The successful treatment of mania due to acquired immunodeficiency syndrome using ziprasidone: a case series.

Secondary causes of mania need to be considered when atypical features of mania are manifested. These would include those patients with a later onset and without a prior psychiatric history. This case series investigates the use of ziprasidone for the treatment of mania due to HIV, a complication that could develop in those patients with advanced stages of AIDS.

Validity of the Massachusetts Youth Screening Instrument-2 (MAYSI-2) scales in juvenile justice settings.

High prevalence rates of psychological problems among juvenile offenders underscore the need for effective mental health screening tools in the juvenile justice system. In this study, we evaluated the validity of the Massachusetts Youth Screening Instrument-2 (MAYSI-2) developed by Grisso and Barnum (2001) to identify mental health needs of adolescents in various juvenile justice settings. The sample was 1,192 adolescents (1,082 boys and 110 girls) admitted into Virginia juvenile correction facilities between the dates of July 2004 and June 2006. Analyses revealed higher MAYSI-2 scale scores for girls than for boys and MAYSI-2 scale intercorrelations were similar to those reported in the MAYSI-2 manuals (Grisso & Barnum, 2003, 2006). We also evaluated the concurrent validity of MAYSI-2 scales by examining scale score correlations with related and unrelated extratest variables. Results showed strong convergent validity for several MAYSI-2 scales.

Disinhibition due to disruption of the orbitofrontal circuit treated successfully with carbamazepine: a case series.

The frontal-subcortical pathways play a role in governing behavior. Injury may disrupt their functioning and produce neuropsychiatric symptoms. The authors discuss the kindling theory in the possible production of these symptoms, which significantly improved with the potent antikindling agent, carbamazepine.

Apathy due to cerebrovascular accidents successfully treated with methylphenidate: a case series.

Apathy has been observed in various types of neuropsychiatric illness, including degenerative, traumatic, and cerebrovascular. In this article, the authors describe the neurobiology of cerebrovascular induced apathy and its treatment.

A CASE OF PERIPARTUM OBSESSIVE-COMPULSIVE DISORDER: The Potential Role of Corticosteroids, Gonadal Steroids, and the Neuropeptide Oxytocin in its Pathogenesis.

The perinatal period represents a time of increased vulnerability to psychiatric disorders, including the largely understudied obsessive-compulsive disorder (OCD). In contrast to the gradual onset of typical OCD, postpartum OCD appears to be characterized by the rapid onset of obsessional symptoms after the birth, with onset as early as the second postpartum day with a mean time to onset of 2.2 to 3.7 weeks. We present a case of a patient with prepartum generalized anxiety disorder (GAD) and new-onset postpartum OCD. The patient's ego-dystonic obsessions were aggressive in nature ("harm to newborn") with pathological checking compulsions requiring reassurance that she would not engage in this activity. Neurobiologically, there has been speculation that changes in estrogen and progesterone in the puerperium might alter serotoninergic function, placing some women at risk for this subtype of OCD. Some research studies have found evidence to suggest that oxytocin is associated with OCD. We review the growing evidence that suggests oxytocin and gonadal steroids might play a role in the pathogenesis of some forms of OCD.

A Case of Schizophrenia With Catatonia Resistant to Lorazepam and Olanzapine Monotherapy But Responsive to Combination Treatment: Is It Time to Consider Using Select Second-Generation Antipsychotics Earlier in the Treatment Algorithm for This Patient Type?

OBJECTIVE: Catatonia is a distinct psychomotor syndrome that involves a constellation of up to 40 different symptoms. Although conventionally responsive to benzodiazepines, the catatonic syndrome is much more resistant to benzodiazepine treatment when a feature of schizophrenia. METHOD: We present a patient with schizophrenia with catatonic symptoms, marginally responsive to lorazepam challenge, lorazepam, and olanzapine monotherapy, but ultimately began combination treatment with these 2 medications. RESULTS: Our patient's score on the Bush-Francis Catatonia Rating Scale significantly decreased after 2 weeks of combination lorazepam and olanzapine without adverse effects. CONCLUSION: We propose a modification to the standard treatment protocol for catatonia, especially in those patients with schizophrenia with catatonic features.