[Hyperorexia--anorexia. (On phenomenology and psychodynamics of neurotic eating disorders)].
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Adult↗
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[Differentiation between primary and neurotic sexual disorders].
The object of this paper is to show that there are different forms of sexual anomalies which permit of basic and therapeutic differentiation. Atavisms of responding have been observed to play an essential role in real perversions.
Adolescent↗
[The usefulness of prognostic and therapeutic indexes in neurotic sexual disorders].
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Evaluation Studies as Topic↗
Psychiatric referrals in the general hospital.
Psychiatric disorders and physical illnesses often coexist. Although there is evidence of high psychiatric morbidity in general hospital patients, only a small percentage are referred to the consultation-liaison psychiatrist. The paper describes and discusses the common psychiatric conditions encountered and referred in general hospitals. They include attempted suicides, psychiatric disorders presenting with physical symptoms, organic psychiatric disorders presenting with psychiatric symptoms and the psychiatric consequences of physical illness. The major diagnostic categories of these referrals are organic psychotic disorders, functional psychoses and neurotic disorders. Some broad guidelines are listed for the referring physician. Patients presenting with suicidal ideations or attempts, suspected emotional psychiatric disturbance, a history of psychiatric illness, an apparent incompetence in giving consent for medical procedures and those with diagnostic and management problems could be referred to the psychiatrist.
Disease↗
Decision support for psychiatric diagnosis based on a simple questionnaire.
This paper compares two classifiers: Pseudo Bayesian and Neural Network for assisting in making diagnoses of psychiatric patients based on a simple yes/no questionnaire which is provided at the outpatient's first visit to the hospital. The classifiers categorize patients into three most commonly seen ICD classes, i.e. schizophrenic, emotional and neurotic disorders. One hundred completed questionnaires were utilized for constructing and evaluating the classifiers. Average correct decision rates were 73.3% for the Pseudo Bayesian Classifier and 77.3% for the Neural Network classifier. These rates were higher than the rate which an experienced psychiatrist achieved based on the same restricted data as the classifiers utilized. These classifiers may be effectively utilized for assisting psychiatrists in making their final diagnoses.
Affective Symptoms↗
[Dimensions of bizarre, idiosyncratic thinking. Relationship between thought disorders and affect].
In the present study disorders of thinking were studied in normals, patients with neurotic disorders, borderline patients and both acute and chronic schizophrenics. Disorders of thinking were assessed by the Holtzman Inkblot Technique. By a factor analysis, different dimensions of disordered thinking characteristic of the different diagnostic groups could be identified. Among others two dimensions of schizophrenic thought disorder and one of borderline thought disorder could be identified. This latter dimension showed high correlations with anxiety and hostility. This was true for a dimension of productive schizophrenics thought disorders, but not for a dimension of negative schizophrenics thought disorders.
Acute Disease↗
Growth hormone secretion in prepubertal children with major depression. I. Final report on response to insulin-induced hypoglycemia during a depressive episode.
Insulin tolerance tests (ITTs) were carried out on 46 drug-free prepubertal children with severe emotional disorders. Thirteen met unmodified Research Diagnostic Criteria for major depressive disorder, definite endogenous subtype, 17 met the criteria for nonendogenous major depressive disorder, and 16 fit DSM-III criteria for nondepressed neurotic disorders. The group with endogenous depression had significant hyposecretion of growth hormone (GH) in this test when compared with the other groups. Since GH hyposecretion in response to ITT has been found in most studies to be associated with endogenous major depression in adults, the data support the validity of the diagnosis of prepubertal endogenous major depressive disorder and the hypothesis of similarity or identity of prepubertal and adult major depressive disorders.
Affective Symptoms↗
General introduction to the psychotherapy of Pierre Janet.
