RESOURCES FOR CLINICAL REASONING EXERCISE
KSOM Psychiatry ClerkshipJuly 2010Emily Brennan, MLIS
Library Webpages
NML homepage → By Subject Psychiatry subject guide
http://norris.usc.libguides.com/psychiatry
Mobile Devices subject guide http://norris.usc.libguides.com/mobiledevices
NML homepage → Students Student Portal
Medicine → Year III-IV → Psychiatry Clerkship
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Formulate Research Question3
Scenario: Patient diagnosed with schizophrenia is being treated with an antipsychotic drug (risperidone). This drug is causing patient to gain weight. You wonder if nutrition therapy would be effective for weight loss.
Research question: Is nutrition therapy effective in reducing weight gain caused by antipsychotics?
Search the Literature4
PubMed MeSH database Tutorials
Web of Science Sort by relevance or times cited Includes meeting abstracts/conference proceedings
PsycINFO
Search Strategies5
PubMed: "Antipsychotic Agents"[Mesh] AND "Weight Gain"[Mesh] AND "Nutrition Therapy"[Mesh]
Web of Knowledge: antipsychotic* AND weight gain AND nutrition therapy Try searching with synonyms and narrower terms
E.g., specific drug names in that drug class
Relevant ArticlesBall MP, Coons VB & Buchanan RW. (2001). A program for treating olanzapine-related weight gain. Psychiatric Services, 52(7), 967-
9. “The patients' weight, body mass index, and psychiatric symptoms were assessed and were compared with those of a matched
comparison group who did not attend the Weight Watchers program. Only the men experienced significant weight loss. No correlation was found between weight loss and exercise or change in psychiatric symptoms. “
Blouin M, Binet M, Bouchard RH, Roy MA, Despres JP & Almeras N. (2009). Improvement of metabolic risk profile under second-generation antipsychotics: a pilot intervention study. Canadian Journal of Psychiatry - Revue Canadienne de Psychiatrie, 54(4), 275-9.
“This pilot study suggests that patients under SGAs may benefit from a weight management program and improve their metabolic health, as well as their aerobic fitness.”
Faulkner G, Soundy AA & Lloyd K. (2003). Schizophrenia and weight management: a systematic review of interventions to control
weight. Acta Psychiatrica Scandinavica, 108(5), 324-32. “Both dietary and exercise counselling set within a behavioural modification programme is necessary for sustained weight control.”
Mauri M, Castrogiovanni S, Simoncini M, Iovieno N, Miniati M, Rossi A, et al. (2006). Effects of an educational intervention on weight gain in patients treated with antipsychotics. Journal of Clinical Psychopharmacology, 26(5), 462-6.
“Educational intervention can be an important tool for the management of weight increase in patients treated with APs.”
O'Keefe CD, Noordsy DL, Liss TB & Weiss H. (2003). Reversal of antipsychotic-associated weight gain. Journal of Clinical Psychiatry, 64(8), 907-12.
“Some patients who gain weight while taking antipsychotic medications are able to stop gaining and lose weight over time, largely through behavioral interventions. Dietary interventions appear promising and should be explored further to prevent and reverse weight gain.”
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Select 5 Best Articles7
1. Applicable to your patient
2. Appraise methodology Simple Method for Evaluating the Clinical Literature
3. Publication type
4. Currency
5. Times cited (Web of Knowledge)
Pyramid of Publication Types8
Annotated Bibliography9
Citation style (e.g. APA)
Annotation Discuss content, usefulness, value of each article
Critical appraisal of methodology
Personal Reflection
Essay exploring your personal and general reflections on your interaction with the patient (PPI)
Thoughtful, convincing, insightful, and exploratory; represents your personal self awareness; reveals self-learning; emphasizes your personal feelings and emotions
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Clinical Reasoning/Reflection Exercise
Download from
MedWeb Psychiatry Clerkship Manual
http://medweb.usc.edu/site/clerkships/psych/general_info_psych.pdf
Year III Student Portal – Psychiatry Clerkship tab
http://www.usc.edu/hsc/nml/portals/students/yr3-4.html
Due by 6th week of clerkship
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