PCC Weekly
April 8, 2021
Ptosis and COVID-19: An Unusual Initial Finding
In this report, a COVID-19 case with hemiptosis is presented.
A Patient-Centered Approach to Opioid Use Disorder
Explore the neurobiological, psychological, psychosocial, and cultural determinants of opioid use disorder and review approaches to integrated, culturally competent care.
Observed Sex Differences in Cardiometabolic Indices in Patients on Antipsychotics: Secondary Analyses of a 12-Month Multicenter, Randomized, Controlled Trial
Recognition of sex differences can promote a more personalized patient-centered care approach to ensure goals of therapy are achieved among patients prescribed antipsychotics. Read on to find out more.
Retrograde Ejaculation With Second-Generation Antipsychotics in Schizophrenia: A Case Series and Literature Review
This report describes retrograde ejaculation with second-generation antipsychotics and its management in 4 patients with schizophrenia.
April 1, 2021
Hyperkinetic Movements in Children: Differential Diagnosis, Evaluation, and Treatment
Here, the authors provide primary care providers a foundation for understanding pediatric hyperkinetic movement disorders, including tips on creation of a differential diagnosis, assessment of risk factors, and guidance on management strategies.
Transdermal Psychotropic Agents: “Aye” or “Nay”?
In this brief report, Dr Naguy provides an overview of transdermal psychotropic medications.
Seasonal Variation in Antidepressant Prescribing: Year on Year Analysis for England
The number of prescriptions for antidepressants in England has almost doubled in the past decade. This study examined if this growth and seasonal variation in prescribing rates of different antidepressants by general practice are linked.
A Case of Balint Syndrome Due to Left Basal Ganglia Hemorrhagic Stroke: Exploring the Pathogenesis Through Parietal Lobe Circuits
This report describes a case of Balint syndrome that followed left basal ganglia hemorrhagic stroke.
March 25, 2021
A Case of Influenza Vaccine–Induced Bipolar Depression Treated With Celecoxib
Here, a case is presented of a patient who experienced a sudden relapse of bipolar depression within a few hours of receiving seasonal influenza vaccination.
Factors Leading to Reverse Migration Among Migrant Workers During the COVID-19 Pandemic: A Multicenter Study From Northwest India
This study examined the various psychosocial factors associated with reverse migration among migrant workers during the COVID-19 lockdown in India.
A Unique Case of Bulimia-Induced Purging Immediately Followed by Cannabis-Induced Hyperemesis: Is There a Co-Relation?
Here, the authors present a unique presentation of an adolescent girl with a history of bulimia nervosa with multiple chronic episodes of voluntary purging, which were immediately followed by cannabis-induced hyperemesis.
Facing COVID-19: Psychological Impacts on Hospital Staff in a Tertiary Care Private Hospital in India
The objective of this study was to investigate the prevalence of depression, anxiety, and insomnia among hospital staff working in a tertiary care private hospital in India during the early period of the COVID-19 pandemic.
March 18, 2021
The Impact of COVID-19 on Patients With Schizophrenia and Their Access to Health Care
In this commentary, the authors discuss the impact of COVID-19 on patients with schizophrenia and their access to care.
Coronaphobia in Contemporary Psychiatry: Current Status and Future Prospects
In this commentary, the authors discuss coronaphobia and the advancements that have been made to understand, measure, and treat this reaction to stress related to COVID-19.
Improving Effective Mental Health Consultation for Rural Older Adults Living With Depression and Pain: Learning From the Experiences of Rural Primary Care Physicians
Novel approaches are needed to assist rural primary care physicians in caring for older patients living with depression and pain who are at an elevated suicide risk. Read this article to find out more about the PREDICTOR model.
Interactions of the Placebo Effect and Transcranial Magnetic Stimulation
In this letter to the editor, the authors comment on a case report published previously in the PCC.
COVID-19 and Obsessive-Compulsive Disorder: The Nightmare Just Got Real
There is limited research on how a large-scale pandemic affects different aspects of OCD. Here, read about 2 cases in which there was significant deterioration in symptoms of OCD in the context of the COVID-19 pandemic.
March 11, 2021
Antidepressant-Induced Yawning
Yawning is an unusual side effect of antidepressant medications. Here, read the case of a patient who developed yawning with every antidepressant she was prescribed, resulting in discontinuation of the medication.
Electroconvulsive Therapy in Multiple Sclerosis: A Review of Current Evidence
Patients with multiple sclerosis commonly have neuropsychiatric comorbidity. ECT may be used to treat severe and life-threatening forms of mental illness when other modalities have failed or when a rapid response is required. Read on to find out more.
Joy Journal, Late-Life Depression, and the COVID-19 Pandemic
In this letter to the editor, the authors share ideas related to a report published recently in the PCC.
Recreational Nitrous Oxide and Pernicious Anemia–Associated Vitamin B12 Deficiency in a Patient Presenting With Sensorimotor Polyneuropathy
Here, read about a case of sensorimotor polyneuropathy secondary to vitamin B12 deficiency associated with recreational nitrous oxide use and pernicious anemia in a 26-year-old man.
February 24, 2021
Informing Our Response to 3 Pandemics
In this editorial, Larry Culpepper, MD, PCC Editor in Chief, discusses the 3 pandemics currently affecting patients with mental illness and thanks reviewers for their service in 2020.
