Syllabus and Proceedings Advances in Medicine each year in medical treatment and lost productivity. Further, as the public health crisis of prescription Saturday, May 20, 2017 drug abuse continues to grip the nation, the need to understand the biology of pain and the risks and Medical Mysteries and Practical Med Psych benefits of various pain treatments becomes critical. Updates: Is It “Medical,” “Psychiatric” or a Little of Despite these alarming concerns, few resources have Both...? been dedicated to study pain. Pain is the least Chair: Robert McCarron, D.O. studied phenomenon at the National Institutes of Presenters: Pritham Raj, M.D., Jeremy DeMartini, Health (NIH), yet the most common reason patients Glen Xiong, M.D., Matthew Reed, M.D. proceed to the emergency room seeking care. Moreover, many studies have documented EDUCATIONAL OBJECTIVE: substantial deficits regarding pain education in many 1) Better understand the interplay between general pre-licensure curricula in various health fields. medical conditions and abnormal or maladaptive Essential to the assessment of chronic pain is a behavior; 2) Discuss both common and less common detailed working knowledge of the biopsychosocial psychiatric presentations of frequently encountered model and the influence of mood on pain and vice general medical conditions; and 3) Review “up to versa. The following dynamic discussion will allow date” and evidence-based practice patterns for for a brief but important review of how pain figures medical/psychiatric conditions. into the model and the critical relationship between mood and pain. Next, we will address novel SUMMARY: therapies that address both mood and pain and dive Psychiatrists often encounter clinical scenarios that into the complex phenomenon of how we physically may not have a clear explanation. The Medical respond and experience pain. Finally, we will review Mysteries faculty practice both internal medicine the most salient points regarding rational and psychiatry and will collaborate with the polypharmacy and specific treatment strategies that audience to review several case-based "medical may prove useful for patients suffering from chronic mysteries." A relevant and concise update on several pain. "Med Psych" topics will be discussed. A focus will be placed on covering general medical topics that are Top 10 Medical Stories 2016: A Practical and particularly important to the practice of psychiatry. Comprehensive Review of What We Need to Know Chair: Monique Yohanan, M.D. Pain Medicine and Psychiatry Presenter: David J. Copenhaver, M.D., M.P.H. EDUCATIONAL OBJECTIVE: 1) Review the key medical literature from 2016 with EDUCATIONAL OBJECTIVE: a special focus on stories that are newsworthy and 1) Describe the biopsychosocial model and the likely to impact clinical practice; 2) Provide an relationship to pain; 2) Describe the effect of pain on appraisal of the quality of the evidence supporting mood; 3) Describe the effect of mood on pain and literature selected for inclusion; and 3) Emphasize pain tolerance; 4) Describe novel therapies that disease and lifestyle factors that are associated with address pain and mood; and 5) Compare rational an increase in cardiovascular risk. polypharmacy to other treatment methods. SUMMARY: SUMMARY: The medical treatment of people with psychiatric In the report "Relieving Pain in America," published conditions is essential to optimal care. Disparities in in June of 2011, the Institute of Medicine provided morbidity and mortality for psychiatric patients are shocking insight into pain care in the United States. often related to medical diseases, in particular, The Institute of Medicine report described eye- cardiovascular disease. Cardiovascular diseases and opening statistics stating over 100 million Americans cardiovascular risk factors including diabetes, suffer from chronic pain, with a cost of $635 billion hypertension and hyperlipidemia are common in people with psychiatric diagnoses. In addition, Gunderson, M.D., Mardi Horowitz, M.D. behavioral health factors, such as sedentary lifestyle, impact psychiatric patients in a disparate fashion. EDUCATIONAL OBJECTIVE: This session presents the top 10 medical stories of 1) Illustrate how to use psychodynamic 2016. Selected articles represent topics that are both psychotherapy in PTSD patients; 2) Treat narcissistic newsworthy and likely to impact clinical practice. personality disorder with dynamic therapy; 3) Learn Each publication selected will include an overview of about therapeutic processes in managing BPD the quality of the evidence. patients; 4) Understand when transference work in indicated in dynamic psychotherapy; and 5) Identify Monday, May 22, 2017 and treat resistance in psychodynamic psychotherapy. Using