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S Wetzler

Publications and source records attributed to S Wetzler.

50 records · Page 3Linked to original sources
PubMed1990

Diagnosis of personality disorders by the Millon Clinical Multiaxial Inventory.

The diagnostic efficiency of the Millon Clinical Multiaxial Inventory (MCMI) was examined with regard to the diagnosis of DSM-III axis II personality disorders by practicing psychiatrists. The MCMI displayed fairly good sensitivity but poor specificity and predictive power regarding the diagnosis of any personality disorder. Two possible explanations were offered: a) axis I psychopathology inflates scores on the MCMI personality disorder scales and causes an overdiagnosis of personality disorders by the test; or b) there is an under-recognition of axis II personality disorders (especially in the context of obvious axis I psychopathology) by the average practicing clinician.

Adjustment Disorders↗
PubMed1990

Nosological tunnel vision in biological psychiatry. A plea for a functional psychopathology.

Classical nosology has been the major cornerstone of biological psychiatric research; finding biological markers and eventually causes of disease entities has been the major goal. Another approach, one we have designated as "functional," seems possible, attempting to correlate biological variables with psychological dysfunctions, the latter being considered to be the basic units of classification in psychopathology. We have pursued this route for many years, and based on the resulting findings we formulated the following hypothesis. Signs of diminished dopamine, serotonine, and noradrenaline metabolism, as have been found in psychiatric disorders, are not disorder-specific, but rather are related to psychopathological dimensions; i.e., hypoactivity/inertia; increased aggression/anxiety and anhedonia, independent of the nosological framework in which these dysfunctions occur (van Praag et al. 1990). In this paper only the 5-HT data have been discussed. Implications of the functional approach for psychiatry are discussed, including a shift from nosological to functional application of psychotropic drugs. Functional psychopharmacology will be dysfunction-oriented and therefore inevitably geared towards utilizing drug combinations. This prospect is hailed as progress, both practically and scientifically.

5-Hydroxytryptophan↗
PubMed1990

Monoamines and abnormal behaviour. A multi-aminergic perspective.

Classical nosology has been the cornerstone of biological psychiatric research; finding biological markers and eventually causes of disease entities has been the major goal. Another approach, designated as 'functional', is advanced here, attempting to correlate biological variables with psychological dysfunctions, the latter being considered to be the basic units of classification in psychopathology. Signs of diminished DA, 5-HT and NA metabolism, as have been found in psychiatric disorders, are not disorder-specific, but rather are related to psychopathological dimensions (hypoactivity/inertia, increased aggression/anxiety, and anhedonia) independent of the nosological framework in which these dysfunctions occur. Implications of the functional approach for psychiatry include a shift from nosological to functional application of psychotropic drugs. Functional psychopharmacology will be dysfunction-orientated and therefore geared towards utilising drug combinations. This prospect is hailed as progress, both practically and scientifically.

Arousal↗
PubMed1989

An external validity study of the MMPI Personality Disorder Scales.

This study examined the external validity of the MMPI Personality Disorder (PD) scales. Patients diagnosed with personality disorders (n = 23), according to a structured interview, were contrasted with medical control subjects and psychiatric patients with no personality disorder (n = 33). The MMPI PD scales could discriminate patients with any personality disorder and patients with specific clusters of personality disorders. Convergent validity was demonstrated by high correlations between the MMPI PD scales and the comparable Millon Clinical Multiaxial Inventory scales, as well as the number of DSM-III personality disorder symptoms. This study represents a preliminary step in the external validation of the MMPI PD scales.

Adult↗
PubMed1989

Problems with the differentiation of anxiety and depression.

This paper discusses the problems of differentiating anxiety and depression. Assessment of these two clinical states is particularly difficult since they are typically intermingled. Theoretical analysis of the current use of the constructs and a sound psychometric approach can disentangle them. Unfortunately, the most widely used assessment methods do not measure anxiety and depression independently.

Anxiety Disorders↗
PubMed1989

Factors associated with better compliance with psychiatric aftercare.

The rate of compliance with aftercare following hospitalization is disturbingly low despite its proven efficacy in preventing relapse and rehospitalization. This study of 134 emergency admissions to a New York City municipal hospital examined the impact of patient characteristics, clinical variables, and attitudes toward treatment on compliance with aftercare in the six months following discharge. Excluding 31 patients who required rehospitalization, 70 percent of patients attended their first aftercare appointment, and 40 percent completed six months of aftercare. Factors associated with better compliance with aftercare were continuity of care, as reflected in less time between discharge and the first aftercare appointment; increased number of prior hospitalizations; increased length of hospital stay; less denial of need for treatment; and greater perceived need for medications. Recommendations for improving compliance with after care are presented.

