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PubMed1994

School consultation and the management of obsessive-compulsive personality in the classroom.

The need for a comprehensive assessment involving areas of ability, personality, and motivation when young people are referred to a mental health service with problems of school failure is discussed. Traits associated with obsessive-compulsive personality style are reviewed, and the impact on school performance explored. Three case examples illustrate the ways this personality style interferes with success in the classroom and the concerns and problems encountered in providing intervention. Particular classroom teaching strategies may assist teacher and student in avoiding these problems. In addition, the benefits of SQ3R, Cornell systems, and cooperative learning are discussed, and warning signals, observable by the teacher, described. The process of mental health consultation, contribution to classroom change, and difficulties encountered along with the advantages of professional partnership in the diagnosis and management of school problems are reviewed.

Adolescent↗
PubMedDate not supplied

[Repeat evaluation of impulsiveness in a cohort of 155 patients with obsessive-compulsive disorder: 12 months prospective follow-up].

UNLABELLED: Relationships between OCD and impulsivity are currently under research. METHOD: In the phase 3 of the national study on OCD, 155 patients suffering from an OCD (DSM III-R criteria, score on NIMH-OC > or = 7) had entered a naturalistic follow-up of 12 months duration. Impulsivity was assessed by using the BDS (Behavioral Dyscontrol Scale, offautoquestionnaire of 24 items) at day 0, 6th and 12th months and a semi-structured interview for Obsessive-Compulsive Related Syndrome and Behaviors Spectrum, as defined by Hollander (DSM III-R criteria). RESULTS: Impulsivity was more intense in females (mean score on BDS 35.6 vs 31.9, p = 0.06), in patients with personal history of anxiety-depression (36.3 vs 32.3, p = 0.04) and suicidal behavior (38.3 vs 33.2, p = 0.06) and familial history of OCD (37.1 vs 33.0, p = 0.07). Moreover, syndromal typology of obsessions or compulsions did not seem to influence impulsivity. In contrast, presence of co-existing OC Related Syndrome was significantly linked to higher impulsivity score, especially with "Intermittent Explosive Syndrome" (mean score = 40.1 vs 30.8, p < 10(-4), "Compulsive Buying" (38.5 vs 32.4, p = 0.005), "Hypochondriasis" (36.7 vs 32.1, p = 0.02), "Dysmorphophobia" (37.1 vs 32.4, p = 0.02) and "Depersonnalization" (37.7 vs 32.9, p = 0.05). Paradoxically, impulsivity was augmented in patients with important to severe slowness syndrome (38.3 vs 31.8, p = 0.001). This mixed association between slowness and impulsivity can be an excellent testimony of "Dyscontrol" phenomenon. In 130 patients who had received an anti-obsessional pharmacologic treatment during 12 months follow-up, impulsivity score was gradually reduced from day 0 (mean score = 34.1) at M6 (24.8-22% reduction) and at M12 (20.1-36% reduction). After one year of follow-up, a decreased by > or = 50% of impulsivity score was observed in 42% of obsessional patients. Finally, the response rate of OCD to pharmacotherapy seemed to be modulated by the dimensions of impulsivity and slowness. In fact, the best results after 6 months of treatment were observed in the sub-groups presenting high level of "impulsivity" (62-66% were responders) versus 39% in the sub-group with important to severe slowness.

Adult↗
PubMed1993

[Obsessive compulsive disorders].

Obsessive compulsive disorders (OCD) are a nosographic entity. Their biological rating in serotonergic pathways and the efficacy of serotonergic antidepressants allows for developing a clinical and biological models of OCD. J. Guyotat, one of the first in 1959 to observe the favorable effects of antidepressants on OCD, presents their history. Epidemiological surveys conducted since 1980 have shown that the prevalence of OCD was underestimated until then. The prevalence is 2 to 3% in the adult population, with more women affected. The disorder develops early in childhood and adolescence. Loss of time is an important criteria for OCD but, according to M. Bourgeois, who reviewed the symptoms precisely, this does not warrant identifying a separate "primary obsessive slowness" syndrome. According to M. Bouvard, the prognosis of the disorder, in contrast to that for rituals observed in children between 3 and 5 years of age, is poor, with a risk of chronicity and social disturbances. The prevalence of OCD in children and adolescents is 0.8% and remains stable. The comorbidity, in particular with tics, is discussed. The favorable effects of fluoxetine are reported. J.M. Chignon reviews the concept of comorbidity, developed in internal medicine, and explains that it could be rigorously applied to psychiatry only starting with the DSM III-R. The comorbidity of OCD with other psychiatric diseases is highly variable: it is reviewed for personality disorders (0 to 55%), schizophrenia (4%), substance abuse (10%) and especially depression: one third of patients with OCD will develop a major depressive episode. Based on a clinical case report, M. Faruch leads us from symptoms to behavior therapy. The symptom must be considered for itself, whether it is part or not of the obsessive neurosis. It is legitimate to use antidepressants in combination with behavior therapy.

