Biomedical subjects
Publications and source records attributed to M Kantorska-Janiec.
Trichotillomania is the recurrent pulling out of one's own hair, which results in noticeable hair loss, classified in DSM IV and ICD 10 as an impulse control disorder. Trichotillomania can occur as an isolated symptom or may be associated with affective disorders, schizophrenia, substance abuse, borderline personality, obsessive-compulsive disorder. Its onset is usually in childhood and females are more affected than males.
Depression is more widespread than hypertension. Nevertheless, physicians specialized in family medicine did not have knowledge necessary to diagnose and treat depression and anxiety disorders. Only six persons out of fifty five who filled in the questionnaire could recognize depression correctly (ICD-10 criteria). Doctors knew antidepressant drugs, but they did not know therapeutic doses. We can try to explain this situation through doctor's pre and postgraduate education.
The article reviews the history of psychiatric epidemiology: five generations of American studies and future directions are described. There is also information on European studies and a brief history of classifications of mental disorders.
Clorazepate dipotassium (Tranxene), benzodiazepine of retarded anxiety-relieving, sedative and sleep-inducing action was used in an open sample of 36 patients for fast control of anxiety and aggression in the course of schizophrenia, schizoaffective psychosis and other psychotic disorders. The intensity of aggressive behaviors was assessed as 6-7 items on the CGI scale. After intramuscular injection of clorazepate complementing the so-called basic treatment in the mean daily dose of 150 mg, several hours lasting sedative effect was achieved. No unfavourable interactions between the applied clorazepate (Tranxene) and the other medicines applied simultaneously (mostly neuroleptics and antidepressant drugs) were observed. Clorazepate (Tranxene) is an effective and safe drug giving fast and long-lasting sedation of the patients with low risk of interaction with other drugs or of side-effects.
The analysis of treatment costs includes two basic elements--direct and indirect costs. Two major models of analysis are distinguished; the first is based on prevalence of disorders in population, the second--on incidence of disorder. Independently of chosen method, detailed epidemiological data are the starting point of each analysis. The diagnostic instrument that can be useful in these studies seems to be the CIDI--the Composite International Diagnostic Interview. It gives possibility not only to evaluate the prevalence of mental disorders in general population but also to analyse the comorbidity of disorders in examined persons during their lifetime. Apart from that, it allows to assess the individual functioning in different aspects of life. The CIDI is a highly structured instrument for assessment of mental disorders according to diagnostic criteria ICD 10 and DSM IV. It was designed by WHO to serve cross-epidemiologic studies of psychopathology in general population. It can be employed by non-clinicians lay interviewers after proper training. The core version of CIDI consists of 16 modules (diagnostic categories) that can be used independently. Great deal of studies on its reliability and validity have confirmed its high quality, and nowadays it is used widely in several countries in epidemiological studies.