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[The pain sensitivity of the skin in chronic psychoemotional stress in man].

The focused ultrasound has been used for the comparative study of skin sensitivity to pain in 51 healthy men and 64 patients with neurasthenia, natural model of the chronic psycho-emotional stress. The patients showed a distinct tendency to a decrease of the pain threshold, lowered adaptation to the repeated threshold stimulus, sensitization. With the presence of the above-mentioned factors the pain syndrome occurred relatively more often. Taking into account the fact that the focused ultrasound of rather high intensity affects, first of all, C-afferents which are not only cutaneous but visceral nociceptors as well, an assumption is made that changes in pain sensitivity in the neurasthenic patients are not limited by skin but develop also in the inner medium forming the pain syndrome.

Adult↗

[Chronic fatigue syndrome].

The symptoms of fatigue and exhaustion, which are central to chronic fatigue syndrome and neurasthenia, can lay claim to being"psychopathological entities" in their own right. Although ubiquitous, they by no means reflect a homogeneous clinical picture. Chronic fatigue may occur after physical illness, such as viral infections, or be associated with a range of different psychiatric disorders. There is wide overlap with affective, anxiety, somatoform, and personality disorders, and this should be borne in mind when it comes to classifying these symptoms. To investigate the etiopathogenesis, multifactorial models are required. For treatment, adapted cognitive-behavioral therapy, possibly accompanied by an antidepressant, is effective.

Antidepressive Agents↗

[Intense fatigue in humans. Psychosocial and cultural aspects].

A differentiation between the normal sensation of tiredness and the symptom "fatigue" is often difficult. Both are influenced by cultural, social, psychological and biological factors, which can lead--interactively--to symptom formation. Psychiatric disorders frequently associated with fatigue are all forms of depression, somatization and anxiety disorders, chronic pain states and drug abuse among many others. In at least 2/3 of patients with the fashionable chronic fatigue syndrome--formerly called neurasthenia--a psychiatric diagnosis can be made, most of them also suffer from many symptoms attributes to the autonomous nervous system. The clinical approach should be cautious avoiding diagnostic and therapeutic overaction and therapy should emerge from a diagnosis properly assessed.

Culture↗

[A method for the formalized assessment of neurotic manifestations].

A method of estimation of the level of neurotization and psychopathization modified and tried by the author is described. Four scales are distinguished: asthenias, depressions, anxieties and hypochondrias. Based on a statistical evaluation of the results of examining 152 patients with neurasthenia and 82 normal persons criteria for differentiating between the clinical and subclinical levels of neurotization have been derived.

Adolescent↗

[The clinical characteristics of psychogenias in dental practice].

A total of 90 stomatological patients were subjected to clinico-psychopathological examinations. Of these, 70 were therapeutic and 20 orthodontic ones. The functional stomatological diseases in the form of stomatalgias were revealed in all the patients suffering from neurasthenia, neurotic depression, neurotic development of the personality as well as from psychopathy decompensation. The hypochondriac syndrome was marked by senestopathic and algesic disorders and in some cases, by anxious-phobic disturbances. Associated stomatalgias and neurotic symptomatology resulted in the lingering course and unfavourable dynamics of neuroses. The origin of stomatalgias in psychopathic personalities was accompanied by its decompensation, leading not infrequently to the development of the litigious and quarrelsome personality.

Adult↗

[Analyzing MMPI examination in patients with neurosis by the criteria of Chinese T score].

In the present paper, the results are summarized of MMPI measurements in 210 cases of neurosis. They, by the criteria of Chinese T score, show an increase in the scales 1, 2, 3 and 7 and have an identical rate of 87.5%. Hence, it is reasonable for the scales above to be designated as the coding model of neurosis. In every type of neurosis the scales 1, 2, 3 and 7 have a tendency to increase, but there is a slight difference in their highest point and kurtosis. In depression neurosis, neurasthenia and anxiety neurosis the scale 2 (D) increases dominantly; in hysteria, the scale 3 (HY); in hypochondria, the scale 1 (HS); in phobic and compulsion neurosis, the scale 7. Therefore, MMPI measurements can be useful for clinical classification of neurosis.

