Medical Specialties Commons^™

Depression And Poverty I. Psychosocial And Cultural Determinants, Donald C. Ohuoha, M.D., M.P.H.

Jefferson Journal of Psychiatry

The WorldHealth Organization estimates that over 100 million people worldwide suffer from depression, that three times as many may be affected (1). While major advances have occurred in our understanding of the biological aspects of depression, the understanding of psychosocial causes of depression is still largely sketchy. Thus adequate intervention in dealing with this aspect of treatment of depression is scarce. This paper, divided into two parts, will review recent findings in psychosocial causes of depression and suggest certain strategies.for intervention, speculate on the roles of poverty and the issues raised by poverty on the rates of depression and suggest …

Multiple Personality And Channeling, Rayna L. Rogers, D.O.

Jefferson Journal of Psychiatry

Psychiatry in the 1980's and 1990's has seen a rapid progression in the understanding of dissociative disorders, especially multiple personality disorder. Another phenomenon which has had a parallel rise in the past decade is trance channeling. Channeling is the process by which an individual enters a trance-like state and surrenders control of the body to a "guide" or "entity" who communicates with the listeners or "sitters" gathered for a "reading." The purpose of this paper is to investigate the relationship between these two phenomena, specifically questioning whether channeling is a variant of multiple personality disorder or if it is pathological.

Editor's Column, Edward Kim, M.D.

Jefferson Journal of Psychiatry

He sat on the other side of the large government-issue desk, a bland, a pathetic expression on his face. His vague, contradictory story of visual and auditory hallucinations was punctuated by frequent pauses and "you know,"as if he were expecting me to help him fabricate his symptoms. He himself didn't seem to be trying very hard to convince me of his alleged distress. It would have been simple to admit him; the paperwork was minimal, and there were plenty of beds. I mentioned my skepticism of his history as I told him why I wouldn't admit him. The ensuing flood …

About The Authors

Jefferson Journal of Psychiatry

About the Authors. Jefferson Journal of Psychiatry, Volume 8, Number 2, 1990.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor, Jefferson Journal of Psychiatry, Volume 8, Number 2, 1990.

Effective Psychotherapy With Borderline Patients, Edward Kim, M.D.

Jefferson Journal of Psychiatry

Robert Waldinger, M.D.

John G. Gunderson, M.D.

American Psychiatric Press, 1987

227 pages

$27.50

Psychodynamic Psychiatry In Clinical Practice, Edward Kim, M.D.

Jefferson Journal of Psychiatry

Glen O. Gabbard, M.D.

American Psychiatric Press, 1990

480 pages $49.95

Legislating Psychiatry, Carla Rodgers, M.D.

Jefferson Journal of Psychiatry

REVIEW OF CLINICAL PSYCHIATRY AND THE LAW, VOL. I

Edited by Robert Simon, M.D.

American Psychiatric Press, 1989, 416 pages, $38.50

Dr. Freud Vs. Dr. Spock, Timothy C. Smith, M.D.

Jefferson Journal of Psychiatry

CHILDREN OF PSYCHIATRISTS AND OTHER PSYCHOTHERAPISTS

Thomas Maeder

Harper and Row publishers, New York 1989, 259 pages, $19.95.

Alzheimer's Disease And Down's Syndrome: An Overview, Dr.Devanshu Desai, M.B.B.S.

Jefferson Journal of Psychiatry

The association between Alzheimer's Disease and Down's Syndrome is well recognized through clinical observations and genetic studies. However, the exact nature and the implications of this link is far from clear as yet. The challenge of diagnosis, genetics and the differences in clinical presentations of Alzheimer's Disease in relation to the Down's Syndrome are reviewed here. Promising areas of research are pointed out and importance of relevant family history is emphasized. A current knowledge in the subject through various studies is presented.

An Historical Review Of Electroconvulsive Therapy, Bruce A. Wright, M.D.

Jefferson Journal of Psychiatry

The initial clinical trial of electroconvulsive therapy (ECT) was performed by Ugo Cerletti and Lucino Bini at the University of Rome in 1938. The following paper will examine both the developments which led to the first trial of ECT, and the use of ECT over th e subsequent fifty years. Hopefully, by investigating the historical aspects of the development and progression of ECT, a better understanding of this treatment modality can be attained.

Working With Homeless Women And Children: Opportunities For Training, Lance D. Clawson, M.D., Ronald J. Koshes, M.D.

Jefferson Journal of Psychiatry

The diversity of the homeless population allows for unique training opportunities in psychiatry, especially for child and adolescent psychiatry fellows. The prevalence of psychopathology both existing in and as a result of displacement and disenfranchisement requires a specialized knowledge of this population and provides an extraordinary education in community outreach, emergency psychiatry and social service delivery systems. The authors review their experience of working with homeless women and children in the community. Possibilities for more comprehensive training and research are also presented.

The Real Mother-Issues In Adoption, Penelope J. Hooks, M.D.

