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At least 343 records · Page 19Linked to original sources
PubMed2003

"Cold calling" in psychiatric follow up studies: is it justified?

BACKGROUND: The ethics of cold calling-visiting subjects at home without prior appointment agreed-in follow up research studies has received little attention although it is perceived to be quite common. We examined the ethical implications of cold calling in a study of subjects with defined neurotic disorders followed up 12 years after initial assessment carried out to determine outcome in terms of symptoms, social functioning, and contact with health services. The patients concerned were asked at original assessment if they would agree to be followed up subsequently and although they agreed no time limit was put on this. OBJECTIVES: To decide if cold calling was ethically justifiable and, if so, to set guidelines for researchers. DESIGN: The study was a cohort study of patients with neurotic disorder treated initially for 10 weeks in a randomised controlled trial. FINDINGS: At follow up by a research medical practitioner 18 of the 210 patients had died and of the remaining 192 patients 186 (97%) were seen or had a telephone interview. Four patients refused and two others did not have interviews but agreed to some data being obtained. However, only 104 patients (54%) responded to letters inviting them to make an appointment or to refuse contact and the remainder were followed up by cold calling, with most patients agreeing readily to the research interview. The findings illustrate the dilemma of the need to get the maximum possible data from such studies to achieve scientific validity (and thereby justify the ethics of the study) and the protection of subjects' privacy and autonomy. CONCLUSIONS: More attention needs to be paid to consent procedures if cold calling is to be defended on ethical grounds but it is unreasonable to expect this to be obtained at the beginning of a research study in a way that satisfies the requirements for informed consent. A suggested way forward is to obtain written consent for the research at the time that cold calling takes place before beginning the research.

Adult↗
PubMed2004

[Effect of psychotherapy on autonomic balance in VDT-operators with somatoform disorders].

BACKGROUND: The omnipresence of stress-inducing factors that stems from the permanent development of our civilization results in a constantly growing number of people with neurotic disorders. Computer technology, a very new labor technique, has become a stressful factor. Stressful factors initially affect the central nervous system, which modifies vegetative functions. The autonomic balance can be a measurable indicator of disease severity. MATERIALS AND METHODS: The study group consisted of 50 VDT-operators with neurotic disorders. Twenty five healthy VDT-operators formed the control group. The autonomic balance was investigated with Holter monitoring. Each of the 50 neurotic VDT-operators were qualified for a 3-month psychotherapy. RESULTS: The analysis of Holter recordings proved that the applied model of psychotherapy significantly reduced the number of sympathicotonics in favor of normotonics in the study group (p < 0.01). CONCLUSIONS: The Holter analysis can be considered as a reliable indicator of the effect of psychotherapy.

Autonomic Nervous System↗
PubMed2002

[Facial pains as symptoms of mental disorders].

One hundred seventeen patients, aged 16-75 years, with orofacial pains were studied. Borderline psychic disorders were detected in 106 cases, schizophrenia--in 11 cases. Facial pain was characterized by (1) polymorphism of sensations changing their site and duration, (2) absence of orofacial sensory deficits, (3) symptoms "mosaic"--a combination of separate signs specific for various "organic" facial pain, (4) absence of objective changes in oral cavity and facial region, (5) key role of psychoemotional factors in pain recurrence and intensification, (6) non-opioid analgesics and carbamazepine inefficacy. A systematics for facial pains of psychic genesis, comprising two groups of disorders, was elaborated. The first group includes facial pain and odontalgia in borderline psychic disorders--neurotic (somatoform, hypochondriac and hysteric) disorders, affective ones (mild depressive episodes and dystimia) and paranoic personality disorder. The second group comprises orofacial cenesthopathies in neurotic-like (schizotypal disorders) and paranoid types of schizophrenia.

Adolescent↗
PubMed1968

Psychopathology of children with minimal brain injuries.