Adolescent↗
PubMed1982

[The evaluation of neuroses findings and treatment possibilities on 615 ambulatory psychotherapy patients].

For 615 neurotic and psychosomatic patients who visited two outpatient psychotherapeutic institutions for initial diagnostic interviews the diagnosis of neurosis was made according to the "Psychischer and Social-Kommunikativer Befundbogen" (PSKB; psychic and social-communicative findings sheet) and supplemented by evaluations based up on prognostic scales. This study presents an overview on the frequencies of symptom as well as personality characteristics in these patients. With regard to prognosis and indication of therapy, special emphasis is placed upon those characteristics which provide information concerning the interaction between patient and examiner.

Ambulatory Care↗
PubMed1996

A spectrum for obsession and personality disorders.

Obsession was introduced by Kraepelin in 1915 and has been studied extensively since. When a person with obsession becomes physically exhausted with chronic rumination accompanied by suspicion, he or she is driven to impulsive acts, and develops a personality disorder that displays persistent abnormal activities. Obsession is related closely to depression and schizophrenia. Obsession is induced when uncertainty and instability dominates intelligence and creativity. The current social hierarchy of a strongly controlled society rejects diversity of humanity and often triggers personality disorders. This article reviews obsession and a myth as primitive mentality, normal and abnormal obsession, obsession vs possession, society and obsession/ impulsion/degeneration, obsession and slowness/autism, a recent biological approach to obsession and a spectrum for obsession.

Adult↗
PubMed1975

Personality tests in Ménière's disorder.

The personality of patients with Ménière's disorder has been evaluated using the Eysenck Personality Inventory and the Middlesex Hospital Questionnaire. The most notable finding was an elevated obsessionality score in the patients with Ménière's disorder as compared with other groups. There was no significant difference between the personality of subgroups of patients complying with rigid definitions of Ménière's disorder and those complying with a more liberal definition. The results of most scales decreased with increasing severity of the disorder, although the obsessionality scores do not follow this tendency.

Anxiety Disorders↗
PubMed1994

Temperament, personality, and the mood and anxiety disorders.

Literature on temperament, personality, and mood and anxiety disorders is reviewed. The review is organized primarily around L. A. Clark and D. Watson's (1991b) tripartite model for these disorders, but other influential approaches are also examined. Negative affectivity (or neuroticism) appears to be a vulnerability factor for the development of anxiety and depression, indicates poor prognosis, and is itself affected by the experience of disorder. Positive affectivity (or extraversion) is related more specifically to depression, may be a risk factor for its development, suggests poor prognosis, and also may be affected by the experience of disorder. Other personality dimensions (e.g., anxiety sensitivity, attributional style, sociotropy or dependence, autonomy or self-criticism, and constraint) may constitute specific vulnerability factors for particular disorders. More longitudinal and measurement-based research that jointly examines anxiety and depression is needed.

Anxiety Disorders↗
PubMed1981

The Middlesex Hospital Questionnaire: a validity study with American psychiatric patients.

The Middlesex Hospital Questionnaire (MHQ) was used as a screening test for psychiatric disorder in 169 new outpatients. The profile obtained on the six subscales of the MHQ was strikingly similar in this American sample compared to four previous British reports. The MHQ significantly differentiated between diagnostic groups, most particularly between neuroses and personality disorders. Moreover, 75 per cent of the patients could be correctly classified as either neurosis or personality disorder on the basis of their MHQ total and subscale scores. The MHQ appears to be particularly useful in identifying phobic disorders, and the phobia subscale consistently discriminated between anxiety-phobic states and other diagnostic groups.

Adult↗
PubMed1988

Correspondences and thought-transference during psychoanalysis.

