When an older inpatient develops altered mental status, the answer is not always delirium or dementia—it is often both. In this review we discuss how to distinguish acute from chronic cognitive change, avoid missing hypoactive delirium, use medications judiciously, and set realistic expectations for patients and families.
Palliative care psychiatry often requires a shift in how we think about symptoms, medications, and time. Dr. Shalev discusses distinguishing demoralization from depression and grief, choosing treatments when patients may not have weeks to wait, deprescribing thoughtfully, and supporting patients and families through serious illness.
People with psychiatric disorders may face elevated dementia risk—but what’s driving that connection, and what can clinicians do about it? Dr. Hedges reviews the epidemiological evidence across depression, bipolar disorder, schizophrenia, ADHD, and PTSD, and offers practical steps for supporting long-term cognitive health in everyday psychiatric practice.
We’ve long worried about respiratory depression when injectable olanzapine is combined with benzodiazepines. But in a retrospective cohort of nearly 700 ED cases, the combination did not appear to raise major safety concerns, offering some reassurance for severe agitation management.
Metformin is already used to limit antipsychotic-related weight gain in schizophrenia. But two related trials from the same research group suggest it might also modestly improve working memory and verbal learning, raising the question of whether a common metabolic agent could double as a cognitive one.
Although DSM-5-TR cautions against diagnosing catatonia and delirium at the same time, real-world patients do not always fit neatly into one category. A prospective quality-improvement study of more than 700 medical inpatients found substantial overlap between the two syndromes, with implications for screening and treatment.
Soft drinks are implicated in obesity and diabetes. But could they also influence depression—and if so, through what mechanism? A German cohort study of 932 adults points to an unexpected variable in the relationship between dietary habits and mood.
Dr. Hendrick is a clinical professor at the David Geffen School of Medicine at UCLA and is the director of inpatient psychiatry at Olive View—UCLA Medical Center, where she carries a caseload of patients and provides teaching and supervision for medical students and psychiatry residents. After completing medical school and psychiatric residency at UCLA, she spent several years working as a principal investigator and co-investigator on N.I.M.H. funded research studies. She has authored or co-authored over 75 research papers, editorials, books and other publications. She has a long-standing interest in the needs of severely mentally ill patients from underserved populations and has worked in community mental health settings her entire career.
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