Search

The article presents the cases of a 73-year-old divorced female and an 85-year-old widowed man to discuss the effectiveness of psychodynamic psychotherapy in older people. Topics include the complaint of back and leg pain and difficulty sleeping by the widowed male, the feeling of anxiety of the divorced woman, and the use of the psychotherapy treatment to the old man due to his extreme amount of guilt and to the old woman due to her diagnosis of adjustment reaction with mixed mood.

Background and Objectives: Psychiatry residents provide care for individuals diagnosed with co-occurring mental illness and substance use disorders (SUDs). Small studies have shown that clinicians in general possess negative attitudes towards these dually diagnosed individuals. This is a serious concern, as clinicians' stigmatizing attitudes towards individuals with mental illnesses may have a particularly potent adverse impact on treatment. The goal of this study was to examine the attitudes of psychiatry residents towards individuals with diagnoses of schizophrenia, multiple SUDs, co-occurring schizophrenia and SUDs, and major depressive disorder.Methods: A questionnaire was sent to psychiatry residents (N = 159) around the country. It was comprised of two sections: (i) demographic information, which included information about level of training; and (ii) the 11-item Medical Condition Regard Scale (MCRS) for individuals with the four different diagnoses.Results: Psychiatry residents had more stigmatizing attitudes towards individuals with diagnoses of SUDs with and without schizophrenia than towards those individuals with diagnoses of schizophrenia or major depressive disorder alone. Senior residents possessed more negative attitudes towards individuals with SUDs than junior residents.Discussion and Conclusions: The attitudes of psychiatry residents' towards individuals with SUDs with and without schizophrenia were negative and were worse among senior residents. There were many potential reasons for these findings, including repeat negative experiences in providing care for these individuals.Scientific Significance: The negative attitudes of psychiatry residents towards individuals with SUDs are worrisome. Future work is needed to better understand these attitudes and to develop interventions to improve them. (Am J Addict 2017;26:75-79). [ABSTRACT FROM AUTHOR]

The article presents a case study of a woman, with mental depression and psychotic-related symptoms, requesting a termination of pregnancy. The obstetrics service evaluated the patient and gave inpatient psychiatry team a 5-day window to treat the patient and make a final capacity determination regarding an abortion request. The woman elected to continue her planned pregnancy and carry the fetus on full term under obstetrics service and care.

Mutism in adults has a wide differential, and can be difficult to evaluate. Defined as an absence or reduction of speech, either voluntary or avolitional, mutism is typically associated with catatonia, usually in schizophrenia, but also depression, bipolar disorder, intoxication, and neurological conditions. Mutism in non-catatonic schizophrenia was common before anti-psychotic use, correlating with untreated illness. Case reports continue to appear in developing nations, but accounts of mutism in patients with advanced treatment are scarce. Here we present an unusual case of mutism in non-catatonic schizophrenia, in which it appears as both psychotic symptom and adaptive behavioral strategy. [ABSTRACT FROM AUTHOR]