Stiff-person syndrome presenting as eating disorder: a case report.

OBJECTIVE: To report a case of a 35-year-old female initially treated for anorexia nervosa who was found to have Stiff-Person Syndrome (SPS). METHOD: Case report. RESULTS: The patient reported panic attacks at meal times that were found to consist of tetanic contractions of the axial musculature. Swallowing initiated reflexive painful muscle spasms that consequently resulted in cibophobia and significant weight loss. Her serum tested positive for anti-glutamic acid decarboxylase antibodies, and she subsequently improved with appropriate treatment for SPS. DISCUSSION: SPS has not been previously reported in the context of eating disorders, although it has been linked to other psychiatric disorders. Often the psychiatrist may be the first physician to diagnose SPS. We present this case to alert practitioners to the potential co-morbidity and symptom overlap between SPS and eating disorders, to aid in early recognition and appropriate treatment of this rare illness.

Commentary: core competencies and the training of psychiatric residents in therapeutic risk management.

The treatment of patients who, due to their clinical presentation, pose potential liability risks to the psychiatrist is one of the more stressful aspects of modern psychiatric practice. The need to educate psychiatric residents about the principles of risk management that guide the safe provision of good patient care in such patients is paramount in the current malpractice environment. In this commentary, we discuss the teaching of therapeutic risk management, as described by authors Simon and Shuman, in general psychiatry residency, particularly as it can be integrated within the existing core competencies established by the Accreditation Council on Graduate Medical Education (ACGME). A model outline of this integration for suicide risk management within each of the existing core competencies is presented.

Speaking out for mental health: collaboration of future journalists and psychiatrists.

OBJECTIVES: The authors assess the effects of an educational intervention on the attitudes and understanding of psychiatric residents and journalism students, review how collaboration between these disciplines affects these attitudes, and propose the development of similar programs within residency to enhance systems-based learning. METHODS: A collaborative curriculum involving a workshop, didactics, and team projects was conducted over 6 months among journalism students and psychiatric residents. Attitude assessments were obtained before and at the conclusion. RESULTS: Data support that a brief interdisciplinary curriculum can affect the attitudes of both psychiatric residents and journalism students regarding mental illness and the media. Attitudinal changes and areas of focus for the future are identified. CONCLUSION: Psychiatrists should be familiar with the relationship between media and stigma. Focusing on psychiatrists and journalists in training may change attitudes between disciplines to promote future collaboration, and innovative curricula within residency training may increase the comfort level between physicians and the media.