Home About us Contact
|
Home About us Contact | ||
|
|
||
Psychiatrists
Kinds of Psychiatrists Selected AbstractsCOMMENTARY BY A PSYCHIATRIST, SEXUAL AND COUPLE THERAPISTBRITISH JOURNAL OF PSYCHOTHERAPY, Issue 3 2000Michael Crowe No abstract is available for this article. [source] Jesus the Village Psychiatrist , By Donald CappsRELIGIOUS STUDIES REVIEW, Issue 3 2008Robert M. Price No abstract is available for this article. [source] Are psychiatrists affecting the legal process by answering legal questions?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2008Timothy Hardie Background,Psychiatrists are often asked to answer legal questions. The extent to which they answer strictly legal rather than medical matters is not known. Aim,To investigate how strongly psychiatrists in England and Wales express opinions on one legal question , that of diminished responsibility in respect of a murder charge, and how this is related to outcome in court. Method,Our data were extracted from psychiatric reports and case files supplied by the then Department of Constitutional Affairs (now the Ministry of Justice) on cases heard in the Crown Courts between 1 January 1997 and 31 December 2001 in which the defence of diminished responsibility had been raised. The cases had been selected by the Law Commission in their earlier review of partial defences to murder. We devised a reliable system of rating the presence/absence and strength of expression of a legal opinion in the medical reports. We tested the data for relationship between nature and strength of opinion and progression to trial and verdict. Results,Psychiatric reports were available on 143 of 156 cases in which diminished responsibility was considered. They yielded 338 opinions on at least one aspect of diminished responsibility. In 110 (93%) of the 118 cases in which there was a diminished verdict, this was made without trial and, therefore, without reference to a jury. In only eight (27%) out of the 30 cases that went to trial, was a diminished responsibility verdict made. Half of the reports (169) gave a clear opinion on diminished responsibility, a third (121) invited the court to draw a particular conclusion and only 11% (36) provided relevant evidence without answering the legal questions. When there was an opinion or an invitation to make a finding on the legal question, a trial was less likely. A trial was also less likely if reports agreed on what the verdict should be. Conclusions,Psychiatrists frequently answer the legal question of diminished responsibility. The judiciary and medical experts should join in research to examine the consequences of different styles or approaches in presentation of essentially similar evidence in court. Copyright © 2008 John Wiley & Sons, Ltd. [source] Bridging Psychiatric and Anthropological Approaches: The Case of "Nerves" in the United StatesETHOS, Issue 3 2009Britt Dahlberg Psychiatrists and anthropologists have taken distinct analytic approaches when confronted with differences between emic and etic models for distress: psychiatrists have translated folk models into diagnostic categories whereas anthropologists have emphasized culture-specific meanings of illness. The rift between psychiatric and anthropological research keeps "individual disease" and "culture" disconnected and thus hinders the study of interrelationships between mental health and culture. In this article we bridge psychiatric and anthropological approaches by using cultural models to explore the experience of nerves among 27 older primary care patients from Baltimore, Maryland. We suggest that cultural models of distress arise in response to personal experiences, and in turn, shape those experiences. Shifting research from a focus on comparing content of emic and etic concepts, to examining how these social realities and concepts are coconstructed, may resolve epistemological and ontological debates surrounding differences between emic and etic concepts, and improve understanding of the interrelationships between culture and health. ["nerves," cultural models, metaphor, psychiatry, embodiment] [source] Joint Symposium of the Society for the Study of Addiction and the Faculty of Substance Misuse of the Royal College of PsychiatristsADDICTION BIOLOGY, Issue 2 2003Article first published online: 9 JUN 200 First page of article [source] Political therapy: an encounter with Dr John Alderdice, psychotherapist, political leader and peer of the realmINTERNATIONAL JOURNAL OF APPLIED PSYCHOANALYTIC STUDIES, Issue 2 2009Graham Little Abstract This paper comprises an encounter by the author in 1992 with the distinguished Northern Ireland psychotherapist and political leader, The Lord Alderdice of Knock. Born in Northern