scholarly journals The one and the many: a case highlighting comorbidity and complexity in psychiatry

2020 ◽  
Vol 44 (4) ◽  
pp. 169-173
Author(s):  
Jonathan Williams ◽  
Ruth Cain ◽  
Danilo Arnone ◽  
Michalis Kyratsous
Keyword(s):  
General Practice ◽  
Case Report ◽  
Clinical Practice ◽  
Lived Experience ◽  
Developmental Disorders ◽  
Medical Model ◽  
Hyperactivity Disorder ◽  
The Face ◽  
The Many ◽  
The One

Diagnostic categorisation is a typical stage of the medical model. Nevertheless, it is important to consider what is helpful to both the clinician and the patient when symptoms, experiences and perceptions are categorised. In this case report, we address the problem of comorbidity and complexity in psychiatry. Research and clinical experience point to significant overlap between personality disorders, mood disorders, and developmental disorders such as attention-deficit hyperactivity disorder. In the face of such complexity, we discuss ways of addressing and managing multiple diagnoses in clinical practice. We synthesise the perspectives and views of a general practice trainee, two consultant psychiatrists and a person with lived experience.

scholarly journals Improvement in refractory psychosis after initiating management for underlying ADHD

2015 ◽  
Vol 84 (S1) ◽  
pp. 6-8
Author(s):  
Michael Blaszak ◽  
Danica Brister ◽  
Jordon Charlebois ◽  
Erica Hoe ◽  
Maggie Siu
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Case Report ◽  
Clinical Practice ◽  
Attention Deficit ◽  
Clinical Case ◽  
Psychotic Symptoms ◽  
Visual Hallucinations ◽  
Hyperactivity Disorder ◽  
Stimulant Medications ◽  
Pathophysiologic Mechanisms

We report on a unique clinical case of psychosis precipitated by Attention Deficit Hyperactivity Disorder (ADHD) and explore its implications for clinical practice as well as our understanding of these conditions. We describe a clinical case of a 46-year-old male presenting with auditory, olfactory, tactile, and visual hallucinations. We reviewed the literature on reported cases in which psychotic symptoms were treated with stimulant medications for ADHD comorbidity. This case report reveals the potential for properly selected patients to benefit from a consideration of ADHD comorbidity and a trial of treatment with that focus. In addition, the literature reveals a pathophysiologic association between psychosis and ADHD supported by neurobiological data. However, far more research is required to fully understand these conditions and their relationship. We conclude that ADHD and psychosis have some related pathophysiologic mechanisms but their connection has not been adequately explored. This case adds support to literature suggesting that in refractory psychosis, clinicians should re-evaluate the diagnosis and one of the considerations should be ADHD. In certain cases, the presence of psychotic symptoms with ADHD should not exclude the use of stimulants.

Listening to an asian teenager and the diversities of his transition in the South Brazil: A case report

2011 ◽  
Vol 26 (S2) ◽  
pp. 363-363
Author(s):  
N. Gonçalves ◽  
S.K. Fuji ◽  
S.N. Cordeiro ◽  
E.R. Turato
Keyword(s):  
Case Report ◽  
Clinical Practice ◽  
Married Couple ◽  
Cultural Transition ◽  
Her Family ◽  
Parents And Children ◽  
The Family ◽  
The Face ◽  
Material Conditions ◽  
South Brazil

IntroductionFrom the viewpoint of society, adolescence can be considered a transition phase into adulthood. For many psychoanalysts, the changes originating from the puberty process are accompanied with an “anguish of growth”. The crisis installed due to this process can be marked by something peculiar in the life of each one.ObjectivesTo discuss the clinical practice, looking towards an understanding of the peculiarities that mark the psychotherapy of an adolescent who lives through a cultural transition.MethodCase report referring to a clinically listening to a 15 years old adolescent who was born and raised in Japan, then moved to Brazil with her family when was 12 years old.ResultsAdaptation to a different culture was what motivated the patient's mother to seek attention for her daughter. The family brings the image of an idealized Japan. The change did not only bring consequences to the daughter, but to the family that went through reorganization in the face of customs and material conditions. The new conditions ended up accentuating conflictive questions by the married couple and the difficulty of organizing the positions of the parents and children in family dynamics, interfering in the process of separation/ individualization of the adolescent. The patient found within a typical Japanese music group an outlet in which she could confront other discussions that stamp her identity.ConclusionsPsychocultural transition has marked this phase in the life of this adolescent. Within a referential group of oriental culture, the patient has found support for these changes.

