Rounds in the General Hospital
For hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms, Dr Stern discusses diagnosis and management with members of the Consultation Service at Massachusetts General Hospital. These rounds reports will prove useful for clinicians practicing at the interface of medicine and psychiatry.
Rounds in the General Hospital
Managing Anxiety, Agitation, and Pain in Critically Ill Patients
April 1, 2025
Pain, fear, anxiety, sleep disturbances, and agitation are common symptoms among critically ill patients, causing distress, interfering with medical care, and contributing to morbidity post discharge.
Rounds in the General Hospital
Wishing That Your Patient Would Die: Reasons and Reactions
February 25, 2025
The authors explore the complexity, intensity, and critical decision-making faced by health care staff while caring for chronically and critically ill patients, especially in the context of medical futility.
Rounds in the General Hospital
Management of Insomnia in the General Hospital
January 21, 2025
Although the etiology of insomnia is often multi-factorial, both nonpharmacologic and various pharmacologic approaches can provide rapid relief; unfortunately, each is associated with drug-drug interactions and potentially problematic side…
Rounds in the General Hospital
Focal Impaired Awareness Seizures: Evaluation and Management
January 3, 2025
Focal impaired awareness seizures can look like other psychiatric, neurological, and medical presentations, and due to the changes in affect, behavior, and cognition, are often misdiagnosed as a primary…
Rounds in the General Hospital
Treatment of Pain in the Context of Alcohol and Substance Use Disorders
October 17, 2024
When prescribing opioids for pain, prescription monitoring programs should be checked, regular urine toxicology screening should be conducted, and patients with an opioid use disorder should receive FDA-approved medication…
Rounds in the General Hospital
Management of Rumination and Obsessions in Primary Care
May 30, 2024
Difficult-to-control negative repetitive thoughts can manifest as ruminations or obsessions. Appropriate early identification and intervention can positively affect the course and prevent an episode of psychiatric illness.
Rounds in the General Hospital
Strategies for Cutting Down and Stopping Alcohol Use
May 28, 2024
Knowledge of nonpharmacologic approaches as well as medications’ mechanisms of action, side effects, and drug-drug interactions can facilitate the timely and appropriate use of psychotropics to help individuals cut…
Rounds in the General Hospital
Traumatic Brain Injury: Manifestations and Management
May 9, 2024
Imaging provides important information about structural and functional brain changes following TBI, and results can guide interventions. In addition to pharmacologic approaches for persistent symptoms, psychoeducation is an invaluable…