Ireland in 1955, John Alderdice graduated in Medicine in 1978, and qualified as a member of the Royal College of Psychiatrists in 1983, followed by higher specialist training in Psychoanalytic Psychotherapy. Alderdice joined the Northern Ireland Alliance Party in 1978, and in 1987 was elected Party Leader. Raised to the peerage as Baron Alderdice in 1996, he was one of the key negotiators of the Good Friday Agreement signed in 1998. This 1997 paper includes the author's interview with Alderdice, together with his observations on Alderdice's two-handed psychoanalytic and political practice, his "political therapy". Drawing upon the author's roots as a Belfast-born Australian, the paper reflects on the possibilities of Alderdice's applied psychoanalysis , of politics "off the couch". Copyright © 2009 John Wiley & Sons, Ltd. [source] Burnout and stress amongst old age psychiatristsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2002Susan M. Benbow Abstract Objective To investigate the relationship between work patterns, burnout and stress in consultant old age psychiatrists. Methods We sent a postal survey to all old age psychiatrists on the Faculty of Old Age Psychiatry, Royal College of Psychiatrists, list. Participants completed a workload questionnaire, the Stress Checklist and the Maslach Burnout Inventory during a specified week. Results Burnout scores were unaffected by gender and team working, but old age psychiatrists scoring within the high burnout range were younger, scored highly on stress, spent less time on research, study and audit, and more time travelling. The whole group scored highly on emotional exhaustion. Conclusions Job plans should encourage research/study and audit, and cut down travelling. The finding related to age is not fully understood, but suggests consideration of support groups for new consultants and review of whether current training programmes adequately prepare people for work as a consultant. Copyright © 2002 John Wiley & Sons, Ltd. [source] National survey to assess current practices in the diagnosis and management of young people with dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2002Rebecca Cordery Abstract Background The Royal College of Psychiatrists has recommended that old age psychiatrists may be best placed to take responsibility for service provision for younger people with dementia. There are concerns however, that if referral between specialists, particularly neurologists and old age psychiatrists, is incomplete, patients may be under investigated or inappropriately followed up. Objectives We have assessed the current level of referral between these specialists, how each investigates their patients and details of follow up care. Method We conducted a postal survey of all consultant neurologists and consultant old age psychiatrists in the UK with an overall response rate of 64%. Results and Conclusions The ideal of full collaboration between old age psychiatrists and neurologists is not achieved. Young patients may be under investigated if managed solely by an old age psychiatrist and may not receive adequate follow up services if managed solely by a neurologist. Copyright © 2002 John Wiley & Sons, Ltd. [source] Assessment and diagnosis of depression in people with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 1 2003J. A. McBrien Abstract Background Despite widespread acceptance that depression can occur in adults with intellectual disability (ID), the difficulties encountered in its assessment and diagnosis have hampered the individual clinician, and meant that questions of prevalence, treatment choice and outcome remain problematic. Method The present paper reviews the progress in this field since three reviews, all published in the mid-1990s, recommended further attention to three interlinked issues: diagnostic criteria, the symptoms of depression in this group and the lack of rating scales. Results Despite a further 11 published papers and other studies in progress, the method of diagnosis for people with severe and profound ID remains debatable, with some authors advocating adherence to standard criteria, others suggesting adding criteria to the standard ones and yet others believing that substitute criteria are called for. However, for those with mild to moderate ID, a consensus is emerging that standard diagnostic criteria are appropriate. There has been progress in examining some of the symptoms which might constitute depression in people with ID. New diagnostic criteria issued by the Royal College of Psychiatrists are to be welcomed. There is an assumption in much of the research that symptoms of behaviour commonly termed challenging or maladaptive must be atypical symptoms of depression, but