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Letter To The Editor

Jefferson Journal of Psychiatry

Dr. Chessick responds to Dr. Dorn's Review of why Psychotherapists fail.

In Response: A Discussion Of "Bulimia As A Masturbatory Equivalent", C. Philip Wilson, Md

Jefferson Journal of Psychiatry

My research and that of my colleagues in the psychodynamic cause, structure and treatment of patients with bulimic anorexia nervosa correlates with and confirms the hypotheses presented by Levin ( 1) that bulimic symptoms may represent a masturbatory equivalent.

In our recently published book, Fear of Being Fat: The Treatment of Anorexia Nervosa and Bulimia (2) we confirmed Sperling's findings (3) that unresolved preoedipal fixations to the mother contribute to difficulties in psychosexual development and that anorexic girls and boys displace sexual and masturbatory conflicts from the genitals to the mouth.

In Search Of The "Fundamental Rule" Of Supportive Psychotherapy, Jeffrey R. Sarnoff, Md

Jefferson Journal of Psychiatry

Early in my first year of residency training in psychiatry, while working between acute-care inpatient units and a busy crisis service, it appeared that virtually every patient was said to have been treated with supportive psychotherapy, in conjunction with psychotropic medication. This appearance was deceiving, and if not for thorough supervision, reading, discussion with faculty and peers, and autocritical review, I might still believe that my earliest, and perhaps sickest, patients were indeed treated with supportive psychotherapy. In retrospect, some were and some were not; the explanation for this discrepancy came with the realization that I did not have very …

Learning And Teaching Psychoanalytic Psychotherapy, Ann E. Steel, Md

Jefferson Journal of Psychiatry

Book review of:

AN INTRODUCTION T O PSYCHOTHERAPY

Sidney Tarachow, M.D.

New York: International University Press, Inc.,1963. 332 pp., $32 .50

Canoe Trip, David Mitchell, Md

Jefferson Journal of Psychiatry

"Perfect," he said as he carved his knife into the surgical wound, exposing another layer of fascia. We were standing in the operating theatre: he, the surgical chief resident, and I, a third-year medical student. It was the first of many appendectomies I would scrub in for during my surgical rotation. The patient was a I2-year-old boy who had come to the Grand Valley Hospital emergency room that day. He had a low-grade fever, sweats, and periumbilical pain that had migrated to the right lower quadrant of his abdomen. After quizzing me on various anatomical structures, removing the inflamed appendix, …

Folie Á Deux, Ulhas Mayekar, Md

Jefferson Journal of Psychiatry

Folie a deux, also called dual psychosis, involves the transfer of delusional ideas from a psychotic individual to a nonpsychotic individual within the framework of a close relationship, with the eventual in corporation of the delusional system into the psyche of the previously non psychotic individual.

Diagnosis In The Neuroleptic Malignant Syndrome, James H. Dallman, Md, Cpt, Mc

Jefferson Journal of Psychiatry

Neuroleptic malignant syndrome (NMS) is an uncommon, potentially lethal complication of treatment with antipsychotic medication. First described in American journals by Delay and Deniker in 1968 (1), this syndrome has been reported for many years in the European and Japanese literature.

Decision Trees For Use In Childhood Mental Disorders, Henry A. Doenlen, Md

Jefferson Journal of Psychiatry

The third edition of The Diagnostic and Statistical Manual ofMental Disorders (DSM-III) (1) provides specific diagnostic categories for use in childhood mental disorders, even though these diagnoses are not limited to children. In addition, many of the diagnostic categories used for adults are considered appropriate for use in children. DSM-I II instructs the clinician to diagnose children by first considering the section "Disorders First Evident in Infancy, Childhood, or Adolescence" before considering the disorders described elsewhere. However, this may lead to problems because some major diagnostic categories such as affective disorders and schizophrenia are not included …

The Neuropsychiatric Syndrome Of A Psychomotor Seizure Disorder In Shakespeare's Othello, The Moor Of Venice, Alan J. Cohen, Md

Jefferson Journal of Psychiatry

Many of Shakespeare's characters suffer from the myriad of medical and surgical ailments that afflict mankind. Although many of these diseases serve merely to enhance the subtle shading of character in Shakespearean drama, certain disorders seem to provide a vital focus for the basic theme and plot development of the plays. No group of disorders is more implicated by the behavior and thought patterns of Shakespeare's characters than neuropsychiatric disease. Othello, the Moor of Venice stands out as a striking example of a tragedy

in which the main character suffers grievous consequences from a disease that affects …

Carbamazepine In Treatment Of The Violent Psychotic Patient, Lauren A. Pate, Md

Jefferson Journal of Psychiatry

Violence in the psychiatric setting may be perpetrated by patients with a variety of diagnoses including character disorders, episodic dyscontrol syndromes, and drug or alcohol intoxication. The violent behavior of aggressive psychotic patients is typically the most bizarre, unpredictable, and the least responsive to intervention with neuroleptics or lithium carbonate. Carbamazepine, an established anticonvulsant, has achieved growing prominence as an adjunctive measure in treatment of the violent psychotic. This paper will review the literature and summarize the posited pharmacological mechanisms, reported side effects, and clinical experience with carbamazepine in controlling the symptoms of violence and aggression in psychosis.

