DOCSLIB.ORG

Exploring a Multifactorial, Clinical Model of Thought Disorder : Application of a Dimensional, Transdiagnostic Approach

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Exploring a Multifactorial, Clinical Model of Thought Disorder : Application of a Dimensional, Transdiagnostic Approach University of Louisville ThinkIR: The University of Louisville's Institutional Repository Electronic Theses and Dissertations 8-2017 Exploring a multifactorial, clinical model of thought disorder : application of a dimensional, transdiagnostic approach. Mara Ann Hart University of Louisville Follow this and additional works at: https://ir.library.louisville.edu/etd Part of the Clinical Psychology Commons, Mental Disorders Commons, Psychiatric and Mental Health Commons, and the Psychological Phenomena and Processes Commons Recommended Citation Hart, Mara Ann, "Exploring a multifactorial, clinical model of thought disorder : application of a dimensional, transdiagnostic approach." (2017). Electronic Theses and Dissertations. Paper 2740. https://doi.org/10.18297/etd/2740 This Doctoral Dissertation is brought to you for free and open access by ThinkIR: The University of Louisville's Institutional Repository. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of ThinkIR: The University of Louisville's Institutional Repository. This title appears here courtesy of the author, who has retained all other copyrights. For more information, please contact [email protected]. EXPLORING A MULTIFACTORIAL, CLINICAL MODEL OF THOUGHT DISORDER: APPLICATION OF A DIMENSIONAL, TRANSDIAGNOSTIC APPROACH By Mara Ann Hart B.A., Loyola College in Maryland, 2006 M.S., Loyola College in Maryland, 2009 A Dissertation Submitted to the Faculty of the College of Arts and Sciences of the University of Louisville In Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy in Clinical Psychology Department of Psychological and Brain Sciences University of Louisville Louisville, KY August 2017 Copyright 2016 by Mara Ann Hart All rights reserved. EXPLORING A MULTIFACTORIAL, CLINICAL MODEL OF THOUGHT DISORDER: APPLICATION OF A DIMENSIONAL, TRANSDIAGNOSTIC APPROACH By Mara Ann Hart B.A., Loyola College in Maryland, 2006 M.S., Loyola College in Maryland, 2009 A Dissertation Approved on: July 29, 2016 by the Following Dissertation Committee Dissertation Director Richard Lewine Benjamin Mast Janet Woodruff-Borden Suzanne Meeks Tracy Eells ii I cannot experience your experience. You cannot experience my experience. We are both invisible men. – R.D. Laing, The Politics of Experience iii ACKNOWLEDGEMENTS I was introduced to thought disorder on my first day of graduate school; so began a five- year journey through which this dissertation evolved. Many people provided help and support along the way. Above all, I am grateful for Rich Lewine, an incredible mentor, researcher, and clinician, who helped me see that grappling with complexity is more important than searching for answers. I am deeply grateful for Debbie Levy, who shared this remarkable dataset with me, without which, this dissertation would not have been possible. Thank you to Morgan Martin, who helped me code thousands of lines of data… twice, somehow staying interested and enthusiastic throughout the process. And to my lab mates, Rachel and Cat, who were there from the beginning and made this journey a whole lot more fun. I would also like to thank to mom and grandma, my cheerleaders, who still can’t quite figure out what this dissertation is about, but have had unyielding interest and confidence in me nonetheless. And to Brian and Olive who have been limitlessly patient and supportive. iv ABSTRACT EXPLORING A MULTIFACTORIAL, CLINICAL MODEL OF THOUGHT DISORDER: APPLICATION OF A DIMENSIONAL, TRANSDIAGNOSTIC APPROACH Mara A. Hart July 29, 2016 Background: Bleuler saw thought disorder as the core defining feature of psychotic phenomena, reflective of the “splitting of the psychic functions” that occurred when, in the process of thinking, one’s ideas and feelings disconnect, becoming fragmented and competing functions. Unfortunately, interest in thought disorder as the conceptual core of psychosis was lost with rise of the modern DSM system, paralleling the shift towards a more simplistic, categorical way of defining psychiatric disorders. Aims: This study examined thought disorder from a dimensional perspective, with the aim of disentangling qualitative heterogeneity and diverse sources of influence. Analyses were based on a large, transdiagnostic sample (n = 322), including individuals diagnosed with schizophrenia, schizoaffective disorder, and bipolar disorder. Structural equation modeling was used to estimate the unique and combined effects of family psychiatric history, age-at-onset, affective state, and sex on two dimensions of thought disorder, namely idiosyncratic thinking and combinatory thinking. We also explored the utility of categorical (i.e. DSM) diagnosis, by estimating the relative proportion of variance it accounted for within the model. v Results: The overall model accounted for 11% of variance in idiosyncratic thinking and 3% of the variance in combinatory thinking. Negative affect was the strongest predictor of idiosyncratic thinking (r = .27), although this effect was significantly more robust in those with a family history of psychosis (r = .37) compared to those without (r = .02). DSM diagnosis was a significant predictor of IV, explaining 7% of unique variance when entered into the full model compared to 9% of the variance when estimated independently, which suggests that the portion of variance explained by diagnosis was largely independent of other predictors in the model. Discussion: The pattern of associations among family psychiatric history, age-at- onset, and negative affect that predicted idiosyncratic thinking are suggestive of a developmental process. This hypothesis is explored in the context of previous research. The broad implications of this research on the classification and study of psychosis is also discussed. vi TABLE OF CONTENTS INTRODUCTION ........................................................................................................................... 