Medical Specialties Commons^™

Sexual Side Effects Of Psychiatric Medications In Women: A Clinical Review, Laura L. Post, Md, Faacs

Jefferson Journal of Psychiatry

Sexual side effects of psychiatric medications have been estimated to occur in 60% of male clients (1) and 30% of female clients (2). Despite a body of literature relating individual medications to specific sexual side effects, few studies have satisfactorily addressed the psychotropic-induced sexual dysfunctions in women. The spectrum of known sexual sided effects resulting from psychopharmacologic interventionswill be reviewed. Guidelines for appropriately addressing the possibility of sexual side effects within a therapeutic relationship for maximizing reporting of sexual side effects, and for possible treatment approaches to sexual side effects will be described.

Positron Emission Tomography In Psychiatry: New Sights, New Insights, Shitij Kapur, Md, Sylvain Houle, Md, Phd, Frcp (C), Gregory M. Brown, Md, Phd, Frcp (C)

Jefferson Journal of Psychiatry

Positron Emission Tomography (PET) is a new tool with which to explore the neurobiological basis of psychiatric illness. PET permits in-vivo measurement of regional cerebral blood flow, regional glucose metabolism, as well as information about neurochemicals and their receptors. Since regional cerebral bloodflow and glucose metabolism reflect ongoing neuronal activity, the neural bases of different cognitive processes and emotional states can be discerned using PET. Findings from recent studies in schizophrenia, affective disorders, obsessive-compulsive disorders, anxiety disorders, and dementia are reviewed with a special emphasis on how these findings may' be useful in developing a more comprehensive framework for understanding …

Literature Review: Stress Reactance In Psoriatic Patients, W. Michael Hooten, Md

Jefferson Journal of Psychiatry

The association between stress and psoriasis is well documented. A subgroup of psoriatic patients appear to be high stress reactors who can identify specific psychosocial stresses which exacerbate their psoriasis. In contrast, low stress reactors report no association between stress and the exacerbation of psoriasis. In differentiating high versus low stress reactors, a review of the literature suggests: 1) a neurogenic mediated disease process; 2) high stress reactors' disease course is not confounded by underlying psychopathology and, 3) high stress psoriatics experience more disease related stress than low stress reactors.

Being Stalked: A Psychiatrist's Perspective, Kalpana I. Nathan, Md, Tina T. Lee, Md, James Missett, Md, Phd

Jefferson Journal of Psychiatry

It is only recently that stalking has been criminalized after some highly publicized forensic cases. Psychiatric focus has been on erotomania, and in this article we primarily highlight stalking as a separate entity with psychiatric and legal implications. The case reports reveal our vulnerability as therapists, and we hope will raise our awareness of stalking as a potentially dangerous situation. The legal statutes vary in different states, but our recommendations may provide guidelines towards formulating policies and procedures for the safety of healthcare providers.

The Diagnosis Of Multiple Personality Disorder, Joshua D. Mcdavid, Md, Mph

Jefferson Journal of Psychiatry

This paper represents an attempt to facilitate the clinician or psychiatrist in making a diagnosis of Multiple Personality Disorder, the most severe of the dissociative disorders. Emphasis will be placed on detecting signs, symptoms, and information that occur within the constituent parts of a typical psychiatric interview, and that are highly suggestive of MPD even in the absence of alter presentation.

Theme And Content Of Delusions In Asian Indian Psychotic Patients: Correlation With Diagnosis, Christopher Linskey, Md

Jefferson Journal of Psychiatry

The aim of this study was to investigate the types of delusions present in Asian Indian psychotic patients and evaluate correlation with patient diagnosis. Delusional narratives were collected from 50 Indian patients with schizophrenia or an affective disorder. These narratives were judged for delusional theme and content and were correlated with DSM-III-R diagnoses. Using simple categorical analysis, delusional themes of grandiosity and guilt correlated with affective diagnoses. Delusional themes of reference and Schneiderian types were more often associated with schizophrenia. These findings support the concept that delusional themes can be used as valid diagnostic clues in the assessment of psychotic …

Integration Of Assertive Community Treatment Into A Residency Curriculum: The Resident's Perspective, D. Walter Hiott, Md, Alberto B. Santos, Md

Jefferson Journal of Psychiatry

Assertive Community Treatment (ACT) is a service delivery system designed to provide long-term quality care to patients with chronic mental illnesses. A brief description of these programs is presented. These programs can provide valuable training experiences for psychiatric residents. The authors report the results of their survey of residents whose training included a rotation through these services.

