Learning Objectives After participating in this CME activity, the psychiatrist should be better able to: • Categorize and describe different types of abnormal involuntary movements (AIMs). • Identify assessment tools and treatment options for AIMs. Abstract Abnormal involuntary movements (AIMs) comprise a diverse group of movement disorders characterized by uncontrolled and unintended movements (e.g., tremors, tics, dystonia). AIMs can occur at any stage of life and pose significant challenges for clinicians. It is difficult to determine their underlying causes due to the complex neurobiological mechanisms involved. Therefore, it is crucial to quantify the severity and progression of AIMs using well-validated measurement scales, such as the Abnormal Involuntary Movement Scale (AIMS). By employing reliable assessment approaches, clinicians can objectively evaluate the motoric manifestations of AIMs and track them over time. Treatment of AIMs varies depending on their nature and etiology. While AIMs often respond to treatment, serious side effects can undermine treatment efficacy. In this clinically focused narrative review, we categorize different types of AIMs and discuss their neurobiological aspects. Further, we emphasize the importance of using well-validated measurement scales for accurate assessment and discuss available treatment modalities that target the specific AIMs manifestations. Additionally, we cover the need for comprehensive care to address the multifaceted nature of AIMs, accounting for their physical manifestations as well as their psychological, social, and functional toll on patients. By embracing a multidisciplinary approach, health care professionals can provide patient-centered care that promotes overall well-being and enhances the lives of patients coping with AIMs. Regular follow-up assessments are necessary to monitor treatment response, adjust medications when needed, and provide ongoing support for individuals affected by AIMs.
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.
Despite ongoing controversies, schizoaffective disorder remains a separate diagnosis under schizophrenia spectrum disorders in the Diagnostic and Statistical Manual for Mental Disorders , fifth edition. Clinically, schizoaffective disorder has symptom overlap with both schizophrenia and bipolar disorder with psychosis. In this review, we discuss clinical features, brain structural changes, neurodevelopment, neurocircuits, and the genetics of schizoaffective disorder. We also address the similarities and differences in underlying neurobiology of schizoaffective disorder, schizophrenia, and bipolar disorder with psychosis. Finally, we discuss the schizoaffective disorder diagnosis in the context of a transdiagnostic approach to psychosis. [ Psychiatr Ann . 2020;50(5):190–194.]
The underlying cause of psychotic disorders is often uncertain. Determination of the nature, time course, and severity of psychotic symptoms and whether they are a consequence of a primary psychiatric condition or a medical/neurologic illness is essential.
