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The Psychoanalytic Approach To Bulimia, Doris Mirowski, M.D.

Jefferson Journal of Psychiatry

BULIMIA: PSYCHOANALYTIC TREATMENT AND THEORY

Harvey J. Schwartz, M.D., Ed.

International Universities Press, Inc., Madison, CT.

1990 (second edition), 549 pages, $65.00.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor.

What Place Does The Real-Relationship Have In The Process Of Therapeutic Character Change?, Patrice Duquette, Md

Jefferson Journal of Psychiatry

The relationship between therapist and patient is an important tool in the process of helping a patient change. There are various elements that make up the total relationship between patient and therapist, each with its own power to exert for and against change. Transference can be one of the most relentless of these elements in maintaining the status quo for ourpatients. To help our patients make significant gains against this relentless pressure is most of our task in psychotherapy. The real-relationship has been considered in the literature since the early 1940's and is described by Greenson as "the realistic and …

Climbing Through The Milwaukee County Civil Commitment Process, Jon A. Lehrmann, Md

Jefferson Journal of Psychiatry

Civil commitment has become a practically unavoidable process for today's practicing psychiatrist. It creates a complicated triangular relationship involving the legal system, the medical system, and the patient.

This article is a first person narrative of a case which helps describe the Wisconsin civil commitment process as it operates in Milwaukee County. It illustrates the frustrations that a psychiatrist (and in this case a first year psychiatry resident) can experience in such a system. Finally, it addresses these problems associated with civil commitment and discusses possible solutions.

Involuntary Psychiatric Hospitalization And Risk Management: The Ethical Considerations, Richard C. Christensen, Md, Ma

Jefferson Journal of Psychiatry

During an era where physicians go to great lengths to limit personal risk and ensure self-protection from lawsuits, psychiatrists may be inclined to err on the side of involuntarily hospitalizing patients who have been briefly evaluated in the emergency room or clinic setting. However, conscientious treatment decisions, particularly those pertaining to involuntary psychiatric hospitalization, need to address at least two fundamental ethical concerns: the patient's best interests and the clinician's motives. This article discusses the moral components involved in clinical decision making and presents a case example which highlights the ethical implications of involuntary psychiatric hospitalizations.

Polymyalgia Rheumatica Presenting As Depression: The Role Of The History And Physical Examination In Psychiatric Assessment, J.H. Ennis, Msw, Md, J.K. Leclair, Md, Frcp (C), L. Wadas, Bsw, Csw, C. Patterson, Md, Frcp (C)

Jefferson Journal of Psychiatry

Surveys have indicated that physical examination is a diagnostic tool that is infrequently used by psychiatrists. This is an unfortunate state of affairs in light of the act that the bio-psycho-social formulation of health-care problems is integral to the treatment of psychiatric disorders. The situation becomes all the more complex when faced with the high comorbidity of physical and psychiatric illness in the elderly presenting with depression. The physical examination, guided by a detailed history, must be considered an integral part of the assessment of depression in the elderly. A case study of polymyalgia rheumatica presenting as depression is utilized …

Editor's Column, Mary E. Donovan, Md

Jefferson Journal of Psychiatry

In this edition of The Jefferson Journal of Psychiatry we say good-bye to Harvey J. Schwartz, M.D., who founded it as a resident education project ten years ago and who has been our Faculty Advisor ever since. Under Dr. Schwartz's mentorship the Journal has grown from a departmental vehicle for residents' writings to a national publication in which residents can be proud to have their work presented. Having become a nation-wide resident education project, sponsored in part by the APA, the Journal serves to meet a need for all psychiatry residents: to learn about writing, editing and publishing.

Editorial Staff

Jefferson Journal of Psychiatry

Editorial Board for Volume 11, Number 2, 1993 of Jefferson Journal of Psychiatry.

The Evolution Of Cauterization: From The Hot Iron To The Bovie., Michelle F. Deleon, Ms, Charles J. Yeo, Md, Pinckney Maxwell, Iv, Md

Department of Surgery Gibbon Society Historical Profiles

The Bovie electrocautery has become a fundamental tool of modern-day surgery, particularly for its integral role in hemostasis, yet despite this landmark invention and its widespread use, there is very little said about the man behind the machine: William T. Bovie. It would be thousands of years from the inception of cautery in medicine until the birth of Dr. Bovie and his device. However, his work in biophysics and collaboration with Dr. Harvey Cushing would revolutionize surgical practice in the early 20th century and forever ingrain his name into the field of surgery.

