Journal of the Academy of Consultation-Liaison Psychiatry会诊联络精神病学学会杂志
Journal of the Academy of Consultation-Liaison Psychiatry,ISSN 2667-2979,中文译名:会诊联络精神病学学会杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
Journal of the Academy of Consultation-Liaison Psychiatry 最新收录文献
-
2. Implementation and Preliminary Evaluation of an Intravenous Ketamine Protocol for Psychiatric Conditions in Medical and Surgical Units: A One-Year Pilot Study.
PMID:日期:2026-09-21Ketamine is an emerging therapy in psychiatry, but its implementation in the general hospital setting remains limited due to monitoring requirements, personnel allocation, and safety concerns in medically complex patients. Consultation-liaison (C-L) psychiatry services are well-positioned to deliver such interventions, yet practical models for doing so are lacking. To describe the implementation and feasibility of an intravenous ketamine protocol for depression and other psychiatric indications on general medical and surgical units at a quaternary academic medical center. A psychiatry-specific IV ketamine protocol was developed and approved through institutional pharmacy and nursing committees. The infusion rate was capped at 5 mcg/kg/min, with doses ranging from 0.5 to 1.0 mg/kg. Patients were maintained at routine floor-level care with continuous pulse oximetry during infusion. Feasibility was assessed through operational integration into existing hospital workflows, including the need for additional staffing, aborted procedures, care escalations, and the sustained use of the protocol. Tolerability outcomes included side effects, PRN medication use, and infusion rate adjustments or discontinuations. When applicable, depression and anxiety were assessed using the Montgomery-Åsberg Depression Rating Scale, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 at baseline and after each infusion. The protocol was implemented hospital-wide beginning February 2025, with data collection concluding February 2026. Sixteen patients received a total of 51 infusions across medical and surgical units. Primary indications included major depressive episodes, bipolar depression, catatonia, and anxiety. The protocol was sustained over a one-year observation period without additional staffing, modifications to existing unit workflows, or aborted procedures. No infusions required rate adjustment or discontinuation, and no patients required escalation to higher-acuity monitoring or transfer to the ICU or PACU. Eight patients reported transient side effects; no serious adverse events occurred, and one instance of a PRN medication (ondansetron) was administered across all infusions. Among 14 patients treated for depression, 12 showed improvement from baseline to last recorded score, while five met thresholds for response and three for remission. The protocol remains in active use. A capped-rate IV ketamine protocol tailored for psychiatry was feasibly delivered on general medical and surgical floors. The protocol integrated into existing C-L workflows and may serve as a scalable model for expanding access to rapid-acting psychiatric intervention in medically ill populations.
-
3. CL Case Conference: The Evaluation and Management of Anxiety and Cannabis Use in Pregnancy.
PMID:日期:2026-09-21We present a case of a 25-year-old G2P0010 female in her second trimester with a history of unspecified anxiety disorder, cannabis use, and insulin-dependent diabetes who was admitted to the obstetrics and psychiatry hospitals multiple times over the span of months for self-induced vomiting. During her hospitalization, the patient was trialed on different anxiolytics with varied safety profiles in pregnancy. Reproductive psychiatry experts discuss critical aspects of psychiatric care during pregnancy, including medication management of anxiety and agitation while weighing the risks of medicine versus the risks of untreated illness. The impact of perinatal cannabis use on anxiety, its effect on treatment planning, and other pertinent systemic factors to consider in treating complex psychiatric patients in obstetrical settings, such as disposition, are also reviewed.
-
6. Diagnostic Accuracy and Preliminary Psychometric Validation of the Spanish Stanford Proxy Test for Delirium in Non-intubated Mexican ICU and Intermediate Care Patients.
