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PubMed1993

[Psychogenic eating disorders and the family set-up].

The paper examines the position of dysorexic patients within the family set-up, a topic on with until now attention has not been focused, in order to highlight the latter's possible importance since it has been overlooked in favour of the situation of the "fusion family" in which parent-child relations are predominant. The paper underlines the frequency of a subordinate position in relation to "strong" older brothers or sisters. There is no possibility of compensating this feeling of inferiority which therefore conditions the choice of a fictitious goal: regressive and guilty gratification in bulimia and hypecontrol of the body in anorexia.

Adult↗
PubMed1993

[Pimozide in the treatment of psychogenic eating disorders].

PIMOZIDE was given to 14 pat. with anorexia nervosa and 21 pat. with bulimia nervosa The drug evaluated positively some symptoms of eating disorders. Most significantly it improved the bulimic episodes and purging. The accompanying psychiatric symptomatology (depression and anxiety) was mostly not improved. We conclude that Pimozide may be a useful medication in the therapy of basic symptoms (bulimia, purging) in bulimic forms of eating disorders.

Adolescent↗
PubMed1989

[Clinico-physiological analysis of psychogenic (hysterical) sensorimotor disorders].

Forty patients with psychogenic sensorimotor defects and 20 patients with sensorimotor defects of organic nature were examined. Special clinical tests were employed together with the tracing of somatosensory evoked potentials. The clinico-physiological patterns characteristic of the right-handed and left-handed psychogenic sensorimotor disturbances were identified. The studies contributed to the elaboration of differential-diagnostic criteria.

Adult↗
PubMed1985

[Diagnosis and therapy of psychogenic paralyses in the hand region].

Beside the importance of its prehensile function the human hand plays an essential role in the conveyance of expression. Manual gestures support the mimic and confirm the spoken word. Based on the psychofunctional connection between mimic and gesture the hand becomes an outlet for psychogenic disorders. The resultant projection of emotional processes into motor disorders has been a matter of conjecture etiologically. Psychogenic manifestation in isolated motor disorders of the hand is considered to be either a functional nervous disorder or a focal dystonia. In comparison to the conversion phenomena reported up until now, in which flexor muscle units of the hand are involved with increased muscular activity (spasm), the cases presented here are characterized by a functional motor disorder manifested as an isolated paralysis of a selective extensor muscle unit (M. extensor pollicis longus) of the hand. After a multidisciplinary approach including clinical morphology, neurology, EMG and psychiatry the final diagnosis of a psychogenic paralysis of the hand is made using direct electro-stimulation of the neuromuscular unit with a needle electrode under simultaneous elimination of the psychic influence (general anesthesia without muscular relaxation). Through such confirmed motor inactivity the psychic genesis of the clinically existing paralysis is proven. Through immediate introduction of a multimodal therapy including physical and psychiatric treatment psychogenic paralyses of the hand can be restored totally.

Adolescent↗
PubMed1976

[Drug therapy of early-childhood minimal brain damage].

Drug therapy in a child with juvenile psychoorganic syndrome is only one part of a comprehensive therapeutic program in which the main emphasis is on training and education, which are sometimes accompanied by psychotherapy. In many cases drug therapy is totally unnecessary. It may however provide essential support for the efforts of educators and therapists and is sometimes the factor which renders these possible at all. Not all symptoms respond equally well: the best results are obtained in disorders of drive and often in psychogenic disorders which have developed on the basis of the psychoorganic syndrome. Promotion of personality development, which is virtually always retarded in the child with psychoorganic syndrome, remains the exclusive preserve of training. Drug administration has psychogenic as well as chemical effects. It depends to a large extent on the reaction of the environment to the fact that drugs are being given at all, and to the behavioral changes exhibited by the treated child. Drug effects are thus modified, and, with time, determined by the environment, and thus in many cases treatment is possible only on a short-term or (sometimes) periodic basis. Where treatment is on a long-term basis the danger of drug dependency must be borne in mind, since patients with psychoorganic syndrome are particularly exposed to the risk of addiction. For this reason care is necessary in administering amphetamine-type substances. These drug should not be prescribed from puberty onwards; previously initiated treatment with them should be terminated before purberty. It should however be pointed out that the results registered with amphetamines and drugs with similar effect can usually be obtained equally with drugs involving fewer risks in this respect.

Age Factors↗
PubMed1993

[Panic anxious-depressive states in children and adolescents who have experienced natural disasters and catastrophes].

