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Toshiko Yasuda - One of the best experts on this subject based on the ideXlab platform.
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Avoiding diagnostic errors in Psychosomatic Medicine: a case series study
BioPsychoSocial Medicine, 2018Co-Authors: Atsuko Koyama, Yoichi Ohtake, Kanae Yasuda, Kiyohiro Sakai, Ryo Sakamoto, Hiromichi Matsuoka, Hirokuni Okumi, Toshiko YasudaAbstract:Background Non-organic lesions or diseases of unknown origin are sometimes misdiagnosed as “psychogenic” disorders or “Psychosomatic” diseases. For the quality of life and safety of patients, recent attention has focused on diagnostic error. The aim of this study was to clarify the factors that affected misdiagnoses in Psychosomatic Medicine by examining typical cases and to explore strategies that reduce diagnostic errors. Case presentation The study period was from January 2001 to August 2017. The data of patients who had visited the Department of Psychosomatic Medicine, Kindai University Hospital and its branches, Sakai Hospital and Nihonbashi Clinic, were collected. All patients were aged 16 years or over. Multiple factors, such as age, sex, presenting symptoms, initial diagnosis, final diagnosis, sources of re-diagnosis and types of diagnostic errors were retrospectively analyzed from the medical charts of 20 patients. Among them, four typical cases can be described as follows. Case 1; a 79-year-old woman, initially diagnosed with psychogenic vomiting due to depression that was changed to gastric torsion as the final diagnosis. Case 2; a 24-year-old man, diagnosed with an eating disorder that was later changed to esophageal achalasia. Case 10; a 60-year-old woman’s diagnosis changed from conversion disorder to localized muscle atrophy. Case 19; a 68-year-old man, appetite loss from depression due to cancer changed to secondary adrenal insufficiency, isolated ACTH deficiency (IAD). Conclusion This study showed that multiple factors related to misdiagnoses were combined and had a mutual influence. However, they can be summarized into two important clinical observations, diagnostic system-related problems and provider issues. Provider issues contain mainly cognitive biases such as Anchoring, Availability, Confirmation bias, Delayed diagnosis, and Representativeness. In order to avoid diagnostic errors, both a diagnostic system approach and the reduction of cognitive biases are needed. Psychosomatic Medicine doctors should pay more attention to physical symptoms and systemic examination and can play an important role in accepting a perception of patients based on a good, non prejudicial patient/physician relationship.
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avoiding diagnostic errors in Psychosomatic Medicine a case series study
Biopsychosocial Medicine, 2018Co-Authors: Atsuko Koyama, Yoichi Ohtake, Kanae Yasuda, Kiyohiro Sakai, Ryo Sakamoto, Hiromichi Matsuoka, Hirokuni Okumi, Toshiko YasudaAbstract:Non-organic lesions or diseases of unknown origin are sometimes misdiagnosed as “psychogenic” disorders or “Psychosomatic” diseases. For the quality of life and safety of patients, recent attention has focused on diagnostic error. The aim of this study was to clarify the factors that affected misdiagnoses in Psychosomatic Medicine by examining typical cases and to explore strategies that reduce diagnostic errors. The study period was from January 2001 to August 2017. The data of patients who had visited the Department of Psychosomatic Medicine, Kindai University Hospital and its branches, Sakai Hospital and Nihonbashi Clinic, were collected. All patients were aged 16 years or over. Multiple factors, such as age, sex, presenting symptoms, initial diagnosis, final diagnosis, sources of re-diagnosis and types of diagnostic errors were retrospectively analyzed from the medical charts of 20 patients. Among them, four typical cases can be described as follows. Case 1; a 79-year-old woman, initially diagnosed with psychogenic vomiting due to depression that was changed to gastric torsion as the final diagnosis. Case 2; a 24-year-old man, diagnosed with an eating disorder that was later changed to esophageal achalasia. Case 10; a 60-year-old woman’s diagnosis changed from conversion disorder to localized muscle atrophy. Case 19; a 68-year-old man, appetite loss from depression due to cancer changed to secondary adrenal insufficiency, isolated ACTH deficiency (IAD). This study showed that multiple factors related to misdiagnoses were combined and had a mutual influence. However, they can be summarized into two important clinical observations, diagnostic system-related problems and provider issues. Provider issues contain mainly cognitive biases such as Anchoring, Availability, Confirmation bias, Delayed diagnosis, and Representativeness. In order to avoid diagnostic errors, both a diagnostic system approach and the reduction of cognitive biases are needed. Psychosomatic Medicine doctors should pay more attention to physical symptoms and systemic examination and can play an important role in accepting a perception of patients based on a good, non prejudicial patient/physician relationship.
