The experts weighed in on a wide variety of psychiatric issues for the Psychiatric Times February 2022 issue
In the February issue of Psychiatric Times, we connected with experts from across psychiatry to bring you thoughtful articles about a wide variety of psychiatric issues, including the latest in psychedelics; the relationship between neuroplasticity and smart phones; malingering in the COVID-19 era; and ethical considerations for vaccine mandates. Here are some highlights from the issue:
Psychedelics and the Future of PsychiatryOver the past several years, we have witnessed a psychedelic renaissance, and a growing body of evidence suggests that several psychedelic compounds hold strong therapeutic potential for a wide array of mental health conditions.Once dismissed as dangerous and having little therapeutic potential, psychedelic drugs are gaining mainstream acceptance. Research data continue to demonstrate that, on the whole, these medicines are not only safe, but mostly well tolerated. Although more research is needed to better understand safety, especially in the context of at-risk conditions, these favorable safety profiles are enabling deeper exploration of these medicines.
Neuroplasticity and Smart Phones
One of my favorite quotes from philosopher Jiddu Krishnamurti is, “Consciousness is its content.” It makes perfect sense. After reading a book, watching a movie, traveling to Italy, visiting with family over the holidays, finishing a grueling day at work, or surviving a traumatic experience, our mind retains the memories of these experiences in varying regions of our brain. If we ensure a good night’s sleep, the memories of the previous day will be stored for long-term recall in various brain structures during the night by our hippocampus, along with neuronal connections that will allow us to reconstruct all these memory fragments to recreate the experience.
Vaccine Mandate Exemptions for Anxiety: Ethical and Practical Considerations
Lauren T. Edwards, MD; Margaret Emerson, DNP, APRN, PMHNP-BC; David Cates, PhD; and Robert Steel, PhD
Many US health care institutions have established mandatory COVID-19 vaccination policies to protect employees, patients, and the community, as well as to comply with the Occupational Safety and Health Administration’s anticipated emergency temporary standard requiring health care providers with 100 or more employees to ensure that staff are vaccinated.1 In response, some health care workers are submitting vaccine exemption requests for religious, medical, and mental health reasons, and organizations are challenged with determining the validity of these requests with little precedent to inform current policy. The purpose of this article is to discuss how behavioral health (BH) experts in one organization conceptualized anxiety-related medical exemption requests for the COVID-19 vaccine, in an effort to inform others confronted with similar circumstances.
Malingering as a Maladaptive Pattern of Survival During the Pandemic
Malingering is a common challenge for emergency department (ED) clinicians, and disasters such as the COVID-19 pandemic tip more people into such dysfunctional adaptations. We present 3 cases of COVID-19–induced malingering.
Malingering: The Diagnosis
DSM-5 describes malingering as “the intentional production of false or grossly exaggerated physical or psychological problems.”1 More specifically, malingering is a conscious deceptive behavior employed episodically and opportunistically.2 The feigning, simulation, or exaggeration of symptoms is dimensional and continuous rather than an absolute condition.3 Suspected secondary gains include food and shelter, medications, financial gains, and avoidance of jail, work, or family responsibilities.4 In the absence of traditional and reliable psychiatric symptoms, and given the presence of the manipulative features described, malingering is not always considered a legitimate psychiatric disorder.
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