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Defiant Children: A Clinician's Manual For Assessment And Parent Training By Russell A. Barkley, M.D., Stephen Zerby M.D.

Jefferson Journal of Psychiatry

No abstract provided.

[In Response To "The Neuroleptic Treatment Of Schizophrenia: Dosing Strategies, Depot Preparations And Novel Medications" By Alexander S. Young, M.D. (Volume 13, 18-26)], James Longhurst M.D., Joseph Cassar M.D.

Jefferson Journal of Psychiatry

No abstract provided.

The Relevance Of Transference During Medication Management: A Case Of Erotized Transference, Helen C. Kales M.D., James Abelson M.D., Ph.D., Michelle B. Riba M.D.

Jefferson Journal of Psychiatry

Forces existing in psychiatry may diminish the importance of psychotherapy training as psychiatrists are increasingly given the task of medication management. Psychotherapeutic relationships can be created in medication management settings, however, and the neglect of concepts such as transference could have deleterious consequences. The authors describe the case of a man with a traumatic brain injury referred for medication management who developed an erotized transference toward his female resident-physician. This case illustrates the concept that an understanding of transference is relevant to the setting of medication management

Gabapentin In The Treatment Of Bipolar Disorder, Wendy M. Waits, Donald P. Hall Jr., M.D.

Jefferson Journal of Psychiatry

Gabapentin, a relatively new anti-epileptic drug (AED), is emerging as a therapeutic option for treatment refractory and rapid-cycling bipolar illnesses. Pharmacotherapy for bipolar disorders traditionally involves valproate, carbamazapine, or lithium, drugs which are associated with numerous adverse effects. Conversely, gabapentin has an attractive pharmacokinetics profile and relatively few side effects. There are no large randomized controlled clinical trials to date examining gabapentin’s role in mood stabilization. However, informal reports have cited encouraging results in up to 80% of patients and general tolerance to side effects. These findings make the new drug a possible choice for patients who have failed to …

The Somatization Of Depression In Native Pakistani Women, Rubeena H. Mian M.D., Linda S. Grossman Ph.D.

Jefferson Journal of Psychiatry

Previous studies have pointed out the comorbidity of somatization and depression among non-Western psychiatric patients. We studied the somatization of depression in Pakistani women. Two groups were studies: inpatients with DSM-III-R diagnoses of major depression and a comparison sample of women living in the community without psychiatric diagnoses. Both groups were administered a rating scale for somatization. Results indicated that patients reported significantly more somatic symptoms than nonpatients. These findings support the concept that somatization may be a cultural mode of mental distress among Pakistani women, as has been observed for other non-Western populations.

Folie Á Deux: Two Case Reports, Mohammad Y. Abu-Salha M.D.

Jefferson Journal of Psychiatry

Two cases of “Shared Psychotic Disorder” were diagnosed over a period of less than a year in a children’s psychiatric center. Shared Psychotic Disorder is one of the differential diagnoses that need to be entertained when evaluating a delusional patient. Including the patient’s family and/or significant others in the assessment increases the possibility of diagnosing Shared Psychotic Disorder. An eight-year-old girl was admitted after exhibiting psychotic behavior with paranoid delusions she shared with her mother. Specifically, she reported that “neighbors next door were repeatedly breaking into her house, pinning her down, raping her, and injecting her with I.V. drugs.” An …

Early Detection Of Autism In The Population, John D. Mclennan M.D., Ph.D.

Jefferson Journal of Psychiatry

Frequently there is a delay in the diagnosis of autism in children which may result in a lost opportunity to provide early intervention. Signal detection studies have suggested that single items have good predictability for autism which suggests simple screening procedures may be helpful in the early detection of an autistic disorder. Studies of autism in the very young have found that specific social deficits appear to characterize this group. A three stage procedure is presented as a possible approach to detect autism at an early age in the population thereby allowing for early intervention.

Editor's Column, Tanis Gaitens M.D.

Jefferson Journal of Psychiatry

No abstract provided.

Children And Adolexcents Of Distinction - Culturally Diverse Children And Adolescents: Assessment, Diagnosis, And Treatment By Ian A. Canino, M.D. And Jeanne Spurlock, M.D., Lloyda R. Broomes M.D.

Jefferson Journal of Psychiatry

No abstract provided.

Stevens-Johnson Syndrome Following Treatment With Carbamazepine For A Mood Disorder, Albert Coleman M.D., M.P.H., B. Trappler M.D.

Jefferson Journal of Psychiatry

A case of Stevens-Johnson Syndrome (SJS) induced by carbamazepine in a psychiatric patient with schizo-affective disorder is reported. The patient also had diabetes mellitus and was on glyburide which posed an initial dilemma at the onset of SJS as to the causative drug. In view of the expanding use of carbamazepine in psychiatric patients and the potentially lethal consequences of SJS, the authors suggest a risk management approach when initiating Carbamazepine therapy to reduce the incidence and morbidity of the syndrome.

Steroid-Induced Psychosis Presenting As "Alice In Wonderland" Syndrome, Vinobha Gorriah M.D., Frank W. Favazza M.D., Migdalia Fort-Ramirez M.D.