Albert F G Leentjens - One of the best experts on this subject based on the ideXlab platform.
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delirium an evidence based Medicine ebm monograph for Psychosomatic Medicine practice comissioned by the academy of Psychosomatic Medicine apm and the european association of consultation liaison psychiatry and Psychosomatics eaclpp
Journal of Psychosomatic Research, 2012Co-Authors: Albert F G Leentjens, James R Rundell, Teresa A Rummans, Jewel Shim, R Oldham, L Peterson, Kemuel L Philbrick, W Soellner, D Wolcott, Oliver FreudenreichAbstract:a Department of Psychiatry, Maastricht University Medical Centre, P.O. Box 5800, 6212 AZ Maastricht, The Netherlands b Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA c Department of Psychiatry, University of California, San Francisco, CA, USA d Medical Education Programme Psychiatry, San Francisco School of Medicine, University of California (Fresno Campus) and Fresno County Department of Behavioral Health, Fresno, CA, USA e Ingham Regional Medical Center, Lansing, MI, USA f Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA g Department of Psychosomatic Medicine and Psychotherapy, General Hospital Nuremberg, Nuremberg, Germany h Oncology Supportive Care Services, Samuel Oschin Comprehensive Cancer Institute, Samuel Oschin Cancer Center, Los Angeles, CA, USA i Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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reprint of Psychosomatic Medicine and consultation liaison psychiatry scope of practice processes and competencies for psychiatrists working in the field of cl psychiatry or Psychosomatics a consensus statement of the european association of consulta
Journal of Psychosomatic Research, 2011Co-Authors: Albert F G Leentjens, Deane L Wolcott, Else Guthrie, Roger G Kathol, Albert DiefenbacherAbstract:Abstract Objective In 2008, the Board of the European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) and the Academy of Psychosomatic Medicine (APM) Council commissioned the creation of a task force to study consensus-based summaries of core roles, scope of clinical practice, and basic competencies for psychiatrists working in the field of Psychosomatic Medicine (PM) and/or Consultation-Liaison Psychiatry (CLP). Method The task force used existing statements of competencies and feedback from EACLPP and APM symposia and workshops to develop a draft document. After review by the EACLPP and APM committees, and the EACLPP Board and APM Council, a period of comment from the field preceded a final draft resubmitted for consideration of the EACLPP Board and APM Council in February 2010. Results The two organizations completed approval of final publication of the consensus statement on June 11, 2010. This consensus statement is a summary of clinical competencies, scope of clinical effort, and roles considered by the sponsoring organizations to be fundamental to the practice of this subspecialty or special area of expertise, anywhere, of PM or CLP. Conclusion This consensus statement delineates a set of basic competencies and roles of a PM/CLP psychiatrist to serve as an internationally recognized base that may be used by national societies and institutions to formulate their own competencies, scope of practice, and roles or help with guideline formulation.
