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N Sartorius

Publications and source records attributed to N Sartorius.

At least 91 records · Page 5Linked to original sources
PubMed1990

Classifications in the field of mental health.

For the first time in the Ninth Revision of the International Classification of Diseases (ICD-9) the chapter on mental disorders contained short glossary definitions for each category. A number of changes in attitudes and policies at the international and national levels, particularly the reorientation of mental health programmes to include behavioural and psychosocial problems, came at an opportune time and had a positive influence on the development of proposals for the chapter on mental and behavioural disorders in the Tenth Revision (ICD-10). This in turn enabled WHO to undertaken an intensive and extensive assessment of international needs in the classification of mental disorders and, where the situation was not unequivocal, to organize field trials to provide the empirical data necessary for problem solution. The result is a series of compatible classifications of mental and behavioural disorders based on ICD-10. The first, produced mainly as a reference tool for statistical purposes, will be included in ICD-10 with short glossary definitions as was the case for ICD-9. Other versions will be published for practising clinicians (with enhanced glossary definitions followed by diagnostic guidelines) for research (with full definitions, diagnostic guidelines and diagnostic criteria); for use in the provision of services to the mentally ill; and for use in general health (primary) care. There will also be a multiaxial classification of mental disorders in children to identify the clinical syndrome, resulting disability and environmental factors. It is hoped that these versions tailored to the needs of different groups working in the field of mental health will result in further improvements in communications between those responsible for the provision of services and care.

Disease↗
PubMed1989

Psychosomatic medicine and primary health care (PHC).

Psychosomatic medicine emphasizes that mental and physical illness are inextricably linked and promotes a comprehensive approach to a patient's health problems. The article examines the principles of primary health care and demonstrates the importance of these notions to its development.

Humans↗
PubMed1988

On the expression of psychosis in different cultures: schizophrenia in an Indian and in a Nigerian community.

This sub-study of the WHO Determinants of Outcome of Severe Mental Disorders research project was aimed at characterizing the behavioral and expressive qualities of schizophrenia in two highly diverse cultures. Early research has indicated that the core elements involving affect, perceptual and cognitive dysfunction in schizophrenia are highly similar in form in most cultures of the world. Much of the cross-cultural literature emphasizes, however, strong differences in the ways in which schizophrenia is actually expressed and manifested in different settings. The basic methodology for psychiatric description and diagnosis in the WHO program was the Present State Examination. In five of the field centers a method for investigating the expressive quality and the social behavior of patients in their own communities through the eyes of significant others was applied. This method was then subjected to psychometric tests of cross-cultural applicability and found to be valid for comparing behavior across settings. The expressive patterns of the Indian and Nigerian patients were studied from two perspectives. Indian schizophrenics were described by family members as manifesting a more affective and "self-centered" orientation; the Nigerian patients presented with a highly suspicious, bizarre, anxious quality to the basic behavioral pattern. The main features of pathology were in general accord with the descriptions of indigenous psychiatrists. The special qualities of the psychosis in the two cultures were interpreted against the background of traditional psychopathological and anthropologic theories concerning the psychodynamics and the influence of differing social conflictual themes in the two cultures. Analysis of psychopathology in this manner was found to enhance understanding of underlying mechanisms and the role of cultural conflicts in its expression.

Adolescent↗
PubMed1988

Is schizophrenia universal?

The question whether schizophrenia occurs in similar forms in different populations and cultures was first raised by Kraepelin at the turn of the century. However, methodological difficulties have impeded for decades the development of comparative cross-cultural research, and it was not until the 1960s that investigations of the kind Kraepelin envisaged became feasible. A major role in launching multi-centre clinical and epidemiological studies of schizophrenia in over 20 countries in different parts of the world has been played by the World Health Organization. The WHO studies have demonstrated that: (I) syndromes of schizophrenia occur in all cultures and geographical areas investigated; (II) their rate of incidence is very similar in the different populations; (III) the course and prognosis of schizophrenia is extremely variable, but outcome is significantly better in the developing countries. These findings have fundamental implications for the conceptualization of schizophrenia and for designing strategies of new research.

Cross-Cultural Comparison↗
PubMed1988

Experience from the mental health programme of the World Health Organization.

