Biomedical subjects
Publications and source records attributed to S N Gerson.
The authors report a case of Cushing's Disease that first presented as a diagnostically confusing Atypical Psychosis. Sudden death occurred secondary to unexpected gastrointestinal bleed. Pathological findings confirmed the diagnosis. Neurochemical mechanisms for the behavioral aberrations are explored.
Schizophrenia and posterior aphasia are easily cross-diagnosed, primarily because of similarities in verbal output, i.e., vagueness, looseness of association, and apparent confusion. Tape-recorded interviews with 8 posterior aphasics and 10 "loose" schizophrenics were transcribed and analyzed to provide guidelines for the clinician to differentiate the two conditions by monitoring verbal expression. Six major differentiating characteristics were identified. The authors present hypotheses that emphasize differing neuroanatomical loci and neuropsychological mechanisms to explain the differences in verbal output in schizophrenia and posterior aphasia.
A thirty-one-year-old paraplegic male requested a penile prosthesis. Psychiatric evaluations were done of both the patient and his wife. Within seventy-two hours of his arriving home with the prosthesis installed, his wife left their house to seek a divorce. The implications of this event for selecting patients for such devices are explored. Reservations are expressed about a prosthesis being inserted for patients married after the onset of impotence.
Corporate America's healthcare cost crisis and the country's budget deficit are forcing limits on the resources used to finance healthcare, including mental healthcare. At the same time, the 1990 Americans with Disabilities Act bars discrimination against patients with chronic illnesses, including chronic mental illness. Therefore, corporate benefits managers need guidance on how to ethically and rationally allocate scarce clinical resources to those high-morbidity insureds who utilize disproportionate amounts of these resources. In particular, how should we define the public/private interface: When do patients who repeatedly fail to respond to treatment fall out of the private sector's responsibility? The author, medical director for a leading behavioral healthcare utilization management company, offers the following guidelines recommending reasonable and practical limitations on trials of treatment for seven common categories of difficult psychiatric patients.