Medical Specialties Commons^™

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor for Jefferson Journal of Psychiatry, Volume 8, Number 1, 1990.

Treating Dual Diagnosis Patients: Challenges And Opportunities, Robert H. Howland, M.D.

Jefferson Journal of Psychiatry

The use and abuse of drugs and alcohol have recently gained greater attention both from the public and the medical profession. Despite increasing cognizance of its unfortunate consequences, substance use has become a more pervasive element of contemporary society. As substance abuse has come to affect more segments of the population, it is not surprising that this problem also has affected the mentally ill. Awareness of the mentally ill substance abuser has grown, although this population has not been well studied or well served by the mental health system. These dually diagnosed patients often are depicted as the square pegs …

Special Article: One Resident's Perspective On A Different Style Of Psychopharmacological Practice, Michael Amiel, M.D., Docteur J.P. Blayac

Jefferson Journal of Psychiatry

This article provides a comparison of psychopharmacological practices in the U.S. and France. The prescription as well as proscription of various classes of psychotropic drugs are considered. Even though the general guidelines of psychopharmacological practice remain the same, the details vary considerably and are determined especially by commercial factors.

INTRODUCTION

Though a comparison of current clinical psychopharmacological practices in France and the U.S. is an unaddressed topic, these contrasts may be quite striking to an American-trained psychiatrist. The following observations are based on my two month inpatient experience as a fourth-year psychiatric resident at a public psychiatric institution located in …

Editor's Column, Elizabeth Trefzger, Md

Jefferson Journal of Psychiatry

In selecting articles for, and preparing this latest issue of the Jefferson Journal, I am impressed by the ongoing trend towards refinement that is present in the submissions which we receive. This has been both encouraging and exciting for everyone concerned with the production of the Journal. Much as any other piece of scientific literature, the value of criticism in the production of the work cannot be forgotten . While reflecting on the need for refined and worthwhile criticism I have been reminded of the value of criticism in education. It is through criticism, our own self evaluation, and that …

About The Authors

Jefferson Journal of Psychiatry

About the authors in the Jefferson Journal of Psychiatry, Volume 7, Number 2, 1989.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor to Jefferson Journal of Psychiatry, Volume 7, Number 2, 1989.

Book Review: Humanizing Freud, Edward Kim, M.D.

Jefferson Journal of Psychiatry

FREUD: A LIFE FOR OUR TIME

Peter Gay, Ph.D.

W.W. Norton & Company

New York, 1988 651 pages

$25.00

Book Reviews: Clinical Experiences, Indoctrination And Education In Alcoholism, Marguerite M. Blythe, M.D.

Jefferson Journal of Psychiatry

HEAVY DRINKING: THE MYTH OF ALCOHOLISM AS A DISEASE

Herbert Fingarette

Berkeley, University of California Press 1988, 166 pages

In Response: The Place Of Psychotherapy Training In Residency Programs, Homer C. Curtis, M.D.

Jefferson Journal of Psychiatry

As a belated response to the debate about the value of teaching psychotherapy in psychiatric residency training, (Jefferson Journal of Psychiatry, Vol. 5(I):54-66, 1987) I would like to add my voice to the affirmative side. That there is such a debate seems symptomatic of an unfortunate and unnecessary misuse of important advances in neurobiology to justify the sidelining of psychodynamic psychotherapy. A search of the psychiatric literature of recent years reveals an emphasis on biological psychiatry and a relative neglect of psychotherapy. A similar trend has been noted in some residency programs and in the annual meetings of the American …

A Practical Approach To The Assessment And Management Of Psychiatric Emergencies, J. Gregory Kyser, M.D., Bradley C. Diner, M.D., Gilbert W. Raulston, M.D.

Jefferson Journal of Psychiatry

Patients present to the psychiatric emergency room manifesting a wide variety of symptoms ranging from mild anxiety to violent, uncontrollable behavior. The emergency room psychiatrist must recognize these various presentations and provide appropriate interventions for such patients. It may not be of the utmost importance to distinguish between the subtypes of schizophrenia or endogenous vs. exogenous depression, just as it is not crucial to decide immediately the cause of an acute abdomen, primarily to recognize its presence. However, it is critical to recognize the presence of a psychosis, suicidal intent or the presence of an organically caused alteration in mental …

Confrontations With Death: Psychological Responses During Internship, Michael Miller, M.D.

