Today we have TWO world renowned experts to teach us about eating disorders!

Dr. Anne O'Melia is the Chief Clinical and Quality Officer at ERC Pathlight, where she leads a multidisciplinary team of over 1,000 therapists, dietitians, and nurses caring for patients across the country. She is board certified in pediatrics, general psychiatry, child and adolescent psychiatry, and consultation-liaison psychiatry. She has co-authored numerous articles and book chapters on eating disorders.

Dr. Patricia Westmoreland has spent decades traveling the globe speaking and publishing about eating disorders, and is currently working in private practice. Dr. Westmoreland has particular expertise in the forensic aspects of eating disorders, and in managing the medical complications of eating disorders. Dr. Westmoreland is board certified in internal medicine, general psychiatry, forensic psychiatry, and consultation-liaison psychiatry.

We review how to identify when disordered eating patterns require clinical attention and outline the most common eating disorders encountered in the general medical hospital, including anorexia nervosa, bulimia nervosa, and avoidant/restrictive food intake disorder (ARFID). The episode covers prevalence rates, high-risk populations, and the significant morbidity and mortality associated with eating disorders.

Our guests discuss key clinical information needed for diagnosis, criteria for medical hospitalization, and the spectrum of available levels of care. We take a deep dive into anorexia nervosa, reviewing its clinical trajectory, diagnostic criteria, subtypes, and complications. Finally, we examine evidence-based approaches to medical stabilization, psychotherapy, and pharmacotherapy in the treatment of eating disorders.

Key References:

1. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Eating Disorders (Crone 2023)

2. Ethical Challenges in the Treatment of Patients With Severe Anorexia Nervosa (Westmoreland 2024)

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Dr. Mira Zein, Associate Professor of Psychiatry and Behavioral Science at Stanford University, walks us through decisional capacity determinations.

This is a great episode for learners rotating through a consultation-liaison psychiatry service, and will really help you shine on rounds when you quote the Appelbaum-Grisso criteria (seriously, do it)! We also invite psychiatry residents and CL psychiatrists to share this episode with their favorite primary team to help non-psychiatrists make capacity determinations on their own... They are often best suited to do so!

Dr. Zein walks us through the Appelbaum-Grisso criteria and discusses each criterion (communication, appreciation, understanding, rationality) in detail. This discussion goes beyond a textbook understanding of the topic, delving into several difficult cases of determining decisional capacity. We discuss common reasons for psychiatric consultation regarding capacity, and how to navigate difficult conversations when fielding consults. You will also learn about common illnesses that can cause diminished capacity, and how to proceed if a patient is found to lack decisional capacity (for a certain decision, at a certain time 😉).

Key resources:

1) APA Resource Document on Decisional Capacity Determinations in Consultation-Liaison Psychiatry: A Guide for the General Psychiatrist (2019)

2) Seminal Article on Appelbaum-Grisso Criteria (Appelbaum 1988)

3) Evaluating Capacity: Appelbaum’s Framework Interpreted Diagrammatically (Bari 2023)

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⁠SimplePractice.com/bootcamp⁠ (Now with AI documentation! Exclusive 7 day free trial and 70% off four months)

⁠Oasis Psychiatry Conferences ⁠(enter code BOOTCAMP at checkout for additional 10% savings)

⁠Beat the Boards⁠ (enter code BOOTCAMP at checkout for addition 10% savings)

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Dr. Paula Zimbrean, Professor of Psychiatry and Yale School of Medicine and Director of Transplant Psychiatry Services at Yale New Haven Hospital, introduces us to the field of transplant psychiatry.

We discuss the role of psychiatrists in solid organ transplantation, including pre-transplant evaluations. We then discuss the various phases through which transplant patients require support, starting with a diagnosis of advanced organ disease. We cover the pre-transplant phase, peri-operative recovery, early post-transplant stressors, and finally psychiatric considerations that last months to years after transplant. Dr. Zimbrean discusses ethical challenges faced by psychiatrists working in a transplant setting, and shares considerations for the future of transplant psychiatry.

Selected references:

1. Transplant Psychiatry: A Case-Based Approach to Clinical Challenges
2. Transplant Psychiatry: An Introduction

SUPPORT OUR PARTNERS:

SimplePractice.com/bootcamp (Now with AI documentation! Exclusive 7 day free trial and 70% off four months)

Oasis Psychiatry Conferences (enter code BOOTCAMP at checkout for additional 10% savings)

Beat the Boards (enter code BOOTCAMP at checkout for addition 10% savings)

CME to Go (enter code BOOTCAMP at checkout for addition 10% savings)