Brief Psychotic Episodes and Depressed Mood in a Patient With Borderline Personality Disorder and Antiphospholipid Syndrome.

Psychiatric disorders are reported to be associated with systemic inflammatory conditions and autoimmune diseases. Antiphospholipid syndrome (APS) is a rare condition with poorly understood prevalence and incidence in the general population. Case reports have described co-occurrences of psychiatric conditions and APS.

Borderline Personality Disorder With Atypical Traits in a 30-Year-Old Female: A Case Report.

In this paper, we report an atypical presentation of borderline personality disorder (BPD) in a 30-year-old female with a history of childhood molestation and trauma and a prior diagnosis of post-traumatic stress disorder (PTSD). The patient was hospitalized due to anxiety, depression, and guilt over her relapse into alcohol use disorder. During her hospital stay, we diagnosed her with BPD based on psychiatric examination, clinical interviews, and patient history.

Psychological Testing in a Complex Case: Psychosis in Co-occurring PTSD, Gender Dysphoria, and Bipolar Disorder.

This case report investigates the concurrent presence of post-traumatic stress disorder (PTSD) and bipolar disorder (BD) in the transgender population. We present a case involving a 21-year-old female-to-male transgender individual (preferred pronouns - they/them). The patient had a history of psychosis, trauma, gender dysphoria (GD), inconsistent hormone (testosterone) treatments, and a self-attributed diagnosis of "associative identity disorder" with 21 distinct "identities.

Psychiatric Disorder in a Patient With Beckwith-Wiedemann Syndrome: A Case Report.

Patients with Beckwith-Wiedemann syndrome (BWS) often suffer from pheochromocytoma and hypoglycaemia and are vulnerable to disorders associated with the hypothalamic-pituitary-adrenal axis (HPA), such as major depressive disorder, generalised anxiety disorder, borderline personality disorder, etc. Features of pheochromocytoma even overlap with features of anxiety disorders, panic disorders, etc. These patients undergo multiple major surgeries under general anaesthesia at a very young age due to recurrent tumours that can affect their behavioural and emotional development.

Chronic Refractory Insomnia in a Patient With Undiagnosed Bipolar Disorder and Long-Standing Traumatic Brain Injury.

Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object or when an object pierces the skull and enters brain tissue. TBI can be classified into primary and secondary brain injury.

Diagnostic Dilemma and Management Difficulties in a Young Patient With Psychosis and Benign Chorea: A Case Report and Review of the Literature.

Psychosis presents with hallucinations, delusions, disorganized speech, abnormal psychomotor behavior, and negative symptoms. It most commonly appears in the setting of schizophrenia, although it could also appear in bipolar disorder, major depression, post-traumatic stress disorder (PTSD) and even in medical conditions and substance use. In young people, the diagnosis of psychosis can present as a challenge due to the overlap of psychotic conditions and other emotional, behavioral, and developmental disorders.

Synergistic Effects of Psychotropics Leading to Extraordinary Weight Gain.

A 22-year-old woman had significant weight gain after being on two atypical antipsychotics, an antiepileptic, and an antidepressant for 12 months, with her weight increasing from 70 kg to 160 kg, or by 90 kg, over 16 months. This case report examines the possible synergistic effects of psychotropics, particularly two atypical antipsychotics, leading to adverse side effects, particularly severe obesity, in the context of other examined pharmacological and non-pharmacologic risk factors. Psychotropic monotherapy is the advised prescribing treatment guideline.

Feasibility of Adjunctive Bright Light Therapy for Depressive Symptoms on an Acute Psychiatric Floor.

Background: Bright light therapy (BLT) has been increasingly used as an experimental treatment in non-seasonal unipolar depression. While clinical trials have demonstrated the efficacy of BLT in ameliorating depression for outpatients, studies examining BLT in the psychiatric inpatient setting are currently lacking.

Aim: The purpose of this study is to explore whether BLT as adjunctive treatment for depressive symptoms on an acute psychiatric floor is feasible and explore associated changes in depressive symptoms.

Deliberate Foreign Body Ingestion in a 35-Year-Old Woman With Borderline Personality Disorder and Several Psychiatric Comorbidities.

Deliberate foreign body ingestion (DFBI) is a rare psychopathological disorder that involves the swallowing of non-nutritive objects to cause self-harm. It is most commonly associated with borderline personality disorder (BPD). Very scant literature has been published on the psychopathological understanding or psychopharmacological interventions.

Diet Quality and Mental Health Amongst Acute Inpatient Psychiatric Patients.

This is the first study that explored the self-reported dietary habits of acute psychiatric inpatients. We found that 75% of the psychiatric inpatients have an unhealthy diet, which correlates with higher body mass index (BMI) and lower education level. We also found an increased sugar consumption in inpatients with schizophrenia.

