By William R. Dubin M.D., Robert Stolberg M.D. (auth.)
2. The Psychiatric exam 7 three. natural mind Syndromes-Delirium and Dementia 21 four. Psychosis 37 five. Non-psychotic Disturbances forty seven 6. The Violent sufferer fifty nine 7. The Suicidal sufferer sixty seven eight. Alcohol Abuse seventy five nine. Drug Abuse eighty five 10. different universal Psychiatric Emergencies one hundred and one Appendix: Psychiatric unwanted effects of clinical medications 109 Index one hundred sixty five bankruptcy 1 creation creation Psychiatric sufferers might be one of the so much disconcerting sufferers to regard in an emergency division atmosphere. simply because those sufferers usually current with violence, confusion, suicidal makes an attempt and peculiar habit and ideas, non-psychiatric physicians frequently react with quite a few levels of ache and avoidance. despite the fact that, it is usually vital to choose even if the proposing signs are because of useful or natural sickness due to the fact that critical morbidity and mortality can ensue in sufferers with acute natural mind illness. The differential analysis would come with: useful (Psychiatric) illness natural disorder Affective problems Delirium Schizophrenic problems Dementia character problems anxiousness problems Adjustment problems Findings that are useful in elevating the index of suspicion for natural ailment are: a) Disorientation to time and position b) Fluctuating point of recognition 1 EMERGENCY PSYCHIATRY/2 c) Age over forty five without earlier psychiatric background d) irregular autonomic symptoms (vital symptoms, pupillary responses, sweating) e) Acute onset of psychotic disease (hours to days) f) Ongoing clinical sickness and its remedy g) attractiveness that hallucinations and delusions are often saw in natural in addition to practical disease.
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Extra info for Emergency Psychiatry for the House Officer
Chronic subdural hematoma(s) 7. Electrolyte imbalance 8. Endogenous toxins (as with hepatic or renal failure) 9. Exogenous toxins such as carbon monoxide 10. Hypothyroidism 11. Hypoglycemia 12. Cerebral infections such as tuberculosis, syphilis, parasites or yeasts 13. Intracranial aneurysms 14. Normal-pressure hydrocephalus 15. Pseudodementia 16. Vitamin deficiencies 17. Wilson's disease ORGANIC BRAIN SYNDROMES/31 dementia is quite extensive (Table I and II). There are certain reversible causes of dementia that the examining physician should ~emember (London, 1978).
Huntington's chorea 12. Kuf's disease 13. Marchiafava-Bignami disease 14. Down's syndrome 15. Multiple myeloma 16. Multiple sclerosis 17. Collagenous disease 18. Parkinsonism-dementia complex of Guam 19. Pick's disease 20. Post-concussion syndrome 21. Presenile dementia with motor neuron disease 22. Presenile glial dystrophy 23. Primary parenchymatous cerebellar atrophy with dementia 24. Primary subcortical gliosis 25. Progressive supranuclear palsy ORGANIC BRAIN SYNDROMESI33 Untreatable Forms of Dementia 26.
B. Karasu and L. Bellak, Brunner/Mazel, New York, 1980. 5. P. Tips on Studying for the Psychiatry Boards. Resident and Staff Physician, October 1978, pp. 119-123. 6. C. M. Nicholi. , 1978, pp. 173-197. 7. Pfeiffer, E. Borderline States. Diseases of the Nervous System, 35: 212-219, 1974. 8. Shapiro, E. Psychodynamics and Developmental Psychology of the Borderline Patient: A Review of the Literature. American Journal of Psychiatry, 135: 1304-1315, 1978. 9. R. The Technique of Psychotherapy, Parts 1 and 2, 2nd edition, Grune and Stratton, New York, 1967.
Emergency Psychiatry for the House Officer by William R. Dubin M.D., Robert Stolberg M.D. (auth.)