Psychosomatics
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Delirium is a common neuropsychiatric disorder in medical and surgical inpatients of all ages. It is associated with increased long-term mortality, longer length of hospital stay, poor functional recovery, and increased likelihood of nursing home placement. ⋯ This study indicates that the Japanese version of the DRS-R-98 has high reliability and validity, and is a useful tool for assessing delirium among Japanese medically ill populations.
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Comment Letter
Methylene blue and serotonin toxicity: definite causal link.
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The authors review the literature related to patients who obtain a Do-Not-Resuscitate (DNR) order in preparation for a suicide attempt. ⋯ The article recommends screening for suicidal ideation before issuing DNR orders, having clear hospital policies regarding the honoring of DNR orders if suicide is attempted, and clarification of state DNR laws regarding suicide.
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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.