744 children and adolescents at the age of 1-17 years who underwent disasters (earthquakes) and catastrophes were observed. In 216 cases anxious-depressive conditions of different duration were revealed. These disorders were divided into 3 groups: the neurosis of fear (42.1%), phobia-like states of the type "panic disorders" (31.0%) and mixed somatogenic and psychogenic disorders of "panic type" (26.9%). The least favorable prognosis was noted in the 3d group. The questions of drug therapy and psychotherapy of every type of these disorders are discussed.

Accidents↗
PubMed2000

[Not Available].

Since the epoch-making publication of Sir Francis Galton, twin research has been an excellent method in order to assess the influence of nature and nurture. In this overview the history of twin research is described for the field of psychogenic disorders by the examples of diagnosis of zygosity, representativity of the sample, criminality, homosexuality and some disorders such as enuresis, obsessive-compulsive disorders and anorexia nervosa. Nowadays the modern methods of molecular genetics for diagnosis of zygosity offer new and overwhelming possibilities of twin research.

History↗
PubMed2000

[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↗
PubMed1998

[Paranoid nosogenic reactions in patients with somatoform disorders].

The authors examined 16 patients with ischemic heart disease who had psychogenic disorders with ideas of rationalization of therapy. Paranoial personality disorders (paranoial psychopathy) was diagnosed in 11 patients, pseudopsychopathy in residual schizophrenia in 5 patients. The patients had either a fanatic idea of creating new methods of self-therapy and an autoaggressive behavior (performing some dangerous manipulations, usage of non-medicamentous substances, etc.). The premorbid state of such patients was characterized by inclination to paranoial reactions and a special predisposition to them combined with an egodystonic attitude to corporal manifestations. Paranoial reactions of such type were reversible and disappeared in the course of somatic state improvement.

Humans↗
PubMed2004

Non-epileptic seizures of the elderly.

OBJECTIVE: To characterize non-epileptic seizures (NES) in the elderly and compare their features with NES of a younger control group. METHODS: The database of the epilepsy monitoring unit of the Cleveland Clinic Foundation (CCF) was searched for patients aged 60 years and older having undergone long-term video-/EEG monitoring between 1994 and 2002, with the subsequent diagnosis of NES. Videotapes of all events were evaluated by independent observers. NES were classified based on the clinical manifestations recorded on video, EEG and imaging data, and compared with a control group of younger adults with NES. RESULTS: Thirty-nine elderly patients were included. Seventeen of them (44%) had NES only, six (15%) had both epilepsy and NES. The control group consisted of 20 patients, two of them had NES and epilepsy. The NES were classified as physiological in 10 elderly patients (43%) and one control patient. They included TIA, syncope, movement disorders and sleep disorders. Psychogenic NES were found in 13 elderly and 19 control patients and were associated with somatoform disorders, anxiety disorders, mood disorders and reinforced behavior pattern. Psychogenic NES consisted of predominant motor activity in 8 (61%) elderly and 13 (68%) control patients, unresponsiveness in 4 (31%) elderly and 2 (11%) control patients and subjective symptoms in 1 (8%) elderly and 4 (21%) control patients. Twelve (71%) of the patients of each group without evidence for epilepsy were on anticonvulsant drugs at the time of admission. CONCLUSION: NES are a frequent problem in elderly patients referred to a comprehensive epilepsy center. In contrast to a younger control group, physiological and psychogenic NES are equally frequent in the elderly. Loss of responsiveness was seen in only 20% of patients with psychogenic NES. Although most of the patients did not have any evidence for epilepsy, more than two thirds of these patients had been placed on anticonvulsive drugs.

Adult↗
PubMed1998

[Patient management in geriatric psychiatry by ambulatory care services. Results of an empirical analysis].

This study was designed to provide information to which extend home-based nursing care services for the elderly take part in the care for older people with mental disorders. Also of interest was the involvement of clinical facilities and services of the geropsychiatric treatment system in the health care for the clients. A one day data collection in 29 nursing care services in two North Rhine-Westphalian regions could raise informations about 1,246 clients aged 60 years and over 1,522 persons (41.8%) had a mental disorder, diagnosed by a nursing and/or medical professional. 68% of the mental disordered clients had dementia or a demential disorder, 6% a functional psychosis, and 31% a neurotic, psychogenic disorder or substance abuse (small number of clients with two and more diagnoses). 82% of clients with mental disorders had one or more additional somatic disease(s). These diseases were mostly the cause for the involvement of home-based nursing care service. Barely 8% of clients with mental disorders were placed from clinical facilities and services of the geropsychiatric treatment system into the nursing care services. Beside the home-based care, only a 12% of mental disordered received clients outpatient psychiatric treatment. Systematic cooperation between the nursing care services and the system of (gero-) psychiatric treatment was a rare exception.

