Opening a new unit in an existing psychiatric hospital.

The authors describe philosophical and logistical issues they encountered in opening a new unit in an existing, freestanding psychiatric hospital. The historical background of the hospital is described. Four principles were found essential in ensuring a smooth opening and providing consistent high-quality patient care: 1. Medical staff input on design of the new unit. 2. Careful selection of key personnel by the unit's chief of service. 3. Team meetings to develop unit concepts prior to opening. 4. Using patient feedback and criticism as a guide to change.

Treatment of anorexia nervosa in a young adult patient with diabetes mellitus.

The case history and clinical course of a young adult patient who had diabetes mellitus and developed anorexia nervosa is described. This patient was referred for long-term inpatient treatment after short-term treatment efforts had failed. Inpatient treatment utilizing behavior modification, psychodynamic therapy, and family interventions in a long-term therapeutic milieu is discussed. This case is also contrasted with previous accounts of diabetic adolescents who developed anorexia; however, it is noted that no other reports exist of cases of anorexia developing in adult insulin-dependent diabetic patients. The necessity of integrating a variety of therapeutic techniques in such cases is discussed.

Psychosis after neuroleptic withdrawal in a manic-depressive patient.

The authors present a case of neuroleptic-induced supersensitivity psychosis in a manic-depressive patient. They discuss the clinical differentiation of such a withdrawal psychosis from schizophrenic decompensation.

Differential diagnosis of palinacousis in a psychiatric patient.

Palinacousis is a relatively rare neurological phenomenon that may be misdiagnosed in psychiatric patients if it is not differentiated from the auditory hallucinations of psychotic illness. The authors present a case of palinacousis that responded to phenytoin.