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The Risk Of Hospitalizing Suicidal Patients: A Personal Retrospective, Leora Bar-Levav, M.D.

Jefferson Journal of Psychiatry

Many statistically significant risk factors for suicide have been identified. Unfortunately, no study can identify the patient who will, in fact, kill himself. Maintaining a low threshold for hospitalization of potentially suicidal patients generally lowers their short-term risk. Hospitalization, however, like every medical intervention, carries attendant side effects. The dynamic implications of hospitalization for suicidal patients are considered in this paper along with recommendations to lessen the deleterious effects of such an intervention.

An Overview Of The Separation Phenomenon And The Experience Of Hospitalization For Children, Tara Pressley, M.D.

Jefferson Journal of Psychiatry

When children are psychologically bonded to a caretaking adult they experience a characteristic spectrum of emotions and behaviors upon being separated from that attachment figure. This paper reviews the literature pertaining to the separation phenomenon and the emotional experience of hospitalisation for children in an attempt to integrate this knowledge into the diagnosis and treatment of children hospitalized medically and psychiatrically.

Panic Disorder And Non-Cardiac Chest Pain: A Brief Review, Ruth Infante, M.D.

Jefferson Journal of Psychiatry

The relationship between chest pain and panic disorder is explored; after coronary artery disease and other medical diseases have been ruled out, panic disorder remains a significant contributor to morbidity. Panic disorder is treatable; hence it is important that psychiatrists educate the non-psychiatric medical community so that appropriate referrals and treatment can be made. This would lead to a decrease in health care costs.

Neuroleptic Malignant Syndrome: Diagnostic Dilemma In The Medically Ill, Mahmoud A. Parsa, M.D., Andrew J. Picken,, Robert Keating, M.D.

Jefferson Journal of Psychiatry

Neuroleptic malignant syndrome is a potentially fatal complication of neuroleptic treatment. It is characterized by a variery of signs and symptoms associated with autonomic instability, and hypothalamic and extrapyramidal dysfunction. Since other medical disorders may mimic its clinical presentation, the accurate recognition of this syndrome in the medical setting is often a diagnostic dilemma. Three medically ill patients with a clinical presentation suggestive of neuroleptic malignant syndrome are presented here. The authors discuss the complexity of making the diagnosis, and offer a brief review of the literature.

A Psychiatric Presentation Of Wernicke's Encephalopathy Following Intravenous Fluid Administration, Douglas Geenans, D.O.

Jefferson Journal of Psychiatry

Psychiatrists are frequenlly challenged to differentiate primary psychiatric symptoms from those that arise secondary to medical illness. Errors in clinical assessment can lead to significant morbidity and even mortality. Wernicke's encephalopathy is a medical condition that presents, in part, as psychiatric symptomatology. Despite an estimated incidence of 2%, 80% of the cases are undiagnosed. Of its classic triad, ophthalmoplegia and ataxia call be quite subtle, or even absent, whereas mental status changes are present in all but 10% of cases. This disorder, although widely recognized as a complication of alcoholism, has many less frequently considered etiologies, including iatrogenic causes, which …

Demystifying The Psychiatric Case Formulation, Len Sperry, M.D., Ph.D.

Jefferson Journal of Psychiatry

Until recently case formulation was an ethereal art, in that there was 110 standard, agreed-upon format for conceptualizing and writing formulations. However, the increasing emphasis on accountability in psychiatric care, the trend toward theoretical integration, and the difficulty trainees experience in mastering formulation skills highlight the need for a standard format. The descriptive, etiological and treatment-prognostic components of a formulation are discussed as a standard format for conceptualizing and writing case formulations. Four written formulations are described in terms of content, structure and process to illustrate this format.

Public Perceptions Of Electroconvulsive Therapy: A Historic Review, Steven M. Jenkusky, M.D.

Jefferson Journal of Psychiatry

Electroconvulsive therapy, an effective treatment for depression, mania and some forms of schizophrenia, has had a tumultuous and controversial history. The dramatic nature of the therapy as well as its use in the mentally ill in a seemingly indiscriminate manner has historically captured the public's attention and concern. The evolution of this therapy and the public and psychiatric profession's responses to it are reviewed here. Often the public's understanding of the therapy, how it is administered, its applications and side effects have lagged behind how the psychiatric profession views ECT, although at times mental health professionals have remained opposed to …

About The Authors

Jefferson Journal of Psychiatry

About the authors, Jefferson Journal of Psychiatry, Volume 10, Number 1, 1992.

Letters To The Editor

Jefferson Journal of Psychiatry

Letter to the Editor, Jefferson Journal of Psychiatry, Volume 10, Number 1, 1992.

Perspectives On The Mind, S. Nassir Ghaemi, M.D.

