Psychosomatics
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Many survivors of severe injuries develop significant psychiatric morbidity, especially trauma-related psychiatric disorders, anxiety, and depressive disorders. ⋯ Severely injured accident victims seem to face a major risk of PTSD and impairments in health-related quality of life. For patients with polytrauma, there is a need for a biopsychosocial conceptual framework at the interface of psychiatry and trauma surgery in general hospitals.
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A recent series of case reports has demonstrated a significant, previously unrecognized drug interaction between serotonin reuptake inhibitors (SRIs) and methylene blue (MB). ⋯ SRIs can interact with MB, causing a serious adverse reaction consistent with serotonin syndrome.
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Because of increasing survival rates among transplant recipients, there is now growing attention on evaluating and enhancing patient quality of life (QOL) during these extended years of survival. ⋯ Given the effects of pain on QOL in transplant patients, increased attention toward more effective clinical assessment and treatment of pain is warranted.
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"Nonmedical" (i.e., illicit) use of opioid analgesics has skyrocketed among the general population during the past decade, with similar increases observed among pain patients who take opioids by prescription. ⋯ Abuse-disorder patients had a similar physical but worse psychiatric/personality presentation than other chronic-pain patients, which suggests the need for increased psychiatric involvement.