Biomedical subjects
Publications and source records attributed to V Siomopoulos.
While every patient who talks about suicide should be taken seriously, some patients are more likely than others to commit suicide. The author discusses the personal, social, medical, and psychiatric factors associated with high suicide risk and suggests strategies for intervention+.
The author discusses the DSM-III-R diagnostic criteria of narcissistic personality disorder in the context of Kernberg's and Kohut's observations and theorizing. He also describes other clinical manifestations of this disorder often mentioned in the literature but not included in DSM-III-R, and attempts to integrate these features into a comprehensive clinical description that distinguishes (1) features that are invariably present either emanating from the grandiose self or defensively protecting or covering up the grandiose self, and (2) features that become manifest episodically in the setting of narcissistic involvements with other people.
Psychiatric iatrogenic disorders may be induced by drug therapy or by untoward developments in the patient-physician relationship. Physicians who are familiar with the adverse effects of prescribed medications may be able to prevent such drug-related iatrogenic disorders as tardive dyskinesia, the neuroleptic malignant syndrome, sudden death and drug dependence. Awareness of problems that may arise in the physician-patient relationship may prevent such outcomes as suicide, anxiety, hypochondriasis, invalidism and psychotic symptoms.
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Heterocyclic antidepressants have been used successfully in the treatment of migraine, enuresis and encopresis, peptic ulcer disease, irritable bowel syndrome, chronic pain, narcolepsy, sleep apnea and attention deficit disorder. The mechanism of their therapeutic effects in these conditions is still unclear. Serotonergic, noradrenergic, anticholinergic and antihistaminic properties and rapid-eye-movement sleep suppression have been implicated.
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In an earlier study medical students were found to view psychiatry with considerable anxiety partly because of an underlying fear of contact with psychiatrists and mentally ill patients. After supervising medical students for several years, the present authors found that the students' reactions to psychiatric patients may include, besides fear, a variety of behaviors which seem to reflect a process of identification with the patient. In this paper they describe various patterns of this process and their effects upon student-patient interaction.
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Sadism has been for a long time, among psychoanalytic and other writers, the subject of extensive theorizing and controversy. This paper takes a fresh look at the many dimensions (sexual, characterological, neurotic, psychotic, neurological) of this old aberrations.