The session will provide participants with education on the proper screening, diagnosis, and treatment of ADHD in children, adolescents, and adults.

7:00-7:30 a.m. Breakfast
7:30-9:00 a.m. Symposium

This educational activity is supported by an independent medical educational grant from Shire.
This activity is sponsored by CME LLC. Veritas Institute for Medical Education, Inc. is the content provider.

So you've got the basics of coding and documentation down. Now it's time for the real fun! Just when you thought picking the right code was easy! Here we go into depth regarding advanced of psychiatric and psychotherapy coding, with emphasis on advanced techniques such as the usage of modifiers, places of service other key components to coding correctly for maximizing reimbursement. We will also look at policies and procedures related to improving reimbursement such as benefit checking, service prepayment, payment variance audits and other areas in the revenue cycle. Included in the discussion will be case studies and examples.

Upon the completion of this activity, participants will be able to:

1. Understand and use advanced and rarely used CPT codes for services.
2. Understand what CPT Modifiers and Places of Service are and how to apply them.
3. Use policies and procedures to improve reimbursement and their relationship to proper coding and charging.

Psychiatrists are asked to render opinions and help in the management and treatment of a number of conditions which etiology may be primarily neurological, but its manifestations clearly psychiatric. Delirium is a transient, reversible organic mental syndrome caused by dysfunction in cerebral metabolism, characterized by an acute or subacute onset. Features of delirium include disturbance of consciousness, change in cognition, perceptual disturbances, global cognitive impairment, attentional abnormalities, increased or decreased psychomotor activity, and sleep-wake cycle disruption. Alcohol, medication intoxication, and withdrawal stages will be given special attention, as possible and common causes of delirium. The inappropriate treatment usually leads to improper treatment, thus delaying appropriate management.

Upon the completion of this activity, participants will be able to:

1. Understand the pathophysiology of delirium;
2. Understand the research-based, effective treatment options for delirium, including the use of atypical antipsychotic and other novel agents.
3. Learn research proven preventing techniques.

Iraq and Afghanistan veterans are returning home. Because so many are reservists, they will be coming back into civilian life.The prevalence of mental health disorders in these returning veterans is significant and very different in the clinical presentation than others with such conditions as PTSD. This seminar will address the identification of those veterans and their families in need, clinical interventions, and problems/solutions that therapists may face in providing services at all stages of the war experience, pre-deployment, deployment, and the return home.

By participating in this activity, participants will be able to:

1. Understand the importance of providing psychological, social, and/or psychiatric support for families of servicemen and service women in the different phases of War.
2. Appreciate the need for varied services (including addressing legal issues) to be delivered in different settings, including schools, work, places of worship, etc.
3. Gain further knowledge treating multiaxial aspects of the serviceman or service woman- and their families.

The session will encourage participants to explore the barriers of recognition and management of nonadherence in psychiatric patients with comorbid conditions and provide skills to balance long-term treatment requirements with optimized chronic care delivery.

This activty is supported by an educational grant from Eli Lilly and Company and Bristol-Myers Squibb and Otsuka America Pharmaceuticals, Inc.

This activity is sponsored by CME LLC.

Competent health care providers have to deal with many different aspects of their patients' lives - from social issues, financial issues, relationship issues, and cultural issues. Integrative therapies also address all of these areas. The application of Integrative therapies (which used to be known as "Complementary and Alternative Therapies") is now getting much more commonplace and is gaining in some areas of medicine greater acceptance. Your patients may be using herbs, meditation, massage, acupuncture, and aromatherapy because they believe that these integrative therapies may improve their health. As there are potential benefits and risks of these integrative therapies, whether they are being substituted for medications and/or psychotherapy or being used along with medications and/or psychotherapy, aspects of potential liability are also reviewed.

Upon the completion of this activity, participants will be able to:

1. Have knowledge of several Integrative Therapies your patients may be incorporating into their overall mental health care.
2. See how the paradigm of patient care may be shifting to include the use of Integrative Therapies and what some of the barriers are.
3. Understand how knowing- or not knowing- that your patient may be employing Integrative Therapies may have legal implications.

