RESOURCES FOR CLINICAL
REASONING EXERCISE
KSOM Psychiatry Clerkship
July 2010
Emily Brennan, MLIS
Library Webpages
2

NML homepage → By Subject
 Psychiatry
subject guide
 http://norris.usc.libguides.com/psychiatry
 Mobile
Devices subject guide
 http://norris.usc.libguides.com/mobiledevices

NML homepage → Students
 Student
Portal
 Medicine
→ Year III-IV → Psychiatry Clerkship
Formulate Research Question
3

Scenario: Patient diagnosed with schizophrenia is
being treated with an antipsychotic drug
(risperidone). This drug is causing patient to gain
weight. You wonder if nutrition therapy would be
effective for weight loss.

Research question: Is nutrition therapy effective in
reducing weight gain caused by antipsychotics?
Search the Literature
4

PubMed
 MeSH
database
 Tutorials

Web of Science
 Sort
by relevance or times cited
 Includes meeting

PsycINFO
abstracts/conference proceedings
Search Strategies
5

PubMed: "Antipsychotic Agents"[Mesh] AND
"Weight Gain"[Mesh] AND "Nutrition
Therapy"[Mesh]

Web of Knowledge: antipsychotic* AND weight
gain AND nutrition therapy
 Try
searching with synonyms and narrower terms
 E.g.,
specific drug names in that drug class
Relevant Articles
6
Ball MP, Coons VB & Buchanan RW. (2001). A program for treating olanzapine-related weight gain. Psychiatric Services, 52(7),
967-9.
“The patients' weight, body mass index, and psychiatric symptoms were assessed and were compared with those of a matched
comparison group who did not attend the Weight Watchers program. Only the men experienced significant weight loss. No
correlation was found between weight loss and exercise or change in psychiatric symptoms. “
Blouin M, Binet M, Bouchard RH, Roy MA, Despres JP & Almeras N. (2009). Improvement of metabolic risk profile under
second-generation antipsychotics: a pilot intervention study. Canadian Journal of Psychiatry - Revue Canadienne de
Psychiatrie, 54(4), 275-9.
“This pilot study suggests that patients under SGAs may benefit from a weight management program and improve their
metabolic health, as well as their aerobic fitness.”
Faulkner G, Soundy AA & Lloyd K. (2003). Schizophrenia and weight management: a systematic review of interventions to
control weight. Acta Psychiatrica Scandinavica, 108(5), 324-32.
“Both dietary and exercise counselling set within a behavioural modification programme is necessary for sustained weight
control.”
Mauri M, Castrogiovanni S, Simoncini M, Iovieno N, Miniati M, Rossi A, et al. (2006). Effects of an educational intervention on
weight gain in patients treated with antipsychotics. Journal of Clinical Psychopharmacology, 26(5), 462-6.
“Educational intervention can be an important tool for the management of weight increase in patients treated with APs.”
O'Keefe CD, Noordsy DL, Liss TB & Weiss H. (2003). Reversal of antipsychotic-associated weight gain. Journal of Clinical
Psychiatry, 64(8), 907-12.
“Some patients who gain weight while taking antipsychotic medications are able to stop gaining and lose weight over time,
largely through behavioral interventions. Dietary interventions appear promising and should be explored further to prevent and
reverse weight gain.”
Select 5 Best Articles
7
1.
Applicable to your patient
2.
Appraise methodology

Simple Method for Evaluating the Clinical Literature
3.
Publication type
4.
Currency
5.
Times cited (Web of Knowledge)
Pyramid of Publication Types
8
Guidelines
Systematic
Reviews
Meta-analysis
Randomized Controlled
Trials
Cohort Studies
Case Control Studies
Case Series
Case Reports
Ideas, Editorials, Opinions
Annotated Bibliography
9

Citation style (e.g. APA)

Annotation
 Discuss
content, usefulness, value of each article
 Critical
appraisal of methodology
Personal Reflection
10

Essay exploring your personal and general
reflections on your interaction with the patient
(PPI)

Thoughtful, convincing, insightful, and exploratory;
represents your personal self awareness; reveals
self-learning; emphasizes your personal feelings
and emotions
Clinical Reasoning/Reflection Exercise
11

Download from
 MedWeb
Psychiatry Clerkship Manual
 http://medweb.usc.edu/site/clerkships/psych/general_info
_psych.pdf
 Year
III Student Portal – Psychiatry Clerkship tab
 http://www.usc.edu/hsc/nml/portals/students/yr3-4.html

Due by 6th week of clerkship
Questions?
12
Make an apt for a personal consultation!
Emily Brennan, MLIS
ebrennan@usc.edu