The Serotonin Theory Of Depression, Christopher W. Kerr

Jefferson Journal of Psychiatry

In its simplest form, the serotonin deficiency theory of depression postulates that there is a net reduction in serotonin transmission in depressive illness. The pathophysiological change may result from two different mechanisms. The first involves a decrease in serotonin (5-HT) availability which has the consequential effect of compensatory receptor up-regulation or super sensitivity. The second mechanism implies a primary defect in receptor activity and/or signal transduction. The objective of this review is to analyze the serotonin system in depression as it relates to the above two postulates.

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 Journal 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.

The editorial board of the Journal is proud to announce the recipient of the 1993 Jefferson Journal Award: Scott …

Editor's Column, Mary E. Donovan, Md

Jefferson Journal of Psychiatry

With this edition of the Jefferson Journal of Psychiatry I am pleased to welcome Edward Silberman, M.D. as our new Faculty Advisor. Dr. Silberman is the Residency Program Director at Thomas Jefferson University, and he brings a great deal of enthusiasm about resident research, writing and publishing to the Journal. In addition to enthusiasm, he brings his own experience with writing for psychiatric publication with which to advise us, and we welcome his guidance as the Journal begins its twelfth year of publication.

Editorial Staff

Jefferson Journal of Psychiatry

Editorial Staff for Volume 12, Number 1, 1994 for Jefferson Journal of Psychiatry.

Psychodynamic Contours Of Post-Traumatic Stress Disorder, Noah D. Freedman, Md

Jefferson Journal of Psychiatry

PSYCHOTHERAPY OF THE COMBAT VETERAN

Harvey J. Schwartz, M.D., Ed.New York, Spectrum Publications, 1984

Distributed by: Integrated Publishers, 195 McGregor St., Manchester , NH 03102, 603-669-5933

Psychodynamics: The State Of The Art, Robert Hall, M.D.

Jefferson Journal of Psychiatry

PSYCHODYNAMIC CONCEPTS IN GENERAL PSYCHIATRY

Harvey J. Schwartz, MD with Efrain Bleiberg, MD and Sidney Weissman, MD editors

American Psychiatric Press, Inc., in press.

Walking In One's Own Shoes, Robert Neil Gerstman, D.O.

Jefferson Journal of Psychiatry

ILLNESS IN THE ANALYST:IMPLICATIONS FOR THE TREATMENT RELATIONSHIP

Harvey J . Schwartz, M.D. and Ann-Louise S. Silver, M.D.,

Editors International Universities Press, New York 1990, 347 pp., $42.50

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.

Carbamazepine-Associated Hyponatremia, Mitchell S. Gandelman, Md, Phd, Sandra Dabora, Md, Phd, Rebecca L. Johnson, Md, Michelle B. Riba, Md

Jefferson Journal of Psychiatry

Four cases of CBZ-induced or exacerbated hyponatremia are described in middle-aged to elderly females. Two cases are remarkable in that the pretreatment sodium levels demonstrate hyponatremia. A return to prior sodium levels was observed upon the discontinuation of carbamazepine therapy. No definitive conclusions can be drawn from these case reports; however, similarities in the cases can be examined as follows: (1) all four women have medical problems, in particular two patients had pre-existing hyponatremia; (2) all four patients were using concurrent medications; (3) all four women presented psychotic. A literature review examines risk factors, pharmacological mechanism, and the time course …

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 …

Firesetting In Children, Donna V. Mehregany, Md

Jefferson Journal of Psychiatry

This article reviews the literature regarding the history, etiology, diagnosis, and treatment of firesetting. A critique of the literature reveals the need to generate a clearer definition of firesetting as well as more stringent criteria for diagnosing firesetting. The standard treatments for firesetting are reviewed. Linkage of childhood firesetting to future adolescent and adult crimes is also examined. Finally, avenues for future research are discussed.