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Psychosomatic Medicine and consultation liaison psychiatry scope of practice processes and competencies for psychiatrists working in the field of cl psychiatry or Psychosomatics corrected a consensus statement of the european association of consultat
Psychosomatics, 2011Co-Authors: Albert F G Leentjens, Roger G Kathol, Albert Diefenbacher, Elspeth GuthrieAbstract:OBJECTIVE: In 2008, the Board of the European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) [corrected] and the Academy of Psychosomatic Medicine (APM) Council commissioned the creation of a task force to study consensus-based summaries of core roles, scope of clinical practice, and basic competencies for psychiatrists working in the field of Psychosomatic Medicine (PM) and/or Consultation-Liaison Psychiatry (CLP). METHOD: The task force used existing statements of competencies and feedback from EACLPP and APM symposia and workshops to develop a draft document. After review by the EACLPP and APM committees, and the EACLPP Board and APM Council, a period of comment from the field preceded a final draft resubmitted for consideration of the EACLPP Board and APM Council in February 2010. RESULTS: The two organizations completed approval of final publication of the consensus statement on June 11, 2010. This consensus statement is a summary of clinical competencies, scope of clinical effort, and roles considered by the sponsoring organizations to be fundamental to the practice of this subspecialty or special area of expertise, anywhere, of PM or CLP. CONCLUSION: This consensus statement delineates a set of basic competencies and roles of a PM/CLP psychiatrist to serve as an internationally recognized base that may be used by national societies and institutions to formulate their own competencies, scope of practice, and roles or help with guideline formulation.
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Psychosomatic Medicine and consultation liaison psychiatry scope of practice processes and competencies for psychiatrists or Psychosomatic Medicine specialists a consensus statement of the european association of consultation liaison psychiatry and the academy of Psychosomatic Medicine
Psychosomatics, 2011Co-Authors: Albert F G Leentjens, James R Rundell, Roger G Kathol, Albert Diefenbacher, Else GuthrieAbstract:Objective In 2008, the Board of the European Association of Consultation-Liaison Psychiatry and Psychosomatic Medicine (EACLPP) and the Academy of Psychosomatic Medicine (APM) Council commissioned the creation of a task force to study consensus-based summaries of core roles, scope of clinical practice, and basic competencies for psychiatrists working in the field of Psychosomatic Medicine (PM) and/or Consultation-Liaison Psychiatry (CLP). Method The task force used existing statements of competencies and feedback from EACLPP and APM symposia and workshops to develop a draft document. After review by the EACLPP and APM committees, and the EACLPP Board and APM Council, a period of comment from the field preceded a final draft resubmitted for consideration of the EACLPP Board and APM Council in February 2010. Results The two organizations completed approval of final publication of the consensus statement on June 11, 2010. This consensus statement is a summary of clinical competencies, scope of clinical effort, and roles considered by the sponsoring organizations to be fundamental to the practice of this subspecialty or special area of expertise, anywhere, of PM or CLP. Conclusion This consensus statement delineates a set of basic competencies and roles of a PM/CLP psychiatrist to serve as an internationally recognized base that may be used by national societies and institutions to formulate their own competencies, scope of practice, and roles or help with guideline formulation.
Atsuko Koyama - One of the best experts on this subject based on the ideXlab platform.
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Avoiding diagnostic errors in Psychosomatic Medicine: a case series study
BioPsychoSocial Medicine, 2018Co-Authors: Atsuko Koyama, Yoichi Ohtake, Kanae Yasuda, Kiyohiro Sakai, Ryo Sakamoto, Hiromichi Matsuoka, Hirokuni Okumi, Toshiko YasudaAbstract:Background Non-organic lesions or diseases of unknown origin are sometimes misdiagnosed as “psychogenic” disorders or “Psychosomatic” diseases. For the quality of life and safety of patients, recent attention has focused on diagnostic error. The aim of this study was to clarify the factors that affected misdiagnoses in Psychosomatic Medicine by examining typical cases and to explore strategies that reduce diagnostic errors. Case presentation The study period was from January 2001 to August 2017. The data of patients who had visited the Department of Psychosomatic Medicine, Kindai University Hospital and its branches, Sakai Hospital and Nihonbashi Clinic, were collected. All patients were aged 16 years or over. Multiple factors, such as age, sex, presenting symptoms, initial diagnosis, final diagnosis, sources of re-diagnosis and types of diagnostic errors were retrospectively analyzed from the medical charts of 20 patients. Among them, four typical cases can be described as follows. Case 1; a 79-year-old woman, initially diagnosed with psychogenic vomiting due to depression that was changed to gastric torsion as the final diagnosis. Case 2; a 24-year-old man, diagnosed with an eating disorder that was later changed to esophageal achalasia. Case 10; a 60-year-old woman’s diagnosis changed from conversion disorder to localized muscle atrophy. Case 19; a 68-year-old man, appetite loss from depression due to cancer changed to secondary adrenal insufficiency, isolated ACTH deficiency (IAD). Conclusion This study showed that multiple factors related to misdiagnoses were combined and had a mutual influence. However, they can be summarized into two important clinical observations, diagnostic system-related problems and provider issues. Provider issues contain mainly cognitive biases such as Anchoring, Availability, Confirmation bias, Delayed diagnosis, and Representativeness. In order to avoid diagnostic errors, both a diagnostic system approach and the reduction of cognitive biases are needed. Psychosomatic Medicine doctors should pay more attention to physical symptoms and systemic examination and can play an important role in accepting a perception of patients based on a good, non prejudicial patient/physician relationship.