Children with the syndrome of minimal brain injuries, i.e. with psychic sequelae of a slight, diffuse lesion of the cerebral tissue, suffer from disorders of neural activity on different levels, from "primary disorders" such as of simple motor reactions and sensory defects to the most complicated performances such as speech and concept formation. It is assumed that mild lesions of the reticular formation of the brain stem is the common neurophysiological denominator of the whole syndrome. The psychopathological pictures, however, develop only from the continuous interaction of an organically conditioned state with unsuitable educational methods of the irritated parents and with other pathogenic factors of the external environment. The pictures can be divided into four basic diagnostic groups: behaviour disorders, neurotic manifestations, psychopathic traits, and psychotic manifestations.

Attention Deficit Disorder with Hyperactivity↗
PubMed1987

Convergence of parent checklists and child psychiatric diagnoses.

This study examined the correlation between the Childrens' Behavior Questionnaire by Rutter, Tizard, and Whitmore (1970) and clinical diagnoses in a total of 1,468 in- and outpatients. The following diagnoses were considered: conduct disorder, emotional disorder, mixed disorder of conduct and emotions, and the hyperkinetic syndrome. In general, correlations were low, but subscores indicating conduct or neurotic disorders had somewhat higher correlation with these respective disorders than the hyperactivity subscore. Sensitivity figures (i.e., percentage of true positives) were moderate to low, while specificity figures (i.e., percentage of true negatives) were high. It is concluded that convergence of parent checklists and child psychiatric diagnoses in unselected samples is only moderate.

Adolescent↗
PubMed1996

Stability of psychiatric diagnoses in clinical practice.

This is a retrospective study that aimed at studying the diagnostic stability of psychiatric diagnoses over a 4-year period. Three-hundred and twelve patients (n = 312) admitted more than once to Al Ain in-patient unit from January 1, 1990 to December 31, 1993, were the subjects for this study. The sample included patients with the following index diagnoses: acute psychoses (n = 37), alcohol abuse (n = 15), bipolar disorder (n = 27), depressive disorders (n = 63), drug abuse (n = 21), hysteria (n = 23), neurotic disorders (n = 50) and schizophrenia (n = 76). Diagnoses on discharge for first admissions were considered the index diagnoses. The shift from index diagnoses to subsequent diagnoses was counted. Diagnostic stability was calculated as the percentages of index diagnoses that did not change over time. In nearly half of the patients the index diagnoses changed over the 4-year period. Highest diagnostic stability was found in patients with index diagnoses of alcohol abuse, schizophrenia and drug abuse (92%, 74% and 71% respectively), while the lowest stability was found in patients with neurotic, hysterical, depressive disorders, acute psychoses and bipolar disorders (38%, 48% and 45%, 42%, 52% respectively). Two distinct patterns of shifts were noted. First shift occurred between functional psychoses and second shift between depressive and neurotic disorders. This study provides further support to the notion that diagnostic stability in clinical practice is still far from being satisfactory.

Adult↗
PubMed2002

[Dance therapy in the treatment of psychiatric and somatic disorders].

The article is an attempt of review of recent achievements in dance therapy. It presents possibilities of introducing dance into the treatment of psychiatric disturbances (psychoses, dementias, neurotic disorders) and somatic disorders (rheumatoid arthritis, osteoporosis, terminal stages). The authors basing on the contemporary literature describe positive results of dance therapy in various clinical situations.

Arthritis, Rheumatoid↗
PubMed1981

[Clinical aspects of the residual disturbances in a favorable course of obsessive neurosis].

Using the clinico-catamnestic method the authors examined residual neurotic states in 36 patients with a history of obsessional neurosis. The residual neurotic disorders manifested psychopathologically in the form of isolated rudiments of the obsessive-phobic syndrome combined frequently with some effaced vegetative, asthenic, and affective disturbances. Despite their inertness and many-year persistence the residual neurotic disorders showed a tendency to subsidence. Clinical differentiation between the residual states on the one hand, and neurotic development, slowly-progressing schizophrenia, and cyclothymia with obsessions on the other was carried out.

Adult↗
PubMed1984

Psychiatric hospitalization in twins.

