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PubMed1984

[Sonography of the abdomen as a screening method].

Abdominal ultrasonic screening of patients clinically asymptomatic of abdominal disease was performed in 5 720 subjects. In these asymptomatic persons pathological ultrasonic findings were reported in 47.1% of all cases, but these were mostly without clinical relevance. This is especially true for diffuse liver disease (30.9%), asymptomatic gallstones (6.1%), and typical renal cysts (5.7%). Asymptomatic malignant abdominal tumours (0.2% or 13 cases) were detected very rarely, and were found to be mostly renal carcinomas.

Abdomen↗

PubMed1983

[Use of vitrectomy instruments in anterior segment surgery].

The use of vitreous surgery instruments in anterior segment surgery is described. The bimanual ocutome technique has been used, in some cases in combination with the special infusion/cutting needle. Three different approaches (limbus, pars plana, limbus and pars plana) are illustrated. The choice of surgical procedure is discussed; it depends mainly on the anterior segment pathology. Personal views and experience (64 eyes) are compared with those of other authors.

Adolescent↗

PubMed1999

Oocyte donor selection from 554 candidates.

Oocyte donation is a technique in full expansion in the field of human reproduction. The main problem with this technique is the shortage of oocytes. In our programme, prospective donors are selected from anonymous, well-informed university students over 18 years of age, who give their informed consent in writing. Before being accepted as donors, the candidates' personal and family medical histories were taken and they were given a gynaecological examination, genital ultrasonography, and analysed for syphilis, acquired immune deficiency syndrome, hepatitis B and C, coagulation factor VIII, fetal haemoglobin and karyotype. The donors received economic compensation of about 750 euros. Over the last 6 years, 554 medical histories have been taken. Fifty-eight candidates (10.5%) were rejected because of previous family or personal pathologies. Only 243 out of 496 (49%) continued the study. Sixteen candidates (7%) were rejected as a result of gynaecological problems and ultrasonographic results; and 12 (4.9%) as a result of their blood test results; 215 donors were accepted (38.8% of the original population). Other options for recruiting oocyte donors are commented on and we argue that the methodology described here is the most suitable one.

Adult↗

PubMed1984

Psychological aspects of essential blepharospasm.

Evaluation of 20 essential blepharospasm patients by using structured interview and psychological testing (MMPI, Rorschach) revealed characteristic pathological personality patterns in all cases. Recent losses or life change, marital conflict, and specific precipitating events were common. Test findings indicated unexpressed hostility, denial, and repression in a majority of women. Three of five men showed evidence of depression. This initial systematic investigation of psychological factors in blepharospasm supports the hypothesis that neurological and psychogenic factors may interact etiologically. The data suggest that personality, recent stress, and precipitating events warrant both clinical assessment and controlled research to determine the specificity and prevalence of these findings.

Adult↗

PubMed2001

Stigma as a barrier to recovery: Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence.

OBJECTIVE: Major depression is undertreated despite the availability of effective treatments. Psychological barriers to treatment, such as perceived stigma and minimization of the need for care, may be important obstacles to adherence to the pharmacologic treatment of major depression. The authors examined the impact of barriers that were present at the initiation of antidepressant drug therapy on medication adherence in a mixed-age sample of outpatients with major depression. METHODS: A two-stage sampling design was used to identify adults with a diagnosis of major depressive disorder, as determined by the Structured Clinical Interview for Diagnosis, who sought mental health treatment at outpatient clinics. Additional instruments were administered to 134 newly admitted adults who had been taking a prescribed antidepressant medication for at least a week to assess perceived stigma, self-rated severity of illness, and views about treatment. The patients were reinterviewed three months later and were classified as adherent or nonadherent on the basis of self-reported estimates of the number and frequency of missed doses. RESULTS: Medication adherence was associated with lower perceived stigma, higher self-rated severity of illness, age over 60 years, and absence of personality pathology. No other characteristics of treatment or illness were significantly related to medication adherence. CONCLUSIONS: Perceived stigma associated with mental illness and individuals' views about the illness play an important role in adherence to treatment for depression. Clinicians' attention to psychological barriers early in treatment may improve medication adherence and ultimately affect the course of illness.