This course takes attendees on a provocative journey into the nature of happiness and the search for a novel framework for conceptualizing human nature - the human matrix. Practical ramifications for unstalling stalled treatment planning, enhancing the therapeutic alliance, preventing suicide, and creating a "tough resiliency" in both patients and clinicians are described in detail with clinical case examples.

By participating in this activity, attendees will be able to:

1. 1) Explain the concept of the human matrix model in everyday clinical practice, from engaging patients to treatment planning;
2. Discuss a unique definition of happiness and its implications for nurturing a resilient and "tougher happiness" and a more powerful style of treatment planning; and
3. Apply the principles of the "Human Matrix Model" for treatment planning, including healing matrix effects, damaging matrix effects, and the Red Herring Principle.

The best examination of a patient's neurocognitive status is a careful history and includes a clinical assessment that looks for variations from normal changes in a patient's neuroanatomy and records specific findings.

By participating in this activity, attendees will be able to:

List the primary domains of the neurocognitive mental status exam. 2) Employ simple, effective clinical tests to probe brain function. 3) Utilize systematic cognitive screening to confidently diagnose common dementia syndromes in geriatric patients.

The very common problem of partnered women who lose their desire for sexual behavior (HSDD) is addressed by understanding the nature of sexual desire, psychological intimacy, women's biology and the frequent transitions that occur within their lives. HSDD is an active arena of pharmacological research.

Upon the completion of this activity, participants will be able to:

1. Understand the individual, interpersonal, biological, and cultural aspects of sexual desire problems and their solutions.
2. Take a thorough history to estimate the patient's sexual desire situation.
3. Separate HSDD in women with ovarian function and those who are menopausal.
4. Appreciate the differences between a disorder model and a problem model.

The session will provide participants with strategies for improving rates of remission for major depressive disorder (MDD), including treatment resistant depression, along with combination and augmentation strategies for depression with atypical antipsychotics.

This activity is supported by an educational grant from Bristol-Myers Squibb and Otsuka America Pharmaceutical, Inc.

This activity is jointly sponsored by The Albert Einstein College of Medicine with Montefiore Medical Center and CME LLC. The Institute for Continuing Healthcare Education is the content provider.

Medication adherence can be a major challenge in patient care. This course will cover ten specific, practical and easily adopted interviewing techniques to improve medication adherence. These techniques are derived from the highly acclaimed motivational strategy known as the "medication interest model."

By participating in this activity, attendees will be able to:

1. Apply techniques such as the "inquiry into lost dreams" and the "trap-door question";
2. Identify the challenges in medication adherence by understanding how and why patients weigh the pros and cons of taking medications; and
3. Demonstrate the principles and applications of the medication interest model in a sophisticated fashion to a variety of difficult clinical situations.

This lecture synthesizes the concepts of love as a shifting nuanced series of nine ideas and vital interpersonal processes and skills. It emphasizes that temporary emotional disconnections are inevitable and elucidates the mechanisms that limit love's capacity to endure and flourish.

By participating in this activity, attendees will be able to:

1. Understand what love is and what it is not;
2. Recognize the universal aspects of connection-disconnection-reconnection as an inherent characteristic of long-term relationships;
3. Stimulate thoughts about the capacity of love relationships to generate symptoms that are often diagnosed and treated without reference to their likely origin; and
4. Provide a background for the other sexual topics in this lecture series.

Both psychiatric and nonpsychiatric clinicians tend to underutilize screeners and rating instruments in their busy practices. This is an error worth rectifying expeditiously for the following reasons: use of screeners and rating instruments can actually improve outcomes, it can be very time efficient and many quality tools are available for no charge. This workshop will show videos of a few clinical scenarios and discuss what tools might have been appropriate to use. Copies of noncopyrighted screeners and rating instruments, appropriate for both psychiatric and nonpsychiatric settings, will be made available to participants. A toolkit filled of screeners and rating instruments will be brought to the workshop to show participants how they can create one for their own use.

By participating in this activity, attendees will be able to:

1. Recognize the many noncopyrighted tools available for clinician use covering a range of psychiatric disorders;
2. Define these tools that are very time efficient and improve diagnostic yield; and
3. Describe how to choose the right tool and how to score them.

