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PubMed1998

Premorbid personality traits of patients with organic (ICD-10 F0), schizophrenic (F2), mood (F3), and neurotic (F4) disorders according to the five-factor model of personality.

The present article aims to examine premorbid personality traits of psychiatric patients with various diagnoses by asking their close relatives to retrospectively rate the patients' usual self with a questionnaire designed for the five-factor model of personality, a rapidly emerging comprehensive theory of personality structure. Data for 140 patients and 84 controls were analyzed. Although psychiatric patients as a group were characterized by high neuroticism and low conscientiousness when compared with the healthy controls, there were only a few traits that distinguished a particular diagnostic group from either the normal control or from the rest of the patients: neurotic disorder patients had higher neuroticism scores than the normal controls; unipolar depressives had a higher conscientiousness score than the rest of the patient group. No salient premorbid trait was noted for patients with organic mental disorders, schizophrenic disorders or bipolar disorders.

Adult↗
PubMed1984

DSM-III and the diagnosis of organic mental disorders.

Among the many emergency patients who complain of behavioral symptoms, a significant proportion suffer from a physical illness manifesting as an organic mental disorder. Dementia and delirium should be considered in the presence of an impairment of orientation, alertness, or cognition. Effort is required to remain aware of the organic differential diagnoses of hallucinatory, delusional, amnestic, and affective disorders or of personality changes not associated with overt changes of sensorium or cognitive abilities. We review the DSM-III classification of organic mental disorders published by the American Psychiatric Association, and consider the usefulness of historical data, mental status examination, physical examination, laboratory investigations, and hospitalization in the differentiation of organic from functional disorders.

Amnesia↗
PubMed2006

[Five-word test: insufficiently sensitive but very specific for organic memory disorders].

OBJECTIVES: The "five-word test', derived from the Grober and Buschke test, is an easy and rapid tool to distinguish between organic disorders of memory encoding and apparent memory deficits due to inefficient information retrieval strategies. Its metrological characteristics require specification. METHODS: Subjects were classified as demented or non-demented according to DSM IV and NINCDS-ARDA criteria after a dementia assessment and a neuropsychological assessment. All subjects took the five-word test. RESULTS: In all, 142 patients took this test (81 with and 61 without dementia). It was insufficiently sensitive: 80.2% for a score of 10/10 and 60.49% for 9/10. Its specificity, however, was excellent: 100% for scores below 9/10. It also helped identify mistakes due to organic memory disorders, in the form of "intrusion" in the various tests. DISCUSSION: Although this test showed a lack of sensitivity for detecting dementia or organic memory disorders, it remains a useful tool: a pathologic score does permit affirmation of those diagnoses. CONCLUSION: The practical qualities (simplicity and rapidity of administration) of the five-word test make it an essential tool in the evaluation by geriatricians or general practitioners of cognitive disorders in the elderly.

Aged↗
PubMed1996

Caffeine and its effect on persons with mental disorders.

Whereas caffeine is widely accepted for use in society, it can be physically and psychologically harmful, especially to those with a mental illness. The effects of caffeine on specific mental illnesses and the medications used to treat them will be discussed. A review of addiction to caffeine and withdrawal from caffeine will also be presented. An assessment tool used to determine potential caffeine abuse is provided.

Caffeine↗
PubMed2004

Transitive inference in schizophrenia: impairments in relational memory organization.

Transitive inference (TI) describes a fundamental operation of relational (e.g., explicit) memory organization [Eichenbaum, H., Cohen, N.J., 2001. From Conditioning to Conscious Recollection: Memory Systems of the Brain. Oxford Univ. Press]. Here we investigate TI in schizophrenia (SZ), a neurocognitive disorder associated with explicit but not implicit memory dysfunction. SZ patients and healthy controls were trained on a series of learned discriminations that were hierarchically organized (A>B, B>C, C>D, and D>E). They were then tested on each training pair and two novel "inference" pairs: AE, which can be evaluated without consideration of hierarchical relations, and BD, which can only be evaluated by hierarchical relations. SZ patients and controls successfully learned the training pairs and correctly responded to the nonrelational AE pairs. However, SZ patients were less accurate than controls in responding to the relational BD pairs, consistent with the hypothesis that higher-level memory processes associated with relational memory organization are impaired in SZ. The results are discussed with respect to the relational memory model and candidate neuro-cognitive mechanisms of TI.

Adult↗
PubMed1989

Clinical validity.

