Consultation Dilemma Catatonia in a Patient with Prior TBI: MentaI or Medical Disorder?

Mr. R, a 27 year old Hispanic male with history of traumatic brain injury (TBI) over ten years prior but no psychiatric history, presents to the psychiatric consultation service with recent onset of mutism, psychotic behavior and new diagnosis of epilepsy. The differential diagnosis is broad and includes both medical and psychiatric causes: post-ictal state, non-convulsive status epilepticus, delirium due to metabolic conditions, drugs, catatonia, conversion disorder, major depression with psychotic features, new onset schizophrenia or a combination of these possible diagnoses.

Do medical student stress, health, or quality of life foretell step 1 scores? A comparison of students in traditional and revised preclinical curricula.

Theory: We explored the theory that measures of medical students' well-being and stress from different types of preclinical curricula are linked with performance on standardized assessment.

Hypotheses: Self-reported stress and quality of life among sophomore medical students having different types of preclinical curricula will vary in their relationships to USMLE Step 1 scores.

Method: Voluntary surveys in 2010 and 2011 compared self-reported stress, physical and mental health, and quality of life with Step 1 scores for beginning sophomore students in the final year of a traditional, discipline-based curriculum and the 1st year of a revised, systems-based curriculum with changed grading system.