Jesse O. Cavenar

Preliminary study of carbamazepine in post-traumatic stress disorder

Ten patients meeting DSM-III criteria for post-traumatic stress disorder (PTSD) participated in a five-week open trial of carbamazepine. Seven patients manifested moderate to very much improvement, as shown on the Clinical Global Impression scale. Among the multiple symptoms associated with PTSD, nightmares, flashbacks, and intrusive recollections were selectively reduced in intensity and frequency. The results suggest that a kindling model or a model of a paroxysmal disorder may be applicable to PTSD.

Electroconvulsive therapy in the presence of brain tumor. Case reports and an evaluation of risk.

The clinical basis for the long established contraindication of electroconvulsive therapy (ECT) in the presence of brain tumor is reviewed, as is the recent literature that has questioned the absolute nature of that contraindication. A need for a specific estimate of risk is noted. Seven retrospective case reports are added to the 28 cases reported in the literature. The clinical case report data are then pooled and evaluated by outcome. Results indicate a 74 per cent overall morbidity, including a 28 per cent 1-month mortality rate for patients with brain tumors who receive ECT. Twenty-one per cent of the patients had a positive behavioral response to ECT without complication.

Their Problems Continue

: From August 5, 1964, the onset of the Vietnam War, until the official ending of the war, May 7, 1975, the Vietnam War tore at the fabric of American society. That tear has not yet been mended. Our nation as a whole has opposed thoughtful reflection about the Vietnam War, and our veterans continue to suffer its consequences. This article summarizes some of the national and psychological problems caused by the war. Special characteristics of the Vietnam War that contributed to these problems are discussed, and post-traumatic stress disorder is reviewed.

Blepharospasm: organic or functional?

Abstract The literature concerning blepharospasm, a rare condition characterized by involuntary and sustained closure of the eyelids, is reviewed, and four patients evaluated and treated by us, described. Our experiences reviewing the literature, and treating patients affected by this condition, lead us to believe that several significant aspects of this disease have not been previously understood or reported.

Capgras syndrome-a biochemical marker?

Two cases of Capgras syndrome are reported in which platelet monoamine oxidase (MAO) activity is significantly less than that of 24 psychiatric controls and 39 nonpsychiatric controls. This is the first report of a consistent biochemical abnormality associated with the Capgras phenomenon. Additional evidence is discussed which suggests that psychiatric patients with Capgras syndrome may belong to a discrete group of behavioral disorders characterized by reduced platelet MAO activity.

Abdominal pain in expectant fathers.

Three case histories of patients experiencing significant emotional difficulties while anticipating fatherhood are reported. Each man, during his wifes pregnancy, experienced abdominal pain for which no physical cause could be found. Contrary to previous findings, our experience indicates that such pain, called the couvade syndrome, usually requires psychiatric hospitalization.

A diagnostic approach to pain.

Abstract Various factors involved in pain, including the causative stimulus, the affective-cognitive reaction, and the subsequent coping reaction, are explored, and a composite model is provided that may be helpful in narrowing the diagnosis and thus localizing areas where effective intervention may be possible.

Serum dopamine-β-hydroxylase in chronic alcoholism

Previous reports suggest that high serum dopamine-beta-hydroxylase (DBH) activity may be associated with vulnerability to alcoholism. However, there are also contradictory studies in the literature. Therefore we measured serum DBH in chronic alcoholics followed for 12 months in a treatment programme after psychiatric hospitalization for acute alcoholism. Mean serum DBH activity in the alcoholics was unchanged from controls at 3 months, 6 months and 12 months following hospital discharge. These data imply that serum DBH activity does not provide a useful metabolic screen for vulnerability to chronic alcoholism. However, prospective studies of patients at high risk to develop alcoholism will be helpful in further clarification of this issue.

On conscious primal scene fantasies.

Pertinent literature concerning the pathogenicity of the primal scene is reviewed. Two psychoanalytic cases, both of whom had conscious primal scene fantasies prior to beginning psychoanalysis, are discussed. These fantasies did not represent significant ego or superego deficits. The authors suggest that conscious primal scene fantasies, in these patients, represented screen memories. Both patients were successfully analyzed.