Psychosomatics
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Although required by the Accreditation Council for Graduate Medical Education, training of general psychiatry residents in Psychosomatic Medicine (PM) varies significantly between programs. In 1996, the Academy of Psychosomatic Medicine (APM) developed guidelines for residency training in PM. Since then, there has been no assessment of the status of PM training during psychiatry residency. ⋯ There is significant variation in how residents are taught PM during their training. The APM is a well-recognized organization that may define what constitutes adequate residency training in PM and may help programs fulfill the educational needs of residents.
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Extracorporeal membrane oxygenation (ECMO) is increasingly used to save patients with severe cardiopulmonary failure at high risk of dying, but the long-term psychiatric outcome of the treatment has not been studied. ⋯ Severe life-threatening cardiovascular or pulmonary failure with subsequent ECMO is associated with an increased prevalence of long-term psychiatric disorders and distress. Studies addressing the etiology and prevalence of psychiatric consequences after ECMO are needed.
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There have been no studies describing post-intensive care unit (ICU) alcohol use among medical-surgical ICU survivors. ⋯ Alcohol use decreases in the early aftermath of medical-surgical ICU admission and then increases significantly by one year post-ICU. Interventions for unhealthy alcohol use among medical-surgical ICU survivors that take into account comorbid psychiatric symptoms are needed.
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The advent of face transplantation has raised both ethical and psychological issues. Mortality of 18 existing face transplant recipients is 11.1% (2/18) through 2011. ⋯ Standardized data collection may help quantify psychological outcomes with facial transplantation to determine whether the risks of immunosuppression over time are offset by improved quality of life for recipients.
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To confirm the existence of the proposed three-core symptom domains in delirium by analyzing a dataset of nondemented adults using selected core symptoms as measured by the Delirium Rating Scale-Revised-98 (DRS-R98) scale. ⋯ Our EFA and CFA confirm and validate the proposed three-core domains of delirium, where symptoms were highly related to the domain that they were hypothesized to represent. These domains are consistent with delirium being a state of impaired consciousness, and should be considered necessary to assess whether in clinical or research settings.