Psychiatry Commons^™

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.

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.

Mead Johnson Award

Jefferson Journal of Psychiatry

The Mead Johnson 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 will be selected by the Journal's editorial board from manuscripts submitted on any subject related to psychiatric practice and/or research.

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.

Editorial Staff

Jefferson Journal of Psychiatry

Editorial Board for Jefferson Journal of Psychiatry, Volume 10, Number 1, 1992.

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.

Mead Johnson Award

Jefferson Journal of Psychiatry

The Mead Johnson 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 will be selected by the Journal's editorial board from manuscripts submitted on any subject related to psychiatric practice and/or research. We invite authors to review the Information for Contributors section of this issue. The board will announce the 1991 …

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 …

Editorial Staff

Jefferson Journal of Psychiatry

Editorial Staff for Jefferson Journal of Psychiatry, Volume 9, Number 2, 1991.

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