none of the studies reviewed demonstrate this effectively. This is compounded by methodological flaws in the way that depressed samples are arrived at for further study. Although new rating scales have emerged, there is as yet no gold standard diagnostic tool for depression amongst people with ID. Conclusions It is suggested that, given these difficulties, the validity of the conceptual frameworks for depression is still in doubt. It remains the case that large-scale, collaborative, prospective studies are called for. [source] Physical examinations of mental health service usersPROGRESS IN NEUROLOGY AND PSYCHIATRY, Issue 4 2010Andrew Peter Vanezis BSc, MBChB The Royal College of Psychiatrists recommends that every psychiatric inpatient should have a thorough physical examination within 24 hours of admission. Here, the authors present their cross-sectional audit to assess the timing and quality of physical examinations within an inner London inpatient mental health unit. Copyright © 2010 Wiley Interface Ltd [source] The reality of bipolar disorder: views on management and impactPROGRESS IN NEUROLOGY AND PSYCHIATRY, Issue 5 2008Mark Greener Psychiatrists were encouraged to share their clinical experience of managing bipolar disorder in a satellite meeting held during the Latest Advances in Psychiatry SymposiumVII,in London,in April.Mark. Copyright © 2008 Wiley Interface Ltd [source] Audit of ophthalmological examination in psychiatryPROGRESS IN NEUROLOGY AND PSYCHIATRY, Issue 2 2007MRCPsych, Muthukumar Kannabiran DPM Psychiatrists revealed in a survey that they feel that ophthalmological examination is important for patient care. Further audit of their practice showed that training improved the percentage of patients given such examinations. The authors discuss the implications of these findings for the training of psychiatrists. Copyright © 2007 Wiley Interface Ltd [source] Adolescent Substance Use Disorders and Psychiatrists: Competent Assessment and Treatment?THE AMERICAN JOURNAL ON ADDICTIONS, Issue 3 2008Christopher R. Thompson MD No abstract is available for this article. [source] What General Psychiatrists Ask Addiction Psychiatrists: A Review of 381 Substance Abuse Consultations in a Psychiatric HospitalTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2003Shelly F. Greenfield M.D. We reviewed the records of 381 consecutive substance abuse consultations completed by the Substance Abuse Consultation Service (SACS) of McLean Hospital to ascertain 1) the most frequent reasons why general psychiatrists consulted the SACS, and 2) the clinical characteristics of these patients. The most frequent reasons for consultation were to make aftercare recommendations (66.1%) or to make (19.7%) or clarify (6.3%) a substance use disorder (SUD) diagnosis. Mood disorders were the most prevalent co-occurring psychiatric disorder; alcohol use disorders were the most prevalent SUDs. The findings indicate the potential utility of a substance abuse consultation service in a psychiatric hospital. [source] The Association Between Rural Residence and the Use, Type, and Quality of Depression CareTHE JOURNAL OF RURAL HEALTH, Issue 3 2010John C. Fortney PhD Abstract Objective: To assess the association between rurality and depression care. Methods: Data were extracted for 10,319 individuals with self-reported depression in the Medical Expenditure Panel Survey. Pharmacotherapy was defined as an antidepressant prescription fill, and minimally adequate pharmacotherapy was defined as receipt of at least 4 antidepressant fills. Psychotherapy was defined as an outpatient counseling visit, and minimally adequate psychotherapy was defined as , 8 visits. Rurality was defined using Metropolitan Statistical Areas (MSAs) and Rural Urban Continuum Codes (RUCCs). Results: Over the year, 65.1% received depression treatment, including 58.8% with at least 1 antidepressant prescription fill and 24.5% with at least 1 psychotherapy visit. Among those in treatment, 56.2% had minimally adequate pharmacotherapy treatment and 36.3% had minimally adequate psychotherapy treatment. Overall, there were no significant rural-urban differences in receipt of any type of formal depression treatment. However, rural residence was associated with significantly higher odds of receiving pharmacotherapy (MSA: OR 1.16 [95% CI, 1.01-1.34; P= .04] and RUCC: OR 1.04 [95% CI, 1.00-1.08; P= .05]), and significantly lower odds of receiving psychotherapy (MSA: OR 0.62 [95% CI, 0.53-0.74; P < .01] and RUCC: OR 0.91 [95% CI, 0.88-0.94; P < .001]). Rural residence was not significantly associated with the adequacy of pharmacotherapy, but it was significantly associated with the adequacy of psychotherapy (MSA: OR 0.53 [95% CI, 0.41-0.69; P < .01] and RUCC: OR 0.92 [95% CI, 0.86-0.99; P= .02]). Psychiatrists per capita were a mediator in the psychotherapy analyses. Conclusions: Rural individuals are more reliant on pharmacotherapy than psychotherapy. This may be a concern if individuals in rural areas turn to pharmacotherapy because psychotherapists are unavailable rather than because they have a preference for pharmacotherapy. [source] Itinerant Surgical and Medical Specialist Care in Kansas: Report of a Survey of Rural Hospital AdministratorsTHE JOURNAL OF RURAL HEALTH, Issue 2 2001Rick Kellerman M.D ABSTRACT In most rural areas, specialist nonprimary care, when available, is provided by "itinerant" physicians and surgeons who periodically visit from a distant home base. Little is known about current usage and acceptability of itinerant specialists in rural communities. Administrators of hospitals in rural and frontier Kansas counties were asked to report the frequency of itinerant care in their facilities, the home base of each specialist and a listing of procedures performed during specialist visits. Administrators were also asked to respond on a Likert scale to six questions inviting their assessment of itinerant care. Responses were received from 53 of 56 hospitals. All offered at least one monthly session of itinerant medical or surgical care. The most common specialties represented were cardiology (in 87 percent of hospitals), urology (68 percent), orthopedics (68 percent) and radiology (60 percent). General surgeons consulted in over 80 percent of responding hospitals. Psychiatrists, dermatologists and neurologists were rarely available in the hospitals surveyed. Administrators generally rated itinerant care highly, though some expressed concern about revenue lost when specialists performed procedures in their home-base office or hospital. No associations were found between amount of care offered and potential explanatory variables such as hospital size, distance from subregional centers, or percentage of patients hospitalized locally. Furttier study is needed to better understand differences in itinerant specialist utilization and acceptance among rural Kansas hospitals. Because Kansas demographics are similar to those of many other American rural areas, such study may offer insights applicable to other regions. [source] Screening of antenatal depression in Pakistan: risk factors and effects on obstetric and neonatal outcomesASIA-PACIFIC PSYCHIATRY, Issue 1 2010Nazish Imran MBBS MRCPsych Abstract Introduction: To determine the frequency of probable antenatal depression (AD) in pregnant women in third trimester, assess the risk factors and its impact on obstetric and neonatal outcomes in a developing country. Methods: A prospective study conducted in a tertiary care hospital in Lahore from March 2007 to July 2007. Two hundred and thirteen pregnant women in the third trimester, attending the Gynecology Outpatient Clinic were recruited. They were assessed by a semistructured questionnaire to gather demographic details and various risk factors for AD. AD was assessed by Edinburgh Postnatal Depression Scale. All women were followed until delivery to determine their obstetric and neonatal outcomes. Results: Out of 213 women, 91 (42.7%) scored above the cut-off for AD. More women with depression reported problems in their marriage, problems with parents/in laws, history of domestic violence, past history of psychiatric problems and history of postnatal depression. In the obstetric risk factors history of previous miscarriages, stillbirths, and complications in previous pregnancy reached statistical significance. Thirty-seven (17.3%) women were lost to follow up. Women with AD had more obstetric complications during delivery. Babies of mothers with AD had significantly low birth weight, as well as low mean APGAR scores at 1 and 5 minutes following birth. Discussion: AD is a common problem in Pakistani Society. In view of the risk factors and adverse outcomes associated with depression during pregnancy, there is need for close liaison between Gynaecologists and Psychiatrists in managing these patients. [source] How Thailand has modified the section on mental disorders in the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10),ASIA-PACIFIC PSYCHIATRY, Issue 2 2009Pichet Udomratn MD Abstract Introduction: In 2000, the Thai Ministry of Public Health appointed a taskforce to revise the International Statistical Classification of Diseases and Relate Health Problems 10th Revision (ICD-10) to make it more suitable for use in Thailand: the ICD-10 Thai Modification (ICD-10 TM). Methods: The Royal College of Psychiatrists of Thailand appointed psychiatrists from various hospitals to form a working group