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avoiding diagnostic errors in Psychosomatic Medicine a case series study
Biopsychosocial Medicine, 2018Co-Authors: Atsuko Koyama, Yoichi Ohtake, Kanae Yasuda, Kiyohiro Sakai, Ryo Sakamoto, Hiromichi Matsuoka, Hirokuni Okumi, Toshiko YasudaAbstract:Non-organic lesions or diseases of unknown origin are sometimes misdiagnosed as “psychogenic” disorders or “Psychosomatic” diseases. For the quality of life and safety of patients, recent attention has focused on diagnostic error. The aim of this study was to clarify the factors that affected misdiagnoses in Psychosomatic Medicine by examining typical cases and to explore strategies that reduce diagnostic errors. The study period was from January 2001 to August 2017. The data of patients who had visited the Department of Psychosomatic Medicine, Kindai University Hospital and its branches, Sakai Hospital and Nihonbashi Clinic, were collected. All patients were aged 16 years or over. Multiple factors, such as age, sex, presenting symptoms, initial diagnosis, final diagnosis, sources of re-diagnosis and types of diagnostic errors were retrospectively analyzed from the medical charts of 20 patients. Among them, four typical cases can be described as follows. Case 1; a 79-year-old woman, initially diagnosed with psychogenic vomiting due to depression that was changed to gastric torsion as the final diagnosis. Case 2; a 24-year-old man, diagnosed with an eating disorder that was later changed to esophageal achalasia. Case 10; a 60-year-old woman’s diagnosis changed from conversion disorder to localized muscle atrophy. Case 19; a 68-year-old man, appetite loss from depression due to cancer changed to secondary adrenal insufficiency, isolated ACTH deficiency (IAD). This study showed that multiple factors related to misdiagnoses were combined and had a mutual influence. However, they can be summarized into two important clinical observations, diagnostic system-related problems and provider issues. Provider issues contain mainly cognitive biases such as Anchoring, Availability, Confirmation bias, Delayed diagnosis, and Representativeness. In order to avoid diagnostic errors, both a diagnostic system approach and the reduction of cognitive biases are needed. Psychosomatic Medicine doctors should pay more attention to physical symptoms and systemic examination and can play an important role in accepting a perception of patients based on a good, non prejudicial patient/physician relationship.
Nicoletta Sonino - One of the best experts on this subject based on the ideXlab platform.
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Psychosomatic Medicine is a comprehensive field not a synonym for consultation liaison psychiatry
Current Psychiatry Reports, 2010Co-Authors: Giovanni A Fava, Carlotta Belaise, Nicoletta SoninoAbstract:There is controversy surrounding the term Psychosomatic. If it is used as an equivalent of consultation liaison psychiatry, there is little justification for retaining it. Psychosomatic Medicine, however, may be defined as a comprehensive interdisciplinary framework for the assessment of psychosocial factors affecting individual vulnerability, course, and outcome of any type of disease; holistic consideration of patient care in clinical practice; and integration of psychological therapies in the prevention, treatment, and rehabilitation of medical disease. Psychosomatic Medicine has developed several clinimetric tools for assessing psychosocial variables in the setting of medical disease and has raised the need for specific evaluations in medical assessment. The term Psychosomatic Medicine today seems to be more timely than ever and provides a home for innovative and integrative thinking at the interface of behavioral and medical sciences.
