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PubMed2000

[Dreams and psychologic defence in children and juveniles with neurotic disorders].

The examination of 78 patients at different stages of neurotic disorders and 25 healthy individuals (10-17 years old) has shown that the dynamics of dreams at compensatory stage was directed to their intensification, affective and cognitive activation and to reduction of dreams' activity during decompensation of neurotic disorders. This may indicate their role in psychologic defence. In neurotic patients peculiarity of the reaction to stress was the presence of some latent period after stress, that preceded the very reaction of dream to stress, its longer duration than in healthy individuals and its qualitative peculiarity. That may reflect complexity of adaptation to stress influence in neurotic patients.

Adaptation, Physiological↗
PubMed2006

[Bioelectric brain activity in patients with neurotic disorders].

Seventy-three patients with neurotic disorders, aged 14-35 years, and 33 healthy controls have been examined using electroencephalographic method with spectral analysis of EEG, which has been conducted on the Brain Surfing system by the algorithm of direct Fourier transformation. The patients had changes of brain electric activity manifesting as insufficiency of thalamo-cortical synchronizing systems that caused an excessive activating effect of reticular formation on the cortex realized through extrathalamic reticular cortical and septo-hippocampal activation paths. Determinative in electrophysiological brain organization was the theta-rhythm, a marker of excessive emotional and autonomic activation, which directly correlated with an extent of personality accentuation and severity of neurotic state.

Adolescent↗
PubMed1996

The Nottingham Study of Neurotic Disorder: influence of cognitive therapists on outcome.

BACKGROUND: In previously published papers from the Nottingham Study of Neurotic Disorder a short treatment package of cognitive-behaviour therapy was no more effective than placebo drug treatment after 10 weeks' assessment in a cohort of 210 patients with neurotic disorders. This paper examines the outcome over two years of the patients treated by cognitive-behaviour therapy separated into two therapist groups, those who were competent in administering treatment and those of uncertain competence. METHOD: The therapists (mainly community psychiatric nurses) of 70 patients with an original DSM-III diagnosis of either dysthymic, panic or generalised anxiety disorder were separated into two groups on the basis of their perceived competence by their supervisor (DK). Ratings of psychopathology were made at regular intervals over two years by assessors blind to knowledge of treatment or therapist. RESULTS: The patients treated by competent therapists (n = 30) generally showed greater improvement than those allocated to therapists of uncertain competence (n = 40), mainly with respect to depressive symptoms, and the difference persisted over two years, long after the cognitive-behaviour therapy had been completed. CONCLUSIONS: Cognitive-behaviour therapy given by competent therapists over a 10 week period is of lasting benefit in neurotic disorder.

Adult↗
PubMed1998

Prediction of outcome in neurotic disorder: a 5-year prospective study.

BACKGROUND: There have been no previous studies of the outcome of different neurotic disorders in which a prospective group with original randomization to treatment have been followed up over a long period. Such studies are important in identifying the factors associated with good and poor outcome. METHODS: A 5-year follow-up assessment was made of a cohort of 210 psychiatric out-patients seen in general practice psychiatric clinics with a DSM-III diagnosis of generalized anxiety disorder (71), panic disorder (74) or dysthymic disorder (65) and randomized to drug treatment, cognitive and behaviour therapy, and self-help. A total of 182 of the patients (87%) were assessed after 5 years by examination of hospital and GP records using a standardized procedure and outcome determined with a four-point outcome scale. RESULTS: One hundred and seven (60%) of the patients had a favourable outcome but the remainder continued to be handicapped either intermittently or continuously throughout the 5-year period. Analysis of the value of initial data in predicting outcome using polychotomous step-wise logistic regression revealed that five variables were significant predictors of poor prognosis: older age; recurrent episodes; the presence of personality disorder at entry; general neurotic syndrome at entry; and symptom severity after 10 weeks. The initial DSM diagnosis and original treatment given, together with ten other variables, were of no predictive value. CONCLUSIONS: The long-term outcome of neurotic disorder is better predicted by age, personality and recency of onset than by other clinical variables with the exception of initial response to treatment.

Adult↗
PubMed2004

Psychosocial and seizure factors related to depression and neurotic-disorders among patients with chronic epilepsy in Nigeria.

