scholarly journals An Unusual Presentation of Catatonia-Like Behavior: Differentiating Malingering from Catatonia

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Andy Y. Wang ◽  
Urrooj H. Rehman
Keyword(s):  
Social Services ◽  
Psychiatric Hospital ◽  
Current Literature ◽  
Medical Management ◽  
Unusual Presentation ◽  
Medical Interventions ◽  
Psychiatric Illnesses ◽  
Patient Goals ◽  
Volitional Behavior ◽  
External Incentives

Malingering involves the intentional production of physical or psychological behaviors due to motivation from external incentives, posing unique challenges to healthcare. Although malingering as an entity has been well studied, the current literature does not explore the intentional production of catatonia-like behavior or how to differentiate malingering from catatonia. Here, we describe a 45-year-old female who was admitted to an acute psychiatric hospital with a complex presentation of catatonia-like signs that was ultimately thought to be volitional behavior, resulting in a diagnosis of malingering. We highlight the important factors considered in her presentation, the differences between her behaviors and true catatonia, and other important differential diagnoses to consider. Although a diagnosis of malingering is difficult to make, we underscore the importance of reaching this conclusion in order to avoid unnecessary and potentially harmful medical interventions. We stress the importance of shifting focus from medical management to more appropriate patient goals such as providing social services and treatment of other underlying psychiatric illnesses.

scholarly journals An unusual presentation of colon perforation following percutaneous nephrolithotomy

2014 ◽  
Vol 8 (11-12) ◽  
pp. 862 ◽  
Author(s):  
Barbara Chubak ◽  
Joshua M Stern
Keyword(s):  
Sore Throat ◽  
Percutaneous Nephrolithotomy ◽  
Current Literature ◽  
Signs And Symptoms ◽  
Bowel Injury ◽  
Unusual Presentation ◽  
Diagnosis And Treatment ◽  
Colon Perforation ◽  
Tubeless Pcnl ◽  
Prompt Diagnosis

Colon perforation is a rare but serious complication of percutaneous nephrolithotomy (PCNL), meriting particular attention to its signs and symptoms for prompt diagnosis and treatment. We report an unusual presentation of colon perforation following tubeless PCNL, characterized by sore throat, pneumomediastinum, and neck and shoulder crepitus. In addition to the details of this case, we review the current literature on bowel injury during PCNL and its management.

scholarly journals Social services Interventions and the Mental Health and Mortality of care leavers: a population based data linkage study in Northern Ireland and Finland

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Aideen Maguire ◽  
Anne Kouvonen ◽  
Dermot O'Reilly ◽  
Hanna Remes ◽  
Joonas Pitkänen ◽  
...  
Keyword(s):  
Mental Health ◽  
Northern Ireland ◽  
Health Outcomes ◽  
Social Services ◽  
Psychiatric Hospital ◽  
Poor Mental Health ◽  
Mental Health Outcomes ◽  
Care Intervention ◽  
Increased Risk ◽  
Self Harm

BackgroundResearch has highlighted the poor mental health of looked after children compared to those never in care. However, little is known on what becomes of these children and their mental health trajectories after they leave the care of social services. In addition, previous studies are limited in their ability to differentiate between type of social care intervention received; kinship care, foster care or residential care. AimTo utilise nationwide social services data from two countries (Northern Ireland (NI) and Finland), with similar populations but different intervention policies, linked to a range of demographic and health datasets to examine the mental health outcomes of young adults in the years following leaving care. MethodsData from both countries on children born 1991-2000 were linked to social services data, hospital admissions, prescribed medication data and death records. Mental health outcomes were defined after the age of 18years (when statutory care provision ends) examined by care intervention and included admissions to psychiatric hospital, for self-harm and death by suicide. ResultsThe gender split in care in Finland is reflective of the population but more males are in care in NI. Initial results from Finnish data suggest those exposed to care in childhood have an increased risk of self-harm, psychiatric hospital admission and suicide after the age of 18years compared to those never in care. After adjusting for gender, age of entry to care and deprivation at birth those exposed to any care intervention had 3 times the risk of suicide (HR=3.06, 95% CI 1.18,7.98). Risk increased with duration in care but was equivalent across care intervention types. Analysis on the NI data is underway. ConclusionFull results will be available December 2019 and will explore which care pathways are most associated with poor mental health outcomes informing discussion around intervention opportunities and policy.

Health Policy and the History of Welfare States: A Reinterpretation

1998 ◽  
Vol 10 (2) ◽  
pp. 239-256 ◽  
Author(s):  
Daniel M. Fox
Keyword(s):  
Health Policy ◽  
Social Services ◽  
Job Security ◽  
Alternative Interpretation ◽  
Welfare States ◽  
Retirement Income ◽  
Course Of Disease ◽  
Economic Productivity ◽  
Medical Interventions ◽  
History Of

This article assesses recent studies of the history of welfare states and proposes an alternative interpretation of the history of policy for health services. Health policy, like policy for retirement income, job security and unemployment, social services and housing, has been profoundly influenced by the politics of economic productivity, social justice, and demographic change in each country. However, health policy has also been guided by perceptions of the nature and course of disease and opinions about the probability that particular medical interventions, organized and distributed in particular ways, would ameliorate its effects.

