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Biomedical subjects

J Cullberg

Publications and source records attributed to J Cullberg.

At least 37 records · Page 2Linked to original sources
PubMed1993

Sandra: successful psychotherapeutic work with a schizophrenic woman.

This presentation concerns a young woman who gradually developed a schizophrenic picture on the basis of a borderline personality, and who recovered after more than 20 years of incapacitating symptoms. Today she sees her psychotherapy as decisive for the outcome. The material was collected from case records as well as from interviews with the patient and her therapist. Special emphasis is laid on the attitude and working methods of the therapist as these were viewed retrospectively by the two participants in the therapeutic process.

Adult↗
PubMed1992

Social conditions in a total population with long-term functional psychosis in three different areas of Stockholm County.

A number of social conditions regarding interpersonal relations, housing and employment were studied in a total population of individuals with long-term functional psychosis (n = 341) drawn from the population aged 18-64 years inhabiting three different areas of Stockholm County, altogether about 57,000 inhabitants. Individuals were included irrespective of whether they had a psychiatric treatment contact or not. They were mostly unmarried (57%) and living alone (64%). Most were unemployed (69%) and over half received a disability pension. However, 76% had their own flat and a reasonable financial standard, not deteriorating with illness duration. The diagnosis of schizophrenia led to poorer social conditions, as did early age at onset, male sex and co-morbidity of substance abuse. A larger number of individuals lived in an institution in the urban area while a greater number lived with relatives in the rural area.

Adolescent↗
PubMed1992

Persistent auditory hallucinations correlate with the size of the third ventricle in schizophrenic patients.

In a study of psychotherapy in schizophrenic patients, the existence of certain clinical and anamnestic variables, such as persistent auditory hallucinations, was found to correlate with a negative outcome. To test whether these clinical variables could be a sign of organic brain abnormality, the records of 33 schizophrenic patients who had been examined by computerized tomography (CT) were investigated regarding the occurrence of these symptoms. A significant correlation was found between width of the third ventricle and the occurrence of such auditory hallucinations, which also persisted between acute phases. No correlation was found between the CT measures and other clinical characteristics, including hallucinations rated at admission by the Comprehensive Psychopathological Rating Scale (CPRS). The results are interpreted to suggest a disturbance of diencephalic brain regions in a subgroup of schizophrenic patients that are further characterized by persistent auditory hallucinations and a lack of response to psychodynamic psychotherapy.

Adult↗
PubMed1991

Recovered versus nonrecovered schizophrenic patients among those who have had intensive psychotherapy.

Eight cases of fully recovered formerly schizophrenic (DSM-III-R) patients who had been treated with intensive psychodynamic psychotherapy were compared with 10 nonrecovered schizophrenic patients who also had been treated with intensive psychotherapy. There were no significant differences in chronicity, medication or type and amount of psychotherapy given. The most striking difference between the groups was the type and quality of auditory hallucinations. In the nonrecovered group the hallucinations were more dominating and often of the running commentary type, sometimes occurring even in calm periods. Visual hallucinations were also found more commonly in the nonrecovered group. The findings are discussed in terms of predominantly genetic vs predominantly lesional vulnerability. The limitations of the study lie in the scarcity of cases and the sometimes low quality of the hospital records.

Adult↗
PubMed1991

Patterns of care among people with long-term functional psychosis in three different areas of Stockholm County.

This study of long-term functionally psychotic people in Stockholm County describes the psychiatric and somatic care provided as well as social welfare support and medication in a total cohort. This group included all non-organic cases of psychosis aged 18-64 years. The group was found still to be very dependent on institutional care, with an average of 75 d of psychiatric inpatient care. Males spent twice as long as females as inpatients, and people from the urban area spent a longer time than those from the other areas. Antipsychotic medication increased from the rural to the urban area. The diagnosis of schizophrenia and early age at onset were each per se associated with higher likelihood of inpatient treatment and depot medication. Contrary to expectations, medication with antipsychotic drugs was shown to increase with illness duration.

Adolescent↗
PubMed1990

From community mental health services to specialized psychiatry: the effects of a change in policy on patient accessibility and care utilization.

In 1975, a community mental health (CMH) centre with most of its resources channelled to outpatient services was set up in a defined catchment area of 75,000 inhabitants near Stockholm. In 1981, the CMH centre was allocated 3 inpatient wards of its own. An outpatient unit to treat long-term psychotic patients was also built up from existing resources. Emergency cases were directed to the primary health care services or to the emergency department of a hospital. During the same period, the number of doctors in the area's primary health care services increased fourfold. The social, demographic and diagnostic composition of the patient population and its utilization of in- and outpatient care in connection with these organizational changes are described. The population of the cathment area increased by 12.5% and the patient population decreased by 40%. The decrease was particularly great among first-time visitors (-54%), patients from lower social groups (-53%) and those with crisis diagnosis (-71%). The number of patients with psychoses increased (+26%). Outpatient visits and hospital utilization increased by one third. The number of compulsory admissions increased by 20% (still being far below the mean number in Stockholm). The decrease in the patient population is attributed to the reduction in accessibility to the CMH centre at a time when primary care services in the area were undergoing a sizeable expansion. The increased care utilization is the result of an internal redistribution of resources in favour of resource-demanding, long-term psychotic patients.

