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At least 1,747 records · Page 97Linked to original sources
PubMed1989

Suicide and parasuicide in multiple personality disorder.

Multiple personality disorder (MPD) has been diagnosed with increasing frequency in the 1980s: according to one estimate 6,000 cases have now been diagnosed in North America (Coons 1986). The diagnosis of MPD can be difficult because patients usually present in a polysymptomatic fashion, and the specific features of their dissociative disorder may be difficult to elicit (Kluft 1985a, 1987). One of the most common presenting features consists of suicidal ideation and suicide attempts. Putnam et al. (1986), for instance, noted suicidality as a presenting symptom in nearly 70% of 100 cases of MPD reported to them by 92 clinicians throughout North America. We have collected a series of 236 cases of MPD reported to us by 203 clinicians throughout North America. Our results show that 72% of the patients attempted suicide. The purpose of this report is to compare 48 cases of MPD from this series with no previous suicide attempts to 167 cases that have attempted suicide to determine features that differentiate the patients who attempt suicide from those who do not.

Adult↗
PubMed1990

Managed care and the discharge dilemma.

Efforts at cost containment in medicine and psychiatry are ubiquitous. The escalating costs of health care have led to a variety of initiatives to manage the use of expensive settings and treatments. Cost containment aims to be cost efficient. When it is applied to the treatment of the severely mentally ill, clinical and ethical dilemmas intensify. Access to health insurance is more restricted for the mentally ill (Sharfstein et al. 1984). The benefits that are available are rationed by "fourth party" case managers, independent operators who make money by selling "third party" insurance companies the services of reviewing ongoing care in such a way as to contain costs and conserve resources. Most often this involves pressure to develop discharge plans and to move patients from the expensive inpatient to the less expensive outpatient setting as soon as it is safe and feasible (Melnick and Lyter 1987). For some patients, however, as illustrated below, this proves to be a most formidable task.

Adult↗
PubMed2002

Microsurgical replantation of sexual organs in three patients.

OBJECTIVE: The present study deals with microsurgical replantation technique. MATERIAL AND METHODS: The technique was applied in 3 patients whose sexual organs had been accidentally cut off. RESULTS: Necrosis of the sutured organs occurred in 2 cases. In 1 case, however, healing with proper miction and sexual function was achieved. Prolonged period (over 12 hours) from the accident to operation as well as the extensive injury of tissues with the vascular system crush were considered to be the main reason for failure. CONCLUSIONS: Microsurgical reconstruction of penis and testes with the use of vessel grafts prolonged the hypoxia which led to necrosis. Disturbances in vein blood outflow from the sutured organs contributed to this process as well. The third case resulted in success mostly due to quick intervention (5 h from injury) as well as to proper microsurgical reconstruction of vessels, nerves, and urethra. In addition suprapubic urine diversion was successfully applied and the urethra healed on the perforated catheter. Routine antibiotics as well as antithrombotic prophylactics were administered in all of the 3 cases.

Adolescent↗
PubMed2005

The language of cutting: initial reflections on a study of the experiences of self-injury in a group of women and nurses.

Non-suicidal self-injury is a distressing act, which can arouse dissent and negative comment in service users and providers. The purpose of the study was to describe how women who self-injure and nurses assign meaning to shared discourses about self-injury. The wider study is framed in a grounded theory methodology. Fourteen qualified nurses and 11 women who have self-injured were interviewed using unstructured and initially open-ended interviews, lasting 45-90 minutes. Initially a thematic analysis was used to code data. In this report, three of the early themes are reported with some comparative interpretations. Nurses lack understanding of the meanings of cutting behaviour. A common language is needed if nurses are to be effective in helping women who have self-injured to express distress in less damaging ways.

Attitude of Health Personnel↗
PubMed2006

Body modification and suicidal behavior.

In a large sample of individuals who belong to a website for body modification, having body modifications (e.g., piercings, tattoos, scarification and surgical procedures) was associated with a higher incidence of prior suicidality (i.e., suicidal ideation and attempted suicide). However, controls for self-reported depression weakened the strength of these associations.

Adolescent↗
PubMed2004

Use of the psychiatric consultation letter as a therapeutic tool.

OBJECTIVE: Carefully crafted medical consultation letters can serve the dual purpose of transmitting the consulted psychiatrist's opinion to the referring doctor and enhancing the quality of the doctor-patient therapeutic relationship. Using the same document for both purposes simultaneously can enhance the consultation letter's overall effectiveness, as illustrated by three case examples. CONCLUSIONS: Future teaching programmes for undergraduate and postgraduate psychiatry students should incorporate consultation letter writing workshops to improve students' skills in clearly expressing their opinions and management recommendations in written form.

Adolescent↗
PubMed1993

Biometric analysis of the dental casts of Maasai following traditional extraction of mandibular permanent central incisors and of Kikuyu children.

Dental plaster casts of 93 Maasai and 79 Kikuyu children age 12-15 years were analysed. Four biometric measurements were taken of the maxillary and mandibular casts: intercanine distance (C-C), inter-molar distance (M-M), canine arch circumference (C-C ACirc.), and molar arch circumference (M-M ACirc.). Incisor space (IS) was also measured in the mandibular casts. The mean values of all measurements except (M-M) in the mandibular casts were significantly reduced in the Maasai who had permanent central incisors extracted compared to the non-extracted Maasai and the Kikuyu. The mean incisor space in the Maasai with extractions was 6.3 mm compared to 11.7 mm in the non-extracted Maasai group. The extent of reduction of IS, C-C, C-C ACirc. and M-M ACirc. following extractions of the incisors may depend on the mesial drift of lateral incisors, jaw growth and soft tissue influence. The position of the tongue and occlusal relationship of the molars may prevent bucco-lingual movements maintaining a constant M-M. There was no significant difference in the mandibular cast dimensions of the non-extracted Maasai and the Kikuyu. Analysis of the maxillary cast dimensions of the Maasai with extraction, non-extracted Maasai and Kikuyu showed no significant differences suggesting that the extraction of mandibular incisors has no effect on maxillary arch dimensions. The variability in growth of the dento-alveolar complex itself may explain why the dental arch dimensions are similar in the Maasai and Kikuyu despite ethnic differences. There was no significant difference between the male and female dental arch dimensions.

Adolescent↗