During my first site visit, I presented a patient who was admitted to the psychiatric ER for suicidal ideations. This young woman was an overwhelmed individual who found it difficult to adjust to situations surrounding COVID, a loss of a job, and breakup with a long-term boyfriend. I found this case particularly interesting because I was able to understand how she was feeling and could even relate some of my feelings and worries surrounding all these unknowns. The PA and I discussed the importance of talk therapy and staying in touch with loved ones during this time, and how it …

Treatment-Specific Associations Between Brain Activation and Symptom Reduction in OCD Following CBT: A Randomized fMRI Trial This study examined if brain activity is associated with treatment response to CBT (cognitive behavioral therapy) in adolescents and adults with OCD. This was compared to a control group (stress management therapy).  This was a RCT of 87 participants. 42 were assigned to CBT and 45 were assigned to SMT. Patients were required to have an early age at symptom onset (<15 years) and moderate or greater levels of symptoms at baseline – score >16 on either the standard or the Children’s version of …

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H&P 1 CC: Suicidal Ideations and Depression HPI 31 y/o female with no PMH and no past psych history brought in by EMS for questionable suicide attempt with cyclobenzaprine. EMS was called by the patient’s work counselor who was told she took 8-10 pills of cyclobenzaprine on Sunday so she could “sleep for a long time” because she “didn’t want to deal with life”. Prior to taking pills, she states she was coming home from a work trip and felt anxious and heart palpitations, which prompted her to call her counselor 2 days later on Tuesday. Pt stated she has …

Overall, this rotation was a great learning experience. This rotation definitely presented as a challenge at first. I found it particularly difficult to interview patients who were acutely psychotic and not in touch with reality since it was hard to follow their thought process. Although this was challenging at first, it became easier to establish a rapport with them after being stabilized in the Psychiatric ER. My perspective on psychiatric patients changed as a result of this rotation. There is sometimes a negative stigma that occurs with patients who have mental health issues. However, you realize that all these patients …