Psychiatry Commons^™

Domperidone For Drug-Induced Orthostatic Hypotension-A Review, Daniel E. Mcdonald, M.D., Raymond W. Lam, M.D., F.R.C.P.(C)

Jefferson Journal of Psychiatry

Drug-induced orthostatic hypotension (OH) is a common side effect of heterocyclic and MAOI antidepressant medications. It usually does not respond to conservative treatment and drug treatments with mineralocorticoids or central dopaminergic antagonists such as metoclopramide have significant long-term side effects that limit their use. Domperidone, a peripherally acting dopaminergic antagonist with few side effects, has been used in a number of small clinical trials to treat OH of various etiologies. We reviewed 9 studies of domperidone in the treatment of OH. Although limited by small sample sizes and poor design, these studies generally showed successful treatment of OH by domperidone. …

Delusional Misidentification Syndromes, Zeljko Jocic, M.D.

Jefferson Journal of Psychiatry

Delusional misidentification syndromes are reviewed by their phenomenology, epidemiology, clinical characteristics, associated clinical findings, etiological theories, diagnostic evaluation, and treatment. Related neuropsychiatric syndromes are described and distinctions between them and delusional misidentification syndromes addressed. Current psychological and biologic-cognitive theories are briefly discussed. These peculiar phenomena are probably more frequent than previously thought, if they are specifically sought and recognized. Organic factors play a definitive role in their occurrence and two brain regions frontal and temporal, are presumably dysfunctional.

Editor's Column, Patricia M. Ferrie, M.D.

Jefferson Journal of Psychiatry

As the editor of the Journal I find it challenging to oversee publication in many different areas of psychiatry. From cognitive therapy to consultation for the treatment of burned children I know, or quickly learn the more intricate details of the field. In compiling this issue, I was particularly struck by the number of articles focusing on Child and Adolescent Psychiatry, an area of our field to which I have had limited exposure in my first two years of training.

About The Authors

Jefferson Journal of Psychiatry

About the Authors, Jefferson Journal of Psychiatry, Volume 9, Number 2, 1991.

Letters To The Editor

Jefferson Journal of Psychiatry

Letter to the Editor, Jefferson Journal of Psychiatry, Volume 9, Number 2, 1991.

First The Body, Then The Mind, Sandra M. Zebrowski, M.D.

Jefferson Journal of Psychiatry

ADULT ANALYSIS AND CHILDHOOD SEXUAL ABUSE

Edited by Howard B. Levine

The Analytic Press 1990, Hardcover, 231 pp, $29.95

Assault On Childhood, Noah D. Freedman, M.D.

Jefferson Journal of Psychiatry

INCEST-RELATED SYNDROMES OF ADULT PSYCHOPATHOLOGY

Edited by Richard P. Klufr , M.D.

Washington, D.C., American Psychiatric Press

1990, Hardcover, 308 pages, $32.00

The Psychoanalysis Of Incest, Doris Mirowski, M.D.

Jefferson Journal of Psychiatry

THE TRAUMA OF TRANSGRESSION. PSYCHOTHERAPY OF INCEST VICTIMS

Selma Kramer , M.D. and Salman Akhtar, M.D.,

Editors Jason Aron son Inc.

1991, $27.50, 186 Pages.

Cultural Diversity And The Dsm-Iii-R: Can A Barking Man Be Diagnosed?, Edward F. Foulks, M.D., Ph.D.

Jefferson Journal of Psychiatry

The case of the Barking Man JJP 9(1):82-88, 1991) raises once again the question whether some mental disorders are "Culture Bound Syndromes" or are merely cultural manifestations of basic mental disorders which plague humankind wherever they live. Bernstein and Gaw (1) have recently made a compelling argument for the former position using the example of Koro. Koro affects a variety of ethnic groups throughout Southeast Asia and is characterized by an acute, morbid panic accompanied by the idea that the penis is retracting and will disappear, at which time, the patient fears, he will die. The disorder is widespread, affecting …

Commentary On "Multiple Personality And Channeling", Richard P. Kluft, M.D.

