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[Not Available].

Using the data basis of the Mannheim Cohort Study the present paper investigates the correlation between socio-economic Status and psychogenic impairment due to predominantly psychosocially influenced ("psychogenic") disorders (neurotic spectrum disorders, personality disorders, stress reactions and somatoform disorders) in a representative adult Community sample. The period of observation amounted up to 11,1 years. Subjects investigated within our follow-up study for this interval (n=301) were drawn from an representative adult Community population sample (N=600). Within the three step class model members of the lower class were at all investigation time points significantly stronger impaired compared to the members of the middleand upper class. Investigating the clinical impairment related to the intragenerative class mobility those subjects, which could achieve a social rise between two points of investigation were even prior, to the first investigation time point, less affected compared to the ones remaining in their social class. Vice versa subjects in the process of an social decline presented a stronger psychogenic impairment prior to their decline compared to those, which remained stable in their social class. These dynamic correlations offer evidence for the effect of the socalled "drift-hypothesis", which postulates, that persons due to their disease decline in their social Status respectively after improving rise to a higher social class.

Epidemiology↗

[The population treated in the general psychiatric sector in 1993 and 1998. Clinical and demographic evolution].

BACKGROUND: The French information system in public psychiatry sectors does not collect morbidity data for the population being treated, estimated as more than a million persons in 1997. Consequently, two surveys were financed by the "Direction Générale de la Santé" and carried out in 1993 and 1998 in order to specify clinical, social and demographic characteristics of the patients. These surveys allowed a follow-up of evolutions according to the pathology and mode of treatment in a context where outpatient treatments are becoming increasingly frequent. METHODS: A census of the patients was made at a given moment, between one and fifteen days according to the mode of treatment. One sector out of two was surveyed, using a systematic selection process. The ICD-10 was used for diagnosis reference. The same methodology was applied in 1993 and 1998. Comparisons were made with the data supplied by the sectors annually and with the data concerning the general population in order to calculate rates per age groups. RESULTS: Between 1993 and 1998, the number of patients increased by +37% in outpatient care, and in part time care, and decreased by -12% in full time care. Rates for patients increased for all age groups in outpatient and part time care, more particularly for the 35 to 49 years old. Conversely, rates decreased in full time care, above all for patients over seventy. In each mode of treatment, the number of patients presenting mood disorders and neurotic disorders increased more than the average, and the proportion of patients with organic mental disorders and mental retardation decreased. Evolutions were different according to the mode of treatment schizophrenia, schizotypal and delusional disorders, and disorders of adult personality and behaviour. CONCLUSIONS: Recourse to outpatient care and part time care increased considerably over five years but evolutions were markedly different from one diagnosis to another. In full time care, the decrease more particularly concerned certain pathologies and age groups. Three phenomena, with possible interactions, could explain the evolutions observed: the population liable to have recourse to psychiatric care is increasing, health policies have changed and care supply has become diversified, and recourse to psychiatric care is now increasingly accepted.

Adult↗

Associated psychopathology in conversion patients without organic disease.

The authors examine the associated psychiatric diagnoses of 100 consecutive patients with conversion symptoms without organic disease. More than 80% of the subjects present a coexisting psychiatric disorder. The most frequent are affective disorder, personality disorder, other "neurotic" disorder and substance abuse. The authors conclude that conversion should be considered as a nonspecific symptom.

Adult↗

[Heart rhythm in cardiovascular disorders of neurotic origin].

Cardiac rhythm (CR) and vegetative parameters at rest and after a series of short-term loads were compared in normal subjects and neurotic patients with the cardiologic syndrome (group 1) and those with vegetovascular crisis (Group 2). At rest, second-group patients demonstrated the best CR stabilization (by sigma R-R), with the CR oscillation pattern respiratory constituent (RC) diminished and its slow-wave (SW2) constituent prevailing as well as the highest arterial BP and intrasystemic dissociations (the Kërdo index). First-group patients showed the greatest sigma R-R, with the SW2 prevailing in the presence of a greater RC contribution, as compared to group 2 patients. Different patterns of post-exercise change were demonstrated: normal subjects showed increased heart rate, BP and sigma R-R, with doubled SW1 contribution, reduced SW2 and unchanged RC, an evidence of sympathetic mobilization in the presence of vagal pacemaker effects. In second-group patients, heart rate and BP were reduced, the contribution of SW2 increased, and that of SW1 and RC diminished, while the initial CR stabilization by the sigma R-R remained unchanged. Inter-systemic dissociations were demonstrated, using the Hildebrandt index; this combination signals overstrain of the controlling mechanisms, growing centralization of CR control and disadaptation. In first-group patients, BP rose, heart rate and sigma R-R declined, while the CR oscillation pattern remained basically unchanged, suggesting a rigidity of the central adaptation mechanisms.

Adult↗

[Peptide therapy of sleep disorders in neurotic rats].

As a result of chronic stress, anxiety appeared in the rats behaviour, motor activity increased, heart rate quickened, blood pressure raised, conditioned instrumental alimentary reflexes missed, the duration of deep phases of sleep lowered, time of falling asleep became longer, the number of awakening increased. The change in quantitative characteristics of sleep was accompanied by its worsening, especially of rapid sleep. Administration of substance P (SP) eledoisin hexopeptide (EH) (250 mcg/kg), 100-200 mcg/kg of delta sleep peptide and 10 mcg/kg of ethylcrotyl barbiturate improved the rats behaviour and sleep parameters. Calipnon accelerated falling asleep. Delta sleep peptide increased sleep duration. SP and EH restored not only the quantitative characteristics of deep phases of sleep but greatly improved their quality: lowered the blood pressure disrupted tachycardia, normalized the conditioned activity.