Upon completion of this activity, participants will be able to:

1. Detect and diagnose Alzheimer's disease (AD) using DSM-IV criteria, APA & AAN practice guidelines;
2. Utilize clinical information to differentiate AD from other cognitive disorders;
3. Optimally manage patients using both behavioral and pharmacological techniques.

This course provides an overview of a clinical approach to diagnosis, evaluation and management of autonomic disorders.

By participating in this activity, attendees will be able to:

1. Discuss the clinical cases of orthostatic hypotension, orthostatic intolerance, autonomic neuropathies and disorders of sweating;
2. Discuss patient care by highlighting the ways by which the clinician can provide useful consultations and effectively manage patients suffering from autonomic disorders; and
3. Formulate a differential diagnosis and offer a treatment plan for patients with common and less common varieties of autonomic dysfunction.

Headache is one of the most common of human afflictions. Nearly 30 million Americans live with migraine, but only a fraction of them receive effective treatment. The impact of inadequate or ineffective care is enormous, in both direct and indirect costs. The course discusses the update in the diagnosis and management of both primary and secondary headache disorders.

By participating in this activity, attendees will be able to:

1. Differentiate primary headache disorder from headache symptomatic of other disease;
2. Identify both episodic and chronic primary headache disorders; and
3. Discuss the treatment plans for both primary and secondary headache disorders.

Public outrage has justifiably ensued when convicted sex offenders who are released from prison commit subsequent sexual assaults.  At least seventeen states currently allow for the indeterminate civil commitment (i.e., locked psychiatric placement) of those sex offenders assessed as dangerous once they have completed their prison terms. These SVP statutes have engendered controversy both on constitutional and ethical grounds. All the DSM-IV-TR system can provide is a catalog of the specific mental disorders.  But which ones should count towards SVP civil commitment?

Upon the completion of this activity, participants will be able to:

1. Identify why twenty states have passed statutes mandating long term civil psychiatric commitment for sexually violent predators who are about to be released from prison.
2. List the legal and ethical difficulties that make this one of the most controversial areas in all of mental health practice.
3. Differentiate how well or poorly different DSM diagnoses fit into the statutory definition of mental disorder that triggers sexual predator civil commitment proceedings.

Is it better conceptualized as a state, a trait, or a culture-bound construct? Are there predictable and universal causes of human happiness? To what degree is one's degree of happiness modifiable by any life event or intervention? In this session, participants will get an introduction to the science of subjective well-being. The session will provide an overview of the history, epidemiology, social psychology and neurobiology of happiness.

By participating in this activity, attendees will be able to:

1. Identify the three psychological components of subjective well-being
2. Discuss the evidence that happiness is or is not related to wealth, health, love, or sexual activity; 3)Discuss the evidence of an inborn component to human happiness and;
3. List four interventions likely to lastingly enhance subjective well-being.

This is meditation's moment. From the cover of Time Magazine to the coffee table discussions of morning talk shows, meditation has acquired near mythic status both as an avenue to personal fulfillment and as a universal solvent against a dizzying array of diseases, mental and physical. However, despite increasing evidence that meditation may confer health benefits, significant gaps remain in our understanding of how meditation alters mind-body functioning to promote emotional and physical well-being. By providing a state-of-the-art update on what we do and do not know about meditation and meditation and mental health - with a focus on depression - this presentation will provide clinicians with information essential for thinking about how to incorporate meditation into their work with patients. The first talk in this program will provide an overview of research findings regarding mental health benefits of meditation, with a focus on rigorously examining areas of remaining uncertainty. The second talk will drill down deeper into a particular style of meditation - compassion meditation - to explore how this type of meditation may modulate deleterious stress responses relevant to health. The program will conclude with a chance for audience members to get a first hand sense of compassion meditation through a brief guided meditation.

At the end of this program, participants should be able to:

1. Describe the most important unanswered research questions regarding how to best apply meditation to mental illness.
2. Describe the different types of meditation practices that appear to offer the most promise as health interventions.
3. Describe how meditation practices may improve central nervous system, stress and immune functioning in ways likely to benefit mental and physical disease.
4. Describe what is known from the research literature regarding the effect of meditation on depression and anxiety in medically healthy and medically ill individuals.
5. Describe strategies for implementing meditation into clinical practice.

