Reliability and practicality of measuring waist circumference to monitor cardiovascular risk among community mental health center patients.

The aim of this study was to evaluate the clinical utility of measuring waist circumference (WC) in obese individuals with severe psychiatric disabilities. Reliability of the measure and researchers' comfort were assessed. Thirty outpatients with a diagnosis of schizophrenia or schizoaffective disorder were recruited from an urban community mental health center and WC was measured using two methods by three different raters. Inter- and intra-rater reliability was calculated. Raters reported on their comfort with obtaining WC. There was good inter-rater reliability and an acceptable rate of error independent of measurement location. Overall, raters were not comfortable with the WC measurement process for multiple reasons and reported difficulty with the measurement process. Our findings suggest that non-medical staff can reliably and validly measure WC within a typical outpatient mental health treatment setting, but discomfort with the procedure and difficulty with the measurement process may interfere with this practice as part of usual care.

Report of a mental health survey among Chinese international students at Yale University.

OBJECTIVE: To examine the prevalence of depression and anxiety symptoms in Chinese international students, to identify factors that might be associated with these 2 symptom complexes, and to investigate their perception of mental health issues and counseling services. PARTICIPANTS: Chinese students (N = 130) at Yale University. METHODS: Participants completed an anonymous online survey in fall 2009. RESULTS: Forty-five percent reported symptoms of depression, and 29% reported symptoms of anxiety. A self-evaluation of poor current health, a poor relationship with one's advisor, and a low exercise regimen were associated with a higher prevalence of depression and anxiety symptoms. Twenty-seven percent of responders were not aware of the availability of mental health and counseling services on campus. CONCLUSIONS: This study suggests that efforts should be made to improve the relationship between students and their advisors and to enhance the awareness of and the accessibility to mental health and counseling services to improve the mental health of Chinese international students.

Chronic catatonia with obsessive compulsive disorder symptoms treated with lorazepam, memantine, aripiprazole, fluvoxamine and neurosurgery.

Catatonia is a syndrome with protean manifestations and multiple aetiologies. In this report, the authors describe the case of a young woman who presented for care after a 13-year period of catatonia-like symptoms, including mutism, refusal to eat and persistent neck flexion. Medical management included placement of a percutaneous endoscopic gastric tube for nutritional support. A thorough medical investigation later revealed the presence of a cervical spine haemangioma that was treated surgically, with improvement in neck posturing. Psychopharmacological treatment included lorazepam, aripiprazole and memantine. Addition of fluvoxamine to target obsessive compulsive disorder (OCD)-like symptoms resulted in clinical improvement, suggesting OCD as a possible cause of this patient's chronic catatonic state.

Safe return to homeland of an illegal immigrant with psychosis.

The disposition of illegal immigrants who lack social support and wish to return to their homeland is a frequent and difficult challenge for many mental health facilities in the United States. This case involved an undocumented Mexican patient with severe psychosis who was safely transferred to his hometown according to his and his family's wishes through the use of specific services provided by the Mexican Consulate. We hope that publication of this case will make the medical community more aware of the availability of these underused services, which can make a major difference in the prognosis of some undocumented patients who would otherwise be left without resources or appropriate care.

Nonviral vector gene modification of stem cells for myocardial repair.

Therapeutic angiogenesis and myogenesis restore perfusion of ischemic myocardium and improve left ventricular contractility. These therapeutic modalities must be considered as complementary rather than competing to exploit their advantages for optimal beneficial effects. The resistant nature of cardiomyocytes to gene transfection can be overcome by ex vivo delivery of therapeutic genes to the heart using genetically modified stem cells. This review article gives an overview of different vectors and delivery systems in general used for therapeutic gene delivery to the heart and provides a critical appreciation of the ex vivo gene delivery approach using genetically modified stem cells to achieve angiomyogenesis for the treatment of infarcted heart.

A pilot study of a weight management program with food provision in schizophrenia.

Obesity is a serious medical problem that disproportionately affects people with severe mental illness. Behavioral strategies aimed at lifestyle modification have proven effective for weight loss in general population but have not been studied adequately among persons with schizophrenia. We have conducted a randomized controlled pilot trial of an established weight loss program, modified for this specific population, and supplemented with a novel food replacement program, as well as practical, community based teaching of shopping and preparing healthy food. The program not only arrested weight gain, and produced meaningful weight loss, but also weight loss continued 6 months after the intervention is completed. Cognitive impairment had no bearing to the extent a participant benefited from the program. As a conclusion, well designed simple behavioral programs can produce lasting weight loss for patients with schizophrenia and comorbid obesity, improve metabolic indices, and possibly decrease significant medical risks associated with obesity.

Two cases of brief psychotic disorder related to media coverage of the September 11, 2001 events.

To our knowledge new-onset psychotic symptoms have not been reported in connection with the September 11, 2001 terrorist attacks on the World Trade Center and the Pentagon. We describe two cases of brief psychotic disorder in adults who experienced the terrorist attacks from afar through television coverage. The patients were brought in for assessment to a medical center in the northeastern United States approximately 2 weeks after the attacks on September 11. We discuss the role of television coverage of stressful events in the induction of psychotic symptoms.