Prehospital Management of Earthquake Casualties Buried Under Rubble

2005 ◽  
Vol 20 (2) ◽  
pp. 122-133 ◽  
Author(s):  
Itamar Ashkenazi ◽  
Boris Isakovich ◽  
Yoram Kluger ◽  
Ricardo Alfici ◽  
Boris Kessel ◽  
...  
Keyword(s):  
Medical Management ◽  
Pertinent Literature ◽  
Medical Interventions ◽  
Practical Guideline ◽  
Prehospital Management ◽  
Earthquake Casualties

AbstractEarthquakes continue to exact a heavy toll on life, injury, and loss of property. Survival of casualties extricated from under the rubble depends upon early medical interventions by emergency teams on site. The objective of this paper is to review the pertinent literature and to analyze the information as a practical guideline for the medical management of casualties accidentally buried alive.

Working with Transgender Adolescents: Essential Guidelines and Applications

2021 ◽  
Vol 11 ◽  
Author(s):  
Kevin Chou ◽  
Brandon Johnson
Keyword(s):  
Clinical Practice ◽  
Current Literature ◽  
Gender Dysphoria ◽  
Evidence Base ◽  
Medical Intervention ◽  
Professional Organizations ◽  
Comprehensive Treatment ◽  
Endocrine Society ◽  
Medical Interventions ◽  
The World

Background: There has been a rise in the numbers of adolescents identifying as transgender and seeking medical treatment for gender dysphoria. While gender clinics are developing across the country, not all transgender adolescents have access to these centers. There is, therefore, an increased need for other clinicians to be aware of interventions and guidelines to help transgender youth and their families. Objective: The aim of this article is to provide an overview of current literature and guidelines for treating transgender adolescents with gender dysphoria. Methods: Using keywords “gender”, “gender dysphoria”, “transgender”, “trans*”, “adolescent trans*”, the authors searched PubMed to gather current literature on treating transgender adolescents. Additionally, sources from primary transgender resources online were obtained, including current endocrine and psychological guidelines. Results: This article discusses important gender concepts that are relevant to treating all transgender individuals. It describes models of engagement with transgender adolescents seeking treatment, including assenting and consenting to medical intervention. Finally, we discuss the assessment of transgender adolescents’ needs and present an overview of the various guidelines outlining both non-medical and medical interventions targeted to treat gender dysphoria in this population. Conclusions: Knowledge of treating adolescents with gender dysphoria is imperative as gender dysphoria presents more commonly in practice. Multidisciplinary collaboration is required to provide comprehensive treatment to this population. Guidelines from professional organizations such as the World Professional Association for Transgender Health and the Endocrine Society provide instructions for clinical practice while the evidence base in this field continues to expand.

Finding common ground: Aligning institutional and survivorship steering committee (SSC) goals.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 80-80
Author(s):  
Andrew Joseph Ward ◽  
John Bell ◽  
Lindsey Jerkins
Keyword(s):  
Social Services ◽  
Support Groups ◽  
Common Ground ◽  
Medical Center ◽  
Academic Medical Center ◽  
Specific Treatment ◽  
Steering Committee ◽  
Care Plans ◽  
Patient Goals ◽  
One Year

80 Background: Developing a Survivorship program goes beyond providing survivorship care plans to patients upon completion of cancer treatment. Programs can take many forms; ranging from very robust with long-term follow-up to minimal, with patients returning to the primary care provider when cancer-specific treatment is complete. To develop our program at an academic medical center with 2900 annual new cancer patients, we chose to enlist a SSC of survivors to help shape our program. Methods: In addition to fulfilling the American College of Surgeons Commission on Cancer Standard 3.3 requirements, we also desire to meet the needs of the patient. Thus, the survivorship program coordinator requested that providers within the Cancer Institute (CI) identify patients to form a SSC. 13 physicians contributed a total of 14 patients as candidates. Each patient was invited to participate and 7 accepted. The initial SSC meeting was held 6 months after initiation of our survivorship program. Results: SSC members represented 5 different primary malignancies and had varying degrees of experience within the treatment continuum. The initial meeting began with an overview of the current services available in the CI. Members were also given the opportunity to share treatment & survivorship experiences. Some of the SSC members utilized patient navigation during CI initial intake; others had experience with CI support groups. Some used ancillary services such as physical therapy, integrative health, financial counselors, and social services; others were not aware these services were available. A list of 4 categories of goals for program development was suggested with a meeting planned again in one year to review progress. Meeting one year later, the group determined progress was made in 3/4 (75%) of the goals. Conclusions: When creating a Survivorship program, patient goals should be considered and aligned with institutional and accreditation goals. One way to ensure that this is accomplished is to enlist front-end input from a SSC that represents a wide variety of treatment experiences and providers. In our experience, this strategy leads to alignment of patient and programmatic goals resulting in increased patient satisfaction and program quality.

