Andrew Visit 1: A middle-aged male with a history of major depressive episodes

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Title:	Andrew Visit 1: A middle-aged male with a history of major depressive episodes
Topic:	Psychiatry
Relevant Terms:	Major Depressive Disorder, Mood Disorders, Psychotherapy
Primary Audience:	Psychiatrists
Launch Date:	24-Nov-10
Credits:	0.75 AMA PRA Category 1 Credit™
Expiration Date:	The accreditation for this activity has expired.
Curriculum Name:	Effective Strategies for Patients with Complex Depression in Psychiatric Practice: A Case-Based Approach

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Learning Objectives

Upon completion of the activity, participants should be able to:

Explain the rationales for using either augmentation or switching as second-line strategic approaches for individual patients with complex depression
Use patient-completed and/or physician-administered assessment tools to evaluate patients with major depressive disorder
Assess the importance of identifying patients with comorbid disease
Develop evidence-based strategies for pharmacotherapy in patients with treatment-resistant depression

Faculty

Bradley N. Gaynes, MD, MPH
Professor
Department of Psychiatry
University of North Carolina School of Medicine
Chapel Hill, North Carolina

George I. Papakostas, MD
Director, Treatment-Resistant Depression Studies
Massachusetts General Hospital
Boston, Massachusetts
Associate Professor of Psychiatry
Harvard Medical School
Boston, Massachusetts

Philip R. Muskin, MD
Professor of Clinical Psychiatry
Columbia University
Chief of Service: Consultation-Liaison Psychiatry
Department of Psychiatry
Columbia University Medical Center
Research Psychiatrist
New York State Psychiatric Institute
New York, New York

Philip R. Muskin, MD

Dr. Muskin's research and publications include mood disorders and AIDS, the psychodynamics of the failure of empathy towards patients with AIDS, panic disorder, treatment of anxiety and depression in medically ill patients, maladaptive denial of physical illness, personality disorders in the primary care setting, the role of religiosity in patients' decisions regarding do-not-resuscitate status, the psychodynamics of physician-assisted suicide, and the impact of intercessory prayer on medical outcomes.

He is the editor of Complementary and Alternative Medicine and Psychiatry, published by American Psychiatric Press, Inc. in 2000, one of the editors of Psychosocial Treatment for Medical Conditions (2003), and an editor of Psychological Effect of Catastrophic Disasters: Group Approaches to Treatment (2006) and one of the authors of How to Use Herbs, Neutraceuticals and Yoga in Mental Health Care (2009). Dr. Muskin has received many academic awards, including Outstanding Teacher of the Year at the New York State Psychiatric Institute (NYSPI) on three separate occasions, the Association for Academic Psychiatry Lifetime Achievement Award, the Society for Liaison Psychiatry Award for outstanding contributions to the field of Consultation-Liaison Psychiatry and the Irma Bland Award for Residency Teaching (APA).

Dr. Muskin is a distinguished fellow of the American Psychiatric Association, is a Fellow of the Academy for Psychosomatic Medicine and is a Distinguished Life Fellow of the Association for Academic Psychiatry. In 1989 he founded the Trained Liaison Comforter Program at Columbia Presbyterian Hospital; a volunteer program that provides emotional support for families of patients in intensive care units.

He served as a consultant to the Red Cross First Step program for widows, has been a consultant to the Vivian Beaumont Theater, and is a volunteer facilitator in the NYPD Stress Management Program. He is Past-President of the Association for Academic Psychiatry and the Society for Liaison Psychiatry.

Dr. Muskin was the Program Chair for the 1999 meeting of the Academy of Psychosomatic Medicine. He has been a member of the Scientific Program Committee of the American Psychiatric Association since 1990, serving as chair for the 2001 and 2002 meetings. He was the chair of the APA Council on Psychosomatic Medicine.

Course Viewing Requirements

PC
Internet Explorer (v6 or greater), or Firefox

MAC
Safari

Estimated time to complete activity: 0.75 hours

Sponsored by

Supported by an educational grant from

Target Audience

This activity is designed to meet the needs of psychiatrists and other mental health care professionals who are interested in the management of patients with major depressive disorder.

Program Overview

Major depressive disorder (MDD) is a serious chronic illness that affects the lives of millions of patients and their families and poses challenges for psychiatrists caring for these individuals. Despite the availability of effective treatments, many patients with MDD fail to achieve remission, the primary goal of therapy. More than half of patients either do not respond or only partially respond to first-line antidepressants. In addition, comorbid chronic medical conditions complicate the clinical presentation and treatment decisions, and require special consideration. A number of effective pharmacologic treatment strategies have been studied for patients in these challenging situations and include switching to another approved antidepressant, combining treatment with an approved antidepressant agent, or augmenting with an agent of a different class.

These activities will focus on the assessment and management of patients with complex MDD and will present evidence‑based intervention strategies to both focus on patient-identified symptoms and increase the rate of patients' achieving remission.

Accreditation Statement

SciMed is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation

SciMed designates this educational activity for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosure and Resolution of Conflicts of Interest

SciMed requires all individuals who are involved with the development or delivery of content in any of its activities to disclose financial relationships they may have with commercial interests. Should SciMed determine that any of the disclosed relationships constitutes a conflict of interest, as defined by the ACCME, SciMed will act to resolve such a conflict.

When asked to report relevant financial relationships with commercial interests, faculty reported the following:

Bradley N. Gaynes, MD, MPH
Grants/Research Support: M3 Information

Philip R. Muskin, MD

Speakers Bureau: AstraZeneca, Bristol-Myers Squibb Company, Jazz Pharmaceuticals

Retained Consultant: Otsuka America Pharmaceutical, Inc.

George I. Papakostas, MD

Grants/Research Support: Bristol-Myers Squibb Company, Forest Laboratories, Inc., Pamlab, L.L.C., Pfizer Inc, Precision Human Biosystems

Retained Consultant: AstraZeneca, Bristol-Myers Squibb Company, Eli Lilly and Company, Pamlab, L.L.C., Wyeth Pharmaceuticals

Honoraria for non–speakers bureau presentations: AstraZeneca, Bristol-Myers Squibb Company, GlaxoSmithKline, Lundbeck Inc., Otsuka America Pharmaceutical, Inc.

Shari Fallet, DO, an employee of SciMed and a member of the planning committee for this activity, reports owning stock in Pfizer Inc. All other SciMed personnel involved in the development of content for this activity have no relevant financial relationships to report.

The materials for this activity were peer reviewed by Jeffrey R. Strawn, MD, Assistant Professor, Departments of Psychiatry and Behavioral Neuroscience and Pediatrics, University of Cincinnati College of Medicine. Dr. Strawn has no relevant financial relationships to report.

Off-label Product Discussion
Faculty have indicated that this activity will not include discussion of off-label uses.

Instructions for Participating in This Activity and Obtaining CME Credit

There are no fees for participating in and receiving CME credit for this online educational activity. To obtain CME credit for participating in this activity during the period November 24, 2010 through November 24, 2011, participants must 1) read the educational objectives and disclosure statements; 2) study the educational activity; and 3) participate in the postactivity exercise. Once you have completed the educational activity and postactivity exercise, you will be directed to complete an evaluation form.

Disclaimer

The opinions or views expressed in this CME activity are those of the presenters and do not necessarily reflect the opinions or recommendations of SciMed or the commercial supporter(s). Participants should critically appraise the information presented and are encouraged to consult appropriate resources for information surrounding any product, device, or procedure mentioned.

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