Regional cerebral blood flow related to psychiatric symptoms in dementia with onset in the presenile period.
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Affective Symptoms↗
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Chronic psychosis in epilepsy. A clinical investigation of 29 patients.
A clinical study comprising psychiatric, psychological and neurological examination of 29 patients suffering from long-term psychosis and severe epilepsy was performed. Only five patients fulfilled the diagnostic criteria of schizophrenia. They differed from the rest of the patients by being less organic and having infrequent laterality to the left of their epileptogenic focus. They were regarded as genuine schizophrenics, while the pathogenesis of the remaining sample was considered multifactorial, including both organic and psycho-social causes.
Adult↗
Psychiatric hospitalization in Italy before and after 1978.
The available information system in Italy does not allow to adequately evaluate the change in patterns of hospitalization that have taken place after the 1978 Mental Health Act came into force. There are huge differences among Northern and Southern Italy and inside these areas. On average, the reduction of public psychiatric hospitals activity had begun around 70's. People living in these hospitals at the census day January 1st were about 75,000 in the first years of the 70's, were 58,000 in 1977 and further decreased to 38,000 in 1981 (67.6 per 100,000 total population). This decrease was not counterbalanced either by private psychiatric hospitals, or by the newly opened Psychiatric Departments in general hospitals. Scant or no information is available on intermediate facilities, and on follow-up of discharged inpatients.
Affective Disorders, Psychotic↗
Schizophrenic relapse after drug withdrawal is predictable.
Thirty-two patients in remission were followed by regular ratings during a prospective neuroleptic withdrawal study. They were outpatients who fulfilled the DSM-III criteria of schizophrenia and who were motivated for drug withdrawal. The relapse rate was 81%. The results from the rating scales confirm the hypothesis that a symptom increase occurs before psychotic relapse. In the order statistical differences occurred, the factors predicting relapse were those concerned with positive psychopathology, motor dysfunction, impaired affects and sleep disturbances. The corresponding symptoms and signs were mainly concerned with thought disorders, paranoid ideation, overactivity, depression and insomnia middle, all of nonpsychotic degree of severity. If prodromes appear, the patient should resume his neuroleptic treatment, or other preventive measures should be taken. By such therapeutic interactions, psychotic relapse may be prevented, or can be dealt with in an outpatient setting.
Adult↗
Post-influenzal psychiatric disorder in adolescents.
The association between influenza and psychiatric disorder in adolescents was studied at a time when both were highly prevalent concurrently. First 505 secondary school pupils aged 15-18 completed questionnaires, including a symptom inventory derived from the SCL-90-R. Subsequently, 113 blood samples were examined for influenza antibody titers of five virus strains. Statistical analysis showed that adolescents who had been ill with influenza in the previous six months had significantly more psychiatric disorder than those who had not been ill with influenza in that period.
Adolescent↗
Satisfaction with care reported by psychiatric inpatients. Relationship to diagnosis and medical treatment.
In this survey, 274 patients were sent a questionnaire concerning satisfaction with psychiatric treatment and the ward 1 month after their discharge from hospital. Fifty-two percent of the patients responded. Answers to the 56 items of patient satisfaction were analyzed in relation to patient diagnoses and treatment given. Patients who were diagnosed as suffering from affective disorders or from reactive psychoses were more satisfied than patients with schizophrenia or paranoia or with transitory adjustment reactions. Patients who had no personality disorder diagnosis and patients with character neurosis were more satisfied than patients with antisocial or borderline personality disorders. Patients on antidepressant medication were much more satisfied than other patients. The results of the study are discussed with regard to the need of further research in this area and to quality assurance.
Combined Modality Therapy↗
Psychiatric problems affecting dental care of the elderly.
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Aged↗
Some ethical considerations in defensive psychiatry: a case study.
Involuntary admission of a patient deemed dangerous may be motivated by a wish to protect the patient and others from potential violence-or by a practitioner's wish to limit personal liability. Evidence is offered to suggest that the practice of defensive psychiatry is not uncommon, and a case demonstrating the role of professional self-protection in an involuntary commitment decision is presented. Procedural modifications in the commitment process are proposed as a means of protecting patients' civil liberties.