Jefferson Journal of Psychiatry

PHILOSOPHY, PSYCHIATRY, AND NEUROSCIENCE: THREE APPROACHES TO THE MIND

Edward M. Hundert

Clarendon Press: Oxford, 1989

$19.95

313 pages

Learning Cognitive Therapy, A.J. Allen, M.D., Ph.D.

Jefferson Journal of Psychiatry

A PRACTICAL GUIDE TO COGNITIVE THERAPY

Dean Schuyler, M.D.

W.W. Norton, 1991

$22.95

153 pages

Goodbye, Steven M. Sokoll, M.D.

Jefferson Journal of Psychiatry

SAYING GOODBYE. A CASEBOOK OF TERMINATION IN CHILD AND ADOLESCENT ANALYSIS AND THERAPY

Edited by Anita G. Schmuckler, D.O.

Hillsdale, NJ. The Analytic Press, 1991

$42.95

377 pages

Rethinking The Oedipus Complex, Daniel B. Block, M.D.

Jefferson Journal of Psychiatry

SON AND FATHER: BEFORE AND BEYOND THE OEDIPUS COMPLEX

Peter Bios, Ph.D.

Free Press, New York, 1985

$27.95

186 pages

Dynamic Insight Into Psychoanalysis, Melinda Fudge, M.D.

Jefferson Journal of Psychiatry

THE USE OF THE SELF: COUNTERTRANSFERENCE AND COMMUNICATION IN THE ANALYTIC SITUATION

Theodore J. Jacobs, M.D.

International Universities Press, Inc., 1991

$40.00

237 pages

Evaluation And Treatment Of Demented Elderly, Barry Rovner, M.D.

Jefferson Journal of Psychiatry

There are currently 27 million people over 65 in the United States and this number will double in the next 50 years. This will confront psychiatrists and other physicians with the care of many elderly patients with dementia. These patients will often require hospitalization when ill because their mental, physical, and social functioning tends to break down at once, overwhelming families and outpatient physicians. Once hospitalized, they require accurate diagnoses, multidisciplinary care, and planning for rehabilitation from the on set of the hospitalization. However, dementia is often undiagnosed and untreated in university hospitals as well as in primary care clinics …

The Mysterious Pathologic Process Of Autistic Disorder, Clyde Sheehan, M.D.

Jefferson Journal of Psychiatry

This is a condensed literature review of current etiological and treatment findings in autism. Numerous studies examining autistic individuals for a biological marker have been performed with renewed interest over the past several years. Biochemical studies have revealed excessive amounts of serotonin, dopamine and opiods in marry autistics. Reductions in self injurious behaviors, aggressiveness, hyperactivity and stereotypies in patients on medications targeting these specific receptor sites have been documented. Though genetic studies indicate a significant contribution to the transmission of autism, the final common etiological pathway remain unknown.

Psychiatric Interventions With Burned Children, Ravi Bhalla, M.D., Diane Kaufman, M.D., Diane Schrier, M.D.

Jefferson Journal of Psychiatry

This paper reviews the literature and identifies etiologic and management factors in the care of the burned child. It was provoked by direct involvement with two sisters, seriously burned under similar circumstances, each at age two. Their suffering is shared by approximately 500,000 children each year. Despite the enormity of the problem, psychological evaluation and treatment interventions are still not routinely incorporated into the care of these children and their caregivers. The authors hope to encourage psychiatrists and other mental health professionals to become more involved in the prevention, diagnosis, treatment, and clinical investigation of the burned child.

The Syndrome Of Antidiuretic Hormone Secretion In Psychiatric Patients, Kathleen Crapanzano, M.D.

Jefferson Journal of Psychiatry

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a common medical illness which has many etiologies-some of which are particular to psychiatric patients. This review will discuss the diagnosis of SIADH and then the various etiologies for its development with emphasis on those which are more relevant to psychiatric patients. Future research will be directed to a further understanding of this disorder, as well as to treatment options to decrease the significant morbidity associated with this condition.

Domperidone For Drug-Induced Orthostatic Hypotension-A Review, Daniel E. Mcdonald, M.D., Raymond W. Lam, M.D., F.R.C.P.(C)

Jefferson Journal of Psychiatry

Drug-induced orthostatic hypotension (OH) is a common side effect of heterocyclic and MAOI antidepressant medications. It usually does not respond to conservative treatment and drug treatments with mineralocorticoids or central dopaminergic antagonists such as metoclopramide have significant long-term side effects that limit their use. Domperidone, a peripherally acting dopaminergic antagonist with few side effects, has been used in a number of small clinical trials to treat OH of various etiologies. We reviewed 9 studies of domperidone in the treatment of OH. Although limited by small sample sizes and poor design, these studies generally showed successful treatment of OH by domperidone. …

Delusional Misidentification Syndromes, Zeljko Jocic, M.D.