Buffered Memory: A Hypothesis For The Maintenance Of Functional, Virus-Specific Cd8(+) T Cells During Cytomegalovirus Infection., Christopher M Snyder

Department of Microbiology and Immunology Faculty Papers

Chronic infections have been a major topic of investigation in recent years, but the mechanisms that dictate whether or not a pathogen is successfully controlled are incompletely understood. Cytomegalovirus (CMV) is a herpesvirus that establishes a persistent infection in the majority of people in the world. Like other herpesviruses, CMV is well controlled by an effective immune response and induces little, if any, pathology in healthy individuals. However, controlling CMV requires continuous immune surveillance, and thus, CMV is a significant cause of morbidity and death in immune-compromised individuals. T cells in particular play an important role in controlling CMV and …

Hand Problems Among Endourologists., Kelly A Healy, Raymond W Pak, Ryan C Cleary, Arturo Colon-Herdman, Demetrius H Bagley

Department of Urology Faculty Papers

BACKGROUND AND PURPOSE: Endourology has evolved rapidly for the management of both benign and malignant disease of the upper urinary tract. Limited data exist, however, on the occupational hazards posed by complex endourologic procedures. The aim of this study was to determine the prevalence and possible causes of hand problems among endourologists who routinely perform flexible ureteroscopy compared with controls.

MATERIALS AND METHODS: An online computer survey targeted members of the Endourological Society and psychiatrists in academic and community settings. A total of 600 endourologists and 578 psychiatrists were contacted by e-mail. Invited physicians were queried regarding their practice settings …

Promoting Your Institutional Repository On And Off Campus, Daniel G. Kipnis, Msi

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Webinar presentation for Association for Library Collections and Technical Services.

Molecular Diagnostics In Periprosthetic Joint Infection., Javad Parvizi, Lesley Walinchus, Bahar Adeli

Department of Orthopaedic Surgery Faculty Papers

Periprosthetic joint infection (PJI) is a significant and costly challenge to the orthopedic community. The lack of a gold standard for diagnosis remains the biggest obstacle in the detection and subsequent treatment of PJI. Molecular markers in the serum and joint fluid aspirate hold immense promise to enhance the development of a firm diagnostic criterion. The primary goal is one marker with high sensitivity and specificity. Here, we review our current research efforts in the field of molecular markers: C-reactive protein, erythrocyte sedimentation rate, white blood cells, and leukocyte esterase. Each marker has been studied to determine its sensitivity, specificity, …

About The Authors

Jefferson Journal of Psychiatry

About the Authors, Jefferson Journal of Psychiatry, Volume 11, Number 1, 1993.

The Abc's Of Schizophrenia, Mary Donovan, Md

Jefferson Journal of Psychiatry

SCHIZOPHRENIA GENESIS, THE ORIGINS OF MADNESS

Irving I. Gottesman

W.H. Freeman and Company, New York, 1991

296 pages, $14.95, paperback

A New Voice On Personality Disorders, Dan Block, M.D.

Jefferson Journal of Psychiatry

BROKEN STRUCTURES: SEVERE PERSONALITY DISORDERS AND THEIR TREATMENT

Salman Akhtar, M.D.

Jason Aronson, Inc., 1991

So Much Success, So Little Joy, Robert Neil Gerstman, D.O.

Jefferson Journal of Psychiatry

GOOD GRIEF: THE STORY OF CHARLES M. SCHULTZ

Rheta Grimsley Johnson

Pharos Books, New York 1989

$17.95, 256 pgs.

Perspectives On Psychotherapy: In Our Evolving Profession, Susan M. Hall, M.D.

Jefferson Journal of Psychiatry

MOMENTS OF ENGAGEMENT: INTIMATE PSYCHOTHERAPY IN A TECHNOLOGICAL AGE

Peter D. Kramer , M.D.

W.W. Norton & Co.1989

Hardcover, 260 pp., $24.95

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor. Jefferson Journal of Psychiatry, Volume 11, Number 1, 1993.

A Resident Initiated Prite Review Course: Trials And Tribulations, David W. Metzler, M.S., M.D., Daniel L. Kinsey, M.D., Lesley R. Dickson, M.D., Mark Hyatt, M.D.

Jefferson Journal of Psychiatry

The experience of developing a review course to study for the Psychiatry Resident's In-Training Exam (PRITE) is discussed. Residents in our program felt that the review course was useful with respect to the following: studying for the PRITE; future study for National Boards; and learning of new material.

The Psychiatry Resident's In-Training Exam (PRITE) was developed in 1979 as a mechanism to assess the knowledge base of psychiatric residents in a standardized format (1,2,3). The exam was originally designed to simulate the American Board of Psychiatry and Neurology (ABPN) examination, PART I, and has gained widespread acceptance despite questions about …

Thalamic Tumor Presenting As Major Depression And Headache, Robert Jay Claire, M.D.

Jefferson Journal of Psychiatry

We report the case of a 39 year old male who presented with Major Depression, headache, and apathy. Within six weeks of his initial presentation the patient died from a "Central Herniation Syndrome" after biopsy of a left thalamic lesion. The statistics of medical problems presenting as psychiatric disorders as well as recent literature on personality changes associated with thalamic infiltration are reviewed.