Jefferson Journal of Psychiatry

A 40 year old overweight male with a history of bronchial asthma, hypertension, and “schizophrenia” was admitted for intractable bronchial asthma. He did not have a history of drug or alcohol use.

Upon admission, he was treated with high doses of IV methyl prednisone, oral prednisone, and triamcinolone inhaler. He developed complex visual hallucinations which decreased following tapering of prednisone and discontinuation of the triamcinolone. EEG showed diffuse slowing suggesting a toxic metabolic state.

Managed Mental Health Care: An Oxymoron Of Ethics?, Jonathan M. Metzl M.D.

Jefferson Journal of Psychiatry

No abstract provided.

The Role Of Group Psychotherapy In Psychiatric Residency Training, Shahbaz R. Khan M.D., Katherine A. Cowan M.D., Pedro Ruiz M.D.

Jefferson Journal of Psychiatry

Group psychotherapy has become a well-recognized treatment modality in the mental health field. Educationally, however, group psychotherapy has not reached the priority level it deserves. We described our experiences in using group psychotherapy as a training tool at the University of Texas at Houston. In describing our program, we used case illustrations to better demonstrate the richness of our training experiences. Group psychotherapy should be more extensively used in the training of tomorrow’s mental health professionals.

The Neuroleptic Treatment Of Schizophrenia: Dosing Strategies, Depot Preparations And Novel Medications, Alexander S. Young M.D.

Jefferson Journal of Psychiatry

Significant progress has been made over the past decade in the use of antipsychotic medication. An improved understanding of neuroleptic side effects has led to the development of new clinical strategies for dosing traditional medications. Traditional medications have become widely used in depot preparations. Risperidone, a new medication with an improved side effect profile, has recently become available. Clozapine, a novel medication, has entered widespread use. The use of these new clinical technologies is briefly discussed, along with the implications they have for the role of the psychiatrist in community mental health settings.

Ultradian Cycles Of Mood In Normal And Depressed Subjects, Donald P. Hall Jr., M.D., David Benedek M.D., Audrey Chang

Jefferson Journal of Psychiatry

Objective: To study ultradian cycles of mood in four inpatient groups.

Method: We assessed the mood of depressed and nondepressed subjects, on an hourly basis, between 7:00 a.m. and 10:00 p.m. for two consecutive days using a visual analog scale of mood. Hourly mood scores for each group were plotted against time.

Results: We found ultradian cycles with mean lengths of 3-4 hours in all groups. The major depressive episode and adjustment disorder depression groups, however, had ultradian cycles of significantly greater amplitude than ward staff.

Conclusions: Depressed patients demonstrate greater amplitude in ultradian cycles of mood than nondepressed subjects.

Smoking Rates After Cessation Of Alcohol And/Or Cocaine: A Pilot Study, Timothy R. Jennings M.D.

Jefferson Journal of Psychiatry

Objective: To assess the change in smoking rates in alcohol and/or cocaine dependent patients after the cessation of the primary drug of use.

Design: A self-report questionnaire was administered upon admission to a Residential Treatment Facility, in the fourth week, and in the final (sixth) week of the program. The control group was administered a self-report questionnaire at the time of intake as controls and again four and six weeks later.

Setting: Residential Treatment Facility (RTF) a 30 bed inpatient alcohol and drug treatment unit, at Eisenhower Army Medical Center, Fort Gordon, Georgia.

Patients: A Total of 42 patients; 37 …

Editor's Column, Carmen Z. Harlan M.D.

Jefferson Journal of Psychiatry

No abstract provided.

Treatment Of Chronic Mental Illness, Anu A. Matorin, Md

Jefferson Journal of Psychiatry

RESIDENT'S GUIDE TO TREATMENT OF PEOPLE WITH CHRONIC MENTAL ILLNESS

(GAP Report 136; 1993)

Formulated by the Committee on Psychiatry and the Community, Group for the Advancement of Psychiatry American Psychiatric Press, Inc., 1993, 230 pages, $30.00

A Mesmerizing Book, Daniel A. Monti, Md

Jefferson Journal of Psychiatry

HYPNOSIS IN THE RELIEF OF PAIN

Ernest R. Hilgard and Josephine R. Hilgard

Brunner/Maze!, Inc., New York 1994, paperback, $28 .95, 294 pgs.

Prediction Of Treatment Response And Diagnosis In Psychiatry, Eduardo Dunayevich, Md

Jefferson Journal of Psychiatry

The lack of diagnostic gold standards and the multiplicity of vantage points used to conceptualize mental illness renders psychiatric diagnostic and therapeutic approaches susceptible to individual and cultural biases. Developments in therapeutic approaches have often provided vantage points from which to conceptualize psychopathology. The identification of predictors of treatment response may be a useful element for clinicians to select between multiple treatment tools in an expanding therapeutic armamentarium while fostering refinements in current diagnostic systems.

