General hospital psychiatry
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Gen Hosp Psychiatry · Nov 2013
Personality does not distinguish people with fibromyalgia but identifies subgroups of patients.
The objectives were to compare the personality of fibromyalgia (FM) patients with other chronic painful and nonpainful disorders considering the confusion due to psychopathology and to assess the clustering of FM patients according to their personality profile. ⋯ Identifying personality-based subgroups of FM might allow implementing specific preventive strategies. FM treatment might be optimized by increasing medication compliance, improving therapeutic alliance and testing different therapeutic options and treatment sequencing for each personality subgroup.
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Gen Hosp Psychiatry · Nov 2013
Case ReportsAntiseptic phobia in a patient experiencing anesthesia awareness during cleft palate repair surgery: a case report.
Specific phobia is an excessive and irrational fear often triggered by a stressor. Among different types of phobias arising in medical settings, we could not find any case reported for exclusively antiseptic fluids without any medical-surgical intervention. The term "anesthesia awareness" (AA) signifies the specific surgical period of time when an individual, in spite of being under intended general anesthesia, remains aware of the sensory stimuli and the memories of which also remain available for his subsequent explicit recall in the future. ⋯ In spite of an estimated prevalence of 0.1%-0.2% of all the surgeries, our knowledge about this condition is limited. The most commonly reported consequences of AA are acute painful flashbacks of surgical events along with the emotional turmoil and a sense of helplessness followed later by posttraumatic stress disorder. Here, we report a unique case of occurrence of "antiseptic-phobia" in a patient following the experience of anesthesia awareness during cleft palate repair surgery.
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Gen Hosp Psychiatry · Nov 2013
Case ReportsDeterioration in donepezil-induced PR prolongation after a coadministration of memantine in a patient with Alzheimer's disease.
The side effects and interaction of memantine and donepezil hydrochloride when used concomitantly are currently unknown. We encountered a case of a 77-year-old female with Alzheimer's disease in which the concomitant use of memantine exacerbated the prolonged electrocardiogram PR interval which appeared while donepezil hydrochloride was being orally administered. In terms of the cardiac circulation system side effects caused by donepezil hydrochloride and memantine, bradycardia has been reported. However, clinicians should be also aware of PR prolongation associated with the concomitant use of donepezil and memantine.
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We attempted treatment of chronic psychogenic pseudosyncope with serial conscious sedation interviews. ⋯ Conscious sedation interviews may improve symptoms of the psychogenic pseudosyncope, but the improvement may be temporary.
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Gen Hosp Psychiatry · Sep 2013
The development of a population-based automated screening procedure for PTSD in acutely injured hospitalized trauma survivors.
This investigation aimed to advance posttraumatic stress disorder (PTSD) risk prediction among hospitalized injury survivors by developing a population-based automated screening tool derived from data elements available in the electronic medical record (EMR). ⋯ Automated EMR screening can be used to efficiently and accurately triage injury survivors at risk for the development of PTSD. Automated EMR procedures could be combined with stepped care protocols to optimize the sustainable implementation of PTSD screening and intervention at trauma centers nationwide.