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Biomedical subjects

F G Zitman

Publications and source records attributed to F G Zitman.

At least 55 records · Page 3Linked to original sources
PubMed1996

Visual hallucinations in psychologically normal people: Charles Bonnet's syndrome.

BACKGROUND: Charles Bonnet's Syndrome (CBS), characterised by the presence of complex visual hallucinations in psychologically normal people, was considered for a long time to be rare. Systematic research on CBS has been limited. However, it has been realised that CBS occurs frequently in elderly, visually handicapped patients, and we have been able to study the syndrome in a large number of patients. METHODS: After screening 505 visually handicapped patients, 60 were found to meet proposed diagnostic criteria for CBS (generally, the existence of hallucinations without delusions or loss of insightful cognition.) Psychopathological characteristics, personal meaning, and the emotional impact of hallucinations, as well as factors influencing the hallucinations, were analysed. FINDINGS: Although diagnostic criteria demand merely "partial insight", all patients had full insight into the unreal nature of their hallucinations. Other characteristics varied. In 46 (77%) patients, hallucinations lacked a personal meaning. Sensory deprivation and a low level of arousal seemed to favour the occurrence of hallucinations. CBS caused considerable distress in only 17 (28%) patients. However, all patients were glad to be told that their hallucinations were not due to mental disease. The proper diagnosis had been made in only one of the 16 patients who had consulted a doctor. INTERPRETATION: Although largely unrecognised in clinical practice, CBS should be considered as a diagnosis in patients who complain of hallucinations and who meet defined diagnostic criteria. There is no proven treatment, but many patients will benefit from reassurance that their hallucinations do not imply mental illness.

Aged↗
PubMed1995

Ageing in adults with Down's syndrome in institutionally based and community-based residences.

Seventy-one subjects with Down's syndrome (DS), between the ages of 29 and 68 years, and 46 matched controls (without DS) were examined for intelligence, memory (short- and long-term memory, and spatial and temporal orientation), communication (receptive, expressive and written language) and daily living skills (personal, domestic and community daily living skills). All subjects were screened on hearing and visual functions, thyroid functions, depression and dementia. DS-subjects and controls were matched on chronological age, mental age, living conditions and male/female ratio. Comparisons were made between five subgroups (1) non-demented institutionalized subjects with DS (DSi-group; n = 35); (2) non-demented institutionalized controls without DS (Ci-group; n = 22); (3) demented institutionalized subjects with DS (n = 10); (4) non-demented subjects with DS living in group homes (DSg; n = 26); and (5) non-demented controls without DS living in group homes (Cg; n = 24). Institutionalized and non-institutionalized subjects, as well as demented and non-demented subjects differed significantly on all functions measured. Multiple regression analysis was performed to examine the influence of age and sensory deficits on adaptive and cognitive functioning. In DSg subjects, significant associations were found between age and mental age, and between age and performances on written language. In (non-demented) DSi subjects, significant relations were found between age and memory functions observed in daily circumstances. Moreover, in the (non-demented) DSi elderly, visual impairment was significantly related to depressed performance on daily living skills. No age effects were seen in control subjects. Infirmities of old age like dementia and sensory deficits were far more common in people with DS than in controls. Psychiatric and diagnostic aspects of clinical depression and dementia were emphasized in particular.

Activities of Daily Living↗
PubMed1995

The Charles Bonnet syndrome: a large prospective study in The Netherlands. A study of the prevalence of the Charles Bonnet syndrome and associated factors in 500 patients attending the University Department of Ophthalmology at Nijmegen.

BACKGROUND: The aims were to determine the prevalence of the Charles Bonnet syndrome (CBS) in low-vision patients and analyse possible associated ophthalmic and sociodemographic factors. METHOD: A semi-structured interview on visual hallucinations was given to 300 adult low-vision patients and 200 elderly general ophthalmic patients. Positive cases were examined with the Geriatric Mental State Schedule and the Mini Mental State Examination. Diagnostic criteria were as follows: complex, persistent, or repetitive visual hallucinations; full or partial retention of insight; no hallucinations in other modalities; and no delusions. Ophthalmic and sociodemographic data were gathered for all patients. RESULTS: The prevalence of CBS in low-vision patients was 11%. CBS was significantly associated with an age over 64 years and a visual acuity in the best eye of 0.3 or less. No significant associations with ophthalmic diagnoses, patient sex, marital status, or social circumstances were found. CONCLUSION: Our findings support association of CBS with sensory deprivation and advanced age.

