Current theoretical approaches to animal intelligence either in the form of adaptive specializations or general processes make no explicit predictions nor do they provide substantial evidence concerning individual differences in problem solving. Two strains of mice (Mus musculus) were run through a battery of water escape tasks consisting of 4 spatial learning tasks, a visual discrimination task, and an activity control. The 2 strains were the second filial generation (F 2) from a cross between C57BL/6 and DBA/2Js inbred strains and a CD-I outbred strain. Results indicated positive correlations across all learning tasks in both strains for latency and error measures. Factor analysis revealed a significant first factor for these measures in both strains. These results suggest that at least some spatial and visual tasks in mice under this motivational condition share common properties.
Summary
Clinical scenario
A 65‐year‐old man presented with a 12‐h history of deteriorating rash. Two weeks previously he had completed a course of neoadjuvant chemotherapy for ductal carcinoma of the breast. On examination there were bullae, widespread atypical targetoid lesions and 15% epidermal detachment. There was no mucosal involvement on presentation, but subsequently it did evolve. Skin biopsy showed subepidermal blistering with epidermal necrosis. This confirmed our clinical diagnosis of overlap Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). On transfer to intensive care he was anxious and fearful.
Management question
What are the psychological impacts of SJS/TEN on this man's life?
Background
SJS and TEN have devastating outcomes for those affected.
Objectives
To conduct a Critically Appraised Topic to (i) analyse existing research related to the psychological impact of SJS and TEN and (ii) apply the results to the clinical scenario.
Methods
Seven electronic databases were searched for publications focusing on the psychological impact of SJS/TEN on adults over 18 years of age.
Results
Six studies met the inclusion criteria. Healthcare practitioners’ (HCPs’) lack of information around the disorder was highlighted. Patients experienced undue stress and fear. Some patients had symptoms aligned to post‐traumatic stress disorder (PTSD), anxiety and depression.
Discussion and recommendation
The evidence suggests that SJS and TEN impact psychologically on patients’ lives. Education of HCPs, to address their lack of awareness and information on SJS/TEN, should facilitate their capacity to provide information and support to patients, thereby reducing patient anxiety. On discharge, a follow‐up appointment with relevant HCPs to reduce the possibility of PTSD occurring should be considered.
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