1 Limitations of DSM Classification .............................................................................................. 4 Dimensional Measurement: Capturing the Psychosis Continuum .............................................. 8 Thought Disorder: Conceptualization and Assessment ............................................................... 9 Diagnosis-Based Study of Thought Disorder. ........................................................................... 15 The Significance of Affective Experience in the Etiology of Thought Disorder ...................... 20 Moderators and Correlates of Thought Disorder ....................................................................... 25 Demographic Factors. ........................................................................................................... 25 Clinical Factors. .................................................................................................................... 27 Summary ............................................................................................................................... 30 Study Purpose and Hypotheses ................................................................................................. 31 Overview of Proposed Model ............................................................................................... 32 Primary Research Questions ................................................................................................. 34 METHODS .................................................................................................................................... 36 Description of Dataset ............................................................................................................... 36 Measures .................................................................................................................................... 37 Thought Disorder. ................................................................................................................. 37 Affective State. ...................................................................................................................... 39 Family Psychiatric History. ................................................................................................... 41 Analysis Plan ............................................................................................................................. 47 Specified Model. ................................................................................................................... 47 Analysis Decisions ................................................................................................................ 48 Model Fit Criteria. ................................................................................................................. 48 Sample Size and Statistical Power. ....................................................................................... 50 Preliminary Analyses. ........................................................................................................... 50 Missing Values and Outliers ................................................................................................. 53 Primary Analyses ....................................................................................................................... 62 Measurement Model .............................................................................................................. 62 Structural Model .......................................................................................................................
Load more

Recommended publications
  • Do the Lifetime Prevalence and Prognosis of Schizophrenia Differ Among World Regions? Cheryl Lynn Smith
    Claremont Colleges Scholarship @ Claremont CMC Senior Theses CMC Student Scholarship 2018 Do the Lifetime Prevalence and Prognosis of Schizophrenia Differ Among World Regions? Cheryl Lynn Smith Recommended Citation Smith, Cheryl Lynn, "Do the Lifetime Prevalence and Prognosis of Schizophrenia Differ Among World Regions?" (2018). CMC Senior Theses. 1978. http://scholarship.claremont.edu/cmc_theses/1978 This Open Access Senior Thesis is brought to you by Scholarship@Claremont. It has been accepted for inclusion in this collection by an authorized administrator. For more information, please contact [email protected]. Do the Lifetime Prevalence and Prognosis of Schizophrenia Differ Among World Regions? A Thesis Presented by Cheryl Lynn Smith To the Keck Science Department Of Claremont McKenna, Pitzer, and Scripps Colleges In partial fulfillment of The degree of Bachelor of Arts Senior Thesis in Human Biology 04/23/2018 LIFETIME PREVALENCE AND PROGNOSIS OF SCHIZOPHRENIA 1 Table of Contents Abstract …………………………………………………………...……………………… 2 1. Introduction………………………………………………...…………...……………… 3 2. Background Information ……………………………...……………………………….. 5 2.1 Historical Background of Schizophrenia ……………………....…………… 5 2.2 Lifetime Prevalence of Schizophrenia …………………………...…..……… 12 2.3 Prognosis in People with Schizophrenia ……………....………...…..……… 13 3. Methods …………………………………………...……………………..……………. 17 4. Results ……………………………………………...…………………….…….…….... 18 5. Discussion ……………………………………………...……………………………… 24 6. Acknowledgements …………………………………………...……………………….