Age Factors↗
PubMed1995

[Standardized behavior assessment plays a minor role in arriving at indications for admission to a psychogeriatric nursing home].

To investigate the role which standardised, patient related data play in indicated admission to a psychogeriatric nursing home, we compared the data of 120 indicated with those of 68 not-indicated patients. High scores on subscales 'helplessness' and 'inactivity' of the Dutch version of the Stockton Geriatric Rating Scale were the best predictors of indicated admission to a certain extent (21.6%). Furthermore a history of cardiac diseases and the state of being unmarried increased the probability of indicated admission to a small degree. Only a limited percentage of the variance in the decision of the indication committee could be explained. The limited availability of data which are collected in a standardised way, especially data concerning the caregiving system and the absence of valid and reliable instruments for the investigation of indicated admission are the most probable causes of this fact.

Activities of Daily Living↗
PubMed1994

Neuroleptic drug use in nonpsychiatric departments of a Dutch university hospital.

During a 1-year period, neuroleptic drug utilization was assessed in nonpsychiatric departments of a Dutch university hospital in defined daily doses (DDD), DDD per 100 patients and per 100 bed days. Substantial divergence was found among the nonpsychiatric departments with respect to the quantity as well as the types of neuroleptic used, but there was no relationship between psychiatric consultations and neuroleptic use. In semistructured interviews, the senior consultant at each department stated that neuroleptics were used not only for the treatment of behavior disorders but also for nonpsychiatric indications, such as pain, nausea, and hiccups. In addition, specific neuroleptics were considered to be appropriate for the treatment of specific indications, but the doses anticipated to be effective were in many cases well below the DDDs. It is concluded that substantial quantities of neuroleptics are prescribed for nonpsychiatric use. This is remarkable, because very little is known about nonpsychiatric indications and the effects of neuroleptics, including the unwanted side effects, in patients who are somatically ill.

Antipsychotic Agents↗
PubMed1994

Is the social acceptability of psychiatric patients decreased by orofacial dyskinesia?

A group of psychiatric patients with and without orofacial dyskinesia (OFD) were filmed in pairs on videotape and a group of first-year social studies students were asked to select one candidate from each pair to fill a (simulated) job opening. A stationary picture (photograph) in which OFD was not visible and moving images (a video film) in which dyskinesia was visible were shown of each patient. The video effect, which was an indicator of the increase in popularity of a patient on the video film compared with the photograph, differed significantly between the OFD and control patients. Making the movement disability visible caused a relative decrease in the popularity of the OFD patients as opposed to an increase in the popularity of the control patients.

Adult↗
PubMed1992

Biochemical measures in patients with a somatoform pain disorder, before, during, and after treatment with amitriptyline with or without flupentixol.

The possible relationship between a number of biochemical parameters and measures of pain and depression was studied in chronic pain patients without a major depression. In a double-blind crossover study, patients were treated with amitriptyline combined with a low dose of flupentixol or placebo. We investigated whether pretreatment biochemical values correlated with initial data on pain and/or depression, or whether they had predictive value for treatment outcome. We also studied systematically the effect of both treatment regimes on the biochemical parameters themselves and their relation to the plasma levels of amitriptyline. From our results, the possible involvement of the serotonin system in somatoform pain disorder is confirmed and no direct relation with the noradrenergic system could be inferred. The lack of involvement of a number of putative, depression-related, biochemical parameters suggests that affective disorders and pain syndromes do not share all mechanisms in common.

Adult↗
PubMed1992

Hypnosis and autogenic training in the treatment of tension headaches: a two-phase constructive design study with follow-up.