The managerial structure of collaborative studies is usually not described in reports presenting results from such investigations. The same is true about the experience obtained in the day to day conduct of such studies. Ethical rules which should govern collaboration between individuals and centres are rarely spelled out. The paper presents an outline of WHO's mental health programme and proposes, on the basis of experience obtained in the course of several WHO multicentric international studies, a set of guidelines concerning ethical aspects of scientific collaboration involving several centres or teams.

Cross-Cultural Comparison↗
PubMed1987

Expressed emotion and schizophrenia in north India. I. Cross-cultural transfer of ratings of relatives' expressed emotion.

A bilingual rater was trained in English in a technique of assessing relatives emotional attitudes to patients, and was then required to rate material in Hindi without any further experience. This strategy revealed that the rating of critical comments, hostility and positive remarks could be transferred from English to Hindi without distortion. There were problems with the remaining two scales, over-involvement and warmth, but these were due to technical issues connected with rating and not to cross-cultural distortion.

Adolescent↗
PubMed1987

Expressed emotion and schizophrenia in north India. II. Distribution of expressed emotion components among relatives of schizophrenic patients in Aarhus and Chandigarh.

We measured the components of expressed emotion among two samples of relatives of first-contact patients from Aarhus (Denmark) and Chandigarh (India). The Danes were very similar in most respects to samples of British relatives, whereas the Indian relatives expressed significantly fewer critical comments, fewer positive remarks, and less over-involvement. Within the Chandigarh sample, city-dwellers were significantly more expressive than villagers of all EE components except over-involvement.

Adolescent↗
PubMed1987

Expressed emotion and schizophrenia in north India. III. Influence of relatives' expressed emotion on the course of schizophrenia in Chandigarh.

We conducted a one-year follow-up of patients who had made a first contact with psychiatric services in Chandigarh, North India, and had been assigned a diagnosis of schizophrenia. The expressed emotion (EE) of the patients' relatives was assessed early on. We found the same associations between the individual components of EE and relapse of schizophrenia as in previous Anglo-American studies, but only the association between hostility and relapse was statistically significant. Applying the same criteria as in the Anglo-American studies for 'high EE', we found a significant relationship between high EE and relapse rates. We conclude that the significantly better outcome of Chandigarh first-contact patients compared with a London sample is largely due to the significantly lower proportion of high-EE relatives in the North Indian sample.

Attitude to Health↗
PubMed1986

Early manifestations and first-contact incidence of schizophrenia in different cultures. A preliminary report on the initial evaluation phase of the WHO Collaborative Study on determinants of outcome of severe mental disorders.

In a context of a WHO collaborative study, 12 research centres in 10 countries monitored geographically defined populations over 2 years to identify individuals making a first-in-lifetime contact with any type of 'helping agency' because of symptoms of psychotic illness. A total of 1379 persons who met specified inclusion criteria for schizophrenia and other related non-affective disorders were examined extensively, using standardized instruments, on entry into the study and on two consecutive follow-ups at annual intervals. Patients in different cultures, meeting the ICD and CATEGO criteria for schizophrenia, were remarkably similar in their symptom profiles and 49% of them presented the central schizophrenic conditions as defined by CATEGO class S+. However, the 2-year pattern of course was considerably more favourable in patients in developing countries compared with patients in developed countries, and the difference could not be fully explained by the higher frequency of acute onsets among the former. Age- and sex-specific incidence rates and estimates of disease expectancy were determined for a 'broad' diagnostic group of schizophrenic illness and for CATEGO S+ cases. While the former showed significant differences among the centres, the differences in the rates for S+ cases were non-significant or marginal. The results provide strong support for the notion that schizophrenic illnesses occur with comparable frequency in different populations and support earlier findings that the prognosis is better in less industrialized societies.

Adolescent↗
PubMed1986

Cross-cultural research on depression.

A critical review of evidence about the following issues is presented: frequency of depression, clinical picture of depression, suicide, treatment, appearance of disease, terminology, and future trends. In each instance questions that have remained unanswered and may deserve scientific investigation are listed. Although much has been learned already, numerous problems remain unsolved. It is concluded that properly conducted cross-cultural research can yield results which can help to resolve the conundrum of depression and respond to the challenge which depression poses to the society, to public health authorities and to the individuals who suffer from it.

Adult↗