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the clinical domains of Psychosomatic Medicine
The Journal of Clinical Psychiatry, 2005Co-Authors: Giovanni A Fava, Nicoletta SoninoAbstract:Background The Psychosomatic evidence that has consolidated over the past decades provides the ideal background for dealing with the new needs that emerge in current medical practice. Method A review of the Psychosomatic literature, using both MEDLINE and manual searches, was performed. Search terms were Psychosomatic, Psychosomatic Medicine, mind-body Medicine, and biopsychosocial. Medical journals and books in English were also searched manually. Articles, with particular reference to review articles, which were judged to be relevant to clinical practice, were selected. Results The following aspects were found of particular clinical interest: assessment of psychosocial factors affecting individual vulnerability (life events, chronic stress and allostatic load, well-being, and health attitudes), evaluation of psychosocial correlates of medical disease (psychiatric disturbances, psychological symptoms, illness behavior, and quality of life), application of psychological therapies to medical disease (lifestyle modification, treatment of psychiatric comorbidity, and abnormal illness behavior). Conclusion A Psychosomatic approach may be crucial in managing patients with unexplained somatic symptoms and in identifying psychological distress that cannot be diagnosed by psychiatric categories. Furthermore, it may contribute to recovery and rehabilitation by specific interventions.
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Psychosomatic Medicine emerging trends and perspectives
Psychotherapy and Psychosomatics, 2000Co-Authors: Giovanni A Fava, Nicoletta SoninoAbstract:Developments have occurred in all aspects of Psychosomatic Medicine. Among factors affecting individual vulnerability to all types of disease, the following have been highlighted by recent research: recent and early life events, chronic stress and allostatic load, personality, psychological well-being, health attitudes and behavior. As to the interaction between psychological and biological factors in the course and outcome of disease, the presence of psychiatric (DSM-IV) as well as subclinical (Diagnostic Criteria for Psychosomatic Research) symptoms, illness behavior and the impact on quality of life all need to be assessed. The prevention, treatment and rehabilitation of physical illness include the consideration for Psychosomatic prevention, the treatment of psychiatric morbidity and abnormal illness behavior and the use of psychotropic drugs in the medically ill. In the past 60 years, Psychosomatic Medicine has addressed some fundamental questions, contributing to the growth of other related disciplines, such as psychoneuroendocrinology, psychoimmunology, consultation-liaison psychiatry, behavioral Medicine, health psychology and quality of life research. Psychosomatic Medicine may also provide a comprehensive frame of reference for several current issues of clinical Medicine (the phenomenon of somatization, the increasing occurrence of mysterious symptoms, the demand for well-being and quality of life), including its new dialogue with mind-body and alternative Medicine.
James R Rundell - One of the best experts on this subject based on the ideXlab platform.
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consultation liaison psychiatry vs Psychosomatic Medicine what s in a name
Psychosomatics, 2017Co-Authors: Robert J. Boland, Steven A. Epstein, James R Rundell, David GitlinAbstract:Background: In November of 2017, The Academy of the Psychosomatic Medicine voted to change its name to the Academy of Consultation-Liaison Psychiatry. It followed a similar change in which the American Board of Medical Specialties voted to change the name of the field to Consultation-Liaison Psychiatry. Objective: The authors, all instrumental in bringing about this change, discuss the history and rationale for this name change.
