Neurocognitive rehabilitation of Down syndrome

Blog post by Jean-Adolphe Rondal, Ph.D., jeanarondal@skynet.be, Emeritus Professor of Psycholinguistics at the University of Liège, Belgium, Juan Perera, Ph.D., asnimo@telefonica.net, Director of the Center Principe de Asturias, University of the Balearic Islands, Mallorca, Spain,  and Donna SPIKER, Ph.D., donna.spiker@sri.com  Program Manager of the Early Childhood Program, SRI International, Menlo Park, California, USA.

Down syndrome is one of the most commonly occurring developmental disorders, with considerable bodies of research within many different disciplines. Despite calls for strong interdisciplinary and transdisciplinary approaches to both research and treatment of developmental disorders, including Down syndrome, bringing together knowledge across disciplines in a systematic and comprehensive way is still rare. 

The utility of non-psychiatric phenotype in diagnosing secondary psychosis, and of psychopathology in diagnosing primary psychosis

Blog post by Rudolf N. Cardinal, clinical research associate, Department of Psychiatry, University of Cambridge, and honorary specialist registrar, Cambridgeshire and Peterborough NHS Foundation Trust, and Edward T. Bullmore, professor of psychiatry, University of Cambridge.

Psychosis originally meant any kind of disordered mental state [1], and subsequently a severe mental disorder involving loss of contact with reality [2, 3]. Nowadays it may be defined (1) narrowly as the presence of delusions and/or hallucinations without insight, or (2) more broadly to include delusions and/or hallucinations with insight into their hallucinatory nature, or (3) more broadly still to include disordered thought or speech, or (4) yet more broadly to include severe behavioural abnormalities including behavioural disorganization, gross excitement and overactivity, or psychomotor retardation and catatonia [4, 5]. Different classificatory systems vary slightly in their definition [4, 5].

A Mental Healthcare Model for Mass Trauma Survivors

Blog post by Metin Basoglu, Professor of Psychiatry, & Ebru Salcioglu, Associate Professor of Psychology and Research Associate, Trauma Studies, Department of Psychological Medicine, Institute of Psychiatry, King’s College London & Istanbul Center for Behavior Research and Therapy (ICBRT / DABATEM), Turkey

Mass trauma events, such as wars, armed conflicts, acts of terror, political violence, torture, and natural disasters affect millions of people around the world. Currently there is no mental healthcare model that is capable of addressing the needs of masses of trauma-exposed people, particularly the dispossessed populations of developing countries that often bear the brunt of mass trauma events. Effective dealing with this problem requires interventions that are (1) theoretically sound, (2) proven to be effective, (3) brief, (4) easy to train therapists in their delivery, (5) practicable in different cultures, and (6) suitable for dissemination through media other than professional therapists, such as lay people, self-help tools, and mass media. Current treatments commonly used with trauma survivors do not meet more than two or three of these requirements. The last requirement is particularly important, as even the most effective treatment is of limited use if it cannot be widely disseminated to millions of people in need of help.

Delirium as a Cause of Violent Behavior

Blog Post by James J. Amos MD, University of Iowa, USA

Another reason why it would important to prevent delirium is the risk for violence patients can have for themselves and others. Patients who would not otherwise be violent can sometimes become violent when exposed to medications with which they’re unfamiliar. One combination of drugs that most people tolerate well but which can provoke intoxication delirium in others is Versed and Fantanyl. Versed is a sedative-hypnotic in the benzodiazepine class (Valium is in the same class) and Fentanyl is an opioid pain killer. Demerol is another opioid pain-killer that is a well-recognized cause of delirium.

These medications are often used on outpatient minor surgical procedures to produce sedation and analgesia. Occasionally, the relaxed and pain-free states they produce can cause an altered mental state that make people appear as though they’ve been on an all-night bender on alcohol.

