General hospital psychiatry
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Gen Hosp Psychiatry · Mar 2011
Randomized Controlled TrialEnhancing the population impact of collaborative care interventions: mixed method development and implementation of stepped care targeting posttraumatic stress disorder and related comorbidities after acute trauma.
The objective of the study was to develop and implement a stepped collaborative care intervention targeting posttraumatic stress disorder (PTSD) and related comorbidities to enhance the population impact of early trauma-focused interventions. ⋯ Stepped care protocols targeting PTSD may enhance the population impact of early interventions developed for survivors of individual and mass trauma by extending the reach of collaborative care interventions to acute care medical settings and other nonspecialty posttraumatic contexts.
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Gen Hosp Psychiatry · Jan 2011
Review Case ReportsA case of delirium, motor disturbances, and autonomic dysfunction due to baclofen and tizanidine withdrawal: a review of the literature.
We report a case of delirium accompanied by extrapyramidal symptoms and autonomic dysfunction in a 59-year-old man following abrupt cessation of baclofen and tizanidine. An extensive search for the etiology was undertaken, but it was only after a careful history was taken that suspicion for baclofen and tizanidine withdrawal was raised. The delirium and motor disturbances resolved within 24 h of reintroduction of baclofen. Withdrawal from muscle relaxants requires a high index of suspicion but should be considered in patients who manifest signs and symptoms of withdrawal from the medications, particularly visual hallucinations, rigidity and autonomic dysfunction.
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Gen Hosp Psychiatry · Jan 2011
Case ReportsDrug-induced leukoencephalopathy presenting as catatonia.
We discuss the case of a 35-year-old woman who presented with thought impoverishment, disorganized behavior, and echolalia. The patient's condition progressed to treatment-refractory catatonia. ⋯ Following improvement, she acknowledged cocaine use that suggested a diagnosis of cocaine-induced leukoencephalopathy (CIL). This case report seeks to elucidate radiological and clinical features of DIL.
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Gen Hosp Psychiatry · Jan 2011
Case ReportsLong-term maintenance lorazepam for catatonia: a case report.
Catatonia is described as a syndrome of motor abnormality associated with the disorder of thought, behavior and emotions. Lorazepam has been shown to be useful in the short-term management of catatonia [Ungvari G. S., Kau L. ⋯ F., Lorazepam treatment of acute and chronic catatonia in two mentally retarded brothers. J Clin Psychiatry 1994;55:20-23] described the use of maintenance lorazepam in a mentally retarded boy with catatonia of 5 years' duration, which improved slowly over a period of 5 months. We present a case of recurrent catatonia, in which symptoms relapsed whenever an attempt was made to taper off lorazepam.
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Gen Hosp Psychiatry · Nov 2010
Randomized Controlled Trial Multicenter Study Comparative StudyAssociation between change in depression and change in weight among women enrolled in weight loss treatment.
To examine the association between improvement in depression and loss of weight among women with depressive symptoms entering a behavioral weight loss program. ⋯ Among women with co-occurring obesity and depression, short-term improvement in depression is associated with weight loss.