scholarly journals Alternatives to the face-to-face consultation in general practice: focused ethnographic case study

2018 ◽  
Vol 68 (669) ◽  
pp. e293-e300 ◽  
Author(s):  
Helen Atherton ◽  
Heather Brant ◽  
Sue Ziebland ◽  
Annemieke Bikker ◽  
John Campbell ◽  
...  
Keyword(s):  
General Practice ◽  
Participant Observation ◽  
Health Issues ◽  
Ethnographic Case Study ◽  
Structured Interviews ◽  
Face To Face ◽  
The Face ◽  
General Practices ◽  
The One

BackgroundNHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives.AimTo understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice.Design and settingFocused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016.MethodNon-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the ‘one sheet of paper’ mind-map method to identify the line of argument in each thematic report.ResultsCase study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other’s practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal.ConclusionExperience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team.

scholarly journals ПОЭТИКА ЦИКЛА НОВОГОДНИХ СТИХОВ М. В. ИСАКОВСКОГО (СРАВНИТЕЛЬНО-ТИПОЛОГИЧЕСКИЙ АСПЕКТ)

2020 ◽  
Vol 18 (4) ◽  
pp. 306-330
Author(s):  
Aleksey Petrov
Keyword(s):  
The Other ◽  
Russian People ◽  
Soviet People ◽  
Death Time ◽  
The People ◽  
The Face ◽  
Post War ◽  
The Many ◽  
The One ◽  
Mortal Danger

Six New Year (eonic) poems by M. V. Isakovsky, written between 1942 and 1972, are examined in the article as a non-author's cycle with its own ‘plot’. It captured such philosophical phenomena as death, guilt, suffering, chance, etc., which revealed themselves in a sacred moment of time — the New Year. The three “battlefield” toasts reflected Isakovsky's sense of guilt before himself and the people; the desire to cast a spell on hostile forces and thus bring victory closer. The humorous post-war toast of 1948 demonstrated the return of life in the USSR to a peaceful track, which was signified by the restoration of state and family holidays, dinner parties. The official ‘newspaper’ toast “for 1958” expresses the idea of “new happiness” that emphasizes the motive of peaceful labor exploits of the Soviet people, while the poems “for 1973” can be classified as confessional. Isakovsky's New Year poems are also analyzed in the context of two traditions — Russian aeonic poetry and ritual toasts. Connections with poems by V. A. Zhukovsky, P. A. Vyazemsky, M. I. Tsvetaeva, A. T. Tvardovsky are traced. New Year poetic toast, on the one hand, became one of the many genres that contributed to the unity of the Russian people in the face of mortal danger during the war; on the other hand, it preserved a number of archaic topoi (the experience of the New Year’s transition as a sacred time; ritual magic formulas that invoke Death, Time and Fate; the biblical archetype of the chosen people, etc.).

The Libertarian, Fictionalist, and Compatibilist Responses to Hard Determinism

2020 ◽  
pp. 265-312
Author(s):  
Michael S. Moore
Keyword(s):  
Free Will ◽  
The Other ◽  
Human Choice ◽  
Hard Determinism ◽  
The Face ◽  
Responsible Action ◽  
The Many ◽  
The One

This chapter surveys the various responses to hard determinism, all of which seek to salvage responsibility in the face of the thought that all of our actions and choices are caused by factors over which we have no control. Those responses are grouped into three large categories: libertarianisms, fictionalisms, and compatibilisms. Libertarians believe that we do possess contra-causal free will, at least some of the time. Fictionalists believe that we must fictionalize responsibility so that we can construct it so as to be compatible with the determination of human choice by factors themselves unchosen. Compatibilists believe that there is no contradiction between free and responsible action, on the one hand, and determination of human choice, on the other. Various subcategories of each of these groupings are explored, and a case is made to subscribe to one of the forms of compatibilism, classical compatibilism. Ten amendments are offered to classical compatibilism aimed at eliminating the many problems that have been raised for classical compatibilism these past sixty years.

scholarly journals Pulmonary recurrence from prostate cancer and biochemical remission after metastasis directed therapy. A case report