    [Show full text]
  • The Clinical Presentation of Psychotic Disorders Bob Boland MD Slide 1
    The Clinical Presentation of Psychotic Disorders Bob Boland MD Slide 1 Psychotic Disorders Slide 2 As with all the disorders, it is preferable to pick Archetype one “archetypal” disorder for the category of • Schizophrenia disorder, understand it well, and then know the others as they compare. For the psychotic disorders, the diagnosis we will concentrate on will be Schizophrenia. Slide 3 A good way to organize discussions of Phenomenology phenomenology is by using the same structure • The mental status exam as the mental status examination. – Appearance –Mood – Thought – Cognition – Judgment and Insight Clinical Presentation of Psychotic Disorders. Slide 4 Motor disturbances include disorders of Appearance mobility, activity and volition. Catatonic – Motor disturbances • Catatonia stupor is a state in which patients are •Stereotypy • Mannerisms immobile, mute, yet conscious. They exhibit – Behavioral problems •Hygiene waxy flexibility, or assumption of bizarre • Social functioning – “Soft signs” postures as most dramatic example. Catatonic excitement is uncontrolled and aimless motor activity. It is important to differentiate from substance-induced movement disorders, such as extrapyramidal symptoms and tardive dyskinesia. Slide 5 Disorders of behavior may involve Appearance deterioration of social functioning-- social • Behavioral Problems • Social functioning withdrawal, self neglect, neglect of • Other – Ex. Neuro soft signs environment (deterioration of housing, etc.), or socially inappropriate behaviors (talking to themselves in
    [Show full text]
  • Schizophrenia Clinical Practice Guidelines
    Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders Cherrie Galletly1,2,3, David Castle4, Frances Dark5, Verity Humberstone6, Assen Jablensky7, Eóin Killackey8,9, Jayashri Kulkarni10,11, Patrick McGorry8,9,12, Olav Nielssen13 and Nga Tran14,15 Abstract Objectives: This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function. Methods: The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international
    [Show full text]
  • African American Males Diagnosed with Schizophrenia: a Phenomenological Study
    Virginia Commonwealth University VCU Scholars Compass Theses and Dissertations Graduate School 2011 African American Males Diagnosed With Schizophrenia: A Phenomenological Study Lorraine Anderson Virginia Commonwealth University Follow this and additional works at: https://scholarscompass.vcu.edu/etd Part of the Nursing Commons © The Author Downloaded from https://scholarscompass.vcu.edu/etd/2563 This Dissertation is brought to you for free and open access by the Graduate School at VCU Scholars Compass. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of VCU Scholars Compass. For more information, please contact [email protected]. AFRICAN AMERICAN MALES DIAGNOSED WITH SCHIZOPHRENIA: A PHENOMENOLOGICAL STUDY A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. by LORRAINE B. ANDERSON Bachelor of Science in Nursing, University of Connecticut, Storrs, Connecticut, 1968 Master of Science in Clinical Counseling, Our Lady of the Lake University, San Antonio, Texas, 1979 Master of Public Administration, University of Southern California, Los Angeles, California, 1992 Director: DEBRA E. LYON, PHD, RN, FNP-BC, FNAP PROFESSOR AND CHAIR, SCHOOL OF NURSING Virginia Commonwealth University Richmond, Virginia August 2011 ii Acknowledgements A scholarly dissertation is analogous to a special tapestry in that it reflects the orderly creative alignment of materials and ideas. I wish to thank members of my dissertation committee, Dr. Debra Lyon, Dr. Inez Tuck, Dr. Janet Colaizzi, Dr. Jeanne Salyer and Dr. Shaw Utsey for their facilitation of this weave. I was fortunate to have had the expertise and support of two committee chairs helping me appreciate the warp and the woof underlying the dissertation tapestry I sought to create.
