When a person gets depressed over their divorce, they are said to have a mental illness. When a person becomes psychotic from a manic episode due to their bipolar disorder, they are also said to have a mental illness. But are both of these illnesses mental illnesses? The definition of mental is that which relates to cerebral, brain, cognitive or intellectual processes. Many disorders occur from problems in the anatomy or ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old woman is seen for follow-up evaluation. Two weeks ago, she was in a car accident, and an incidental pituitary adenoma was found on a cervical spine CT scan. She has no residual injuries from the car accident. She is otherwise healthy and takes no medications. She went through menopause at ...

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Imagine losing your grip on reality; your only place to turn is the local hospital. Once there, you give up your personal effects, your clothes, and often, your right to leave. You wear paper scrubs in a sparse room, lay on an uncomfortable bed, and have a guard nearby preventing your escape. In seeking help, you have become a prisoner. This is done for your and for the hospital personnel’s ...

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When a patient arrives on labor and delivery clutching her birth plan, I’ll admit, I want to escape immediately to a remote, uninhabited island with no modern form of communication. I’d crate the carrier pigeons too, just to be safe. Many of us who deliver babies have an unshakable belief that women with birth plans unlock Pandora’s nether regions, releasing a huge flock of horrifying Kraken. The Kraken take perverse glee ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 34-year-old woman is evaluated for very dry, painful hands. She works in a daycare center and washes her hands 15 to 20 times daily, often for 2 to 3 minutes at a time. She has been applying lotion multiple times daily with no relief of the pain. She has a ...

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Mom. She was a feisty 100 percent Italian, straight from New Jersey. Her dad, straight from Italy, was a tailor and made the finest suits for New York and New Jersey businessmen. Mom learned this trade well. She could sew some of the most beautiful tailored suits for herself. She loved to cook and every night was a banquet, a feast which required up to 2 hours of clean-up time ...

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I found this study to be absolutely fascinating. The link is to the abstract; the complete article is behind a paywall, but I can get it for anybody who’s interested in reading the whole study in detail. Its title is “Fundamental frequency variation in crying of Mandarin and German neonates.” I have always assumed, like most people I suspect, that babies cry the same the world over. When they’re uncomfortable or ...

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The recent horrible events involving racial profiling, excessive force, and gun violence are deeply troubling but not new. Who can forget the Bronx shooting of Amadou Diallo in 1999 when 41 bullets rained down on his unarmed body. I can uniquely identify with the black experience because of my own numerous experiences of being pulled over for no other apparent reason except for being in the wrong neighborhood, wrong state ...

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When I talk to my patients, one of the greatest concerns I hear is regarding the fear that they might get a cancer at some point in their life. It is a very reasonable fear, as cancers of the female reproductive tract and breasts are not as rare as we might like. Perhaps educated by Angelina Jolie’s announcement of her BRCA mutation in 2013, many women now ask me about ...

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Prior to the release of DSM-5 in 2013, I referred at times to the pocket copy of DSM-IV parked in my office bookcase.  The main reason was to enter the right diagnostic codes on insurance forms.  I also sometimes quoted DSM criteria to show a patient that ADHD can’t arise in adulthood, that daily mood swings are not characteristic of bipolar disorder, or that six months of sobriety is still “early” ...

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