Jefferson Journal of Psychiatry

In her paper, "Multiple Personality and Channeling," Dr. Rogers compares and contrasts the two phenomena, tries to outline some distinctions between them, and expresses concern lest persons who have the ability to channel be pathologized for their capacity" to engage in a creative social activity which is currently very much in vogue" (p.11 ) (1). I appreciate her efforts and here will offer some additional observations and reflections from my own work and experience.

Psychiatry And Psychoanalysis In The Nineties, Diane E. Custer, M.D.

Jefferson Journal of Psychiatry

The Jefferson Journal of Psychiatry is now accepting reports on meetings and panel discussions for our new "Panel Reports" column. Authors should submit their manuscripts for approval by those who participated in the panel or meeting prior to submission to the Journal for editorial review.

The Philadelphia Association.for Psychoanalysis hosted a panel designed for medical students, psychiatric residents, psychiatrists and other professionals interested in applying psychoanalysic thought and listening skills to areas in general psychiatry. The educational objectives included increasing familiarity with the various components of psychoanalytic listening, (greater skill in making use of psychoanalytic listening in work with patients) …

Re-Visioning Group Psychotherapy Training In Psychiatry, Len Sperry, M.D., Ph.D.

Jefferson Journal of Psychiatry

The literature on group training in psychiatry reveals that most residency programs include didactic seminars but few offer supervised group therapy experience or require competence in referral for group therapy. Not surprisingly, research shows that few residents utilize group therapy-either leading a group or making referrals to groups-after graduation. This paper reviews the current "vision" of group training and offers an alternate vision. The assumptions, group formats and competencies of this new vision are described. Emphasized are the development of skills and competency of making appropriate referrals to groups, which may positively impact resident attitudes and practice patterns regarding group …

Potential Drug Interactions With Coumadin (Warfarin) And Prozac (Fluoxetine): A Brief Report And Review Of The Literature, Robert Jay Claire, M.D., Mark E. Servis, M.D., David L. Cram, Jr., Pharm.D.

Jefferson Journal of Psychiatry

We were asked to see a woman with recurrent depression and a history of deep vein thrombosis. (Consultation and Liaison Service). She had been started initially on Prozac (fluoxetine) and was secondarily started on Coumadin (warfarin). The patient presented with severe bruising of both lower extremities. We were asked to investigate the case to determine if a drug interaction with Prozac had produced the problem. A review of the world's literature failed to produce a report of a drug interaction between Prozac and Coumadin producing a bleeding disorder. Scrutiny of this case could not produce evidence that this occurred. A …

Psychiatric Presentation Of Creutzfeldt-Jakob Disease: A Case Study, Mahmoud A. Parsa, M.D., Kyra Minninger

Jefferson Journal of Psychiatry

Creutefeldt-Jakob disease is a fatal degenerative disorder of the central nervous system. The variability of its prodromal psychiatric and neurologic manifestation often obscures the diagnosis. This paper reports a case that illustrates the complexity of diagnosing this disease early in the clinical course, and offers a brief review of the literature.

Psychiatric Manifestation Of Vitamin B-12 Deficiency: An Update, David Metzler, M.S., M.D., William H. Miller, M.D., C. Stephen Edwards, M.D.

Jefferson Journal of Psychiatry

Psychiatric manifestations of vitamin B-12 deficiency are reviewed from 1986 to the present. Specific clinical entities reviewed include depression, organic psychosis, obsessive-compulsive disorder, childhood manifestations and dementia. We recommend that consideration be given to B-12 deficiency as an etiological factor in some cases of depression, organic psychosis, certain childhood disorders and dementia. Routine screening of people overage 65 is addressed.

Psychiatric Consultation For The Demented Elderly, Kenneth Paul Rosenberg, M.D.

