Psychiatry Commons^™

Carbamazepine In Treatment Of The Violent Psychotic Patient, Lauren A. Pate, Md

Jefferson Journal of Psychiatry

Violence in the psychiatric setting may be perpetrated by patients with a variety of diagnoses including character disorders, episodic dyscontrol syndromes, and drug or alcohol intoxication. The violent behavior of aggressive psychotic patients is typically the most bizarre, unpredictable, and the least responsive to intervention with neuroleptics or lithium carbonate. Carbamazepine, an established anticonvulsant, has achieved growing prominence as an adjunctive measure in treatment of the violent psychotic. This paper will review the literature and summarize the posited pharmacological mechanisms, reported side effects, and clinical experience with carbamazepine in controlling the symptoms of violence and aggression in psychosis.

The Stress Factor: Exploring The Possibility Of A Psychological Component To Cancer, Bernard M. Edelstein, Md

Jefferson Journal of Psychiatry

As dwellers in the same house, it seems only logical that psyche and soma would be interdependent , that well-being in one would promote health in the other, and that illness in one would soon become manifest in its partner. Yet quantifying this intuitive relationship has long been a difficult task. Establishing a mechanism for disease-heart disease, infectious disease, neoplastic disease which can withstand the scrutiny of experimental rigor, is difficult enough. To introduce a seemingly not quantifiable entity such as psychology in the form of stress or anxiety presents such great complexity that for a long time it seemed …

Using Psychoanalytically Oriented Psychotherapy With The Elderly, Mark D. Miller, Md

Jefferson Journal of Psychiatry

Psychotherapy with the elderly, like geriatric medicine, has become a subject of renewed interest. This paper will review some pertinent aspects of the subject and hopefully dispel some myths. A case will be presented where psychoanalytically oriented psychotherapy was employed. In this case, forced termination was necessary after one year due to the therapist graduating from residency.

Psychoanalysis: Science Or Fiction?, Emanuel E. Garcia

Jefferson Journal of Psychiatry

The completion of this paper comes coincidentally at a time when a book by a scholarly philosopher, Adolf Grunbaum, entitled The Foundations of Psychoanalysis:A Philosophical Critique, has just been published and purports to answer the question of the scientific status of analysis. This temporally follows Jeffrey Masson's work (1) which accuses Freud of abandoning the so-called seduction hypothesis and by so doing laying unsound groundwork for the "science" that consumes Freud's nearly limitless energies . In short, it is a period in which psychoanalysis finds itself condemned, but perhaps in a …

Faculty Advisor's Column, Harvey J. Schwartz, Md

Jefferson Journal of Psychiatry

It is with great pleasure that with this issue of The Jefferson Journal of Psychiatry-A Resident Publication we are expanding into a national journal for psychiatric residents. As part of that effort, we welcome the American Psychiatric Association Committee of Residents as our national editorial board. Our circulation will include all psychiatry residents, residency directors, and department chairmen nationwide . We look forward to continuing our three year tradition of presenting scholarly, thought provoking and creative ideas from psychiatric residents around the country. Our commitment to the two pillars of clinical and …

Editor's Column, Jeffrey R. Sarnoff, Md

Jefferson Journal of Psychiatry

The Jefferson Journal of Psychiatry (JJP) seeks to enhance the scope and quality of post-graduate training in psychiatry, by providing a forum in which residents can publish a wide variety of scientific communications.

Editorial Staff

Jefferson Journal of Psychiatry

List of Editorial Staff for Volume 4, Number 1, Winter 1986 issue of the Jefferson Journal of Psychiatry.

Respiratory Dyskinesia--An Under-Recognized Side-Effect Of Neuroleptic Medications, Mukesh Mohan Bhimani

Department of Psychiatry

Respiratory dyskinesia is an under-recognized side effect of neuroleptic administration. There are only few studies that have addressed the prevalence of respiratory dyskinesia in patients with tardive dyskinesia. Our case report highlights the need to regularly examine patients on antipsychotics for any evidence of dyskinetic movements including respiratory musculature. Since RD is underrecognized and misdiagnosed, early detection can improve long term prognosis as treatment options are few and usually of only limited effect. A 62-year-old Asian male, retired civil engineer, had more than 20 years history of depressive illness, developed antidepressant induced hypomania, and was given risperidone upto 1 mg …

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor for the Jefferson Journal of Psychiatry, Volume 3, Number 2, July 1985.

E = Mc², John Matt Dorn, Md

Jefferson Journal of Psychiatry

Book Review: WHY PSYCHOTHERAPISTS FAILRichard D. Chessick, M.D.New York: Jason Aronson, 1971203 pp., $20.00

Street People, John Matt Dorn, Md

Jefferson Journal of Psychiatry

In this issue the Journal inaugerates a new section of creative writing, in which we hope to encourage the artistic expression of psychiatric residents. We welcome original material of any nature: poems, short stories. or otherwise. The following one act play is meant to dramatize the often complex issues that surround the evaluation and care of "street people."