on this matter. The ICD-10 Australian Modification was used as an example and the ICD-10 Diagnostic Criteria for Research was used as a reference book. Results: The fourth and fifth characters added are the major modifications of the ICD-10 TM for the typing of an emotionally unstable personality disorder and treatment-resistant schizophrenia. However, we could not add any specific codes for patients dependent on amphetamine-type stimulant drugs. Discussion: The ICD-10 TM has now been widely used throughout the country since 2003, with informal feedback suggesting that it is useful. Further research needs to be conducted into its impact on clinical care in Thailand. [source] Leadership Program for Young Psychiatrists: an experience of a lifetimeASIA-PACIFIC PSYCHIATRY, Issue 1 2009Ashutosh Chauhan MD [source] Child sexual abuse in the etiology of depression: A systematic review of reviewsDEPRESSION AND ANXIETY, Issue 7 2010Roberto Maniglio Psy.D. Ph.D. Abstract Background: Despite a large amount of research, there is considerable controversy about the role that child sexual abuse plays in the etiology of depression. To prevent interpretative difficulties, mistaken beliefs, or confusion among professionals who turn to this literature for guidance, this article addresses the best available scientific evidence on the topic, by providing a systematic review of the several reviews that have investigated the literature on the issue. Methods: Seven databases were searched, supplemented with hand search of reference lists from retrieved papers. The author and a psychiatrist independently evaluated the eligibility of all studies identified, abstracted data, and assessed study quality. Disagreements were resolved by consensus. Results: Four reviews, including about 60,000 subjects from 160 studies and having no limitations that could invalidate their results, were analyzed. There is evidence that child sexual abuse is a significant, although general and nonspecific, risk factor for depression. The relationship ranges from small-to-medium in magnitude and is moderated by sample source. Additional variables may either act independently to promote depression in people with a history of sexual abuse or interact with such traumatic experience to increase the likelihood of depression in child abuse survivors. Conclusions: For all victims of abuse, programs should focus not only on treating symptoms, but also on reducing additional risk factors. Depressed adults who seek psychiatric treatment should be enquired about early abuse within admission procedures. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Should a psychiatrist give the ,special patient' VIP treatment?ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009Acta Psychiatrica Scandinavica No abstract is available for this article. [source] Joint liaison psychiatry,diabetes clinic: a new specialist serviceDIABETIC MEDICINE, Issue 6 2000C. Mitchell Summary Aims Specialist diabetes clinics have an established role in prevention and management of complications. As psychological problems are usually treated separately from diabetes centres, the role of a specialist psychiatrist within a teaching hospital was assessed. The aims of the study were to describe referral patterns, specific psychiatric conditions and treatments offered. Results During weekly outpatient sessions over a 12-month period, 31 patients were referred with a wide range of psychiatric diagnoses. One-third of patients were seen on the day and two-thirds within 2 weeks of referral. Treatments included anti-depressant medication, counselling and cognitive behaviour therapy. Successful discharge was obtained in 10 subjects and eight were undergoing continued treatment. Conclusions The range of specific diagnoses requiring psychiatric supervision supported the role of specifically trained personnel as seen in a joint liaison psychiatry,diabetes service. Keywords diabetes mellitus, joint clinic, liaison psychiatry [source] Lithium monitoring before and after the distribution of clinical practice guidelinesACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2000John M. Eagles Objective: To determine whether distribution of clinical practice guidelines improves lithium monitoring and whether standards of monitoring differed between patients in psychiatric contact and those seen only in primary care. Method: Standards of monitoring were assessed for patients on lithium in northeast Scotland throughout 1995 and/or throughout 1996. Guidelines were circulated in January 1996 to all local general practitioners and psychiatrists. Monitoring was compared between 1995 and 1996 and for patients with and without psychiatric contact. Results: Both primary care and