Shifting Trends in Admission Patterns of an Acute Inpatient Psychiatric Unit in the State of New York.

Introduction Deinstitutionalization has led to various changes in the utilization of healthcare services. The increased focus on treating patients within the community has led to variations in the utilization patterns of inpatient units. Shifts in demographic variables and disease-related, system-based, and economic factors have been observed.

Awareness of treatment needs and length of stay amongst psychiatric inpatients.

Introduction: Inpatient psychiatric units experience significant pressure from third party payers to keep length of stay (LOS) to a minimum despite having to treat more severely ill patients. However, there is a paucity of empiric data for guiding treatment decisions that maximize therapeutic outcome while minimizing LOS. We therefore endeavored to begin utilizing a newly created psychometric instrument that assesses patient psychological factors, which we propose will allow for LOS prediction and individualization of therapeutic outcome.

Obesity and psychotropics.

Weight gain is on the rise in the United States as is the diagnosis and treatment of mental disorders. These two phenomena are distinctly separate but tend to overlap in that most psychotropic agents approved for use in the United States are associated with the potential to induce weight gain. Metabolic disorders such as diabetes, hypercholesterolemia, and hypertension are also on the rise and often associated with weight gain and clearly associated with certain psychotropic medications.

Obesity in adults with serious and persistent mental illness: a review of postulated mechanisms and current interventions.

Background: An epidemic of overweight and obesity in the United States has had profound effects on the health of the general population, with consequent development of metabolic syndrome and related morbidity and mortality. However, these effects have been more widespread among adults with serious and persistent mental illness.

Methods: A literature search was conducted using the PubMed and Ovid databases.

Weight gain, obesity, and psychotropic prescribing.

A majority of psychiatric medications are known to generate weight gain and ultimately obesity in some patients. There is much speculation about the prevalence of weight gain and the degree of weight gain during acute and longitudinal treatment with these agents. There is newer literature looking at the etiology of this weight gain and the potential treatments being used to alleviate this side effect.

A study of polypharmacy with second generation antipsychotics in patients with severe and persistent mental illness.

Background: There is a paucity of empirical support for polypharmacy with second generation (atypical) antipsychotics (SGAs), especially in understudied populations.

Objective: To investigate the frequency, effectiveness, and safety of this practice in patients with severe and persistent mental illness who are chronically hospitalized.

Methods: A chart review was conducted at a state psychiatric hospital in Syracuse, NY.

A retrospective study of weight changes and the contributing factors in short term adult psychiatric inpatients.

Introduction: The authors endeavored to determine if there is significant weight gain during acute psychiatric inpatient hospitalization for adults and, if so, what are the contributing factors.

Methods: A retrospective chart review was conducted of all patients admitted to the psychiatric inpatient unit of a University Hospital in the year 2001. The study was approved by the Institutional Review Board.

The potential risks of commonly prescribed antipsychotics: during pregnancy and lactation.

Chlorpromazine, haloperidol, fluphenazine, clozapine, risperidone, quetiapine, olanzapine, ziprasidone, and aripiprazole are antipsychotics commonly used in psychiatric medicine. Approximately one third of pregnant women with psychotic symptoms use antipsychotics at least once. This review will discuss the effects of antipsychotic use during pregnancy and lactation on the fetus and infant.

Variable effects of psychosocial factors on the clinical course of schizophrenia.

Background: Recent work suggests that psychosocial stress factors play a lesser role (qualitatively) in the progression of schizophrenic illness in male patients. The authors endeavored to determine if hospitalization in schizophrenic patients of both sexes is associated with less quantifiable psychosocial stress over time.

Methods: Male and female, schizophrenic inpatients from 2 urban centers in New York State (n = 31) were enrolled in this retrospective and cross-sectional study.

Resolution of risperidone-induced hyperprolactinemia with substitution of quetiapine.

Objective: To report a case of risperidone-induced hyperprolactinemia that was successfully managed with quetiapine.

Case Summary: A 30-year-old white woman with schizoaffective disorder, depressive type, and comorbid alcohol and cocaine abuse was treated successfully for her psychotic symptoms with risperidone until she developed adverse effects consistent with hyperprolactinemia. This was confirmed by laboratory blood tests, as her prolactin level was 186.

Gabapentin's effect on agitation in severely and persistently mentally ill patients.

Objective: To study the effects of adjunctive gabapentin on agitation in severely and persistently mentally ill (SPMI) inpatients.

Method: Eleven chronic SPMI inpatients on stable psychotropic medication regimens were evaluated before and after the initiation of adjunctive gabapentin for six months. The following psychometric tests were used: Brief Psychiatric Rating Scale (BPRS), Corrigan Agitated Behavior Scale (CABS), and Clinical Global Impression (CGI)-Severity.