Publications by authors named "Gareen Hamalian"

7 Publications

  • Page 1 of 1

A Common Agenda: The Longitudinal Integrated Clerkship Model in Medical Student Education in the Correctional Care Setting.

Acad Psychiatry 2017 06 6;41(3):436-437. Epub 2017 Mar 6.

Colorado Permanente Medical Group, Denver, CO, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40596-017-0684-6DOI Listing
June 2017

New Guidelines for Forensic Assessment.

J Psychiatr Pract 2016 03;22(2):124-7

VASILE: Psychiatry Resident, University of Colorado, Denver, COHAMALIAN: Denver Health Medical Center and Assistant Professor, University of Colorado, Denver, COWORTZEL: Michael K. Cooper Professor of Neurocognitive Disease, Director of Neuropsychiatry, and Associate Professor in Psychiatry, Neurology, and Physical Medicine and Rehabilitation, and Faculty for the Forensic Psychiatry Fellowship at the University of Colorado, Denver, CO; Director of Neuropsychiatric Services for the Rocky Mountain MIRECC, Denver VA, Denver, CO.

The American Academy of Psychiatry and the Law (AAPL) recently published guidelines for forensic assessment intended for psychiatrists and other clinicians working in medicolegal roles, or performing evaluations and offering opinions in relation to legal or regulatory matters. Although these guidelines do not establish a singular standard for forensic evaluation, they are intended to inform practice. Although nuances pertaining to any given case and the pertinent medicolegal issues involved will require professional judgment as to how best to conduct any particular evaluation, the guidelines do offer many helpful tenets and guiding principles that are broadly applicable. Psychiatrists and other clinicians performing forensic evaluations need to be aware of these guidelines and should strive to incorporate them as appropriate. In this column we offer a brief synopsis of the approach to the forensic psychiatric assessment based upon the AAPL Practice Guideline for the Forensic Assessment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PRA.0000000000000141DOI Listing
March 2016

Risk Factors for Readmission on an Adult Inpatient Psychiatric Unit.

Qual Manag Health Care 2016 Jan-Mar;25(1):22-31

Departments of Behavioral Health (Drs Rylander, Hamalian, Lozano, and Nussbaum) and Internal Medicine (Dr Rylander and Ms Keniston), Denver Health, Denver, Colorado; and Department of Psychiatry, University of Colorado School of Medicine, Aurora (Dr Colon-Sanchez).

Objective: Readmission rates have been proposed as a possible quality metric for inpatient psychiatry. Little is known about predicting readmissions and identifying modifiable factors that may reduce early readmissions in these settings.

Methods: We reviewed 693 medical records from our adult inpatient psychiatric unit to identify factors associated with patients' readmission within 90 days of discharge.

Results: After adjusting for all variables, and including interactions between identified factors, we found several demographic features predicting readmission, including male gender with suicidal ideation on admission (odds ratio [OR] = 13.2; 95% confidence interval [CI], 3.4-51.9), a diagnosis of a psychotic disorder with a prior medical admission (OR = 5.7; 95% CI, 1.7-20.6), and suicidal ideation with comorbid personality disorder (OR = 5.3; 95% CI, 1.4-20.6). Demographic features decreasing the odds of readmission included being non-white with homeless living situation (OR = 0.18; 95% CI, 0.04-0.82), medication changes made within 48 hours of discharge (OR = 0.44; 95% CI, 0.23-0.84), and the number of medications dispensed without documented follow-up plan or appointment (OR = 0.88; 95% CI, 0.81-0.96).

Conclusion: Future prospective studies utilizing qualitative and quantitative methods are required to more precisely define a wider array of metrics. Improved identification of demographic features associated with early readmissions may suggest areas to target as we seek to the quality of inpatient psychiatric care.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/QMH.0000000000000077DOI Listing
February 2017

Self-cannibalism (autosarcophagy) in psychosis: a case report.

J Nerv Ment Dis 2015 Feb;203(2):152-3

*Department of Psychiatry, University of Colorado School of Medicine, Aurora; and †Denver Health Hospital, Colorado.

Only nine previous cases of self- or auto-cannibalism (autosarcophagy) have previously been reported in the literature. Here, we report a 29-year-old man with psychosis and a history of polysubstance use who presented after his second attempt to self-cannibalize. This case raises questions about the underlying causes and dynamics of self-cannibalism in psychiatric illness and its relation to other types of self-harm behavior.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/NMD.0000000000000252DOI Listing
February 2015

Psychiatric consequences of actual versus feared and perceived bed bug infestations: a case series examining a current epidemic.

Psychosomatics 2012 Jan-Feb;53(1):85-91

Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.psym.2011.08.001DOI Listing
April 2012

Stimulant-induced trichotillomania.

Subst Abus 2010 Jan;31(1):68-70

Department of Psychiatry, New York University School of Medicine, New York City, New York, USA.

A prior report described the presentation of cocaine-induced trichotillomania, which resolved with the cessation of cocaine use. Here the authors describe the case of stimulant-induced trichotillomania that resolved with the discontinuation of stimulants and initiation of olanzapine. To the authors' knowledge this is the first reported adult case of stimulant-induced trichotillomania. The case is of a patient with a previous diagnosis of attention deficit hyperactivity disorder whose symptoms of trichotillomania coincide with abuse of amphetamine and with the resolution of symptoms in the absence of amphetamine use. Given the increase in exposure of prescription amphetamines among adults, further study into the association between stimulants and adverse events such as trichotillomania is needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/08897070903442723DOI Listing
January 2010

RS3PE presenting in a unilateral pattern: case report and review of the literature.

Semin Arthritis Rheum 2009 Jun 2;38(6):428-33. Epub 2008 Jun 2.

Division of Rheumatology, New York University School of Medicine, New York University Hospital for Joint Diseases, New York, NY 10003, USA.

Objectives: To review the clinical features and pathophysiologic implications of remitting seronegative symmetrical synovitis with pitting edema (RS(3)PE) presenting in a unilateral manner.

Methods: We identified and characterized an index case of RS(3)PE presenting in a unilateral pattern. We subsequently performed a systematic literature search to identify other reports of patients with unilateral RS(3)PE.

Results: The index case was a 76-year-old male with a prior history of right hemiparesis owing to a cerebrovascular accident 25 years prior, who developed a classic picture of RS(3)PE involving hand (metacarpophalageal and wrist joint) arthritis and dorsal pitting edema, accompanied by an elevated erythrocyte sedimentation rate, but only in the nonhemiparetic hand. The condition responded rapidly to low-dose prednisone. Our literature search identified 5 other cases of unilateral RS(3)PE, including 2 presented only in the Italian or German literature. Of the 5 cases, 2 were in patients with preexisting neurologic disease, in which the neurologically affected side was spared. One additional case initially presented as unilateral disease but rapidly progressed to bilaterality. Two cases presented in a fully unilateral manner despite no reported neurologic abnormalities on the unaffected sides.

Conclusions: While RS(3)PE is almost always a symmetric disease of the upper extremities, it may rarely present in a unilateral fashion. The apparent ability of neuropathic changes to protect against the expression of RS(3)PE in an extremity suggests a role for neural and possibly other local factors in the genesis/modulation of the onset or maintenance of RS(3)PE.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.semarthrit.2008.03.008DOI Listing
June 2009