Rounds in the General Hospital
For hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms, Dr Stern discusses diagnosis and management with members of the Consultation Service at Massachusetts General Hospital. These rounds reports will prove useful for clinicians practicing at the interface of medicine and psychiatry.
Rounds in the General Hospital
Managing Anxiety, Agitation, and Pain in Critically Ill Patients
April 1, 2025
Pain, fear, anxiety, sleep disturbances, and agitation are common symptoms among critically ill patients, causing distress, interfering with medical care, and contributing to morbidity post discharge.
Rounds in the General Hospital
Wishing That Your Patient Would Die: Reasons and Reactions
February 25, 2025
The authors explore the complexity, intensity, and critical decision-making faced by health care staff while caring for chronically and critically ill patients, especially in the context of medical futility.
Rounds in the General Hospital
Psychotic Disorders in Children and Adolescents: A Primer on Contemporary Evaluation and Management
April 13, 2014
Have you ever been unsure about whether a young person in your practice was psychotic or simply imaginative? Have you wondered how to evaluate such a patient and what…
Rounds in the General Hospital
Intoxications Associated With Agitation, Tachycardia, Hypertension, and Fever: Differential Diagnosis, Evaluation, and Management
May 16, 2013
Have you ever wondered what prompts a patient to become suddenly and severely agitated, with prominent elevations in temperature, heart rate, and blood pressure? Have you been challenged by…
Rounds in the General Hospital
Using Stimulants for Attention-Deficit/Hyperactivity Disorder: Clinical Approaches and Challenges
March 28, 2013
Have you been reluctant to prescribe stimulants for patients with attention-deficit/hyperactivity disorder (ADHD) and comorbid autism, bipolar disorder, or seizures for fear of exacerbating the underlying disorder? In this…
Rounds in the General Hospital
Toxicologic Testing for Opiates: Understanding False-Positive and False-Negative Test Results
July 26, 2012
Have you ever had a patient who insisted that he or she was neither using nor abusing opiates when the toxicology screen was positive? Have you ever considered if…
Rounds in the General Hospital
Insertion of Foreign Bodies (polyembolokoilamania): Underpinnings and Management Strategies
February 16, 2012
Have you ever had to evaluate and manage a patient with polyembolokoilamania (inserting a foreign body into 1 body orifice or more)? Have you wondered why he or she…
Rounds in the General Hospital
Recognition of Psychiatric Symptoms and Conditions in Latino Patients
November 24, 2011
Do psychiatric symptoms manifest differently in Latino patients? How should you screen for psychiatric problems in these patients? Read this case vignette and discussion to explore some of the…
Rounds in the General Hospital
Late-Onset Cinephilia and Compulsive Behaviors: Harbingers of Frontotemporal Dementia
June 2, 2011
View this case vignette and discussion of an elderly man who developed progressive compulsive cinephilia so that you can facilitate the diagnosis, evaluation, and treatment of patients with similar…
Rounds in the General Hospital
Prior Discharges Against Medical Advice and Withdrawal of Consent: What They Can Teach Us About Patient Management
January 27, 2011
Read this article to review a case vignette example of a discharge against medical advice, known characteristics and prevalence of such discharges, and management strategies for the presented patient…
Rounds in the General Hospital
Current Approaches to the Recognition and Treatment of Alcohol Withdrawal and Delirium Tremens: "Old Wine in New Bottles" or "New Wine in Old Bottles"
June 17, 2010
How long and how much alcohol does a person have to drink before being at risk for developing withdrawal symptoms after sudden abstinence? Which strategies can best manage alcohol…