Animals↗

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↗

Increased level of salivary prostaglandins in patients with major depression.

We quantified the amounts of salivary prostaglandin (PG) D2, PGE2, and PGF2 alpha by radioimmunoassay in 32 patients with major depressive disorder, 16 patients with minor depressive disorder, 24 patients with neurotic disorders (panic, generalized anxiety, phobic, somatization, and obsessive compulsive), and 28 healthy controls. In the saliva of patients with major depressive disorder, the concentrations of immunoreactive PGs (PGD2, 385 +/- 71 pg/ml; PGE2, 498 +/- 105 pg/ml; PGF2 alpha, 444 +/- 100 pg/ml) were significantly higher than those of the healthy controls (PGD2, 129 +/- 18 pg/ml; PGE2, 207 +/- 25 pg/ml; PGF2 alpha, 164 +/- 17 pg/ml). On the other hand, the salivary concentrations of immunoreactive PGs from patients with minor depressive disorder or neurotic disorders were comparable to those of the controls. These results suggest that the level of salivary PGs may be an indicator of major depressive disorder.

Adult↗

[Neurotic states in children with epileptic parents].

On the basis of neurological, encephalographic and clinico-anamnestic examinations of 106 children with a family history of epilepsy the authors have specified a group of children (n = 38) suffering from different neurotic disorders which included neurotic ticks, sleep disturbances, affective-shock reactions and signs of asthenization. The role of familial factors in the formation of neurotic states of children is emphasized. The authors consider the time during which the child was exposed to psychotraumatic circumstances and the relationship between the severity of epileptic process in parents and the development of neurotic disorders in their progeny. A conclusion has been made that the disease of the parents can exert both direct and indirect influence on the nervous system of the child, this leading to the development of different neurotic states. The prophylaxis of neurotic disturbances in children should include the creation of healthy psychic atmosphere in families where one of the parents suffers from epilepsy.

Adolescent↗

Epilepsy and insanity during the early 19th century. A conceptual history.

During the first half of the 19th century, epilepsy and the insanities were considered as closely related "neurotic" disorders. Under the influence of factors such as the decline of the 18th-century Cullean concept of neurosis, the development of the new descriptive psychopathology, the introduction of statistics, and the availability of longitudinal observations of hospitalized cohorts, epilepsy was redefined as a "neurological" disease by the 1850s. The reaction of psychiatry to the exclusion of the mental disorder as a defining feature of epilepsy manifested itself in the creation of the "masked epilepsy" concept. This notion is behind the later development of categories such as "borderland" and "equivalent," which are still of some relevance to 20th-century views of epilepsy.

Brain↗

ICD-10 field trial in German-speaking countries--summary, judgement and perspectives.

On the basis of the results of the field trial, the most important classificatory innovations of ICD-10, together with their advantages and disadvantages are described. The initial good acceptance of the new system could be further improved by structural modifications, such as a uniform and systematic description of the individual diagnostic categories. Criticism of content was focused on affective and neurotic disorders and adult personality disorders. When it is introduced, the psychiatric chapter of ICD-10 will surpass most of the hitherto existing psychiatric classification systems in size, differentiation and international testing.

Adolescent↗

Psychiatric study of non-responders among elderly health examinees in Stockholm.

A psychiatric study has been carried out on a group of 72-year-olds. They were selected at random among the 2,878 persons born in 1905 and resident in the municipality of Stockholm who failed to appear for a general health checkup 6 years earlier. Among the 86 persons who could be evaluated of the 104 originally selected, 53 were found to be without psychiatric symptoms. Organic brain diseases were found in four cases, psychoses in three and neurotic disorders, chiefly depressive states, in 15 cases, while 10 subjects had sleeping disturbances and one chronic alcoholism. The social group distribution among the examinees indicated that it was those most in need of medical or social help who failed to participate in the health checkup.

Aged↗

Nosological status of endogenous anxiety: 'anxious thymopathy' revisited.

In 1950 López Ibor described a nosological entity called anxious thymopathy ('timopatía ansiosa'). The origin of his description was the observation of recoveries of neurotic patients during psychotherapy which were not directly related to the psychodynamic process. Such a spontaneous fading of neurotic anxiety was suspected to be of an endogenous character. This led to the description of a vital anxiety, a mood disturbance similar to Schneider's [1950] vital sadness present in endogenous depressions. Normal and pathological (vital) anxiety were thought to be different, vital anxiety having a biological origin, so that biological treatment was applied to it. In the course of the years, López Ibor came to the conclusion that anxious thymopathy was not an independent nosological entity, rather that vital (also called endothymic) anxiety was an element present in all forms of neurotic disorders integrated with personality and biographical factors. This research led to the concept of neuroses as mood disorders [López Ibor, 1966].

Anxiety↗

Socio-economic status and mental morbidity in certain tribes and castes in India--a cross-cultural study.

The authors made a field-survey of mental morbidity in all the tribal and caste groups residing in a cluster of villages in West Bengal, India, and found that, in each group, higher socio-economic classes had higher rates of mental morbidity. Different groups having a similar cultural pattern showed no significant difference in their rates of morbidity. Groups having different cultural patterns differed significantly in their rates of morbidity. In the tribal groups some neurotic disorders were absent.

Cross-Cultural Comparison↗