It is no coincidence that 3 out of every 4 depressed patients in the United States are overweight. Yet, we as mental health professionals often neglect this key area of practice, focusing strictly on the mind and ignoring the body. Systemic inflammation has long been associated with and has been found to perpetuate depression, and a growing body of data indicates that one of the principal sources of inflammation is obesity, particularly visceral fat mass. In this evidence-based session, Dr. Shelton will highlight strategies for incorporating obesity as an end point for the treatment of depression and offer practical ways to prescribe a diet and exercise regimen designed to improve depressed mood.
Sleep disturbances remain common problems among patients with mental health disorders. The challenges in providing effective treatment to these patients may relate to the use of medications that may not optimally address a patient’s symptom complex. Knowledge about comorbid conditions that may complicate insomnia therapy and the pharmacological properties of available insomnia medications are essential to formulating effective treatment plans. This session will explore these treatment challenges, reviewing the multiple influences that may contribute to difficulty with sleep onset and maintenance. Dr. Neubauer will review a variety of therapeutic options, and will include an update on the pharmacodynamics and pharmacokinetics of medications approved for insomnia treatment.
The use of exercise in the treatment of major depressive disorder (MDD) has gained support, as evidenced by the inclusion of exercise treatment in the American Psychiatric Association’s most recent treatment guidelines. However, data suggest that mental health professionals infrequently prescribe or discuss exercise with their patients. This session will review the current evidence supporting exercise in the treatment of MDD. Dr. Rethorst will also highlight strategies to effectively prescribe exercise to patients with MDD by including interactive activities in this session.
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder presenting for treatment in children and adolescents, and is a growing presentation in adults. However, few mental health professionals currently feel comfortable diagnosing ADHD across the lifespan; and even fewer are comfortable with their knowledge base on treatment strategies for these patients. Little is known by mental health professionals about the long-term effects of chronic treatment on the course and associated problems of ADHD despite an expanding international literature. This session will provide an update on the course, comorbidity, and long-term treatment of ADHD.
When it comes to the topic of adherence to antipsychotic medication for the treatment of schizophrenia, the vast majority of studies focus on nonadherence and how to “correct” nonadherence. This begs the question—why would patients want to take antipsychotic medication anyway? This session will flip the topic around and assume that stopping medication is “normal” given the diagnosis of schizophrenia and that it is our job as clinicians to figure out a patient-centered strategy to help our patients understand in a real way that antipsychotic medication might be worth all of the challenges and difficulties.
Mental health professionals continue to struggle with the 2013 CPT code changes. As Medicare and other payers initiate audits, this session will help improve mental health professionals’ knowledge base and documentation abilities. Drs. Shah and Lustig will review the 2013 CPT code changes, introduce new CPT codes for Applied Behavior Analysis, and discuss medical record audits by payers and documentation requirements to support billed services. Additionally, there are new CPT codes for the intensive behavioral interventions that will interest mental health professionals who specialize in autism spectrum disorders.
Insomnia is the second most commonly encountered symptom in clinical medicine, reported by 80% of psychiatric patients. It is also one of the most challenging complaints in psychiatric practice, as it complicates the care of many mental illnesses. Although numerous hypnotic agents are available for insomnia management, they are predominantly agents with the same mechanism (ie, activation at the GABA-BZ receptor complex). Over the past few years, however, a variety of agents have been introduced with several more under development that possess novel mechanisms for the management of insomnia. These agents have introduced the possibility of enhanced safety and unique suitability for specific psychiatric populations. This session will review the basic sleep mechanisms and traditional GABA-ergic medications, as well as novel agents acting as melatonin, histamine, and orexin receptors. It will also present strategies for tailoring available pharmacologic agents to the patient’s clinical need to optimize clinical efficacy.
The release of the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013 represented the first significant revision of the diagnostic manual in 20 years. Many of the changes, especially in the mood disorders section, were intended to enhance clinician recognition of new disorders and specifiers that have specific treatment implications. Through a series of case vignettes, Dr. First will outline the changes to the mood disorders in the DSM-5 and highlight those modifications intended to improve decision-making about patient management. Controversies surrounding some of these changes will also be discussed.
A deeper understanding of pediatric bipolar spectrum disorders has been gained in recent years through neuroimaging and neuropsychologic testing, both of which implicate specific brain regions and functions that are distinct among children and adolescents with these disorders. Such research has led to exciting new interventions that incorporate these findings to specifically address these circuitry connections. In this session, Dr. Carbray will highlight the latest data and discuss how to integrate theoretical underpinnings of brain circuitry dysfunction into neurobiologically informed treatments for children and adolescents affected by pediatric bipolar spectrum disorders.
Developed in collaboration with the International Bipolar Foundation.
Trauma survivors often report suffering from dreams that reference traumatic incidents. The re-occurrence of trauma memories during sleep has long-term negative ramifications and emotional impact among survivors. If providers are knowledgeable about techniques to address recurrent nightmares, then they are more likely to effectively facilitate appropriate interventions to decrease nightmares, enhance sleep, and improve overall functioning. The goal of this session is to educate practitioners about interventions that can improve the quality of sleep for their patients struggling with chronic posttraumatic stress disorder by using medication and psychotherapy. Through their respective clinical experience, the presenters will share practical methods to assess and treat one of the most distressing symptoms of traumatic stress: recurrent, traumatically-based nightmares.