Jefferson Journal of Psychiatry

Delusional misidentification syndromes are reviewed by their phenomenology, epidemiology, clinical characteristics, associated clinical findings, etiological theories, diagnostic evaluation, and treatment. Related neuropsychiatric syndromes are described and distinctions between them and delusional misidentification syndromes addressed. Current psychological and biologic-cognitive theories are briefly discussed. These peculiar phenomena are probably more frequent than previously thought, if they are specifically sought and recognized. Organic factors play a definitive role in their occurrence and two brain regions frontal and temporal, are presumably dysfunctional.

Editor's Column, Patricia M. Ferrie, M.D.

Jefferson Journal of Psychiatry

As the editor of the Journal I find it challenging to oversee publication in many different areas of psychiatry. From cognitive therapy to consultation for the treatment of burned children I know, or quickly learn the more intricate details of the field. In compiling this issue, I was particularly struck by the number of articles focusing on Child and Adolescent Psychiatry, an area of our field to which I have had limited exposure in my first two years of training.

About The Authors

Jefferson Journal of Psychiatry

About the Authors, Jefferson Journal of Psychiatry, Volume 9, Number 2, 1991.

Letters To The Editor

Jefferson Journal of Psychiatry

Letter to the Editor, Jefferson Journal of Psychiatry, Volume 9, Number 2, 1991.

First The Body, Then The Mind, Sandra M. Zebrowski, M.D.

Jefferson Journal of Psychiatry

ADULT ANALYSIS AND CHILDHOOD SEXUAL ABUSE

Edited by Howard B. Levine

The Analytic Press 1990, Hardcover, 231 pp, $29.95

Assault On Childhood, Noah D. Freedman, M.D.

Jefferson Journal of Psychiatry

INCEST-RELATED SYNDROMES OF ADULT PSYCHOPATHOLOGY

Edited by Richard P. Klufr , M.D.

Washington, D.C., American Psychiatric Press

1990, Hardcover, 308 pages, $32.00

The Psychoanalysis Of Incest, Doris Mirowski, M.D.

Jefferson Journal of Psychiatry

THE TRAUMA OF TRANSGRESSION. PSYCHOTHERAPY OF INCEST VICTIMS

Selma Kramer , M.D. and Salman Akhtar, M.D.,

Editors Jason Aron son Inc.

1991, $27.50, 186 Pages.

Cultural Diversity And The Dsm-Iii-R: Can A Barking Man Be Diagnosed?, Edward F. Foulks, M.D., Ph.D.

Jefferson Journal of Psychiatry

The case of the Barking Man JJP 9(1):82-88, 1991) raises once again the question whether some mental disorders are "Culture Bound Syndromes" or are merely cultural manifestations of basic mental disorders which plague humankind wherever they live. Bernstein and Gaw (1) have recently made a compelling argument for the former position using the example of Koro. Koro affects a variety of ethnic groups throughout Southeast Asia and is characterized by an acute, morbid panic accompanied by the idea that the penis is retracting and will disappear, at which time, the patient fears, he will die. The disorder is widespread, affecting …

Commentary On "Multiple Personality And Channeling", Richard P. Kluft, M.D.

Jefferson Journal of Psychiatry

In her paper, "Multiple Personality and Channeling," Dr. Rogers compares and contrasts the two phenomena, tries to outline some distinctions between them, and expresses concern lest persons who have the ability to channel be pathologized for their capacity" to engage in a creative social activity which is currently very much in vogue" (p.11 ) (1). I appreciate her efforts and here will offer some additional observations and reflections from my own work and experience.

Psychiatry And Psychoanalysis In The Nineties, Diane E. Custer, M.D.

Jefferson Journal of Psychiatry

The Jefferson Journal of Psychiatry is now accepting reports on meetings and panel discussions for our new "Panel Reports" column. Authors should submit their manuscripts for approval by those who participated in the panel or meeting prior to submission to the Journal for editorial review.

The Philadelphia Association.for Psychoanalysis hosted a panel designed for medical students, psychiatric residents, psychiatrists and other professionals interested in applying psychoanalysic thought and listening skills to areas in general psychiatry. The educational objectives included increasing familiarity with the various components of psychoanalytic listening, (greater skill in making use of psychoanalytic listening in work with patients) …

Re-Visioning Group Psychotherapy Training In Psychiatry, Len Sperry, M.D., Ph.D.

Jefferson Journal of Psychiatry

The literature on group training in psychiatry reveals that most residency programs include didactic seminars but few offer supervised group therapy experience or require competence in referral for group therapy. Not surprisingly, research shows that few residents utilize group therapy-either leading a group or making referrals to groups-after graduation. This paper reviews the current "vision" of group training and offers an alternate vision. The assumptions, group formats and competencies of this new vision are described. Emphasized are the development of skills and competency of making appropriate referrals to groups, which may positively impact resident attitudes and practice patterns regarding group …