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PubMedDate not supplied

[Relationship between psychogenic symptomatology and intelligence].

Corresponding to variables "leading symptoms in the psychic area" and "psychosomatic diseases in a restricted sense" 493 patients have been divided in four groups. Taking the hypothesis that patients with a different symptomatic show different results in the HAWIE (Hamburg-Wechsler-Intelligence-Test for Adults) four groups have been compared corresponding to their HAWIE-scores. It turns out that patients with a psychic leading symptomatic without important somatic disease and patients with psychosomatic illness in a restricted sense without psychic symptoms showed better results compared with other patients in the verbal tests. For this correlations of the higher scores in the verbal part of the intelligence-test with the phenomena that the investigator more often found the diagnosis of a psychic leading symptom or a psychosomatic disease in a restricted sense the following interpretations are considered: 1. The innerpsychic effort connected with different psychogenic disorders is reflected in the cognitive efficiency. 2. The diagnosis of limited psychomatic illness is also a result of the verbal interaction of doctor(s) and patient.

Humans↗
PubMed1999

Pediatric movement disorders.

Movement disorders in children encompass disorders of motor control--both hyperkinetic (excessive movement) and hypokinetic (decreased movement). This article focuses on the hyperkinetic movement disorders, particularly tremor, Wilson's disease, dystonia, tics and Tourette syndrome, chorea, myoclonus, neuroleptic-induced movement disorders, and psychogenic movement disorders. Phenomenology of the disorders as well as clinical presentation, basic pathophysiology, genetics, and treatment are discussed.

Antipsychotic Agents↗
PubMed1999

[Treatment of insomnia in patients with borderline mental diseases].

Zolpidem, non-benzodiazipine preparation, was used for therapy of 56 patients with insomnia. 4 groups of patients were treated: a) with a prevalence of asthenic symptomatology in psychogenic disorders; b) with polymorphic neurotic symptomatology and autonomic disorders; c) with affective pathology of neurotic level; d) with nervous anorexia and bulimia. Zolpidem was quite effective in all groups of patients in terms of normalization of falling asleep, improvement of quality of sleep without changing of daily activity. A good drug tolerance was found in elderly patients.

Adolescent↗
PubMed2000

[Intravenous thrombolytic therapy: ideal treatment for acute ischemic stroke].

In four patients with symptoms of presumed acute ischaemic stroke intravenous treatment with recombinant tissue plasminogen activator (rtPA) was considered. Two patients indeed received rtPA within 3 hours after onset of symptoms. One of them, a 55-year-old woman, recovered and was able to resume her job as a teacher four months later. The other patient, a 38-year-old man, had a severe bleeding complication that could be stopped, but the patient died several days later because of the massive stroke. The third patient, an 82-year-old woman, could not be treated with rtPA because the time of onset of neurological deficit was uncertain. Nevertheless, she recovered well from her hemiplegia after a few days. The fourth patient, a 24-year-old woman, did not receive rtPA because her symptoms were thought to be the result of a psychogenic disorder. Intravenous thrombolysis increases the risk of intracranial haemorrhage, but should be considered a useful treatment for ischaemic stroke provided there is no doubt about this diagnosis and treatment with rtPA can be started within 3 hours of onset of the neurological deficit.

Acute Disease↗
PubMed1999

[Psychotherapy: the earlier, the better. Postponing therapy harms the patient and health insurance].

Psychotherapeutic measures produce good results providing they are initiated in good time, and the treatment is appropriate to the problem and given by a competent therapist. There are, however, numerous difficulties that can result in the psychogenic disorders becoming chronic. The poor public acceptance of psychotherapy is based on fear and the negative perception of this form of treatment. It would appear to be of great importance to improve the image of psychotherapy to avoid chronicity.

Cost Savings↗
PubMed2002

The cause and natural history of isolated urinary retention in young women.

