Kim D. Bullock

Group therapy for patients with psychogenic nonepileptic seizures: a pilot study.

Great advances have been made in the diagnosis of people with psychogenic nonepileptic seizures (PNES) since the advent of video/EEG monitoring. However, treatment options for this population have lagged significantly. This pilot study was undertaken to evaluate whether group therapy done with a psychodynamic focus would offer a useful intervention. Twelve patients entered the study and seven completed at least 75% of the 32 weekly sessions. The Beck Depression Inventory and the Global Severity Index of the Symptom Checklist-90 showed improvement as well as an overall decrease in PNES frequency. The data suggest that group therapy focusing on interpersonal issues may benefit patients with PNES.

Current Status of the Utilization of Antiepileptic Treatments in Mood, Anxiety and Aggression: Drugs and Devices

Interventions that have been utilized to control seizures in people with epilepsy have been employed by the psychiatric community to treat a variety of disorders. The purpose of this review will be to give an overview of the most prominent uses of antiepileptic drugs (AEDs) and devices like the Vagus Nerve Stimulator (VNS) and Transcranial Magnetic Stimulation (TMS) in the treatment of psychiatric disease states. By far, the most prevalent use of these interventions is in the treatment of mood disorders. AEDs have become a mainstay in the effective treatment of Bipolar Affective Disorder (BAD). The U.S. Food and Drug Administration has approved the use of valproic acid for acute mania, and lamotrigine for BAD maintenance therapy. AEDs are also effectively employed in the treatment of anxiety and aggressive disorders. Finally, VNS and TMS are emerging as possibly useful tools in the treatment of more refractory depressive illness.

Group Dialectical-Behavior Therapy Skills Training for Conversion Disorder With Seizures

Neuroimaging evidence suggests deficits in affective regulation in conversion disorder (CD). Dialectical-behavior therapy skills training (DBT-ST) was developed to target emotion dysregulation. This study was aimed to test the feasibility of stand-alone DBT-ST for CD using Linehans manual for borderline personality disorder. In a prospective naturalistic design, 19 adult outpatients diagnosed with video EEG-confirmed seizure type CD were recruited and received weekly group DBT. Seventeen out of 19 subjects finished an average of 20.5 weeks of treatment. The mean seizure rate decreased by 66%. Cessation of seizures occurred in 35% of the sample. Completion rates reached 90%.

Obsessive-Compulsive Disorder Presenting as Gender Dysphoria/Gender Incongruence: A Case Report and Literature Review

ABSTRACT Objective: With the intensified public awareness and media coverage of issues concerning gender identity and gender incongruence, distinguishing true gender dysphoria or incongruence from the sexual obsessions of obsessive-compulsive disorder (OCD) is especially important. Although intrusive sexual obsessions are not uncommon in OCD, obsessions concerning sexual content are more difficult for clinicians to identify as OCD than other types of obsessions (e.g., obsessions concerning contamination). Making the correct diagnosis helps ensure that appropriate clinical treatment can be offered. Methods: We present a case report of a homosexual, single, young male with new-onset intrusive repetitive obsessive thoughts that he was transgender. The case report is accompanied by a review of the pertinent endocrine and psychiatric literature. Results: A Yale-Brown Obsessive Compulsive Scale indicated a significant negative impact of the patients symptoms. Conclusion: To our knowledge, this is the first cas...

Clinical Cases and Self-Study Review for the Mental Health of Military and Veteran Populations

This chapter contains case studies for a wide range of mental health scenarios pertinent to active military service members and veterans. Each clinical case study is followed by a self-study review, which includes a set of questions and assignments regarding diagnoses, treatment plans, ethical considerations, and military and veteran systems of care. These self-study reviews are designed to help the learner understand the unique needs of military and veteran populations and to practice applications of the fundamental principles for mental health care of these populations. The learner may refer back to relevant chapters from the book to build a conceptual framework for understanding these cases and their implications for care.