Biomedical subjects
Publications and source records attributed to S Akhtar.
This paper describes four culture-bound psychiatric syndromes seen in India. It highlights their phenomenology and briefly comments upon the socio-cultural correlates of such symptom constellations.
Mahler's theory of symbiosis and separation-individuation demonstrates the essential unity of drive, ego, and object relations psychologies. By highlighting the role that early dyadic relations play in psychic structure formation, her theory expands the understanding of human psychic development and its failures. This paper reviews Mahler's propositions and underscores their clinical importance by describing two cases where much preoedipal reconstructive work preceded the emergence of an analyzable oedipal transference neurosis.
Various views of schizoid personality disorder in descriptive psychiatry, psychoanalysis, DSM-III and DSM-III-R are reviewed and synthesized to develop a composite picture of the syndrome. The disorder is seen as consisting of characteristic deficits in six areas of psychosocial functioning: (1) self-concept, (2) interpersonal relations, (3) social adaptation, (4) ethics, standards and ideals, (5) love and sexuality, and (6) cognitive style. Such a view maintains historical continuity in the use of the term "schizoid," combines descriptive and psychodynamic observations and correlates the behavioral and psychostructural aspects of the schizoid pathology. The paper also identifies guidelines for distinguishing the schizoid personality from other personality disorders as well as areas needing continued research.
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In a survey of borderline personality disorder, 23 studies that included data on age, sex, or race of the patient samples were identified. Comparison of patients who had borderline personality disorder with control groups in these studies revealed that a significant preponderance of patients with the disorder were young, white, and female. This finding cannot be considered conclusive because data were pooled from studies with questionable sampling techniques. Yet, this demographic profile warrants confirmation because it may imply diagnostic biases or actual differences in the prevalence of borderline personality disorder among various groups.
The author delineates the syndrome of identity diffusion as consisting of six clinical features: 1) contradictory character traits, 2) temporal discontinuity in the self, 3) lack of authenticity, 4) feelings of emptiness, 5) gender dysphoria, and 6) inordinate ethnic and moral relativism. This syndrome implies severe character pathology and is distinct from adolescent identity crisis. The conceptualization has a significant bearing on the differential diagnosis and psychotherapy of personality disorders.
After briefly reviewing various contributions to the concept of splitting, the authors describe the clinical manifestations of this defense. These include 1) inability to experience ambivalence, 2) impaired decision making, 3) oscillation of self-esteem, 4) egosyntonic impulsivity, and 5) intensification of affects. The authors then discuss the relevance of such conceptualizations to the differential diagnosis and psychotherapy of personality disorders.
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Disposition kinetics and urinary excretion of sulphadimidine were investigated in 16 dogs following a single intravenous injection (100 mg/kg body weight). Biochemical parameters including blood pH, blood glucose, plasma triglycerides and total plasma proteins of these animals were determined. The animals were injected alloxan (125 mg/kg) intravenously and when blood glucose level exceeded 300 mg%, the biochemical parameters, disposition kinetics and urinary excretion of sulphadimidine were determined again. After alloxan treatment of the dogs, there was a highly significant (P less than 0.01) decrease in blood pH, increase in blood glucose and plasma triglycerides levels when compared with the pretreatment values. The alloxan diabetic dogs showed a highly significant (P less than 0.01) reduction in elimination half-life (t1/2 beta) and apparent volume of distribution (Vd(area)) and increase in overall elimination rate constant (kel), total body clearance (ClB) and percentage of sulphadimidine dose excreted in urine. In normal dogs, one-half of the intravenous dose and after alloxan treatment two-third of the dose was eliminated through urinary excretion during 48 hours after injection. This study shows that the metabolic alterations of alloxan induced diabetes in dogs, influence the drug disposition and urinary excretion which indicate the need for the adjustment of dosage regimen in such metabolic disorders.
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The authors trace the evolution of narcissistic personality disorder as a nosological entity in a critical survey of the literature, considering and comparing differing theoretical viewpoints regarding the genesis of this disorder. They review its various descriptions, including the one in DSM-III, and develop a composite picture of the syndrome. The disorder consists of characteristic deficits in six broad areas of functioning: 1) self-concept, 2) interpersonal relationships, 3) social adaptation, 4) ethics, standards, and ideals, 5) love and sexuality, and 6) cognitive style. The authors identify guidelines for distinguishing the narcissistic personality from other personality disorders as well as areas needing continued research.
This study examines AMA discharges from a psychiatric inpatient unit. Such discharges are found to occur with greater frequency (p .005) among individuals with alcoholism and character disorders. The AMA patients do not, however, seem to form a homogeneous group in themselves. This study identifies two subgroups of AMA patients: the "early" AMA and the "late" AMA, depending upon their length of stay in the hospital prior to AMA discharge. The demographic, clinical and psychodynamic differences between the two sub-groups are discussed. Some practical recommendations are made in regard to the prevention and management of AMA discharge requests.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This review brings together the considerable, scattered literature on the sexuality of the schizophrenic. It encompasses the reports pertaining not only to the overt sexual behavior of schizophrenics but also their subjective experience including various delusions and hallucinations related to sexuality. Also reviewed are the sexual side effects of antipsychotic medication and sexual crimes and perversions occurring among individuals suffering from schizophrenia. The effectiveness of various treatment modalitites, including sex therapy, in controlling the bizarre sexual behavior that often accompanies schizophrenia, is also considered. Twelve unusual cases are also briefly reported. A greater awareness of these "sexual" symptoms of schizophrenia may be utilized to sharpen diagnostic sensitivity to the incipient forms of the disorder, to estimate prognosis in a given case, and to better understand some sexual crimes. In certain cases, such knowledge may alter the choice of antipsychotic medication.