To establish the effect of psychosocial and seizure factors on Depression and Neurotic Disorders among clinically diagnosed Nigerian patients, with epilepsy. This study utilized the multivariate statistical design to evaluate the associations between some psychosocial and seizure factors on increase depression and neurotic disorders. The Neurology outpatient clinics of two tertiary facilities in Nigeria: Aro Neuro-psychiatric Hospital/World Health Organization Collaborating Centre, Abeokuta and the University College Hospital Ibadan, were used for the study. Two hundred and sixty four (264) consecutive clinic attendees with a clinical diagnosis of epilepsy participated in the study. Perceived Stigma Scale (PSS); Washington Psychosocial Seizure Inventory (WPSI-Modified): Becks Depression Inventory (BDI) and Crown-Crisp Experiential Index (CCEI). Significant main effect for seizure control, stigma, emotional adjustment, vocational adjustment, interpersonal adjustment, adjustment to seizures but not for age at onset of epilepsy, financial adjustment and gender, were recorded on depression. Similarly significant main effect for seizure control, stigma, emotional adjustment, adjustment to seizures but not for age at onset of epilepsy, gender, vocational adjustment, financial adjustment and interpersonal adjustment were recorded for neurotic disorders. The study highlights some of the factors, which may contribute to the understanding of epilepsy-related psychopathologies and implication for psychotherapeutic intervention among individuals with epilepsy in Nigeria.

Adaptation, Psychological↗
PubMed2005

The Nottingham study of neurotic disorder: predictors of 12 year costs.

OBJECTIVE: To examine the relationship between clinical, demographic and socio-economic characteristics and the long-term costs of a cohort of neurotic patients. METHOD: Analysis of the costs of a cohort of 210 people entered in the Nottingham study of neurotic disorders, a randomized controlled evaluation of five treatments for neurotic disorders. Service use data were collected at 5 and 12 years after study entry. Multiple regression analyses were conducted. RESULTS: The total cost per patient over the 12-year follow-up period was calculated to be $11,940 (SD $15,520) ( pound7450, SD pound9690). Higher costs were significantly associated with the presence of general neurotic syndrome, an initial diagnosis of dysthymia and a recurrent episode of illness. CONCLUSION: The total costs of care for a range of neurotic disorders are broadly comparable with other estimates of costs reported in the literature for similar populations. Those responsible for higher costs in the longer-term have comorbid anxiety, depressive and personality disorders.

Adult↗
PubMedDate not supplied

Neurotic disorders and the receipt of psychiatric treatment.

Access to psychiatric treatment by people with neurotic disorders in the general population is likely to be affected both by the severity of disorder and by sociodemographic differences. In the household component of the National Surveys of Psychiatric Morbidity >10,000 subjects in Great Britain with psychiatric symptoms were interviewed using the CIS-R. They were also asked about difficulties experienced in performing seven types of everyday activity. All subjects classed as having an ICD-10 disorder were questioned about their experience of treatment with antidepressants, hypnotics, and counselling or psychotherapy. Less than 14% of people with current neurotic disorders were receiving treatment for them. Within the previous year, only a third had made contact with their primary care physician for their mental problem: of these <30% were receiving treatment. Overall, 9% of people with disorders were given medication and 8% counselling or psychotherapy. A diagnosis of depressive episode was that most associated with antidepressant medication. Treatment access was affected by employment status, marital status, and age, but the major determinant was symptom severity. Neither sex nor social class influenced which people received treatment. People with psychiatric disorders seldom receive treatment, even when they have consulted their primary care physician about them. In many cases, this must represent unmet needs with a strong claim on health resources. There are also inequalities in the receipt of treatment, although the major influence is the severity of disorder.

Adolescent↗
PubMed1989

[Neurotic disorders in industrial workers].

