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Biomedical subjects

Randy A Sansone

Publications and source records attributed to Randy A Sansone.

At least 19 recordsLinked to original sources
PubMed2006

The relationship between suicide attempts and low-lethal self-harm behavior among psychiatric inpatients.

In this study, we examined the relationship between suicide attempts and low-lethal self-harm behavior in a sample of psychiatric inpatients. Using a cross-sectional approach, we surveyed 107 participants about their histories of suicide attempts, including overdoses, as well as various low-lethal self-harm behaviors. Compared with those without such histories, individuals with histories of suicide attempts, including overdoses, were significantly more likely to report a greater number of: 1) low-lethal self-harm behaviors; 2) specific symptom clusters of self-harm behavior (i.e., self-mutilation, substance abuse, medically self-defeating behaviors); and 3) specific individual self-harm behaviors (e.g., torturing oneself with self-defeating thoughts, abusing prescription medications). These data suggest that suicide attempts and low-lethal self-harm behavior are likely to co-exist in many psychiatric inpatients.

Adult↗
PubMed2006

The comfort level of internists with the prescription of psychotropic medication.

INTRODUCTION: Empirical data indicate that patients seen in internal medicine outpatient settings have substantial rates of depression and other psychiatric disorders. Surprisingly, the training requirements established by the Residency Review Committee in Internal Medicine do not include a specific psychiatry training curriculum, but rather vaguely refer to "sufficient instruction and clinical experience" in psychiatry. METHOD: In this study, internists on staff at a community hospital were surveyed to ascertain their general level of comfort with prescribing psychotropic medication. The study hypotheses were: (1) compared with other psychotropic medications, internists would generally be most comfortable with the prescription of antidepressants; (2) younger, rather than older, internists would be more comfortable with prescribing psychotropic medications; and (3) internists with greater outpatient, versus inpatient, responsibilities would be more comfortable with psychotropic medication prescription. RESULTS: This sample of internists demonstrated differences in prescribing comfort by medication group (F(3) = 48.99, p < .001) and was most comfortable in prescribing antidepressants and benzodiazepines, in contrast to antipsychotics and other types of psychotropic medications; comparing older with younger internists, there was a significant between-group difference in the mean number of medications positively endorsed, t(66) = 2.16, p <.05, with younger internists indicating broader comfort levels; and inpatient internists were significantly more comfortable prescribing antipsychotics than outpatient internists, t(117) = -3.38, p = .001. CONCLUSIONS: There are some distinct psychotropic prescription trends among internists, which have implications for future training and quality improvement programs.

Adult↗
PubMed2006

Borderline personality symptomatology and employment disability: a survey among outpatients in an internal medicine clinic.

OBJECTIVE: The relationship between borderline personality symptomatology and employment disability has undergone limited study. Four previous studies indicate a possible relationship, but each has its own inherent limitations. In the present study, we examined this relationship among 94 internal medicine outpatients. METHOD: Using a sample of convenience, we administered 2 self-report measures for borderline personality (the Personality Diagnostic Questionnaire-4th Edition, which is based on DSM criteria, and the Self-Harm Inventory, which correlates with scores on the Diagnostic Interview for Borderlines) and inquired about the lifetime presence and length of either psychiatric or medical disability. The study was active from February 2003 through January 2005. RESULTS: There was a significant and positive correlation between scores on both borderline personality measures and the length of psychiatric disability for women (r = .33, r = .36, p = .05); however, no significant relationship was found between scores on either measure for borderline personality and the length of either psychiatric or medical disability for men. CONCLUSIONS: These findings suggest that, in contrast to men, there may be a relationship between borderline personality symptomatology and psychiatric disability only among women (i.e., there may be a gender difference). We discuss the possible implications of these results.

Journal Article↗
PubMed2005

An unusual cause of dizziness in bulimia nervosa: a case report.

OBJECTIVE: The current article describes the case of a 23-year-old female with purging-type bulimia nervosa who was evaluated by her primary care physician for dizziness and lightheadedness. METHODS: After laboratory studies were performed by her primary care physician, the patient was admitted to the hospital because of severe anemia. The patient had been taking nonsteroidal antiinflammatory drugs (NSAIDS) at prescribed doses for shin splints that were secondary to jogging and developed gastric erosion. RESULTS: Endoscopic examination showed that she had diffuse gastritis with linear, streaky ulcerations throughout the body of the stomach. DISCUSSION: Lightheadedness is a common clinical symptom among individuals with eating disorders, but is typically related to dehydration, malnutrition, hypometabolism, and/or combinations of these factors. Clinicians need to consider NSAID use, which may cause erosive gastritis, blood loss, and lightheadedness.

Adult↗
PubMed2005

Childhood trauma and employment disability.

INTRODUCTION: While the relationship between childhood trauma and employment disability has undergone very limited study, existing data suggest a possible correlation. METHOD: In this study of 91 outpatients in an internal medicine setting, we surveyed participants and inquired about their childhood histories of sexual, physical, and emotional abuse, of physical neglect, and of witnessing violence. We also asked whether participants had ever been on employment disability, either psychiatric or non-psychiatric, and the length of that disability. RESULTS: Being or having been on disability was significantly related to childhood histories of emotional abuse, physical neglect, and witnessing violence. Being or having been on psychiatric disability was significantly related to childhood emotional abuse and physical neglect while being on non-psychiatric medical disability was significantly related to witnessing violence. The percent of one's lifetime on disability was significantly related to physical and emotional abuse as well as witnessing violence. CONCLUSIONS: Maltreatment in childhood appears to have a relationship to employment disability in adulthood. The authors discuss the implications of these findings.

