Education

Functional neurological disorder in liaison psychiatry: a co-produced educational resource
First Author Last Name: Filippidou

Abstract:

Summary
Functional neurological disorder (FND) presents with a range of neurological symptoms. Therefore, these patients are usually referred to the neurology team, although mental health liaison teams are also commonly involved in their care as in-patients. This article gives an overview of FND in adults, its diagnosis and management strategies, in the acute hospital. It discusses the common diagnoses it can be mistaken for, some techniques for psychoeducation and the value of the patient perspective. It emphasises the significance of clear communication, appropriate use of resources and considerate discharge planning. The role of liaison psychiatry is key, as an advocate for an improved multidisciplinary approach, establishment of local integrated multidisciplinary pathways, enhanced education for all clinicians and ongoing research to optimise treatment. FND needs an individualised, patient-centred approach to address the complex needs of this patient cohort.

Annotation

The finding: This co-produced educational article provides a comprehensive overview of functional neurological disorder (FND) as encountered in acute hospital settings, written specifically for C-L psychiatrists. The article covers positive diagnosis, assessment strategies, psychoeducation techniques, multidisciplinary management, discharge planning, and iatrogenic harm avoidance. The resource incorporates a first-person patient narrative, grounding the clinical guidance in lived experience and underscoring the profound impact that communication style and team coordination have on patient outcomes.

Strength and weaknesses: The article's greatest strength is its practical, clinically actionable format; it is organized around what C-L psychiatrists actually do during a consultation, from pre-assessment note review through discharge planning. The educational resource incorporating patient authorship adds authenticity and an important balance to purely clinician-driven recommendations in an illness with significant stigmatization. The discussion of iatrogenic harm — covering eight distinct sources including diagnostic overshadowing, stigma, and misuse of the FND label — is particularly valuable. The article's primary limitation is its relatively regional focus, meaning some guidance around service pathways and specialist center referral may not translate to other healthcare systems. Additionally, while it references neuroimaging advances and emerging diagnostic technologies, these sections remain brief and would benefit from expansion given their growing clinical relevance.

Relevance: FND is an incredibly common reason for C-L psychiatry involve in general hospitals, yet many C-L psychiatrists, despite their expertise, may experience uncertainty in diagnosis and communication. This resource serves as an accessible, up-to-date reference that C-L psychiatrists can use directly in clinical practice and in teaching. The psychoeducation section — including the "software versus hardware" analogy — offers concrete language that clinicians can adapt when explaining FND to patients and families.

Current Status of Interprofessional Education in Consultation-Liaison Psychiatry: What Are the Gaps?
Elizabeth B Gilbert, Adrienne D Mishkin, Molly Howland, Cheryl L Hurd

Abstract:

Much of healthcare in the United States and around the world is provided by interprofessional teams, making interprofessional education (IPE) an important aspect of healthcare provider training. Interprofessional education has been widely studied across a variety of clinical contexts, demonstrating improved educational and clinical outcomes. Though consultation-liaison psychiatry (CLP) has been an interprofessional subspecialty since its inception, there is little literature examining how to apply IPE research to CLP settings. In this paper, we aim to summarize existing IPE literature, describe where existing research is most applicable to CLP, critically examine IPE research with a CLP lens, and formulate practical guidance for clinicians in CLP.

Annotation

The finding: This narrative review examines the current state of interprofessional education (IPE) within consultation-liaison psychiatry (CLP), concluding that while IPE is inherently embedded in CLP practice, it remains poorly formalized and understudied. The authors summarize existing IPE literature, identify where it applies to CLP settings, and offer both informal daily strategies (e.g. introductions, delineate tasks, model positive regard) and formal structured recommendations (e.g. rotate leaders across professions, real-world simulations, protect time) for CLP teams. Three clinical vignettes illustrate common interprofessional challenges — including role confusion, hierarchy imbalances, and scope-of-practice misunderstandings — with practical discussion of how each could be handled more effectively.

Strength and weaknesses: This article fills a genuine gap: despite CLP being one of the most inherently interprofessional subspecialties in medicine, there is virtually no literature examining how IPE principles should be applied specifically within CLP teams. The authors synthesize a broad body of IPE literature efficiently and provide actionable, tiered recommendations. The clinical vignettes are realistic and pedagogically effective. The primary limitations are those inherent to a narrative review: the authors acknowledge the general IPE literature has significant heterogeneity, and the specific CLP IPE literature remains extremely sparse and largely anecdotal.