PURPOSE: Using a questionnaire mailed to patients we evaluated the course and natural history of urinary retention in women, of which the cause is attributed to electromyography abnormality of the striated urethral sphincter. Previously urinary retention in young women has often been considered to be due to multiple sclerosis or a manifestation of a psychogenic disorder. MATERIALS AND METHODS: A questionnaire was mailed to 216 women with abnormal sphincter electromyography and urinary retention. Of the 112 responses we analyzed the 91 from those who had been in complete urinary retention. RESULTS: Mean patient age at the onset of complete retention was 27.7 years (range 10 to 50). No patients had neurological features indicating a cauda equina lesion or central demyelination and none had progressed to features of a general neurological disorder. Mean maximum bladder capacity at the initial episode of complete retention was 1,208 ml. Of the women 65% reported an event that had apparently precipitated urinary retention, most commonly a gynecologic surgical procedure using general anesthesia. Sacral neuromodulation was the only therapeutic intervention that restored voiding. CONCLUSIONS: The concept of an organic cause of urinary retention in otherwise healthy young women has considerable importance in terms of correct management. Neurological investigation in these women does not reveal underlying neurological disease. It is thought that this disorder is due to a primary failure of relaxation of the striated urethral sphincter.

Adolescent↗
PubMed2002

Evaluation of dysuria in adults.

Dysuria, defined as pain, burning, or discomfort on urination, is more common in women than in men. Although urinary tract infection is the most frequent cause of dysuria, empiric treatment with antibiotics is not always appropriate. Dysuria occurs more often in younger women, probably because of their greater frequency of sexual activity. Older men are more likely to have dysuria because of an increased incidence of prostatic hyperplasia with accompanying inflammation and infection. A comprehensive history and physical examination can often reveal the cause of dysuria. Urinalysis may not be needed in healthier patients who have uncomplicated medical histories and symptoms. In most patients, however, urinalysis can help to determine the presence of infection and confirm a suspected diagnosis. Urine cultures and both urethral and vaginal smears and cultures can help to identify sites of infection and causative agents. Coliform organisms, notably Escherichia coli, are the most common pathogens in urinary tract infection. Dysuria can also be caused by noninfectious inflammation or trauma, neoplasm, calculi, hypoestrogenism, interstitial cystitis, or psychogenic disorders. Although radiography and other forms of imaging are rarely needed, these studies may identify abnormalities in the upper urinary tract when symptoms are more complex.

Adult↗
PubMed1992

[Participation refusal by probands in an epidemiologic long-term study--sociodemographic, clinical and psychometric findings].

Usually little is known about probands who participated in an epidemiological longitudinal field survey but refused participation in follow-up investigations. For reasons of data protection and on account of the fact that investigative instruments used in longterm field surveys or panel studies are more focused on well defined issues (opinions, attitudes, assessment of behaviors) and less on personality variables, differentiated statements on probands who explicitly refused cooperation can hardly be made. In our epidemiological longitudinal field study on prevalence and course of psychogenic disorders we have a different situation. Within the limits of our study we had the unique opportunity to gain far-reaching information on probands who refused to participate in preceding investigations in regard to sociodemographic, psychometric and clinical variables. The clientele of refusers we present in our paper mainly comprises elderly, married, rather obsessive-compulsive structured, lower-class females. According to our data interactive aspects are equally responsible for reduced cooperativeness. The significance of our findings for the planning and carrying out of epidemiological longitudinal field surveys is discussed.

Adult↗
PubMed1992

[Gilles-de-la-Tourette syndrome].

Gilles de la Tourette's syndrome, a combination of multiple chronic tics and vocalizations, usually first occurring during childhood, is described in its history, symptomatology, genetics, etiology and therapy. Traditionally TS has been viewed either as an organic or as a psychogenic disorder. We propose an integrative concept combining both aspects. During a vulnerable phase in childhood a hypersensitivity of dopamine 2-receptors, induced by gene defects or perinatal trauma, leads to a lack of suppression of subcortical programs which discharge as tics. Tics are modified by multiple psychological contents (aggressive or sexual impulses, imitation of others) which tend to become independent of their origin. Severity of tics in the course of the illness is often dependent on the emotional status of the patient. Recent research focuses on the search for a major gene locus and the relationship between dopamine-receptor hypersensibility and the disturbances of other neurotransmitter systems (norepinephrine, serotonin, endorphin).

Combined Modality Therapy↗
PubMed2005

[Burning mouth].

