Biomedical subjects

R Lowinger

Publications and source records attributed to R Lowinger.

3 recordsLinked to original sources

PubMed1999

Psychiatric emergencies: rapid response and life-saving therapies.

Mental status in older patients can be acutely affected by a range of factors, particularly polypharmacy, disorders of cognition, psychosis, and elder abuse. Patients so affected may be agitated, uncooperative, combative, suicidal, or incapable of participating in treatment decisions. In a life-threatening emergency, a patient may need to be restrained or a treatment administered against a patient's wishes. Key to successful management of psychiatric emergencies is an awareness of the potential scenarios, familiarity with appropriate interventions, and an understanding of patient rights. An increased alertness for life-threatening behaviors can help prevent an event from worsening and minimize the likelihood of a patient acting out on a threat of violence or suicide.

Aged↗

PubMed1997

Cognitive deficits and psychopathology in elderly schizophrenic patients.

The authors investigated the syndromal and cognitive profiles of 25 DSM-III-R older schizophrenic inpatients with continuous acute psychotic symptoms and compared them with 20 younger schizophrenic patients by means of a multidimensional assessment battery. Subjects were medically well and without neurological comorbidity and were comparable in length of current hospitalization and medication regimens. There were no significant differences between the two groups on various symptom rating scores or on neurological variables. The older group's mean scores for various cognitive measures did not reach the value for senile dementia. They also scored significantly better on a memory test and on formal cognitive functions. These findings support the notion of a stable encephalopathy, rather than a dementia-like process, underlying the course of the illness. Authors discussed limitations and implications of these findings.

Adult↗

PubMed1993

Psychogeriatric emergencies.

Through training and orientation, clinicians specializing in geriatric medicine are well-equipped to identify the various contributors to life-threatening mental states and associated conditions of older adults. The clinical drill to sort out factors contributing to a change in mental status is well-known and only the less frequently encountered causes and complications of treatment are considered in the previous paragraphs. In situations where a major mental disorder or suicidal or assaultive ideas are suspected, psychiatric consultation will be helpful. When treatment decisions (e.g., acceptance of hospital admission or diagnostic procedures) are difficult to resolve because of distress or conflict in the patient or family, a psychiatric consultation should also be considered. The more challenging task lies in the area of preventable emergencies, those that arise as a result of unsuspected suicidality, elder abuse or an unrecognized anxiety disorder. The pressures of ED practice and the complexity of pathology seen in the clinic work against keeping the physician alert to these possibilities. However, the present economic distress and demographic shifts in American society are unlikely to slow the increase in late life suicide and abuse. The extent to which more aggressive efforts at community outreach might offset the costs of emergency care as well as our seniors' quality of life remain to be demonstrated.

Aged↗