Aftercare↗
PubMed1989

Diagnosis of major depression by self-report.

The Symptom Checklist-90 (SCL-90), Millon Clinical Multiaxial Inventory (MCMI), and Minnesota Multiphasic Personality Inventory (MMPI) test profiles of inpatients and outpatients with DSM-III major depression (n = 48) were contrasted with the test profiles of a control group of patients with diverse psychiatric disorders (n = 68). In addition, the diagnostic efficiency of the relevant depression subscales for the diagnosis of major depression were examined. The results indicated that the three self-report tests may be used to diagnose DSM-III major depression, and that the depressed patients had characteristic test profiles.

Adult↗
PubMed1989

Cognitive functioning in depression.

Verbal learning and memory, and recognition of famous faces, were assessed in 21 non-demented inpatients with RDC endogenous depression. Severity of depression was related to attention span, and patient age was related to measures of learning and recall. However, even in this severely depressed sample, verbal learning/memory measures were not below normative values. Facial recognition was significantly impaired relative to test norms. The results suggest that mild impairment in the early stages of verbal information encoding, and more marked impairment in the recognition of famous faces, may be associated with depression. These impairments differ from the cognitive changes associated with aging.

Age Factors↗
PubMed1988

Neuroendocrine evidence for serotonin receptor hypersensitivity in panic disorder.

Normal controls (NC) (n = 15), patients with panic disorder (PD) (n = 13) and patients with major depression (MD) (n = 17) were challenged with a single, oral dose (0.25 mg/kg) of the selective 5HT agonist m-chlorophenyl-piperazine (MCPP) or placebo. Blood samples were assayed for cortisol and MCPP levels every 30 min. The PD group had an augmented cortisol release when compared to the other two groups. Finally, a significant correlation was found across all subjects between clinical anxiety level and cortisol release on MCPP. These data support the hypothesis of 5HT receptor hypersensitivity in PD.

Adult↗
PubMed1988

Behavioral indications for serotonin receptor hypersensitivity in panic disorder.

Immediate placebo-corrected behavioral responses to m-chlorophenylpiperazine (MCPP), a selective serotonin agonist, are reported in 11 normal controls, 10 patients with panic disorder, and 10 patients with major depression. Whereas the normal and depressed groups showed no noteworthy behavioral response, panic disorder patients became more anxious, depressed, and hostile, and 60% had panic attacks. These data suggest a hypersensitive postsynaptic serotonin receptor system in some panic disorder patients.

Adult↗
PubMedDate not supplied

Denosologization of biological psychiatry or the specificity of 5-HT disturbances in psychiatric disorders.

5-Hydroxytryptamine (5-HT) disorders have been reported to occur in a variety of psychiatric disorders. The situation has been called chaotic, the disturbances non-specific. We reject this viewpoint. 5-HT disturbances are non-specific only from a nosological/categorical viewpoint; they seem rather specific from a functional/dimensional point of view, correlating as they do with particular psychopathological dimensions, i.e. aggression-, anxiety- and possibly mood-disregulation, across diagnosis. The evolution of 5-HT research in psychiatry illustrates the importance of what we have called the functional approach, implying dissection of a given psychopathological syndrome in its component parts, i.e., the psychological dysfunctions, and searching for correlations between biological and psychological dysfunctions. The rigid preoccupation of biological psychiatry with the search for markers of disease entities has hampered progress. The functional approach should be incorporated in biological psychiatry, not as an alternative for the nosological approach but as its complement.

Anxiety Disorders↗
PubMedDate not supplied

Dissociative symptomatology and aggressive behavior.

The present study examined the relationship between dissociative symptomatology and a range of aggressive behavior in a general psychiatric outpatient population. Of the total sample (n = 122), 29% scored above 25 on the Dissociative Experiences Scale (DES). Patients with high DES scores (> 25) were significantly more likely than patients with lower DES scores (< 25) to report a history of childhood sexual abuse, to have attempted suicide, and to report more assaultive behavior, irritability, and negativism. There were no differences between the patients with high versus low DES scores on homicidal behavior. To better manage and treat outpatients with dissociative symptomatology, it is important to clarify the association between outwardly aggressive behavior and dissociative experiences.

Adult↗