A 3-part series on the manifestations of physician burnout, how COVID-19 changed its scope and revealed systemic fractures, and finally, the path towards resolution and reformation. 

Crisis Point: The Physician Burnout Crisis

. Prior to joining MJH Life Sciences in 2019, he worked as a digital reporter covering nanotechnology, life sciences, material science and more with 

. He graduated with a degree in journalism from Temple University in 2008 and began his career as a local reporter for a chain of weekly newspapers based on the Jersey shore. When not working, he enjoys going to the beach and enjoying the shore in the summer and watching North Carolina Tar Heel basketball in the winter.

And the rates and severity of postpartum depression and postpartum anxiety has only increased during the COVID-19 pandemic.

Anita Clayton, MD, chair of psychiatry and neurobehavioral sciences at the University of Virginia School of Medicine, explained in an interview with 

 why many women are facing these postpartum concerns.

“So I’d say that women who do have postpartum depression often attribute it to other things,” Clayton said. “The baby is up in the night and they need to breastfeed it. That they aren’t getting much sleep. That they need to lose weight.”

2022 Annual Psychiatric Times™ World CME Conference

Clayton also discussed how critical it is for OBGYN doctors to collaborate with psychiatrists when an issue is identified.

“I think the area that OBGYN’s are most concerned about is postpartum depression from their mothers or just from neglect because the mother is depressed,” she said.

Clayton went on to say there is a recommended screening tool commonly used in the US for postpartum depression and there is also an intravenous treatment that has shown promise in this patient population.

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Postpartum depression rates have increased since the COVID-19 pandemic.

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Anita Clayton, MD: Women's Issues in Psychiatry

Identifying and forecasting when a patient might become 

 in San Diego on August 12, Michael Thase, MD, professor of psychiatry, Perelman School of Medicine, University of Pennsylvania, spoke about the need for more medications for treatment-resistant depression.

, Thase explained how there is a segment of the population that the existing medications just will not work for them.

“For many people depression is a short lasting somewhat limiting condition,” Thase said. “Sometimes people can’t get out of it.”

Thase said one of the risk factors for this type of depression is substance use, such as drugs and alcohol. And the COVID-19 only exacerbated some of those issues.

“Rates of depression have gone up during the pandemic,” Thase said. “And since one risk factor for becoming chronically depressed is not getting help and since the pandemic has challenged the treatment capability of society, more people are not only depressed but fewer people are getting help. I am fairly confident we are going to have trouble ahead.”

Alcohol, stress, drug use, and not seeking help are all risk factors for chronic depression.

Michael Thase, MD: Risk Factors for Chronically Depressed Patients

 is something that has become much more complex in recent decades.

Whether or not the drug has positive psychiatric effects can be largely based on the individual percentages of the 2 main compounds of marijuana--tetrahydrocannabinol (THC) and cannabidiol (CBD).

, John J. Miller, MD, Medical Director, Brain Health Website, Seacoast Mental Health Center and co-chair of the 

 in San Diego, explained how complicated the guidance for promoting cannabis is for patients with conditions like depression and anxiety.

“One of the biggest issues currently is that cannabis is a very vague and general term,” Miller said. “Back in the early 60s when it was being used recreationally it was from the original plant. Those strains of cannabis had about 2% THC and 2% CBD.”

Miller said the CBD molecule is the part that has shown efficacy in treating conditions like psychosis and anxiety, while also having inflammatory properties.

He also said 1 of the issues with current studies is they will use the term “cannabis” without breaking down the percentages of THC and CBD.

“A lot of the literature because it doesn’t differentiate the components of the cannabis it is hard to draw evidence based conclusions that we can apply clinically,” Miller said.

CBD has shown promise in treating anxiety and psychosis. 

John J. Miller, MD: Guidance on Cannabis Use in Psychiatry

There remains significant gaps in treatment for patients with 

, particularly when the disease is identified early.

 in San Diego on August 12, Christopher Schneck

University of Colorado HIV Clinic, talked about how we can improve treatment strategies when bipolar disorder is identified early.

“Really this is thinking about what groups who have not fully developed bipolar disorder can we stage an intervention,” Schneck said. “And thinking about both psychopharmaceutic interventions and psychotherapeutic interventions. There really isn’t much out there in the literature.”

In combat these gaps in care, Schneck said there have been a number of recent studies involving both adult patients with bipolar disorder and pediatric patients as well.