The Stress Factor: Exploring The Possibility Of A Psychological Component To Cancer, Bernard M. Edelstein, Md

Jefferson Journal of Psychiatry

As dwellers in the same house, it seems only logical that psyche and soma would be interdependent , that well-being in one would promote health in the other, and that illness in one would soon become manifest in its partner. Yet quantifying this intuitive relationship has long been a difficult task. Establishing a mechanism for disease-heart disease, infectious disease, neoplastic disease which can withstand the scrutiny of experimental rigor, is difficult enough. To introduce a seemingly not quantifiable entity such as psychology in the form of stress or anxiety presents such great complexity that for a long time it seemed …

Using Psychoanalytically Oriented Psychotherapy With The Elderly, Mark D. Miller, Md

Jefferson Journal of Psychiatry

Psychotherapy with the elderly, like geriatric medicine, has become a subject of renewed interest. This paper will review some pertinent aspects of the subject and hopefully dispel some myths. A case will be presented where psychoanalytically oriented psychotherapy was employed. In this case, forced termination was necessary after one year due to the therapist graduating from residency.

Psychoanalysis: Science Or Fiction?, Emanuel E. Garcia

Jefferson Journal of Psychiatry

The completion of this paper comes coincidentally at a time when a book by a scholarly philosopher, Adolf Grunbaum, entitled The Foundations of Psychoanalysis:A Philosophical Critique, has just been published and purports to answer the question of the scientific status of analysis. This temporally follows Jeffrey Masson's work (1) which accuses Freud of abandoning the so-called seduction hypothesis and by so doing laying unsound groundwork for the "science" that consumes Freud's nearly limitless energies . In short, it is a period in which psychoanalysis finds itself condemned, but perhaps in a …

Faculty Advisor's Column, Harvey J. Schwartz, Md

Jefferson Journal of Psychiatry

It is with great pleasure that with this issue of The Jefferson Journal of Psychiatry-A Resident Publication we are expanding into a national journal for psychiatric residents. As part of that effort, we welcome the American Psychiatric Association Committee of Residents as our national editorial board. Our circulation will include all psychiatry residents, residency directors, and department chairmen nationwide . We look forward to continuing our three year tradition of presenting scholarly, thought provoking and creative ideas from psychiatric residents around the country. Our commitment to the two pillars of clinical and …

Editor's Column, Jeffrey R. Sarnoff, Md

Jefferson Journal of Psychiatry

The Jefferson Journal of Psychiatry (JJP) seeks to enhance the scope and quality of post-graduate training in psychiatry, by providing a forum in which residents can publish a wide variety of scientific communications.

Editorial Staff

Jefferson Journal of Psychiatry

List of Editorial Staff for Volume 4, Number 1, Winter 1986 issue of the Jefferson Journal of Psychiatry.

Advancing Stage Of Female Reproductive Life Associated With Bipolar Illness Exacerbation, Wendy K. Marsh, Terence Ketter, Sybil L. Crawford, Julia V. Johnson, Anthony J. Rothschild

Sybil L. Crawford

Introduction: Perimenopause confers an increased risk of depression in the general population, yet bipolar disorder mood course remains unknown. Methods: Clinic visits in 519 premenopausal, 116 perimenopausal including 13 women transitioning from peri- to postmenopause, and 133 postmenopausal women with bipolar disorder who received naturalistic treatment in the multisite STEP-Bipolar Disorder study over 19.8 +/- 15.5 months were analyzed for mood state. Results: Advancing female reproductive stage was associated with significant decline in mood elevation; significant decline in euthymia; no significant difference in major depression; and symptomatic significant increase. Conclusions: Advancing stage of female reproductive life was associated with bipolar …

Respiratory Dyskinesia--An Under-Recognized Side-Effect Of Neuroleptic Medications, Mukesh Mohan Bhimani

Department of Psychiatry

Respiratory dyskinesia is an under-recognized side effect of neuroleptic administration. There are only few studies that have addressed the prevalence of respiratory dyskinesia in patients with tardive dyskinesia. Our case report highlights the need to regularly examine patients on antipsychotics for any evidence of dyskinetic movements including respiratory musculature. Since RD is underrecognized and misdiagnosed, early detection can improve long term prognosis as treatment options are few and usually of only limited effect. A 62-year-old Asian male, retired civil engineer, had more than 20 years history of depressive illness, developed antidepressant induced hypomania, and was given risperidone upto 1 mg …

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor for the Jefferson Journal of Psychiatry, Volume 3, Number 2, July 1985.

E = Mc², John Matt Dorn, Md

Jefferson Journal of Psychiatry

Book Review: WHY PSYCHOTHERAPISTS FAILRichard D. Chessick, M.D.New York: Jason Aronson, 1971203 pp., $20.00