International journal of psychiatry in medicine
-
Int J Psychiatry Med · Jan 2003
Case ReportsAmmonia induced encephalopathy from valproic acid in a bipolar patient: case report.
Valproic acid is widely used as a mood stabilizer. We report a case of an adult with bipolar disorder taking therapeutic doses of valproic acid, who presented to the emergency department with coma related to hyperammonemia as a complication of valproic acid treatment. ⋯ Clinicians should consider hyperammonemia in all patients who present with coma and other mental status changes while on valproic acid. In such patients, ammonia level should be obtained in addition to liver function tests.
-
Int J Psychiatry Med · Jan 2003
Case ReportsRisperidone in the treatment of acute confusional state (delirium) due to neuropsychiatric lupus erythematosus: case report.
Acute confusional state (delirium) appears as one of the common neuropsychiatric manifestations of systemic lupus erythematosus (SLE). It has been suggested that neuropsychiatric SLE (NP-SLE) could promote the occurrence of drug-induced extrapyramidal symptoms (EPS). ⋯ However, no reports of the use of atypical antipsychotics in delirium due to NP-SLE have been published. Here we report a case of NP-SLE presenting an acute confusional state (delirium), which was successfully managed by risperidone.
-
Int J Psychiatry Med · Jan 2002
National prescribing patterns in the management of extrapyramidal symptoms among patients with schizophrenia.
Antipsychotics, particularly typical agents, have been shown to cause extrapyramidal symptoms (EPS). We hypothesized a negative association between concomitant (at same visit) prescriptions for atypical antipsychotics and prescriptions for medications to manage EPS. ⋯ As expected, we observed the hypothesized joint prescribing pattern. The results ofthis study suggest that atypical antipsychotic prescriptions strongly predict fewer prescriptions for EPS treatment, and, by implication, reduced need for EPS treatment in actual ambulatory care practices throughout the nation.
-
Int J Psychiatry Med · Jan 2002
ReviewCrossing the secular divide: government and faith-based organizations as partners in health.
Recent debate over the relationship between government and faith-based organizations has renewed interest in the opportunities and challenges that are associated with change in this area of health care policy. Experience exists already that faith-based organizations can provide effective health education and services in the community. Limited infrastructure and liability are among the important barriers to their expansion. Spurred by the demographics of an aging population and increasing health care costs, we argue the necessity of further partnering, within well-defined limits, to maximize the availability of health care education and services throughout this nation.
-
Int J Psychiatry Med · Jan 2002
Case ReportsFalse allegations of child physical abuse: a case of Münchausen by proxy-like syndrome?
The diagnosis of factitious disorder by proxy is still under investigation. Few studies have researched the psychological status and potential underlying psychopathology of the perpetrator, as well as the impact on the child's development and the pathological reactions of rearing a child within the context of a distorted reality. In this article, we present the case of a 12-year-old boy where this diagnosis was suspected. ⋯ The parents presented with shared psychosis and the child presented with conduct disorder, factitious disorder, and emotional problems. We suggest that this case represents a Münchausen by proxy-like syndrome involving both the legal and medical systems. Hypotheses regarding the pathogenesis of symptoms in the child are noted, underscoring the differences between Münchausen by proxy syndrome appearing in infancy with that appearing in older children.