Depression

A collection of educational materials in the Online Learning Center.

Mental Health and Burnout, Part 1

While there has been increased awareness of the concept of burnout in general, many Internal Medicine physicians may have gaps in their knowledge as to what burnout is and how they may be affected by it. Given that over 50% of physicians have experienced symptoms of burnout at some point during their careers (with rates significantly increasing during the COVID-19 pandemic), it is imperative that they understand the signs and the physical and mental consequences burnout can have. This includes increased rates of medical errors, depression, suicide, and leaving the medical field.

Geriatrics and Palliative Medicine for Internal Medicine Physicians: 2025 Video Recordings Package

Highly knowledgeable clinician educators will focus on practical, evidence-based strategies that the internal medicine physician can use across care settings to better identify and treat serious and chronic conditions common to older populations, such as cognitive impairment; function assessment, frailty, and falls; depression and anxiety; and hazards of hospitalization.

Geriatrics and Palliative Medicine for Internal Medicine Physicians: 2024 Video Recordings Package

Expert clinician-educations will focus on practical, evidence-based strategies that the internal medicine physician can use across care settings to better identify and treat serious and chronic conditions common to older populations, such as cognitive impairment; function assessment, frailty, and falls; depression and anxiety; and hazards of hospitalization.

Primary Care Psychiatry: Practical Skills for Internists: 2023 Video Recordings Package

Internal medicine physicians are often on the “front lines” in both specialty and primary care settings for the assessment and treatment of psychiatric disorders. Most psychiatric disorders are treated by nonbehavioral specialists, and more than 80% of antidepressants are prescribed by non-psychiatrists. Formal psychiatric training for internists is often limited and does not cover foundational topics, which are relevant to everyday practice in the general medical setting.

Primary Care Psychiatry: Practical Skills for Internal Medicine Physicians: 2025 Video Recordings Package

Expert clinician educators will provide an evidence-informed update for internal medicine physicians on practical approaches to interviewing patients to recognize, diagnose, treat, and/or refer patients with commonly encountered mental health disorders. Faculty with training in both internal medicine and psychiatry will emphasize the importance of a patient-centered approach, motivational interviewing, and simple cognitive behavioral techniques that can be quickly used in medical settings.

Primary Care Psychiatry: Practical Skills for Internal Medicine Physicians: 2024 Video Recordings Package

Expert clinician-educators will provide a practical, evidence-based update for internal medicine physicians on approaches to interviewing patients with the goal of recognizing, diagnosing, treating, and/or referring patients with commonly encountered mental health disorders. Faculty with training in both internal medicine and psychiatry will emphasize the importance of a patient-centered approach, motivational interviewing, and quick cognitive behavioral techniques that can be quickly used in medical settings.

Digital Health Equity: Bridging the Divide

The digital divide is the gap between those who have access to technology or the Internet and those who do not, typically on the basis of higher versus lower socioeconomic status. Thirteen percent of U.S. adults do not use the Internet; of these, 19% do not use it because of cost barriers related to Internet service or computer ownership. In addition, demographic variables, such as age, education, community (rural, urban, or suburban), or income, may contribute to non-adoption of technology.

Quality Indicators for Major Depressive Disorder in Adults: A Review of Performance Measures by the American College of Physicians

Physician Suicide Prevention and the Ethics and Role of a Healing Community: An American College of Physicians Policy Paper

Identifying Core Clinical Topics and Recommending Core Performance Measures for Internal Medicine Physicians

ACP Response to Senate Finance Committee Inquiry Concerning Policies to Improve Behavioral Health Care

ACP Letter to the Senate Supporting Passage of Lorna Breen Healthcare Provider Protection Act of 2021

ACP Letter to the House Supporting Passage of Lorna Breen Healthcare Provider Protection Act of 2021

ACP Support Letter to the Senate HELP Committee for S. 3679, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act

ACP Letter for the Record on the Dr. Lorna Breen Health Care Provider Protection Act

Testosterone Treatment in Adult Men with Age-Related Low Testosterone: A Clinical Guideline from the American College of Physicians (2020)

Evidence-Based Interventions to Improve the Palliative Care of Pain, Dyspnea, and Depression at the End of Life

Performance Measures Depression

Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan

Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the eligible encounter.

Depression Utilization of the PHQ-9 Tool

The percentage of adolescent patients (12 to 17 years of age) and adult patients (18 years of age or older) with a diagnosis of major depression or dysthymia who have a completed PHQ-9 tool during a four month measurement period.

