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PubMed1985

Child psychiatric disorders: prevalence and perspectives.

This article provides a review of child psychiatric epidemiology, particularly as it applies to community prevalence surveys. By way of introduction, the administrative and scientific uses of epidemiology are outlined. Major issues in the field are discussed including prevalence versus incidence, definition of deviance and correlates, psychometric properties of instruments, sampling, sources of data, general maladjustment versus specific disorder, and comparability and generalizability of results. Current findings presented include a review of prevalence estimates for general maladjustment, conduct disorder, neurotic disorder, hyperactivity, and depressive disorder. Information is presented on the correlates of sex, age, social class, family factors, and school influences. The clinical implications of the correlate data are discussed and include the importance of utilizing multiple sources of data during the assessment phase and basing a treatment plan on a comprehensive assessment in which interventions are aimed at specific risk factors and strengths. Last, future directions of the field are suggested including the importance of gaining data on the correlates of the duration rather than the occurrence of disorders and the need for randomized clinical trials in which innovative prevention and treatment programs are launched and carefully evaluated.

Adaptation, Psychological↗
PubMed1997

Estimation of the future numbers of patients with mental disorders in Japan based on the results of National Patient Surveys.

To estimate the future numbers of patients with mental disorders, schizophrenic disorders, and neurotic disorders, prevalence obtained from the National Patient Surveys conducted by the Ministry of Health and Welfare of the Japanese government was projected by using linear models by age and sex. The prevalence of whole mental disorders and neurotic disorders will increase, while that of schizophrenic disorders will not do so much. The numbers of patients with mental disorders were estimated to be 973 thousand for males and 1,359 thousands for females in the year of 2008, which were 622 thousand and 733 thousand in 1993, respectively. The disease-specific numbers in 2008 were 562 thousand for schizophrenic disorders and 867 thousand for neurotic disorders, both were 451 and 437 thousand in 1993, respectively. Because of the increase of old age population, the number of old patients with each disorder will also become large.

Adolescent↗
PubMed1984

The first 100 admissions to a regional general purpose adolescent unit.

Details are presented of the first 100 admissions to a regional "general purpose" psychiatric unit for adolescents. Seventy-seven per cent had been referred from other consultants, including 51 per cent from child and adolescent psychiatrists. There was a high incidence of family disruption and disharmony. Apart from a small group of "organic" problems (eight) they were evenly distributed between four major diagnostic groupings: psychotic disorder, conduct disorder, neurotic disorder and mixed conduct/neurotic disorder. Use was made of a variety of treatment approaches and the best outcomes were in the neurotic group (81 per cent some or much improved at discharge) and the psychotic group (68 per cent some or much improved). Attention is drawn to the high rate of "premature" discharge (41 per cent) including 18 per cent expelled because of their behaviour. Nearly 50 per cent of these fell in the conduct disorder group and there are obvious implications for the selection process.

Adolescent↗
PubMed2002

[Psychotherapy in a psychiatric hospital].

This study was aimed to evaluate the role of psychotherapy in psychiatric in-patient care at the example of the Bezirksklinikum Regensburg (BKR) (Community Clinic in Regensburg, Germany). Based on a sample of 6,719 patients suffering from F2-F6 ICD-10 diagnoses, the data of the psychiatric basic documentation (BADO) from January 1995 until April 1999 was retrospectively analysed regarding type and frequency of psychotherapy, influencing factors on indication, and effects of psychotherapy on treatment success. In 33% of cases, specific psychotherapy was in use. A client-centered therapy was carried out in 20% of patients. Other techniques of psychotherapy such as behaviour therapy, cognitive therapy, IPT for schizophrenics, or psychodynamic psychotherapy were applied to 2-6% of patients. Inpatients with eating disorders, personality disorders, neurotic disorders, somatization disorders, and depression were more likely to receive a specific psychotherapy. A significantly positive effect on treatment success was only documented in affective disorders, whereas a significantly negative influence was found in personality disorders.

Adult↗
PubMed2005

Incidence of mental disorders in second-generation immigrants in sweden: a four-year cohort study.

BACKGROUND: Few studies have investigated mental health among second-generation immigrants who have reached adulthood. The aim of this study was to examine whether second-generation adult immigrants have a higher risk of being hospitalised for mental disorders than the Swedish majority population after adjustment for socio-economic status. METHODS: In total 1.9 million Swedish-born women and men aged 16-34 were followed from 1 January 1995 to 31 December 1998 for first hospital admissions for mental disorders, categorised in four main diagnosis groups. Second-generation immigrants comprised four groups and the Swedish majority population was used as reference group. Cox proportional hazard models were used to analyse the data. RESULTS: Second-generation immigrants with one parent born in Sweden and second-generation Finns had higher risks of being hospitalised for psychotic disorders, affective disorders, neurotic disorders, and personality disorders than the Swedish majority population. For second-generation Finns the age- and sex-adjusted hazard ratio for psychotic disorders was 2.42 (CI = 2.09-2.80). No significant hazard ratios were found for second-generation labour immigrants. For second-generation refugees the risk of being hospitalised was higher than for the Swedish majority population but only for psychotic disorders. All results remained significant and decreased only slightly after adjustment for income and education. CONCLUSIONS: Many groups of second-generation immigrants have a higher risk of being hospitalised for mental disorder than the majority population. With increasing global migration it is crucial for all industrialised countries to take measures to improve mental health among second-generation immigrants.

Adolescent↗
PubMed1996

Circadian rhythm of parasuicide in relation to violence of method and concomitant mental disorder.

