February 2015

Feb
2015
Vol. 27. No. 1

LETTERS TO THE EDITOR

Hypersexuality after self-inflicted nail gun penetrating traumatic brain injury and neurosurgery: Case analysis with literature review

Kenneth R. Kaufman, MD, MRCPsych | Tanya M. Schineller, MB, BCh, BAO | Anthony Tobia, MD | Jeffrey A. Schneider, MD | Issa P. Bagayogo, MD, PhD

TO THE EDITOR: Hypersexuality and alterations in sexual preference are uncommon behavioral complications of traumatic brain injury (TBI) involving lesions to basal frontal, temporal, diencephalic, and limbic structures.1 Experimental brain injury in animals has produced hypersexual behaviors2-4; however, there is a paucity of experimental knowledge in humans. Much of the current knowledge on human hypersexuality has been found through lesion studies and non-TBI including infarctions, tumors, and epilepsy.1,5-10 Functional imaging has permitted expanding our knowledge without traumatic experimentation.10…

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Culture, impaired access to mental health care, and bipolar disorder: Case analysis

Kenneth R. Kaufman, MD, MRCPsych | Eileen S. Hwang, MD, PhD

TO THE EDITOR: Access to mental health treatment often is impacted by cultural themes. This could relate to nonacceptance of psychiatric diagnoses as true illnesses, perceived shame by the patient or family, or fear of ostracism. As a result, patients remain untreated with unnecessary morbidity, increased direct and indirect costs, and potential mortality. This case report addresses depression and intentional overdose in a Chinese-American patient with bipolar disorder while suggesting means to maximize early intervention and minimize morbidity and mortality in patients from various cultural backgrounds.

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