The authors describe the impact on training that accompanied an assignment of senior (PGY-4) resi... more The authors describe the impact on training that accompanied an assignment of senior (PGY-4) residents to work one-half day each week for a six month period at a community-based agency concerned with the care of persons with severe and persistent mental illness who were formerly homeless. As the goals and methods of psychiatric training are rethought and adapt to programmatic shifts and economic pressures, new opportunities open up to move treatment and training to the "front lines" in the community where an innovative therapeutic armamentarium for persons with severe and chronic mental illness is developing.
The authors describe the impact on training that accompanied an assignment of senior (PGY-4) resi... more The authors describe the impact on training that accompanied an assignment of senior (PGY-4) residents to work one-half day each week for a six month period at a community-based agency concerned with the care of persons with severe and persistent mental illness who were formerly homeless. As the goals and methods of psychiatric training are rethought and adapt to programmatic shifts and economic pressures, new opportunities open up to move treatment and training to the "front lines" in the community where an innovative therapeutic armamentarium for persons with severe and chronic mental illness is developing.
... There is no good reason why mental health practitioners cannot see this any more clearly than... more ... There is no good reason why mental health practitioners cannot see this any more clearly thanpeople who treat any other class of disorders. ... Many bipolar patients and patients with a significant affect disorder co-morbid with a borderline personality structure are poor ...
This study explored the approach to marketing herbal substances and the specific remedies being s... more This study explored the approach to marketing herbal substances and the specific remedies being sold for the treatment of memory complaints. Gingko and phosphatidylcholine/phosphatidylserine were most frequently recommended, often in combinations with many other substances. Counseling regarding toxicity is nil.
The International Journal of Psychiatry in Medicine, 2010
A 90-year-old woman who had received more than 100 electroconvulsive treatments (ECT) over many y... more A 90-year-old woman who had received more than 100 electroconvulsive treatments (ECT) over many years requested another course for depression. After the third ECT, an electrocardiogram showed new T-wave inversion (V2-V6) and ST elevation (V2). Catheterization revealed severe left ventricular dysfunction but no coronary obstruction, leading to a diagnosis of Takotsubo cardiomyopathy (stress-related). The patient's recovery was uneventful. Recent literature cites three other cases post-ECT. It appears that elderly women are at greatest risk, repeated stress is generally required, and recovery is achieved quickly. Elevated levels of catecholamines and of vasopressin may be implicated.
To explore the ways in which psychiatry residents conceptualize the terms &am... more To explore the ways in which psychiatry residents conceptualize the terms "mood" and "affect," a 14-item questionnaire was sent to residency programs in New York. The questions consisted of possible definitions of mood and affect; all questions required a "true" or "false" response. Residents (N=99) were asked how they viewed mood and affect from a temporal perspective (i.e., sustained versus momentary) and in terms of an objective-subjective (or external-internal) dichotomy. There were inconsistencies in the temporal view of mood (said to be sustained by 60.6% and momentary by 50.5%) and affect ("pervasive" by 26.3% and "momentary" by 66.3%). Residents overwhelmingly defined mood as being subjective and internal and affect as being objective and external. If mood and affect are to be viewed from both perspectives, psychiatrists must infer the enduring internal emotional tone (mood) of a patient over an entire interview.
... References 1. Serby M, Larson P, Kalkstein D: Olfactory sense in psychoses. ... An item-level... more ... References 1. Serby M, Larson P, Kalkstein D: Olfactory sense in psychoses. ... An item-level confirmatory factor analysis (3) failed to empirically support the Yale-Brown Obsessive Compulsive ScaleSymp-tom Checklist categories, given the heterogeneity within cer-tain ...
Of 58 demented residents in an American-Chinese nursing home, 44 (75.9%) had multi-infarct dement... more Of 58 demented residents in an American-Chinese nursing home, 44 (75.9%) had multi-infarct dementia, seven (12.1%) had possible Alzheimer's disease, four (6.9%) had other dementias, and three 5.2% had unknown disorders. Alzheimer's disease was relatively less prevalent than in U.S. nursing homes overall.
The authors assessed the extent of change in the length of psychiatry clerkships in U.S. medical ... more The authors assessed the extent of change in the length of psychiatry clerkships in U.S. medical schools from 1995-1996 to 1998-1999 and explored the relationship between clerkship length and percentage of medical students choosing psychiatry as a career. Data from 124 U.S. medical schools over 4 years included clerkship length in weeks and percentage of graduating students entering psychiatry residencies. Fifteen schools sustained reductions in rotation length; the mean clerkship measured in weeks decreased for the entire sample from 6.27 to 6.04 (t=3.086, P<0.003). There was no significant correlation between clerkship length and recruitment into psychiatry. There appears to be a trend toward shorter psychiatry clerkships in recent years; however, there is no demonstrable relationship between length of clerkship and medical student interest in psychiatry as a career.
The Journal of Neuropsychiatry and Clinical Neurosciences, Oct 15, 2014
Three elderly patients experienced musical hallucinations (MH) in the context of hearing loss. In... more Three elderly patients experienced musical hallucinations (MH) in the context of hearing loss. In at least two of the cases, the onset was sudden. All three patients had pontine T2/FLAIR hyperintense foci on MR scan after the onset of the MH.