Depression Response at Twelve Months, Progress Towards Remission

The percentage of adolescent patients (12 to 17 years of age) and adult patients (18 years of age or older) with major depression or dysthymia who are progressing towards remission by achieving a response (PHQ-9 or PHQ-9M score reduced by 50% or greater) twelve months (+/- 60 days) after an index visit.

Depression Response at Six Months- Progress Towards Remission

The percentage of adolescent patients (12 to 17 years of age) and adult patients (18 years of age or older) with major depression or dysthymia who are progressing towards remission by achieving a response (PHQ-9 or PHQ-9M score reduced by 50% or greater) six months (+/- 60 days) after an index visit.

Depression Remission at Twelve Months

The percentage of adolescent patients 12 to 17 years of age and adult patients 18 years of age or older with major depression or dysthymia who reached remission 12 months (+/- 60 days) after an index event date.

Depression Remission at Six Months

The percentage of adolescent patients 12 to 17 years of age and adult patients 18 years of age or older with major depression or dysthymia who reached remission six months (+/- 60 days) after an index event date.

Bipolar Disorder and Major Depression: Appraisal for Alcohol or Chemical Substance Use

INACTIVE REVIEW: This measure review is older than five years. Percentage of patients with depression or bipolar disorder with evidence of an initial assessment that includes an appraisal for alcohol or chemical substance use.

Adult Major Depressive Disorder (MDD): Comprehensive Depression Evaluation: Diagnosis and Severity

INACTIVE REVIEW: This measure review is older than five years. Percentage of patients aged 18 years and older with a diagnosis or recurrent episode of major depressive disorder (MDD) with evidence that they met the DSM-IV criteria for MDD AND for whom there is an assessment of depression severity during the visit in which a new diagnosis or recurrent episode was identified.

Anti-Depressant Medication Management

"Percentage of patients 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression, and who remained on an antidepressant medication treatment. Two rates are reported. a. Percentage of patients who remained on an antidepressant medication for at least 84 days (12 weeks). b. Percentage of patients who remained on an antidepressant medication for at least 180 days (6 months).

Depression

This issue provides a clinical overview of depression, focusing on screening, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

Comparing the Effectiveness of Depression Treatments for Patients Undergoing Maintenance Hemodialysis

Medicine and Nonmedicine Options for the Treatment of Adults With Major Depressive Disorder

Screening for Depression in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement

Quality Indicators for Major Depressive Disorder in Adults: A Review of Performance Measures by the American College of Physicians

Major depressive disorder (MDD) is a severe mood disorder that affects at least 8.4% of the adult population in the United States. Characteristics of MDD include persistent sadness, diminished interest in daily activities, and a state of hopelessness. The illness may progress quickly and have devastating consequences if left untreated. Eight performance measures are available to evaluate screening, diagnosis, and successful management of MDD. However, many performance measures do not meet the criteria for validity, reliability, evidence, and meaningfulness. The American College of Physicians (ACP) embraces performance measurement as a means to externally validate the quality of care of practices, medical groups, and health plans and to drive reimbursement processes. However, a plethora of performance measures that provide low or no value to patient care have inundated physicians, practices, and systems and burdened them with collecting and reporting of data. The ACP’s Performance Measurement Committee (PMC) reviews performance measures using a validated process to inform regulatory and accreditation bodies in an effort to recognize high-quality performance measures, address gaps and areas for improvement in performance measures, and help reduce reporting burden. Out of 8 performance measures, the PMC found only 1 measure (suicide risk assessment) that was valid at all levels of attribution. This paper presents a review of MDD performance measures and highlights opportunities to improve performance measures addressing MDD management.

The American College of Physicians Living Guideline on Depression: A Step Forward, but Gaps Remain

Nonpharmacologic and Pharmacologic Treatments of Adults in the Acute Phase of Major Depressive Disorder: A Living Clinical Guideline From the American College of Physicians