Correspondences, when the analyst has not verbalized his disturbed thoughts and they appear in the patient's spoken associations during analytic treatment, are not due to a single cause. Rather, they occur under a variety of circumstances: chance, coincidence, communication through sensory stimuli and perceptions, sometimes of extraordinary subtlety; or possibly thought-transference. Even if the latter possibility were doubted, the correspondence still may have usefulness as a finding of significance for the treatment process itself. It may alert the analyst to repressive forces directed toward the mix of his disturbing thoughts (reality derived), residues of old conflict areas that these have activated, even if transiently, and also to the current state of his countertransference. Utilizing the patient's associations will increase the analyst's awareness and facilitate the latter's quickly working through of these elements. This will favor progress of treatment. As for the question of thought-transference, preliminary findings suggest that the conditions under which it seems to occur involve the simultaneity of (1) the analyst's tendency to repress disturbing thoughts (including activated infantile residuals) because of guilt at being distracted and (2) qualitatively similar conflictual themes emerging from repression in the patient's unconscious. It raises the question as to whether extrasensory communication is between the unconscious of the two persons involved, occurring at a time when two opposite forces--repression in the analyst and modification of repression of qualitatively similar idea-complexes in the patient--are operative. The subject of correspondences and thought-transference in psychoanalytic treatment requires further study.

Adult↗
PubMed2001

The role of personality in the onset of eating disorders and treatment implications.

The relationship of personality and eating disorders is largely unclear. The development of well-specified conceptual models of this relationship, developments in family history, behavior genetic and prospective longitudinal research methodology, and careful consideration of how trait constructs may interact with state variables to produce or maintain eating disorders all will help to advance this area of research.

Feeding and Eating Disorders↗
PubMed1976

A prospective evaluation of open prefrontal leucotomy.

Forty-three patients received an open prefrontal leucotomy for severe and intractable psychiatric illnesses. As a result of the operation three patients died, three developed personality changes and one had repeated grand-mal seizures. Of the 40 patients followed up for six months, 57-5% showed marked improvement in their clinical state and 30-0% mild to moderate degrees of improvement whilst no patient's condition was considered to be worse. Significant improvement was obtained after operation in the mean scores on the Hamilton Anxiety Scale, the Hamilton Depression Scale, the Beck Depression Scale and the Neuroticism Scale of the Eysenck Personality Inventory. Extroversion, as measured by the Eysenck Personality Inventory, was significantly increased after operation. It is recommended that open prefrontal leucotomy procedures be replaced by the safer stereotactic or electrode implantation techniques and that all psychosurgery be confined to specialist units.

Adult↗
PubMed1987

[Death and neurosis. Anxiety, the death instinct, object loss and narcissism as the background of the human experience of death].

The present study gives an overview of concepts which try to explain the meaning of death in neurosis. Phenomenological-anthropological and psychoanalytic approaches are drawn into consideration. After an introductory phenomenological description the significance of death in symptomatology, in the inducing situation and in psychodynamic is discussed. The attempts to integrate the phenomenon of death into psychoanalytic metapsychology are represented by means of drive theory and objectrelation-theory. In the "anthropological-integrative" concept of death (D. Wyss) death is proved in the experience of time and separation. D. Wyss emphasized the connection between the experience of death on one side and the development of reflection or the process of structuring consciousness on the other side. Experience of time, separation and thinking are closely related with anxiety which may become another keyword for understanding the meaning of death. Finally the author discusses the question whether Narcissistic Neurosis and Narcissistic Personality Disorders could be connected with the unsolved death problem or a denial of death. The "narcissistic human being" is described as someone who is thrown back on himself because he is not able to cope with his basic anxieties, his limitations and his transitoriness.

Adaptation, Psychological↗
PubMed1988

[Comparative effectiveness of the combined use of fenazepam, haloperidol, lithium and metabolic preparations in treating the psychopathologic disorders with obsessions in slowly progressive schizophrenia].

The effectiveness of combined phenazepam, lithium, haloperidol and metabolic drugs (alpha-tocopherol, pyridoxal phosphate, nicotinamide) treatment of patients with slow progredient schizophrenia is analyzed. The psychotropic drugs were administered at doses lower below mean therapeutic ones by 1/2 to 1/3. Combined therapy proved effective even in the cases resistant to active antipsychotic treatment. No considerable untoward effects (extrapyramidal disorders) were found. The therapy had a differentiated impact on the obsessive syndrome and other borderline psychopathologic states. These advantages allow one to recommend the therapy for long-term support in schizophrenic patients with benign course of the disease.