This article deals with Pierre Janet's concept of "Psychological Analysis" (analyse psychologique). It brings out Janet's criticism of Sigmund Freud's ideas, and delineates the difference between psychological analysis (Janet) and psychoanalysis (Freud). Further it points out that Janet's theories on the pathogenesis of neurotic disorders rely on the concept of psychic trauma and associated fixed ideas. Mental force and mental tension, described in greater detail, are essential for the pathogenesis of mental disorders. According to Janet, a significant characteristic of the neurotically disturbed person is a feature that Von Gebsattel calls "Werdenshemmung" ("inhibition of becoming"), a state which impairs the life development of the ill person.
History, 19th Century↗
[Biological and social correlates of favorable and unfavorable neurosis course].
Four hundred ninety seven patients with neurosis of Astana (Kazakhstan) community, 116 men and 381 women, have been studied. The patients were traced in 5-year follow up study. Favorable and unfavorable types of the disorder were established, the latter being characterized by transforming into neurotic personality development. The influence of endogenous and environmental factors on neurosis prognosis was examined. To elaborate adequate measures for preventing neurotic personality development, criteria for favorable and unfavorable prognosis of neurotic disorders were suggested.
Adult↗
[So-called functional diseases and disorders of the stomach].
While analyzing the data available in the literature and their own findings, the authors propose a classification of functional diseases and disturbances of the stomach by origin, nature of functional disorders, and clinical symptoms. They consider the features of gastric functional disturbances in chronic diseases of the gastrointestinal tract, abnormalities of other organs and systems, diseases of the nervous system, intoxications, arrhythmias, nitriture, etc. Among the patients admitted to the Clinic of Neuroses and Psychotherapy, individuals suffering from neurotic disorders or neurotic continuous mild abnormalities of the stomach, neurosis-like disorders complicating the course of chronic gastroenterologic diseases have been identified. Principles and patterns of management of patients with gastric functional diseases and disturbances have been developed.
Cardiovascular Diseases↗
A-B status and sex stereotyping among psychotherapists and patients. Toward a model for maximizing therapeutic potential.
Previous studies indicate that mental health professionals, when evaluating the mental health of males and females, sex role stereotype to the disparagement of females. Some feminists have further assumed that male therapists in particular discourage self-actualization of females, and have argued that female patients should be seen by female therapists only. This study examined the major hypothesis that among both male and female therapists and among both male and female patients, there may be identifiable kinds of therapists and patients who sex role stereotype more than others. A total of 240 subjects (male and female) were recruited from three populations: professional psychotherapists, medical and nursing students, and psychiatric patients. Each subject was administered an A-B therapist scale and a sex role stereotyping questionnaire. Analysis of variance of this 3 x 2 x 3 factorial study revealed: a) patient groups stereotyped significantly more than professional therapist groups (p less than .01), with student groups stereotyping intermediately; b) within each major group, male subjects stereotyped significantly more than their female counterparts (p less than .01); and c) within each male group and within each female group, A status subjects stereotyped significantly more than B status subjects (p less than .01), with AB status subjects stereotyping intermediately. Previous research has indicated that A status psychotherapists are more effective in treating schizophrenic disorders, while B status therapists are more effective in treating neurotic disorders. Since our results reveal a strong relationship between A-B status and degree of stereotyping, our discussion explores the possibility of differentially matching psychotherapists and patients in order to maximize therapeutic potential. Matching could be done according to complementary differences between psychotherapist and patient (in terms of A-B status and sex role stereotyping) or according to similarities between psychotherapist and patient, depending on whether reconstructive or supportive therapy is the objective. Sex of patient and therapist as well as diagnosis of the patient are other variables considered in the model for maximizing the therapeutic potential.
Adult↗
[Parental and peer attachment of hospitalized adolescent patients--pilot study].