Adaptation, Psychological↗

PubMed1996

Verbal creativity, depression and alcoholism. An investigation of one hundred American and British writers.

BACKGROUND: An earlier study of 291 world famous men had shown that only visual artists and creative writers were characterised, in comparison with the general population, by a much higher prevalence of pathological personality traits and alcoholism. Depressive disorders, but not any other psychiatric conditions, had afflicted writers almost twice as often as men with other high creative achievements. The present investigation was undertaken to confirm these findings in a larger and more comprehensive series of writers, and to discover causal factors for confirmed high prevalences of affective conditions and alcoholism in writers. METHOD: Data were collected from post-mortem biographies and, where applicable, translated into DSM diagnoses. The frequencies of various abnormalities and deviations were compared between poets, prose fiction writers, and playwrights. RESULTS: A high prevalence in writers of affective conditions and of alcoholism was confirmed. That of bipolar affective psychoses exceeded population norms in poets, who in spite of this had a lower prevalence of all kinds of affective disorders, of alcoholism, of personality deviations, and related to this, of psychosexual and marital problems, than prose fiction and play writers. CONCLUSIONS: A hypothesis is developed, which links the greater frequency of affective illnesses and alcoholism in playwrights and prose writers, in comparison with poets, to differences in the nature and intensity of their emotional imagination. This hypothesis could be tested by clinical psychologists collaborating with experts in literature on random samples of different kinds of writers.

Alcoholism↗

PubMed1977

Clinical problems and levels of psychosomatic dysfunction.

As an introduction, some doctrinary and technical problems dealing with the complexity of the human mind and the possible approaches to investigate and treat the personality are discussed and, among them, the "medical model" is emphasized. A brief description of some cases in the author's experience are presented; they, at first, had been very difficult to diagnose. However, after some time, they were found to be of indisputable neuro-psychogenetic pathogenesis. The psychosomatic aspects of each case are analyzed, with emphasis on the different levels of pathogenic action and the means of elaboration to defend and readapt the affected personality, resulting in its final clinical expression. There are four possible levels where the primary dysfunction may act; (a) physiopathologic neuronal level; (b) cerebral subsystemic level; (c) psychodynamic level; (d) psychosocial level. The primary dysfunction, acting as a new stimulus on each of these levels, may determine in the personality pathologic responses that may assume very complex clinical situations. Many of these responses are quite different from the precipitating primary dysfunction, although there are still many evident links among them.

Adolescent↗

PubMed1989

Psychiatric assessment of leg fracture patients: a pilot study.

Of 200 consecutively admitted leg fracture patients, 101 consented to be screened for psychopathology using the BSI and SMAST questionnaires. Probable cases of psychopathology were referred for diagnostic psychiatric evaluation. Of the participants, 80.2 percent were identified as possible psychiatric cases. Diagnostic evaluation revealed high prevalence of substance abuse (66.0%), depression (46.8%), and personality pathology (38.3%). Accident victims tended to be single young males. Accidents occurred mostly during leisure hours, and were often associated with alcohol use. Psychiatric assistance appears essential in the management of such patients. Psychiatrists need to be especially knowledgeable about chemical dependency, interpersonal issues and psychotherapy.

Accidents↗

PubMed1994

Levels of psychopathology at hospital admission and discharge: the Million Clinical Multiaxial Inventory as a prognostic measure.

This study compares two pathological personality disorder scales and two severe clinical syndrome scales from the Millon Clinical Multiaxial Inventory in relation to clinical change from admission to discharge on the major dimensions of the Brief Psychiatric Rating Scale. For a sample of 52 inpatients, 17 with schizophrenia, 27 with major depression, and 8 with bipolar (manic) disorder, we investigated the prognostic utility of these Millon scales for identifying clinical improvement. Findings indicated that, while the Millon scales identified admission levels of psychopathology on three Brief Psychiatric Rating Scales, the Millon inventory predicted clinical improvement on only the brief rating of Thinking Disturbance. These findings are considered in light of prognosis as a clinical research question that is distinct from diagnostic discrimination and case identification.

