Delayed cognitive decline following cranial irradiation.
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Biomedical subjects
Publications and source records attributed to J J Jeffries.
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Explore the source record for details and available documents.
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There are few mental illnesses that have as profound an effect on individuals and their families as schizophrenia. The management of patients with schizophrenia requires the clinician to be aware of the wide range of outcomes and the multiple facets of management that can be used. This article examines the variety of ways in which the physician can work with patients with schizophrenia to help them achieve their full potential.
BACKGROUND: Erotomania, as a primary disorder, is categorized in DSM-III-R under delusional (paranoid) disorder. However, erotomanic delusions also are seen frequently in the context of other psychiatric disorders. There is increasing evidence that patients with such delusions often have an underlying affective disorder and effective treatment of the underlying disorder can lead to resolution of the erotomanic delusions. METHOD: The case histories of three patients with prominent affective features and erotomanic delusions are presented. RESULTS: Each patient was treated with bilateral electroconvulsive therapy (ECT) after experiencing treatment failure with numerous other somatic therapies. One showed only a slight and transient improvement, while two demonstrated resolution of the erotomanic delusions. CONCLUSION: Bipolar and schizoaffective disorder should be considered in patients with erotomanic delusions, and ECT may offer an effective alternative when other somatic treatments have failed.
The introduction of neuroleptics over 40 years ago was a landmark in medical history. Although effective, antipsychotics have many side-effects, some severe. Because of the great needs in this therapeutic area, there has been a risk of viewing the introduction of new agents such as clozapine as panaceas. The true advantages of the new atypical neuroleptics need to be assessed realistically, by critically evaluating their effects on positive and negative symptomatology, potential adverse effects and cost benefit. Due in part to the toxic effects of neuroleptics, obtaining consent to treatment is fraught with complexities of a legal and ethical nature. However, despite the many burdensome aspects of this disease, including the high risk of suicide among patients, clinicians should foster patients insight and a collaborative approach to coping with schizophrenia.
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During the past 30 years, the prescription of neuroleptic medication has made a major impact on the treatment of symptoms in patients with schizophrenia. Nonetheless, for many patients, symptom remission and social functioning remain less than optimal. Consequently, clinicians have employed a combined approach of drugs, psychosocial therapies, and psychiatric rehabilitation to treat the range of deficits presented by individuals suffering with this illness. In this article, we describe Focal Family Therapy, a model of family therapy developed for working with families and patients who are struggling with schizophrenia. Using the example of a particular case, we illustrate the following: (a) the identification and formulation of the Focal Issue; (b) the targeting of behavior and attitudes that will constitute the Focal Change; and (c) the techniques of Focal Family Therapy.
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A case is described in which a patient developed acute pancreatitis following an overdose of amoxapine and procyclidine. Pancreatitis is not at this time a recognized complication of the use or abuse of these two drugs. Other drugs were used in the medical management of the complications of the overdose, but none of these are drugs known to be associated with pancreatitis. Amoxapine is probably, but not certainly the cause of the pancreatitis. Possible mechanisms for this unusual and serious complication are described.