Asystole a few seconds after the electrical stimulation of electroconvulsive therapy
Asystole during electroconvulsive therapy (ECT) occurs occasionally and is potentially harmful. Asystole typically happens immediately after the electrical stimulation due to excessive parasympathetic nervous system activity by direct stimulation of the vagus nerve. A case of a woman with depression and strong suicidal ideation who showed asystole during an ECT seizure is presented. Her 15-sec-long asystole did not occur immediately after the ECT stimulation, but 11sec after the stimulation. Her electrocardiogram suggested that her asystole was due to excessive parasympathetic nervous system activity, similar to common asy...
Source: Psychosomatics - March 26, 2018 Category: Psychiatry & Psychology Authors: Shunsuke Takagi, Yuuya Terasawa, Takashi Takeuchi Source Type: research
Who Should Decide? Residence Capacity Evaluation of a Cognitively-Impaired Older Adult Requesting an “Unsafe” Discharge to Home
Psychiatric consultations are often requeste determine decisional capacity for elderly patients with cognitive impairment who refuse a safe discharge, typically to a skilled nursing facility (SNF).1,2 The presumed benefits of discharge to a SNF include safety, reliable medical care, rehabilitation for those with hospital-related disabilities, and nursing care that includes assistance with activities of daily living. On hospital admission, family members may request discharge to a SNF. In executing this plan, staff may focus narrowly on physical safety instead of considering strategies to help the patient return home. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Naalla Schreiber, Tia Powell, Mary Alice O ’Dowd Tags: Case Report Source Type: research
Prolonged Psychosis Associated with Left Insular Stroke: Talking to God in the Walls
Anatomically, the insula is the part of the cerebral cortex lying within the lateral cerebral fissure; it includes the basal ganglia, external capsule, claustrum, and the capsula extrema. Most of its blood supply comes from the middle cerebral artery and its branches. Functionally, it plays multiple roles, including pain regulation and processing, motor and sensory perceptions, as well as speech, language, and auditory processing (Fig.). (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Nuria Thusius, Magdalena Romanowicz, Karolina Mlynek, Christopher Sola Tags: Case Report Source Type: research
Use of a gabapentin protocol for the management of alcohol withdrawal: a preliminary experience expanding from the consultation/liaison psychiatry service ☆
Benzodiazepines are the conventional mainstay to manage alcohol withdrawal; however, patients are subsequently at increased risk for poor sleep, cravings, and return to drinking. Research on alternative pharmacologic agents to facilitate safe alcohol withdrawal is scant. Gabapentin is one medication shown in small studies to reduce the need for benzodiazepines in the setting of alcohol withdrawal. The continuation of gabapentin after alcohol withdrawal appears to be safe during early sobriety and may aid in reducing alcohol-related cravings or returning to alcohol consumption. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Jonathan G. Leung, Daniela Rakocevic, Nicholas D. Allen, Elliot M. Handler, Bruno A. Perossa, Kristin L. Borreggine, Amy L. Stark, Hannah K. Betcher, Daniel K. Hosker, Blaine A. Minton, Benjamin R. Braus, Ross A. Dierkhising, Kemuel L. Philbrick Source Type: research
Valproic Acid Attenuates Postoperative Psychosis Following Aggressive Resection of a Intracardiac Carcinoid Neuroendocrine Tumor: A Case Report
Identifying and differentiating cases of postoperative psychosis and delirium can be challenging. Possible connections among psychotic symptoms, postoperative complications, and symptoms of neuroendocrine cancers need to be considered. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Noha Abdel Gawad, Andrew Kohner, Taha Ali, Wayne Hofstetter, Alan Valentine Tags: Case Report Source Type: research
Who should decide? Residence capacity evaluation of a cognitively impaired older adult requesting an “unsafe” discharge to home
Psychiatrists are routinely consulted to determine decisional capacity for elderly patients with cognitive impairment who refuse a safe discharge to a nursing facility and want to return home. The medical team pursuing this discharge plan is often narrowly focused on a patient ′s physical safety. Psychiatric consultants should take a holistic view of the discharge options and consider the physical, medical, psychological, social, and emotional risks and benefits of each discharge option. The psychiatrist can then apply the sliding scale of decisional capacity more effec tively. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Naalla Schreiber, Tia Powell, Mary Alice O ′Dowd Source Type: research
The Psychosocial Effects of Perioperative Complications After Bariatric Surgery
Bariatric surgery is an effective weight loss tool that results in sustained weight loss, improvement in obesity-related comorbidities, and positive psychosocial outcomes. However, bariatric procedures also present with risks, as surgical complications are not uncommon. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Karen Ho, Raed Hawa, Susan Wnuk, Allan Okrainec, Timothy Jackson, Sanjeev Sockalingam Tags: Original Research Report Source Type: research