An update is available for this article. Description: The purpose of this guideline from the American College of Physicians (ACP) is to present updated clinical recommendations on nonpharmacologic and pharmacologic interventions as initial and second-line treatments during the acute phase of a major depressive disorder (MDD) episode, based on the best available evidence on the comparative benefits and harms, consideration of patient values and preferences, and cost. Methods: The ACP Clinical Guidelines Committee based these recommendations on an updated systematic review of the evidence. Audience and Patient Population: The audience for this guideline includes clinicians caring for adult patients in the acute phase of MDD in ambulatory care. The patient population includes adults in the acute phase of MDD. Recommendation 1a: ACP recommends monotherapy with either cognitive behavioral therapy or a second-generation antidepressant as initial treatment in patients in the acute phase of moderate to severe major depressive disorder (strong recommendation; moderate-certainty evidence). Recommendation 1b: ACP suggests combination therapy with cognitive behavioral therapy and a second-generation antidepressant as initial treatment in patients in the acute phase of moderate to severe major depressive disorder (conditional recommendation; low-certainty evidence). The informed decision on the options of monotherapy with cognitive behavioral therapy versus second-generation antidepressants or combination therapy should be personalized and based on discussion of potential treatment benefits, harms, adverse effect profiles, cost, feasibility, patients' specific symptoms (such as insomnia, hypersomnia, or fluctuation in appetite), comorbidities, concomitant medication use, and patient preferences. Recommendation 2: ACP suggests monotherapy with cognitive behavioral therapy as initial treatment in patients in the acute phase of mild major depressive disorder (conditional recommendation; low-certainty evidence). Recommendation 3: ACP suggests one of the following options for patients in the acute phase of moderate to severe major depressive disorder who did not respond to initial treatment with an adequate dose of a second-generation antidepressant: • Switching to or augmenting with cognitive behavioral therapy (conditional recommendation; low-certainty evidence) • Switching to a different second-generation antidepressant or augmenting with a second pharmacologic treatment (see Clinical Considerations) (conditional recommendation; low-certainty evidence) The informed decision on the options should be personalized and based on discussion of potential treatment benefits, harms, adverse effect profiles, cost, feasibility, patients' specific symptoms (such as insomnia, hypersomnia, or fluctuation in appetite), comorbidities, concomitant medication use, and patient preferences.

Values and Preferences of Patients With Depressive Disorders Regarding Pharmacologic and Nonpharmacologic Treatments: A Rapid Review: Annals of Internal Medicine: Vol 176, No 2

Background: Developers of clinical practice guidelines need to take patient values and preferences into consideration when weighing benefits and harms of treatment options for depressive disorder. Purpose: To assess patient values and preferences regarding pharmacologic and nonpharmacologic treatments of depressive disorder. Data Sources: MEDLINE (Ovid) and PsycINFO (EBSCO) were searched for eligible studies published from 1 January 2014 to 30 November 2022. Study Selection: Pairs of reviewers independently screened 30% of search results. The remaining 70% of the abstracts were screened by single reviewers; excluded abstracts were checked by a second reviewer. Pairs of reviewers independently screened full texts. Data Extraction: One reviewer extracted data and assessed the certainty of evidence, and a second reviewer checked for completeness and accuracy. Two reviewers independently assessed risk of bias. Data Synthesis: The review included 11 studies: 4 randomized controlled trials, 5 cross-sectional studies, and 2 qualitative studies. In 1 randomized controlled trial, participants reported at the start of therapy that they expected supportive-expressive psychotherapy and antidepressants to yield similar improvements. A cross-sectional study reported that non-Hispanic White participants and men generally preferred antidepressants over talk therapy, whereas Hispanic and non-Hispanic Black participants and women generally did not have a preference. Another cross-sectional study reported that the most important nonserious adverse events for patients treated with antidepressants were insomnia, anxiety, fatigue, weight gain, agitation, and sexual dysfunction. For other comparisons and outcomes, no conclusions could be drawn because of the insufficient certainty of evidence. Limitations: The main limitation of this review is the low or insufficient certainty of evidence for most outcomes. No evidence was available on second-step depression treatment or differences in values and preferences based on gender, race/ethnicity, age, and depression severity. Conclusion: Low-certainty evidence suggests that there may be some differences in preferences for talk therapy or pharmacologic treatment of depressive disorders based on gender or race/ethnicity. In addition, low-certainty evidence suggests that insomnia, anxiety, fatigue, weight gain, agitation, and sexual dysfunction may be the most important nonserious adverse events for patients treated with antidepressants. Evidence is lacking or insufficient to draw any further conclusions about patients' weighing or valuation of the benefits and harms of depression treatments. Primary Funding Source: American College of Physicians. (PROSPERO: CRD42020212442)

Cost-Effectiveness of First- and Second-Step Treatment Strategies for Major Depressive Disorder: A Rapid Review: Annals of Internal Medicine: Vol 176, No 2