Various conditions of the oral mucosa can give rise to a burning sensation. Candidosis, geographic tongue (erythema migrans), mucocutaneous conditions and stomatitis can all cause mouth burns with visible changes to the oral mucosa. The so-called 'burning-mouth syndrome' (BMS) is a fairly rare but extremely unpleasant condition characterised by a bilateral burning sensation of the oral mucosa in the absence of clinically visible mucosal changes. Frequently-associated symptoms include dry mouth and loss or change of taste. The aetiology is unknown, even though most of the literature focuses on the role of a possible underlying psychogenic disorder. Several mucosal disorders can cause symptoms similar to BMS. Therefore, careful oral examination is required before establishing the diagnosis of BMS. Additional laboratory tests or a specialist examination rarely yield abnormal findings of relevance. Reassurance and understanding are important keywords in the management of patients suffering from BMS. Unless clearly indicated dental or medical treatment should be avoided, even if the patient insists on it, since such treatment is rarely effective.

Antidepressive Agents↗
PubMedDate not supplied

[Parkinsonism and Camptocormia with focal spinal myopathy: case report and responsiveness to treatment].

INTRODUCTION: Camptocormia is characterised by extreme flexion of the thoracolumbar spine. It suffered an increase during walking and it is relieved in supine position. Camptocormia has been described in psychogenic disorders, but in other diseases, including Parkinson's disease as well. It has been recently described several cases with focal spinal myopathy, and we present a patient with this clinical association. CASE REPORT: This 82-year-old man had a 6-year history of parkinsonian symptoms, mostly of rigid-akinetic type. He was in stage 4 on Hoehn & Yahr scale, and he had reached 62 points on Unified Parkinson Disease Rating Scale. Over the past 6-8 months, he developed progressive forward flexion of the trunk with clinical features of camptocormia. He suffered flogotic symptoms and signs on her lower back, and there were no dystonic posture or clinical features. Lumbar computerised tomography showed fat replacement of the paravertebral L3 muscles. A surgical paravertebral muscle examination and biopsy were performed, showing diffuse fat replacement and only a marginal myopathic focus. It was made several therapeutic approaches, with levodopa dose increase, reduction, fractioning, and addition of dopa-agonists. All of these strategies failed. It was determined to try a steroid course, but there were no improvement, so physiotherapy and rehabilitation measures did. He finally was confined to wheelchair. CONCLUSIONS: Physiopathologic and therapeutic aspects of camptocormia in Parkinson's disease are unclear. Their relationship could be casual or causal. Patients with clear inflammatory myopathy could benefit from steroid therapy, but patients with end-stage myopathy probably do not so.

Aged, 80 and over↗
PubMed1991

[Acute inner ear deafness].

Sudden inner ear hearing loss initially might suggest a psychogenic disorder of hearing, particularly when it is bilateral and simultaneous. The differential diagnosis includes disseminated encephalitis, syphilitic labyrinthitis and Cogan's syndrome. The history and cause of acute bilateral deafness in meningitis are easy to recognise. Furthermore, unilateral acute inner ear deafness should not be regarded as idiopathic without further consideration. A acoustic neuroma is a possible cause even of a low-tone hearing loss. More controversial is rupture of the round window membrane as a cause of sudden deafness. The deafness after epidemic parotitis obviously leads to a total unilateral hearing loss in every case. Even labyrinthine apoplexy with loss of hearing and vestibular function can be caused by a tumour of the cerebellopontine angle. Idiopathic sudden deafness should be defined as an acute sensory hearing loss whose anatomical basis in an acute vascular endolymphatic hydrops of unknown cause. The sudden deafness affects only one ear; tinnitus and brief vertigo can be accompanying symptoms. A sudden hearing disorder due to other causes should be distinguished from idiopathic lesions.

Audiometry, Evoked Response↗
PubMed1991

Altered hormonal status in a female deprived of food for 18 days.

