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1. Syphilis in Clinical Psychiatry: A Review

Author

Burton R Hutto

Subjects
Adult, Male, Sexually transmitted disease, Gerontology, medicine.medical_specialty, Penicillins, Disease, Spinal Puncture, Neurosyphilis, Syphilis Serodiagnosis, Syphilis, Latent, Arts and Humanities (miscellaneous), Epidemiology, Prevalence, medicine, Humans, Syphilis, Intensive care medicine, Applied Psychology, business.industry, Mental Disorders, Public health, Penicillin G, medicine.disease, United States, Psychiatry and Mental health, Infectious disease (medical specialty), business
Abstract

Syphilis is a potentially fatal infectious disease that has a long history of association with psychiatry. Recent developments in epidemiology, diagnosis, and treatment guidelines warrant a review of the current relationship of syphilis to clinical psychiatry. After a recent peak of incidence in the United States, syphilis is once again on the decline. Although the prevalence of syphilis remains endemic in certain locations, it has been targeted for elimination. Meanwhile, diagnostic testing remains complex and imperfect, especially for the detection of late stages of infection and neurosyphilis. The U.S. Public Health Service recently revised guidelines for the evaluation and management for syphilis. This paper discusses these developments and their specific implications to psychiatric practice. The likelihood of discovering previously unsuspected cases through screening and recommendations on high-risk groups to screen are discussed. A case example illustrates some of the key concepts.

Published
2001
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2. SUBTLE PSYCHIATRIC PRESENTATIONS OF ENDOCRINE DISEASES

Author

Burton R Hutto

Subjects
Male, medicine.medical_specialty, business.industry, Mental Disorders, Signs and symptoms, Endocrine System Diseases, Thyroid Diseases, Hypoglycemia, Diagnosis, Differential, Psychiatry and Mental health, Calcium Metabolism Disorders, medicine, Etiology, Humans, Endocrine system, Female, Medical history, Differential diagnosis, Psychiatry, business, Clinical psychology
Abstract

Endocrine disorders frequently present initially to psychiatrists. This article reviews the differential diagnosis of psychiatric and endocrine disorders. The range of endocrinopathies is presented, with emphasis placed on the common psychiatric symptomatology associated with these conditions. Various signs and symptoms that might stimulate a psychiatrist to pursue a work-up for each endocrine disorder are also emphasized.

Published
1998
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3. Folate and cobalamin in psychiatric illness

Author

Burton R Hutto

Subjects
medicine.medical_specialty, Psychosis, lcsh:RC435-571, Neurocognitive Disorders, MEDLINE, Folic Acid Deficiency, Cobalamin, chemistry.chemical_compound, Folic Acid, Risk Factors, lcsh:Psychiatry, Humans, Medicine, Dementia, Clinical significance, Psychiatry, Depressive Disorder, Neurotransmitter Agents, business.industry, Brain, Vitamin B 12 Deficiency, medicine.disease, Clinical Practice, Vitamin B 12, Psychiatry and Mental health, Clinical Psychology, Eating disorders, Clinical research, chemistry, business
Abstract

The linkage of cobalamin and folate deficiency to psychiatric illness has been studied and debated since these vitamins were first discovered in the 1940s. The clinical relevance of these deficiencies remains the subject of investigation and scholarly discussion. This article reviews case reports and studies derived from a MEDLINE search for English-language articles related to folate, cobalamin, and psychiatric illness. Emphasis is given to clinical research and recent developments. Preclinical evidence for direct effects of folate and cobalamin on brain functioning is compelling, and numerous associations of their deficiencies to psychiatric illness are evident. These vitamin deficiencies may typically present initially with psychiatric symptoms, but any direct causal relationship to specific neuropsychiatric illnesses are not well defined. The relationship of these vitamins in dementia is significant, but they may only rarely be a cause of truly reversible dementia. Folate deficiency appears most tightly connected with depressive disorders, and cobalamin deficiency with psychosis. Contrary to intuition, vitamin deficiencies appear to occur infrequently with eating disorders. Other diagnoses have been investigated much less extensively. The diagnosis and management of these deficiencies in the context of neuropsychiatric illness is still a matter of discussion. The quality of clinical research in this area is improving, but there are many unanswered questions that affect clinical practice. Clinicians should remain vigilant to the possibility of deficiencies of folate and cobalamin in diverse psychiatric populations. Normal hematological indices do not rule out the deficiencies. Further study is needed to refine the detection and clinical management of these vitamin deficiencies in psychiatric populations.