Background: Major depressive disorder (MDD) is the most prevalent, disabling form of depression, with a high economic effect. Purpose: To assess evidence on cost-effectiveness of pharmacologic and nonpharmacologic interventions as first- and second-step treatments in patients with MDD. Data Sources: Multiple electronic databases limited to English language were searched (1 January 2015 to 29 November 2022). Study Selection: Two investigators independently screened the literature. Seven economic modeling studies fulfilled the eligibility criteria. Data Extraction: Data abstraction by a single investigator was confirmed by a second; 2 investigators independently rated risk of bias. One investigator determined certainty of evidence, and another checked for plausibility. Data Synthesis: Seven modeling studies met the eligibility criteria. In a U.S. setting over a 5-year time horizon, cognitive behavioral therapy (CBT) was cost-effective compared with second-generation antidepressants (SGAs) as a first-step treatment from the societal and health care sector perspectives. However, the certainty of evidence is low, and the findings should be interpreted cautiously. For second-step treatment, only switch strategies between SGAs were assessed. The evidence is insufficient to draw any conclusions. Limitations: Methodologically heterogeneous studies, which compared only CBT and some SGAs, were included. No evidence on other psychotherapies or complementary and alternative treatments as first-step treatment or augmentation strategies as second-step treatment was available. Conclusion: Although CBT may be cost-effective compared with SGAs as a first-step treatment at a 5-year time horizon from the societal and health care sector perspectives, the certainty of evidence is low, and the findings need to be interpreted cautiously. For other comparisons, the evidence was entirely missing or insufficient to draw conclusions. Primary Funding Source: American College of Physicians.

Nonpharmacologic and Pharmacologic Treatments of Adult Patients With Major Depressive Disorder: A Systematic Review and Network Meta-analysis for a Clinical Guideline by the American College of Physicians

An update is available for this article. Background: Primary care patients and clinicians may prefer alternative options to second-generation antidepressants for major depressive disorder (MDD). Purpose: To compare the benefits and harms of nonpharmacologic treatments with second-generation antidepressants as first-step interventions for acute MDD, and to compare second-step treatment strategies for patients who did not achieve remission after an initial attempt with antidepressants. Data Sources: English-language studies from several electronic databases from 1 January 1990 to 8 August 2022, trial registries, gray literature databases, and reference lists to identify unpublished research. Study Selection: 2 investigators independently selected randomized trials of at least 6 weeks' duration. Data Extraction: Reviewers abstracted data about study design and conduct, participants, interventions, and outcomes. They dually rated the risk of bias of studies and the certainty of evidence for outcomes of interest. Data Synthesis: 65 randomized trials met the inclusion criteria; eligible data from nonrandomized studies were not found. Meta-analyses and network meta-analyses indicated similar benefits of most nonpharmacologic treatments and antidepressants as first-step treatments. Antidepressants had higher risks for discontinuation because of adverse events than most other treatments. For second-step therapies, different switching and augmentation strategies provided similar symptomatic relief. The certainty of evidence for most comparisons is low; findings should be interpreted cautiously. Limitations: Many studies had methodological limitations or dosing inequalities; publication bias might have affected some comparisons. In some cases, conclusions could not be drawn because of insufficient evidence. Conclusion: Although benefits seem to be similar among first- and second-step MDD treatments, the certainty of evidence is low for most comparisons. Clinicians and patients should focus on options with the most reliable evidence and take adverse event profiles and patient preferences into consideration. Primary Funding Source: American College of Physicians. (PROSPERO: CRD42020204703)

Chronic Eosinophilic Pneumonia With Multiple Drug-Related Risk Factors: Diagnosis and Management | Annals of Internal Medicine: Clinical Cases

Chronic eosinophilic pneumonia is a rare illness characterized by pneumonic infiltrates with peripheral eosinophilia. The underlying cause is unknown, but it is associated with multiple medications. The present article reports a woman in her 60s with a history of chronic sinusitis and asthma who presented with subacute cough and hemoptysis and significant peripheral and bronchioalveolar eosinophilia. This patient also had anxiety and depression treated chronically with trazodone and venlafaxine, which are associated with eosinophilic pneumonia. Symptoms promptly resolved within 24 hours following steroid treatment. This article highlights the diagnostic challenge eosinophilic pneumonia presents.

