Showing 1-20 of 42 for: Essential Evidence Topics > Psychiatric and substance abuse 
- Alcohol intoxication and poisoning
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: Diagnosis of alcohol intoxication is made by history and physical examination. A positive blood alcohol concentration (BAC) is helpful to secure the diagnosis but does not correlate with the degree of intoxication or self-perceived in
- Alcohol withdrawal
Essential Evidence Topics, 3-Feb-2023
Overall Bottom Line: Alcohol-withdrawal symptoms typically start within 4 to 12 hours after cessation of alcohol, peak within 24 to 48 hours, and resolve within 4 to 5 days. The Clinical Institute Withdrawal Assessment Scale is a reproducible and valid
- Amphetamine toxicity
Essential Evidence Topics, 3-Jul-2022
Bottom Line: The most used amphetamines are MDMA (methylenedioxymethamphetamine, "Ecstasy," "Adam"), MDA (3,4-methylenedioxyamphetamine, tenamfetamine, "Eve"), and recently PMA (paramethoxyamphetamine). Amphetamine overdose can range from agitation and eu
- Anorexia, bulimia, and eating disorders
Essential Evidence Topics, 14-Jan-2020
Overall Bottom Line: Consider eating disorders among young women with low body mass index (BMI); patients who express concern about weight but are not overweight; women with menstrual disturbances or amenorrhea; patients with GI symptoms, physical signs o
- Attention-deficit/hyperactivity disorder
Essential Evidence Topics, 10-Apr-2023
Overall Bottom Line: The diagnosis of attention-deficit/hyperactivity disorder (ADHD) is made on the basis of reports of behavior and symptoms and not by specific testing. Use the Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria
- Autism
Essential Evidence Topics, 26-Dec-2021
Overall Bottom Line: AAP guidelines (but not USPSTF) recommend screening all children at 18 and 24 months of age by using the M-CHAT tool. Refer children suspected of having an autism spectrum disorder (ASD) for both educational intervention services (s
- Barbiturate toxicity
Essential Evidence Topics, 6-Jul-2022
Bottom-line: Obtain objective proof, when possible, of the time, quantity, and amount of the ingested product. Treatment is supportive. Ipecac or cathartic treatment should not be used; activated charcoal may prevent further absorption of ingested phe
- Benzodiazepine toxicity
Essential Evidence Topics, 4-Jan-2023
BOTTOM LINE: Clinical presentation generally consists of CNS depression, drowsiness, slurred speech, nystagmus, coma, respiratory depression, and hypotension. Address the ABCs (airway, breathing, circulation). Do not give ipecac or activated charcoal wi
- Bipolar disorder
Essential Evidence Topics, 10-Feb-2023
Overall Bottom Line: Screen patients with symptoms of depression, irritability, or impulsivity for bipolar disorder using a validated instrument. Refer patient with suspected bipolar disorder to a psychiatrist for a comprehensive psychiatric interview.
- Chronic fatigue syndrome
Essential Evidence Topics, 24-Mar-2023
Overall Bottom Line: Among patients with longstanding fatigue, only about one-third meet the Centers for Disease Control and Prevention (CDC) criteria for chronic fatigue syndrome (CFS). Cognitive behavioral therapy (CBT) and graded exercise therapy
- Cocaine misuse
Essential Evidence Topics, 6-Sep-2021
Overall Bottom Line: Suspect cocaine use in patients with abnormal mentation, especially in the setting of symptoms of a hyperadrenergic state including nausea, trouble concentrating, anxiety, paranoia, jitteriness, and euphoria. A validated screening t
- Depression
Essential Evidence Topics, 9-Dec-2022
Background: OVERALL BOTTOM LINE There is no significant difference in performance of screening instruments, so choose a tool most practical for the clinical setting. The best diagnostic tool is a detailed history performed by the practitioner in the con
- End-of-life care
Essential Evidence Topics, 28-Mar-2023
OVERALL BOTTOM LINE: There are many conditions (eg, cancer, end-stage heart disease), where it is reasonable to help patients and their families prepare for dying. Accurate and timely communication with patients and families and attention to physical, p
- Fatigue
Essential Evidence Topics, 25-Oct-2021
Overall Bottom Line: Fatigue occurs in up to 20% of patients who seek medical care. Among patients with longstanding fatigue, only one third meet CDC criteria for chronic fatigue syndrome (CFS). A thorough history and physical examination are crucial
- Female athletic triad syndrome
Essential Evidence Topics, 30-Mar-2021
Overall Bottom Line: The history should focus on training regimen, menstrual history, previous fractures, family history of osteopenia, and signs of disordered eating. Explain the potential connection between poor nutrition and caloric intake coupled wi
- Fetal alcohol syndrome
Essential Evidence Topics, 24-Sep-2021
Overall Bottom Line: Fetal alcohol syndrome (FAS) defects are permanent and may prevent affected individuals from living independently. High rates of co-morbid conditions are found in children with FAS including attention deficit hyperactivity disorder
- Fragile X syndrome
Essential Evidence Topics, 29-Jun-2021
Overall Bottom Line: Fragile X is the most commonly inherited form of mental retardation. The most common neurobehavioral manifestation is autism spectrum disorder (ASD), which is present in 51% to 67% of males. Genetic testing is recommended for any
- Generalized anxiety disorder
Essential Evidence Topics, 10-Apr-2023
Overall Bottom Line: Studies demonstrate the effectiveness of cognitive-behavioral treatment for generalized anxiety disorder (GAD). SSRIs and SNRIs are generally considered first-line pharmacologic treatments for GAD; escitalopram, venlafaxine, and dul
- Hallucinogen poisoning
Essential Evidence Topics, 2-Nov-2021
Bottom-line: Address the ABCs (airway, breathing, circulation). Do not give ipecac or activated charcoal without recommendation from a poison center or emergency department. Acute intoxication is managed by minimizing stimulation and “talk down therapy”
- Hepatitis (alcohol-induced)
Essential Evidence Topics, 26-Oct-2021
Overall Bottom Line: Alcoholic hepatitis is a clinical diagnosis that is supported by laboratory findings, but there is no pathognomonic examination finding or serologic test for the disease. The AST/ALT ratio is 2 or more times the upper limit of norma
