The Psychiatric quarterly
-
The Psychiatric quarterly · Mar 2009
Review Case ReportsDelirious mania and malignant catatonia: a report of 3 cases and review.
Delirious mania is often difficult to distinguish from excited catatonia. While some authors consider delirious mania a subtype of catatonia, the distinction between the two entities is important as treatment differs and effects outcome. It appears that as catatonia is described as having non-malignant and malignant states, the same division of severity may also apply to delirious mania. ⋯ The patients are amnestic, may lose control of bowel and bladder, but still respond to atypical antipsychotics and mood stabilizers. However, with increasing progression of the disease course and perhaps with an increasing load of catatonic features, delirious mania may convert to a malignant catatonic state (malignant delirious mania) which is worsened by antipsychotics and requires a trial of benzodiazepines and/or ECT. Three case reports are presented to illustrate the diagnostic conundrum of delirious mania and several different presentations of malignant catatonia.
-
The Psychiatric quarterly · Mar 2009
"Unfortunately, we treat the chart:" sources of stigma in mental health settings.
Stigma within mental health settings may be equally detrimental to people with mental illnesses as societal stigma. ⋯ These data suggest that stigma in mental health settings may be due to structural, systemic pressures on practitioners, with practitioners' emphasis on symptoms and deficits as a secondary factor.