To this day one of the most curious gaps in the historiography of French psychiatry is the era between the fin-de-siècle and the 1920s, years that overlapped the life and career of Valentin Magnan (1835-1916), a pivotal figure in the historical classification of mental diseases. This paper seeks to address ...

Falls from heights represent an uncommon means of suicide. Regional variations are attributable to the presence of particular sites which attract suicidal individuals. The Jacques Cartier Bridge in Montreal is one such site, though less well known than North American sites such as the Golden Gate Bridge or Niagara Falls. ...

During the past decade pharmacological research has greatly enhanced the understanding of several variables affecting the prescription of psychotropic medication. One variable of increasingly recognized importance is the gender of the patient. Significant gender differences have been described for psychiatric disease prevalence, symptom presentation, treatment-seeking behavior, and receipt of psychotropic ...

Fibromyalgia, medical disorders associated with fibromyalgia, and various psychiatric disorders may complicate the assessment of the longterm illnesses caused by the eosinophilia-myalgia syndrome (EMS). The effect of these conditions on the evaluation of outcome in EMS is shown by the use of clinical vignettes derived from a review of medical ...

Overt aggression in its various forms is the most prevalent symptom presenting to pediatric mental health providers, regardless of setting. It is a behavior with a heterogeneous etiology and requires a comprehensive approach to evaluation and treatment. Evaluation of the aggressive child must assess medical, neurologic, psychiatric, psychosocial, familial, and/or ...

This article reviews the current status and emerging trends of outcome data from research studies of psychiatric and psychosocial interventions for mental disorders in patients in the general medical sector. Although data from such studies have had limited success to date in influencing health policy, legislators and administrators are increasingly ...

The effects of prohibiting cigarette smoking on the behavior of patients on a 25-bed psychiatric inpatient unit were assessed immediately after implementation of a smoking ban and two years later. No major behavioral disruptions were observed after the ban. The number of calls for security assistance, physical assaults, instances of ...

The authors examine the relationship between the age of illness onset and the ability to tolerate a medication-free period in a sample of acutely ill schizophrenic patients. Patients were admitted to an inpatient research unit for the treatment of acute and recurrent psychiatric symptoms. Prior medications were discontinued upon admission ...

Diffuse slowing constitutes 40% of all electroencephalogram (EEG) abnormalities in psychiatric patients. Correlations have been demonstrated between the degree of slowing of the EEG and impairment of functions such as awareness, attention, memory, and comprehension. We conducted the current study in order to determine whether diffuse EEG slowing in hospitalized ...

A total of 728 patients admitted to the medical, gynaecological and surgical departments of one urban and one rural general hospital in Austria were investigated for psychiatric morbidity. Using the Clinical Interview Schedule and its case criteria, the prevalence of psychiatric morbidity was found to be highest in medical departments ...

A randomized, controlled, clinical trial (N = 104) was conducted to test the hypothesis that a protocol of collaboration and communication between neurologist and general practitioner, sustained with psychiatric consultation, would reduce medical consumption (especially of diagnostic procedures and medication) in medical outpatients with low back pain. The intervention was ...

The determination of an appropriate level of prospective payment for inpatient medical services requires consideration and documentation of psychiatric problems which impact on resource utilization. A major source of information for reimbursement planning is the list of secondary diagnoses referred to as "complications and comorbidities" (CCs) taken from the medical ...

A case of adrenal carcinoma with severe hypertension referred for treatment of "catatonia" illustrates the need for a high index of suspicion of organic mental disorder in medical patients, even when there is clinical evidence of a psychiatric condition and a history of psychosocial stressors. This case illustrates the need ...

The mind-brain barrier is being challenged by clinicians using both medications and psychotherapy for the major psychiatric disorders. In this article, six categories of study are outlined: (1) diagnosis-specific questions, (2) psychotherapeutic aspects of randomized controlled medication trials, (3) psychotherapeutic aspects of pharmacotherapy, (4) the pharmacotherapist and the nonmedical psychotherapist ...

OBJECTIVE: Several surveys from twenty to thirty years ago demonstrated that approximately 80 percent of patients were readily accepting of psychiatric consultation. The aim of this study was to re-examine whether medical inpatient attitudes toward psychiatric consultation have changed in the past twenty-five years and whether the type of psychiatric ...

Psychosis has been viewed with vastly different attitudes in different contexts. Medical professionals frequently assume that patients should have adequate insight into their abnormal experience. "Lack" of insight has been regarded as a characteristic feature of schizophrenic psychosis. However, these experiences have frequently been construed from a non-medically related perspective ...

Forensic psychologists and forensic psychiatrists (about 80% of whom were certified by a specialty board) were surveyed regarding their beliefs about the necessary and appropriate content for reports on competency to stand trial (CST) (N = 102) and criminal responsibility/not guilty by reason of insanity (CR) (N = 96). Report ...