    [Show full text]
  • Neurocase: the Neural Basis of Cognition Transient Paligraphia
    This article was downloaded by: [Florida International University] On: 16 June 2015, At: 04:31 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Neurocase: The Neural Basis of Cognition Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/nncs20 Transient paligraphia associated with severe palilalia and stuttering: A single case report Alfredo Ardila a , Monica Rosselli b , Cheri Surloff c & Jennifer Buttermore b a Instituto Colombiano de Neuropsicologia , Bogota, Colombia b Florida Atlantic University , Davie, Florida c Miami Institute of Psychology , Miami, FL, USA Published online: 17 Jan 2008. To cite this article: Alfredo Ardila , Monica Rosselli , Cheri Surloff & Jennifer Buttermore (1999) Transient paligraphia associated with severe palilalia and stuttering: A single case report, Neurocase: The Neural Basis of Cognition, 5:5, 435-440, DOI: 10.1080/13554799908402737 To link to this article: http://dx.doi.org/10.1080/13554799908402737 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information.
    [Show full text]
  • A Call for Research on the Development of MDD with Psychotic Features Christopher P
    A Call for Research on the Development of MDD with Psychotic Features Christopher P. M. Courtney Faculty Advisor: Dr. Meredith Montgomery, LPCC-S Part 1: Background Part 2: Literature Review Part 3: Psychosocial Development Neurochemistry Erikson’s Psychosocial Development • The Dopamine Hypothesis states that • Considering Erikson's psychosocial stage theory17, MDD symptoms of psychosis (particularly as w/ psychotic features onset seems to increase with ego seen in schizophrenia, which MDD with development between adolescence & later life18. psychotic features can mimic or even • When the fidelity of adolescence falls to the converse of develop into) can be attributed to a identity, that is, identity confusion19, it throws a normative disturbed dopaminergic signal transduction8 experience into a storm of insecurity, which easily can • Bupropion, better known as Wellbutrin, is start and lead to a core disturbance. Intro and Occurrence Stats currently one of the more prescribed anti-depressants, and according to • Young adulthood then begins as a search for intimacy, as In recent years, Major Depressive Disorder (MDD) is Moreira9 extremely effective in the regulation of clinical depression; those at this stage begin to turn outward in an attempt to becoming more normalized considering medication for it specifically, as it inhibits the reuptake of dopamine through the dopamine share their newfound identity. The antithesis of isolation appears in commercials and other media on a regular basis. and norepinephrine transporters10. It must be noted that this is an enters, as those who failed to reconcile the preceding Psychotic symptoms, an often-misunderstood specifier for unusual function for an anti-depressant, although in this case it allows it to identity conflict feel either that they are psychologically this disorder, are occurring more frequently while being work in tandem with anti-psychotics such as Aripiprazole11.
