Live Grand Rounds: Difficult to treat depression (DTD): Clinical Value and Research Challenges
Many patients with depression cannot be brought into a state of sustained symptom remission. Sometimes called “treatment resistant” depression, they may be better understood as “difficult to treat depressions” (DTD) because this clinical heuristic promotes the search for treatable pharmacological, psychosocial, and biological/medical obstacles to achieving or sustaining remission. Furthermore, the DTD heuristic recognizes that some depressions may be better managed by optimizing symptom control, quality of life, and daily function, rather than by conducting multiple revisions in treatment from which little, longer-term benefit may be expected. The clinical challenges (e.g., selecting assessments for treatable causes; identifying treatment sequences for specific patients) as well as the research challenges (e.g., defining types of DTD; assessing outcomes) are discussed.
Category
  • Grand Rounds
  • Mood Disorders
Format
  • Live Webinar
Credits
  • 1.00 ACEP NBCC clock hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Category I credits for Social Workers
  • 1.00 Psychologists
  • 1.00 MNA Contact Hours for Nurses
  • 1.00 Participation
Event date January 31, 2024
Live Grand Rounds: A Systematic Approach to the Management of Difficult-to-Treat Depression
“Treatment resistant depression (TRD)” is defined when a patient’s depression has failed to respond to two consecutive adequate trails of different antidepressants. This begs the question as to who or what is “resistant”. TRD focuses on non-response, does not take into account the equally challenging situations of lack of a sustained response or intolerance/contraindication/non-acceptance of treatment. “Difficult-to-treat depression (DTD)” is an alternative, more clinically orientated, concept of depression with poor outcomes. It describes depression that continues to cause a burden to the patient despite usual treatment efforts by the clinician. Most importantly, DTD is associated with a chronic, rather than acute, illness model of care. Key to this is holistic, individualised, management identifying factors that may contribute to the poor outcome and which may be tractable. While remission of symptoms is the primary goal of treatment, if this is difficult to achieve, the focus might more appropriately shift towards optimal management of residual symptoms and most importantly improvement in psychosocial functioning and quality of life. This presentation will discuss how to manage DTD systematically using the DTD model of care to optimize not only symptomatic improvement of patients, but also reducing risks of relapse and maximizing improvements in patient’s quality of life.
Category
  • Grand Rounds
  • Mood Disorders
Format
  • Live Webinar
Credits
  • 1.00 ACEP NBCC clock hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Category I credits for Social Workers
  • 1.00 Psychologists
  • 1.00 MNA Contact Hours for Nurses
  • 1.00 Participation
Event date February 7, 2024
Live Grand Rounds: Treatment Resistant & Chronic Depression Treatment Modalities
It is estimated that approximately 280 - 350 million people in the world suffer from depression and is the leading cause of disability around the world. Treatment response and remission do not occur in every patient treated for depression and have led to the use of the term treatment resistant depression (TRD). This talk will review the model of treatment resistant depression, its limitations and offer a view through a difficult to treat depression model. This talk will also focus on the importance of thorough assessment as well as current and future treatments.
Category
  • Grand Rounds
  • Mood Disorders
Format
  • Live Webinar
Credits
  • 1.00 ACEP NBCC clock hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Category I credits for Social Workers
  • 1.00 Psychologists
  • 1.00 MNA Contact Hours for Nurses
  • 1.00 Participation
Event date February 14, 2024
Live Grand Rounds: Ethical Considerations in Psychedelic-Assisted Therapies
As clinical trials progress in the United States, the potential for psychedelic-assisted psychotherapy for various indications to become an approved prescription treatment looks increasingly promising. Clinicians interested in new treatment options for mood, anxiety, and substance use disorders can learn the basics on psychedelic-assisted therapy treatment elements and the current state of the research. This information will be presented to help clinicians consider how psychedelic-assisted psychotherapy might be used in the future to serve their patient populations and highlight key ethical considerations in this area.
Category
  • Conceptual Psych
  • Ethics/Legal
  • Grand Rounds
Format
  • Live Webinar
Credits
  • 1.00 ACEP NBCC clock hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Category I credits for Social Workers
  • 1.00 Psychologists
  • 1.00 MNA Contact Hours for Nurses
  • 1.00 Participation
Event date February 21, 2024
Live Grand Rounds: The Neuroscience of Psychotherapy
Over the past few decades, advances in the neurosciences have led to exciting opportunities to correlate subjective symptom reports with objective measures using imaging and neuroendocrine markers. It is well established that psychotherapy has biological effects on reshaping maladaptive neuronal responses, leading to more flexible activation patterns. This occurs in tandem with clinical response to successful psychological treatments, as patients may soften their rigid cognitions regarding self and others, allowing for more measured approaches to their conflicts. It can be difficult to assimilate the expansive literature on this topic, making it hard to know what information is relevant and useful for practitioners. This presentation will distill how psychotherapy can lead to neurobiological change, linking its effect with the maladaptive activation patterns seen in common psychiatric conditions.