Jefferson Journal of Psychiatry

During internship, the daily confrontation with the consequences of disease contributes much to the distress which young physicians experience (I). Not only are interns responsible for first line medical care, they must also provide emotional support for their patients struggling with pain, disability and impending death. This paper seeks to examine some of the factors responsible for the turmoil involved in caring for these dying patients.

Our conceptions of death and dying are determined to a large extent by the cultural context in which we live. Compared with other times in which death was not so ego alien, we presently …

Identity Formation And Reformation In First And Second Career Psychiatric Residents, Steven J. Kingsbury, M.D., Ph.D.

Jefferson Journal of Psychiatry

Although all residents seek to acquire competence, those entering psychiatry as a first career appear to use different strategies for the early protection of self esteem than do those entering psychiatry as a second career. These differences and their ramifications for the resident and the residency are discussed.

Differences appear in the formation of a professional identity as a psychiatrist when that career is the second career as opposed to the formation of that identity when the career is the first. For most older psychiatric residents, a first career typically precedes the entrance into psychiatry. In my case, I was …

On Becoming A Psychiatrist: A Resident's Perspective, Phebe M. Tucker, M.D.

Jefferson Journal of Psychiatry

Developing an identity as a psychiatrist is a process which has been seen by many to span an individual's career; from the first decision of choice of a career, through residency training and beyond, into the years of practice. As part of a "Residents' Day Paper," psychiatrists in the Oklahoma City area were surveyed in order to look at their perceptions of the growth of their professional identities. Despite the limitations of a small sample population, limited to one metropolitan area, some interesting common patterns emerged: the psychiatrists surveyed had diverse educational and cultural back grounds, similar practical and unconscious …

Telephone Associated Pathology: Clinical Case Studies And Discussion, Mark Servis, M.D.

Jefferson Journal of Psychiatry

The advancement of modern technology shapes and develops new expressions of psychopathology and accompanying treatments. This is most apparent with the telephone, an instrument of contact and communication for the patient, and assessment and intervention for the therapist. The telephone both constrains and creates unique constellations of patient symptomatology. This paper will examine one such telephone symptom complex-the habitual over use of the telephone by non-bipolar patients. The frequent monopolization of the phone seen in some bipolar patients will not be considered, though the elements of intrusion and aggression discussed in this paper are probably shared by manic patients.

A …

A Pilot Study Of Brief Group Therapies For Preschool Children: Parent Training Vs Group Play Therapy Vs Project Group, William S. Evans, Jr., M.D., Susan A. Black, M.D.

Jefferson Journal of Psychiatry

The optimum modality for treating preschool age children with behavioral and emotional problems is uncertain. One study showed that children with good ego strength respond to psychotherapy independent of whether it is group or individual psychotherapy, provided that a minimum period of psychotherapy occurs (ovick, 1965). The literature has demonstrated that parent training, individual play therapy, and group therapy are all effective modes of treatment with children (Axline, 1969; Moreland, et ai, 1983; Pesco solido & Petrella, 1986). Due to the limited psychiatric resources in the military setting and increasing demand for service, the option for individual therapy may be …

The In-Hospital Suicide: A Psychological Autopsy Of A System Involving Borderline Dynamics, Kathleen A. Hughes, Md, Al Santos, Md

Jefferson Journal of Psychiatry

This manuscript reviews principles of hospital management in the care of severe borderline patients with concomitant affective syndromes. The case presented highlights a process of experiential learning in a novice clinician (a beginning psychiatric resident) and illustrates several critical areas of concern with these patients. The following four facets of clinical management are discussed: 1) Failed attempts to understand borderline dynamics and subsequent countertransference reactions; 2) Staff resistance to consistent, honest and open acknowledgement of suicide potential; 3) Special risks when borderline dynamics are combined with affective syndromes; and 4) Possible suicide preventive measures and their relative effectiveness.

