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PubMed1988

[Delimitation of morbid and nonmorbid querulousness].

The differences are established in the manifestations and course of litigious-paranoid disorders of psychogenic personality-related origin and nonpathological querulousness. Pathologic litigiousness is characterized by a larger constitution-personality predisposition, lesser situational dependence and possibility of psychopathologic classification of querulous manifestations. An excessive intensity and length of querulousness, as related to the objective value of the psychogenesis, the more pronounced trend to litigiousness manifestations, progressive loss of their relation to situational cues, aggressive traits in behavior, are all characteristic of litigious-paranoid disorders. These and other features of litigious-paranoid disorders can be used as differential diagnostic factors in differentiating between pathologic and nonpathologic querulousness.

Antisocial Personality Disorder↗
PubMed1999

Therapy of behavioral disorders in Parkinson's disease.

Behavioral disturbances in Parkinson's disease (PD) are a common source of disability to both patients and their families, but there is a considerable controversy regarding their frequency and their neuropathological and neurochemical bases. Since they are so common, the disorders associated with PD should be well recognized, and proper management by neurologists is required. The most frequent behavioral disturbances encountered in patients with PD are depression, anxiety, cognitive impairment and dementia. Also frequent are sleep disorders such as sleep fragmentation, REM sleep behavior disorder, insomnia and altered dreaming. The most troublesome situations come from drug-induced psychiatric states, such as delusional states, hallucinations, paranoid ideation, delirium, and confusion. The treatment of these behaviors is reviewed here.

Behavioral Symptoms↗
PubMed1992

Increasing generalized social interactions in psychotic and mentally retarded residents through peer-mediated therapy.

This study investigated whether withdrawn adults living in a residential center for psychotic and mentally handicapped persons could serve as peer therapists to increase the social interaction of other withdrawn residents. Two pairs of residents served as participants. Treatments were introduced and evaluated within a multiple baseline with reversal design. After baseline, the peer therapist was instructed to increase the social interactions of a target peer through engagement in social interactions. The results demonstrated that the peer therapist increased the social interactions of target peers. However, these increases did not generalize to other residents until the introduction of a multiple peer therapist condition. The percentage of time the peer therapists interacted with other nontarget residents also increased throughout the study. These results were maintained during a 4-month follow-up condition.

Adult↗
PubMed2006

Parenting behaviors associated with risk for offspring personality disorder during adulthood.

CONTEXT: Research has suggested that some types of parental child-rearing behavior may be associated with risk for offspring personality disorder (PD), but the association of parenting with offspring PD has not been investigated comprehensively with prospective longitudinal data. OBJECTIVE: To investigate the association of parental child-rearing behavior with risk for offspring PD during adulthood. DESIGN: The Children in the Community study, a prospective longitudinal investigation. SETTING AND PARTICIPANTS: A community-based sample of 593 families interviewed during childhood (mean age, 6 years), adolescence (mean ages, 14 and 16 years), emerging adulthood (mean age, 22 years), and adulthood (mean age, 33 years) of the offspring. MAIN OUTCOME MEASURE: The Structured Clinical Interview for DSM-IV Personality Disorders. RESULTS: Ten types of parenting behavior that were evident during the child-rearing years were associated with elevated offspring risk for PD during adulthood when childhood behavioral or emotional problems and parental psychiatric disorders were controlled statistically. Parental behavior in the home during the child-rearing years was associated with elevated risk for offspring PD at mean ages of 22 and 33 years. Risk for offspring PD at both assessments increased steadily as a function of the number of problematic parenting behaviors that were evident. Low parental affection or nurturing was associated with elevated risk for offspring antisocial (P = .003), avoidant (P = .01), borderline (P = .002), depressive (P = .02), paranoid (P = .002), schizoid (P = .046), and schizotypal (P<.001) PDs. Aversive parental behavior (eg, harsh punishment) was associated with elevated risk for offspring borderline (P = .001), paranoid (P = .004), passive-aggressive (P = .046), and schizotypal (P = .02) PDs. CONCLUSIONS: Parental behavior during the child-rearing years may be associated with risk for offspring PD that endures into adulthood. This risk may not be attributable to offspring behavioral and emotional problems or parental psychiatric disorder, and it may not diminish over time. Low parental nurturing and aversive parental behavior during child rearing may both be associated with elevated risk for offspring PDs.

Adolescent↗
PubMedDate not supplied

Cognitive behavioural nursing therapy in paranoid psychosis.

This paper provides an account of cognitive behavioural interventions applied by nurses to a patient experiencing paranoia. The paper provides a brief review of the process of such interventions and incorporates a case study.

Adult↗
PubMed1975

Effects of disulfiram on the amphetamine-induced behavioral syndrome in the cat as a model of psychosis.

We have previously reported that, from a phenomenological standpoint, the behavioral manifestations of cats chronically intoxicated with amphetamine parallel the evolution of the paranoid psychosis induced by the drug in humans. However, certain manifestations in the cat, such as frozen postures, disjunctive behaviors and postures, cataleptic-like phenomena, obstinate progression, loss of righting reflex and pupillary changes, did not appear to be consistent with the phenomenology of the paranoid psychosis. Since treatment of schizophrenic patients with disulfiram, an inhibitor of norepinephrine synthesis that acts at the level of the enzyme dopamine beta-hydroxylase, thereby leading to increased dopamine concentrations, had been found to profoundly exaggerate psychotic symptomatology, amphetamine behavioral syndrome in the cat as it is modified by pretreatment with disulfiram. Following such pretreatment, a faster development of certain end-stage components of the amphetamine syndrome was obtained. Thus, on the first day, development of a Reactive attitude and of more prominent behavioral disjunction occurred with the combined drug administration as compared with amphetamine alone. In contrast with the facilitation of these behaviors was the absence of dyskinesias and hyperreflexia on that day. Stereotyped behavior, loss of motor initiative and hyperkinetic activity were markedly enhanced and appeared with a shorter latency period on subsequent days of the intoxication cycle. Loss of righting reflex was an early manifestation in these animals. During the later days, the particularly high level of compulsive activity was evident from the occurrence of an obstinate progression syndrome and the performance of stereotyped movements of the head in the presence of a crucifixion posture. In general, modification of the amphetamine effects on behavior was in a direction consistent with comparable features in experimental catatonia and the catatonic form of schizophrenia. The need to integrate such phenomena in any amphetamine model of psychosis is stressed and analogies are drawn with similar features reported in animals treated with bulbocapnine or other psychotogenic compounds and with symptoms of human amphetamine psychosis and schizophrenia.

