Future of C-L Psychiatry
Integrative medicine is the term now used for “complementary and alternative,” as the older term did not accurately describe these treatments and practices. These are treatment approaches that are appropriate in many disorders. This symposium will focus on areas that can be incorporated into inpatient and outpatient treatment of C-L patients. In the USA approximately $30 billion is spent annually on these treatments, much of which does not have an evidence base to support the expenditure. Issues of evidence-base, quality control, drug interactions, and marketing will be presented. Nutritional Psychiatry has been steadily gaining attention and recognition as a subspecialty with an evidence base. While not prescriptive in its recommendations, solid clinical guidelines are clinically useful and effective. We will present an overview of why and how Nutritional Psychiatry is relevant and its clinical applications. The presentation will review the gut-brain axis, discuss the implications for certain psychiatric diagnoses and the associated dietary recommendations based on research. C-L providers may intuitively consider exercise helpful for mental health and something to encourage to patients, but few may feel they have adequate knowledge or comfort with the topic to encourage exercise as part of psychiatric management. To address this gap, we will present the evidence regarding the relationship between exercise and depressive and anxiety disorders; review the potential mechanisms of action for benefit; and offer a conceptual model for the role of the C-L provider in facilitating exercise as a treatment modality, including strategies for engagement, utilization of other resources, and barriers that may arise for patient and provider. Mind body medicine has evolved as a strong clinical strategy in the treatment of many medical conditions, especially when used in conjunction with pharmaceutical and procedure-based approaches. While many clinicians are familiar with the topic, few are comfortable introducing mind body therapies in a clinical setting. We will present seminal papers in the evidence-base around mind body medicine along with concrete strategies that can be employed in the inpatient and outpatient settings. The overall goal of the session is to familiarize clinicians with approaches that they can utilize when they next see patients after our meeting.