Thyroid function and psychiatric disorders

1991 ◽  
Vol 3 (4) ◽  
pp. 61-64
Author(s):  
P.J.M. Schoof ◽  
L. Timmerman ◽  
E.J. Colon ◽  
H.J. Leijnse-Ybema
Keyword(s):  
Psychiatric Disorders ◽  
Psychiatric Hospital ◽  
Thyroid Function ◽  
Psychotic Disorders ◽  
Psychiatric Diagnoses ◽  
Low Concentration ◽  
Psychiatric Illnesses

SummaryTo answer the question if it is possible for specific psychiatric illnesses to influence the thyroxine-concentration, a group of 376 patients admitted to a psychiatric hospital was studied retrospectively.13.5% had an elevated thyroxine-concentration and only 0.6% had a low concentration.Of the group of 145 men, 22.8% was found to have an elevated thyroxine-concentration. In the group of 196 women we found 6.6% to be elevated. A low thyroxine was found in only 0.5% of the women and 0.7% of the men.In the group with an elevated thyroxine the psychiatric diagnoses of schizophrenia and psychotic disorders NOS are more common (19.6% and 17.4% respectively) than in the group with a normal thyroxine (4.4% and 6.5% respectively).

scholarly journals Medical Management of Diverticular Disease

2018 ◽  
Vol 31 (04) ◽  
pp. 214-216
Author(s):  
Liam Knott ◽  
Craig Reickert
Keyword(s):  
Diverticular Disease ◽  
Current Literature ◽  
Medical Management ◽  
Complicated Diverticulitis ◽  
Uncomplicated Diverticulitis ◽  
Recurrent Diverticulitis ◽  
Surgical Options ◽  
Acute Uncomplicated Diverticulitis

AbstractThis article reviews the current literature supporting the non-surgical options for treatment in acute uncomplicated diverticulitis, complicated diverticulitis, and options for prevention of recurrent diverticulitis.

scholarly journals Les Phenomenes Mystiques Chez le Malade Psychiatrique

1974 ◽  
Vol 19 (6) ◽  
pp. 563-568 ◽  
Author(s):  
Robert Duguay ◽  
Louis Chaloult ◽  
Léon Tétreault
Keyword(s):  
Chronic Illness ◽  
Psychiatric Hospital ◽  
Mystical Experience ◽  
Psychiatric Patients ◽  
Psychological State ◽  
Sexual Life ◽  
Behavioral Symptoms ◽  
French Canadian ◽  
Psychiatric Illnesses ◽  
Religious Personality

An inquiry about mystical phenomena in psychiatric patients was done in a large French Canadian psychiatric hospital. Four hundred and fifteen patients, taken at random, with functional psychiatric illnesses, were assessed. It was found that 19.28% of this population experienced mystical phenomena. The mystical experience was defined as an unusual psychological state in which a subject had the conviction of being in contact with God or any religious personality of the religion (angels, saints, etc…). The incidence of the mystical phenomena was studied in connection with four parameters: 1. identification characteristics of the patient 2. type of illness 3. sexual life of the patient 4. tendency of the patient to swear Six statistically significant features were identified in mystical patients: these patients have more sexual behavioral symptoms, are more inclined to swear, are more often paranoid schizophrenics with a chronic illness, are not married and have belonged previously to a religious order.

Use of Hospital Services by Chronic Schizophrenics in the Community

1979 ◽  
Vol 134 (4) ◽  
pp. 417-421 ◽  
Author(s):  
Hugh Freeman ◽  
A. J. Cheadle ◽  
J. R. Korer
Keyword(s):  
Social Services ◽  
Psychiatric Hospital ◽  
General Practitioners ◽  
Present State ◽  
Hospital Services ◽  
Chronic Schizophrenics ◽  
Heavy Medium ◽  
Schizophrenic Patients ◽  
One Year ◽  
State Examination

SummaryA sample of chronic schizophrenic patients from an urban community, living outside hospital, were reassessed on the Present State Examination one year after a first examination. During this time their use of psychiatric hospital services was recorded. One hundred and two patients had satisfactory interviews on both occasions. These could be divided into Heavy, Medium and Light users of services, the numbers being 8, 14 and 63 respectively, while 17 only saw their general practitioners or had no treatment. A ranking of the sample in terms of severity showed no correlation with use of these services; second PSE scores were not significantly different from the first. Heavy and Medium users of hospital services were in contact with Social Services to a significantly greater extent than other patients.

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