Adolescent↗
PubMed2004

Prevalence of anxiety symptoms among a sample of outpatients in an internal medicine clinic: a pilot study.

Previous studies in primary care settings indicate that Axis I anxiety disorders range in prevalence from 2.1% to 14.8%. However, the prevalence of anxiety symptoms, rather than Axis I diagnoses, has undergone limited study. In a pilot study, we surveyed 88 outpatients in an internal medicine clinic and explored the prevalence of various anxiety symptoms based on four measures of anxiety and worry. Thirty percent of participants endorsed mixed anxiety features, 33% reported generalized anxiety symptoms, nearly half acknowledged obsessive-compulsive personality symptoms, and nearly a quarter identified meaningful levels of worry. Seventeen percent of participants were positive on all four study measures. These data suggest that anxiety symptoms are probably more prevalent in primary care settings than recognized.

Anxiety↗
PubMed2004

Psychological aspects of fibromyalgia: research vs. clinician impressions.

OBJECTIVE: This study was designed to compare the psychological features of patients with fibromyalgia, as described in the research literature, with physicians' clinical impressions. METHOD: Using a survey method, physicians (n=44) and physicians-in-training (n=54) were polled regarding their clinical impressions of 18 psychological features, culled from the research literature, which are attributed to fibromyalgia patients. RESULTS: Over 90% of respondents reported that fatigue, muscle tension, pain proneness, depression and anxiety were clinically associated with fibromyalgia patients "frequently" or "very frequently." The majority of respondents (52%) endorsed 10 of 18 items as occurring "frequently" or "very frequently." CONCLUSIONS: Physicians and physicians-in-training appear to observe in fibromyalgia patients over half of the psychological features identified in the research literature. For the remainder of items, we discuss possible explanations for the disparity.

Anxiety↗
PubMed2004

Chronic suicidality and borderline personality.

Suicidal ideation is a complex clinical event. In this article, acute suicidal ideation is compared with chronic suicidal ideation, specifically their different meanings, relationships with Axis I and Axis II disorders, intrapsychic functions, approaches to assessment, and interventions. The potential risks of acute hospitalization of the chronically suicidal borderline personality disorder patient are discussed as well as a longitudinal, multidimensional treatment strategy for the chronically suicidal individual.

Antisocial Personality Disorder↗
PubMed2003

Metoclopramide and unintended weight gain.

OBJECTIVE: This paper describes the case of a 19-year-old female with anorexia nervosa (restricting type) who was prescribed metoclopramide (Reglan, Robins, Richmond, VA) for delayed gastric emptying. She subsequently experienced dramatic and unintended weight gain. RESULTS: The initial treatment of delayed gastric emptying with metoclopramide did not result in a significant change in body weight. However, an increase in the dose resulted in a 20% increase in the patient's body weight over a 2-month period. DISCUSSION: The risks of weight gain that accompany the administration of metoclopramide are discussed, as well as the postulated etiology and psychological implications for the patient.

Adult↗
PubMed2003

Anxiety symptoms and healthcare utilization among a sample of outpatients in an internal medicine clinic.

OBJECTIVE: In this study, we explored the role of anxiety symptoms (i.e., symptoms that would probably not fulfill DSM criteria) in relationship to healthcare utilization. METHOD: We surveyed 117 outpatients in an internal medicine clinic regarding four types of anxiety symptoms (i.e., mixed anxiety features, generalized anxiety, obsessive-compulsive personality features, worry), and through a retrospective review of medical records, examined healthcare utilization patterns. RESULTS: Nearly 28% of participants endorsed "positive" results on at least three of the anxiety-symptom measures. When examined for relationships to healthcare utilization, only obsessive-compulsive personality features demonstrated a significant relationship. CONCLUSIONS: While anxiety symptoms were common in this primary care sample, their impact on healthcare utilization was limited, in that only obsessive-compulsive personality features demonstrated a relationship.

Adolescent↗
PubMed2003

QTc prolongation due to propranolol overdose.

Prolongation of the QTc interval (a QT interval that has been corrected for heart rate) increases the risk of cardiac arrhythmias, and is an important topic with regard to psychotropic medication. Several typical (e.g., pimozide, thioridazine, haloperidol) and atypical (e.g., sertindole, ziprasidone) antipsychotics may cause QTc prolongation as well as some antidepressants in overdose (e.g., citalopram). We wish to present a case of QTc prolongation that was due to an overdose of propranolol (used in psychiatry for the treatment of akathisia, lithium-induced tremor, and performance anxiety; used in medicine for hypertension and congestive heart failure).

Adolescent↗
PubMed2003

Sertraline-induced hyperglycemia: case report.

Empirical studies with humans suggest that selective serotonin reuptake inhibitors (SSRIs) may, through increases in serotonergic activity, increase insulin secretion, increase insulin sensitivity, and lower serum glucose levels. Indeed, the potentially beneficial effects of SSRI treatment in diabetics are documented. However, we describe the case of a female, with diet-controlled, type 2 diabetes, whose glucose levels increased with exposure to sertraline.

Antidepressive Agents↗