Psychogenic polydipsia (PPD), a clinical disorder characterized by polyuria and polydipsia, is a common occurrence in inpatients with psychiatric disorders. The underlying pathophysiology of this syndrome is unclear, and multiple factors have been implicated, including a hypothalamic defect and adverse medication effects. Hyponatremia in PPD can progress to water intoxication and is characterized by symptoms of confusion, lethargy, and psychosis, and seizures or death. Evaluation of psychiatric patients with polydipsia warrants a comprehensive evaluation for other medical causes of polydipsia, polyuria, hyponatremia, and the syndrome of inappropriate secretion of antidiuretic hormone. The management strategy in psychiatric patients should include fluid restriction and behavioral and pharmacologic modalities.
Objectives-Prenatal substance use contributes birth defects, prematurity, and infant mortality in the U.S. As such, it is critical that medical professionals receive appropriate education and actively engage in screening patients; however, a physician's gender may influence differences in screening practices. The purpose of this study is to examine male and female Ob/Gyn physician's beliefs and practices related to perinatal substance use screening and to identify the significant correlates of using a standardized screening tool.Methods-Data were collected from 131 Ob/Gyn physician's in Kentucky using a web-based survey. Chi-square and t-tests were used to distinguish differences between male (n=84) and female (n=47) providers. Binary logistic regression was also used to assess the independent correlates of the use of a standardized screening tool.
Results-FemaleOb/Gyn physician's were more likely to "believe in" the effectiveness of screening, to discuss sensitive topics with patients, and were motivated to screen as a part of comprehensive care or because screening could produce a behavioral change. Female providers were also more likely to use a screening tool in a multivariate model; however, being female was no longer significant after additional variables were included in the model. Specifically, younger Ob/Gyn physicians who frequently discussed mental health issues with female patients of childbearing age, and were motivated to screen because it is part of comprehensive care were significantly more likely to use a standardized substance use screening tool.Conclusions-In summary, less than half of Ob/Gyn physicians were using a standardized screening tool and the majority of physicians were using the CAGE. This suggests additional training is needed to increase their use of substance use screening tools, especially those geared towards pregnant women. Lexington, KY 40506; cboser0@uky.edu This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (NSDUH, 2005), in the past month 4.3% of pregnant women reported using illicit drugs, 9.8% reported using alcohol, 4.1% reported binge drinking, and 18.0% reported smoking cigarettes. While there has been a documented decline in substance use during pregnancy, the number of prenatal substance using women is still significant and the problems experienced by their unborn child are preventable (Goler et al., 2008). Therefore, it is critical that medical professionals adhere to guidelines which suggest that universal screening should occur for substance use disorders in both primary care practices as well as in specialized medicine (Chasnoff et al.,...
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