Published
1997
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5. Contributeurs

Author

Marschall S. Runge, M. Andrew Greganti, Adaora A. Adimora, Maha Alattar, Robert M. Aris, Victoria Lin Bae-Jump, Maria Q. Baggstrom, A. Sidney Barritt, Marc K. Bassim, Toby Bates, Anne W. Beaven, Robert G. Berger, Lee R. Berkowitz, Stephen A. Bernard, William S. Blau, John F. Boggess, Mary C. Bowman, Mark E. Brecher, Philip A. Bromberg, Sue A. Brown, Vickie Brown, Paul C. Bryson, Robert A. Buckmire, Elizabeth Bullitt, Craig Burkhart, M. Janette Busby-Whitehead, John B. Buse, Debra L. Bynum, Lisa A. Carey, Timothy S. Carey, Culley C. Carson, Patricia P. Chang, Sanjay Chaudhary, David R. Clemmons, James M. Coghill, Romulo E. Colindres, AnnaMarie Connolly, Benjamin J. Copeland, Todd Correll, Cynthia J. Denu-Ciocca, Thomas S. Devetski, Darren A. DeWalt, Luis A. Diaz, James F. Donohue, Mary Anne Dooley, Jean M. Dostou, Douglas A. Drossman, Carla Sueta Dupree, Rose J. Eapen, Charles S. Ebert, Nurum F. Erdem, Joseph J. Eron, Ronald J. Falk, Mary Katherine Farmer-Boatwright, Elizabeth A. Fasy, Alan G. Finkel, William F. Finn, David P. Fitzgerald, Carol A. Ford, Catherine A. Forneris, Amy M. Fowler, W. Craig Fowler, Wesley Caswell Fowler, Michael W. Fried, Don A. Gabriel, Shannon Galvin, Lisa M. Gangarosa, James C. Garbutt, Cynthia Gay, Susan A. Gaylord, Leonard S. Gettes, Andrew J. Ghio, John H. Gilmore, Paul A. Godley, Lee R. Goldberg, Richard M. Goldberg, Matthew N. Goldenberg, Brian P. Goldstein, Robert S. Greenwood, Ian S. Grimm, Steven H. Grossman, Robert E. Gwyther, John J. Haggerty, Russell P. Harris, William D. Heizer, Ashley G. Henderson, David C. Henke, Michael A. Hill, Alan L. Hinderliter, Albert R. Hinn, Gerald A. Hladik, Hal M. Hoffman, Mina C. Hosseinipour, James F. Howard, David Y. Huang, Xuemei Huang, Burton R. Hutto, Kim L. Isaacs, Bruce F. Israel, Thomas S. Ivester, Heidi T. Jacobe, Peter Lars Jacobson, Lukas Jantac, Jaspaul S. Jawanda, Sandra M. Johnson, Beth L. Jonas, Joanne M. Jordan, Jonathan J. Juliano, Kevin A. Kahn, Andrew H. Kaplan, Nigel S. Key, William Y. Kim, John S. Kizer, Caroline M. Klein, Philip J. Klemmer, Karen Kölln, Mark J. Koruda, James E. Kurz, Jeffrey LaCour, Alim M. Ladha, W. Derek Leight, Peter A. Leone, B. Anthony Lindsey, Ryan D. Madanick, Lawrence K. Mandelkehr, J. Douglas Mann, Silva Markovic-Plese, Allen F. Marshall, William D. Mattern, Celeste M. Mayer, Travis A. Meredith, William C. Miller, Beverly S. Mitchell, Stephan Moll, Douglas R. Morgan, Dean S. Morrell, M. Cristina Muñoz, Patrick H. Nachman, Kelly C. Nelson, Carla M. Nester, Linda M. Nicholas, E. Magnus Ohman, Bert H. O'Neil, David A. Ontjes, Robert Z. Orlowski, Daniel J. Parsons, Dhavalkumar D. Patel, Cam Patterson, Kristine B. Patterson, Amanda Peppercorn, Harold C. Pillsbury, W. Kimryn Rathmell, Daniel S. Reuland, Yehuda Ringel, M. Patricia Rivera, Craig N. Rosebrock, Pinchas Rosenberg, Robert A.S. Roubey, David S. Rubenstein, Susan Riggs Runge, Mark Russo, William A. Rutala, William E. Sanders, Hanna K. Sanoff, Scott L. Sanoff, Yolanda V. Scarlett, Emily J. Schwarz, Brent A. Senior, Jonathan S. Serody, Nicholas J. Shaheen, Thomas C. Shea, Richard G. Sheahan, William W. Shockley, Roshan Shrestha, Emily E. Sickbert-Bennett, Micah J. Sickel, Linmarie Sikich, Ross J. Simpson, Sidney C. Smith, Mark A. Socinski, P. Frederick Sparling, Thomas E. Stinchcombe, George A. Stouffer, Teresa K. Tarrant, Mark Taylor, Michael J. Thomas, Nancy E. Thomas, John M. Thorpe, Stephen L. Tilley, Jenny P. Ting, Robert S. Tomsick, Charles M. van der Horst, Bradley V. Vaughn, Pamela G. Vick, Robert J. Vissers, Peter M. Voorhees, Tracy Y. Wang, Lea C. Watson, David J. Weber, Robert S. Wehbie, Mark C. Weissler, Ellen C. Wells, Young E. Whang, Park W. Willis, John B. Winfield, Gary S. Winzelberg, David A. Wohl, Leslie P. Wong, Diem N. Wu, and Steven Zacks