It is recognized that from 33-80% of inpatient psychiatric patients have concurrent medical disease. A large proportion of these are unrecognized prior to psychiatric hospitalization (1). In 1983, Martin clearly stated that "psychiatric symptoms are often the …

Five Hours With Frank: A Case Study, Mark E. Kunik, M.D.

Jefferson Journal of Psychiatry

This manuscript explores a resident's dilemma when performing a psychiatric evaluation within the context of releasing a convicted rapist.

A Case Report Of Folie'a Deux: Husband-And-Wife, Ryan M. Nishihara, Craig T. Nakamura

Jefferson Journal of Psychiatry

Shared paranoid disorder is a relatively rare psychiatric disorder in which paranoid delusions are transferred from one individual to one or more other susceptible person(s) in close association. Folie a deux describes a shared paranoid disorder involving two people and is characterized by a complex dependant relationship between the involved individuals. Provided there is no additional underlying psychopathology, there is a good prognosis for the submissive partner. Here we present a case report and discussion off folie a deux involving a husband and wife. Although folie a deux is a relatively uncommon disorder, it is important to recognize such cases …

Clozapine-Induced Seizures And Eeg Changes: A Case Report And Discussion Of Clinical Management, Jeffrey Daly, M.D., Stephen Salloway, M.D., M.S.

Jefferson Journal of Psychiatry

Clorapine is an atypical antipsychotic agent associated with a higher frequency of seizures than standard neuroleptics. In addition, clozapine causes epileptiform abnormalities in the EEG in up to 72% of patients. A patient who developed a generalized seizure shortly after beginning clozapine treatment and the patient's EEG findings are presented. The neuropharmacology of dozapine and the management of clozapine-induced seizures and EEG abnormalities are discussed.

Cultural Aspects Of A Patient's Symptomatology: A Case Report, Theresa M. Miskimen, M.D.

Jefferson Journal of Psychiatry

Culture influences numerous aspects of human experience including behavior, beliefs, values and attitudes. A case report is presented emphasizing how cultural manifestations of a psychiatric illness may materially affect presentation of symptoms, illness perception, and explanatory model of illness of a patient. Cultural background is explored to offer improved rapport and patient care.

Entering Academic Psychiatry: A Resident's Perspective, Julio Licinio, M.D.

Jefferson Journal of Psychiatry

University-based psychiatry residency programs encourage the pursuit of academic careers, both on admission, by favoring applicants with evidence of a commitment to investigation, and after residency training, by selecting as faculty residents who have demonstrated academic and research productivity. While attempting to achieve multiple goals, some residents may be discouraged to pursue an academic career as a result of marked conflict between the clinical and academic components of training. The substantial differences in priorities among psychiatry residents ought to be explored early in residency training by devoting seminars to career planning and by facilitating the pursuit of academic activities under …

The Other Drug War: Societal Attitudes And The Pharmacologic Treatment Of Anxiety Disorders, Bruce Wenokur, D.O., M.P.H.

Jefferson Journal of Psychiatry

Societal attitudes with respect to mood altering agents have undergone cyclical changes through American history. Cycles of relative tolerance and intolerance affect the perception of psychotropic drugs for illicit use, as well as legitimate medical therapy, often creating confusion between these two realms. This article examines the relationship between the prevailing social climate and the subsequent restrictions placed on the use of opiates. Historical attitudes toward opiate use serve as a model to explore the current social climate as it pertains to the pharmacologic treatment of anxiety. The under treatment of anxiety disorders is hypothesized to result largely from social …

A Comparative Content Analysis Of Emily Dickinson's Letters, Patricia Harrison, M.D., Carol Mcleod, M.A.

Jefferson Journal of Psychiatry

To investigate the relationship between creativity and mental illness, a computer content analysis of a random sampling of Emily Dickinson's (ED) letters and a selected sample of ED's "anxiety" letters were compared with speech samples from female subjects with panic disorder (n = 4) and speech samples from a female control group (n = 8). Although this can only be considered a pilot study, the findings suggest that ED's word profiles are more similar to the panic disorder group than to the control group. Limitations of this study (i.e., small sample sizes) and suggestions for future research are discussed.

Jefferson Journal Award

Jefferson Journal of Psychiatry

The Jefferson Journal Award has been established to honor the best paper submitted during each calendar year to the Jefferson Joumal of Psychiatry:A Resident Publication. An award of one thousand dollars is given to the chosen author, with an additional one thousand dollars to be given to the residency program or fellowship in which the author is enrolled. The winning submission is selected by the Journal's editorial board from manuscripts submitted on any subject related to psychiatric practice or research.

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

Jefferson Journal of Psychiatry

As change and reform become more important words in our vocabulary as physicians, I feel reassured that the Jefferson Journal of Psychiatry will continue in its current form. As we developed from an intradepartmental to an international publication we have experienced numerous changes, one of which was the need for funding from outside of Jefferson's residency program.