Syllabus and Proceedings Courses Friday, October 05, 2018 Thursday, October 04, 2018 2018 Psychiatry Review and Clinical Synthesis Buprenorphine and Office-Based Treatment of Directors: Philip R. Muskin, M.D., M.A., Tristan Opioid Use Disorder Gorrindo, M.D. Director: John A. Renner, M.D. Faculty: Ilse R. Wiechers, MaryBeth Lake Faculty: Petros Levounis, M.D., Andrew John Saxon, M.D. EDUCATIONAL OBJECTIVES: At the conclusion of this session, the participant EDUCATIONAL OBJECTIVES: should be able to: 1) Identify gaps in knowledge in At the conclusion of this session, the participant psychiatry and neurology through self-assessment; should be able to: 1) Discuss the rational and need 2) List key diagnostic and treatment strategies for for Medication-Assisted Treatment (MAT) of opioid major disorders in psychiatry; 3) Create individual use disorder; 2) Apply the pharmacological learning plans for addressing knowledge gaps; and 4) characteristics of opioids in clinical practice; 3) Convey a working knowledge of the various topical Describe protocols of treatment for buprenorphine areas likely to be encountered during lifelong and other forms of MAT and protocols for optiaml learning activities. patient/treatment matching; 4) Describe the legislative, logistical and regulatory requirements of SUMMARY: office-based opioid pharmacotherapy; and 5) Discuss Using a “flipped classroom” design, participants will treatment issues and management of opioid use engage in a multi-week self-study exercise designed disorder in adolescents, pregnant women and to increase knowledge and critical reasoning of patients with acute and/or chronic pain. essential psychiatric and neurology topics. The first book, Study Guide for the Psychiatry Board SUMMARY: Examination, consists of several hundred self-study The course will describe the resources needed to set multiple-choice questions (MCQ) including answers up office-based treatment with buprenorphine and and explanations. The second book is a curated naltrexone for patients with opioid use disorder and compendium of review articles from FOCUS: The will review 1) DSM-5 criteria for opioid use disorder Journal of Lifelong Learning, which have been and the commonly accepted criteria for patients compiled to summarize current diagnostic and appropriate for office-based treatment of OUD; 2) treatment approaches for major disorders in confidentiality regulations related to treatment of psychiatry. The third text is Approach to the substance use disorders; 3) Drug Enforcement Psychiatric Patient, a case-based exploration of Administration requirements for prescribing opioids psychiatric topics. Course participants are for the treatment of OUD and for record keeping; 4) encouraged to use these materials to review major staffing requirements, billing, and common office topics in psychiatry prior to attending IPS: The procedures; 5) the epidemiology, symptoms, and Mental Health Services Conference. During the live current treatment of anxiety, common depressive portion of this course, participants will work in small disorders, ADHD, and how to distinguish groups and with expert faculty in general psychiatry, independent psychiatric disorders from substance- geriatric psychiatry, child psychiatry, and induced psychiatric disorders; and 6) common consultation-liaison psychiatry to complete a series clinical events associated with addictive behavior, of case-based vignettes that have been designed to including relapse, medication diversion and illustrate high-yield and key learning points for major disruptive behavior. Special treatment populations, disorders in psychiatry. This four-hour clinical including adolescents; pregnant women; and synthesis session is designed to help learners geriatric, HIV positive, and chronic pain patients will integrate and apply knowledge through clinical be addressed, and small-group case discussions will vignettes and to reinforce key principles in be used to reinforce learning. psychiatry. Good Psychiatric Management for Borderline Pediatric Psychoparmacology Personality Disorder Director: John T. Walkup, M.D. Director: Brian A. Palmer, M.D., M.P.H. Faculty: Thomas K. Cummins, M.D., Julie Sadhu, Faculty: Victor Hong, M.D., John Gunder Gunderson, Rachel R. Ballard, M.D., Nicholas M. Hatzis, M.D. M.D. EDUCATIONAL OBJECTIVES: EDUCATIONAL OBJECTIVES: At the conclusion of this session, the participant At the conclusion of this session, the participant should be able to: 1) Discuss the assessment of should be able to: 1) Diagnose borderline personality aberrant behaviors associated with Autism Spectrum disorder correctly, including differentiating from Disorder and the evidence base for their mood disorders and explaining the diagnosis to a psychopharmacological treatment; 