Category
  • Grand Rounds
  • Mood Disorders
  • Psychotherapy
Format
  • Live Webinar
Credits
  • 1.00 ACEP NBCC clock hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Category I credits for Social Workers
  • 1.00 Psychologists
  • 1.00 MNA Contact Hours for Nurses
  • 1.00 Participation
Event date March 6, 2024
Live Grand Rounds: Risk Factors and Warning Signs for Adolescent Suicide Attempts
Suicide is a leading cause of death among youth and an urgent public health and clinical concern. King’s presentation will cover the demographic and clinical risk for adolescent suicide attempts, highlighting the importance of multi-factorial risk prediction. Following a discussion of risk factors, Dr. King will describe the challenges of suicide risk screening and share the evidence base for three adolescent suicide risk screening tools, discussing their relative strengths and weaknesses. Finally, recent empirical data on the 14-hour warning signs for adolescent suicide attempts will be presented.
Category
  • Child & Adolescent
  • Grand Rounds
  • Suicide/Crisis
Format
  • Live Webinar
Credits
  • 1.00 ACEP NBCC clock hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Category I credits for Social Workers
  • 1.00 Psychologists
  • 1.00 MNA Contact Hours for Nurses
  • 1.00 Participation
Event date March 20, 2024
Live Grand Rounds: Managing Behavioral and Psychological Symptoms of Dementia (BPSD) In The Era Of Boxed Warnings
Behavioral and Psychological Symptoms of Dementia (BPSD) refers to a group of non-cognitive symptoms and behaviors that occur commonly in patients with dementia. They result from a complex interplay between various biological, psychological and social factors involved in the disease process. BPSD is associated with increased caregiver burden, institutionalization, a more rapid decline in cognition and function and overall poorer quality of life. It also adds to the direct and indirect costs of caring for patients with dementia. Available data indicate efficacy for some non-pharmacological and pharmacological treatment modalities for BPSD. However, recently the use of psychotropic medications for the treatment of BPSD has generated controversy due to increased recognition of their serious adverse effects.
Category
  • Geriatrics/Older Adults
  • Grand Rounds
  • Mood Disorders
  • Psychopharmacology
Format
  • Live Webinar
Credits
  • 1.00 ACEP NBCC clock hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Category I credits for Social Workers
  • 1.00 Psychologists
  • 1.00 MNA Contact Hours for Nurses
  • 1.00 Participation
Event date April 25, 2024
Live Grand Rounds: Creative Resilience & Aging: Frank Sinatra’s Aging in Rhythm
Frank Sinatra (1915-1998) was among the most admired and influential performing artists of the 20th century, with an approach to rhythm and phrasing that left a deep and lasting impression on all popular singers to follow. At the same time, his public persona and private life were among the most controversial of public figures. This presentation will use images, audio, and video clips to illustrate Mr. Sinatra’s professional journey across six decades, including examination of his lifelong alcohol use and periods of despondency and suicidality. We will pay special attention to how he dealt with his own aging process, including how he continued to tour in concert well into the progressive dementia that would eventually end his career. His story holds rich implications for considering the creative resilience potential in aging, and for the limitations to such resilience posed by illness and functional impairment.
Category
  • Geriatrics/Older Adults
  • Grand Rounds
  • Well-Being
Format
  • Live Webinar
Credits
  • 1.50 ACEP NBCC clock hours
  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 Category I credits for Social Workers
  • 1.50 Psychologists
  • 1.50 MNA Contact Hours for Nurses
  • 1.50 Participation
Event date April 30, 2024
Live Grand Rounds: Ethical Issues in Treating LGBTQ Patients
The American Psychiatric Association’s Principles of Medical Ethics emphasize competence, respect and up-to-date knowledge as a basis for appropriate professional behavior toward lesbian, gay, bisexual, transgender and queer (LGBTQ) patients. After providing some definitions of helpful terms, this presentation then reviews historical psychiatric attitudes towards LGBTQ patients that could be construed, at best, as patronizing and, at worst, overtly hostile. In modern clinical practice, as opposed to trying to “cure” homosexuality or “transsexualism,” LGBTQ patients are helped to live their lives according to their own natures and desires. This presentation outlines some common clinical questions raised by LGBTQ patients—what is known and not known about the origins of homosexuality and transgender expression, sexual orientation conversion efforts (SOCE), therapist self-disclosure, how therapists should address LGBTQ patients, and controversies surrounding treatment of transgender children—as well as ethical issues raised in these clinical encounters.
Category
  • Ethics/Legal
  • Grand Rounds
  • LGBTQIA+
Format
  • Live Webinar
Credits
  • 1.00 ACEP NBCC clock hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Category I credits for Social Workers
  • 1.00 Psychologists
  • 1.00 MNA Contact Hours for Nurses
  • 1.00 Participation
Event date May 22, 2024