Hospitalization rates of monozygotic (MZ) and dizygotic (DZ) twin pairs in Finland were compared for schizophrenia, neuroses, and alcoholism. Record-linkage of hospital records and death certificates for the years 1972-1979 was carried out for persons in the Finnish Twin Cohort (16,649 like-sexed twin pairs). The ratio of the number of observed vs that of expected concordant pairs and the ratio of concordance rates between MZ and DZ pairs were greater among males than females, and greater among young (40 years old or less) than among older pairs. The highest difference was found in schizophrenia and the lowest in neuroses. Pairwise concordance rates for schizophrenia (11.0% for MZ and 1.8% for DZ) seem to indicate great environmental influence (high proportion of discordant pairs) with apparent genetic liability (6.1-fold ratio in concordance between MZ and DZ pairs). In neurotic disorders, the difference of pairwise concordance rates between MZ and DZ pairs (6.8% vs 4.0%) was quite low, not strongly supporting a genetic hypothesis. Of the MZ pairs concordant for psychiatric hospitalization, 47% had lived together for their whole life time; of those discordant, 16% lived together. The corresponding figures for DZ pairs were 18% and 15%. The effect of intrapair relationships in disease-concordant pairs should be taken into account when evaluating the effect of genetic and environmental factors in psychiatric disorders.

Adult↗
PubMed1985

The psychosocial adjustment of Australian Vietnam veterans.

The authors reviewed the case records of a random sample of 126 Australian Vietnam veteran inpatients, recorded the diagnostic and background data, and made new DSM-III diagnoses. Neurotic disorders accounted for 49% of the primary or secondary diagnoses. Only 10% of the overall sample had a primary diagnosis of posttraumatic stress disorder but 27% of the veterans who had seen combat had a primary diagnosis of the disorder. Twenty-nine percent of the overall sample were given a primary diagnosis of alcohol abuse or dependence. The early developmental environment of the overall sample frequently included poor parent-child relationships, high rates of parental separation, and family histories dominated by parental alcohol abuse.

Adult↗
PubMed1995

[How can acceptance by psychiatric patients of group psychotherapy be improved? An empirical study of the effect of combined individual and group psychotherapy on attitude to group psychotherapy].

This study investigates whether the sceptic attitude of many psychiatric patients to group therapy can be improved by a combined individual and group therapy program. The investigation was made on 50 patients, most of them with neurotic disorders, partly with secondary alcohol or substance abuse as well as some schizophrenic patients. Before admittance to the psychotherapy program enquiries were made by means of a questionnaire, about what subject they would like to speak in the individual or group therapy sessions. The results differ significantly dependent on sociodemographic and illness related factors. A second examination after discharge reveals an ameliorated attitude concerning group therapy in nearly all central themes. Thus, one of the important goals of in-patient psychotherapy has been achieved to improve patients ability to receive out-patient group therapy.

Adult↗
PubMed1998

[Psychophysiological health aspects of population living in radiation-contaminated territories].

A combined psychophysiologic study of 100 individuals living in territories contaminated by radionuclides and 60 people from ecologically clean region. There were no significant differences in the incidence of neurotic disorders between people from these regions (61.2 and 65.3%, respectively). The highest sensitivity to small radiation doses was observed at rather young age (20-40 years). It was found that a considerable role in the development of borderline psychic disorders belongs to both somatic disturbances due to low-dose radiation and psychogenic effects. A combined action of psychogenic and somatogenic factors aggravated symptoms of neurotic disorders and promoted widening of a range of psychic disturbances. Some part of the population from the contaminated territories tended to the development of cerebro-vascular psychoorganic pathology resultant from a breakdown of the reserves of the adaptation. Now the stress factor of radionuclides exposure is not so important as social and economic problems.

Adult↗
PubMed1983

Labelling and drug effects in the treatment of neurotic affective disorders: an experimental investigation.