Adolescent↗
PubMed1989

Epidemiology of long-term functional psychosis in three different areas in Stockholm County.

This study is the first in a series investigating different aspects of living conditions and care utilization in a total population with long-term functional psychoses (LFP). The study cohort (n = 302) was defined as people that: were aged 18-64 years, were affected by a nonorganic psychosis continuously during at least 6 months, showed psychotic features or residual symptoms during 1984, and had their home address in the study area during 1984. The study area consists of one rural and one suburban municipality, and one urban parish (57,035 inhabitants aged 18-64 years). The LFP concept used shows a high interrater reliability (kappa = 0.93). The one-year prevalence in the rural, suburban and urban areas was 3.4, 5.6 and 6.6 per 1000 respectively, thus producing a gradient from the rural to the urban areas. The prevalence of schizophrenia (DSM-III) was 2.6, 3.8 and 5.0 per 1000 respectively. The other diagnoses covered by the LFP concept (paranoia, major affective disorder with psychotic features, and psychotic disorder not elsewhere classified) showed the same gradient, with the exception of paranoia, which showed a lower rate in the urban area. The prevalence of schizophrenia was higher among males, while for paranoia the prevalence was higher among females.

Adolescent↗
PubMed1989

Early separation and suicidal behaviour in the parental homes of 40 consecutive suicide attempters.

Forty suicide-attempt patients who were consecutively admitted to an intensive-care unit, their significant others and treatment personnel were investigated by semistructured interviews. The patients were divided into neurosis (n = 14), abuse (n = 19) and psychosis (n = 7) groups. Twenty-one of the patients (52%) had lost contact with one or both parents before the age of 18, in 25% of cases owing to death and in 27% because of the parents' divorce or separation. Parents and/or siblings of 19 patients (47%) had shown suicidal behaviour in the form of attempted suicide and/or suicide. Differences between the groups were not significant. Alcohol abuse in the parental home was overrepresented in the abuse group compared with the other groups. The role of identification with the dead and suicidal parent in prompting suicidal actions in adulthood is discussed, as well as that of the impeded evolution of stable external object relations owing to parental losses.

Adult↗
PubMed1988

Who commits suicide after a suicide attempt? An 8 to 10 year follow up in a suburban catchment area.

One hundred and sixty-three individuals in a suburban catchment area of 72,000 inhabitants made registered suicide attempts during 1975-1976 (i.e. 159/100,000 greater than or equal to 18 years). They were followed up by means of the Swedish Register of Death Causes over a period of 8-10 years. Police reports, autopsies and psychiatric records were also studied. Six cases of verified suicide were found and four additional cases were considered as probable or possible suicides. Thus the cumulative rate over 8-10 years was 3.7-6.1%. There was a mean number of 3.5 suicide attempts before the eventual suicide. The most important common factor overall was alcohol or drug abuse with social deterioration (seven in 10 cases). The rest (three in 10 cases) were depressed women with long-standing suicidal processes. The importance of recognizing chronic abuse as probably the most important background factor is stressed. The total group encompasses individuals with longstanding and severe life problems and difficulties in relating to society. The realistic chances of being able to provide effective suicide prophylaxes for most of these patients requires well planned and longstanding treatment and rehabilitation programmes.

Adolescent↗
PubMed1988

Prevalence and incidence of eating disorders in a suburban area.

There has been no previous epidemiological study on anorexia nervosa (AN) and bulimia (BU) where non-medical care givers have also been included in the case-finding procedure. In this study, psychiatric, somatic, child psychiatric, social and primary care personnel were systematically asked for information on patients. Fifty-one cases of eating disorder (17 AN, 34 BU) according to slightly modified DSM-III criteria were traced in a suburban catchment area of 78,000 inhabitants during a two-year period. This means a two-year prevalence of 66/100,000 (22 AN and 44 BU). For females between 16-24 years the prevalence of AN was 258/100,000; BU: 473/100,000; total 730/100,000 (1/137). There were also 10 "possible cases" where the diagnosis could not be established with certainty, mainly because of insufficient information. If these patients were added, the number of cases would be 61 (or a prevalence of 79/100,000 inhabitants). The one-year incidence for AN was 2.6/100,000 and for BU 3.9. The incidence for AN was 43/100,000 for females 16-24 years old (1/2326). For BU it was 65/100,000 (1/1538). There seems to be no clear social class grouping. Twenty (56%) of the adult patients had been hospitalized for eating disorder during the last six-year period.

Adolescent↗