The authors describe the impact on training that accompanied an assignment of senior (PGY-4) resi... more The authors describe the impact on training that accompanied an assignment of senior (PGY-4) residents to work one-half day each week for a six month period at a community-based agency concerned with the care of persons with severe and persistent mental illness who were formerly homeless. As the goals and methods of psychiatric training are rethought and adapt to programmatic shifts and economic pressures, new opportunities open up to move treatment and training to the "front lines" in the community where an innovative therapeutic armamentarium for persons with severe and chronic mental illness is developing.
The authors describe the impact on training that accompanied an assignment of senior (PGY-4) resi... more The authors describe the impact on training that accompanied an assignment of senior (PGY-4) residents to work one-half day each week for a six month period at a community-based agency concerned with the care of persons with severe and persistent mental illness who were formerly homeless. As the goals and methods of psychiatric training are rethought and adapt to programmatic shifts and economic pressures, new opportunities open up to move treatment and training to the "front lines" in the community where an innovative therapeutic armamentarium for persons with severe and chronic mental illness is developing.
... There is no good reason why mental health practitioners cannot see this any more clearly than... more ... There is no good reason why mental health practitioners cannot see this any more clearly thanpeople who treat any other class of disorders. ... Many bipolar patients and patients with a significant affect disorder co-morbid with a borderline personality structure are poor ...
This study explored the approach to marketing herbal substances and the specific remedies being s... more This study explored the approach to marketing herbal substances and the specific remedies being sold for the treatment of memory complaints. Gingko and phosphatidylcholine/phosphatidylserine were most frequently recommended, often in combinations with many other substances. Counseling regarding toxicity is nil.
The International Journal of Psychiatry in Medicine, 2010
A 90-year-old woman who had received more than 100 electroconvulsive treatments (ECT) over many y... more A 90-year-old woman who had received more than 100 electroconvulsive treatments (ECT) over many years requested another course for depression. After the third ECT, an electrocardiogram showed new T-wave inversion (V2-V6) and ST elevation (V2). Catheterization revealed severe left ventricular dysfunction but no coronary obstruction, leading to a diagnosis of Takotsubo cardiomyopathy (stress-related). The patient's recovery was uneventful. Recent literature cites three other cases post-ECT. It appears that elderly women are at greatest risk, repeated stress is generally required, and recovery is achieved quickly. Elevated levels of catecholamines and of vasopressin may be implicated.
To explore the ways in which psychiatry residents conceptualize the terms &am... more To explore the ways in which psychiatry residents conceptualize the terms "mood" and "affect," a 14-item questionnaire was sent to residency programs in New York. The questions consisted of possible definitions of mood and affect; all questions required a "true" or "false" response. Residents (N=99) were asked how they viewed mood and affect from a temporal perspective (i.e., sustained versus momentary) and in terms of an objective-subjective (or external-internal) dichotomy. There were inconsistencies in the temporal view of mood (said to be sustained by 60.6% and momentary by 50.5%) and affect ("pervasive" by 26.3% and "momentary" by 66.3%). Residents overwhelmingly defined mood as being subjective and internal and affect as being objective and external. If mood and affect are to be viewed from both perspectives, psychiatrists must infer the enduring internal emotional tone (mood) of a patient over an entire interview.
... References 1. Serby M, Larson P, Kalkstein D: Olfactory sense in psychoses. ... An item-level... more ... References 1. Serby M, Larson P, Kalkstein D: Olfactory sense in psychoses. ... An item-level confirmatory factor analysis (3) failed to empirically support the Yale-Brown Obsessive Compulsive ScaleSymp-tom Checklist categories, given the heterogeneity within cer-tain ...
Of 58 demented residents in an American-Chinese nursing home, 44 (75.9%) had multi-infarct dement... more Of 58 demented residents in an American-Chinese nursing home, 44 (75.9%) had multi-infarct dementia, seven (12.1%) had possible Alzheimer's disease, four (6.9%) had other dementias, and three 5.2% had unknown disorders. Alzheimer's disease was relatively less prevalent than in U.S. nursing homes overall.
The authors assessed the extent of change in the length of psychiatry clerkships in U.S. medical ... more The authors assessed the extent of change in the length of psychiatry clerkships in U.S. medical schools from 1995-1996 to 1998-1999 and explored the relationship between clerkship length and percentage of medical students choosing psychiatry as a career. Data from 124 U.S. medical schools over 4 years included clerkship length in weeks and percentage of graduating students entering psychiatry residencies. Fifteen schools sustained reductions in rotation length; the mean clerkship measured in weeks decreased for the entire sample from 6.27 to 6.04 (t=3.086, P<0.003). There was no significant correlation between clerkship length and recruitment into psychiatry. There appears to be a trend toward shorter psychiatry clerkships in recent years; however, there is no demonstrable relationship between length of clerkship and medical student interest in psychiatry as a career.
The Journal of Neuropsychiatry and Clinical Neurosciences, Oct 15, 2014
Three elderly patients experienced musical hallucinations (MH) in the context of hearing loss. In... more Three elderly patients experienced musical hallucinations (MH) in the context of hearing loss. In at least two of the cases, the onset was sudden. All three patients had pontine T2/FLAIR hyperintense foci on MR scan after the onset of the MH.
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