RESUMO
Primary care physicians have an important historical role in the delivery of mental health care despite the evolution of psychiatry as a specialty. Collaboration between primary care physicians and psychiatrists has been limited by problems of access to psychiatric care or consultation. Although managed care, in some forms, has been successful in addressing this issue, it has largely served as a new barrier to effective collaboration and to meeting the mental health care needs of patients.
Assuntos
Relações Interprofissionais , Programas de Assistência Gerenciada , Equipe de Assistência ao Paciente , Atenção Primária à Saúde , Psiquiatria , Administração de Caso , Controle de Acesso , Humanos , Estados UnidosRESUMO
The authors describe a 24-year-old woman with borderline personality disorder and prolonged fever of unknown origin. After an extensive search for a fever source, they noted that her temperature responded to pseudoseizures and to phenobarbital.
Assuntos
Transtorno da Personalidade Borderline/psicologia , Febre de Causa Desconhecida/psicologia , Transtornos da Personalidade/psicologia , Transtornos Psicofisiológicos/etiologia , Adulto , Temperatura Corporal/efeitos dos fármacos , Transtorno da Personalidade Borderline/complicações , Eletroencefalografia , Transtornos Autoinduzidos/fisiopatologia , Feminino , Febre de Causa Desconhecida/tratamento farmacológico , Febre de Causa Desconhecida/fisiopatologia , Humanos , Fenobarbital/uso terapêutico , Transtornos Psicofisiológicos/tratamento farmacológico , Transtornos Psicofisiológicos/fisiopatologia , Convulsões/fisiopatologiaRESUMO
The authors describe a 62-year-old woman with symptoms of major depression presumed to be secondary to propranolol use. The patient responded poorly to imipramine; however, her symptoms cleared rapidly when atenolol was substituted for propranolol.
