Bianca is a 35-year-old, divorced Brazilian woman with a history of depression, anxiety, trauma, and substance abuse who has made several serious suicide attempts. Before three years ago, Bianca had no history of mood or anxiety symptoms. In fact, most of her recent psychiatric symptoms have occurred in the context of heavy substance use.Bianca was previously stable and gainfully employed as a legal secretary in the court system of Brazil. She functioned well until she came to the United States ten years ago looking for a better life. During the first seven years of her life as an illegal immigrant, Bianca struggled with the fear of deportation, issues of acculturation, and the lack of stable employment. Three years ago, Bianca married George, an American citizen, with the explicit purpose of obtaining legal immigration status. Despite the immigration ruse, Bianca hoped the marriage would work anyway. Before marrying,
Since it was established in 1979, the U.S. Department of State's mental health service has functioned as a unique program of care for U.S. diplomats and their family members, currently encompassing more than 250 U.S. embassies and consulates worldwide. Such an approach has allowed for rapid delivery of high-quality care in collaboration with regional medical officers, nurse practitioners, physician assistants, nurses, and local assets. Data from the past three decades indicate that the program has had low rates of medical evacuation and repatriation and low rates of mortality. Building from its roots in disaster and crisis response, the program now offers integrated mental health care in a geographically distributed, worldwide program to address the general medical and behavioral health needs of an expanding U.S. diplomatic presence in increasingly remote, challenging, and dangerous environments.
A patient who presented with seizures, opisthotonos, catatonia, and autonomic dysfunction developed features consistent with sporadic encephalitis lethargica. She received a course of ECT and had full recovery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.