Adolescent↗
PubMed1978

[Differential diagnosis of slowly progressive schizophrenia in children].

Slowly progressive schizophrenia in children is marked in 45.5% of all the cases. This form of development usually cannotes a favourably developing variant of continuous and attack-like schizophrenia, characterized by a gradual increase of psychopath-like (schizoid) personality changes. For this reason it is necessary to differentiate the diagnosis of schizophrenia with the dynamics of psychopathy in children. The paper contains data of some criteria of a differential diagnosis of slowly progressive schizophrenia in relation to early childhood autism, psychic infantilism, obsessional neurosis, pathologically developing age crises and cyclothymia in children.

Adolescent↗
PubMed2004

[Pathological jealousy].

Pathological jealousy can make life unbearable for all concerned. The proximity of this condition to obsessive-compulsive phenomena has given rise to the notion that it might respond to substances of proven value in the treatment of obsessive-compulsive disorders. This case history exemplifies the successful treatment of pathological jealousy with the selective serotonin reuptake inhibitor (SSRI) fluoxetine. The substance not only proved to be a successful antidepressant, but also effectively mitigated the anguish of the patient's pathological jealousy. On the basis of these findings, fluoxetine--as also other SSRIs--should always be considered as a possible effective pharmacological strategy for the treatment of pathological jealousy.

Adult↗
PubMed1992

Predisposition factors in anorexia nervosa.

Since its first recognition, a number of researchers have endeavored to link anorexia nervosa to underlying pathology. For example, in the past, attempts were made to associate anorexia with such psychiatric disturbances as schizophrenia, anxiety disorders, and obsessive-compulsive and antisocial personality disorders. Most recent efforts have focused on the possible link between anorexia nervosa and affective disorders. This article reviews the literature concerned with investigating psychiatric disturbances and genetic variables hypothesized as predisposing factors in the etiology of anorexia nervosa. Particular emphasis is given to research which discusses the association between anorexia nervosa and depression. Psychopharmacological evidence and family genetics studies are reviewed. Suggestions for future research are also made.

Adolescent↗
PubMed1977

Obsessional personality disorder and remembering.

Patients suffering from obsessional personality disorder (anankasts) have been described as possessing 'superior memories', because of the detailed precision of their accounts. At the same time, such classical phenomena as doubt, checking and rumination imply faulty recall. This paradox is discussed, and some predictions drawn from a hypothesis regarding the cognitive charactteristics of obsessional disorder. Findings are presented which indicate that, by comparison with matched psychiatric controls, anankasts do not excel in the long-term recall of factual information or meaningful anecdotal material. But they show the following mnemonic features: (a) Superiority of immediate memory span, reflecting high levels of attention. (b) Superior recall of ambiguous anecdotal material, reflecting a tendency to the pointless 'rehearsal' of such material. (c) Weak redintegration in personal reminiscence. It is suggested that anankasts' doubts about their remembering refer not so much to the correctness of what is being recalled as to the quality of the recalling itself.

Compulsive Personality Disorder↗
PubMed2005

Relationship between two aspects of perfectionism and obsessive-compulsive symptoms.

In this study was investigated the relationship between two aspects of perfectionism (Concern over Mistakes and Personal Standards) and obsessive-compulsive symptoms. College students (57 men and 193 women: M age = 19.5 yr., SD = 1.9) majoring in psychology were from introductory psychology classes and a psychological assessment practice class. They completed the Padua Inventory, which assesses obsessive-compulsive symptoms, and the subscales of Concern over Mistakes and Personal Standards of the Frost Multidimensional Perfectionism Scale, which assess the tendency to be concerned about making mistakes and the tendency to set excessively high standards, respectively. Multiple regression analysis indicated that only the Concern over Mistakes scores predicted significantly all Padua Inventory subscale scores. Perhaps only being concerned over making mistakes may be associated with obsessive-compulsive symptoms. The tendency to set high standards was not strongly correlated with obsessive-compulsive symptoms. Further, the relationship between setting high standards and having obsessive-compulsive symptoms reported in previous studies may be spurious. Further work is required to untangle these associations.

Adult↗