Animals↗
PubMed1986

Behavioral side effects of triazolam in psychiatric inpatients: report of five cases.

Triazolam was administered to five psychiatric inpatients for a two-week period. This period was preceded by a one-week placebo baseline and followed by another week of placebo administration. All conditions were double blind. By the second week of active drug administration, psychopathology greatly intensified across all of the patients with the emergence of anxiety, memory impairment, confusion, paranoid ideation, and hallucinations. The drug-induced behavioral changes persisted during the initial withdrawal period, but then gradually subsided. Also following drug withdrawal, four patients showed a marked worsening of their sleeplessness for several nights.

Adult↗
PubMed1995

Evolutionary perspectives on paranoid disorder.

Certain subtypes of DD may represent abnormal forms of previously well-characterized, content-specific behaviors that represent evolved adaptations to challenges of social interaction and mating. Such rare delusional states may be manifestations of an adaptive hypersensitivity to important environmental threats or opportunities, or may be a byproduct of behavioral misfiring triggered by unfamiliar environmental cues or perceptions.

Adaptation, Psychological↗
PubMed1992

Recurrent fluent aphasia associated with a seizure focus.

The relationship between dominant hemisphere seizure activity and aphasia is unclear. Although speech arrest, expressive speech problems, and comprehension difficulties have often been associated with temporal lobe seizure activity, neologistic, paraphasic speech is rare. We report a patient with seizures following encephalitis who had recurrent episodes of fluent, severely aphasic speech with impaired comprehension which correlated with continuous, high voltage spike and slow wave activity in the left temporal region. During a several-day period of intermittent electrographic seizure activity, he had fluctuating receptive aphasia, and he developed transient paranoid psychosis following treatment. We discuss the behavioral manifestations of his left temporal seizures and correlate the changing nature of his behavior with therapeutic interventions. This case, as well as a review of others, suggests that paroxysmal fluent aphasia results from a partially treated electrographic seizure focus in the dominant temporal lobe.

Anomia↗
PubMed2000

The SCL-90-R as a screening instrument for severe personality disturbance among outpatients with mood and anxiety disorders.

Our objective was to examine whether the SCL-90-R, a widely used self-report measure of distress and psychopathology, could screen for personality disorders in general and for severe personality disturbance (SPD) in particular, at the time when patients seek treatment for a state (mood or anxiety) disorder. The SCL-90-R was administered to 112 consecutive outpatients with various mood and anxiety disorders. The personality severity index (PSI) score, defined as the mean value of the scores on the SCL-90-R subscales of interpersonal sensitivity, hostility, and paranoid ideation, was compared with the current symptom index (CSI) score, defined as the mean value of the scores on the remaining six SCL-90-R subscales. A positive screen was considered if PSI > CSI. SPD was defined as the presence of any DSM-III-R Cluster A and/or Cluster B personality disorder. The accuracy of the screen was verified by means of the Structured Clinical Interview for DSM-III-R Personality Disorders. The sensitivity of the PSI > CSI criterion to screen for SPD was 89.4%, while its sensitivity to screen for any DSM-III-R personality disorder was 72.9%. The SCL-90-R subscales that contributed the most to the screening discriminability of this SCL-90-R-derived screening measure were hostility, paranoid ideation, somatization, and obsessive-compulsive behavior. The SCL-90-R may be used to screen for SPD in routine work with outpatients with mood and anxiety disorders, but the results of the screening need to be verified because of the possibility of false negatives and false positives, although that possibility is apparently low. These findings may have important prognostic and treatment implications.

Adult↗
PubMed2004

[Psychiatric examination performed by phone to determine guardianship--is it legally valid?].

BACKGROUND: The administration of a psychiatric evaluation to determine guardianship entails the prerequisite of a full psychiatric examination of the patient. In psychogeriatrics, dementia is the common reason for measures to determine incompetence and guardianship and in general psychiatry it is applicable for the diagnosis of schizophrenia. Legal guardianship is determined by the court and can apply to aspects involving confidentiality such as the patient's assets or body or both, and its duration can be temporary or permanent. This is a case study of a 30 year old man who had never undergone a psychiatric examination. His parents reported behavior that was suggestive of a prolonged paranoid psychotic state for the past 8 years with deterioration in the last year. All attempts by his parents to bring him to a medical or psychiatric examination were refused by the patient. In order to prevent further deterioration of the situation, the family was advised to request legal guardianship for him. Due to his refusal to be examined and the lack of indication for a forced examination, a long taped phone conversation was conducted with the patient and later validated to ensure that this was the patient in question. This conversation together with heteroanamnesis, provided the basis for writing a psychiatric evaluation recommending the appointment of a legal guardian for the patient. To the best of our knowledge, the court's decision to appoint a legal guardian based on a telephone conversation is a precedent.

Confidentiality↗