Technology to Help Your Practice: A Practical Overview SUMMARY: Chair: John Luo, M.D. This session will provide an overview of long-term psychodynamic psychotherapy in present-day EDUCATIONAL OBJECTIVE: practice. Dr. Robert Michels will elaborate on the 1) Incorporate appropriate security measures with concept of resistance and how it can be successfully smartphones and computers to maintain and usefully incorporated into the therapy setting. confidentiality of health information; 2) Recognize Dr. Mardi Horowitz will discuss PTSD and its security risks of phishing attacks and avoid malware; treatment. He will cover the current controversies 3) Appropriately utilize social media for marketing about the role of exposure in the treatment and and outreach to patients; 4) Assess their online e- describe his research on using psychodynamic reputation and implement strategies to improve therapy as an alternative to exposure treatment. Dr. reputation; and 5) Assess smartphone applications Eve Caligor will illustrate a transference-focused for use with patients. psychodynamic therapy for narcissistic personality disorder. Dr. John Gunderson will show how to apply SUMMARY: good psychiatric management to BPD and present Technology use today touches almost every aspect the data suggesting that it is just as effective as of the psychiatric practice, including documentation, other empirically validated therapies for BPD. In so billing and communication. There are a great doing, he will also provide an overview of what number of Internet-based applications, including psychodynamic therapeutic processes comprise electronic medical records, social media, search good psychiatric management. Finally, Dr. Glen engines, and health information resources, that hold Gabbard will illustrate the role that transference both great potential good as well as harm with work has in long-term psychodynamic regard to patient care. Smartphones and tablets as psychotherapy. He will base his recommendations well access this wealth of information, and their on the research he has been involved with in Norway “apps” show great promise to change the delivery of and at the Menninger Clinic. In all five presentations, health care. This session will cover issues of security, there will be an emphasis on how research informs privacy, connectivity, and innovation in technology the psychotherapist's interventions. Theory and use in psychiatric practice. practical clinical strategies will be discussed in terms of how one applies to the other. The continued role Advances in Psychiatry of long-term psychodynamic psychotherapy will be emphasized. To make this case, there will be Saturday, May 20, 2017 numerous references to the growing database of studies that lead to the conclusion that Advances in Long-Term Psychodynamic psychodynamic psychotherapy can be considered an Psychotherapy empirically validated entity for use in depression, Chair: Glen O. Gabbard, M.D. anxiety disorders, some personality disorders. Presenters: Eve Caligor, M.D., Robert Michels, John patients who have been traumatized, and those who come to therapy with an uncertain view of their elective surgery? Which psychiatric drugs cause condition and what it is they are seeking. Each osteoporosis? Time will be allotted to answer presenter will provide brief case examples where the audience members’ questions. mechanism of action can be illustrated, and the decision-making regarding what intervention is most Sunday, May 21, 2017 helpful will be discussed as well. A central feature of long-term psychodynamic therapy is that each The New Motivational Interviewing of 2017: Learn individual is unique, and the therapeutic approach the Essentials, Practice Your Skills and Help Your has to be adjusted to who the patient is and what Patients Change the patient wants and needs. There will also be Chairs: Petros Levounis, M.D., Carla Marienfeld, M.D. discussion of how one prepares the patient for long- Presenters: Natassia Gaznick, Bachaar Arnaout term psychodynamic psychotherapy, both in terms of postulated mechanisms of action and what role EDUCATIONAL OBJECTIVE: the patient has to play in making the therapy 1) Describe the new terminology for the spirit and effective. The presenters will provide ample time for processes of motivational interviewing (MI) based on discussion with the audience so questions and the third edition of Motivational Interviewing; 2) concerns can be considered. Each of the presenters Practice the four processes of motivational will also have the opportunity to respond to other interviewing in interactive small- and large-group presenters' lectures. Dr. Glen Gabbard will chair and formats; and 3) Discuss the rationale for using the serve as the moderator of the entire session in