Few psychiatric disorders have yet been adequately validated and it is still an open issue whether there are genuine boundaries between the clinical syndromes recognized in contemporary classifications, or between these syndromes and normality. In the long run validation depends on the elucidation of aetiological processes. There are, however, a number of strategies which clinicians could use, but at present rarely do, in order to improve and validate existing classifications. Most of these involve studying populations which have been deliberately chosen to represent a broader grouping than a single diagnostic category, or even a group of related categories.

Humans↗
PubMed1976

A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. I. Development and reliability.

A standardized, semi-structured interview for examining and recording the mental state in elderly subjects is described. It allows the classification of patients by symptom profile and can demonstrate changes in that profile over time. It is believed that good reliability is demonstrated between psychiatric raters both for psychiatric diagnosis made on the basis of the schedule findings and for individual items. The Geriatric Mental State Schedule (GMS) consists mainly of items from the eighth edition of the PSE (Wing et al. 1967), together with additional items from the PSS (Spitzer et al. 1964), and extra sections dealing with disorientation and other cognitive abnormalities. Modifications have been introduced to facilitate interviewing elderly subjects.

Aged↗
PubMed1994

Correlates of codisorders in homeless and never homeless indigent schizophrenic men.

We recently completed a case-control study of 100 literally homeless and 100 never homeless indigent schizophrenic men in New York City, in which concurrent substance abuse and antisocial personality disorder were widespread. In this paper we probe the correlates of 'pure' schizophrenia (single disorder, N = 60), schizophrenia and substance abuse (double disorder, N = 89), and schizophrenia, substance abuse, and antisocial personality disorder (triple disorder, N = 50), across the homeless/never homeless distinction. Subjects were recruited from a homeless shelter and mental health service programmes in Upper Manhattan. Psychologist and social worker interviewers administered the Structured Clinical Interview for DSM-III-R, I, and II and other structured instruments to explore social, family and illness history, the current illness, and aspects of treatment and family support. Codisorder subjects emerged from more disadvantaged family backgrounds, experienced greater school difficulties, began drug use in early adolescence, were more prone to hyperactivity in childhood, and were more likely to have spent time in jail. While codisorder groups did not differ on key aspects of schizophrenia, the triple disorder group was found to suffer from a more severe form of substance abuse than double disorder subjects, associated with an earlier age of onset and abuse of a wider array of substances. The widespread prevalence of codisorders among indigent schizophrenic men has major significance for clinical psychiatry. Study of the correlates of codisorders has revealed important differences in social, family, and illness history which may guide the development of more effective treatments and improved service delivery.

Adolescent↗
PubMed1990

The relationship between intellectual impairment and mood disorder in the first year after stroke.

In a community-based study of patients with a first-ever stroke, intellectual impairment (as defined by scores on a common screening test for dementia, the Mini-Mental State Examination) was found in 26% at 1 month post-stroke, and in 21% at 6 and 12 month follow-up. Low scores on the screening test were associated with greater age, physical disability before the stroke, larger stroke lesion volumes as measured on CT scan, and non-stroke changes such as atrophy and white matter low attenuation on the CT scan. There was a negative correlation between scores on the Mini-Mental State Examination and symptom levels on two measures of mood disorder. However, there was no evidence of a specific relationship between major depression and low scores on the Mini-Mental State. We examined various aspects of the relationship between mood symptoms and low scores on the Mini-Mental State, but found no evidence to support the suggestion that this relationship represented an example of depressive pseudodementia. We discuss the significance of our findings for clinical psychiatry and neuropsychology.

Adolescent↗
PubMed1990

Mood disorders in long-term survivors of stroke: associations with brain lesion location and volume.

Sixty surviving patients from a community-based stroke register who had CT scan evidence of a single brain lesion and neurological signs appropriate to it were interviewed three to five years following their first-ever stroke. Mood disorder (anxiety and depression), physical disability, and intellectual impairment were assessed using standardized measures. The position and volume of the brain lesion was determined from CT scans performed soon after the stroke. The prevalence of depressive disorder was lower in this sample than that reported in previous studies (DSM-IIIR major depression 8.3%; all DSM-IIIR depressive disorders 18.3%). Reports by other workers for an association of depressive disorder either with left-sided brain lesions, or with anteriorly placed lesions in the left cerebral hemisphere, were not supported. Neither was there evidence of a correlation between symptom score and proximity of the lesion to the anterior pole of the left cerebral hemisphere. Psychiatric symptom scores were however greater with larger volume brain lesions. Anxiety disorders, especially agoraphobia, were relatively common (20% if diagnosed in the presence of depressive disorder), but were not related to lesion location or volume.

Activities of Daily Living↗