TY - CHAP M1 - Book, Section TI - Psychiatric Principles A1 - Zerbo, Erin A. A1 - Kondracke, Andrea M. A2 - Hoffman, Robert S. A2 - Howland, Mary Ann A2 - Lewin, Neal A. A2 - Nelson, Lewis S. A2 - Goldfrank, Lewis R. PY - 2015 T2 - Goldfrank's Toxicologic Emergencies, 10e AB - Psychiatric problems may be the cause or the effect of many toxicologic ­presentations. Suicide attempts and aggressive behaviors are commonly associated with toxicity and can be uniquely difficult to assess and manage. Patient behaviors are often viewed dichotomously as either totally intentional and deliberate or totally “out of control” and irrational. The truth is usually more complex, with some aspects occurring within the awareness and control of the patient and other aspects either unknown or overwhelming to the patient. Neuropsychological conceptions of “behavioral disinhibition”­ as a baseline personality trait that is relatively fixed are complementary to presumed organic etiologies of disinhibition such as intoxication or brain injury; in the latter cases, frontal lobe dysfunction is directly implicated. Yet more subtle frontal lobe dysfunction is likely occurring in many patients without such a direct neurological insult: patients with psychosis or mania, personality disorders, attention-deficit/hyperactivity disorder, or even agitation in the context of psychological distress. A patient’s innate capacity for self-restraint can vary widely, and some will present with behavioral disturbances much more readily than others.112 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1108426791 ER -