Adult↗

PubMedDate not supplied

[Therapeutic strategies for depression].

To date, no one antidepressant medication has been proven to be more efficient than another. Physicians are still waiting for good criteria to select which antidepressant has more chances of being effective in certain patients. Nevertheless, guidelines for antidepressant prescription could improve the rate of success in treating depression. All antidepressant medications share the same indication: a major depressive episode. Some compounds have indications other than a major depressive episode, which may be taken into account by the prescribing physician. Many researchers have tried to identify predictive criteria of response to antidepressants. The predictive clinical criteria include: endogeneity, early response, severity and duration of depression, pathological personality traits, quality of the environment, and co-morbid organic abnormalities. Paraclinical criteria have also been studied: levels of monoamines, neuro-endocrinological parameters, enzymatic activities, polysomnography, and brain imaging. Different recommendations have been proposed to guide therapeutic strategies from the acute period to the post-acute period, but three items have been mentioned most often: risk of negative side effects, patient expectations, and level of proof of efficacy of the compounds. Mild to moderate major depressive episodes raise a difficult question: can psychotherapy be an alternative option to antidepressant medication?

Antidepressive Agents↗

PubMed1988

EEG maturation on children with different economic and psychosocial characteristics.

It has been shown that EEG maturation can be described in terms of regression equations on age of broad band EEG frequency parameters. In the present paper six groups of children with different economic and psychosocial characteristics of three countries were studied. Regression equations on age of the EEG relative power (expressed in percentages of the total EEG activity) in the delta, theta, alpha and beta bands in 8 bipolar derivations were computed in each group of children and the slopes compared with those previously published by John et al. (1980). Those children who grew up with adequate nutritional, sanitary and cultural environmental conditions showed the same slopes as U.S. and Swedish children selected with strict criteria of normality. Children nourished in poor socioeconomic and sanitary environments and who frequently had pathological personal antecedents with risk factors associated with brain damage showed either a slow maturation of the EEG characterized by smaller slopes of theta relative power or a great variance of EEG parameters and no relation of these parameters to age.

Child↗

PubMed1992

The stress of marriage to an alcoholic.

1. Historically, wives of alcoholics have been described as having disturbed, pathological personalities that were instrumental in causing and maintaining their husbands' drinking. More recently, researchers have tended to support the view that the behavior of these women reflects their stressful circumstances. 2. The women in the study reported interpersonal, extrapersonal, and intrapersonal stressors. The most frequently reported and highest ranked stressor was their relationships with their husbands. 3. Sobriety does not necessarily mean that stressors disappear. 4. More research is needed for nurses to have the knowledge necessary to help wives of alcoholics to cope with their stressors.

Adaptation, Psychological↗

PubMed1976

[Long-term stable remissions in slowly progressive juvenile schizophrenia].

Protracted stable remissions without residual psychotic disorders are not homogenous while as their typology to a great extent depends upon the clinical picture of the previous attack and the differences in the structure and degree of negative changes. The most stable remissions appeared to be those where the negative disorders did not go beyond the pathological personality changes (pseudopsychopathic states) which by their structure were similar to the expansive pole of schizoid psychopathy. After more polymorphic attacks the remissions had a more deep register of negative disturbances, with signs of a sluggish development, increasing the probability of repeated attacks.

Adolescent↗

PubMed2002

[Dynamics of neurotic depression in children and adolescents].

