Psychiatry Commons^™

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.

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.

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.

Public Perceptions Of Electroconvulsive Therapy: A Historic Review, Steven M. Jenkusky, M.D.

Jefferson Journal of Psychiatry

Electroconvulsive therapy, an effective treatment for depression, mania and some forms of schizophrenia, has had a tumultuous and controversial history. The dramatic nature of the therapy as well as its use in the mentally ill in a seemingly indiscriminate manner has historically captured the public's attention and concern. The evolution of this therapy and the public and psychiatric profession's responses to it are reviewed here. Often the public's understanding of the therapy, how it is administered, its applications and side effects have lagged behind how the psychiatric profession views ECT, although at times mental health professionals have remained opposed to …

About The Authors

Jefferson Journal of Psychiatry

About the authors, Jefferson Journal of Psychiatry, Volume 10, Number 1, 1992.

Letters To The Editor

Jefferson Journal of Psychiatry

Letter to the Editor, Jefferson Journal of Psychiatry, Volume 10, Number 1, 1992.

Perspectives On The Mind, S. Nassir Ghaemi, M.D.

Jefferson Journal of Psychiatry

PHILOSOPHY, PSYCHIATRY, AND NEUROSCIENCE: THREE APPROACHES TO THE MIND

Edward M. Hundert

Clarendon Press: Oxford, 1989

$19.95

313 pages

Learning Cognitive Therapy, A.J. Allen, M.D., Ph.D.

Jefferson Journal of Psychiatry

A PRACTICAL GUIDE TO COGNITIVE THERAPY

Dean Schuyler, M.D.

W.W. Norton, 1991

$22.95

153 pages

Goodbye, Steven M. Sokoll, M.D.

Jefferson Journal of Psychiatry

SAYING GOODBYE. A CASEBOOK OF TERMINATION IN CHILD AND ADOLESCENT ANALYSIS AND THERAPY

Edited by Anita G. Schmuckler, D.O.

Hillsdale, NJ. The Analytic Press, 1991

$42.95

377 pages

Rethinking The Oedipus Complex, Daniel B. Block, M.D.

Jefferson Journal of Psychiatry

SON AND FATHER: BEFORE AND BEYOND THE OEDIPUS COMPLEX

Peter Bios, Ph.D.

Free Press, New York, 1985

$27.95

186 pages

Dynamic Insight Into Psychoanalysis, Melinda Fudge, M.D.

Jefferson Journal of Psychiatry

THE USE OF THE SELF: COUNTERTRANSFERENCE AND COMMUNICATION IN THE ANALYTIC SITUATION

Theodore J. Jacobs, M.D.

International Universities Press, Inc., 1991

$40.00

237 pages

Evaluation And Treatment Of Demented Elderly, Barry Rovner, M.D.

Jefferson Journal of Psychiatry

There are currently 27 million people over 65 in the United States and this number will double in the next 50 years. This will confront psychiatrists and other physicians with the care of many elderly patients with dementia. These patients will often require hospitalization when ill because their mental, physical, and social functioning tends to break down at once, overwhelming families and outpatient physicians. Once hospitalized, they require accurate diagnoses, multidisciplinary care, and planning for rehabilitation from the on set of the hospitalization. However, dementia is often undiagnosed and untreated in university hospitals as well as in primary care clinics …

The Mysterious Pathologic Process Of Autistic Disorder, Clyde Sheehan, M.D.

Jefferson Journal of Psychiatry

This is a condensed literature review of current etiological and treatment findings in autism. Numerous studies examining autistic individuals for a biological marker have been performed with renewed interest over the past several years. Biochemical studies have revealed excessive amounts of serotonin, dopamine and opiods in marry autistics. Reductions in self injurious behaviors, aggressiveness, hyperactivity and stereotypies in patients on medications targeting these specific receptor sites have been documented. Though genetic studies indicate a significant contribution to the transmission of autism, the final common etiological pathway remain unknown.

Psychiatric Interventions With Burned Children, Ravi Bhalla, M.D., Diane Kaufman, M.D., Diane Schrier, M.D.

Jefferson Journal of Psychiatry

This paper reviews the literature and identifies etiologic and management factors in the care of the burned child. It was provoked by direct involvement with two sisters, seriously burned under similar circumstances, each at age two. Their suffering is shared by approximately 500,000 children each year. Despite the enormity of the problem, psychological evaluation and treatment interventions are still not routinely incorporated into the care of these children and their caregivers. The authors hope to encourage psychiatrists and other mental health professionals to become more involved in the prevention, diagnosis, treatment, and clinical investigation of the burned child.

The Syndrome Of Antidiuretic Hormone Secretion In Psychiatric Patients, Kathleen Crapanzano, M.D.

Jefferson Journal of Psychiatry

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a common medical illness which has many etiologies-some of which are particular to psychiatric patients. This review will discuss the diagnosis of SIADH and then the various etiologies for its development with emphasis on those which are more relevant to psychiatric patients. Future research will be directed to a further understanding of this disorder, as well as to treatment options to decrease the significant morbidity associated with this condition.