This study investigates the effects of assigned diagnostic labels, with their accompanying predictions of therapeutic response, and prescribed psychotropic drugs. It was thought that such 'labelling' effects might be important in ambiguous situations, such as neurotic anxiety-depressive states, where diagnoses of 'reactive depression' or 'anxiety state' might justifiably be made and treatment with either diazepam or nortriptyline legitimately given. The depression label and its concomitant two-weekly prediction of improvement with antidepressants produced a set towards slower response with higher self-report depression. Nortriptyline produced significantly more improvement in self-report depression than diazepam in the first 2 weeks of treatment. No significant interaction effects were detected between diagnosis or drug. One month after the initial diagnostic evaluation there were no significant effects from either diagnostic label or drug.

Adolescent↗
PubMed1983

The diagnosis and drug treatment of anxiety disorders.

Anxiety, phobic and related neurotic disorders lend themselves to diagnostic confusion because of the large and variable array of symptoms associated with them. This has complicated attempts at coherent classification. This paper examines the problems in diagnosis and classification and the diversity of causal models of these disorders. It offers an alternative integrated perspective that may have heurestic merit in guiding clinicians to a practical choice of treatment and in delineating a useful starting point for the biological investigation of these disorders.

Anti-Anxiety Agents↗
PubMed1997

[Psychiatric disorders, suicide attempts, lesions and poisoning among adolescents treated in an emergency room, Ribeirão Preto, São Paulo, 1988-1993]

An epidemiological study was conducted to determine the occurrence of psychiatric and related disorders, according to the International Classification of Diseases, among adolescents treated in an emergency room of a teaching hospital in Ribeirão Preto, São Paulo, Brazil from 1988 to 1993. Adolescents studied represented 23% of the cases treated during this period. Neurotic Disorders (300), Suicide and self-inflicted Lesions (E950-E959), and Schizophrenic Psychoses (295) predominated among females. Signs and Symptoms related to alcohol and drugs (291, 292, 303, 304, 305), Schizophrenic Psychoses (295) and Neurotic Disorders (300) predominated among males. Adolescents studied were predominantly in the 20 to 24 and 15 to 19 year range, in this order.

Journal Article↗
PubMed1982

Mortality in the Lundby study. Natural death in different forms of mental disorder in a total population investigated during a 25-year period.

There is an increased mortality among persons who are or who have been under psychiatric care. In any normal population many individuals suffer from mental disorders without coming into contact with psychiatric services, and our knowledge of the mortality pattern of these groups is limited. The Lundby cohort comprises 3,563 persons from a total population, followed concerning mental disorders during 15 and 25 years. In the present study we have investigated the mortality from nonviolent, natural causes among persons in the Lundby cohort with a history of mental disorders, irrespective of contact with psychiatrists or other physicians. The relative death rate from natural causes compared with the standard population was found to be 1.5 among men and 1.2 among women with backgrounds of mental disorders. Neurotics had no excess mortality in this study.

Adolescent↗
PubMed2000

[Differentiated types of chronic agoraphobia].

The study included 60 patients aged 18-65 years with anxious-phobic disorder (APD)--agoraphobia with and without panic disorders. Diagnosis of the disease was performed according to ICD-10. It was established that dynamics and outcome of APD with stable agoraphobia depend on some comorbid psychic disorders (neurotic, nonpsychotic affective, personality disorders, slow-progredient schizophrenia). Influence of such disorders on APD depends on level of realization of the comorbid correlations: symptomatic (nondelirious hypochondria) and intersyndromal ones (affective and personal disorders as well as slow-progredient schizophrenia). Typology of APD with stable agoraphobia is proposed, that is determined by comorbid correlations with the phenomena of nondelirious (overvaluable or neurotic) hypochondria. Agoraphobia, comorbid with the phenomena of overvaluable hypochondria, is characterized by isolated phobic avoidance (1-2 situations), lack of the signs of progredience of psychopathologic disorders and relatively favourable outcome (lack of the cases of invalidism, decrease of a professional status in 8% of the patients). Agoraphobia, comorbid with the phenomena of neurotic hypochondria, is characterized by total phobic avoidance, syndromal comorbidity with polymorphic and generalized somatophormic disorders, depressive disorders syndromally completed, slow-progredient schizophrenia and less favourable outcome (avoidance behaviour of severe degrees was found in 57% of the patients, including 18% of patients disabled due to mental disease).

Adolescent↗