Seven hundred thirty nine children and adolescents with neurotic depression (293 male, 446 female, aged 1-17 years) have been examined. Depression was mildly expressed in 90.9% of the cases and moderately--in 9.1%. In clinical picture anxious, asthenic, astheno-anxious and anxious-melancholic depression types were present. In neurotic depression in children and adolescents, the initial (the first) and subsequent (the second) stages have been detected. In a case of favorable development of the disease it stops at the initial stage. In a case of poor prognosis (192 patients) the dynamics of disease was distinguished by 3 features: increase of somatization and development of psychosomatic disorders (119 patients), endogenization (45) and formation of pathologic personality changes (28). During treatment clinical variants of disease and its dynamics peculiarities in the every stage are suggested to be taken into account.

Adolescent↗

PubMed2002

[Clinical features and psychopathology of factitious disorders].

Factitious disorders are characterized by self-produced symptoms and a chronic course, sometimes with severe complications. Pathomimia occurs more often in women, even though the Munchausen syndrome is found especially in men. Among the various clinical features of pathomimia, the most frequent are factitious fevers and cutaneous pathomimia. Factitious psychiatric disorders are not rare, such as factitious psychotic symptoms, mournings or post-traumatic stress disorders. The main elements of diagnostic orientation are the odd expression of the reported symptoms, a capricious and disconcerting course, as well as the multiplicity of the previous history, with many imprecise diagnoses. Concerning the psychopathology, and contrary to the simple simulation, immediate utility of the alleged symptoms is not the expected goal, one of the essential psychological motivations being to challenge the physician. Among comorbid pathological personalities, there seems to be some close relations between pathomimia and hysterical personality, whereas the Munchausen syndrome shares common features with antisocial personality.

Adult↗

PubMed2002

[Psychic disorders and excessive daytime sleepiness]

Hallucinations (mainly visual), psychosis and excessive daytime sleepiness are potential side-effects of dopaminergic treatment. They may require a reduction or suppression of dopaminergic agonists, and the prescription of atypical neuroleptic agents or vigilance-enhancing drugs. The recent description of narcolepsy-like sleep onset in rapid eye movement sleep periods synchronous with hypnagogic hallucinations in patients with dopaminergic-induced psychosis or excessive daytime sleepiness, suggests that the mesodiencephalic lesions may predispose to the psychic effects of dopaminergic treatment. Disease-related mood disorders, sexual compulsions, gambling or levodopa addiction may also be amplified by the antiparkinsonian treatment. These complications illustrate the neuro-psychic aspect of Parkinson's disease: psychic troubles may result from a subtle balance between the direct effects of drugs, the pre-morbid pathological personality and the cortical and subcortical lesions.

Journal Article↗

PubMed2002

[Psychic disorders and somnolence].

Disorders of Excessive Somnolence↗

PubMedDate not supplied

[Study of eating habits in a female population comparing groups with and without food-related diseases].

GOAL: To analyze female subjects in the rural setting to detect food-related disorders and factors associated with these. To isolate these factors and prevent the development of food-related disorders in Primary Health Care. Also to assess continuity in the alterations in the general, sub-clinical and bulimic populations. SCOPE AND SUBJECTS: 127 women with absence of dysfunctions: 57 sub-clinical and 63 bulimics, all from south-western Spain. INTERVENTIONS: Those adolescents at risk of dysfunctions would present positive results in pathological personality traits; therefore, their identification in Primary Health Care would avoid the transition to complete forms and would be favour the theory of the continuum. RESULTS: Significant differences were found between sub-clinical and bulimic women for mean age and age of onset of eating-related difficulties. Subjects without eating-related dysfunctions have a lower body mass index (BMI) than sub-clinical ones and the latter have less than bulimic subjects, both now and in the past. The objective and subjective history of excess weight was recorded for all three populations, together with eating-related behaviour and the various symptoms suggesting personality disorders, and data on their consumption of toxic substances. CONCLUSIONS: In our sample, 30% of the population obtained scores above the cut-off value in the two scales used, so they could be considered at risk for having food-related dysfunctions and it is necessary to take action at the level of Primary Health Care, as it is in the transition from childhood to adolescence that diets are begun to be followed because of an excessive assessment of weight and it is in this sphere that early action can be taken.

Adolescent↗