The Journal of clinical psychiatry
-
Despite increasing pediatric psychiatric emergency room service (PPERS) visits, data are lacking regarding visit characteristics and appropriateness. ⋯ Over one third of PPERS visits were inappropriate, characterized by better functioning, low harm potential or severity of presenting complaint, and absent suicidality or psychosis. Development of and improved access to urgent child and adolescent psychiatric outpatient care services in the community and referral agent educational programs may minimize inappropriate PPERS visits.
-
A correct diagnosis of bipolar disorder is crucial to determining appropriate treatment strategies, but the majority of patients with this illness are initially misdiagnosed. Bipolar presentations share features with other psychiatric disorders such as unipolar depression and borderline personality disorder, and comorbid medical conditions further complicate diagnosis. Clinicians may minimize diagnostic and treatment issues by focusing on differential diagnosis and dual treatment of bipolar disorder and co-occurring conditions. The physical health of patients with bipolar disorder should be monitored, because this population is at risk for obesity, metabolic syndrome, and associated conditions.