The Forgotten Evaluation: Taking Competence Seriously, Seth E. Tabb, Md, Scott A. West, Md

Jefferson Journal of Psychiatry

The medical literature devotes little attention to the application of competency to the general medical patient. Commonly, the only cases recognized as necessitating a competency evaluation are overtly psychotic patients, patients requiring written informed consent, and those patients who refuse treatments strongly recommended by their physician. Clarifying terminology and redefining competency provides a practical screening method for assessing competency in all patients. When physicians neglect the evaluation of competency, patient autonomy is compromised. Not only are all physicians capable of performing a competency evaluation, they are ethically and professionally required to do so.

Transition To Psychiatric Residency: Unique Stresses; Unique Rewards, Catherine A. Belitsky, Md, Frcp(C), Sidney H. Kennedy, Md, Frcp(C)

Jefferson Journal of Psychiatry

An individual's decision to pursue a psychiatric residency following medical school training is shaped by many factors. Beginning residents are often ill prepared for the relative impact that the shift from medical doctor to psychiatric resident entails. This paper reviews the literature regarding demographic and psychological factors relating to recruitment, dynamic and practical issues confronting the beginning resident, and various coping styles adopted. These factors are considered in the context of an inpatient setting where the majority of residents begin their training. Much of the resident response is seen as adaptive and a number of strategies for coping are suggested.

Patients Who Request A Female Psychotherapist, Timothy C. Smith, Md, Melinda Fudge, Md, Salman Akhtar, Md, Steven Samuel, Phd

Jefferson Journal of Psychiatry

Upon arriving at an outpatient clinic, many patients request to see a female psychotherapist. Yet little has been written on this topic. The aim of this study was to explore the demographic and clinical characteristics of such patients. We compared patients who voiced a preference for a female therapist with controls on the demographic variables of age, sex, race, marital and financial status and the clinical characteristics of diagnosis, history of sexual abuse, sexual preference, overt presence of sexual or social difficulties, history of prior treatment, gender of the previous therapist, and treatment drop out rate. A chi square analysis …

Non-Neuroleptic Pharmacotherapy Of Schizophrenia, Sajiv John, Md, Atul Mahableshwarkar, Md

Jefferson Journal of Psychiatry

Patients with schizophrenia are typically treated with a neuroleptic and some form of psychosocial intervention. In spite of optimum treatment, up to one-third of patients continue to remain severely disabled due to persistent positive or negative symptoms. A variety of drugs have been tried as alternatives or additions to traditional neuroleptics in these patients. This paper is a review of these nonneuroleptic treatment alternatives and an attempt to establish some guidelines for their use.

A Case Study Of Obsessive-Compulsive Disorder: Some Diagnostic Considerations, Jeanette M. Stumbo Zaimes, Md

Jefferson Journal of Psychiatry

Obsessive-Compulsive Disorder (OCD) was considered a rare disorder prior to 1984 when the initial results from the Epidemiologic Catchment Area survey demonstrated a substantial prevalence of the disorder (1). Thus there may be many patients today who entered treatment prior to 1984 with undiagnosed OCD. This paper gives the history of one such patient and reviews the current literature on OCD as it pertains to the diagnostic evidence in this case.

Concepts And Models Of Empathy: Past, Present, And Future, Elizabeth Ann Baxter, Md

Jefferson Journal of Psychiatry

The subject of empathy has been increasing in popularity and importance; correspondingly, the theoretical aspects of empathy are in need of further development. This paper outlines key concepts and processes related to empathy, particularly the mechanisms of identification and regression as they are discussed in the models of empathy articulated by Fleiss, Greenson, and Jordan. Similarities and differences of the models are examined, in addition to each model's description of the roles of identification and regression. Although each model has made significant contributions towards a theoretical perspective of empathy, none of them have distinguished pathological from non-pathological uses of identification. …

Case Report: Sometimes A Cigar Is Just A Cigar, Zafar Y. Ibrahim, Md, Ellen F. Brooks, Md

Jefferson Journal of Psychiatry

This unusual case underscores the need for psychiatrists to consider treatable and curable causes of acute behavior changes even when historical data are not easily available. This case presentation invites physicians of mind (and body) to utilize simple and common-sense approaches while evaluating their patients.

Editor's Column, Mary E. Donovan, Md

Jefferson Journal of Psychiatry

"Sometimes a cigar is just a cigar. " Others had learned, "My son, sometimes a cigar is just a good smoke." Like many of our colleagues, we believed that these were Freud's words during a question and answer session after a lecture he gave at Clark University. The words were comforting in a way, giving us a chance to chalk at least some things up to pure coincidence, thus releasing us from relentless unconscious agendas and hidden sexual interpretations.

Editorial Staff

Jefferson Journal of Psychiatry

Editorial staff for Volume 12, Number 2, 1995 Jefferson Journal of Psychiatry.

Current Concepts-Past Contributions, Cynthia L. Theiss, Md

Jefferson Journal of Psychiatry

WOMEN BEYOND FREUD: NEW CONCEPTS OF FEMININE PSYCHOLOGY

Edited by Milton M. Berger, M.D., with chapters by Marianne Horney Eckardt, Carol Gilligan , Douglas H. Ingram, Helen Singer Kaplan, Harold I. Lief, Jean Baker Miller, Silvia W. Olarte, Susan Quinn, and Mario Rendon

Brunner/Mazel, Inc., New York , 1994, 162 pages, $26.95