Jefferson Journal of Psychiatry

Psychiatric consultations for the demented elderly are often required and requested by the Medical service. With the rise in the number of demented elderly being housed in acute care hospitals, the need.for these consultations is increasing. In this paper, the author presents a case and discusses the role of the consultant in (1) diagnostics, (2) therapeutics, (3) assessment of involuntary vs. voluntary placement in an institution, (4) medical staff education, (5) family education, and (6) the management of evoked feelings and countertransference among the medical and nursing staff.

Hiv-Positivity, Aids, And The Military Psychiatry Residency Experience, Ronald J. Koshes, M.D.

Jefferson Journal of Psychiatry

Psychiatry residents in the military work with a diverse population of HIV-positive and AIDS patients who are in various stages in their illnesses, military careers, and acceptance of the disease process. In this circumstance, the military psychiatry resident must be a clinician, administrator, and patient advocate. Additionally, the military resident must uphold Department of Defense regulations which mandate that soldiers be both physically and emotionally fit to perform their duties. This paper describes the unique role of the military psychiatrist in working with HIV-positive and AIDS patients in the military setting.

The Management Of Performance Anxiety With Beta-Adrenergic Blocking Agents, James A. Bourgeois, M.D.

Jefferson Journal of Psychiatry

Performance anxiety consists of several symptoms experienced in the context of public performance and is classified in DSM-III-R under social phobia. Performance anxiety must be distinguished from panic disorder, generalized social phobia, and generalized anxiety disorder. Performance anxiety symptoms can be detrimental to both performer and performance. These symptoms can be controlled by the judicious use of beta-adrenergic blocking agents. The use of beta-adrenergic blocking agents should be considered as part of a psychiatric stress-management program for these patients.

Psychiatry And Cardiac Transplantation, Mark Graham, M.D.

Jefferson Journal of Psychiatry

This paper explores the role of psychiatry in the field of cardiac transplantation by way of a literature review. The various stages of cardiac transplantation are discussed with respect to their time frame within the transplantation process, the cognitive and emotional reactions of patients within a given stage, and the dynamics of staff, patient, and family interactions. Research and clinical experience in the field suggest psychiatric assessment, follow-up, and, when necessary, intervention are valuable and important in promoting successful psychological adjustment as patients face their adaptive tasks in the various stages of the transplantation process.

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

Jefferson Journal of Psychiatry

As a senior medical student applying to residency programs, I became acquainted with the term "eclecticism." Many programs described themselves as "eclectic"; it appealed to the progressive, pluralistic spirit in all of us. Yet it implied, erroneously I believe, that limiting the foci of psychiatric resident education was neither necessary nor desirable. The regressive appeal of eclecticism lies in the denial that all true commitments entail some relinquishment of other possibilities; the pleasures of socialization are bought through the renunciation of defecating or urinating at the slightest urge. The hypothetical eclectic psychiatrist has given up none of his or her …

About The Authors

Jefferson Journal of Psychiatry

About the Authors, Jefferson Journal of Psychiatry, Volume 9, Number 1, 1991.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor, Jefferson Journal of Psychiatry, Volume 9, Number 1, 1991.

Bringing Back The Mind, Edward Kim, M.D.

Jefferson Journal of Psychiatry

PSYCHODYNAMIC PSYCHIATRY: THEORY AND PRACTICE

John Frosch, M.D. 1990

International Universities Press

Vol I, 359pp, $50.00

Vol II, 505pp, $60.00

Death, Freedom, Isolation And Uncertainty, Cordula Holzer, M.D.

Jefferson Journal of Psychiatry

LOVE'S EXECUTIONER & OTHER TALES OF PSYCHOTHERAPY

Irvin Yalom, M.D. New York, Basic Books, 1989

288 pp.$ 19.95 (Hardcover) 9.95 (Paperback)

Successful Private Practice In The 1990s, Susan Marcel, D.O.

