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Protocol for Psychopharmacologic Management of Behavioral Health Comorbidity in Adult Patients with Diabetes and Soft
Aaron Pinkhasov1, Deepan Singh, Benjamin Kashan
1Aaron Pinkhasov, MD, FAPA • Clinical Associate • Professor of Medicine and Psychiatry • Stony Brook University School of Medicine • Stony Brook, New York • Chairman • Department of Behavioral Health • Winthrop University Hospital • Mineola, New York Deepan Singh, MD, FAPA • Clinical Assistant Professor • Psychiatry • Stony Brook University School of Medicine • Stony Brook, New York • Child, Adolescent and Adult Psychiatrist • Winthrop University Hospital • Mineola, New York Benjamin Kashan, MD • Clinical Research Fellow • Division of Wound Healing and Regenerative Medicine, Department of Surgery • Winthrop University Hospital • Mineola, New York Julie DiGregorio, CCRP • Supervisor • Research and Clinical Trials • Division of Wound Healing and Regenerative Medicine, Department of Surgery • Winthrop University Hospital • Mineola, New York Theresa M. Criscitelli, EdD, RN, CNOR • Assistant Vice President • Perioperative Services, Division of Wound Healing and Regenerative Medicine, Department of Surgery • Winthrop University Hospital • Mineola, New York Scott Gorenstein, MD, FACEP • Clinical Assistant Professor • Surgery • Stony Brook University School of Medicine • Stony Brook, New York • Clinical Director • Division of Wound Healing and Regenerative Medicine, Department of Surgery • Winthrop University Hospital • Mineola, New York Harold Brem, MD, FACS • Professor • Surgery • Stony Brook University School of Medicine • Stony Brook, New York • Chief • Division of Wound Healing and Regenerative Medicine, Department of Surgery • Winthrop University Hospital • Mineola, New York.
General Purpose:
To provide information about the effect of psychiatric comorbidities on wound healing in patients with diabetes mellitus (DM).
Target Audience:
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.
Learning Objectives/Outcomes:
After participating in this educational activity, the participant should be better able to:1. Discuss the connection between DM and the development of psychiatric comorbidities.2. Identify the drugs recommended in the treatment of these psychiatric comorbidities.3. List cautions and contraindications related to the drugs discussed.
Abstract:
In patients with diabetes mellitus type 2, psychiatric comorbidities such as depressive and anxiety disorders are 60% or more prevalent than in the general population. The severity of mental illness and the duration of diabetes have been shown to correlate with worsening glycemic control, thus impeding wound healing. A retrospective chart review was conducted in all patients with diabetes mellitus admitted to the wound service with prior or current psychiatric symptoms of anxiety, depression, or cognitive impairment. A psychopharmacologic protocol was developed based on the clinical data collected and treatment parameters used by the behavioral health consultation liaison service.
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