Aged↗
PubMed2003

Acute dyspnea in the office.

Respiratory difficulty is a common presenting complaint in the outpatient primary care setting. Because patients may first seek care by calling their physician's office, telephone triage plays a role in the early management of dyspnea. Once the patient is in the office, the initial goal of assessment is to determine the severity of the dyspnea with respect to the need for oxygenation and intubation. Unstable patients typically present with abnormal vital signs, altered mental status, hypoxia, or unstable arrhythmia, and require supplemental oxygen, intravenous access and, possibly, intubation. Subsequent management depends on the differential diagnosis established by a proper history, physical examination, and ancillary studies. Dyspnea is most commonly caused by respiratory and cardiac disorders. Other causes may be upper airway obstruction, metabolic acidosis, a psychogenic disorder, or a neuromuscular condition. Differential diagnoses in children include bronchiolitis, croup, epiglottitis, and foreign body aspiration. Pertinent history findings include cough, sore throat, chest pain, edema, and orthopnea. The physical examination should focus on vital signs and the heart, lungs, neck, and lower extremities. Significant physical signs are fever, rales, wheezing, cyanosis, stridor, or absent breath sounds. Diagnostic work-up includes pulse oximetry, complete blood count, electrocardiography, and chest radiography. If the patient is admitted to the emergency department or hospital, blood gases, ventilation-perfusion scan, D-dimer tests, and spiral computed tomography can help clarify the diagnosis. In a stable patient, management depends on the underlying etiology of the dyspnea.

Acute Disease↗
PubMedDate not supplied

[Classification of dysphonias based on the primary etiologic factor (part I)].

INTRODUCTION: Phonation is a complex integral function of the organism. Regular phonation is characterized by: clarity and adequate pitch. Dysphonia is a disorder of phonation. It may have many acoustic forms, but hoarseness is the best known symptom of dysphonia. Acoustic phenomena are caused by: aperiodicity of vocal vibration, turbulent air flow in the glottis and incomplete glottis closure. PREVIOUS CLASSIFICATIONS OF DYSPHONIAS: The best known classification of dysphonias was introduced by Perello. There are two groups: organic dysphonias and functional dysphonias. On the 8th Congress of Union of European Phoniatricians, in Koszeg (Hungary, 1979), Majdevac proposed a new classification. CLASSIFICATION OF DYSPHONIAS: We are proposing a new classification, made according to the primary etiologic factor in dysphonias. In this paper, we shall consider the first four. I DYSPHONIAS CAUSED BY PRIMARY FUNCTIONAL DISORDERS: This group includes: 1. Hyperkinetic dysphonia grade I 2. Hyperkinetic dysphonia grade II 3. Hypokinetic dysphonia 4. Contact hyperplastic dysphonia 5. Dysodic dysphonia II DYSPHONIAS CAUSED BY PRIMARY NEUROGENIC DISORDERS: This group includes: 1. Central dysphonias 2. Spasmodic (spastic) dysphonia 3. Dysphonia caused by myasthenia gravis 4. Dysphonia within skull base syndromes 5. Dysphonia caused by unilateral palsy of the inferior laryngeal nerve 6. Dysphonia caused by bilateral palsy of the inferior laryngeal nerve 7. Dysphonia caused by palsy of the superior laryngeal nerve III DYSPHONIAS CAUSED BY PRIMARY PSYCHOGENIC DISORDERS: This group includes: 1. Psychogenic aphonia 2. Psychogenic dysphonia 3. False mutation IV DYSPHONIAS CAUSED BY PRIMARY SOMATIC DISORDERS: This group includes: 1. Dysphonia caused by insufficiency of vocal cords 2. Dysphonia caused by oedema of vocal cords 3. Dysphonia caused by laryngitis (secondary functional) 4. Cord-ventricular voice 5. Posttraumatic dysphonia 6. Arthrogenic dysphonia 7. Presbyphonia CONCLUSION: Dysphonia is a disorder of phonation which originates at the glottis level. When disorders of phonation are concerned it is necessary to study the organism as a whole as well as all mechanisms which take part in voice production. In that case the damaged part of the phonation system can be diagnosed, which enables efficient medical treatment of the disorder.

Humans↗