2018 ◽  
Vol 90 (1) ◽  
pp. 74 ◽  
Author(s):  
Riccardo Boschian ◽  
Michele Rizzo ◽  
Lorenzo Zandonà ◽  
Carlo Trombetta ◽  
Giovanni Liguori
Keyword(s):  
Prostate Cancer ◽  
Case Report ◽  
Clinical Practice ◽  
Radical Prostatectomy ◽  
Pulmonary Metastases ◽  
Left Lung ◽  
Lower Lobe ◽  
Subsequent Reduction ◽  
Biochemical Remission ◽  
The One

We report a case of a 69-years-old man who presented with a solitary 1 cm nodule in the lower lobe of the left lung almost 3 years after radical prostatectomy for pT3aN0M0, Gleason score 4+3 disease, without evidence of osseous or lymphatic spread. Surgical resection of the pulmonary lobe confirmed the metastatic nature of the lesion, with subsequent reduction of serum PSA to undetectable levels. After 2 years from the metastasis resection, serum PSA is still undetectable, without the necessity of additional treatments. Solitary pulmonary metastases from prostate cancer (Pca) are rare in clinical practice, with only 29 previous cases described besides the one that we present.

Costumes and Choreography from Bodenwieser's Trunk: The Coat as Affective Memory

2019 ◽  
Vol 37 (1) ◽  
pp. 89-110
Author(s):  
Rachel Fensham
Keyword(s):  
Modern Dance ◽  
Human Condition ◽  
Personal Life ◽  
Creative Thought ◽  
Cain And Abel ◽  
Embodied Research ◽  
The Many ◽  
The One ◽  
Material Evidence ◽  
Selection Of

The Viennese modern choreographer Gertrud Bodenwieser's black coat leads to an analysis of her choreography in four main phases – the early European career; the rise of Nazism; war's brutality; and postwar attempts at reconciliation. Utilising archival and embodied research, the article focuses on a selection of Bodenwieser costumes that survived her journey from Vienna, or were remade in Australia, and their role in the dramaturgy of works such as Swinging Bells (1926), The Masks of Lucifer (1936, 1944), Cain and Abel (1940) and The One and the Many (1946). In addition to dance history, costume studies provides a distinctive way to engage with the question of what remains of performance, and what survives of the historical conditions and experience of modern dance-drama. Throughout, Hannah Arendt's book The Human Condition (1958) provides a critical guide to the acts of reconstruction undertaken by Bodenwieser as an émigré choreographer in the practice of her craft, and its ‘materializing reification’ of creative thought. As a study in affective memory, information regarding Bodenwieser's personal life becomes interwoven with the author's response to the material evidence of costumes, oral histories and documents located in various Australian archives. By resurrecting the ‘dead letters’ of this choreography, the article therefore considers how dance costumes offer the trace of an artistic resistance to totalitarianism.

Óscar Romero and the Politics of Sainthood

2011 ◽  
Vol 5 (3) ◽  
pp. 265-291
Author(s):  
Manuel A. Vasquez ◽  
Anna L. Peterson
Keyword(s):  
Human Rights ◽  
Civil War ◽  
El Salvador ◽  
The Other ◽  
Post Colonial ◽  
Holy See ◽  
The Poor ◽  
The Face ◽  
Crisis Of Modernity ◽  
The One

In this article, we explore the debates surrounding the proposed canonization of Archbishop Oscar Romero, an outspoken defender of human rights and the poor during the civil war in El Salvador, who was assassinated in March 1980 by paramilitary death squads while saying Mass. More specifically, we examine the tension between, on the one hand, local and popular understandings of Romero’s life and legacy and, on the other hand, transnational and institutional interpretations. We argue that the reluctance of the Vatican to advance Romero’s canonization process has to do with the need to domesticate and “privatize” his image. This depoliticization of Romero’s work and teachings is a part of a larger agenda of neo-Romanization, an attempt by the Holy See to redeploy a post-colonial and transnational Catholic regime in the face of the crisis of modernity and the advent of postmodern relativism. This redeployment is based on the control of local religious expressions, particularly those that advocate for a more participatory church, which have proliferated with contemporary globalization

