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[Psychodermatology: current state of the problem].

An analysis of comorbidity of psychiatric and dermatological pathology in historical, epidemiological and clinical aspects is presented. Psychocutaneous disorders (delusional parasitosis, hypochondria circumscripta, obsessive-compulsive disorders with self-mutilations, pathomimia) play a central role in systematics elaborated in the present study. The authors suggest that delusional parasitosis is a subtype of paranoiac psychosis (paranoia, paranoiac schizophrenia). Psychiatric disorders triggered by dermatological pathology were specified as nosogenous reactions, depressive reactions with sociophobia, pathologic personality development (paranoiac, sensitive, hypochondriac). Atopic dermatitis, eczema, urticaria, psoriasis, herpes simplex, alopecia areata, rosacea, etc, are regarded among dermatological psychosomatic disorders with psychogenic manifestation/exacerbation.

Comorbidity↗

[Standards, Options and Recommendations 2004: good practice guidelines for second opinion in anatomic and surgical pathology in oncology (integral report)].

CONTEXT: The " Standards, Options and Recommendations" (SOR) project, which started in 1993, is a collaboration between the French Federation of Cancer Centres (FNCLCC), the 20 French Regional Cancer Centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. OBJECTIVE: To develop good practice guidelines for second opinion in anatomic and surgical pathology in oncology, in collaboration with the French Society for Anatomic and Surgical Pathology. METHOD: The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts who define the CPGs using the definitions of the Standards, Options and Recommendations project. Once the guideline has been defined, the document is submitted to independent reviewers for review. RESULTS: The working group defined four types of second opinions in anatomic and surgical pathology: personal consultation, inter-institutional consultation, peer review consultation for a scientific survey, intra-departmental consultation in the context of quality control. The main recommendation is that second opinion should respect the patients' rights and the medical ethics code. For each of the four situations defined recommendations have been developed, taking this principle into consideration.

Ethics, Medical↗

[Mental disorders in women during menopause].

Altogether 126 patients with mental disorders of the non-psychotic nature, that occurred for the first time during menopause were examined. Different vegetative disorders (hot flush, hyperhidrosis, blood pressure fluctuations, asphyxia sensation, numbness of the limbs, skin burning, chill, pruritus) played the leading part in the clinical picture. The mental disorders manifested in the form of extensive age-related , asthenic, hysteric, phobic and depressive disorders. The long-term climacteric was likely to give rise to the formation of a pathological personality.

Adult↗

Religious-ethnic groups in Romania--correlations between lifestyle and health status.

The purpose of this study was to determine the influence of the lifestyle factors from Romania on the state of health, to underlie the significant ethnical and/or confessional differences between the lifestyle and, respectively, their influence on the state of health. Our research group included 242 persons (males 88, females 155), the majority of them living in rural areas. We interviewed the subjects with the use of a questionnaire, we clinically and paraclinically investigated each and every one. The studied multi-ethnical and multi-denominational group is part of the small income population, with elementary education, with a simple and harsh way of life. Use of alcohol and tobacco is very low, overweight persons (18%) and first grade obese persons (36%) constitute more than half of the studied group. One third of the subjects present increased values of cholesterol and/or triglycerides, with an accent on men, having a metabolic syndrome with increased vascular risk. Symptomatology also correlates with the type of diet with fewer symptoms for ovo-lacto-vegetarians and also less personal pathology. Religious affiliation is determinant for the lifestyle and state of health, in comparison to ethnicity, which tends to be neutral in our study. Beliefs and religious affiliation tend to favor a lifestyle free of risk.

Body Mass Index↗

Cardiovascular risk factors and risk behaviors in railway workers. Professional stress and cardiovascular risk.

UNLABELLED: The research considers the hypothesis that stressful professions, such as engine driver, influence the morbidity and mortality through cardiovascular diseases and favour some harmful habits with an impact upon cardiovascular morbidity. METHODS: There were selected for study 496 engine drivers, males, and a control group of 305 males. They were questioned about: name, address, family history, pathological personal history, alcohol intake, smoking, diet habits, physical activity, sleeping hours and stress perception. There were measured: height, weight, blood pressure. There were determined: fasting plasma glucose, cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol. RESULTS: Hypertension was registered in 23.5% of the engine drivers and in only 9.5% the control group (P<0.05). Dyslipidemia was noted in 57.4% of the engine drivers and 52.45% of the control group. Prevalence of smoking and overweight was higher in the control group. Unhealthy dietary patterns and physical inactivity were present in both groups, the circadian rhythms were altered only for engine drivers and questionnaires for stress perception showed higher irritability in the control group. CONCLUSIONS: The prevalence of some risk factors is higher for engine drivers, but for the others it is not. Also it seems that professional stress favours some harmful habits such as tobacco smoking, but the control group smokes more and they are inactive individuals with a great amount of irritability. The results do not totally sustain the idea we started from, that engine driver is a stressful profession; it seems that the effort/reward imbalance is more important than job-demand itself.

