Cut it out or wait it out? Case series of middle fossa arachnoid cysts presenting with psychiatric symptoms and a discussion of the ethics of neurosurgical management

Arachnoid cysts have been linked to neuropsychiatric morbidity. We describe two patients presenting with dissociative and manic symptoms believed to be associated with middle fossa arachnoid cysts. They were managed medically and remitted eventually, but symptoms were resistant. We briefly

CUMS and dexamethasone induce depression-like phenotypes in mice by differentially altering gut microbiota and triggering macroglia activation

Background Although the link between gut microbiota and depression has been suggested, changes of gut microbiota vary largely among individuals with depression. Aims Explore the heterogeneity of microbiota–gut–brain axis and new pathogenic characteristics in murine models of depression. Methods Adolescent

[Editorial] Readiness is all

Emergency room psychiatry does not often make it into the pages of medical journals. Academic thought—and research money—is mostly directed towards longer-term issues in mental health. Epidemiological studies might track patients over decades. Trial endpoints are often set at weeks,

IF

When we took the editorship of Evidence-Based Mental Health (EBMH) at the end of 2013, we set two main objectives: to promote and embed an evidence-based medicine (EBM) approach into daily mental health clinical practice, and to get an impact

Freedom of Speech

Of the many functions delegated to the human nervous system, perhaps none is more essentially human than the ability to express one’s thoughts. For persons with severe speech and motor impairments, restoration of the ability to communicate even simple needs

Freedom of Speech

Of the many functions delegated to the human nervous system, perhaps none is more essentially human than the ability to express one’s thoughts. For persons with severe speech and motor impairments, restoration of the ability to communicate even simple needs

Through the Fog

“You still haven’t figured out why?” my patient asked calmly. He was lucid for the first time in days. “No, but we’ve ruled out many diagnoses.” He sighed deeply and shook his head. “This is a hell of a thing.”

My Intern

“Bobby hasn’t come in yet today,” one of my chief residents told me. “He isn’t picking up his phone or answering his pager. Could you go and check on him?” I was in my final year of my internal medicine

My Intern

“Bobby hasn’t come in yet today,” one of my chief residents told me. “He isn’t picking up his phone or answering his pager. Could you go and check on him?” I was in my final year of my internal medicine

Led Astray

Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information by sharing relevant background and reasoning with the reader (regular type). The authors’ commentary follows.

Bipolar Disorder

Mood fluctuations are common during normal daily life as a result of either stressful or pleasant events. However, severe and persistent mood swings that result in psychological distress and behavioral impairment may be symptomatic of an underlying affective disorder. Affective

Pandemic and Persona

“Try Googling ‘record-setting lake trout New Hampshire,’” I found myself saying recently to an anxious patient while we explored ways to cope with the Covid-19 pandemic. He loves fishing, and I remembered a story in the paper recently — just

Pandemic and Persona

“Try Googling ‘record-setting lake trout New Hampshire,’” I found myself saying recently to an anxious patient while we explored ways to cope with the Covid-19 pandemic. He loves fishing, and I remembered a story in the paper recently — just

Ingestion of Caustic Substances

Caustic substances injure tissue by means of a chemical reaction on direct physical contact. Often thought of as acids or bases, caustics broadly include desiccants, vesicants, and protoplasmic poisons. The term “corrosive” is often used interchangeably with “caustic,” but corrosion

Anorexia Nervosa

Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. Stage.

Placebo and Nocebo Effects

Placebo and nocebo effects are the effects of patients’ positive and negative expectations, respectively, concerning their state of health. These effects occur in many clinical contexts, including treatment with an active agent or a placebo in clinical practice or in

Suicide

Throughout the world, approximately 800,000 people die by suicide every year, accounting for 1.5% of all deaths. Suicide is the 10th leading cause of death in North America and the foremost cause of death worldwide among persons 15 to 24

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