Psychiatry Rounds

Dr. Lantz is Chief of Geriatric Psychiatry, Beth Israel Medical Center, First Ave @ 16th Street #6K40, New York, NY 10003; (212) 420-2457; fax: (212) 844-7659; e-mail: mlantz@chpnet.org.

Case Presentation
Mrs. D is a 72-year-old widowed woman who was referred for psychiatric evaluation by her primary care physician, Dr. B. Mrs. D is a retired school librarian who worked until three months ago, when her school district had to downsize the

Case Presentation
Mr. H is a 66-year-old widowed male who is referred to a psychiatrist by his primary care physician, Dr. D, due to an increase in tic-like movements with occasional verbal outbursts of curse words and noises. Mr. H has worked at an outdoor newsstand for more than 40 years. Since the death of his wife from cancer two years earlier, he has been working double shifts, sometimes spending 16 hours a day at the newsstand.
Dr. D reports that the tics and verbal outbursts have increased over the past

Case Presentation
The patient, Ms. C, is a 68-year-old unmarried white woman who presents to the emergency room (ER) with complaints of shortness of breath. She is well known to the hospital staff due to her frequent visits and because she was employed as a nursing assistant there for more than 30 years. Ms. C is a long-time smoker who suffers from chronic obstructive pulmonary disease (COPD). In addition, she has a diagnosis of hypothyroidism and underwent a lumpectom

Case Presentation
Mr. V is an 84-year-old male who came to the Geriatric Psychiatry outpatient clinic accompanied by his female partner of 18 years, Ms. Y. Both Mr. V and Ms. Y reported that over the past three years he has suffered from progressively worsening anger issues and mild memory problems, which had intensified more over the past year. Mr. V was raised in a traditional Orthodox Jewish community. According to the patient, he agreed to see a psychiatrist because Ms. Y ha...

CASE PRESENTATION
Mrs. P, a 54-year-old Caucasian female, was seen by her primary care provider five years ago with a complaint of “memory problems.” She noted episodes of forgetfulness from as early as age 46. Mrs. P’s husband had noted changes in both her personality and memory. He reported out-of-character use of profanity and a gradual onset of apathy. She had progressively become less attentive to daily routines at home. Mrs. P complained of episodes where she had forgotten the route home, and reported difficulty remembering steps in routine tasks she had performed repeated...

Case Presentation
Mr. C is an 82-year-old married male who was diagnosed with dementia of the Alzheimer’s type four years ago. He lives with his 80-year-old wife in a basement apartment that the couple has shared since they married 58 years ago. Mrs. C has cared for her husband since he first started showing signs of confusion and forgetfulness. The couple has no children, and their only relative is a niece who lives in a distant state.

Mrs. C has never had any formal help in caring for her husband. She takes him with her to run errands and go shopping, and regularly keeps a...

Case Presentation
Mrs. B is a 68-year-old married woman who is referred to a psychiatrist by her primary care physician, Dr. M. Mrs. B underwent extensive dental implant procedures over the past year with a very positive cosmetic and functional result. She was compliant with her care and at first was very pleased with how she looked. Mrs. B initially went to Dr. M asking for advice in finding another dentist. She complained of feeling that “too many things” were implanted in her jaws and wanted another opinion. Dr. M found nothing wrong with her implants and did not deem it necess...

Case Presentation
Mr. B, Jr, is a 62-year-old man living in Florida. He has been trying to call his 87-year-old father who is living alone in the urban apartment in New Jersey that the family moved into more than half a century ago. His father suffered a stroke that left him with right-sided weakness and slurred speech two years ago. His recovery was complicated by several episodes of aspiration pneumonia requiring hospitalization and a prolonged stay at a rehabilitation center. His wife died while he was receiving rehabilitation, and Mr. B, Jr, felt that without his mother’s help h...

Case Presentation

Mrs. D is a 78-year-old widowed woman who recently moved in with her daughter, Mrs. F. Mrs. D comes to see Dr. R for a check of her blood pressure and diet-controlled diabetes. Dr. R has been caring for Mrs. F for many years and is pleased to meet her mother. He finds that unlike her daughter, Mrs. D is considerably more critical of his office staff, waiting time, and the cold temperature of his office. When he brings up the fact that her blood pressure is elevated to 150/100 mm Hg and her finger stick blood glucose is nearly 300 mg/dL, Mrs. D takes notes and asks f...