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Biomedical subjects

H N Sno

Publications and source records attributed to H N Sno.

At least 19 recordsLinked to original sources
PubMed2006

[The guideline 'Psychiatric evaluation in adults'].

Psychiatric evaluation is defined as a systematic evaluation of the causes, the symptoms, the course and the consequences of a psychiatric disorder in order to formulate a diagnosis and a treatment plan, and to answer any questions the patient or referring specialist may have. The main components of a comprehensive psychiatric evaluation are the patient interview and observations of the patient's behaviour. The comprehensiveness of the psychiatric evaluation is affected by contextual, patient-related and situational factors. In the psychiatric diagnosis a distinction is made between the diagnostic classification (according to the DSM-IV-classification) and a structural diagnosis. The sequence ofthe elements ofthe psychiatric evaluation is based on medical tradition. In the mental-status examination all objective and subjective psychiatric symptoms are systematically reviewed. The grouping of the symptoms is based upon the classical division of mental functions into cognitive, affective and conative functions.

Diagnosis, Differential↗
PubMed2006

[The relationship between traumatic experiences and dissociative phenomena].

BACKGROUND: Intuitively we are convinced that there must be a causal relationship between traumatic experiences and dissociation. However, although the theory is both elegant and attractive, the existence of a direct causal link between trauma and dissociation is open to question. Available studies on this theme have methodological shortcomings. AIM: To obtain more insight into the frequency with which psychiatric patients have undergone traumatic experiences and to find out more about the relationship between theses experiences and dissociative phenomena. METHOD: Over a period of two years new outpatients attending psychiatric clinics completed questionnaires about their past life and mental health; in these questionnaires they gave information about traumatic experiences, dissociative phenomena, psychological symptoms and psychological functioning. RESULTS: Only 38 of the 351 patients who completed the questionnaire stated that they had never had any traumatic experiences. A relatively large number of patients mentioned that they had experienced emotional deprivation in their family of origin. The correlation coefficient between traumatic experiences and the scores for dissociative phenomena was 0.30. CONCLUSION: In view of the weak positive correlation between traumatic experiences and dissociative phenomena the hypothesis of a linear causal relationship seems unlikely. It is possible that the relationship is based partly on the poorer general psychological functioning that follows exposure to traumatic experiences.

Adolescent↗
PubMed2000

[Non-oral routes of administration of psychotropic agents].

For patients not able to take oral medication, a psychotropic agent may be selected not only according to its therapeutic and side effects but also to the optional alternative routes of administration. Partly because of the various options of routes of administration haloperidol is the first choice 'classic' antipsychotic medication. As to 'atypical' antipsychotics, the preparation of an ill-tasting clozapine liquid is possible. Lorazepam, clorazepate and diazepam injections (oil in water emulsion) or diazepam per rectiole are non-oral anxiolytics of first choice. Clomipramine and amitriptyline are the only parenteral antidepressants available in the Netherlands. Lithium tablets without controlled release may be administered as a suspension via a catheter. Carbamazepine or valproate may serve as a parenteral alternative for lithium. In case of extrapyramidal side effects of antipsychotics, biperiden or promethazine may be administered parenterally.

Formularies as Topic↗
PubMed1999

Dissociative identity disorder: diagnosis and treatment in the Netherlands.

Dissociative Identity Disorder (DID) is a controversial diagnosis and empirical data on the efficacy of treatment modalities are scanty. The objective of this study was to explore the frequency of the diagnosis, the types and efficacy of prevailing treatment practices, and to examine demographic data on patients in the Netherlands. A questionnaire, including questions on one selected DID patient, was mailed to 1,452 Dutch psychiatrists. The response rate was 46.7%. A total of 273 psychiatrists reported having made the diagnosis at least once. The diagnosis was made in a statistically significant manner more frequently by female psychiatrists, by psychiatrists aged 50 years or younger, and by those certified after 1982. No correlation was observed with primary theoretical orientation or the type or topography of work facility. The mean age of the selected patients was 33.2 and the male:female (M:F) ratio 1:9. The majority of patients were seen once a week in an outpatient setting. Individual psychotherapy and adjunctive anxiolytic or antidepressant medications were the most widely endorsed treatment modalities. Hypnosis was rarely used. We conclude that the diagnosis of DID is not to be dismissed as a local eccentricity. It is warranted as an explanatory framework in the context of a psychotherapeutic treatment.

Adult↗
PubMed1994

The inventory for déjà vu experiences assessment. Development, utility, reliability, and validity.

In this article the development, utility, reliability, and validity of the Inventory for Déjà vu Experiences Assessment (IDEA) are described. The IDEA is a 23-item self-administered questionnaire consisting of a general section of nine questions and qualitative section of 14 questions. The latter questions comprise 48 topics. The questionnaire appeared to be a user-friendly instrument with satisfactory to good reliability and validity. The IDEA permits the study of quantitative and qualitative characteristics of déjà vu experiences.

Adolescent↗
PubMed1994

A continuum of misidentification symptoms.

A case study of a schizophrenic patient with differing forms of experiences of inappropriate familiarity is described. Reduplicative paramnesia is redefined as a delusion of familiarity related to a reduplication of time, place or person. The author proposes the concept of a continuum of positive and negative misidentification symptoms. The positive pole of the continuum ranges from the minor form of déjà vu experience to reduplicative paramnesia. The negative pole ranges from depersonalisation to nihilistic delusions. Differentiation is based on the severity of the disturbance of reality testing. The argumentation is based on the fact that both déjà vu experiences and depersonalisation occurring in pathological as well as non-pathological conditions are phenomenologically uniform.