From an endocrinological aspect, metabolic changes of humoral factors were examined in a female patient deprived of food for 18 days. On admission, serum acetoacetate (AcAc) and 3-hydroxybutyrate (3-OHB) levels markedly increased. The serum free triiodothyronine (T3) level decreased, whereas serum thyroxine (T4) concentrations were within normal range. Diurnal variations of serum cortisol levels were not observed. At day six after admission, the effects of intravenously administered thyrotropin releasing hormone (TRH) on pituitary thyroid stimulating hormone (TSH) was suppressed, whereas growth hormone (GH) was hyper-responsive. Re-feeding gradually normalized the decreased free T3 level following the reduction of serum ketone bodies. The diurnal rhythmicity of cortisol secretion was restored. At day 17, the TSH response to TRH was restored, while the GH hyperreaction was attenuated. The present case provided evidence that starvation elicits lowered TSH response and GH hypersecretion to intravenously administered TRH, and distorts diurnal rhythmicity of adrenal cortisol secretion in a healthy subject without any psychogenic disorders.

Adult↗
PubMed1991

[Encopresis in children. Preliminary report of new therapeutic and diagnostic aspects].

There appears to be no strict boundary between encopresis, which is defined as a psychogenic disorder, and incontinence, in which there is an inability to retain faeces voluntarily. Our findings over an 8-year period suggest that unrecognized functional or organic retention disorders are present in encopresis more often than previously thought. Of 16 children with encopresis who were examined by perfusion manometry 14 were found to have disorders of anorectal functions. Of these, 7 showed pathologically low sphincteral pressure rates and 3 abnormally high rates with coordination disorders. Four had normal sphincteral pressure rates but considerably disturbed sensitivity. In the 3 children examined by MRI so far clear morphological changes were found. The question of whether the deviations found were the result of primary or secondary changes could not be clarified. However, of key importance is that these additional findings enable the use of a combined course of treatment (passive sphincter training by electrostimulation and active sphincter training with biofeedback) that seemed to bring improvement quickly and reliably.

Adolescent↗
PubMed1991

[Psychogenic illness and social mobility between generations].

A representative epidemiological survey on psychogenic disorders confirms the often reported result, that these disorders are more common in lower socioeconomic classes. However, in looking for the socioeconomic origin of the subjects (parental class position), it could be shown that "cases" were equally distributed over social classes. Therefore, it seems to be unlikely that low social class as macrosocial factor in its own right has causative influence on the subjects' later mental health or illness. It seems more likely that microsocial aspects of primary and secondary socialization are of decisive importance. After the "breeding-hypothesis" as an explanation of the inverse relationship between social class and mental illness could be ruled out, the rival hypotheses of social stress and social selection (drift-hypothesis) are discussed. A research design which might test these alternatives is outlined.

Cohort Studies↗
PubMed1990

[Current diagnosis of impotence].

In recent years the true incidence of impotence due to organic diseases in comparison with psychogenic disorders could be verified. New diagnostic tools as penile Doppler ultrasonography, PBI estimation, NPT measurement, invasive SKIT's, neurophysiological methods, selective phalloarteriography, artificial erection and dynamic cavernosography are introduced and are the guide to therapeutic approach.

Adult↗
PubMed1989

[The course of protracted reactive depression in young children].

Clinical-dynamic and catamnestic techniques were used to study 34 children with protracted reactive depression developed as a response to their maladaptation to the nursing house conditions. The following stages of the disease were singled out: I, acute affective-shock responses; II, subacute reactive depression; III, protracted polymorphic depressive-neurotic state; IV, regress of the disease, compensation; V, post-reactive++ state, the outcome of the psychogenic disorders. The psychopathological and psychological characterization of each stage was performed. Some of the "background" factors appeared as determinants of the course and outcome of the disease.

Acute Disease↗
PubMed1979

Visual evoked potential (VEP): basic concepts and clinical applications.

The Visual Evoked Potential is the objective measurement of visual function monitored at the level of the occipital cortex with scalp electrodes. This article summarizes many of the recent clinical applications of the VEP. Included are basic concepts of the VEP and its clinical utilization for the objective assessment of refractive error, visual acuity, amblyopia, binocularity, demyelinating diseases, psychogenic disorders, pre-surgical prediction of post-surgical visual function, visual fields, color blindness and neurological development.

Amblyopia↗