2) Describe the patient; 2) Articulate principles for management of diagnostic assessment of attention deficit safety issues in patients with borderline personality hyperactivity disorder and it’s treatment with disorder; 3) Describe the course and outcome of BPD stimulants and non-stimulant medications; 3) and the impact of BPD on mood disorders and vice- Recognize the developmental stages and ages of risk versa; 4) Explain key principles and evidence in the for anxiety and depressive disorders in children and pharmacological treatment of BPD; and 5) adolescents; 4) Recognize elements of treatment of Understand the role of split treatments and family anxiety and depression in children and adolescents involvement in the treatment of BPD. that differ from treatment of these disorders in adults; and 5) Discuss the presentation, evaluation, SUMMARY: differential diagnosis and treatment of psychotic This course will teach psychiatrists the basics of what symptoms in younger people including similarities they need to know to become capable—and and differences when compared to adults. comfortable—in treating patients with borderline personality disorder. The good psychiatric SUMMARY: management taught in this course has been With respect to autism spectrum disorder, this compared in a randomized study with dialectical course will review the evidence for the use of behavioral therapy and performed equally well. Its psychopharmacological interventions in treatment contents have been developed as a handbook. The of aberrant symptoms associated with ASD that course begins with a focus on interpersonal include attentional symptoms, hyperactivity, anxiety, hypersensitivity as a unifying feature of the disorder. depression, and transdiagnostic symptoms including Through interactive cases, video illustrations of social communication and thinking, irritability, principles, and ample time for questions and repetitive behaviors, and insomnia. With respect to answers, participants will develop skills in diagnosing ADHD, the course will describe how a proper ADHD BPD, understanding its course and outcome, starting assessment requires sensitivity to the age and a treatment, applying principles of developmental status of the child, teen, or young psychopharmacology, and effectively collaborating adult and the translation of the assessment into in multi-provider treatments. Basic information treatment selection and monitoring of stimulant and about the impact of BPD on other psychiatric and non-stimulant medications. With respect to anxiety medical disorders (and vice versa) will help disorders, the course will describe the cognitive and participants more effectively formulate care and behavioral aspects of anxiety and depression as they treatment of patients with BPD and other disorders. appear in children and the role of family interactions Appropriate family involvement and key in reinforcing or mitigating symptoms. Evidence- psychoeducational principles for families are based treatments for anxiety and depression in included. Previous course participants have noted children and adolescents, highlighting distinctions improvement in self-perceived skills in the treatment from adult practice, will be discussed. With respect of BPD as they grow more confident in applying key to new-onset psychosis, the course will review the principles in treatment. similarities and differences in presentation in adolescents as compared to adults, the diagnostic are being called into question, and even those who assessment and medication treatment selection, and do not necessarily identify as gender diverse are still adverse event monitoring. bending gender with the way they dress, how they talk, and the activities they participate in. Society is Transgender Mental Health 101 being forced to look at the historical institution of Director: Eric Yarbrough, M.D. gender now more than ever. Despite the growing Faculty: Sarah C. Noble, D.O., Amir K. Ahuja, M.D., presence of gender diverse people in the media, the Gilbert A. Smith, D.O., Angeliki Pesiridou, M.D. medical and mental health communities’ responses have been lacking. Gender clinics sparsely populate EDUCATIONAL OBJECTIVES: large urban areas, and those tend to be over At the conclusion of this session, the participant capacity with referrals of gender diverse people should be able to: 1) Understand the gender seeking care. The great majority of patients needing spectrum and gender diversity; 2) Understand treatment either get poor treatment from those who gender dysphoria as a diagnosis and when to use it; are not TGNC-competent or simply don’t seek 3) Review gender-affirming psychotherapy; 4) services out of frustration and an inability to connect Review hormone treatment options with detailed