AIM: In the context of Bowlby's theory of attachment authors made an attempt to assess parental and peer attachment in different clinical subgroups of hospitalised adolescents. METHOD: 142 patients--58 with the diagnosis of neurotic disorders, 49 eating disorders and 35 patients with schizophrenic disorders, as well 34 untreated, healthy adolescents were assessed by The Inventory of Parent and Peer Attachment by Armsden and Greenberg. RESULTS: The group of schizophrenic patients was characterised by disturbed attachment with peers and normal attachment with parents.Two other diagnostic subgroups, neurotic and eating disorders were similar as far as nature of attachment was concerned. The attachment was disturbed both with parents and peers, but the level of alienation in relations with peers in the group of eating disorder patients was similar to the level in the group of schizophrenic patients. This conclusion allows us to put the group of eating disorders closer to the group of schizophrenic, than neurotic patients, as far as attachment is concerned. CONCLUSIONS: The Inventory of Parent and Peer Attachment, used for the first time in Poland, can be seen as a promising instrument in assessing three dimensions of attachment: communication, trust and alienation in relations with parents and peers.
Adolescent↗
Psychogenic pain: a study of marital adjustment.
The marital adjustment of patients with psychogenic pain disorder was evaluated and compared with a matched group of patients with other neurotic disorders. Pain patients spouses were found to have better marital adjustment and less psychiatric morbidity than the spouses of neurotic patients. These findings are discussed in terms of the concepts of "sick role homeostasis" and "tertiary gain".
Adaptation, Psychological↗
[Analysis of psychiatric hospital cases in Hamburg 1988-1994--developmental trends, health care deficiencies and prospects].
For the first time it was possible to study psychiatric inpatient treatment over a period of 7 years in a major German city (Hamburg) using data of 77% of all psychiatric inpatient cases collected by health insurance agencies. Among the most prominent results is the fact that 4 out of 8 illnesses with the highest sum of inpatient days of all treatment cases are psychiatric cases. These are schizophrenia, neurotic disorders, affective psychoses and alcohol abuse. Schizophrenia is the diagnosis which adds up to the highest amount of inpatient days in Hamburg hospitals. Of all psychiatric diagnoses, 35% show up in somatic departments, mainly internal medicine. This is especially true for alcohol and drug abuse, neurotic and personality disorders and organic psychoses. The greatest part of these cases were hospitalised for 0 to 3 days only, which points to the importance of crisis intervention provided by somatic departments. By introducing new offers of low threshold detoxification for drug abuse in psychiatry it was possible to increase the percentage of cases treated in psychiatry departments in the years 1993/94 as compared to 1988/89. During the same period the share of cases suffering from all kinds of psychoses decreased in psychiatry whereas the percentage of cases with drug abuse, neurotic and personality disorders rose. In nonpsychiatric departments, diseases seen in the context of alcoholism as well as neuroses and functional disorders prevail among the group of mental disorders. In internal medicine 6% of all cases are related with all kinds of addiction including its respective somatic consequences and 2-3% with neurotic and psychosomatic disorders. Looking at the amount of inpatient days 11.2% are spent for treating alcohol abuse, alcohol psychoses and diseases of liver and pancreas by patients of 15 to 65 years of age. In the light of these results it is suggested to set up psychiatric liaison-services in somatic departments, especially in internal medicine, to deal with psychosomatic and neurotic disorders and of course, alcoholism. This would help to lower hospitalisation costs. The introduction of motivational approach to the treatment of alcoholism in internal medicine departments appears warranted. Such changes of approach would result in new points of emphasis also in psychiatry.
Adolescent↗
Concepts of neurotic and personality disorders in ICD-10: results of the Research Criteria Study.