psychiatric records were scrutinized for 422 and 403 patients prescribed lithium throughout 1995 and 1996, respectively. While monitoring was poor on several parameters during both years, frequency of measurement of both thyroid and renal function improved in 1996. Standards of monitoring were better for patients in psychiatric care. Conclusion: Standards of lithium monitoring require further improvement. Locally agreed practice guidelines are helpful but patients on lithium should be in continuing contact with an experienced psychiatrist. [source] Forensic psychiatry, ethics and protective sentencing: what are the limits of psychiatric participation in the criminal justice process?ACTA PSYCHIATRICA SCANDINAVICA, Issue 399 2000S. N. Verdun-Jones As clinicians, psychiatrists are unequivocally dedicated to relieving the suffering of those who are afflicted with mental disorders. However, the public and those individuals, who are assessed, find it difficult to draw a distinction between forensic psychiatrists acting in a clinical role and the very same professionals acting in an evaluative role, on behalf of the state. This paper examines the ethical issues raised by psychiatric involvement in the sentencing process. It rejects the view that a forensic psychiatrist, who undertakes an evaluation for the state, is to be considered as an advocate of justice who is not bound by conventional ethical duties to the individual whom he or she assesses. It contends that the forensic psychiatrist has an important role to play in presenting evidence that may result in the mitigation of the sentence that may be imposed on a person who is mentally disordered. The paper will focus on these issues in the particular context of the situation in England and Wales, Canada and the United States. [source] Proposed diagnostic criteria for internet addictionADDICTION, Issue 3 2010Ran Tao ABSTRACT Objective The objective of this study was to develop diagnostic criteria for internet addiction disorder (IAD) and to evaluate the validity of our proposed diagnostic criteria for discriminating non-dependent from dependent internet use in the general population. Methods This study was conducted in three stages: the developmental stage (110 subjects in the survey group; 408 subjects in the training group), where items of the proposed diagnostic criteria were developed and tested; the validation stage (n = 405), where the proposed criteria were evaluated for criterion-related validity; and the clinical stage (n = 150), where the criteria and the global clinical impression of IAD were evaluated by more than one psychiatrist to determine inter-rater reliability. Results The proposed internet addiction diagnostic criteria consisted of symptom criterion (seven clinical symptoms of IAD), clinically significant impairment criterion (functional and psychosocial impairments), course criterion (duration of addiction lasting at least 3 months, with at least 6 hours of non-essential internet usage per day) and exclusion criterion (exclusion of dependency attributed to psychotic disorders). A diagnostic score of 2 + 1, where the first two symptoms (preoccupation and withdrawal symptoms) and at least one of the five other symptoms (tolerance, lack of control, continued excessive use despite knowledge of negative effects/affects, loss of interests excluding internet, and use of the internet to escape or relieve a dysphoric mood) was established. Inter-rater reliability was 98%. Conclusion Our findings suggest that the proposed diagnostic criteria may be useful for the standardization of diagnostic criteria for IAD. [source] Conversation with Les DrewADDICTION, Issue 11 2001Article first published online: 15 SEP 200 In this occasional series we record the views and personal experiences of people who have specially contributed to the evolution of ideas in the Journal's field of interest. Dr Drew is an Australian psychiatrist who has made substantial contributions to drug and alcohol policy development in his country . [source] The psychiatrist confronted with a fibromyalgia patientHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue S1 2009Siegfried Kasper Abstract Fibromyalgia is usually treated by rheumatologists but since co-morbid depression and anxiety are frequent, psychiatrists are likely to be confronted with patients suffering from the syndrome. The symptoms associated with fibromyalgia vary from patient to patient but there is one common symptom,they ache all over. In addition to pain, patients report headaches, poor sleep, fatigue, depressed mood and irregular bowel habits, which are also all symptoms of depression. For a formal diagnosis of fibromyalgia, the American College of Rheumatology (ACR) criteria