Upon the comletion of this activity, participants will be able to:

1. Define depression;
2. Outline causes and features of late life depression and discuss the known treatment modalities;
3. Assess therapy outcomes and how to improve these and;
4. Describe the need for maintenance therapy.

Upon the completion of this activity, participants will be able to:

1. Avoid major pitfalls of both tangible & intangible marketing;
2. Understand the ramifications of Customer Service & know how to offer patients "star treatment"; and
3. Develop a marketing budget and an effective 12-Month Marketing Plan, individualized for their practice.

In 1984, Libby Zion died of a fatal drug interaction, and her death led to our present system of residency workplace hourly restrictions. Despite these changes, would a well-rested clinician be able to recognize and prevent her death today?

By participating in this activity, attendees will be able to:

1. Recognize clinically relevant drug interactions;
2. Utilize a framework and teaching tool to predict those patients most at risk for serotonin syndrome and other drug interactions; and
3. Describe the cytochrome P450 system.

Pain is one of the most common reasons patients seek medical attention and a symptom encountered by every physician.  According to American Pain Society estimates, 50 million people are partially or totally disabled by pain and 45% of all Americans seek care for persistent pain at some point in their lives.  Neuropathic pain can be especially difficult to diagnose and treat. In this session, advances in the understanding of the causes of common neuropathic pain syndromes will be reviewed, and treatment options will be addressed.

As a result of participation, attendees will:

1. Be able to better recognize the onset of neuropathic pain.
2. Have a better understanding of a range of treatment options.
3. Will be better able to understand pain physiology and its ramifications.

This session will provide participants with an overview of human aggression. Based on the speaker's new chapter in the forthcoming Kaplan/Sadock Comprehensive Textbook of Psychiatry, this talk will summarize what we know about the origin, pathophysiology, and clinical management of aggression as it occurs in multiple disorders--from ADHD to organic brain injury. Sample cases will be used to illustrate optimum management based on state of the art literature review.

By participating in this activity, attendees will be able to:

1. Identify the brain regions most important for regulating individual human aggression;
2. Discuss how the evolutionary adaptation of sociality helps to explain war;
3. List the 7 big factors that help account for collective human aggression; and
4. Discuss the evidence that interventions to reduce intergroup prejudice can enhance the prospects of long-term peace.

This course will take an indepth look into the legal and ethical dilemmas in late life care. There will be a focus on the issues related to driving, inappropriate sexuality, financial issues, decision making and the right to refuse treatment.

Upon the completion of this activity, particpants will be able to:

1. Briefly describe the causes of dementia;
2. List the differences between normal aging and dementing illness;
3. Describe the stages of functional loss with age; and 4) List the general ethical concepts that govern the provision of care and apply these to a few common areas of concern

Join panelists Tracey Skale, MD, Tom Simpatico, MD, and Pete Earley , for a screening of a one-hour television program produced by The Fred Friendly Seminars for PBS: "MINDS ON THE EDGE: Facing Mental Illness" with a live interactive discussion to follow. The program connects dots between personal dilemmas facing individuals and families who are living with mental illness, medical practices that can be obstacles to treatment, and public policies that all too often fall short in providing support that could make a positive difference. Case studies will be examined across various barriers to treatment that occur both within and outside the provider domain. DVD Copies of MINDS ON THE EDGE will distributed to attendees at the session. Space is limited. More information on the program may be found at www.mindsonthedge.org.

At the end of this presentation, participants will be able to:

1. Discuss how the system of care for mental health, substance abuse and traumatic brain injury is currently fragmented, resulting in large numbers of afflicted persons becoming incarcerated in jails and prisons;
2. Discuss ways in which the current treatment technology for serious mental illness can more effectively be used to reach more people and prevent avoidable incarcerations and homelessness; and
3. Describe instances of barriers to treatment incurred by national, state, and municipal level legislation and the ethical dilemmas circulating these issues.