    [Show full text]
  • Formal Thought Disorder in First-Episode Psychosis
    Available online at www.sciencedirect.com ScienceDirect Comprehensive Psychiatry 70 (2016) 209–215 www.elsevier.com/locate/comppsych Formal thought disorder in first-episode psychosis Ahmet Ayera, Berna Yalınçetinb, Esra Aydınlıb, Şilay Sevilmişb, Halis Ulaşc, Tolga Binbayc, ⁎ Berna Binnur Akdedeb,c, Köksal Alptekinb,c, aManisa Psychiatric Hospital, Manisa, Turkey bDepartment of Neuroscience, Dokuz Eylul University, Izmir, Turkey cDepartment of Psychiatry, Medical School of Dokuz Eylul University, Izmir, Turkey Abstract Formal thought disorder (FTD) is one of the fundamental symptom clusters of schizophrenia and it was found to be the strongest predictor determining conversion from first-episode acute transient psychotic disorder to schizophrenia. Our goal in the present study was to compare a first-episode psychosis (FEP) sample to a healthy control group in relation to subtypes of FTD. Fifty six patients aged between 15 and 45 years with FEP and forty five control subjects were included in the study. All the patients were under medication for less than six weeks or drug-naive. FTD was assessed using the Thought and Language Index (TLI), which is composed of impoverishment of thought and disorganization of thought subscales. FEP patients showed significantly higher scores on the items of poverty of speech, weakening of goal, perseveration, looseness, peculiar word use, peculiar sentence construction and peculiar logic compared to controls. Poverty of speech, perseveration and peculiar word use were the significant factors differentiating FEP patients from controls when controlling for years of education, family history of psychosis and drug abuse. © 2016 Elsevier Inc. All rights reserved. 1. Introduction Negative FTD, identified with poverty of speech and poverty in content of speech, remains stable over the course of Formal thought disorder (FTD) is one of the fundamental schizophrenia [7].
    [Show full text]
  • Early Identification of Psychosis a Primer
    Early Identification of Psychosis A Primer Mental Health Evaluation & Community Consultation Unit TABLE OF CONTENTS Introduction...............................................................................................................3 Psychosis and Early Intervention........................................................................4 Why is Early Intervention Needed?...................................................................5 Risk and Onset..........................................................................................................6 Course of First-Episode Psychosis 1. Prodrome........................................................................................................7 2. Acute Phase....................................................................................................8 3. Recovery Phase..............................................................................................9 Summary of First-Episode Psychosis...............................................................11 Tips for Helpers......................................................................................................12 More Resources......................................................................................................15 Acknowledgements...............................................................................................16 2 INTRODUCTION Psychosis is a condition characterized by loss of contact with reality and may involve severe disturbances in perception, cognition, behavior,
    [Show full text]
  • Schizophrenia Spectrum and Other Psychotic Disorders
    1 SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS 2 OBJECTIVES Know and understand: • How to evaluate a person with psychotic symptoms • The epidemiology and clinical characteristics of late- onset schizophrenia • Evaluation of psychotic symptoms associated with disorders other than schizophrenia • Management of older adult patients with psychotic symptoms 3 TOPICS COVERED • Schizophrenia and Schizophrenia Spectrum Syndromes • Psychotic Symptoms in Delirium and Delusional Disorder • Psychotic Symptoms in Mood Disorder • Psychotic Symptoms in Dementia • Isolated Suspiciousness • Syndromes of Isolated Hallucinations: Charles Bonnet Syndrome • Other Psychotic Disorders Ø Psychotic Disorder Due to Another Medical Condition Ø Substance/Medication-Induced Psychotic Disorder 4 PSYCHOTIC SYMPTOMS • Hallucinations are perceptions without stimuli that can affect any of the 5 sensory modalities (auditory, visual, tactile, olfactory, gustatory) • Delusions are fixed, false, idiosyncratic beliefs that can be: Ø Suspicious (paranoid) Ø Grandiose Ø Somatic Ø Self-blaming Ø Hopeless 5 EVALUATION OF A PERSON WITH PSYCHOTIC SYMPTOMS • First evaluate for underlying causes such as delirium, dementia, stroke, or Parkinson disease Ø Acute onset of altered level of consciousness or inability to sustain attention suggests delirium Ø Delirium, most often superimposed on an underlying dementia, is the most common cause of new-onset psychosis in late life • Next, consider a primary mood disorder • Only after other causes are excluded should the diagnosis of
    [Show full text]
  • The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic Criteria for Research