Jefferson Journal of Psychiatry

SUCCESSFUL PRIVATE PRACTICE IN THE 1990s

Joan Kay Beigel, M.Ed. and Ralph H. Earle, Ph.D. with Lynn Fleischman and

Ritalinda D'Andrea Brunner

Mazell Publishers, 1990

$21.95

224 Pages

The Barking Man: A Case Study Of Rootwork In Psychiatry, Harry D. Goldwasser, M.D.

Jefferson Journal of Psychiatry

Cultures and sub-cultures attempt to describe illness in ways that are most understandable to the people who live in that community. These groups may differ when describing the etiology, course and treatment of any given ailment. Mental illness is just as susceptible to being explained in a manner which differs from group to group. Not surprisingly, psychiatrists trained under the auspices of "mainstream America"-that is, where the Western Judeo-Christian paradigm reigns, may find themselves dismissing symptoms of other sub-cultures. Some patients may have manifestations of true mental illness; others may have symptoms which are culturally sanctioned but which we label …

Conceptualization Of Therapeutic Alliance During Psychiatric Residency Training, Stephen J. Cozza, M.D.

Jefferson Journal of Psychiatry

This pilot study defines the Conceptualization of Therapeutic Alliance (CTA) as the psychotherapist's internalized construct if his ideal patient-therapist relationship based on the principles if Therapeutic Alliance, Working Alliance, and Helping Alliance. The study measures the CTA if third year medical students (MS3s), third year psychiatry residents (PCY3s), and consultant supervising psychotherapists (CSs) utilizing Fiedler's Ideal Therapeutic Relationship Scale. The CTA profiles of each experimental group are correlated with Fiedler's Ideal Therapeutic Relationship. Variance in CTA profiles within each group is also calculated. Preliminary results if this small study (N = 24) show that CTA measurements if the PCY3 group …

Occupational Chemical Exposures And Psychiatric Disorders, Mark L. Dembert, M.D., M.P.H.

Jefferson Journal of Psychiatry

Occupational exposure to metals, solvents, or pesticides can produce disorders of behavior, thought, or mood which can easily be misdiagnosed as 'Junctional." Accurate diagnosis obtained with a relevant clinical history, psychiatric interview, physical examination, and indicated laboratory tests will enable the delivery of necessary medical treatment and concurrently prevent repeat exposure to a hazardous work environment. Published references and organizational sources in occupational medicine and industrial hygiene can beutilized by psychiatrists for determination of the dijferential diagnosis and confirmation of an occupational exposure; in addition, these references can aid in assessing the need for an environmental health hazard survey at …

Subsequent Pregnancy In Women With A History Of Postpartum Psychosis, Richard G. Hersh, M.D.

Jefferson Journal of Psychiatry

Postpartum psychosis stands out among the psychiatric syndromes associated with child birth, not able for the variability of its symptom profile and the potential severity of its course, if unrecognized. Significant questions regarding nosology, etiology, prevention and treatment remain only partially answered (1). While controversy surrounds many of the critical issues regarding postpartum psychosis, including its definition, current epidemiologic data indicates severe, frequently psychotic episodes occur following 1-2 per 1,000 of all births (2). As diagnosis and treatment of puerperal conditions have evolved, clinicians now are frequently involved in assisting women with a history of postpartum psychosis with decision making …

Transference Love And Countertransference Love In Clinical Technique, Ronald J. Koshes, M.D., Colleen E. Sari, M.D.

Jefferson Journal of Psychiatry

The authors review the original and modern concepts of transference and countertransference love as described by Sigmund Freud followed by the more recent theories of Heinz Kohut and Otto Kernberg, focusing on dynamic clinical importance. Case examples are presented to illustrate the important clinical presentations, problems and pitfalls as well as techniques of managing the eroticized transference. The countertransference implications are especially explored as well as indications for supervision.