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American Journal of Psychiatry 08/2011; 168(8):855. · 12.54 Impact Factor
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ABSTRACT: The authors present a patient with multiple pontine lesions who exhibited symptoms consistent with delusional parasitosis. The trigeminal nerve nuclei are located throughout the brainstem. Pathology in either the nuclei or the branches of the fifth cranial nerve has been associated with both sensory and motor disturbances. Delusional parasitosis is a condition in which the patient has the firm belief that small, living organisms have infested his or her skin or other organs. To our knowledge, this is the first case report of delusional parasitosis associated with lesions at the root of the trigeminal nerve.
Psychiatry 08/2010; 7(8):33-7.
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The Journal of Clinical Psychiatry 02/2010; 71(2):210-1. · 5.80 Impact Factor
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ABSTRACT: Over the last few decades in health care a premium has been placed on decreasing the length of stay. Cost containment measures and more effective psychotropic medications have fueled this trend. The new paradigm is "diagnose, stabilize quickly, and discharge to outpatient setting." Although in the short run this model saves money, it is at the cost of an accurate diagnosis; however, in the long run the costs far exceed the initial savings, especially in today's dismal economy. This editorial presents a case report where prolonged psychiatric hospitalization and diagnostic clarification saved the U.S. Air Force $650,000 in unwarranted disability payments.
Military medicine 01/2010; 175(1):viii. · 0.92 Impact Factor
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ABSTRACT: In line with Psychiatry 2009's mission to strengthen its global presence as a leading source of evidence-based information for practicing clinicians, we are pleased to launch the new column, "Psychiatric Clinics from Around the World." This series will enable readers to become familiar with facilities around the world that provide psychiatric care. We hope you find the column interesting. We start the series with a column featuring Wilford Hall Medical Center, the flagship psychiatric facility of the United States Air Force.United States Air Force psychiatry plays a vital role in Operation Iraqi Freedom and Operation Enduring Freedom (Afghanistan). Outside of the military, little is known about US Air Force psychiatry and the Wilford Hall Medical Center. Wilford Hall Medical Center is the US Air Force's flagship hospital and premiere psychiatric hospital. This article briefly discusses the history of Wilford Hall Medical Center and its psychiatric contributions to the wars in Iraq and Afghanistan.
Psychiatry 07/2009; 6(6):52-3.
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ABSTRACT: Resistant schizophrenia is often treated with clozapine after other conventional atypical antipsychotics have failed or have resulted in intolerable side effects. Clozapine is generally reserved for secondary use due to its propensity to cause serious side effects, such as life-threatening agranulocytosis and the necessity for life-long blood monitoring. In this case report we present a 40-year-old female patient who suffered from chronic constipation and bowel infarctions after long-term use with clozapine. Although the use of this medication resulted in multiple abdominal surgeries with subtotal colonic resections, the patient's schizophrenic symptoms only responded to clozapine after several repeat failures with other medications; ultimately, she was continued on this medication.
Psychiatry 04/2009; 6(3):30-5.
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Journal of Clinical Psychopharmacology 07/2008; 28(3):354-5. · 4.10 Impact Factor
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ABSTRACT: This study measured the association between executive function and decision-making capacity in subjects consenting to a noninvasive research protocol.
Subjects consenting to a noninvasive research protocol (N = 21; mean age: 65.5 [standard deviation: 9.2] years) were administered a modified version of The MacArthur Competency Assessment Tool-Treatment (MacCAT-T), Executive Interview (EXIT25), Executive Clock Drawing Task (CLOX), and Mini-Mental State Examination (MMSE).
The EXIT25 was the only instrument to correlate with each decision-making capacity domain: understanding, appreciation, and reasoning.
Executive function as measured by the EXIT25 is associated with multiple decision-making capacity domains.
American Journal of Geriatric Psychiatry 03/2007; 15(2):159-62. · 3.64 Impact Factor
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American Journal of Psychiatry 02/2007; 164(1):173-4. · 12.54 Impact Factor
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ABSTRACT: The use of complimentary/alternative medicine has become popular as evidenced by grocery store aisles and "infomercials" devoted to herbal products. These products are often misconstrued as safe because of their natural origin. With an increase in the consumption of these products, physicians need to be aware of their potential adverse effects. There are several popular over-the-counter herbal products that can affect one's behavior, especially resulting in acute mania and/or psychosis. This article provides an overview of existing literature regarding the increased use of herbal agents, reviews several case reports describing a potential association between herbal products (St. John's Wort and ginseng) and the development of mania and psychosis, and discusses the limitations in determining the frequency of serious adverse effects due to herbal products.
Psychiatry 09/2005; 2(9):56-61.
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ABSTRACT: The purpose of this study was to determine the prevalence, course, and risk factors for executive impairment in patients hospitalized on a general medicine service. One hundred patients were administered the Executive Interview (EXIT25), the Executive Clock Drawing Task (CLOX), and the Mini-Mental State Examination at admission and discharge. Fifty-two percent of the patients at admission and 56% at discharge had scores indicating impairment on at least one measure of executive function. Median scores on every measure improved during hospitalization. Older patients and those with a cardiac or gastrointestinal disorder were more likely to have executive impairment. The prevalence of executive impairment on general medicine services is high. Although improvement in executive function occurs during hospitalization, many patients remained impaired.
Psychosomatics 46(5):411-7. · 2.12 Impact Factor
