Objective To compare the prevalence and correlates of psychiatric co-morbidity across a large sample of college women without an eating disorder, those at high risk for an eating disorder and women diagnosed using DSM-5 criteria for an eating disorder. Participants 549 college age women aged 18–25. Methods Data from the Eating Disorder Examination, the Structured Clinical Interview for DSM-IV Axis I disorders and self-report questionnaires were analyzed using logistic regression for categorical data and ANCOVA for continuous measures. Results Eating disordered symptomatology was strongly associated with anxiety disorders, mood disorders and insomnia. These co-morbidities (type and severity) tend to increase with eating disorder symptom severity. Conclusions Prevention and treatment programs for eating disorders need to address the high levels of mood, anxiety and sleep problems in this population. The findings on insomnia are novel and suggest that sleep disturbance may play an integral role in eating-related difficulties.
The American healthcare industry is generally lacking environmentally sustainable practices. The environmental impact of healthcare practices in the country has been largely disregarded due to ambivalence, ignorance, and fears of additional costs and regulations. The current practices continue to pollute the environment by requiring large amounts of travel and paperwork by both the patient and the clinician. Telemedicine and health information technology help save time, energy, raw materials (such as paper and plastic), and fuel, thereby lowering the carbon footprint of the health industry. By implementing green practices, for instance, by engaging in carbon credit programs, the health industry could benefit financially as well as reduce its negative impact on the health of our planet. Companies that reduce their carbon emissions by implementing energy-saving practices can sell their carbon credits to companies that emit more carbon than permissible by their legally binding commitment. These carbon profits can then be used for healthcare research or to provide healthcare to the underserved. Alternatively, the savings could be used for green purchasing and to implement other carbon-reducing activities. This report reviews the numerous possible options for the American health industry to become greener and lower its carbon footprint while at the same time becoming more time- and cost efficient.
The core doctor-patient relationship is changing and becoming more fluid. Many factors are causing the changes, but they are being underpinned by the current technological revolution, which has spawned terms such as e-patients, health 2.0, participatory medicine, and virtual medicine in cyberspace. The Internet is being used so creatively and commonly by both patients and doctors that it has become literally a "part" of the doctor-patient relationship. To explore how the psychiatrist-patient relationship is changing, five simple questions are examined: How are patient expectations and behaviors changing? Who is using the Internet for mental health care? What online mental health services are currently being offered? How are current and past models of the psychiatrist-patient relationship being affected by these changes? And what is the psychiatrist-patient relationship of the future likely to be? Psychiatrists working in this environment will need to make changes to their practices over time. It is likely that their relationships with patients will continuously change, gradually becoming more participatory and ubiquitous, as care is provided both face-to-face and online-and literally anytime, anywhere.
ATP consultations in Spanish, and those translated from Spanish to English, are feasible, and broad diagnostic reliability was achieved. The ATP process allows for rapid language translation. This approach could be useful across national boundaries and in numerous ethnic groups. Cross-language ATP may also offer significant benefits over the use of real-time interpreting services and has the potential to improve the quality of care by allowing for the addition of culturally relevant information.
The traditional face-to-face doctor-patient relationship is the core of conventional medical practice. One key aspect of this changing relationship is the increasing dependency on asynchronous data collection in clinical consultations. Such electronic communications and data streams may be numeric, text-based, audio, digitized still pictures, video and radiologic, as well as emanating from multiple medical devices. While asynchronous medicine may be established in specialties like radiology and dermatology, there is little research regarding the use of asynchronous medicine in areas of medicine that traditionally rely on the physical doctor-patient interaction such as primary care, internal medicine, geriatrics, and psychiatry. The practice of psychiatry stands out as a discipline that is highly dependent on the quality of the physical meeting between the doctor and the patient, yet even in this specialty it is possible to utilize asynchronous medicine for some types of psychiatric consultations. Asynchronous medicine has the potential to be significantly disruptive to our current healthcare processes, as well as more clinically and economically efficient.
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