Relevance: This article is directly relevant to C-L psychiatrists in any clinical or educational role. The authors offer a framework for thinking about the interprofessional dynamics that C-L psychiatrists navigate daily — with referring services, nursing staff, social workers, advanced practice providers, and trainees — and translates IPE research into concrete steps that CLP teams can take without requiring significant institutional infrastructure.

Advancing Women's Mental Health Education in Psychiatry Residency Training Programs: Insights from a Trainee Needs Assessment
Amanda Koire, Nicole Cirino, Monique Sager, Reid Mergler, Polina Teslyar, Lauren M Osborne, Nancy Byatt, Cindy H Liu

Abstract:

This study assessed resident psychiatrist clinical confidence regarding women's mental health (WMH) topics and interest in receiving WMH education. The authors analyzed cross-sectional survey data from 152 Postgraduate year (PGY) 1-4 Residents in U.S. Adult Psychiatry Residency Training Programs between 12/3/2024-5/29/2025. Relative within-individual confidence in perinatal-focused WMH practice compared to general practice was assessed using paired Wilcoxon signed rank tests. Predictors of the relative confidence gap between perinatal and general practice were evaluated using multiple regression analyses. Resident interest in WMH education and preferred educational interventions was summarized using descriptive statistics. Residents were significantly less confident prescribing to pregnant and lactating individuals and counseling patients about risks and benefits of treatment in pregnancy and lactation compared to general practice (all p < 0.001). More self-reported WMH didactic hours attenuated the confidence gap for perinatal prescribing and counseling during pregnancy and lactation. The majority (62.5%) were not confident they would receive adequate WMH exposure by the end of residency, including 58.8% of PGY-4 residents. All (100%) expressed support for formal requirements for WMH education during residency. Residents were most interested in additional interactive WMH didactics (78.3%), followed by additional clinical electives (75.7%) or a national or program-specific women's mental health track (65.8%). Many residents are not getting the WMH training they need to serve women across the lifespan. When they do get it, it increases their self-efficacy to provide WMH care. Residents need and are recommending more WMH training so they can provide adequate mental health care to women across the lifespan.

Annotation

The finding: This national cross-sectional survey of 152 U.S. adult psychiatry residents (PGY 1–4) assessed clinical confidence and educational preferences regarding women's mental health (WMH), with a particular focus on perinatal psychiatry. Residents demonstrated a significant and consistent "confidence gap" when comparing their general prescribing and counseling confidence to the same tasks in pregnancy and lactation — a pattern that persisted even among PGY-4 residents. Notably, increased didactic hours in WMH — rather than simply having access to a formal WMH track — was the strongest predictor of reduced confidence gaps. Every respondent (100%) expressed support for formal WMH education requirements in residency.

Strength and weaknesses: This study is among the first to assess WMH educational gaps from the trainee perspective, providing a valuable complement to existing intra-institutional/program surveys. The geographically diverse sample and the finding that didactic hours — not just track availability, or clinical site/rotation availability — drive confidence in the generalizability and create clear actionable implications for programs with limited resources. Limitations include convenience sampling, likely overrepresentation of female and URiM residents (suggesting possible self-selection toward WMH-interested trainees), and reliance on self-report for both confidence and educational exposure, as opposed to formal review of internal program curricula and rotation offerings of the programs the survey respondents attend. The study's focus on perinatal psychiatry also leaves other WMH domains (e.g., PMDD, perimenopause) underexplored.

Relevance: C-L psychiatrists frequently encounter pregnant and postpartum patients in general hospital settings, whether on obstetrics services, medical floors, or through emergency consultations. This study underscores that many residents entering or on C-L rotations may carry significant uncertainty around perinatal psychopharmacology and general management — an area where C-L educators can make a targeted impact through structured didactics and bedside teaching. The finding that even brief, interactive didactic instruction narrows confidence gaps supports the case for incorporating WMH-focused teaching into C-L fellowship and residency curricula, even absent a dedicated WMH track.