Editor’s Message: Issue Highlights, May–June 2013

| June 10, 2013 | 0 Comments

ICNS_May-June13_CoverDear Colleagues:

Welcome to the May–June 2013 issue of Innovations in Clinical Neuroscience. This month, we start with a study by Kotwicki and Harvey titled, “Systematic Study of Structured Diagnostic Procedures in Outpatient Psychiatric Rehabilitation: A Three-year, Three-cohort Study of the Stability of Psychiatric Diagnoses.” Here, the authors examined the differential usefulness of two semi-structured interviews of differing length compared to clinical diagnoses for generation of diagnoses that did not require modification over the course of treatment. The authors found, in the examined setting, that there appears to be a reasonable trade-off between brevity and accuracy through the use of the MINI compared to the SCID, with substantial improvements in stability of diagnoses compared to clinician diagnoses. The authors conclude that structured assessment, particularly early in the illness or in short-term treatment settings, may improve treatment planning.

Next, Trigoboff et al present, “Sialorrhea and Aspiration Pneumonia: A Case Study,” in which the authors compare two different clinical outcomes for a patient with a long-standing psychotic disorder prescribed clozapine on two occasions. During the first trial, clozapine was used at a higher dose for this patient and included clinically significant sialorrhea, pneumonia, and pneumonia-like illnesses requiring immediate medical intervention including hospitalization. Clozapine was discontinued for a time, but the patient’s psychotic symptoms were not being adequately controlled on other medications and so a second clozapine trial was attempted. This time, after the appropriate lower dosage for this patient was established, the patient’s psychotic and affective symptoms were controlled and he was not hampered by adverse side effects, As a result, the patient was able to actively participate in social and recreational activities and plans that culminated in discharge from a state psychiatric facility to a supportive community residence.

Following this, Talih presents a case report titled, “A Probable Case of Peduncular Hallucinosis Secondary to a Cerebral Peduncular Lesion Successfully Treated with an Atypical Antipsychotic.” While this rare condition is well-covered in the current literature, the author does a commendable job of describing how this rather complicated diagnosis by exclusion was made, making this article an excellent teaching case for residents.

We wrap up the issue with two of our regular columns. In this month’s Update on Alzheimer’s Disease column, Howe describes the clinical implications of the new diagnostic guidelines for dementia, particularly when dealing with patients who would rather not know that they likely have Alzheimer’s disease. And in this month’s The Interface, Sansone and Sansone examine the perceptions and reactions of mental health clinicians toward patients with borderline personality disorder. We hope you enjoy the issue. As always, we welcome your submissions and feedback.

Amir Kalali, MD
Editor, Innovations in Clinical Neuroscience

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Category: Editor's Message: Issue Highlights, Past Articles

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