General hospital psychiatry
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Gen Hosp Psychiatry · Jul 2008
Case ReportsLack of pain in schizophrenia: a patient whose arm was burned and amputated.
Diminished pain sensitivity or loss of pain sensation in schizophrenic patients has previously been reported. We report an interesting case of a schizophrenia patient who had the disease for 20 years and who had his forearm amputated below the elbow level due to severe burn injury to his muscles, tendons, nerve fibers and bone tissue, caused by direct exposure to flames from a liquefied petroleum gas cylinder, in an attempt to make himself warm during a medicine-free period with active symptoms and without pain sensation.
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To provide an overview of the role of anxiety disorders in medical illness. ⋯ Emerging data offer a strong argument for the role of anxiety in medical illness and suggest that anxiety disorders rival depression in terms of risk, comorbidity and outcome. Research programs designed to advance our understanding of the impact of anxiety disorders on medical illness are needed to develop evidence-based approaches to improving patient care.
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Gen Hosp Psychiatry · May 2008
Randomized Controlled Trial Multicenter Study Comparative StudyFactors associated with the use of physical restraints for agitated patients in psychiatric emergency rooms.
To examine factors associated with physical restraint in psychiatric emergency rooms. ⋯ Restraint practices in Rio are predictable and based on a limited clinical assessment. Predictive factors for physical restraint may vary worldwide, but should be monitored and studied to assist training, and to establish programs to evaluate and refine this controversial practice.
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Gen Hosp Psychiatry · May 2008
The frequency of the psychiatric symptoms in the patients with dyspepsia at a university hospital.
According to the psychiatric hypothesis, the symptoms of dyspepsia may be due to depression, anxiety or a somatization disorder. We investigated the frequency of psychiatric symptoms in patients undergoing endoscopic procedures with dyspepsia, either with or without pathological findings, and compared this with control subjects without dyspeptic symptoms. ⋯ Regarding the high frequency of psychiatric disorders in patients with dyspeptic symptoms, we think that such patients should be evaluated by two separate departments, gastroenterology and psychiatry.
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Gen Hosp Psychiatry · May 2008
Case ReportsSerotonin syndrome: a complex but easily avoidable condition.
Serotonin syndrome is a potentially life-threatening adverse drug reaction caused by excessive serotonergic agonism in central and peripheral nervous system serotonergic receptors (Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005;352:1112-1120). ⋯ N Engl J Med 2005;352:1112-1120). Due to the increasing availability of agents with serotonergic activity, physicians need to more aware of serotonin syndrome. The following case highlights the complex nature in which serotonin syndrome can arise, as well as the proper recognition and treatment of a potentially life-threatening yet easily avoidable condition.