require the patient to have widespread pain for at least 3 months together with tenderness at 11 or more of 18 specific tender points. Treatment of fibromyalgia requires a comprehensive approach involving education, aerobic exercise and cognitive behavioural therapy in addition to pharmacotherapy. The most effective drugs available for the treatment for fibromyalgia, the serotonin noradrenaline reuptake inhibitors, milnacipran and duloxetine and the anti-epileptic, pregabalin, are well known to psychiatrists. Thus the psychiatrist is well placed to initiate treatment in these patients. Copyright © 2009 John Wiley & Sons, Ltd. [source] Monosymptomatic hypochondriacal psychosis presenting with recurrent oral mucosal ulcers and multiple skin lesions responding to olanzapine treatmentINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2006Ulviye Atilgano, lu MD Monosymptomatic hypochondriacal psychosis (MHP) is a form of psychosis characterized by the delusional idea that there is a serious problem in the skin or other body parts. Because MHP patients believe that their complaint is dermatological, not psychiatric, they often admit to several other medical disciplines before coming to a psychiatry clinic. This leads to a series of time-consuming examinations and treatment interventions. In this case report, we emphasize the importance of diagnosing the illness correctly and referring the patient to a psychiatrist. The patient presented in this report has been treated with a new generation neuroleptic, olanzapine. This treatment has led to complete resolution of delusional symptoms. Therefore, we conclude that knowing that MHP is a psychiatric illness allows early establishment of diagnosis and successful treatment. [source] Hippocampal volume and antidepressant response in geriatric depressionINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2002Ming-Hong Hsieh Abstract Background Biological markers of treatment response may include structural brain changes seen on neuroimaging. While most imaging studies have focused on cerebrovascular disease, evidence is growing that the hippocampus may play a role in depression, particularly geriatric depression. Method We studied 60 depressed elderly patients enrolled in a longitudinal study who were treated with antidepressant medications using a treatment guideline-based approach. Baseline and 12-week Montgomery-Asberg Depression Rating Scale (MADRS) scores were obtained via interview with a geriatric psychiatrist. All subjects had a baseline magnetic resonance imaging (MRI) brain scan. MRI scans were processed using standard protocols to determine total cerebral volume and right and left hippocampal volumes. Hippocampal volumes were standardized for total cerebral volume. MADRS scores less than 10 were used to define remission. Results When the group with the lowest quartile of standardized hippocampal volumes was compared to those above the first quartile, those with small right and total hippocampal volumes were less likely to achieve remission. In a subsequent logistic regression model controlling for age small standardized right hippocampal volumes remained significantly associated with remission. Conclusion Further studies with larger sample are needed to determine if left-right hippocampal volume differences do exist in depression, and basic neuroscience studies will need to elucidate the role of the hippocampus in geriatric depression. Copyright © 2002 John Wiley & Sons, Ltd. [source] National survey to assess current practices in the diagnosis and management of young people with dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2002Rebecca Cordery Abstract Background The Royal College of Psychiatrists has recommended that old age psychiatrists may be best placed to take responsibility for service provision for younger people with dementia. There are concerns however, that if referral between specialists, particularly neurologists and old age psychiatrists, is incomplete, patients may be under investigated or inappropriately followed up. Objectives We have assessed the current level of referral between these specialists, how each investigates their patients and details of follow up care. Method We conducted a postal survey of all consultant neurologists and consultant old age psychiatrists in the UK with an overall response rate of 64%. Results and Conclusions The ideal of full collaboration between old age psychiatrists and neurologists is not achieved. Young patients may be under investigated if managed solely by an old age psychiatrist and may not receive adequate follow up services if managed solely by a neurologist. Copyright © 2002 John Wiley & Sons, Ltd. [source] | |||||||||||||||||||||||||||||||||||||