Electronic delivery of nicotine, also termed "vaping," has a growing evidence base suggesting potential harm through both exposure and withdrawal effects. The current report presents the case of a young man with multiple medical comorbidities, including insulin-dependent diabetes mellitus on an insulin pump and presumed Gilbert's disease, and chronic cannabis use who experienced acute agitation with hallucinations in the context of quitting his vape pen "cold turkey" or abruptly discontinuing use without a nicotine replacement. While undergoing hospitalization for his complaint of nausea and vomiting in the context of euglycemic diabetic ketoacidosis and cannabis use, his psychotic symptoms became evident and continued until beginning a nicotine replacement patch.
View Article and Find Full Text PDFDelusional infestation (DI) is a disorder in which patients express a firm, unwavering belief that they are infested with some type of organism but otherwise have a typical grasp on reality with relatively normal cognitive functioning. Although classified as a somatic delusional disorder, DI requires special consideration due to its complicated clinical presentation, requiring attention to several possible explanations for the symptoms the patients describe. The purpose of the current review is to first summarize the clinical background and features of the diagnosis then explore treatment options.
View Article and Find Full Text PDFPrim Care Companion CNS Disord
November 2019
Objective: To determine associations between the rate of physical restraint and demographic variables such as body mass index (BMI), ethnicity, sex, and age in the emergency department (ED) along with clinical variables such as various psychiatric diagnoses and medications.
Methods: This 6-month (October 1, 2016-March 30, 2017) retrospective chart review was conducted in the ED of a community hospital, which is also a teaching institution for medical students and residents but does not have access to psychiatry consultations via phone or in person. A total of 165 agitated patients were included in the study.
We identify a novel contextual variable that alters the evaluation of delayed rewards in healthy participants and those diagnosed with attention deficit/hyperactivity disorder (ADHD). When intertemporal choices are constructed of monetary outcomes with rounded values (e.g.
View Article and Find Full Text PDFWith both its high prevalence and myriad of negative outcomes, Attention-Deficit/Hyperactivity Disorder (ADHD) demands a careful consideration of the efficacy of its treatment options. Although the benefits of medication have a robust empirical background, nonpharmaceutical interventions evoke particular interest, as they are often viewed more favorably by parents. This review pays special attention to the use of working memory and recent cognitive training attempts in ADHD, describing its cognitive, behavioral, and biological effects in relation to current neurological theory of the disorder.
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