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delirium an evidence based Medicine ebm monograph for Psychosomatic Medicine practice comissioned by the academy of Psychosomatic Medicine apm and the european association of consultation liaison psychiatry and Psychosomatics eaclpp
Journal of Psychosomatic Research, 2012Co-Authors: Albert F G Leentjens, James R Rundell, Teresa A Rummans, Jewel Shim, R Oldham, L Peterson, Kemuel L Philbrick, W Soellner, D Wolcott, Oliver FreudenreichAbstract:a Department of Psychiatry, Maastricht University Medical Centre, P.O. Box 5800, 6212 AZ Maastricht, The Netherlands b Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA c Department of Psychiatry, University of California, San Francisco, CA, USA d Medical Education Programme Psychiatry, San Francisco School of Medicine, University of California (Fresno Campus) and Fresno County Department of Behavioral Health, Fresno, CA, USA e Ingham Regional Medical Center, Lansing, MI, USA f Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA g Department of Psychosomatic Medicine and Psychotherapy, General Hospital Nuremberg, Nuremberg, Germany h Oncology Supportive Care Services, Samuel Oschin Comprehensive Cancer Institute, Samuel Oschin Cancer Center, Los Angeles, CA, USA i Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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factors associated with depression treatment response in an outpatient Psychosomatic Medicine practice an exploratory retrospective study
Psychosomatics, 2012Co-Authors: James R RundellAbstract:Background and Objective The author explored depression management outcomes in an outpatient Psychosomatic Medicine (PM) practice to identify factors associated with treatment response. Methods Medical records of 251 patients seen in the Mayo Clinic Rochester outpatient PM clinic who had Patient Health Questionnaire-9 (PHQ-9) scores at the time of initial consultation and after consultation were reviewed. Comparisons of differences in pre- and post-consultation PHQ-9 scores were evaluated to identify patients with treatment response (score decreased > 50%). Results A total of 112 (44.6%) patients had initial PHQ-9 scores ≥ 5. Univariate comparisons revealed higher likelihood of response (25.9%) with lower average number of past antidepressant and antipsychotic trials, and reported good friend and family social support. After controlling for average number of medication trials, reported good friend support remained predictive of response (OR 3.4225, χ 2 4.6743, P=0.31); there was a trend for reported good family support to remain predictive (OR 2.7956; χ 2 2.5933, P=0.097). Conclusion Though exploratory and underpowered to adequately assess all potential contributors, retrospective examination of factors associated with depression treatment-response in this outpatient PM practice emphasizes the relevance of perception of social support as markers of prognosis and outcome.
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pharmacogenomic testing in a tertiary care outpatient Psychosomatic Medicine practice
Psychosomatics, 2011Co-Authors: James R Rundell, Jeffrey P Staab, Gen Shinozaki, Dahlia Saadpendergrass, Katherine M Moore, Donald E Mcalpine, David A MrazekAbstract:Background Pharmacogenomic testing (PGT) has applicability in Psychosomatic Medicine (PM) practice where medical comorbidity and polypharmacy present particularly difficult challenges of drug–drug and drug–disease interactions. No guidelines currently exist for cost-effective use of PGT in PM practice. Objective The authors tested the hypothesis that naturalistically observed PGT ordering patterns and clinical data on test utility derived from a PM practice where PGT is readily available may inform the development of clinical guidelines for cost-effective use of PGT. Method Two sets of data were collected from an outpatient PM practice staffed by seven PM-certified psychiatrists. Psychiatrists were surveyed regarding their indications for ordering PGT. Medical records of patients seen in the PM practice during 2008 were reviewed. Patients who had PGT were compared with two sets of case controls who were not tested, one matched by demographics, the other by ordering psychiatrist. Psychiatrists' ordering indications were compared with clinical data derived from the case-control analyses. Results Psychiatrists listed treatment-resistance as the most common reason for PGT, ahead of intolerance to previous medications. Tested patients differed from controls on measures of both clinical severity and treatment-resistance, including higher self-reported anxiety and depression levels, greater likelihood of family history of mood or anxiety disorders, and larger numbers of prior antidepressant, mood stabilizer, and antipsychotic medication trials. Conclusion Ordering guidelines that emphasize markers of clinical severity and early indicators of treatment-resistance may provide a useful rationale for PGT in outpatient PM practice. Prospective investigations of this proposition are warranted.
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comprar clinical manual of Psychosomatic Medicine k philbrick 9781585623938 american psychiatric publishing
2011Co-Authors: Kathryn Philbrick, James R Rundell, Pawel Netzel, James L. LevensonAbstract:Tienda online donde Comprar Clinical Manual Of Psychosomatic Medicine al precio 53,56 € de K. Philbrick | J. Rundell | P. Netzel | J. Levenson, tienda de Libros de Medicina, Libros de Psiquiatria - Psiquiatria General