Aged↗
Factorial invariance across gender for the primary symptom dimensions of the SCL-90.
The present study was focused on an evaluation of factorial invariance across gender for the primary symptom dimensions of the SCL-90-a multidimensional self-report symptom inventory. The argument is advanced that evidence of invariance across relevant subject parameters is an essential component of reliability for dimensional constructs. Findings indicated subtantial levels of invariance across gender for eight of the nine primary symptom dimensions of the SCL-90 with moderate levels for the ninth. The implications of invariance, for the SCL-90 in particular, and clinical measurement in general are related and discussed.
Adult↗
An investigation of the construct validity of the Bannister-Fransella Grid Test of Schizophrenic Thought Disorder.
An attempt was made to demonstrate the construct validity of the Grid Test in a psychiatric population by showing that: (a) judgements of thought disorder based on the Grid Test were associated with judgements based on a clinical interview; (b) Grid Test scores were not associated with measures of other forms of psychopathology, intelligence, or memory. Results of a principal components factor analysis confirmed both hypothesis, supporting the validity of the Grid Test as a measure of thought disorder.
Diagnosis, Differential↗
The differential diagnosis of homosexuality.
The treatment of homosexuality presents serious difficulties owing to its multifactorial aetiology and variety of psychopathological views. It is suggested that the combined use of psychiatric and psychoanalytic models can contribute to the establishment of a satisfactory differential diagnosis. Out of the innumerable clinical types seen in practice and described in the literature, three major groups can be isolated. The homosexuality which occurs on the background of hysterical, obsessional and other neurotic personality types and related psychiatric conditions, tends to be linked with latent heterosexuality and responds well to all forms of psychotherapy. On the other hand, true homosexuality is often the major presenting symptom of borderline states, narcissistic disorders, psychopathy and the schizo-affective psychoses and carries an unfavourable prognosis with any form of treatment. Cases of actual bisexuality form the third group with its own specific psychopathology. The homosexual solution is seen as a defence and is regarded as a matter of survival for many individuals. It should be treated with the utmost caution by anyone who attempts to remove it.
Character↗
Erotic transference and a threatened sense of self.
In this study of erotic transference the phenomenon is defined in the manner of Freud (1915) and Blum (1973). It involves a circumscribed behaviour which consists of an erotic preoccupation with the therapist which often has the quality of an obsession. It is prolonged, usually for months or years, is relatively immutable, and can be seen as a milder variant of de Clerembault's syndrome. It is suggested that the psychic purpose of the preoccupation is to maintain a threatened sense of self. The erotic content of the preoccupation is likely to be a consequence of the sexualization of the early relationship with caregivers, which was impingeing and disruptive of self-development. In an illustrative case, the disturbance of this development was considered to include an impediment to the development of the transitional field, the mother herself replacing the transitional object.
Adult↗
Psychiatric illness after hysterectomy.
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Adult↗
Management of senile psychiatric disorders.
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Adjustment Disorders↗
Neurosurgical disease encountered in a psychiatric service.
One hundred and seven patients with neurosurgical disease treated in a combined neurosurgical, neurological, and psychiatric unit within a psychiatric service were reviewed retrospectively. Most patients had acute confusional states or dementia without gross localizing signs and in only three cases did the neurosurgical illness closely resemble a non-organic psychiatric syndrome. The great majority showed abnormalities on physical examination and simple investigations. A past history of alcoholism and/or other psychiatric illness was common. Many apparently had been referred to psychiatric hospitals simply because they presented problems of management. Consequently, the staff of the psychiatric hospitals must be aware of neurosurgical disease and have free access to facilities for its investigation and management. If these requirements are fulfilled, the referral of patients with acute confusional states and dementia to psychiatric hospitals may indeed be preferable to their management in general hospitals, where their disturbed behaviour presents a variety of problems with which these hospitals are not usually equipped to cope.
Alcoholism↗
Neuroleptic malignant syndrome and hypothyroidism.
Two patients with primary hypothyroidism who developed neuroleptic malignant syndrome (NMS) are described. Thyroid disease might predispose to NMS by altering brain dopamine metabolism.
Adult↗