He also said studies have looked at siblings of patients with bipolar disorder.

“The way families interact with each other has a great influence on a child’s developmental process and ultimately the development or not of the mood disorder.”

Schneck said there is a 12 session model for treatment in which he will educate both the patient and families about the illness and how to effectively communicate with each other.

There remains a need for better treatments for bipolar disorder when it is identified early. 

Bipolar Disorder

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Christopher Schneck, MD: Early Interventions for Bipolar Disorder

Symptom crossover remains a main reason why diagnostically, mixed feature 

 or unipolar depression are very difficult conditions to identify.

“Someone who is for instance irritable, agitated, just all around moody, might get conceptionally as someone in a mixed state,” Joseph Goldberg, MD, clinical professor of psychiatry at Mount Sinai School of Medicine said in an interview with

. “But you have to rule out other conditions that involve those types of symptoms and there are many.”

Goldberg participated in the “Medical Crossfire: Treatment Approaches to Mixed Features of Bipolar vs Unipolar Depression,” during the conference with Nassir Ghaemi, MD, of Tufts University School of Medicine and Sanjai Rao, MD, of the University of California, San Diego

The doctors discussed issues with mixed feature depression in a debate style format.

Mixed feature depression can be difficult to diagnose because the symptoms can be similar to other psychiatric disorders.

Joseph Goldberg, MD: Treating Mixed Feature Depression

Articles

Investigators identified a correlation between severity of kidney-urinary tract complications and the affected protein involved with intermediate junctional epidermolysis bullosa (JEB).

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Kidney-Urinary Tract Involvement with Intermediate Junctional Epidermolysis Bullosa

Contamination was 11.5% on floors, 7.9% on infusion chairs, and 3.8% on equipment.

C Difficile Infection

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C Difficile Contamination Increases Following CDI Infusions

Prefrontal anodal transcranial direct current stimulation is more effective in treating ADHD compared to stimulation of the right inferior frontal gyrus. 

ADHD

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More Evaluations Needed for Transcranial Direct Current Stimulation Efficacy in Neurodevelopmental Disorders

Jonathan Alicea is an assistant editor for 

. He graduated from Princeton University with a degree with English and minors in Linguistics and Theater. He spends his free time writing plays, playing PlayStation, enjoying the company of his 2 pugs, and navigating a right-handed world as a lefty. You can email him at 

MBTI was effective in reducing sleep onset latency discrepancy but not wake after sleep onset discrepancy.

Sleep

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Mindfulness-Based Therapy For Insomnia May Improve Sleep Onset Latency Discrepancy

Connor Iapoce is an associate editor for 

 and joined the MJH Life Sciences team in April 2021. He graduated from The College of New Jersey with a degree in Journalism and Professional Writing. He enjoys listening to records, going to concerts, and playing with his cat Squish. You can reach him at 

Topical OCS-01 was significantly more effective than vehicle in improving central macular thickness in patients with DME, according to new phase 2 data. 

Age-Related Macular Degeneration

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Topical Dexamethasone Ophthalmic Suspension OCS-01 Effective in DME Treatment

Functional and anatomical improvements with aflibercept treatment were obtained at week 24 and persisted until week 52. 

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Aflibercept Clinically Effective in Inflammatory Choroidal Neovascularization Treatment

Intravitreal 0.2 or 0.1 mg ranibizumab induced a faster regression of plus disease, stage 3 ROP, and AP-ROP compared to laser. 

Median Time to ROP Regression Faster with Ranibizumab Compared to Laser 

Daily self-imaging scans and in-office OCT scans graded by human experts agreed on the fluid status in 96% of the cases. 

Daily Self-Imaging with Home OCT Viable Among Patients with nAMD 

The agency has taken new action against Juul while experts worry about youth addiction and health impacts. But the e-cigarette market has been already well established in the US.

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Up in Smoke: The FDA's Retroactive Fight to Limit E-Cigarettes

Data show foveal thickness fluctuation was significantly associated with logMAR BCVA and the defect length of the foveal EZ band. 

Latest News

Anita Clayton, MD: Women's Issues in Psychiatry

Michael Thase, MD: Risk Factors for Chronically Depressed Patients

John J. Miller, MD: Guidance on Cannabis Use in Psychiatry

Christopher Schneck, MD: Early Interventions for Bipolar Disorder

Joseph Goldberg, MD: Treating Mixed Feature Depression