A discussion on personality disorders (F6) is conducted within the framework of the Research Criteria Study on the basis of one case each of borderline syndrome (F60.31), transsexualism (F64.0), and factitious disorder (F68.1). In the Research Criteria Study the main agreement achieved about personality disorders was 77%, for borderline disorders 94%, transsexualism 91%, and factitious disorders 53%. Additional diagnoses were given in the case of factitious disorder by 43%, for borderline disorders in 15%, and for transsexualism in only 3%. Alternative diagnoses improved the overall agreement about factitious disorders by 21%, about borderline disorders and about transsexualism by 3%. It appears justified to introduce a coding for an alternative main diagnosis. The diagnostic concepts are discussed with respect to practicality, suitability, adequacy and reliability. The raters felt fairly secure about the classification. The research diagnostic criteria proved to be very practical. The raters attributed a high reliability to ICD-10 and, with the exception of factitious disorders, a very valid image of patients.
Borderline Personality Disorder↗
[Indications and prerequisites for psychotherapy].
A list of psychoreactive and neurotic disorders is given, which are often seen in general practice and which are suitable for psychotherapy. These disorders are shortly discussed. Subsequently, a survey of the most important psychotherapeutic methods is given and conditions for a positive outcome are described. Finally, the authors suggest further information on this subject for general practitioners, among others in Balint groups.
Adjustment Disorders↗
Sex differences in the contact rates and utilization of psychiatric services. A three-year follow-up study in northern Finland.
Sex differences in the use of psychiatric services were studied in the Oulu University Central Hospital in Finland during a three-year follow-up. A one-year treated incidence cohort of new patients was used. The total cohort comprised 537 patients (46.7% were males). The annual incidence rate was 6.7 per 1,000 members of the adult population for both males and females. Compared to females, males were younger, more often unemployed, unmarried and lived alone or with parents, and did not as often have an apartment of their own. Males predominated among organic psychoses, personality disorders and dependencies, females among neurotic disorders. Males more often had had previous inpatient care and inpatient care at index contact, and had more admissions, compulsory admissions and emergency outpatient contacts than females. However, there were no sex differences in the use of planned outpatient contacts, in the duration of hospital care and in the total consumption of psychiatric care. Male gender was an independent predictor of hospital admissions.
Adolescent↗
White matter hyperintensities on magnetic resonance imaging of the brain in children with psychiatric disorders.
The current study sought to determine the prevalence, severity, and location of white matter signal hyperintensities (WMH) on brain magnetic resonance imaging assessments of children and adolescents with psychiatric disorders. Seventy-one percent (N = 934) of children admitted to the McLean Hospital Child and Adolescent inpatient treatment unit were evaluated with the Diagnostic Interview Schedule for Children (DISC) within 7 days of admission during the period 1988 to 1993 (total, 1,308 admissions). Four hundred eight of these subjects (43.7%) were referred for brain magnetic resonance imaging (MRI) scans and became our study subjects (mean age, 12.4 years [SD = 2.7]; male/female, 230/178). Study subjects were grouped according to a hierarchical diagnostic system as follows: schizophrenia (n = 42), bipolar disorder (n = 56), unipolar depression (n = 94), conduct disorder/attention deficit disorder (n = 103), and other neurotic disorders (n = 30). Subjects without any level 2 diagnosis on DISC (n = 83) constituted the comparison group. Bipolar disorder, unipolar depression, and conduct disorder/attention deficit disorder groups were significantly more likely to have severe levels of WMH than the comparison group (prevalence rates: 17.9%, 13.8%, 13.6% v 1.2%). In addition, the bipolar disorder group was significantly more likely to have severe levels of WMH than the schizophrenia group (prevalence rates: 17.9% v 2.4%). The frontal lobes were the predominant locations of WMH in the bipolar disorder and unipolar depression groups (76.9% and 60.0%, respectively) and also the most frequent location for the conduct disorder/attention deficit disorder group (35.7%). The current study reports an increased prevalence and severity of WMH in children with bipolar disorder, unipolar depression, and conduct disorder/attention deficit disorder relative to the comparison group and in children with bipolar disorder compared to those with schizophrenia. The development of brain WMH, especially in the frontal lobes, may play a role in the pathophysiology of affective disorders in children and adolescents.
Adolescent↗