Misdiagnosis of severe dystonia.
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Biomedical subjects
Publications and source records attributed to J O Cavenar.
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Termination of psychotherapy has been infrequently examined in the literature and often ignored by many training programs. Not only are criteria and techniques for termination not often discussed, but termination as a therapeutic opportunity has been neglected. The authors present two cases of psychotherapy termination initiated by the therapist and point out that countertransference phenomena, potentially destructive, are the major aspect separating psychotherapy termination by mutual agreement and termination initiated by the therapist. Careful, regular, and attentive supervision for therapists in training is essential to counterbalance the intensified countertransference reactions involved.
A number of researchers have suggested that the pregnant psychiatrist has many intrapsychic conflicts, as a result of the pregnancy, which influence her interactions with colleagues. In contrast, the authors suggest that colleagues' reactions to the pregnancy may be based on their intrapsychic conflicts, which create internal conflicts for the pregnant psychiatrist and affect her relationships with her colleagues. The authors present case reports involving psychiatric residents that illustrate their thesis.
The authors review the concept of hysterical psychosis and its reported psychodynamics. They suggest a psychodynamic issue that apparently has not been previously reported, namely, emotions engendered by an overt sexual advance or rage and disappointment over a lack of a sexual advance. This finding can be most helpful in distinguishing a case of hysterical psychosis from an acute schizophrenic episode.
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We have previously reported 10 patient histories involving various intractable pain syndromes where the administration of Haloperidol either eliminated the need for narcotic analgesics or resulted in a significant reduction in narcotic dosage. We are presently undertaking a controlled double-blind evaluation of Haloperidol as an adjunctive treatment for intractable cancer pain. Based upon the reported clinical observations, these findings are discussed from the following aspects: 1. The isomeric similarity of Haloperidol to Meperidine. 2. Dose response between Haloperidol and analgesic effect. 3. The clinical literature regarding the use of Haloperidol for the effective withdrawal or maintenance of narcotic addicts. 4. The analgesic property as it relates to the opiate receptor.
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The authors report four cases of depression manifesting as organic brain syndrome in adult nongeriatric patients. The correct diagnoses in three cases were made by a psychiatrist's or resident's empathic response to the patient, and in the fourth by the patient's history of depression. The authors state that only by maintaining a high degree of suspicion and trusting one's empathic response to the patient will unusual presentation of depression be recognized.
This study substantiates previous reports that low platelet MAO activity is associated with alcoholism. The results also indicate that low platelet MAO activity in alcoholic probands is associated with a higher prevalence of psychiatric hospitalization in first-degree family members as well as alcoholism and suicide attempts among alcoholics. Psychiatrically ill family members of the alcoholic probands with low platelet MAO activity also demonstrate low enzyme activity whereas the well family members have normal enzyme activity.
The Isakower phenomenon is reviewed, and a psychotherapy case is described. The first 2 dreams of the therapy are felt to be variants of the Isakower phenomenon, and are believed to support several hypotheses in the literature concerning the phenomenon.
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