Conversion Hallucinations In A Patient With Pseudohypoparathyroidism, John Kasckow, Md, Ph.D., Allan Maltbie, Md

Jefferson Journal of Psychiatry

There are few case reports in the literature which discuss psychiatric disturbances in patients with pseudohypoparathyroidism (PH P) (1,2). PHP is a disease characterized by an inadequate response to parathyroid hormone . Often these patients are obese with a short, stocky build and moon-shaped face. Mental retardation is present in as many as 10% of these patients; a reversible dementialike syndrome can also occur (2,3). In addition, Capgras' syndrome has been observed in pseudohypoparathyroid patients (1,2). In these last two reports the authors concluded that the psychosis was probably organically-based. Hay et al (I) noted in their case report that …

What Supports Supportive Therapy?, Peter N. Novalis, M.D., Ph.D.

Jefferson Journal of Psychiatry

Think of 1896, the year Jacob Freud died, kindling a depression in his son Sigmund which led to The Interpretation of Dreams. To a raucous convention in Chicago, William Jennings Bryan declaimed against the gold monetary standard: "You shall not press down upon the brow of labor this crown of thorns, you shall not crucify mankind upon a cross of gold" (I). Years later the monetary gold standard was abandoned during the New Deal, but Freud's newly mined "pure gold of analysis" continued to be an object of adulation and emulation, despite Freud's prediction that its …

Pharmacologic Treatments Of Cocaine Dependence, Michael B. Knable, D.O.

Jefferson Journal of Psychiatry

The rapid escalation of cocaine abuse in the United States in the 1980's has generated a host of interesting hypotheses on various aspects of this problem. After a succinct discussion of epidemiologic, clinical, and neuro-pharmacologic aspects of cocaine abuse, a survey of the current literature on psychopharmacologic management of dependence is offered. While several agents have emerged as useful adjunctive treatments for abstinence syndromes it is important for the clinician to remember that there is not official approval for such treatments. Additionally, psychotherapeutic maneuvers, which remain the major tools in treatment of addicts, should not be overlooked when an experimental …

An Organ Culture System To Model Early Degenerative Changes Of The Intervertebral Disc., Ravi K Ponnappan, Dessislava Z Markova, Paul Jd Antonio, Hallie B Murray, Alexander R Vaccaro, Irving M Shapiro, D Greg Anderson, Todd J Albert, Makarand V Risbud

Department of Orthopaedic Surgery Faculty Papers

ABSTRACT: INTRODUCTION: Back pain, a significant source of morbidity in our society, is related to the degenerative changes of the intervertebral disc. At present, the treatment of disc disease consists of therapies that are aimed at symptomatic relief. This shortcoming stems in large part from our lack of understanding of the biochemical and molecular events that drive the disease process. The goal of this study is to develop a model of early disc degeneration using an organ culture. This approach is based on our previous studies that indicate that organ culture closely models molecular events that occur in vivo in …

Download The Full Pdf Of Jefferson Surgical Solutions Fall 2011, Volume 6, Number 2

Jefferson Surgical Solutions

Download the full PDF of Jefferson Surgical Solutions Fall 2011, Volume 6, Number 2.

Duration Of Symptoms Resulting From Lumbar Disc Herniation: Effect On Treatment Outcomes: Analysis Of The Spine Patient Outcomes Research Trial (Sport)., Jeffrey A Rihn, Alan Hilibrand, Kristen Radcliff, Mark Kurd, Jon Lurie, Emily Blood, Todd J Albert, James N Weinstein

Rothman Institute Papers

BACKGROUND: The purpose of the present study was to determine if the duration of symptoms affects outcomes following the treatment of intervertebral lumbar disc herniation.