The Impact Of Hysterectomy During Adolescence In A Woman Of Reproductive Age, Susan K. Ball, Md

Jefferson Journal of Psychiatry

There is extensive psychiatric literature on the psychological effects of hysterectomy on both pre-menopausal and post-menopausal women, but a careful search covering the last ten years and beyond reveals no references to the impact of hysterectomy during adolescence. There is also nothing on this subject in the gynecological literature of the last ten years. Obviously, the incidence of severe pathology necessitating hysterectomy is extremely rare. However, there can be little doubt that a procedure of such symbolic magnitude at an age when a young woman is trying to integrate her personality, emerge as an autonomous sexual being, and experiencing a …

Psychotherapy Or Pseudotherapy?, Lawson R. Wulsin, Md

Jefferson Journal of Psychiatry

What is psychotherapy? I wish I knew . Thick books and long talks still leave me wondering. Hours of patients and almost as many hours of supervision leave the question hanging. I know what ECT is and how to give a good trial of arnitryptiline, but I am never quite sure if what I am offering is true psychotherapy. Admittedly I am young and have only been wet for five years. But I have had one experience in my short time that put the question in perspective by putting it backwards, that is, what is notpsychotherapy, or what is pseudotherapy?

The Webs We Weave: A Patient With Depression, Mary Ann Venezia, Md

Jefferson Journal of Psychiatry

Looking back over C.'s records, I was struck by a phrase I had used to describe her, "She really seems at a loss as to what she should do with herself. " A more accurate appraisal might have reflected my own uncertainty as to how I could help C. Hospitalized eight times in eight years after serious suicide attempts, she had been treated with neuroleptics, antidepressants, psychotherapy, and been involved with a day program. Once again she was in the hospital, severely depressed following a suicide attempt. There was little the psychiatric establishment had not tried . So I taught …

The Neuroleptic Malignant Syndrome: Do We Know Enough?, Ali Hassan M. Ali, Md

Jefferson Journal of Psychiatry

The Neuroleptic Malignant Syndrome (NMS) is a potentially grave adverse reaction to oral or parenteral neuroleptic therapy that may be an underdiagnosed and easily overlooked clinical problem. NMS is characterized by hyperthermia, hypertension, diaphoresis, muscular rigidity, and altered mentation. There is currently no way of predicting which patients will develop NMS, although its incidence may be higher in patients who are unresponsive to usually effective dosages of neuroleptics ( I) .

NMS was first described in the French literature by Delay and Deniker in 1960 (2). They reported five cases among several hundred patients who were treated with haloperidol (Haldol"), …

A Patient With Aids, Susan Ball, Md, Stephen Hauptman, Do, Jean Helz, Md, Sheila Murphey, Md, Beth Shindell, Mss

Jefferson Journal of Psychiatry

Susan Ball , M.D.. Chief Resident: Mr. B, a thirty-five-year-old white male, was admitted to the medical service with chief complaints of fever, chills, and increasing shortness of breath. This was Mr. B's second admission. His first was six month s ago for pneumonia, leukopenia, and lymphadenopathy of unknown etiology. At that time he was treated with antibiotics; he improved and was discharged. Since that time Mr. B reported continuing to feel weak and lethargic. Two weeks before this admission he noted the onset of fever, chills, sore throat, and a nonproductive cough. He initially saw …

Bulimia As A Masturbatory Equivalent, Eric Levin, Md

Jefferson Journal of Psychiatry

Introduction

In the last few years much has been written about those who binge-eat and then purge. These people, most of whom are women, resort to extreme measures to avoid gaining weight while not foregoing the gratification of eating.

Most recent papers on this disorder have focused upon description, classification, and the search for neurobiological causality . Little has been presented on the psychodynamics of bulimia that would help us understand the symbolic significance of this disorder. The following case presentation illustrates how bulimia may present as a neurotic symptom, and as such may be overdetermined, yet representative of a …

Some Reflections On Termination: Transference And Countertransference, Frederick L. Becker, Jr, Md

Jefferson Journal of Psychiatry

INTRODUCTION

Nearing the completion of my psychiatric residency, I ingenuously told my supervisor that I needed to know the steps of termination in therapy with patients. On the surface, this request reflected an awareness of the issues at hand and their importance. Beneath lay ambivalence and countertransference anxiety . For the graduating resident, time ordinarily invested in thought and study fills with practical considerations of job hunting and starting a practice. The resident' s own unresolved and unsettling separation issues can further push aside therapeutic considerations for his patients. Termination, the art of the veteran therapist, becomes an unwelcome …

The Use Of Light In The Treatment Of Depression, Mark D. Miller, Md

Jefferson Journal of Psychiatry

INTRODUCTION

Light has recently been reported to be a useful treatment in affective illness (1,2, 3, 4, 5, 6). What type of patients respond to this type of treatment ? What is the theoretical mechanism of action of light therapy and what are the implications of this research for the existing theories of affective illness? This review will seek answers to these questions by summarizing the recently reported studies of the effects of light on depression , by reviewing the pertinent contributions from neuroanatomy, endocrinology and circadian rhythm physiology, and, finally, by suggesting some points of integration of these recent …

Faculty Advisor's Column, Harvey J. Schwartz, Md

Jefferson Journal of Psychiatry

The teaching of the concepts and techniques of dynamic psychotherapy to residents is a formidable task facing most all residency directors and faculty. The challenge of 'new' therapies and the revolution in neurobiology has led to a significant deemphasis in dynamic training in many programs in recent years. Where once there was relative uniformity of philosophy, a variety of approaches now abound. Medical school graduates can choose from programs that offer intensive training in psychoanalytic psychiatry as well as those that mention Freud only in passing. Most call themselves 'eclectic' and teach a potpourri of therapies that vary with faculty …