title: Protocol for Psychopharmacologic Management of Behavioral Health Comorbidity in Adult Patients with Diabetes and Soft Tissue Infections in a Tertiary Care Hospital Setting.
abstract: OBJECTIVE
  To provide information about the effect of psychiatric comorbidities on wound healing in patients with diabetes mellitus (DM).
  
  
  BACKGROUND
  This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.
  
  
  OBJECTIVE
  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.
  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.
authors.affiliation: Aaron 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.
authors.forename: Aaron
authors.initials: A
authors.lastname: Pinkhasov
authors.forename: Deepan
authors.initials: D
authors.lastname: Singh
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kashan
authors.forename: Julie
authors.initials: J
authors.lastname: DiGregorio
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Criscitelli
authors.forename: Scott
authors.initials: S
authors.lastname: Gorenstein
authors.forename: Harold
authors.initials: H
authors.lastname: Brem
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D048909:Diabetes Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D017719:Diabetic Foot / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D019468:Disease Management; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis; D011600:Psychopharmacology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012883:Skin Ulcer / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D018461:Soft Tissue Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014481:United States; D014945:Wound Healing / Q000502:physiology