Jefferson Journal of Psychiatry

Our society has deemed adoption a desirable alternative method of creating a family. It satisifies the need of a child for parents, it gratifies the desire of adults who yearn to provide a home and love for a child, and it gracefully solves the dilemma for the one who cannot or will not raise the child. In addition to the usual developmental conflicts, families involved in adoption will encounter a variety of fears, fantasies, resentments, and misconceptions which may adversely affect identity formation in the child. Here I will attempt to explore some of the psychodynamic issues which will be …

Cognitive Information Processing In Borderline Personality Disorder: A Neuropsychiatric Hypothesis, J.Wesley Burgess, Ph.D., M.D.

Jefferson Journal of Psychiatry

Neurocognitive information processing was compared in 18 borderline subjects and 14 controls of similar age and gender. An 11-item screening examination significantly differentiated the two groups (P < 0.001). Significant differences were found on Delayed Memory, Serial Sevens, Rhythm Reproduction, and Perseveration subtests (P < 0.05). The results are interpreted as evidence for mild frontotemporal brain deficits. The findings support a developmental model of borderline disorder where early stress/injury during the childhood period of frontotemporal vulnerability results in failure to negotiate developmental landmarks and adult deficits in cognition, emotion/behavior modulation, and insight.

A Sexually And Physically Abused Child: His Inner World, Carmen Mayugba-Sugai, M.D.

Jefferson Journal of Psychiatry

This paper describes how a sexually abused 8 year old boy's internal dynamics correlated with and influenced his behavior while he was on an inpatient unit. Through play therapy and unit staff's observation, the psychopathological sequelae to the abuse unfolded in a very interesting way. This process of correlating play material with observations of behavior on the unit, helped the treatment team in understanding the child's inner world.

Neurodevelopmental Disorders Associated With Chromosome 15, Karl G. Sieg, M.D.

Jefferson Journal of Psychiatry

Chromosome 15 is a focus of increasing interest to both psychiatry and neurology. Several neurodevelopmental disorders are genetically associated with this autosome, including Prader-Willi syndrome, Angelman syndrome, Dyslexia, Autism, Hyperlexia, Ring 15 Chromosome syndrome, and Trisomy 15 syndrome. This report provides a review of the molecular biology of chromosome 15 and these associated disorders.

Therapeutic Alliance And Involuntary Commitment Of A Minor, Karen Dineen Wagner, M.D., Ph.D, Sharon R. Weinstein, M.D., Richard F. Wagner, Jr., M.D.

Jefferson Journal of Psychiatry

Children are legally entitled to be present throughout the commitment hearing for continued hospitalization. The effect of this process on the therapeutic alliance between the child and the psychiatrist warrants examination. A case study of a 14 year-old boy who participated in the court proceedings is presented. The outcome of the hearing resulted in a disruption of the therapeutic alliance. Alter natives to current commitment procedures for minors are discussed.

Editor's Column, Edward Kim, M.D.

Jefferson Journal of Psychiatry

This issue of the Jefferson Journal of Psychiatry impressively reflects current trends in the American Psychiatric Association. Past President Herb Pardes took as his theme "The Research Alliance: Road to Clinical Excellence." Current President Elissa Benedek has adopted the theme "Our Children, Our Future" for the 1991 annual meeting. Adjusting to the responsibilities of chief editorship (under the watchful eye of my predecessor, Dr. Trefzger), I am impressed by the evolution of the Journal and the manuscripts submitted for review.

Mis Posterior Cervical Spine Surgery: Five-Level Fusion Through A Novel Cervical Tube, Ashwini Sharan Md, Mitchell A. Hardenbrook, Md, John K. Ratliff Md, James Harrop, Md

JHN Journal

Minimally invasive surgical (MIS) techniques to the spine have focused mainly on the lumbar region. Many reports exist on the ability to decompress the neural structures in the lumbar and thoracic spine both via an anterior and posterior approach. Familiarity with these techniques now allows one or two level interbody and pedicle fusions, and treatment of trauma through MIS approaches. Controversy exists as to the efficacy of these techniques because direct studies comparing MIS approaches with open techniques are lacking. However, proponents of these techniques site smaller incision, less muscle retraction, less blood loss, shorter length of stay and better …

Functional Recovery Of Untreated Human Immunodeficiency Virus-Associated Guillain-Barré Syndrome: A Case Report, Adam L. Schreiber, John W. Norbury Iii, Eduardo A. De Sousa

Department of Rehabilitation Medicine Faculty Papers

HIV-associated Guillain-Barré Syndrome is a well-documented phenomenon, typically occurring at seroconversion. GBS may result in functional impairment treated with a combination of medications, plasmapheresis, and rehabilitation. The quantified functional recovery of HIV-associated GBS with or without HIV treatment is not well-described. Utilizing serial FIM scoring, we describe a patient’s recovery from HIV-associated GBS after treatment with IVIg and acute inpatient rehabilitation without HIV treatment.

Surgical Management Of Fungal Vertebral Osteomyelitis, Benjamin M. Zussman, Bs, David L. Penn, Ms, James S. Harrop, Md

JHN Journal

Fungal vertebral osteomyelitis (FVO) is an uncommon but aggressive disease that may cause spinal instability, neurological insult, and possible death. Little data about treatment strategies and patient outcomes exist. A retrospective review of medical and surgical management with follow-up of this disease was performed.