The effect of systemic disease and medication on the number of post-insertion visits was investigated in 157 patients requiring new complete dentures, who were referred to a specialist prosthodontic practice. We found that the number of recall visits increased with age, particularly in patients medicated for central nervous system or ...

OBJECTIVE: This study examines the effects of two medical contexts on the relationship of hypochondriacal traits and their potential correlates. METHOD: Correlates of hypochondriacal traits were compared from a matched sample of fifty-five general medical inpatients with a sample of fifty-five medical inpatients referred for psychiatric evaluation. Patients completed questionnaires ...

This series of four parts is an attempt to summarise some aspects of medicine during the Third Reich. Its aim is not to provide a systematic review but to remind us of this darkest chapter in the history of medicine and its consequences. The paper summarises the complex evolution of ...

BACKGROUND: The clinical validity of the newly developed 20-item Toronto Alexithymia Scale (TAS-20) with regard to the concept of somatization remains to be further established. This study attempts to determine the relationship between alexithymia and measures of psychopathology and illness severity in patients with somatoform disorders as compared to patients ...

This article argues for a more comprehensive analytical approach in medical anthropology than is currently followed, one that combines attention to structural factors (political, economic, medical/psychiatric), experiential/symbolic expressions and meanings, and biological/bodily features of disorders. We show how subject matter that may be defined as "adolescent psychopathology" would be better ...

A 46-year-old man with laryngeal carcinoma was admitted to the medical service for lethargy. The medical team requested a psychiatric consultation to assist with the patient's depression, substance abuse, and noncompliance. The case is presented and discussed with reference to the issues of depression, disfigurement, dysfunction, and substance abuse in ...

BACKGROUND: Health care in Zimbabwe is provided by both orthodox and traditional care providers. With formal medical services under economic strain it is important to understand the extent of consulting with traditional care providers and their effectiveness. METHODS: A cross-sectional community survey recorded consultations and self-treatment for episodes of illness ...

BACKGROUND: Suicide pacts are rarely discussed in the medical literature. We report here the medical and social aspects of a consecutive series of double or pact suicides. METHOD: Coroners' records were examined for 722 consecutive suicides. Data were extracted from them and from medical and psychiatric records. RESULTS: Nine pacts ...

OBJECTIVE: A patient's medical condition can affect the delivery of dental care. Medical consultation is indicated for dental patients whose medical history is uncertain or when physical assessment may indicate an untreated medical problem. The aims of this study were to evaluate the use of medical consultation and determine how ...

Interest in the development of pediatric medical-psychiatric units continues to grow, driven by clinical, financial, and interdisciplinary considerations. While virtually all of the pediatric medical-psychiatric units reported in the literature to date have arisen in the pediatric setting, there are considerations that may encourage the development of such programs in ...

The study's objective was to contrast the prevalence, phenomenology, and medical care utilization for panic disorder from 1980 to 1990. All psychiatric consultations from a university consultation service from the years 1980, 1985, and 1990 were located (N = 2,400). Patients meeting DSM-III-R panic disorder criteria were selected for chart ...

A retrospective chart review of consultations performed by a clinical pharmacist practicing in an adult psychiatric hospital was conducted. Data during the first 12 months of the service were collected from consultation reports, progress notes, physician's orders, laboratory data, and discharge summaries. Twenty-nine consultations were performed, resulting in a total ...

This paper reports the coocurrence of paranoid psychosis and acute lymphocytic leukemia in a 16-year-old African-American male. Subsequently, he developed a neuroleptic malignant-like syndrome and several other ill-defined complications of antipsychotic therapy, which presented difficult management problems for the medical and psychiatric staff caring for him. Definitive treatment for his ...

Patients who failed to attend psychiatric outpatient follow-up were compared with a group of comprising regular attenders. There were 71 defaulters out of 1,664 appointments given during the study period. Schizophrenia was the most common diagnosis. The defaulters did not differ from the controls in terms of age, sex, ethnicity, ...

The medical community must recognize that support of claims for Incapacity Benefit and related commercial schemes places the patient in a small and special sub-population of clinical practice which may require specialist investigation, treatment, and documentation. Determination of functional capacity and of disability requires knowledge either not available or unfamiliar ...

A combined medical-psychiatric inpatient unit at a general medical center in Brooklyn, New York, provides inpatient psychiatric treatment to members of the Orthodox Jewish sect of the Lubavitcher Hassidim, who are generally reluctant to accept treatment in traditional psychiatric inpatient settings. The unit's biological treatment model, which emphasizes long-term maintenance ...