An Adolescent With Wilson’s Disease and Empty Sella Syndrome Presenting as Psychotic Disorder
Psychiatric symptoms in empty sella are uncommon, but empty sella syndrome has been reported to be present along with psychosis. This report presents a case of Wilson’s disease with psychotic presentation and empty sella syndrome in an adolescent.
Neuropsychiatry, Palliative Care, and Culture: What Matters Beyond Diagnosis
Here, the authors present a patient with an end-stage neurodegenerative diagnosis, describe the role of palliative care in his management, and discuss the cultural barriers encountered and opportunities offered to the patient and his caregivers.
Coping With Craving and Withdrawal Due to Substance Use Disorders During the COVID-19 Lockdown
This study assessed craving and withdrawal coping mechanisms used by patients with substance use disorders due to disruption in availability of substances and medications due to sudden lockdown in response to COVID-19.
February 18, 2021
COVID-19 Pandemic–Induced Late-Onset Psychotic Depression With Catatonia
Self-isolation measures, while important in curbing the spread and impact of COVID-19, are likely to increase rates of anxiety and depression. Here, a case is presented of COVID-19–related anxiety leading to late-onset psychotic and catatonic depression.
Quetiapine for the Management of Tardive Dyskinesia in Schizoaffective Disorder Comorbid With Diabetes Mellitus and Chronic Kidney Disease
In this report, the authors describe the successful management of tardive dyskinesia with quetiapine in a man with schizoaffective disorder and comorbid diabetes with renal and neurologic complications as well as hypothyroidism and hypertension.
How We Treat Posttraumatic Stress Disorder
Optimal intervention for patients experiencing PTSD often includes prolonged follow-up that applies both talk and drug therapies in a supportive environment. This narrative review describes psychotherapeutic and pharmacologic approaches to treat PTSD.
Implementation of an Adult ADHD Toolkit in Primary Care: A Prospective Cohort Survey
Adult ADHD presents unique challenges for primary care providers. Thus, volunteer primary care and mental health providers created an Adult ADHD Toolkit with information on ADHD and treatment. This study assessed the impact of toolkit implementation.
Development of Insomnia Associated With Different Formulations of Bupropion
In this brief report, the authors evaluate the effects of a possible association between different bupropion formulations and treatment-emergent insomnia in veterans with major depressive disorder prescribed bupropion based on provider discretion.
Supportive Therapy in the Medically Ill: Using Psychiatric Skills to Enhance Primary Care
Supportive therapy is a practical and flexible psychosocial intervention that busy practitioners can use to help patients struggling emotionally with a medical illness. Learn more in this CME journal article.
Olanzapine-Induced Aggression
Here, read about a 29-year-old woman who presented to our inpatient psychiatric facility for manic-like symptoms including pressured speech, flight of ideas, sexual preoccupations, and self-reported euphoria.
Altered Affective Temperaments in Women With Vaginismus
Are women with vaginismus more susceptible to developing bipolar disorder? This study investigated the affective temperaments of women with vaginismus compared to healthy controls. The results may surprise you.
COVID-19–Associated Panic Disorder
The psychiatric sequelae of the currently evolving COVID-19 pandemic are not yet clear. This report describes a case of panic disorder in a patient with COVID-19 infection.
Delirious Mania: An Approach to Diagnosis and Treatment
Have you ever wondered what is responsible for an altered mental status with agitated behaviors or how to evaluate a patient with such symptoms? If so, then this article illustrating the complexity of diagnosing such a patient should prove useful.
January 21, 2021
Intrusive-Destructive Behaviors: Novel Behavioral Presentations of Patients With Co-Occurring Tourette Syndrome, Obsessive-Compulsive Disorder, and Attention-Deficit/Hyperactivity Disorder
Have you wondered why people act impulsively or compulsively? Have you been frustrated when strategies to change behaviors are unsuccessful? If so, then this article may prove useful by providing insights into intrusive-destructive behaviors.
Multiple Sclerosis During the COVID-19 Pandemic
In this commentary, the authors discuss the challenges with regard to treating patients with multiple sclerosis during the COVID-19 pandemic.
Depression, Anxiety, and Coping During the COVID-19 Pandemic Among Indian Expats in the Middle East: A Survey Study
COVID-19 has increased rates of anxiety and stress. This study evaluated psychological distress and coping mechanisms among Indian expats working in the Middle East during the COVID-19 pandemic.
January 14, 2021
Long-Acting Aripiprazole in the Management of Violence in Treatment Nonadherent Schizophrenia
Long-acting injectable aripiprazole is a viable treatment for patients with psychosis and violent conduct due to its behavioral and cognitive effects. Read this case report to find out more.
Stimulant Use for Analgesia: A Case Series
Here, read about 2 patients who utilized nonprescription stimulants for analgesia. One smoked methamphetamine for relief of chronic back pain, while another smoked cocaine for relief of eye pain secondary to a workplace injury.
A Comment on Clozapine-Induced Enuresis: An Underrecognized and Undertreated Problem
In this letter to the editor, Dr Naguy comments on a report previously published in the PCC.
COVID-19 and Physician Assistant Education: Big Changes in the Classroom, Bigger Changes in the Clinic
In this commentary, the authors discuss the impact of COVID-19 on the delivery of physician assistant education.
January 7, 2021