    The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic criteria for research World Health Organization Geneva The World Health Organization is a specialized agency of the United Nations with primary responsibility for international health matters and public health. Through this organization, which was created in 1948, the health professions of some 180 countries exchange their knowledge and experience with the aim of making possible the attainment by all citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. By means of direct technical cooperation with its Member States, and by stimulating such cooperation among them, WHO promotes the development of comprehensive health services, the prevention and control of diseases, the improvement of environmental conditions, the development of human resources for health, the coordination and development of biomedical and health services research, and the planning and implementation of health programmes. These broad fields of endeavour encompass a wide variety of activities, such as developing systems of primary health care that reach the whole population of Member countries; promoting the health of mothers and children; combating malnutrition; controlling malaria and other communicable diseases including tuberculosis and leprosy; coordinating the global strategy for the prevention and control of AIDS; having achieved the eradication of smallpox, promoting mass immunization against a number of other
    [Show full text]
  • Long-Term Risk of Dementia in Persons with Schizophrenia a Danish Population-Based Cohort Study
    Research Original Investigation Long-term Risk of Dementia in Persons With Schizophrenia A Danish Population-Based Cohort Study † Anette Riisgaard Ribe, MD; Thomas Munk Laursen, PhD; Morten Charles, MD, PhD; Wayne Katon, MD ; Morten Fenger-Grøn, MSc; Dimitry Davydow, MD, MPH; Lydia Chwastiak, MD, MPH; Joseph M. Cerimele, MD, MPH; Mogens Vestergaard, MD, PhD Editorial page 1075 IMPORTANCE Although schizophrenia is associated with several age-related disorders and Supplemental content at considerable cognitive impairment, it remains unclear whether the risk of dementia is higher jamapsychiatry.com among persons with schizophrenia compared with those without schizophrenia. OBJECTIVE To determine the risk of dementia among persons with schizophrenia compared with those without schizophrenia in a large nationwide cohort study with up to 18 years of follow-up, taking age and established risk factors for dementia into account. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study of more than 2.8 million persons aged 50 years or older used individual data from 6 nationwide registers in Denmark. A total of 20 683 individuals had schizophrenia. Follow-up started on January 1, 1995, and ended on January 1, 2013. Analysis was conducted from January 1, 2015, to April 30, 2015. MAIN OUTCOMES AND MEASURES Incidence rate ratios (IRRs) and cumulative incidence proportions (CIPs) of dementia for persons with schizophrenia compared with persons without schizophrenia. RESULTS During 18 years of follow-up, 136 012 individuals, including 944 individuals with a history of schizophrenia, developed dementia. Schizophrenia was associated with a more than 2-fold higher risk of all-cause dementia (IRR, 2.13; 95% CI, 2.00-2.27) after adjusting for age, sex, and calendar period.
    [Show full text]
  • Psychosis in Children and Adolescents
    PSYCH TLC DEPARTMENT OF PSYCHIATRY DIVISION OF CHILD & ADOLESCENT PSYCHIATRY UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES PSYCHIATRIC RESEARCH INSTITUTE Psychosis in Children and Adolescents Written by: Jody L. Brown, M.D. Assistant Professor D. Alan Bagley, M.D. Chief Resident Department of Psychiatry Division of Child & Adolescent Psychiatry University of Arkansas for Medical Sciences Initial Review by: Laurence Miller, M.D. Clinical Professor, Medical Director, Division of Behavioral Health Services Arkansas Department of Human Services Initially Developed: 1-31-2012 Updated 3-31-2014 by: Angela Shy, MD Assistant Professor Department of Psychiatry Division of Child & Adolescent Psychiatry University of Arkansas for Medical Sciences Work submitted by Contract # 4600016732 from the Division of Medical Services, Arkansas Department of Human Services 1 | P a g e Department of Human Services Psych TLC Phone Numbers: 501-526-7425 or 1-866-273-3835 The free Child Psychiatry Telemedicine, Liaison & Consult (Psych TLC) service is available for: Consultation on psychiatric medication related issues including: . Advice on initial management for your patient . Titration of psychiatric medications . Side effects of psychiatric medications . Combination of psychiatric medications with other medications Consultation regarding children with mental health related issues Psychiatric evaluations in special cases via tele-video Educational opportunities This service is free to all Arkansas physicians caring for children. Telephone consults are made within 15 minutes of placing the call and can be accomplished while the child and/or parent are still in the office. Arkansas Division of Behavioral Health Services (DBHS): (501) 686-9465 http://humanservices.arkansas.gov/dbhs/Pages/default.aspx 2 | P a g e Table of Contents 1.
    [Show full text]