Mass clinico-epidemiological screening of the workers of a large industrial enterprise provided data on the genuine prevalence and the clinico-dynamic structure of neurotic disorders in the given population group, on social and industrial factors giving rise to their development, social and labor adaptation of patients afflicted with this pathology. The programs for the primary and secondary care of the neurotic disorders in the industrial workers have been tried on the basis of the Center for Mental Health Care set up at one of the large industrial enterprises in Tomsk. The rendering of extradispensary specialized assistance to neurotic patients at the enterprise itself, including early diagnosis of neuroses, observation over time, application of the differentiated preventive and rehabilitation programs made it possible to diminish the incidence of neurotic disorders, to minimize temporary disability because of the pathology in question, and to raise output per man-hour.

Adult↗
PubMed2000

Neurotic disorders and the receipt of psychiatric treatment.

BACKGROUND: Access to psychiatric treatment by people with neurotic disorders in the general population is likely to be affected both by the severity of disorder and by sociodemographic differences. METHOD: In the household component of the National Surveys of Psychiatric Morbidity > 10,000 subjects in Great Britain with psychiatric symptoms were interviewed using the CIS-R. They were also asked about difficulties experienced in performing seven types of everyday activity. All subjects classed as having an ICD-10 disorder were questioned about their experience of treatment with antidepressants, hypnotics, and counselling or psychotherapy. RESULTS: Less than 14% of people with current neurotic disorders were receiving treatment for them. Within the previous year, only a third had made contact with their primary care physician for their mental problem: of these < 30% were receiving treatment. Overall, 9% of people with disorders were given medication and 8% counselling or psychotherapy. A diagnosis of depressive episode was that most associated with antidepressant medication. Treatment access was affected by employment status, marital status, and age, but the major determinant was symptom severity. Neither sex nor social class influenced which people received treatment. CONCLUSIONS: People with psychiatric disorders seldom receive treatment, even when they have consulted their primary care physician about them. In many cases, this must represent unmet needs with a strong claim on health resources. There are also inequalities in the receipt of treatment, although the major influence is the severity of disorder.

Adolescent↗
PubMed1999

Breast cancer risk among women with psychiatric admission with affective or neurotic disorders: a nationwide cohort study in Denmark.

There is a considerable interest in the possible relationship between psychosocial factors and the onset of breast cancer. This cohort study was based upon two nationwide and population-based central registers: The Danish Psychiatric Central Register, which contains all cases of psychiatric admissions, and The Danish Cancer Registry, which contains all cases of cancer. The register-linkage was accomplished by using a personal identification number. The study population comprised all women admitted to psychiatric departments or psychiatric hospitals in Denmark between 1969 and 1993 with an affective or a neurotic disorder. Overall, 66,648 women comprising 199,910 admissions and 775,522 person-years were included. The incidence of breast cancer in the cohort was compared with the national breast cancer incidence rates adjusted for age and calendar time. In all, 1270 women with affective or neurotic disorders developed breast cancer subsequent to the first admission as compared with the 1242 women expected, standardized incidence ratio (SIR) = 1.02 (95% confidence interval 0.97-1.08). None of the hypothetical risk factors: type of diagnosis, age or calendar period at cohort entry, age at breast cancer, alcohol abuse, alcohol/drug abuse without further specification, total number of admissions, total length of admissions, or time from first admission showed a statistically significant effect on the relative risk of breast cancer. We found no support for the hypothesis that women admitted to a psychiatric department with an affective or a neurotic disorder subsequently have an increased risk of breast cancer.

Adult↗
PubMed1988

[The dynamics of neurotic disorders with autonomic paroxysms].

Multi-dimensional investigation in the peculiarities, clinical course and possible mechanisms of neurotic disorders was performed in 115 patients. In order to study the further course of neurotic disorders and their determinants, as well as the issues of social rehabilitation and psychoprophylactic interferences, 56 patients were studied again after 6 to 8 years. For each of the symptom complexes investigated, the course had distinct features determined primarily by adaptation-compensatory capabilities of personality, and the "system of psychological defense". Most unfavorable was the course of hysterical disorders. Therapeutic policy in these patients should be grounded upon the psychotherapeutic measures aimed at finding the ways that would be psychologically adequate for changing the patients' attitudes and restoring their adaptation.

Asthenia↗
PubMed1995

Affective and neurotic disorders in community-based services: a comparative study in south Verona and south Manchester.