METHODS: An as-treated analysis was performed on patients enrolled in the Spine Patient Outcomes Research Trial (SPORT) for the treatment of intervertebral lumbar disc herniation. Randomized and observational cohorts were combined. A comparison was made between patients who had had symptoms for six months or less (n = 927) and those who had had symptoms for more than six months (n = 265). Primary and secondary outcomes were measured at baseline and at regular follow-up …

Proliferating Cell Nuclear Antigen Is Required For Loading Of The Smcx/Kmd5c Histone Demethylase Onto Chromatin., Zhihui Liang, Marc Diamond, Johanna A Smith, Matthias Schnell, René Daniel

Department of Medicine Faculty Papers

UNLABELLED: ABSTRACT:

BACKGROUND: Histone methylation is regulated by a large number of histone methyltransferases and demethylases. The recently discovered SMCX/KMD5C demethylase has been shown to remove methyl residues from lysine 4 of histone H3 (H3K4), and constitutes an important component of the regulatory element-1-silencing transcription factor (REST) protein complex. However, little is known about the cellular mechanisms that control SMCX activity and intracellular trafficking.

RESULTS: In this study, we found that small interfering RNA-mediated knockdown of proliferating cell nuclear antigen (PCNA) resulted in the reduction of the chromatin-bound SMCX fraction. We identified a PCNA-interaction protein motif (PIP box) in the …

Burden Of Traumatic Spine Fractures In Tehran, Iran., Maziar Moradi-Lakeh, Mohammad R Rasouli, Alexander Vaccaro, Soheil Saadat, Mohammad R Zarei, Vafa Rahimi-Movaghar

Rothman Institute Papers

UNLABELLED: ABSTRACT:

BACKGROUND: The Disability-Adjusted Life Year (DALY) was designed by the World Health Organization (WHO) to measure, compare, and analyze the burden of various diseases. To the best of our knowledge, this is the first study on the assessment of burden of traumatic spinal fracture (TSF) in an Iranian community. We estimated burden of TSF includes both isolated (iTSF) and associated injuries related to traumatic spinal fractures (aTSF) in Tehran, the capital of Iran, for the year 2006-2007 using DALYs.

METHODS: Burden of TSF was estimated based on information provided by the national data on Iranian trauma, data from …

About The Authors

Jefferson Journal of Psychiatry

Biographical information for authors for Volume 7, Number 1, 1989 issue of the Jefferson Journal of Psychiatry.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor Volume 7, Number 1, 1989 for Jefferson Journal of Psychiatry

Book Review: Making All The Difference. Psychotherapy: The Art Of Wooing Nature, Nora M. Kramer, Md

Jefferson Journal of Psychiatry

Book Review:

PSYCHOTHERAPY: THE ART OF WOOlNG NATURE

Sheldon Roth, M.D.

Jason Aronson Inc. Northvale, N.J. (1987), 294 pages.

Book Review: Assessing The Risk, Suicide Risk: The Formulation Of Clinical Judgement, Michael Gray, Md

Jefferson Journal of Psychiatry

Book review of:

SUICIDE RISK: THE FORMULATION OF CLINICAL JUDGEMENT

John T. Maltsberger

New York University Press, New York, 1986

174 pp . $26 .95

In Response: Maintenance Ect, Max Fink, Md

Jefferson Journal of Psychiatry

Therapy resistance, relapsing illness, and rapid cycling are aspects of chronic affective illness that continue to frustrate us. ECT was re-introduced to answer the problem of therapy resistant depression. In their recent review, Matzen et al. (I), report their experience in eight cases treated with maintenance ECT. They argue that maintenance ECT should also be considered for relapsing depressive illness.

No systematic study of maintenance ECT has been undertaken since the early I950s, and yet, as reported by Kramer (2) it continues to be used. Kramer directed inquiries to members of the International Association for the Advancement of Electrotherapy. Of …

Commentary: The Hiv-Positive Resident: Questions And More Questions, Marguerite Blythe, Md

Jefferson Journal of Psychiatry

The resident physician who is infected with the human immunodeficiency virus (HIV) faces unique problems. In addition to the difficulties caused by a chronic and lethal disease, HIV-infected physicians-in-training face ethical, educational and practical problems that are unique to the interplay between residency training and the infection.

To date, physicians who have been found to be infected with HIV have faced public discrimination, many with devastating results. Dr. Hacib Aoun, a Venezulean-born cardiologist who contracted AIDS from a boy with leukemia while he was a resident at Johns Hopkins, overcame rumors about how he had contracted the disease only to …