Published
2011
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7. Syphilis in psychiatric inpatients: prevalence, treatment, and implications

Author

Burton R Hutto and Adaora A. Adimora

Subjects
Adult, Aged, 80 and over, Male, medicine.medical_specialty, Adolescent, business.industry, Mental Disorders, Middle Aged, medicine.disease, Hospitalization, Psychiatry and Mental health, Prevalence, Humans, Medicine, Female, Syphilis, business, Psychiatry, Aged, Retrospective Studies
Published
2000
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9. Contributors

Author

Marschall S. Runge, M. Andrew Greganti, Adaora A. Adimora, Maha Alattar, Robert M. Aris, Victoria Lin Bae-Jump, Maria Q. Baggstrom, A. Sidney Barritt, Marc K. Bassim, Toby Bates, Anne W. Beaven, Robert G. Berger, Lee R. Berkowitz, Stephen A. Bernard, William S. Blau, John F. Boggess, Mary C. Bowman, Mark E. Brecher, Philip A. Bromberg, Sue A. Brown, Vickie Brown, Paul C. Bryson, Robert A. Buckmire, Elizabeth Bullitt, Craig Burkhart, M. Janette Busby-Whitehead, John B. Buse, Debra L. Bynum, Lisa A. Carey, Timothy S. Carey, Culley C. Carson, Patricia P. Chang, Sanjay Chaudhary, David R. Clemmons, James M. Coghill, Romulo E. Colindres, AnnaMarie Connolly, Benjamin J. Copeland, Todd Correll, Cynthia J. Denu-Ciocca, Thomas S. Devetski, Darren A. DeWalt, Luis A. Diaz, James F. Donohue, Mary Anne Dooley, Jean M. Dostou, Douglas A. Drossman, Carla Sueta Dupree, Rose J. Eapen, Charles S. Ebert, Nurum F. Erdem, Joseph J. Eron, Ronald J. Falk, Mary Katherine Farmer-Boatwright, Elizabeth A. Fasy, Alan G. Finkel, William F. Finn, David P. Fitzgerald, Carol A. Ford, Catherine A. Forneris, Amy M. Fowler, W. Craig Fowler, Wesley Caswell Fowler, Michael W. Fried, Don A. Gabriel, Shannon Galvin, Lisa M. Gangarosa, James C. Garbutt, Cynthia Gay, Susan A. Gaylord, Leonard S. Gettes, Andrew J. Ghio, John H. Gilmore, Paul A. Godley, Lee R. Goldberg, Richard M. Goldberg, Matthew N. Goldenberg, Brian P. Goldstein, Robert S. Greenwood, Ian S. Grimm, Steven H. Grossman, Robert E. Gwyther, John J. Haggerty, Russell P. Harris, William D. Heizer, Ashley G. Henderson, David C. Henke, Michael A. Hill, Alan L. Hinderliter, Albert R. Hinn, Gerald A. Hladik, Hal M. Hoffman, Mina C. Hosseinipour, James F. Howard, David Y. Huang, Xuemei Huang, Burton R. Hutto, Kim L. Isaacs, Bruce F. Israel, Thomas S. Ivester, Heidi T. Jacobe, Peter Lars Jacobson, Lukas Jantac, Jaspaul S. Jawanda, Sandra M. Johnson, Beth L. Jonas, Joanne M. Jordan, Jonathan J. Juliano, Kevin A. Kahn, Andrew H. Kaplan, Nigel S. Key, William Y. Kim, John S. Kizer, Caroline M. Klein, Philip J. Klemmer, Karen Kölln, Mark J. Koruda, James E. Kurz, Jeffrey LaCour, Alim M. Ladha, W. Derek Leight, Peter A. Leone, B. Anthony Lindsey, Ryan D. Madanick, Lawrence K. Mandelkehr, J. Douglas Mann, Silva Markovic-Plese, Allen F. Marshall, William D. Mattern, Celeste M. Mayer, Travis A. Meredith, William C. Miller, Beverly S. Mitchell, Stephan Moll, Douglas R. Morgan, Dean S. Morrell, M. Cristina Muñoz, Patrick H. Nachman, Kelly C. Nelson, Carla M. Nester, Linda