Neurosarcoidosis presenting as an intrasellar pseudotumoral mass: case report.
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Biomedical subjects
Publications and source records attributed to L Morissette.
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Borderline patients, because of their symptomatology are frequent users of health care services (mental and physical). A recent review of the literature shows that the authors of this article favor a treatment within the community that should be eclectic, on a long-term basis and with varied intensity. The hospital is part of the therapeutic tools available for the treatment of these patients and should serve to contain crisis, specify diagnosis and to prepare and reinforce a rapid return in their community. Exceptionally, a prolonged hospitalization (> 6 months) would be indicated especially for adolescents.
The notion of "mediation" has profoundly transformed clinical approaches aiming at a change either in knowledge, in the way of being or of behaving. The way to treat narcissistic-borderline adolescents in the long-term in a secure hospital does not escape this notion. Until now, the psychodynamic-analytical approach has been the only one presenting interventions in such context, and this, since many decades. The present article attempts to witness the evolution of the clinical approaches within the Quebec security-hospital milieu, and to translate in E.J. Young's cognitive language part of the clinical work currently done. The active and mediation role of the clinical intervenor (including the psychotherapist) constitutes the guiding line of the gradual transformation of approaches.
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Studies describing the profile of juveniles charged or guilty of homicide have been inconsistent in their findings. For instance, Sendi and Blomgren found that 60 per cent of their adolescent murderers sample suffered from schizophrenia, while Cornell, Benedek, and Benedek identified only 6.9 per cent of psychotic subjects among the homicide group. Important gaps can also be noticed among studies describing the prevalence of personality disorders among homicidal adolescents. Rosner, Wiederlight, Horner-Rosner, and Wieczorek indicate that 50 per cent of the population they studied were diagnosed as having a personality disorder, while Fiddes found no more than 5 per cent of such cases.
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The authors discuss the available literature on a possible modification of traditional hospitalization in psychiatry : the brief hospitalization. Then they share a 30 month' experience in a transitory treatment unit at Albert-Prévost. Finally, the authors underline the fact that even if research and current use promote such an approach, this form of treatment is rare : they look into the reasons for such a state of affair.
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