Apathetic Thyrotoxicosis Presenting With New-Onset Pulmonary Hypertension | Annals of Internal Medicine: Clinical Cases

Apathetic thyrotoxicosis is a distinct clinical entity of hyperthyroidism that occurs in elderly patients. Manifestations include depression, weight loss, mild tachycardia, and symptoms of heart failure. Noteworthy is the absence of typical hyperkinetic motor symptoms. Pulmonary hypertension is an often-overlooked manifestation of thyrotoxicosis. Here, we present a case of a 67-year-old woman who presented to the clinic with complaints of dyspnea on exertion, orthopnea, leg edema, and 20-lb weight loss. Further work-up revealed pulmonary hypertension with thyrotoxicosis, without the typical sympathetic symptoms. After achieving a euthyroid state with methimazole therapy, she experienced resolution of her symptoms, and her pulmonary artery pressures normalized.

Isolated Subcutaneous Sarcoidosis (Darier–Roussy Disease) Without Systemic Involvement: Diagnostic Challenge and Remission Following Intralesional Therapy | Annals of Internal Medicine: Clinical Cases

Subcutaneous sarcoidosis (Darier–Roussy disease) is a rare variant of cutaneous sarcoidosis characterized by painless subcutaneous nodules. We present the case of a 55-year-old woman with a firm, nontender mass overlying her right triceps region, initially misdiagnosed as cellulitis. Biopsy revealed a noncaseating granuloma consistent with subcutaneous sarcoidosis. Extensive systemic work-up was unremarkable, confirming isolated disease. The lesion resolved within 6 months following 2 intralesional corticosteroid injections administered 2 months apart, with no recurrence over 4 years. This case highlights the diagnostic challenges of subcutaneous sarcoidosis and the importance of histopathologic confirmation and multidisciplinary evaluation, even in the absence of systemic symptoms.

Isolated Cutaneous Perianal Crohn Disease With Rare Perineal Involvement | Annals of Internal Medicine: Clinical Cases

We present a rare case of isolated perianal Crohn disease (iPCD) with perineal involvement in a 28-year-old woman who remained free of luminal gastrointestinal symptoms for more than 10 years. The diagnosis was significantly delayed due to clinical overlap with hidradenitis suppurativa and pilonidal disease. The patient had multiple unsuccessful treatments, including antibiotics, immunosuppressants, and biological agents. Complete remission was ultimately achieved with combination therapy using infliximab and azathioprine. This case underscores the importance of early recognition, accurate differentiation from mimicking conditions, and a multidisciplinary approach to managing iPCD.

Recurrent Pain and Heat Retention as Indications of Acquired Idiopathic Generalized Anhidrosis | Annals of Internal Medicine: Clinical Cases

Acquired idiopathic generalized anhidrosis is a rare disease worldwide. It is typically seen in young men. The patient in this case has generalized anhidrosis. Cholinergic urticaria is often associated with this disease, causing recurrent pain, itching, decreased sweating, and hyperthermia. In this case, a 52-year-old man had recurrent generalized pain, itching, and fever for 10 years, especially after exposure to excessive heat from exercise or environmental factors. Increased regular temperature measurements due to the COVID-19 pandemic and recognition of high body temperature as well as the pain becoming more pronounced, led to the diagnosis of acquired idiopathic generalized anhidrosis.

An Unusual Case of Neurogenic Orthostatic Hypotension Without Parkinsonian Features | Annals of Internal Medicine: Clinical Cases

Orthostatic hypotension is a common cause of syncope, especially in the older adult population. While it is a commonly encountered issue as a cause of syncope, neurogenic orthostatic hypotension (nOH) is less common. Accurate diagnosis and management of neurogenic orthostatic hypotension is important especially when conservative measures fail. The condition of nOH is often seen in Parkinson disease or Parkinson plus syndromes. We present an unusual presentation of a patient with nOH who had no parkinsonian features but once started on norepinephrine agonism improved dramatically.

Stress Cardiomyopathy in Chronic Obstructive Pulmonary Disease and Asthma Exacerbations: A Narrative Literature Review | Annals of Internal Medicine: Clinical Cases

In patients with asthma or chronic obstructive pulmonary disease exacerbations, the association between use of β-adrenergic agonists and stress cardiomyopathy is becoming increasingly recognized. Considering the emergence of this association, we sought to consolidate information from the existing body of literature to derive observational trends. One case series and 8 case reports were reviewed. Sex, age, ethnicity, comorbid conditions, presenting symptoms, electrocardiogram findings, troponin values, amount and type of β-agonist used, and time to resolution of cardiomyopathy were examined.