Tension headaches can form a chronic (very long duration) condition. EMG biofeedback, relaxation training and analgesia by hypnotic suggestion can reduce the pain. So far, no differences have been demonstrated between the effects of various psychological treatments. In a constructively designed study, we firstly compared an abbreviated form of autogenic training to a form of hypnotherapy (future oriented hypnotic imagery) which was not presented as hypnosis and secondly we compared both treatments to the same future oriented hypnotic imagery, but this time explicitly presented as hypnosis. The three treatments were equally effective at post-treatment, but after a 6-month follow-up period, the future oriented hypnotic imagery which had been explicitly presented as hypnosis was superior to autogenic training. Contrary to common belief, it could be demonstrated that the therapists were as effective with the treatment modality they preferred as with the treatment modality they felt to be less remedial.

Adult↗
PubMed1992

Autogenic training and self-hypnosis in the control of tension headache.

This study compares autogenic training and training in multiple self-hypnosis strategies in a sample of 56 patients diagnosed as having chronic tension headache on the basis of medical evaluation by a neurologist. At posttreatment and follow-up, no differences between the two treatment regimens in the reduction of headache and psychological distress were observed. During treatment, patients reduced their headache activity and level of psychological distress significantly in contrast to the waiting-list period (p < 0.05). Follow-up measurements indicated that therapeutic improvement was maintained (p < 0.05). Short-term and long-term pain reduction was accompanied by an increase in perceived pain control (p < 0.003). Moreover, those patients who attributed the pain reduction obtained during therapy to their own efforts manifested long-term pain reduction (p < 0.003).

Adaptation, Psychological↗
PubMed1992

Chronic pain beyond patienthood.

Forty nonconsumers (subjects with pain lasting for more than 1 year who had not consulted a doctor because of it during the preceding year) were compared with 46 chronic patients at a pain clinic. The mean duration of the nonconsumers' pain was twice as long as that of the patients'. Although their pain intensity, as assessed with pain diaries, did not differ, their estimated pain intensity was less than that of the pain patients; they took fewer analgesics, were less functionally impaired, made less use of coping strategies associated with poor adjustment, were less depressed, and expected less help from external resources. The "non-consumer attitude" appears to be independent of the duration of the pain complaints.

Adaptation, Psychological↗
PubMed1991

Does addition of low-dose flupentixol enhance the analgetic effects of low-dose amitriptyline in somatoform pain disorder?

In a double-blind, crossover study, the effects of 75 mg amitriptyline alone during 5 weeks on pain intensity were compared with the effects of a combination of 75 mg amitriptyline and 3 mg flupentixol during 5 weeks in 34 patients with somatoform pain disorder. Both treatments resulted in a statistically significant reduction in pain. However, pain reduction in the combined treatment did not differ from that in the treatment with amitriptyline as a single drug. Neither tardive dyskinesias nor other serious side effects were observed. The results do not support the clinical practice of adding low-dose neuroleptics to low-dose antidepressants in the treatment of somatoform pain disorder.

Adult↗
PubMed1991

Autogenic training and future oriented hypnotic imagery in the treatment of tension headache: outcome and process.

The aim of the present study was (a) to investigate the relative efficacy of autogenic training and future oriented hypnotic imagery in the treatment of tension headache and (b) to explore the extent to which therapy factors such as relaxation, imagery skills, and hypnotizability mediate therapy outcome. Patients were randomly assigned to the 2 therapy conditions and therapists. 55 patients (28 in the autogenic therapy condition and 27 in the future oriented hypnotic imagery condition) completed the 4 therapy sessions and 2 assessment sessions. No significant main effect or interaction effects for treatment condition or therapist was revealed. A significant effect for time in analyzing scores for headache pain, pain medication usage, depression, and state anxiety was found. In the self-hypnosis condition, pain reduction proved to be associated with depth of relaxation during home practice (as assessed with diaries) and capacity to involve in imagery (as assessed with the Dutch version [van der Velden & Spinhoven, 1984] of the Creative Imagination Scale [Barber & Wilson, 1978/79; Wilson & Barber, 1978]). After statistically controlling for relaxation and imagery, hypnotizability scores (as assessed with the Dutch version [Oyen & Spinhoven, 1983] of the Stanford Hypnotic Clinical Scale [Morgan & J.R. Hilgard, 1975, 1978/79]) were significantly correlated with ratings of pain reduction. Results are discussed in the context of the neo-dissociation and social-cognitive model of hypnoanalgesia. The clinical relevance and the methodological shortcomings of the present study are also critically assessed.

Adolescent↗