Adult↗

[Importance and extension of the qualitative approach in phenomeno-structural method in psychopathology].

Fundamental principles of phenomeno-structural method partly originate from a phenomenological approach in psychiatry for which, as Jaspers says, "the important thing is less the study of innumerable cases than the intuitive and major comprehension of some particular ones". It means that, far from traditional statistical proceedings, it does not give any priority to the temptation of a cumulative and accumulative collection of data, for which it even receives their greatest misgivings, leaving it out of its procedures. This method also owes a lot to Bergson's insistence on the qualitative characteristics of the "immediate data of consciousness" and of experienced temporality, for which analytical and chronological fragmentations can do nothing but distort the authentically comprehensive grasping, and make them loose their specificity, unity and thus the indecomposability that, by nature, they precisely contain. According to Eugene Minkowski, the psychopathical break-up, proceeding from the deep heart of life, is essentially going to express itself, with its own properties, as a qualitative modification. In this way, the study of some cases carefully chosen, in accordance with their "typical" value, is more important than a blind acquisition of data, i.e. without previous option, orientation or perspective. Starting from their spontaneous words collected during a conversation, the meticulous analysis of the language of the patients, put in resonance with the vivid metaphors of the language in which they are expressed, as Minkowski will so brilliantly show, or via mediations connecting image and language, as in the experiment of the Rorschach--particularly approached in its essential mechanisms by his wife Francoise Minkowska--represents, from this point of view, a mediator and an irreplaceable instrument of a qualitative approach of a normal as well as a pathological personality and, more widely, of the person itself.

Humans↗

[Special care in dentistry. The therapeutic relationship].

Psychological relationship dentist-patient and psychological education of the dentist are in special dental care very important. In fact the patients with medically complex conditions--patients at risk--often present an altered perception of the reality and behavior, therefore they seldom can co-operate during the operating session. It is then very important to carry-out a psycho-pathological diagnosis, which can avoid a dentist's wrong behavior. Anxiety rate, pathological personality and comprehension level are finally studied.

Aged↗

The tormentor and the victim in the nursery.

In our research nursery study of the emergence and vicissitudes of aggression, we had the opportunity to observe the unfolding of a particularly intense tormentor-victim relationship between two boys aged seventeen and nineteen months. Through the large body of developmental information we have accumulated about both of these toddlers, we have been able to explore the infantile roots of what we view as the erotization of aggression. We see the fusing of aggression with libido as playing a crucial role in both normal and pathological personality formation.

Aggression↗

[Functional, involutional and pathological oral changes with age. 6. Systemic disease].

The present study was realized to determine the frequency variety and concentration of old and new health disease in patients attending a school of Dentistry, classification to an age variable. This paper ends a series of articles about estomatological changes associated to an aging process. The main findings indicate that when patients grow older an increment in variety and number of pathological personal background. The results suggest a very well defined difference in the prevalence and concentration among subjects over and under 50 years. The risk factor was 1:1 in patients older than that. The importance of considering the Clinical history in patients as a determining factor in the global dental evaluation, for the decision. making in treatment planning.

Adult↗

[Are psycho-organically disordered children inconspicuous as adults? A follow-up study of 125 probands].

ADD is very well known in english speaking countries (DSM III 26-29). At first american authors have demonstrated that psycho-organic disturbances do not disappear in all cases of adulthood. Attention deficit disorders, lack of concentration, weak short time memory, word finding difficulties, visuo-motor function deficiency, lability of mood, impulsivity, lack of self-control will often be found in adults. A defective ego-function seems to be the central disorder. These patients often grow up to pathologic personalities with a propensity to neurosis, addiction, various types of psychosis, namely to schizophrenia. With consideration to the heterogeneity of ADD, MDD hyperkinetic syndrome, psycho-organic syndrome etc. accurate follow-up studies are necessary for a better delineation on this nosological concept. Therefore we have investigated the development of 78 psycho-organic patients of our out-patient department. The first examination was made at the age of 10 years and the second ten years later. We obtained the following results: 1/3 of all patients were free of mental symptoms at the main age of 23 years. 1/2 presented slight symptoms in the cognitive field and/or in the emotional life, but vocational training and social adjustment were not impaired. 1/6 of the patients showed no improvement. They had remained in their family, still need care and help and were unable to accomplish professional training. These findings were compared with those of two groups of healthy persons (20 recruits of the swiss army and 27 female students of a nursing school). The differences were statistically significant in several dimensions.