Sideroblastic Anemia in a Young Woman Being Treated for Wilson Disease | Annals of Internal Medicine: Clinical Cases

D-penicillamine and zinc are both useful in the treatment of Wilson disease. Both drugs can cause pancytopenia by the direct toxic effect on the marrow or sideroblastic anemia caused by hyperzincemia-induced hypocupremia. Although serum copper levels are not useful in the diagnosis of pancytopenia in patients with Wilson disease, a bone marrow aspirate correlating with clinical context and biochemical variables can make the differentiation. We present a 20-year-old patient with Wilson disease and an acquired cause of sideroblastic anemia.

Recurrent Strokes in a Hypertensive Smoker: An Atypical Case and Review of Thrombotic Thrombocytopenic Purpura | Annals of Internal Medicine: Clinical Cases

Thrombotic thrombocytopenic purpura (TTP) can present with neurologic symptoms before the development of typical hematologic abnormalities. We describe a patient presenting with decreased grip strength in his right hand who was found to have an ischemic stroke from acute TTP. In the setting of subtle hematologic abnormalities, detection of severely decreased ADAMTS13 activity aided in early diagnosis and prompt initiation of plasmapheresis. Hence, we emphasize the need for high clinical suspicion for TTP in patients with recurrent and cryptogenic strokes, especially in the setting of subtle hematologic findings, as early treatment decreases mortality rate by almost 90%.

Early Diagnosis to Prevent Carbon Monoxide Poisoning Complications | Annals of Internal Medicine: Clinical Cases

Carbon monoxide (CO) is a toxic gas with undetectable features. Every year in the United States, there are approximately 6000 deaths from CO poisoning. Patients usually present with signs of unresponsiveness but may have nonpathognomonic preceding symptoms. Some literature shows benefits of hyperbaric oxygen therapy (HBOT) within the first 24 hours of exposure to reduce the incidence of myocardial injury and neurologic impairment. This case report presents a 67-year-old man with CO poisoning who developed delayed neurologic sequelae (DNS) due to delayed diagnosis and missed therapeutic window for HBOT. Investigation of CO poisoning requires taking a detailed history to avoid delays in diagnosis and treatment.

Community health worker intervention improved anxiety, depression in minority patients

Diets may slightly reduce depressive symptoms in people with elevated cardiometabolic risk

Digital intervention helped improve depression outcomes in primary care

Depression risk lower with GLP-1 receptor agonists than DPP-4 inhibitors, target trial finds

Anxiety, depression treatment linked with improved outcomes in cardiovascular disease

Walking, jogging, yoga, and strength training help treat depression, analysis finds

Mobile apps can help treat moderate to severe depression

ACP's updated depression guideline recommends CBT, second-generation antidepressants

Portal-based population health screening appears effective for depression

U.S. veterans may not always receive preferred treatment for depression

The healing power of music | ACP Hospitalist

Ageism, an often invisible bias | ACP Hospitalist

ACS in premenopausal women addressed by scientific statement | ACP Hospitalist

Expectations of recovery | ACP Hospitalist

Patients perceived as difficult across settings | ACP Hospitalist

Potassium chloride injections recalled | ACP Hospitalist

Guidance highlights risk of psychological distress post-MI | ACP Hospitalist

Nitrous oxide misuse no laughing matter | ACP Hospitalist

CNS-active medications increase readmission risk in older patients | ACP Hospitalist

ACC issues guidance on diagnosis, management of pericarditis | ACP Hospitalist

Depression risk lower with GLP-1 receptor agonists than DPP-4 inhibitors, target trial finds

Depression associated with death in older patients with type 2 diabetes

Exercise and CBT are cost-effective for diabetes patients with depression

Antidepressants associated with decreased mortality rates in patients with diabetes and depression

Spotlight on depression in diabetes

Spotlight on diabetes and sleep

GLP-1 receptor agonists show effects on substance disorders, infections

ADA releases updated Standards of Care for 2025

MKSAP quiz: Elevated HbA1c level, loss of energy in older patient

Spotlight on GLP-1 receptor agonists and suicidality

Antidepressants may mitigate link between inflammatory bowel disease and depression

Depression may be associated with higher risk for aggressive IBD

Spotlight on avoidant/restrictive eating

Spotlight on IBS interventions

Clinical practice update advises on management of cyclic vomiting syndrome

In primary care, second-line IBS therapy with amitriptyline vs. placebo reduced symptoms at 6 mo

Cyclic vomiting syndrome affects 42 per 100,000 Medicaid beneficiaries, study finds

Low-dose amitriptyline appears effective as second-line treatment for IBS

Spotlight on psychological factors and GERD

PPIs, H2 blockers not linked to cognitive problems in older patients, study finds