Pharmacologic Advances In The Treatment Of Schizophrenia, Scott A. West, Md

Jefferson Journal of Psychiatry

The treatment of schizophrenia was revolutionized with the introduction of chlorpromaeine in 1952. The effectiveness of chlorpromazine in controlling psychotic symptoms lead to the dopamine Hypothesis of schizophrenia, which revolutionized our conceptualization of this illness. Since that time, numerous typical antipsychotic drugs have been developed for the treatment of schizophrenia. However, the introduction of clozapine in 1990 began a new era in the pharmacologic management of schizophrenia. Clozapine, an atypical antipsychotic drug, is effective in controlling the positive Symptoms of schizophrenia in a large number of otherwise treatment-resistant patients, and also improves the negative symptoms of the illness in marry …

Psychogenic Amnesia: A Case Involving Amobarbital Interview And The News Media, Tracey G. Skale, Md, James Randolph Hillard, Md

Jefferson Journal of Psychiatry

A young man was admitted to an urban general hospital psychiatric unit after being brought from a local shopping mall unable to remember his name or any other personal information. He was alert and oriented and demonstrated no cognitive impairment. He agreed to an amobarbital interview and agreed to letting local news media display his picture in hopes that someone would recognize him. The amobarbital interview yielded information allowing identification of the individual, with the help of the news media. News media coverage also led to the discovery that the individual was wanted for a violent crime in another state …

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

Jefferson Journal of Psychiatry

It has been a pleasure and a privilege to have been the Faculty Advisor for the Jefferson Journal of Psychiatry for the past 10 years. We began this resident written and edited journal in 1983 as a small in-house publication designed to encourage our residents to put their thoughts about patient care into written form. Since then we have grown considerably and now serve as the only national resident journal in medicine. Many people over the years have made this effort possible. I would like to pay special thanks to our generous and supportive sponsors and …

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.

Interferon Alpha For Chronic Hepatitis D, Zaigham Abbas, Muhammad Arsalan Khan, Mohammad Salih, Wasim Jafri

Department of Medicine

Background:

Hepatitis D virus is a small defective RNA virus that requires the presence of hepatitis B virus infection to infect a person. Hepatitis D is a difficult-to-treat infection. Several clinical trials have been published on the efficacy of interferon alpha for hepatitis D virus (HDV) infection. However, there are few randomised trials evaluating the effects of interferon alpha, and it is difficult to judge any benefit of this intervention from the individual trials.

Objectives:

To evaluate the beneficial and harmful effects of interferon alpha for Patients with chronic hepatitis D.

Search methods:

We identified relevant for the review randomised …

Jean-Martin Charcot - Neurologist By Avocation, Nephrologist By Yearning, Gary Eknoyan

Houston History of Medicine Lectures (2006-2012)

In an age of medical advances and specialization, Jean-Martin Charcot (1825-1893) helped found the discipline of neurology and in 1882 was appointed the first professor of Diseases of the Nervous System in France. As an investigator with broad interests and vast knowledge Charcot contributed to several other disciplines. An early mentor and dominant figure in Charcot's formative years was Pierre Rayer (1793-1867), famous for his seminal contributions to the study of the kidney, who gifted Charcot with his passion for clinical pathological correlations and likely a yearning for the study of kidney diseases. Famous for the clarity and incisiveness of …

Can Computer Assisted Diagnosis (Cad) Be Used As A Screening Tool In The Detection Of Pulmonary Nodules When Using 64-Slice Multidetector Computed Tomography?, Zishan Haider, Muhammad Idris, W. Memon, Nazia Kashif, Sidra Idris, Zafar Sajjad, Saeed Akram

Department of Radiology

Objectives:To evaluate (1) whether or not the addition of computer-assisted diagnosis (CAD) to 64-slice multidetector computed tomography (CT) can be used as a screening tool for detection of pulmonary nodules in routine CT chest examinations and (2) whether or not to advocate the incorporation of CAD as a screening tool into our daily practice. Materials And

Methods:

A retrospective cross-sectional analysis of 109 consecutive Patients who had all undergone routine contrast-enhanced CT chest examinations for indications other than lung cancer at the Radiology Department of Aga Khan University Hospital, Karachi, between November 2010 and January 2011. All examinations were …