Circadian occurrence of parasuicide was evaluated in relation to sex, violence of parasuicide method and psychiatric diagnosis. In all, 457 consecutive episodes of parasuicide were recruited during a 5-year period. Complete data for time of parasuicide, parasuicide method, parasuicide recurrency and psychiatric diagnosis (ICD-9) were available for 304 subjects. Parasuicide methods were classified into two groups depending on the violence of the method. Parasuicide occurred significantly more often in the afternoon and evening hours for both men and women, for both violent and non-violent methods, both in first-even cases and repeaters, and in the following diagnostic groups: organic mental and psychoactive substance disorders, neurotic disorders and personality disorders. The data support the hypothesis of a circadian rhythmicity of parasuicide, showing an area of chronobiological risk in the afternoon and early evening hours.

Adult↗
PubMed2004

[Attempted suicide among teenagers and young adults].

The aim of the study was to present the phenomenon of suicide attempts by self-poisoning in a group of females and males ranging in age from 15 to 29 years, and treated in the Department of Clinical Toxicology Jagiellonian University College of Medicine in Kraków in the years 2000-2002. The group analyzed comprised of 1117 patients, 629 (69.1%) women and 425 (38.1%) men. In the female group, teenagers under 19 constituted 48.9%, whereas young females ranging in age from 20 to 29 years--51.1%. In the male patients group teenagers under 19 constituted 29.4%, the young men (20-29 years of age)--70.6%. The group was analyzed from the point of view of demographic, clinical and social factors such as gender, age, level of education, marital status and occupation (if applicable), the course of self-poisoning and kind of toxic substance involved. In the majority of cases, self-poisoning had been caused by taking one type of medicines, and less frequently by taking mixed-type medicines or by simultaneously taking medicines and ethanol. The most typical drugs used in the attempts included benzodiazepines, phenothiazines, nonsteroidal antiinflammatory and antiepileptic drugs. The assessment of the poisoning severity based on the PSS classification, indicates the predominance of the minor and moderate poisoning. Up to 50% of subjects suffered from mental disorders--most frequently from affective disorders, neurotic disorders, and personality disorders. As an essential part of the problem of suicidal behaviors in teenagers and young adults, suicide attempts among young population require an in-depth analysis. The scale of the problem indicates the necessity of initiating appropriate preventive actions and organizing appropriate psychological and psychiatric care.

Adolescent↗
PubMed1991

[Psychogenic reaction: course and prognostic factors].

A follow-up was made of ninety patients with a diagnosed psychogenic reaction (adjustment disorder) fourteen years after the index hospitalisation. Contrary to expectation, at the follow-up only half of the patients showed no symptoms of the illness. Approximately a quarter of the patients suffered from a more serious illness (drug dependence, schizophrenia or organic mental disorder) than the index diagnosis. The other quarter showed symptoms of a psychogenic disorder (neurotic disorder, personality disorder, adjustment disorder). A number of factors which describe the course of the illness leading to the index hospitalisation permit a prediction of the outcome of the disease.

Adjustment Disorders↗
PubMed1990

[Basic suicidality at a psychiatric hospital].

Using a questionnaire the therapists of the Psychiatric Hospital in Ravensburg Weissenau were requested for information on the suicidality and symptomato-logy of their patients. This was done to assess the acute and chronic suicidality prevalent in a psychiatric hospital. The number of acute and chronic suicidal patients, the prevalence of self-destructive behaviour (38%) as well as the fact that 75% of the 475 assessed patients belonged to diagnostic groups with an imminent high risk of suicidality, show the high "basic suicidality" that therapists of a psychiatric hospital to deal with: 7% of the assessed patients were acutely, 11% chronically and 22% possibly suicidal; 38% had had suicidal episodes at least once in their life. The rate of suicidality was highest among patients with affective psychoses followed by those with personality disorders, neurotic disorders and depressive syndromes.

Adolescent↗
PubMed1995

[Diagnosis and management of neurotic occupational disorders (before pension application)].

This paper summarizes how neurotic disorders affect working capability, with an emphasis on neurotic working disorders. According to official statistics neurotic disorders account for 5.5% of all disability pensions, but they figure less often as diagnoses in medical certificates issued prior to invalidation. The true impact of neurotic disorders may only be guessed, since the diagnosis is easy to miss and only reluctantly proffered when suspected. In contrast to other neurotic disorder afflicting working behaviour, the neurotic working disorder is thematically centered within the sphere of work and profession itself. The disorder is often treated inadequately and belatedly. Typical somatic complaints clusters, characteristic neurotic conflicts and personality traits often encountered with neurotic working disorder are outlined. Diagnosis requires the taking of a psychobiographic history and some knowledge of psycho- and soziotherapy. There are many options for therapy, and there are a few studies evaluating their efficacy. In order to install treatment early, a routine checkup by a psychotherapist is suggested for all patients exceeding a certain number of days off work per year.

Combined Modality Therapy↗
PubMed1995

Psychiatric comorbidity in eating disorders: psychopathological considerations.

The psychiatric comorbidity was examined in patients who met ICD-10 criteria for eating disorders. The most frequent comorbid diagnoses were mood disorders, followed by personality disorders and neurotic disorders. Non-attendance at school was also seen. Eating disorders did not directly cause mood disorders, but rather indirectly brought them about by a devaluation of self-esteem. Features of personality disorders occurred independently of eating disorders, appearing or disappearing relative to the major object or transitional object. Neurotic disorders served as non-verbal communication, a function originally included in eating disorders. It is important to take note of the devaluation of self-esteem and the meanings of symptoms as communication within eating disorders.

Adolescent↗