Adolescent↗

[Viral meningoencephalitis. A clinical study of 1,052 patients].

1,052 medical histories of patients discharged from "Pedro Borrás Astorga" Pediatric Teaching Hospital with a diagnosis of non-urlean viral meningoencephalitis are reviewed. These cases occurred in the period October 1985-March 1986 and they were followed regularly on an outpatient basis for 1 year. The discharges were comparatively analyzed as regards months in the semester, age, sex, nutritional status, personal pathologic history, time from onset of disease to hospitalization, symptoms and signs of onset, diagnostic impression at hospitalization, evolution, and complications.

Adolescent↗

Murder.

Kernberg's concept of the malignant narcissist defines a realm of pathologic personality characterized by the coexistence of marked narcissistic and antisocial traits. This realm comprises what may be seen as a continuum of cases: persons at one end whose inhumanity and propensity toward evil are of modest proportions; at the other, persons manifesting extreme degrees of these qualities. The author has used the biographies of notorious murderers in constructing a scale of malignant narcissism. This scale should aid in defining more clearly the limits of amenability to psychotherapy.

Antisocial Personality Disorder↗

[Pedophilic-voyeuristic behavior].

It is reported on a 26 year-old man with a paedophilic-voyeuristic behavior in the frame of a sexual abnormal development on the basis of a primary sexual pathological personality structure (Szewczyk). The maldevelopment has be expressed monosymptomaticly in the sphere of sexuality.

Adult↗

[Treatment of alcoholism by affective counterattribution].

A new narcopsychotherapeutic technique termed "affective counterattribution" (ACA) is offered to treat alcohol addiction. The use of ACA increased the effectiveness of alcoholism treatment that was ensured by association of strong pharmacogenic negative emotional experience coupled with bright hallucinatory images to notions of alcohol and alcohol-related stimuli. Alcoholic attitude was destroyed and the patients' pathological personality traits were corrected.

Abreaction↗

[Alcoholism--development and treatment from the psychoanalytic viewpoint].

Based on psychoanalytical explanatory models 4 groups of alcoholics can be distinguished: 1. Alcoholics with severe character disorder use their drug as a mean of self-punishment by self-destruction. 2. Alcoholics with low ego strength use alcohol as a stimulus barrier in an attempt at self-healing. 3. In predominantly neurotic patients alcohol consumption is considered as a regression to an oral level of drive satisfaction. 4. Alcoholism as a reaction to adverse life events is not adequately taken into account by classical analytical theory. Depending on the predominant level of personal pathology differential treatment indications are recommended.

Alcohol Drinking↗

[Obsessive-compulsive behavior caused by bilateral lesions of the lenticular nuclei. A new case].

Another case of obsessive behaviour as the consequence of lentiform nuclei lesions is reported. All the aspects of an obsessive neurosis were present: irresistible compulsiveness, acute anxiety in case of non accomplishment, magic-like clues. The symptoms appeared after a carbon monoxide poisoning, in a 31-years-old woman who had previously a pathological personality, of the psychopathic type, but without obsessive features. The onset of compulsions was paralleled by frontal-like psychological changes, but there was no reduction of intellectual or mnesic functions. A previous depressive state continued after the poisoning, so that the patient did not show an empty mind as did the other patients; the loss of "self-psychic activation" was only partial. All these case-reports emphasize the fact that the neuropsychological testing must not be limited to the behaviour and must investigate the "mental content" as well. They also lead us to emphasize similitudes between psychic disorders related to lenticular lesions and those related to frontal lobe lesions, including obsessive-like activities. Such case-reports provide a model in which some components of the obsessive neurosis, hebephrenia and depression are the consequence of an identified brain damage. It can be suggested that the neural circuits involving frontal lobes and parts of the neostriatum and of the pallidum are implicated in the mechanisms of these three types of psychoses.

Adult↗

[Routine double-contrast radiographic examination of the esophagus].

The authors evaluate the opportunity of extending the double-contrast technique to the X-rays examination of the esophagus, with particular regard to physical and chemical features of barium compounds used at present for the X-rays study of digestive tract. The authors expose the results of this kind of X-rays examination in the most important fields of esophageal pathology. Personal experience actually demonstrate the opportuny of extending the double-contrast technique to routine practice, as a first approach to the double-contrast study of the upper digestive tract.

Air↗