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Browsing by Author "Holmes, Emily G."

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    Against Medical Advice Discharge: A Narrative Review and Recommendations for a Systematic Approach
    (Elsevier, 2021-06) Holmes, Emily G.; Cooley, Benjamin S.; Fleisch, Sheryl B.; Rosenstein, Donald L.; Psychiatry, School of Medicine
    Approximately 1%-2% of hospitalizations in the United States result in an against medical advice discharge. Still, the practice of discharging patients against medical advice is highly subjective and variable. Discharges against medical advice are associated with physician distress, patient stigma, and adverse outcomes, including increased morbidity and mortality. This review summarizes discharge against medical advice research, proposes a definition for against medical advice discharge, and recommends a standard approach to a patient's request for discharge against medical advice.
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    A Case of Mast Cell Leukemia: A Review of the Pathophysiology of Systemic Mastocytosis and Associated Psychiatric Symptoms
    (Elsevier, 2018) Jamison, Nathan K.; Holmes, Emily G.; Psychiatry, School of Medicine
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    Catatonia: A Narrative Review for Hospitalists
    (Elsevier, 2023-09-28) Smith, Alyssa C.; Holmes, Emily G.; Psychiatry, School of Medicine
    Background: Catatonia is a complex psychomotor syndrome commonly associated with psychiatric disorders. However, hospitalists encounter this condition on medical floors, where it is typically due to an underlying medical, especially neurological, etiology. Delays in the diagnosis of catatonia are common and lead to worsened outcomes for patients, including a multitude of medical complications, such as venous thromboembolism and stasis ulcers. Catatonia due to a medical condition is less likely to respond to benzodiazepine therapy; identification and treatment of the underlying cause is crucial. Methods: This article provides a practical review of the catatonia literature, with a focus on diagnosis, workup, and management of catatonia for patients admitted to medical hospitals. Conclusions: With greater knowledge about catatonia, internists are uniquely positioned to recognize and initiate treatment.
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    Collaborative Care for Depression and Anxiety in the Bone Marrow Transplant Population: A Pilot Feasibility Study
    (Wiley, 2021) Copeland, Anureet C.; Tan, Xianming; Nash, Rebekah P.; Holmes, Emily G.; Markey, Janell; Shea, Thomas C.; Wood, William A.; Park, Eliza M.; Psychology, School of Science
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    A Rare Presentation of Catatonia due to Primary Adrenal Insufficiency
    (Elsevier, 2019) Puzanov, Maria; Davis, Hillary; Holmes, Emily G.; Psychiatry, School of Medicine
    Primary adrenal insufficiency (PAI), also called Addison’s disease, is an endocrine disorder in which the adrenal glands are unable to produce an adequate amount of glucocorticoids and/or mineralcorticoids. Acute adrenal insufficiency can present with neuropsychiatric symptoms including depression, anxiety, cognitive complaints, and changes in mental status progressing from decreased responsiveness to stupor and coma(1). It has been estimated that the prevalence of neuropsychiatric symptoms in PAI ranges from 64-84%. Though there are no case reports in the recent literature, catatonia has been associated with PAI in historical case reports(2). Therefore, PAI as a cause of catatonia may be under-recognized by psychiatrists and endocrinologists. As PAI can be potentially life threatening, it is important for the consultation-liaison psychiatrist to be able to recognize the condition in the context of vague, nonspecific neuropsychiatric complaints. Here, we present a case of catatonia presenting secondary to PAI and review the literature of neuropsychiatric symptoms associated with PAI.
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