Adult↗
PubMed1993

An early Dutch study of déjà vu experiences.

In 1904 and 1906, Heymans reported the results of two prospective questionnaire surveys on déjà vu experiences and depersonalization in a sample of mainly students. Déjà vu experiences appeared to be more frequent than episodes of depersonalization. Emotional sensitivity, unstable mood fluctuations, apathetic episodes and irregular working rhythm emerged as predisposing personality traits. With the exception of the working rhythm, these traits were more prominent among the respondents with episodes of depersonalization than among those with déjà vu experiences. Heymans inferred that these findings supported his hypothesis that déjà vu experiences and depersonalization both resulted from the diminishing or disappearance of a sense of familiarity due to a momentary reduction of psychological energy. A re-analysis of Heymans' data partly confirmed his findings and conclusions as to the predisposing factors. The authors conclude that his studies and his hypothesis have been hitherto undervalued and would deserve more attention.

Deja Vu↗
PubMed1992

Art imitates life: Déjà vu experiences in prose and poetry.

the déjà vu experience is a subjective phenomenon that has been described in many novels and poems. Here we review over 20 literary descriptions. These accounts are consistent with the data obtained from psychiatric literature, including various phenomenological, aetiological and psychopathogenetic aspects of the déjà vu experience. The explanations, explicitly formulated by creative authors, include reincarnation, dreams, organic factors and unconscious memories. Not infrequently, an association with defence or organic factors is demonstrable on the basis of psychoanalytic or clinical psychiatric interpretation. The authors recommend that psychiatrists be encouraged to overstep the limits of psychiatric literature and read prose and poetry as well.

Deja Vu↗
PubMed1992

Déjà vu experiences and reduplicative paramnesia.

A schizophrenic patient with different forms of experiences of inappropriate familiarity is described. The authors discuss traumatic experiences as aetiological factors in déjà vu experiences and reduplicative paramnesia. Finally, the differential diagnostic problem in psychotic and dissociative phenomena is stressed.

Adult↗
PubMed1991

[Hiv patients in a psychiatric outpatient clinic].

The most often reported psychiatric complications among HIV-infected outpatients include: mood and anxiety disorders, and alcohol or nonopiate drug abuse. Medical records of 32 HIV-infected psychiatric outpatients in the Netherlands were studied. The most common DSM-III(-R) diagnoses included: major depression (n = 10) and adjustment disorder with depressive or anxious mood (n = 10). The psychiatric treatment of the HIV-infected outpatients did not differ fundamentally from the treatment of other psychiatric outpatients with similar problems. The increasing number of HIV infected patients in the Netherlands living outside of Amsterdam, would appear to urge more education of psychiatric and other health care professionals concerning specific aspects of HIV infection, homosexuality, prostitution and intravenous drug abuse.

AIDS Dementia Complex↗
PubMed1991

Attitudes of health-care workers towards AIDS at three Dutch hospitals.

A questionnaire survey was held among 938 doctors and 2304 nurses to assess their attitudes toward AIDS and the influence of their concern about the occupational risks involved. The response was 65 and 72%, respectively. The results suggest that in treating patients with actual or possible HIV infection, in non-invasive procedures many doctors and nurses often take too many precautions, whereas in invasive procedures doctors often take too few. A minority of the respondents were in favour of testing all patients. The majority felt that patients in the high-risk groups should be tested. The percentage in favour of anonymous testing was considerably higher among the doctors than among the nurses. Most of the doctors and nurses were concerned about contagion by patients. This concern had a negative influence on their attitudes toward AIDS. Factual information alone does not suffice to dispel excessive concern. In training and educating medical personnel, attention should be devoted to cognitive as well as emotional aspects.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Psychogenic "HIV infection".

The case of a man who falsely represented himself as being HIV positive is reported. In less than one year he was admitted twice with symptoms suggestive of HIV infection. The diagnoses malingering and factitious disorder were consecutively made. Early recognition of Factitious Disorder is essential to prevent patients from harmful diagnostic procedures or surgical treatments. Psychiatric treatment is best focused on management and care rather than cure. Psychogenic "HIV infection" might become more common than acknowledged up to now. Physicians should consider the occurrence of psychogenic "HIV infection," part of the symptomatology may be psychogenically determined, or indeed frankly simulated.

AIDS Serodiagnosis↗
PubMed1990

The déjà vu experience: remembrance of things past?

The déjà vu experience is a common phenomenon, occurring in pathological as well as nonpathological conditions. It has been defined as any subjectively inappropriate impression of familiarity of a present experience with an undefined past. The authors discuss the epidemiologic data, clinical features, and etiology of the phenomenon of déjà vu. They also review the different hypotheses on the psychopathogenesis of the déjà vu experience and introduce an explanation based on the hologram as a mnestic model.

Brain↗
PubMed1989

HIV infection: psychiatric findings in The Netherlands.

A psychiatric consultation was requested in 51 in-patient cases of HIV infection. Reasons for referral included counselling, the evaluation of depressive symptoms, and the treatment of delirium. The most common DSM-III diagnoses included: delirium (n = 13), major depressive disorders (n = 12), dementia (n = 5), and adjustment disorders with depressive or anxious mood (n = 5). The psychiatric treatment of patients with HIV infection does not differ fundamentally from that of other medically ill patients with similar psychiatric symptoms. However, the psychiatric treatment of patients with HIV infection can be hampered by the fear of contagion, negative attitudes towards homosexuals and drug users, and over-identification or avoidance reactions.

AIDS Dementia Complex↗