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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.

Editorial Staff

Jefferson Journal of Psychiatry

Editorial Board for Jefferson Journal of Psychiatry, Volume 11, Number 1, 1993

Implications Of Observation-Fact Modifiers To I2b2 Ontologies, Jack W. London, Devjani Chatterjee

Kimmel Cancer Center Faculty Papers

Biomedical translational research can be facilitated by integrating clinical and research data. In particular, study cohort identification and hypothesis generation is enabled by the mining of integrated clinical observations and research resources. The "informatics for integrating biology and the bedside, " or i2b2, framework is widely used for this biomedical data mining. The i2b2 "star schema" data model using entity-attribute-value (EA V) formatted concepts is a very efficient strategy for querying large amounts of data. However, until the most recent i2b2 release, the utility of the platform was somewhat constrained by the limitations on being able to express "facts about …

About The Authors

Jefferson Journal of Psychiatry

About the authors, Jefferson Journal of Psychiatry, Volume 10, Number 2, 1992.

In Search Of The Roots Of Psychiatry, S. Nassir Ghaemi, M.D.

Jefferson Journal of Psychiatry

APPROACHES TO THE MIND: MOVEMENT OF THE PSYCHIATRIC SCHOOLS FROM SECT TOWARD SCIENCE

Leston Havens, M.D.

Harvard University Press Cambridge, Massachusetts

1987, 399 pages, $12, paperback.

Psychoanalytic Approach To Child Development, Jeanette M.S. Zaimes, M.D.

Jefferson Journal of Psychiatry

THE COURSE OF LIFE VOL III

MIDDLE AND LATE CHILDHOOD

Editors: Stanley I. Greenspan, M.D. and George H. Pollock, M.D., Ph.D.,

International Universities Press, Inc.

1991, revised edition

562 pages $65.00

Little Elephant Learns About Sex, Judith Watt, M.D.

Jefferson Journal of Psychiatry

WHERE BABIES COME FROM

Stories to Help Parents Answer Preschoolers Questions About Sex

Martin Silverman, M.D. and Harriet Ziefert

Illustrated by Claire Schumacher Random House Press

1989, $19.00

Women's Psychology, Jodi Halpern, M.D.

Jefferson Journal of Psychiatry

FEMALE PSYCHOLOGY, AN ANNOTATED PSYCHOANALYTIC BIBLIOGRAPHY

Edited by Eleanor Schuker, M.D., and Nadine A. Levin son, D.D.S., F.A.C.D.

New Jersey, The Analytic Press

1991, pp.678

Personality Disorder And The Recurrent Swallowing Of Foreign Bodies, Robert Jay Claire, M.D.

Jefferson Journal of Psychiatry

Psychiatrists are frequently asked to assist colleagues with the medical and surgical sequela of psychiatric disorders. The Consultation and Liaison Psychiatry service was consulted by the Surgical Service to evaluate a patient who repeatedly swallowed foreign bodies. The following is a case report, brief review of the literature and discussion.

Reversal Of Catatonia With Midazolam, Larry V. Mcdonald, M.D., Barry I. Liskow, M.D.

Jefferson Journal of Psychiatry

We report a case of dramatic reversal of catatonic symptoms with a single dose of midazolam, an ultra short acting parenteral benzodiazepine commonly used for procedure sedation.

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.