Medical Students Who Engage in the Arts Make Better Doctors

Medical Students Who Engage in the Arts Make Better Doctors

A new study finds that students who devoted more time to the arts and humanities during medical school had significantly higher levels of positive physician attributes like empathy, tolerance of ambiguity, wisdom, and emotional intelligence, while at the same time reporting lower levels of adverse traits like burnout.

“The humanities have often been pushed to the side in medical school curricula, but our data suggests that exposure to the arts are linked to important personal qualities for future physicians,” said senior author Marc Kahn, M.D., MBA, MACP, and Senior Associate Dean in the Tulane University School of Medicine. “This is the first study to show this type of correlation.”

Through an online survey of 739 students at five medical schools across the country, the researchers measured exposure to the humanities (music, literature, theater, and visual arts), positive personal qualities (wisdom, empathy, self-efficacy, tolerance for ambiguity, and emotional appraisal), and negative qualities associated with well-being (physical fatigue, emotional exhaustion, and cognitive weariness).

The researchers found that those who reported more interactions with the humanities also scored higher in openness, visual-spatial skills, and the ability to read their own and others’ emotions.

Those with fewer interactions scored higher for qualities associated with burnout, such as physical fatigue and emotional exhaustion, the researchers report.

“The fields of art and medicine have been diverging for the last 100 years,” said Salvatore Mangione, M.D., Associate Professor of Medicine in the Sidney Kimmel Medical College at Thomas Jefferson University and first author. “Our findings present a strong case for bringing the left and the right brains back together — for the health of the patient and the physician.”

At Jefferson, students are encouraged to pursue the arts and humanities to foster the essential skills related to healthcare including observation, critical thinking, self-reflection, and empathy, the researchers noted. The JeffMD curriculum, through the Medicine + Humanities Scholarly Inquiry track, is a formalized approach to embedding humanities into medical school.

Similarly Tulane offers an elective course in medical humanities, as well as student programming and community service opportunities that engage the arts, the researchers reported.

Tulane’s Creative Premedical Scholars Program offers early acceptance to undergraduate honor students in arts and humanities majors. Slightly less than half of the school’s first-year class of students earned undergraduate degrees in liberal arts, the researchers noted.

The study was published in the Journal of General Internal Medicine.

Source: Tulane University
 
Photo: Tulane University School of Medicine students Shuo Huang and Gabriela Aviles perform for patients at Tulane Medical Center as part of the hospital’s Music Mends program. New research from Tulane and Thomas Jefferson universities shows that medical students who spend more time engaging in the arts may also be bolstering the qualities that improve their bedside manner with patients.
Credit: Tulane Health System
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Social Media Can Help Teens in State Care Feel Connected

Social Media Can Help Teens in State Care Feel Connected

Young people in state care may reap psychological, emotional, and social benefits through the use of social media networks, according to a new UK study by researchers from the Centre for Research on the Child and Family (CRCF) at the University of East Anglia in England.

Until now, many have assumed that social media platforms such as Facebook, Instagram, and WhatsApp would only pose a risk for this vulnerable group.

But the new findings, published in the British Journal of Social Work, show that social media can help young people living in state care maintain healthy and appropriate birth family relationships and friendships, make new connections and ease transitions between placements and adult independence.

In particular, social media platforms such as Facebook can contribute to increased self-esteem and mental well-being, which is particularly helpful for young people in care who frequently report feeling worthless, depressed, and isolated.

“Young people in care face harder, faster, and steeper transitions into adulthood with fewer resources than their peers,” said lead researcher Dr. Simon Hammond. “Placement instability often leads to young people feeling abandoned and isolated at points in their lives when they are at their most vulnerable.

“The young people we worked with talked about how many friends or followers they had on social media. And it was the contacts outside their immediate state care environment that young people saw as their most precious commodity.”

For the study, Hammond made more than 100 visits to four residential care settings in England over a period of seven months. During this time, he conducted in-depth observations on how 10 young people routinely used social media in their everyday lives. He also conducted focus groups and interviews with the young people and their social care professionals.

According to the findings, having positive online networks helped young people in care gain “social capital”. In addition, digital networks were found to help piece together a fragmented social life and act as a bridge beyond the immediate care-home environment.

“Having a strong social support network helps with the physical and psychological isolation reported by young people in care,” said Hammond. “We found that emotional support from people outside the care environment was very important. Keeping up to date with friends and, in some cases birth family members, about everyday life events really helped provide a sense of belonging and connectedness.”

“Stigma and shame are described by many young people in state care. We found that social media provides a window to life before being in care and a way of distancing themselves from it.”

Social media can also help young people at risk of homelessness as they transfer out of state care.

“If young people can reconnect with, create and maintain networks, they have a better chance of accessing supportive networks when it comes to things like finding accommodation,” said Hammond.

In addition, social media offers adolescents the chance to network with organizations that can help them with opportunities for personal progression. However, young people in state care might not want to “like” or “follow” organizations that highlight their experiences because it may leave them vulnerable to stigma.

“Communication via social media carries risks for all users. However, these risks do not stop their usage. Understandably, from the perspective of staff at residential care homes, there was a lot of concern about how best to monitor internet use but we need to be engaged in this digital space to help protect society’s most vulnerable young people,” said Hammond.

Source: University of East Anglia

IQ Decline in Childhood May Portend Psychosis in Adulthood

Emerging research suggests declines in IQ during early childhood and adolescence can lead to psychotic episodes in adulthood. Investigators theorize that declining IQ causes children and young adults to fall progressively behind their peers across a range of cognitive abilities.

Researchers from King’s College London’s Institute of Psychiatry, Psychology & Neuroscience (IoPPN), and Icahn School of Medicine at Mount Sinai in the United States believe educational interventions could potentially delay the onset of mental illness.