M. Nicholas, E. Magnus Ohman, Bert H. O'Neil, David A. Ontjes, Robert Z. Orlowski, Daniel J. Parsons, Dhavalkumar D. Patel, Cam Patterson, Kristine B. Patterson, Amanda Peppercorn, Harold C. Pillsbury, W. Kimryn Rathmell, Daniel S. Reuland, Yehuda Ringel, M. Patricia Rivera, Craig N. Rosebrock, Pinchas Rosenberg, Robert A.S. Roubey, David S. Rubenstein, Susan Riggs Runge, Mark Russo, William A. Rutala, William E. Sanders, Hanna K. Sanoff, Scott L. Sanoff, Yolanda V. Scarlett, Emily J. Schwarz, Brent A. Senior, Jonathan S. Serody, Nicholas J. Shaheen, Thomas C. Shea, Richard G. Sheahan, William W. Shockley, Roshan Shrestha, Emily E. Sickbert-Bennett, Micah J. Sickel, Linmarie Sikich, Ross J. Simpson, Sidney C. Smith, Mark A. Socinski, P. Frederick Sparling, Thomas E. Stinchcombe, George A. Stouffer, Teresa K. Tarrant, Mark Taylor, Michael J. Thomas, Nancy E. Thomas, John M. Thorpe, Stephen L. Tilley, Jenny P. Ting, Robert S. Tomsick, Charles M. van der Horst, Bradley V. Vaughn, Pamela G. Vick, Robert J. Vissers, Peter M. Voorhees, Tracy Y. Wang, Lea C. Watson, David J. Weber, Robert S. Wehbie, Mark C. Weissler, Ellen C. Wells, Young E. Whang, Park W. Willis, John B. Winfield, Gary S. Winzelberg, David A. Wohl, Leslie P. Wong, Diem N. Wu, and Steven Zacks

Published
2009
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11. Dr. Hutto Replies

Author

Burton R Hutto

Subjects
Psychiatry and Mental health, Arts and Humanities (miscellaneous), Philosophy, Applied Psychology
Published
2002
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13. Recognizing thyrotoxicosis in a patient with bipolar mania: a case report

Author

Catherine See Ning Lee and Burton R Hutto

Subjects
medicine.medical_specialty, endocrine system, Lithium (medication), endocrine system diseases, lcsh:RC435-571, business.industry, Thyroid, Case Report, behavioral disciplines and activities, Psychiatry and Mental health, medicine.anatomical_structure, lcsh:Psychiatry, Bipolar mania, mental disorders, medicine, In patient, Thyroid stimulating hormone level, medicine.symptom, Psychiatry, business, Mania, Geriatric psychiatry, medicine.drug
Abstract

Background A thyroid stimulating hormone level is commonly measured in patients presenting with symptoms of mania in order to rule out an underlying general medical condition such as hyperthyroidism or thyrotoxicosis. Indeed, many cases have been reported in which a patient is initially treated for bipolar mania, but is later found to have a thyroid condition. Several case reports have noted the development of a thyroid condition in bipolar patients either on lithium maintenance treatment or recently on lithium treatment. Case presentation We review a case in which a patient with a long history of bipolar disorder presents with comorbid hyperthyroidism and bipolar mania after recent discontinuation of lithium treatment. Conclusion Physicians should consider a comorbid hyperthyroidism in bipolar manic patients only partially responsive to standard care treatment with a mood stabilizer and antipsychotic.

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