Core Competencies and the Psychosomatic Medicine “Supraspecialty”

Blog Post by James J. Amos MD, University of Iowa, USA 

At the annual Academy of Psychosomatic Medicine (APM) meeting this year held on Marco Island, Florida, I heard Dr. Theodore Stern call Psychosomatic Medicine (PM) a “supraspecialty”. Usually it’s described as a subspecialty.  I couldn’t find the word in Webster’s although “supra” comes from the Latin for “above, beyond, earlier”. One of the definitions is “transcending”.  I tried to Google “supraspecialty” and came up empty. So I guess it’s a neologism. The context was a workshop on how to enhance resident and medical student education on Psychosomatic Medicine services. Dr.  Stern coined the term while talking about the scope of practice of PM. As he went through the long list, it gradually dawned on me why “supraspecialty” as a title probably fits our profession, mainly because it makes us, as psychiatrists, accountable for aspects of general and specialty medical and surgical care above and beyond that of Psychiatry alone.

Conversion Disorder

Blog Post by James J. Amos MD, University of Iowa, USA 

I was fascinated by the blog “The Mind in Modern Medicine” by E.S. Krishnamoorthy, et al, posted 10/21/2010. As a Psychosomatic Medicine (PM) specialist, I’m often consulted by neurologists for help managing hysteria, nowadays called conversion disorder. Although it’s been in the somatoform disorder category for many years, the opinion of many of my colleagues is that it’s more of a dissociative state.

The Stolen Book

Blog Post by James J. Amos MD, University of Iowa, USA  

What I wanted to do as I took over the psychiatry consultation service this month was to highlight the usefulness of our newly published book Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry.  I planned to refer to the first chapter on consultation process in order to highlight the importance of clarifying the consultation question. When I asked the residents whether they’d yet seen the copy that I’d donated to the Staff Consult Office a couple of months ago, they said indeed they had, found it useful, and held it up for me to see.

23rd ECNP Congress -The European College of Neuropsychopharmacology

Mental disorders, such as depression, anxiety disorders, addiction and schizophrenia are the core challenge of most health care systems around the world. In the EU alone, each year 27% of the total adult population – this corresponds to 83 Million citizens – suffer from mental disorders. Depression alone affects almost 20 million ranking in the EU as the most disabling disorder of all diseases. Unless appropriately treated, mental disorders are typically associated with a wide range of complications and sequelae for the subjects affected, their partners and families as well as society as a whole, and they can be lethal. Suicide – a frequent complication of depression and other mental disorders – is a major cause of premature death in Europe with over 160.000 completed suicides every year; rates of attempted suicides are at least 10 times higher.

The Impact of Early Life Trauma on Health and Disease: the Hidden Epidemic

Blog Post by Eric Vermetten, MD, PhD, e.vermetten@umcutrecht.nl Associate Professor Psychiatry at the University Medical Center Utrecht, The Netherlands

Traumatic events of the earliest years of infancy and childhood are not lost but, like a child’s footprints in wet cement, are often preserved life-long. Time does not heal the wounds that occur in those earliest years; time conceals them. They are not lost; they are embodied .” (Felitti 2010, this volume)

‘Classic.’ A book which people praise but don’t read—Mark Twain

Blog Post by James Amos, MD, The University of Iowa Hosp and Clinics

When I announced the publishing of our book, Psychosomatic Medicine, An Introduction to Consultation-Liaison Psychiatry,  someone said that it’s good to finally get a book into print and out of one’s head.  The book in earlier years found other ways out of my head, mainly in stapled, paper clipped, spiral bound, dog-eared pages of  homemade manuals, for use on our consultation serviceIt’s a handbook and meant to be read of course, but quickly and on the run. As I’ve said in a previous blog, it makes no pretension to being the tour de force textbook in  America  that inspired it. However, any textbook can evolve into an example of Twain’s definition of a classic.  The handbook writer is a faithful and humble steward who can keep the spirit of the classic lively.