BACKGROUND: Studies to assess quality of care have become increasingly important for research and policy purposes. OBJECTIVE: To evaluate the difference in quality of care between elderly depressed patients hospitalized in specialty psychiatric units and those hospitalized in general medical wards. METHODS: We reviewed retrospectively the medical charts of 2746 ...

The use of prescribed medication was examined in 34 people with learning disability who underwent a planned resettlement from a hospital into the community. No significant differences were found in the number of subjects receiving antipsychotic, antimuscarinic, antidepressant, and anticonvulsant medication, lithium preparations, and non-psychoactive medication, just prior to discharge ...

A randomized controlled clinical trial was conducted in an outpatient clinic of internal medicine to test the hypothesis that a protocol of cooperation and communication between internist and general practitioner, sustained with psychiatric consultation, would reduce medical consumption in a group of medical outpatients with abdominal pain (N = 106). ...

Few events in medical practice create such a sense of failure and guilt as the suicide of a hospital inpatient. The mortality rate is known to be increased in severe psychiatric illness just as it is in most other medical illnesses. The analogy, however, is not generally accepted. Death in ...

BACKGROUND: When inpatients who are on psychiatry services develop hyponatremia, medical consultation is usually required for evaluation and management, thus halting or delaying psychiatric treatment. Risk factors for the development of hyponatremia in this population have not been studied. METHODS: A case-control study of psychiatric inpatients in a tertiary care ...

Using a case example, the authors contrast two different approaches to psychiatric assessment: the medical approach, in which the physician examines signs and symptoms and compares them with diagnostic criteria for various disorders, and the narrative approach, in which the clinician tries to understand symptoms as a part of a ...

Serotonin is a ubiquitous neurotransmitter with widespread projections that provide for the involvement of serotonin in the regulation of many biological and psychological functions. A variety of serotonin receptor subtypes exist that mediate overlapping psychobiological functions and that are targets for a new generation of medications. Although these new generation ...

In this study, we evaluated whether previous medical experience is associated with more sophisticated conceptions of illness causality among 64 children ages 4 to 16 years old. Although age and prorated IQ were found to be strongly related to children's illness causality concepts, duration of medical condition, total hospitalization days, ...

Alternative cut-point scores for the CAST-6, a shortened version of the Children of Alcoholics Screening Test, are examined in three samples: outpatient substance abusers, outpatient psychiatric patients, and medical students. Hit rates for identification are maximized with a lower cut-point for medical students and a higher cut-point for a sample ...

Psychopharmacologic treatment of depression in medically ill patients is greatly enhanced by the availability of new antidepressant medications that have low or no anticholinergic, anti-alpha-adrenergic, antihistaminic, and quinidine-like properties. This article discusses the important pharmacodynamic and pharmacokinetic properties of the selective serotonin reuptake inhibitors (fluoxetine, paroxetine, and sertraline), bupropion, venlafaxine, ...

Psychiatric problems are common in general medical practice and strongly influence medical utilization. A number of studies have shown the positive effects of psychiatric interventions for both medical inpatients and outpatients. Unfortunately, historic and economic forces have tended to keep the medical and mental health components of care separated. This ...

A 40-year-old female with a lumbar drain was admitted to the neurosurgery service with a bacterial meningitis. During the course of her treatment with multiple central nervous system (CNS) active medications, the patient became disoriented and agitated with visual hallucinations and generalized myoclonus. A psychiatric consultation was requested. The case ...

This paper describes an audit study of general psychiatric outpatient defaulters in Hong Kong. Defaulters were increased among those who were married, unemployed, housewives, seen within one year, receiving medications and previously admitted to hospital. Clinical diagnoses (ICD-10 Axis-1) of the F1, F2, F3 and F7 groups were also associated ...

In this study we assessed the accuracy of the General Health Questionnaire in detecting psychiatric disorders in general medical out-patients. A total of 290 newly referred patients were interviewed with the Present State Examination. Prior to the interview, 112 patients completed the full GHQ-60, 100 completed the GHQ-30 and 78 ...

The objectives of this study were (1) to investigate whether the relationship between functional decisional capacity and the resulting quality of treatment posited by the informed consent theory is found in clinical practice; and (2) to describe the range of decisional impairments found in long-term psychiatric inpatients who comply with ...

Attempts to use Event Related Potentials, particularly the cognitive or P300 evoked potential, as measures of CNS effects of THC use have been infrequent and have produced inconsistent results. We published a pilot study in which psychiatric patient THC users had significantly prolonged auditory P300 latencies and reduced amplitudes as ...

The study focuses on how patients' explanations of their illnesses, their own diagnoses and their expectations are related to their experience of general practice consultations. Before seeing the General Practitioner (GP) on call, 127 Finnish acute health centre patients were interviewed about their interpretation of their symptoms, their explanations for ...