Adolescent↗

Three previously-untranslated reviews by Freud from the Neue Freie Presse.

Three short reviews by Freud (1904c, 1904d, 1905f) are presented in English translation. Two of the reviews, which are unusually harsh in their criticism, concern books on the subject of neurasthenia. The third relates to a controversial experiment on magnetism. The reviews were not included in the Standard Edition of Freud's psychological works, nor in any of the earlier collections of his writings.

Austria↗

[Dynamics of the main forms of neurosis].

A total of 162 patients (55 with neurasthenia, 53 with hysteric neuroses, 54 with neurosis of obsessive states) have been followed up with emphasis on the evolutional and age-specific characteristics. The authors have established a peculiar nature of the predisposing and pathogenetic factors in the genesis of neuroses and their subsequent dynamics in relation to age (infantile-adolescent, mature, late). The obtained data have made it possible to develop the principles of the pathogenetic therapy of the main forms of neuroses. These principles are based on the mandatory consideration of age-specific features.

Adolescent↗

[Features of disorders of mental activity in schizophrenics].

A comparative experimental-psychological study of characteristics of psychic activity disorders was conducted in patients of 2 nosological groups: patients with schizophrenia and patients with astheno-neurotic disturbances in neurasthenia. The authors used methods directed at the study of characteristics of involuntary and voluntary attention as the direct expression and prerequisite of the activity of psychic processes. On the basis of the experimental data, the authors attempt to develop a psychological classification of characteristics of determinant factors of changes in psychic activity of patients of two nosological groups compared.

Humans↗

[Experience with the use of posterior pituitary hormones in memory disorders of different etiology].

Results of using vasopressin and pituitrin in 20 patients with memory disturbances of various genesis (due to circulatory disturbances in the vertebrobasilar system, cerebral atherosclerosis, neurasthenia, brain concussion, epilepsy) are reviewed. The therapeutic efficacy of the hormones was evaluated with the use of a complex of psychophysiological methods. Objective changes in the patients' neurological status and subjective state were taken into account. A high therapeutic efficacy of the hormones in the treatment of amnestic syndromes is demonstrated.

Adult↗

[Causes and conditions for the development of protracted neuroses].

The follow-up findings were studied in 102 patients with long-standing (2-17 years) neuroses (neurasthenia, 49 cases, hysterical neurosis, 53 cases) and compared with those in 40 patients with acute forms of these diseases. The results of the study point out to factors predisposing to an unfavourable course of the illness. Ii is noted that in most cases, protracted neuroses develop in individuals with definite personality characteristics and numerous variants of "biological insufficiency", such as aggravated heredity, frequent colds in childhood, attendant somatic pathology, etc. Some risk factors have been emphasized including a prolonged influence of psychotraumatic circumstances on these patients, their late application for help to the psychiatrist and late initiation of the adequate treatment.

Adult↗

[Types of adrenograms in neuroses].

A total of 714 adrenograms (graphic depiction of adrenalin and noradrenalin excretion in relation to the circadian rhythm) obtained from neurotic patients were analyzed. The authors succeeded in ascertaining the differences of their types in patients suffering from hysterical neurosis, neurasthenia and obsessive neurosis. The adrenographic method is believed to be capable of serving as an additional diagnostic criterion in the differential diagnosis of these pathological forms.

Circadian Rhythm↗

[Clinical dynamics of hypochondriacal disorders and mechanisms of their reversal during psychotherapy].

A follow-up study of 18 patients hospitalized for hypochondriac disturbances revealed that in none of the cases was suggestive of a specific hypochondriac neurosis. A formed hypochondriac syndrome was observed at the stage of the neurotic development of the principal forms of neuroses: neurasthenia, neurotic depression, hysterical and obsessive neuroses. The mechanisms of eliminating hypochondriac fixation in all these clinical forms of neuroses are identical.

Adolescent↗

[Clinico-statistical data on psychologically traumatic experiences in various forms of psychogenic disorders].