PMID:日期:2026-09-19To evaluate the diagnostic performance, internal consistency, and construct validity of the Spanish Stanford Proxy Test for Delirium (S-PTD) in non-intubated critically ill Mexican patients admitted to intensive and intermediate care units. We conducted a single-site cross-sectional psychometric study in adult patients admitted to intensive care and intermediate care units within the first 48 hours of admission. Trained nursing staff administered the Spanish S-PTD at the end of the clinical shift, and results were compared with an independent delirium assessment performed by consultation-liaison psychiatrists using DSM-5 criteria. Patients with endotracheal intubation or Richmond Agitation-Sedation Scale (RASS) scores ≤ -3 were excluded by protocol. Diagnostic accuracy, receiver operating characteristic curve performance, internal consistency, and exploratory factor structure were examined. A total of 120 patients were analyzed. Mean age was 62.5 ± 18.1 years, 64 (53.3%) were men, and 87 (72.5%) were admitted for medical conditions. DSM-5 delirium was identified in 21 patients (17.5%), whereas 27 patients (22.5%) screened positive using the S-PTD cutoff of ≥3. At this cutoff, the S-PTD demonstrated an AUC of 0.87, accuracy of 88.3% (95% CI, 81.4%-92.9%), sensitivity of 81.0% (95% CI, 60.0%-92.3%), specificity of 89.9% (95% CI, 82.4%-94.4%), positive predictive value of 63.0% (95% CI, 44.2%-78.5%), and negative predictive value of 95.7% (95% CI, 89.5%-98.3%). Internal consistency was high (Cronbach's α = 0.948). Exploratory factor analysis provided preliminary evidence supporting construct validity and a predominantly unidimensional structure (KMO = 0.84; Bartlett's test p < .001). The first factor had an eigenvalue of 7.71 and explained 64.2% of the variance, whereas the second eigenvalue was 0.97. In this non-intubated ICU/IMCU Mexican cohort, the Spanish S-PTD demonstrated promising diagnostic accuracy and psychometric properties when administered by trained nursing staff. Findings should be interpreted cautiously because of the single-site design, limited number of delirium cases, exclusion of mechanically ventilated and moderately/deeply sedated patients, absence of formal inter-rater reliability testing, and the small number of patients with documented cognitive impairment or dementia. Further multicenter studies, including mechanically ventilated patients, are needed before broad implementation in critically ill populations.
-
9. Benzodiazepine Prescribing in Delirium Diagnosis: National Data on Clinical Practice.
PMID:日期:2026-08-18Delirium is a common and serious neuropsychiatric condition, yet current patterns of benzodiazepine use around delirium diagnoses across various clinical settings remain poorly delineated. This retrospective cohort study aims to characterize clinicians' benzodiazepine prescribing patterns in chart-based delirium diagnosis in various clinical settings within a large national health record network, focusing on medication types, other psychotropic use, and temporal trends. Using a large health database to assess benzodiazepine prescribing in delirium. Data were obtained from the TriNetX US Collaborative Network (132 million patients across 72 health care organizations), including both academic and nonacademic sites with inpatient and critical care services. Between 1,313,619 and 3,821,400 patient records with an International Statistical Classification of Diseases, Tenth Revision clinically-recorded diagnosis of delirium were identified across 4 cohorts using differing delirium definitions, with inclusion irrespective of etiology, comorbidity burden, or medications. Benzodiazepine prescribing patterns before and after delirium diagnosis were examined at 5-day intervals across clinical settings, focusing on lorazepam, midazolam, and diazepam and compared with patterns of antipsychotic medications and dexmedetomidine. Benzodiazepine prescribing patterns over the 2015-2024 period were also evaluated to assess longitudinal trends. Benzodiazepine prescription within 5 days after delirium diagnosis ranged from 37.1% to 57.8% across settings, with higher proportions in critical care compared to inpatient environments. Nonacademic institutions displayed slightly higher use than academic centers, although differences were not consistent across the groups. Benzodiazepine prescription increased progressively in the days preceding the delirium diagnosis and peaked immediately afterward. Lorazepam was the most frequently used agent, followed by midazolam and diazepam. Antipsychotic use ranged from 30.1% to 34.4%, of which haloperidol was the most commonly used antipsychotic, followed by quetiapine, olanzapine, and risperidone. Dexmedetomidine use within 5 days after delirium ranged 18.3-21.7% in critical care settings. Over the past decade, benzodiazepine prescribing in clinically-diagnosed delirium has shown minimal variation, ranging 33.9%-41.2%. Benzodiazepines are frequently prescribed around the time of delirium diagnoses across diverse inpatient settings. Overall, the data highlight a discrepancy between guidelines discouraging benzodiazepines and actual clinical practice. The data suggest the need for further research that may identify clinical approaches to enhance adherence to delirium management guidelines.