Psychotic disorders, such as schizophrenia, are severe mental illnesses affecting one to three percent of the population cause a range of abnormalities in perception and thinking. The study is the first to track IQ scores and cognitive abilities throughout the entire first two decades of life among individuals who develop psychotic disorders in adulthood.

“’For individuals with psychotic disorders, cognitive decline does not just begin in adulthood, when individuals start to experience symptoms such as hallucinations and delusions, but rather many years prior, when difficulties with intellectual tasks first emerge, and worsen over time. Our results suggest that among adults with a psychotic disorder, the first signs of cognitive decline are apparent as early as age four,” said Dr. Josephine Mollon.

The study appears in JAMA Psychiatry.

Previous studies have shown that deficits in IQ begin many years before hallucinations and delusions first appear in patients with psychotic disorders, but the timing of when these IQ deficits emerge has not been clear.

The new study provides the clearest evidence to date of early life cognitive decline in individuals with psychotic disorders.

The study included 4,322 U.K.-based individuals who were followed from 18 months to 20 years old. Those who developed psychotic disorders as adults had normal IQ scores in infancy, but by age four their IQ started to decline, and continued to drop throughout childhood, adolescence and early adulthood until they were an average of 15 points lower than their healthy peers.

As well as falling behind in IQ, individuals who developed psychotic disorders lagged increasingly behind their peers in cognitive abilities such as working memory, processing speed, and attention.

IQ scores fluctuate among healthy individuals, and not all children struggling at school are at risk of developing serious psychiatric disorders.

“It is important to bear in mind that many children will experience some difficulties with schoolwork or other intellectual tasks at some point in their lives, and only a small minority will go on to develop a psychotic disorder,” said senior author Dr. Abraham Reichenberg.

The results suggest that adults who develop psychotic disorders do not go through a deterioration in cognitive function, but instead they fail to keep up with normal developmental processes. Early interventions to improve cognitive abilities may potentially help stave off psychotic symptoms from developing in later life.

“There are early interventions offered to adolescents and young adults with psychosis,” said Reichenberg. “Our results show the potential importance of interventions happening much earlier in life. Intervening in childhood or early adolescence may prevent cognitive abilities from worsening and this may even delay or prevent illness onset.”

The researchers are now examining changes in the brains of individuals who go on to develop psychotic disorders, as well as potential environmental and genetic risk factors that may predispose individuals to poor cognition.

Source: King’s College London/EurekAlert

Study Finds Kids are Not Overmedicated

Many Cesarean Patients Discharged with More Opioid Meds Than Needed

A new study suggests that contrary to popular opinion, psychiatric medications are not overprescribed for American kids. In fact, because of limited access to child psychiatrists, researchers worry more about undertreatment and a failure to explore other means of treatments before medications.

Investigators from Columbia University Irving Medical Center (CUIMC) compared prescribing rates with prevalence rates for the most common psychiatric disorders in children, and discovered that some of these medications may be underprescribed.

“Over the last several years, there has been widespread public and professional concern over reports that psychiatric medications are being overprescribed to children and adolescents in the United States,” said Ryan Sultan, M.D., a child psychiatrist and researcher at CUIMC who led the study.

“We were interested in better understanding this concern.”

The research findings appear online in the Journal of Child and Adolescent Psychopharmacology.

Investigators used data from a national prescription database of 6.3 million children between the ages of three and 24 years. They, and reviewed the annual prescriptions for three psychiatric drug classes: stimulants, antidepressants, and antipsychotics.

They then compared prescribing patterns with known prevalence rates of attention deficit-hyperactivity disorder (ADHD), anxiety disorders, and depression between young children (three to five years), older children (six to 12 years), adolescents (13 to 18 years), and young adults (19 to 24 years).

This is the first national study to analyze prescription rates for these three types of psychiatric medications in youth.

Annually, an estimated one in eight U.S. teenagers has a depressive episode, and roughly one in 12 children have symptoms of ADHD. During the year studied, fewer than one in 30 teenagers received a prescription for antidepressants, and only one in 20 got a prescription for stimulants.

“Our results show that, at a population level, prescriptions of stimulants and antidepressant medications for children and adolescents do not appear to be prescribed at rates higher than the known rates for psychiatric conditions they are designed to treat,” said Sultan.

“These findings are inconsistent with the perception that children and adolescents are being overprescribed.”

Overall psychiatric drug prescription patterns in children and adolescents children in the youngest group accounted for the smallest number (0.8 percent) of prescriptions for any psychiatric drug. Adolescents accounted for the highest number (7.7 percent).

The number of prescriptions for stimulants was highest in older children (4.6 percent), with males accounting for more of these prescriptions than females. Antidepressant prescriptions increased with age and was highest for young adults (4.8 percent), particularly for females. Antipsychotic prescriptions peaked during adolescence (1.2 percent) and were prescribed slightly more often for males in this age group.

“The study also showed that, among young people in the United States, the patterns of prescriptions for antidepressants and stimulants are broadly consistent with the typical ages associated with the onsets of common mental disorders, said Mark Olfson, M.D., professor of psychiatry at CUIMC and senior author of the paper.

“However, the situation with antipsychotic medications is less clear cut. Given clinical uncertainty over their appropriate indications, it is unclear whether their annual use rates, which ranged from 0.1 percent in younger children to 1 percent in adolescents, are above or below the rates of the psychiatric disorders they aim to treat.”

“These results provide some reassurance to those who are concerned about the overprescribing of psychiatric medications to children and teenagers,” said Sultan.

“Improving access to child psychiatrists through consultation services and collaborative care models may help address potential undertreatment while also reducing the risk of prescribing medications before other treatments have been tried.”

Source: Columbia University/EurekAlert