On the basis of clinico-psychopathological studies of patients with different forms of neurosis and the use of the level of mental development concept a special technique was elaborated to detect by questionnaires the predilective "key" psychotraumatizing experiences in the main forms of neurosis (neurasthenia, obsessional neurosis, hysterical neurosis and a special clinical form--explosive reactions). It is assumed that these forms of psychogenic reactions, as well as their respective "key" experiences (exhaustion-overstress, a disturbance of a habitual stereotype, infringement of egocentrism, a negation of concession) form a certain hierarchic system. The "key" character of some types of pathogenic experiences for clinical forms of psychogenic reactions was confirmed statistically. The data indicate a different degree of clinico-nosological delineation of some forms of the reactive states.

Depressive Disorder↗

[Neurotic inhibition].

Inhibition is a normal neuro-physiologic regulation phenomenon which antagonizes the dangerous aspects of excitation and which facilitates the adaptation of man to his surroundings. Inhibition becomes neurotic: -- when it fails in its normative-connection with excitation. -- when accompanied by anxiety, -- when the subject cannot control it, -- however without blocking all the psychic functions as the psychotic inhibition does. Accompanying symptoms diversify its ways of expression. Contemporary to trauma in neurasthenia, it proceeds from early trauma in psychasthenia and in hystero-phobic neuroses. For some authors, it may be innate, perhaps hereditary. It appears particularly severe, because it lasts when the symptomatology has disappeared during the analytic therapy and it seems to resist more than the excitation to chemotherapies.

Anxiety↗

[Chronic fatigue syndrome and psychiatric diseases].

The chronic fatigue syndrome consists of a combination of non-specific symptoms. Some believe that the CFS is subcategory of major depression, because the symptoms are similar to those of major depression. We believe that the CFS is quite different from major depression or neurotic depression, since the CFS has no lack of initiative and effort, no inhibition which is seen in endogenous depression, and sharp fluctuations in general fatigue, anxiety, and various persisting somatic symptoms, such as, malaise and mild fever. CFS seems to be similar to the neurasthenia. It is harmful, at least, in aetiology and treatment, to neglect the diagnosis of the CFS.

Depressive Disorder↗

[The chronic fatigue syndrome].

The chronic fatigue syndrome (CFS) including myalgic encephalomyelitis and the postviral syndrome is a term used today to describe a not fully recognized disease characterized primarily by chronic or recurrent debilitating fatigue and various combinations of neuromuscular and neuropsychological symptoms. The term CFS has been introduced and defined by the Centers for Disease Control (CDC) in Atlanta. Fatigue is one of the most common symptoms in medicine, but CFS as defined by CDC has appeared to be quite rare in the general population. Researchers have suggested that the syndrome is a heterogenous immunologic disorder that follows viral infection, but despite numerous studies on the subject the etiologic factor of the syndrome is unknown. CFS is a controversial diagnosis. In a very high percentage of patients with the CFS depression, phobias or anxiety disorders have frequently preceded the onset of the chronic fatigue. There are many overlapping symptoms between CFS and major depression. Some clinicians suggest that it is not obvious that CFS can be distinguished from neurasthenia.

Diagnosis, Differential↗

[Health effects on workers exposed to low concentration carbon monoxide at high altitude].

Workers exposed to carbon monoxide (CO) at a concentration of 26.8mg/m3 at an altitude of 2,300 metres above sea level were compared with a control group of local inhabitants. There were significant differences in symptoms of headache, vertige fatigue and weakness memory impairment, insomnia, palpitation and neurobehavioral functions. CO concentration in respiratory air and HbCO in blood was higher but partial pressure of oxygen (PO2) and saturation of oxygen (SaO2) in blood was lower in the exposed group than the control group. Self-comparison of CO in respiratory air and HbCO in blood was higher after work than before work. Neurasthenia rate was significantly higher but PO2 and SaO2 significantly lower at high altitude than in the plain. The results indicated that under same CO concentrations the hazards to workers at high altitude were greater than to those working in the plain. The author recommends that at high altitude the CO permissible level should be appropriately lowered.

Adult↗