice care to a patient at the end of life and explores the challenges that he has encountered educating others about the hospice philosophy.Â
Read this case presentation and discussion to find out how a palliative care approach helped Mr A, a 78-year-old veteran with end-stage cardiac disease and several medical comorbidities, have the best possible quality of life and meaningful family interactions in the final 6 months of his life.
Read about the case of Mr A, who, at the age of 60, was placed in the community living center at a Veterans Administration hospital in Charleston, South Carolina. He was treated with dialysis 3 times per week. His arm and leg strength were both impaired. Mr A was known for never smiling and for having little to say, but weekly psychotherapy sessions helped to bring him out of his shell and cope with feelings of helplessness.
Read about the case of Mr A, a 70-year-old man who was diagnosed with amyotrophic lateral sclerosis, a terminal illness progresses through loss of function to death without hope of a cure. Dr Schuyler a brief psychotherapeutic intervention helped Mr A cope with this difficult illness and life stage.
Read about the case of Mr A, who was admitted to the Veterans Administration hospital after he had several falls and showed signs of debilitating weakness. With a diagnosed chronic illness as well as severe heart disease, his expectation was of a brief inpatient stay terminated by death. The patient's mindset and intellectual ability led to a unique focus on achieving resolution of this final stage of life.
In this Primary Care Companion case, diagnose and manage Ms A, an 84-year-old woman whose cognitive changes began about 1 year ago. She is increasingly repetitive, no longer able to manage her finances, and occasionally misses medication doses. Ms A still drives short distances, keeps up her self-care, and enjoys playing bridge with friends, but she has been irritable with her daughter.
What is involved in providing end of life care? After 3 years of working as a palliative care psychiatrist at a Veterans Administration hospital, Dr Schuyler discusses the challenges that patients face and psychotherapeutic strategies that he uses to help them adjust to a new life stage in a healthy way.Â
Families grieve the loss of a loved one, but hospital staff members are less often acknowledged in their grief. Dr. Schuyler met with Mr. A over a 4-month period, each time during one of his admissions to the hospital.When Mr A finally died, he left an empty space Dr. Schuyler's life. This is the story of those 4 months.
Find out how Dr Schuyler applied the cognitive model to help Mr A, a 70-year-old married man who retired at 60 years of age after a busy, productive work life. Mr A was "not prepared to retire" and had never determined how he would spend this phase of his life. His time was spent intoxicated "to forget."
This true patient case and commentary features the story of Mr A, a 35-year-old veteran with debilitating multiple sclerosis, who is facing the emotional consequences of his illness while living in a nursing home unit.
Baclofen, a French Exception, Seriously Harms Alcohol Use Disorder Patients Without Benefit
To the Editor: Dr Andrade’s analysis of the Bacloville trial in a recent Clinical and Practical Psychopharmacology column, in which he concluded that “individualized treatment with high-dose baclofen (30-300 mg/d) may be a useful second-line approach in heavy drinkers” and that “baclofen may be particularly useful in patients with liver disease,” deserves comment.1
First, Andrade failed to recall that the first pivotal trial of baclofen, ALPADIR (NCT01738282; 320 patients, as with Bacloville), was negative (see Braillon et al2).
Second, Dr Andrade should have warned readers that Bacloville’s results are most questionable, lacking robustness. Although he cited us,3 he overlooked the evidence we provided indicating that the Bacloville article4 was published without acknowledging major changes to the initial protocol, affecting the primary outcome. Coincidentally (although as skeptics, we do not believe in coincidence), the initial statistical team was changed when data were sold to the French pharmaceutical company applying for the marketing authorization in France. As Ronald H. Coase warned, “If you torture the data long enough, it will confess.”