Talking to God in the Walls: Prolonged Psychosis Associated with Left Insular Stroke
We describe a 74-year old Caucasian man with a medical history of ESRD status post renal transplant, admitted for a 4-month history of worsening, abrupt-onset psychosis. Initial treatment with several different antipsychotics was unsuccessful. An extensive medical evaluation including multiple Neurology consultations was unrevealing. Cerebrospinal fluid and paraneoplastic panel were negative. No malignancy was identified. Head MRI revealed an area of T2 hyperintensity in the left insular region. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Nuria Thusius, Magdalena Romanowicz, Karolina Mlynek, Christopher Sola Source Type: research
Clozapine Discontinuation and Malignant Catatonia: A Case Report
Catatonia is a psychomotor syndrome first described by Karl Kahlbaum in 1874. The signs and symptoms of catatonia include mutism, posturing, echophenomena, negativism, waxy flexibility, and automatic obedience.1 Malignant catatonia (MC) is a severe variant of catatonia marked by hyperthermia, autonomic instability and rigidity.2 Neuroleptic malignant syndrome (NMS) is a subtype of MC, with a specific etiology. Causes of MC include psychiatric illness, antipsychotic use, corticosteroid intoxication, and illicit drug use. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Leonid Kapulsky, Miranda G. Greiner, Jessica E. Daniels, Janna S. Gordon-Elliott Tags: Case Report Source Type: research
Considerations in Treating Insomnia During Pregnancy: A Literature Review
The prevalence of pregnancy-associated insomnia is high. Although insomnia may flow from normal physiologic features of pregnancy, it may also be an early warning sign of a relapse, or a trigger for a relapse, of a psychiatric illness. Those at risk for psychiatric illnesses may require medications as well as behavioral and psychotherapeutic interventions, to prevent relapse in the perinatal period. Unfortunately, few reviews of psychotropics used to treat pregnancy-related sleep disorders exist. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Simriti K. Chaudhry, Leah C. Susser Tags: Review Article Source Type: research
Valproic Acid Attenuates Postoperative Psychosis Following Aggressive Resection of a Intracardiac Carcinoid Neuroendocrine Tumor: A Case Report
Identifying and differentiating cases of postoperative psychosis and delirium can be challenging. Possible connections among psychotic symptoms, postoperative complications, and symptoms of neuroendocrine cancers need to be considered. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Noha Abdel Gawad, Andrew Kohner, Taha Ali, Wayne Hofstetter, Alan Valentine Tags: Case Report Source Type: research
The Psychosocial Effects of Perioperative Complications After Bariatric Surgery
Bariatric surgery is an effective weight loss tool that results in sustained weight loss, improvement in obesity-related comorbidities, and positive psychosocial outcomes. However, bariatric procedures also present with risks, as surgical complications are not uncommon. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Karen Ho, Raed Hawa, Susan Wnuk, Allan Okrainec, Timothy Jackson, Sanjeev Sockalingam Tags: Original Research Report Source Type: research
Use of a gabapentin protocol for the management of alcohol withdrawal: a preliminary experience expanding from the consultation/liaison psychiatry service ☆
Benzodiazepines are the conventional mainstay to manage alcohol withdrawal; however, patients are subsequently at increased risk for poor sleep, cravings, and return to drinking. Research on alternative pharmacologic agents to facilitate safe alcohol withdrawal is scant. Gabapentin is one medication shown in small studies to reduce the need for benzodiazepines in the setting of alcohol withdrawal. The continuation of gabapentin after alcohol withdrawal appears to be safe during early sobriety and may aid in reducing alcohol-related cravings or returning to alcohol consumption. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Jonathan G. Leung, Daniela Rakocevic, Nicholas D. Allen, Elliot M. Handler, Bruno A. Perossa, Kristin L. Borreggine, Amy L. Stark, Hannah K. Betcher, Daniel K. Hosker, Blaine A. Minton, Benjamin R. Braus, Ross A. Dierkhising, Kemuel L. Philbrick Source Type: research
Valproic acid attenuates acute post-operative psychosis following aggressive resection of intracardiac carcinoid neuroendocrine tumor: A case report
We report the case of a 64-year-old female patient with no known past psychiatric history who developed an acute episode of psychosis following aggressive surgical resection of an intracardiac neuroendocrine carcinoid cancer. IV valproic acid (VPA) resulted in rapid attenuation of her psychotic symptoms over the course of 48hours. (Source: Psychosomatics)
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Noha Abdel Gawad, Andrew Kohner, Taha Ali, Wayne Hofstetter, Alan Valentine Source Type: research
