RESUMEN
Objective: To document the experience of 14 academic child and adolescent psychiatry programs in transitioning to and managing telehealth services during the COVID-19 pandemic. The goal was to understand how programs adopted and sustained telehealth during the pandemic. Telehealth was defined as services delivered via videoconferencing and telephony. Method: In this descriptive study, faculty from 14 programs completed online surveys about the use of both telehealth and in-person services from February 2020 to June 2021. Survey questions addressed telehealth practices (e.g., policies, support resources), monthly service utilization, telehealth modality (videoconferencing vs. telephony), and missed appointments. Results: Programs varied in the proportion of appointments delivered by telehealth prior to the pandemic (February 2020; 0-27%). By May 2020 all programs were providing a majority of visits via telehealth (64-100%). In June 2021, all programs continued to provide services via telehealth (41% to 100%) and reported that they would continue to do so moving forward. Programs addressed many challenges to telehealth provision during the study period, including adding interpreter services, technological support for providers and patients, and formalizing safety and training requirements. Conclusion: Academic child and adolescent psychiatry programs provided outpatient services primarily via telehealth throughout the COVID-19 pandemic and reported that they planned to continue utilizing telehealth in combination with in-person services moving forward. Academic programs should therefore address logistical, technological, and financial barriers to the sustained use of telehealth.
RESUMEN
OBJECTIVE: To determine if any monotherapy drug treatment has robust efficacy to treat comorbid bipolar disorder and chronic pain. DATA SOURCES: The American Psychiatric Association (APA) treatment guidelines for bipolar mood disorder and the 2012 Cochrane database for pain disorders. STUDY SELECTION: We relied on the treatment guides to determine if the drugs that are APA guideline-supported to treat bipolar disorder have supporting data from the Cochrane database for chronic pain. DATA SYNTHESIS: No single drug was mentioned by either guideline to treat this comorbidity. However, carbamazepine was the only drug that has guideline-supported robust efficacy in the management of each condition separately. CONCLUSIONS: Carbamazepine was found to have strong preclinical data for the treatment of comorbid bipolar mood disorder and chronic pain disorders. While requiring more studies in this population, we propose that this treatment modality may benefit patients.