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Articles by Mark Oldham
Promoting Healthy Sleep-Wake and Circadian Rhythms to Prevent Delirium: Next Step, Target Engagement
1 Introduction Sleep–wake and circadian rhythm disturbances have long been hypothesized as a cause of delirium. Notwithstanding research from the 1950s on the effects of prolonged sleep deprivation [1], data on the extent to which sleep disturbances in hospital settings contribute to delirium remain inconclusive.
Automated Screening to Enhance Proactive Consultation-Liaison Psychiatry Services in Acute Medicine Units: Evaluation of Service Outcomes
Abstract Objective: Proactive consultation-liaison (C-L) psychiatry aims to meet the mental health needs of medical-surgical populations—many of which go unmet by the conventional C-L model—through systematic screening and integrated care. We implemented an automated screening list to enhance case identification of an existing proactive C-L service and evaluated service metrics along with clinician- and patient-reported outcomes.
The phenotype of delirium based on a close reading of diagnostic criteria
DATA AVAILABILITY STATEMENT The data that support the findings of this study are available in the primary works from which diagnostic criteria were published.
Functional, cognitive, and cerebrovascular aspects of depression before coronary artery bypass graft surgery: Testing the vascular depression hypothesis
Depression in patients undergoing coronary artery graft bypass (CABG) surgery is associated with morbidity and mortality, making its early identification and clinical management crucial. Vasculopathy and older age, hallmarks of patients requiring CABG, are also features of vascular depression. In this study, we assess for features of vascular depression in patients undergoing CABG surgery.
Finding Catatonia Requires Knowing What to Look for
Catatonia is a psychomotor syndrome identified by its clinical phenotype. Unlike common psychiatric syndromes such as major depression that are characterized by self-report of symptoms, catatonia is identified chiefly by empirically evaluated signs on clinical evaluation. Its signs are recognized through observation, physical examination, or elicitation by clinical maneuvers or the presentation of stimuli.
Finding catatonia requires knowing what to look for
Catatonia is a psychomotor syndrome identified by its clinical phenotype. Unlike common psychiatric syndromes such as major depression that are characterized by self-report of symptoms, catatonia is identified chiefly by empirically evaluated signs on clinical evaluation. Its signs are recognized through observation, physical examination, or elicitation by clinical maneuvers or the presentation of stimuli.
Predisposing and Precipitating Factors Associated With Delirium
Key Points Question What predisposing and precipitating factors are associated with delirium? Findings In this systematic review of 315 studies of delirium representing 101 144 patients across all settings and populations, 33 predisposing and 112 precipitating factors were associated with delirium. Putative pathophysiological mechanisms associated with these factors were heterogeneous.
Proactive C-L Psychiatry: Re-envisioning Psychiatric Care in Medical Settings
Consultation-liaison (C-L) psychiatry provides essential expertise to medically admitted patients. However, there is considerable variation from institution to institution in how consultations are performed, the nature of the liaison role, and the structure of C-L psychiatry service lines. As in all of medicine, the Triple Aim of health care has prompted the field of C-L psychiatry to re-evaluate its vision of value-based care.
Mental Health, COVID-19, and the Invisible Pandemic on the Horizon
The novel coronavirus, severe acute respiratory syndrome coronavirus 2, continues to spread, causing global disruption and infecting the world with strong emotions such as fear, anger, and sadness. Now is the time to recognize the expanding emotional pandemic, to use empirically derived strategies aimed at mitigating the effects of trauma, and to engage proactively with the goal of improving mental health outcomes (Table 1). 1 McCabe O.L. Everly Jr., G.S. Brown L.M. et al.
Posttraumatic Confusional State: Delirium by Another Name
1. “Characterized by all of the following:” Criterion B, part 1: onset “over short period” A. Disturbances of attention Criterion A, part 1 of 2: Disturbance in attention B. Disorientation “to place, time, and situation” Criterion A, part 2 of 2: “reduced orientation to the environment” Criterion C: “disorientation” C. Disturbances of memory (“to encode and recall”) Criterion C: “memory deficit” D. Fluctuation “during the course of the day” Criterion B, part 2: “tends to fluctuate” 2.
Characterising neuropsychiatric disorders in patients with COVID-19
We commend Aravinthan Varatharaj and colleagues for their study on neurological and neuropsychiatric complications of COVID-19, and we echo their comments on the importance of interdisciplinary work in the clinical neurosciences. However, we are concerned by their reliance on the vague term altered mental status and the use of the term encephalopathy without reference to delirium.
Depression Predicts Cognitive and Functional Decline One Month after Coronary Artery Bypass Graft Surgery (NOAHS Study)
RESEARCH ARTICLE Mark A. Oldham M.D. Corresponding Author E-mail address: mark_oldham@urmc.rochester.edu https://orcid.org/0000-0002-0981-7522 University of Rochester Medical Center Co‐first authors with equal effort Correspondence Mark A. Oldham, University of Rochester Medical Center.
A diversified theory of catatonia
As the 150-year anniversary of Kahlbaum's seminal 1874 monograph Die Katatonie: oder das Spannungsirresein (which translates to The Catatonia: or the Tension Insanity) 1 Kahlbaum K Die Katatonie oder das Spannungsirresein. Eine klinische form psychischer Krankheit. A Hirschwald, Berlin; 1874 approaches, fundamental questions remain about the nature of catatonia and its phenotype.
Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology
Contents Introduction 2 Guideline rationale 2 Guideline method 2 Strength of evidence and recommendations 3 Background 3 History 3 Definition 3 Aetiology 5 Catatonia due to a medical condition 5 Catatonia due to another psychiatric disorder 6 Clinical features 6 Descriptive epidemiology 8 Clinical assessment 8 History and physical examination 8 Rating instruments 9 Investigations 10 Challenge tests 12 Lorazepam and other benzodiazepines 12 Zolpidem 13 Other drugs 13 Differential diagnosis 13...
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