Psychiatry 2005 - ISSN: 1550-5952 - Volume 2 - Issue 10 - October 2005
Feature Article:
Self-Mutilation and Pharmacotherapy
by Brian Daniel Smith, MD

Abstract: Objective: To critically review clinical reports on the pharmacotherapy of self-mutilation. Methods: PubMed search and review of articles dating back to 1950 contributing to the understanding of self-mutilation and its treatment, with a special focus on pharmacotherapy. Key word searches include self-mutilation, deliberate self-harm, and pharmacotherapy of borderline personality disorder. Results: Clinical reports specifically demonstrating reductions in self-mutilation mainly consist of open studies and case reports. These reports support the use of SSRIs, naltrexone, atypical antipsychotics, mood stabilizers, and clonidine in the treatment of self-mutilation. Better constructed studies demonstrate general reductions in impulsive aggression, often in the context of borderline personality disorder, through treatment with antidepressants, antipsychotics, and mood stabilizers. Conclusion: There is evidence, albeit limited, for the pharmacologic management of self-mutilation. Fu
Atypical Psychotic Symptoms in a Hispanic Population: Diagnostic Dilemmas and Implications for Treatment
by David Mischoulon, MD, PhD; Isabel T Lagomasino, MD; Chris Harmon, MD

abstract Objective: To better characterize psychotic symptoms and their treatment in Hispanic populations. Design: Chart review. Setting: Chelsea MGH Health Center and Chelsea Counseling Center (both affiliates of the Massachusetts General Hospital). Participants: Forty-four Hispanic patients presenting with psychotic symptoms in the context of mood and anxiety disorders. Measurements: Chart review focussed on diagnosis, description, and cataloguing of psychotic symptoms and review of treatment efficacy. Results: All but two patients described some atypical psychotic symptoms (e.g., doorbells or telephones ringing, voices of children, and visual hallucinations of animals or relatives). Treatment varied; 34 percent received monotherapy (either neuroleptic, antidepressant, or anxiolytic); 61 percent received polypharmacy; of these, 48 percent received a combination of antidepressant and anxiolytic; 19 percent received antidepressant with neuroleptic; 14 percent received antidepressant w
A Computerized Self-Report Symptom Distress Inventory for Use as a Routine Clinical Interview in Schizophrenia
by Kenneth M. Weiss, PhD

abstract A computer-administered interview is described that may be useful for identifying and tracking symptoms and assessing treatment outcome. The Symptoms of Schizophrenia (SOS) Inventory is a 30-item self-report instrument designed to be used with patients with schizophrenia and schizoaffective disorders. It is administered and scored on a personal computer and typically is completed in 3 to 5 minutes. The objective of this study was to examine the validity and reliability of the Symptoms of Schizophrenia (SOS) Inventory. The design of the study was a retrospective chart review. The setting of the study was the Louis Stokes Cleveland VA Medical Center inpatient wards and outpatient psychiatric clinics. Participants included 138 veterans with a diagnosis of schizophrenia or schizoaffective disorder. Measurements were based on scores from the SOS Inventory and Colorado Symptom Index (CSI). There were reliable differences between inpatients and outpatients (t=3.56, p<0.001), and it

Forensic Files:
Posttraumatic Stress Disorder Within the Forensic Arena
by Charles A. Morgan, MD, MA; Seth Feuerstein, MD, JD; Frank Fortunati, MD, JD; Vladimir Coric, MD; Humberto Temporini, MD; and Steven Southwick, MD

Letters to the Editor:
An Anxiety Disorder Secondary to Energy Drinks: A Case Report
Tim Berigan, DDS, MD
Dystonic reaction induced by Ziprasidone
Tanvir Singh, MD; Muhammad I. Rajput, MD
Regarding Forensic files

Psychotherapy Rounds:
Bereavement in Patients with Dual Diagnosis Mental Illness and Mental Retardation/Developmental Disabilities: Case Reports
by Julie P. Gentile, MD; and Mark E. Hubner, MD Series Editor: Paulette Marie Gillig, MD, PhD