The service utilization by patients with affective and neurotic disorders in two defined populations of south Verona in Italy and south Manchester in England was compared. The composition and function of the two community-based psychiatric services, and the sociodemographic characteristics of the two centers are described and related to epidemiologically based data on service use in the community, outpatient clinic, day hospital and inpatient care. The results suggest that close liaison with primary care in south Manchester results in more referrals, and therefore higher treated incidence and prevalence rates. The close integration between hospital and community staff in south Verona is associated with greater permeability of the filter between inpatient and community care, indicated by higher admission rates for patients known to the service, and shorter length of inpatient stay (only for affective disorders) in south Verona compared with south Manchester.

Adolescent↗
PubMed2003

Psycho-social determinants for psychiatric hospitalisation for neurotic disorders in women--a case-control study.

BACKGROUND: Much has been written about the determinants of psychiatric hospitalisation, chiefly for psychotic patients in an emergency. This paper reports the results of a comparative study between in-patients and pathological subjects from the general population. The aim of this work is to evidence the psycho-social determinants of hospitalisation in a psychiatric department for neurotic disorders. METHODS: This study was conducted on a socially fairly privileged population which was, therefore, also fairly homogeneous. The subjects from the two groups were assessed clinically using standardised instruments both for diagnosis (SCAN) and for psycho-social variables (Stressful Life Events: LEDS; Social Support and Self-esteem: Pearlin checklist; care itinerary). RESULTS: Following the analysis of frequency and a multivariate logistic regression analysis, four risk factors for hospitalisation for neurotic disorders were evidenced, including: severity of neurotic disorders, taking a long time to consult a specialist after first onset of anxiety disorders, poor social support, and having experienced one or more provoking agents (Brown and Harris methodology) in the year previous to hospitalisation. CONCLUSION: The severity of the mental pathology is largely responsible for hospitalisation in neurotic patients as it is in psychotic patients, but it is not the only determinant for hospitalisation.

Adult↗
PubMedDate not supplied

The cybernetic approach to the treatment of neurotic disorders.

This work is an attempt at a cybernetic analysis of the process of treatment of neurotic disorders. This approach is based on the consideration of a patient as an object of control. Assuming that the neurosis is an expression of some imbalance in an organism, the process of treatment is reduced to the exertion of influence on the system thrown out of balance (i.e., the patient) so that its homeostasis with the environment is restored. Thus the treatment of neurotic disorders consists of the use of negative feedback, both internal (those within the patients organism) and external (those within the system created by the interaction of patient and environment).

Adult↗
PubMed1989

[Early diagnosis of neurotic disorders using an automated system].

The authors distinguish a complex of informative criteria of early diagnosis of neurotic disorders employed in the screening algorithm. The efficacy of the algorithm was evaluated in 285 patients with neurosis and the diagnosis proved correct in 93-95.2% of cases. The automatized system of screening of neurotic disorders ensures improvements in exact diagnosis, saves time and expenditures.

Algorithms↗
PubMed1992

[Psychiatric-psychologic evaluation of neurotic disorders in the pension process based on a structural-social illness concept].

The psychiatric-psychological judging neurotic disorders is presented under following aspects: the diagnostical guidelines considering international classification systems and the definition of disease given by the jurisdiction. In order to judge the degree of severity of a neurotic disorder with regard to professional fitness this paper proposes Raschs structural social conception of disease.

Disability Evaluation↗
PubMed1991

[Guidelines for interaction by the therapeutic team in inpatient treatment of patients with chronic neurotic disorders].

In treatment of in-patients with chronic neurotic disorders we tried both to reduce distress in the therapeutic team (doctors, nurses, other therapists) as usually caused by those patients, and to improve outcome of treatment. Therefore, three to five guidelines on how to deal with the patient were given to the therapeutic team, and illustrated by possible literal statements to the patient. The guidelines aimed at a general interactional approach to the patient and did not determine specific therapeutic interventions. They were set up following principles of Brief Therapy as developed at the Mental Research Institute in Palo Alto. Results of our intervention in treatment of ten patients are reported. The therapeutic team rated the guidelines generally as positive. The therapeutic outcome varied greatly. A comparison with a matched pair control group showed a favourable tendency. Initial ratings by the team of the prescriptions predicted eventual improvement of the patients.

Adult↗