Case report: a child with cystic fibrosis and phenylketonuria

2020 ◽  
Vol 1 (2) ◽  
pp. 38-44
Author(s):  
Irina V. Vakhlova ◽  
Anastasia D. Kazachina ◽  
Olga A. Beglyanina
Keyword(s):  
Cystic Fibrosis ◽  
Case Report ◽  
Clinical Practice ◽  
Neonatal Screening ◽  
Genetic Disorders ◽  
Epileptiform Activity ◽  
Autism Spectrum ◽  
Speech Development ◽  
Inherited Disorders ◽  
Congenital Diseases

Background. In the international clinical practice there have been occasional reports of phenylketonuria (PKU) and cystic fibrosis (CF) found simultaneously in the same patient. Both PKU and CF are the inherited disorders characterized by autosomal recessive type of inheritance. Currently the combination of two or more inherited disorders in one patient is considered to be a clinical rarity.Case description. This is a clinical case of two genetic disorders, CF and PKU, combined in a 5-year old patient who had been followed up since birth. Owing to implementation of neonatal screening for inherited and congenital diseases into clinical practice, during the first month of life the infant was diagnosed with CF (diagnostically significant elevation of immunoreactive trypsin [IRT] at the initial [163.2 ng/mL] and repeat testing on day 21 of life [138.7 ng/mL]) and PKU (phenylalanine [PA] level 15.9 mg/dL). Both disorders have been confirmed by genetic tests, i.e., homozygous DelF508 mutation was found in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, and P281L mutation in the phenylalanine hydroxylase (PAH) gene was also present in homozygous state. Child’s parents strictly adhered to dietary and treatment recommendations. By the age of 5 years the child developed symptoms of neurological disorder and disorder of the respiratory system, cognitive impairment and delay in speech development, subclinical epileptiform activity with high risk of epilepsy, and chronic inflammation of the respiratory tract.Conclusion. This case report demonstrates the important role of neonatal screening in early diagnosis and timely start of therapy, and underscores the importance of continuous medication in such genetic disorders as CF and PKU. On the whole, such approach brings about a relative preservation of functioning of the most affected organs and systems. By the age of 5 years the child does not form bronchiectases, shows no signs of chronic hypoxia, nutritional deficiency or pronounced neurologic deficit, and is at low risk for the development of autism spectrum disorder. At the same time, the larger scale and longer-term observations are required in order to make the unequivocal conclusions about the prognosis of these diseases under conditions of modern-day medical follow-up.

The Hierophanic Facets of the Seraphic Hymns

Trictrac ◽  
2018 ◽  
Vol 10 ◽  
Author(s):  
Petru Adrian Danciu
Keyword(s):  
Mutual Recognition ◽  
The Other ◽  
Human Being ◽  
Material World ◽  
Face To Face ◽  
The People ◽  
Musical History ◽  
The Face ◽  
The One

Starting from the cry of the seraphim in Isaiahʹ s prophecy, this article aims to follow the rhythm of the sacred harmony, transcending the symbols of the angelic world and of the divine names, to get to the face to face meeting between man and God, just as the seraphim, reflecting their existence, stand face to face. The finality of the sacred harmony is that, during the search for God inside the human being, He reveals Himself, which is the reason for the affirmation of “I Am that I Am.” Through its hypnotic cyclicality, the profane temporality has its own musicality. Its purpose is to incubate the unsuspected potencies of the beings “caught” in the material world. Due to the fact that it belongs to the aeonic time, the divine music will exceed in harmony the mechanical musicality of profane time, dilating and temporarily cancelling it. Isaiah is witness to such revelation offering access to the heavenly concert. He is witness to divine harmonies produced by two divine singers, whose musical history is presented in our article. The seraphim accompanied the chosen people after their exodus from Egypt. The cultic use of the trumpet is related to the characteristics and behaviour of the seraphim. The seraphic music does not belong to the Creator, but its lyrics speak about the presence of the Creator in two realities, a spiritual and a material one. Only the transcendence of the divine names that are sung/cried affirms a unique reality: God. The chant-cry is a divine invocation with a double aim. On the one hand, the angels and the people affirm God’s presence and call His name and, on the other, the Creator affirms His presence through the angels or in man, the one who is His image and His likeness. The divine music does not only create, it is also a means of communion, implementing the relation of man to God and, thus, God’s connection with man. It is a relation in which both filiation and paternity disappear inside the harmony of the mutual recognition produced by music, a reality much older than Adam’s language.

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