Bevacizumab: A Controversial Agent Against High-Grade Gliomas, Sussan Salas, Md, Miguel Guzman, Md, Kevin Judy, Md

JHN Journal

Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor in adults. Despite the current regimen of surgical resection with subsequent external beam radiotherapy and temozolomide, mean survival is 14.6 months and 2-year survival is 26%. GBM is a highly vascular tumor, a result of its increased expression of vascular endothelial growth factor (VEGF) compared to other brain tumors. VEGF promotes endothelial cell proliferation, and is thought to have a pivotal role during tumor progression. Multiple treatment modalities have targeted VEGF and VEGF receptors (VEGFTs) due to their essential roles in the regulation of angiogenic processes. Bevacizumab is a …

The Prevalence Of Cervico-Arterial Dissection In Sub-Arachnoid Hemorrhage In The United States, Ali Seifi, Md, Fred Rincon, Md, Msc, Mitchell Maltenfort, Phd, Pascal Jabbour, Md, Rodney Bell, Md, Michael Moussouttas, Md

Department of Neurology Faculty Papers

Objectives: In this study, we sought to determine the prevalence of cervico-arterial dissection in aubarachnoid hemorrhage (SAH) using a large administrative database.

The Prevalence And Risk Factors Of Acute Myocardial Infarction (Ami) After Acute Ischemic Stroke (Ais) In The United States, Ali Seifi, Md, Fred Rincon, Md, Msc, Michael Moussouttas, Md, Mitchell Maltenfort, Phd, Matthew Vibbert, Md, Rodney Bell, Md, Maria Carissa Pineda, Md, Diana Tzeng, Md, Jacqueline Urtecho, Md, Anish Koka, Md, William Mcbride, Md

Department of Neurology Faculty Papers

Objectives: To determine the prevalence and risk factors for, and the association with in-hospital mortality of, AMI after AIS, and to study the effect of intravenous recombinant tissue plasminogen activator (r-tPA) in this setting. We hypothesized that AMI would be associated with lower survival rate at hospital discharge but that intravenous r-tPA would be associated with lower risk of AMI.

Postoperative Glycemic Variability In Diabetic And Non Diabetic Patients, Boris Mraovic, Md, Brian Hipszer, Md, Zvi Grunwald, Md, David Gratch, Do, Charles J. Yeo, Md, Jennifer Lessin, Rn, Kathleen O'Malley, Rn, Angela Gulino, Md, Peter Simpson, Meng, Jeffrey Joseph

Department of Anesthesiology Faculty Papers

Objectives: Glycemic variability increases oxidative stress and may trigger the inflammation and coagulation cascades. Variability may be associated with increase morbidity and mortality in ICU patients. We analyzed glycemic variability after major surgery in diabetic (DM) and non-diabetic (NDM) patients using an automated intravenous blood glucose monitor (IVBG).

Predictors Of Appropriate Defibrillator Therapies- A Single Center Analysis, Rina R. Shah, Ratika Gupta, Carrie Stackhouse, Robin Ward, Behzad B. Pavri

Division of Cardiology Faculty Papers

Discussion:

• Although differences in HR and the JT interval were statistically significant in patients who received appropriate shock vs. those who did not, these differences are not clinically meaningful
• We did not identify any clinical predictors of early vs. late ICD shocks
• These data suggest that we may not be able to improve on current guidelines for patient selection for ICD implantation.

Participatory Research At Pathways To Housing-Pa: A Consumer Perspective, Patways To Housing Consumer Health Research Team And Department Of Family And Community Medicine

Department of Family & Community Medicine Presentations and Grand Rounds

Research Question: How does housing affect healthcare decision making?

Methods: 11 Clients took part in a 9-week project focused on health. Using qualitative methodology, weekly meetings were recorded, transcribed, then analyzed resulting in the development of thematic findings.

Baseline Monitoring Of Standard Health Indicators In A Formerly Homeless Population, Lara Carson Weinstein, Md, Mph, Marianna Lanoue, Phd, Elizabeth Collins, Bs

Department of Family & Community Medicine Presentations and Grand Rounds

Research Question: What are the rates of baseline health status indicators recording at Pathways to Housing (PTH) using select recommended measures from the National Association of State Mental Health Program Directors (NASMHPD) and the Healthcare Effectiveness Data Information Set (HEDIS)?

How do health indicators compare between clients receiving direct clinical care in the integrated care program vs non-integrated care clients?

Individual Agency, Community Capacity Building, And Chronic Illness Care: Using Participatory Methods To Implement The Stanford Chronic Disease Self Management Program In A Housing First Program, Lara Carson Weinstein, Md, Mph, Abbie Santana, Msph, Carolyn Armour, Cornelius Crossan, James Lawson, Karen Webb

Department of Family & Community Medicine Presentations and Grand Rounds

Research questions:

Is a standardized chronic disease self management program (CDSMP) experienced as a valuable intervention by Pathways' consumers?

What is the impact of collaborative inquiry into health program development on participant's critical agency?

About The Authors

Jefferson Journal of Psychiatry

List of authors for Jefferson Journal of Psychiatry, Volume 8, Number 1, 1990.