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PubMed1987

Prospective study of course of illness in schizophrenia: Part III. Treatment and outcome.

In a prospective study of 86 schizophrenic patients (ICD 9), outcome data were obtained for 86 percent 1 year after clinic discharge. The Strauss-Carpenter outcome scale (frequency of social contacts, employment duration, symptomatology, and duration of rehospitalization) served as the outcome criterion. The Strauss-Carpenter prognostic scale items served as the potential predictors of the course. The followup treatment, which took place during the catamnestic period, was compared with that of other psychiatric diagnostic groups with respect to its continuity and efficiency. The following findings emerged: When compared to patients with neuroses and alcohol dependency, the followup treatment of schizophrenic patients in a large city seems to be better ensured. This is attributed to a clearer concept of treatment for schizophrenic patients. The comparatively favorable outcome of this group of patients seems to be related to this. For the other groups, especially for neurotic disorders, effective treatment concepts have still to be developed and evaluated. Schizophrenic patients receiving continuous neuroleptic medication are rehospitalized significantly less often (28 percent) than those not in continuous treatment (55 percent). This treatment difference is most obvious for patients with multiple admissions. Differences dependent on treatment are not found in other outcome dimensions. However, patients with good heterosexual adjustment profit the most from continuous treatment with neuroleptics in reference to freedom from symptoms. For a more chronic subgroup with a poorer initial level of work adjustment, the functional level deteriorates over the course of illness. Relapse and inpatient readmission are related to retarded recompensation, particularly for chronic patients. This underlines the need for consistent neuroleptic treatment.

Adolescent↗
PubMed1997

Symptoms of neuroses: profile patterns and factor structure of clinic attenders with non-psychotic functional psychiatric disorders.

Consecutively referred out-patients (n = 102) with non-psychotic functional psychiatric disorders were examined. Nine syndrome scores (panic attack, phobic anxiety, generalized anxiety, obsessive-compulsive, dissociative, conversion, somatoform, depersonalization, and depressive) showed patterns corresponding to ICD-10 diagnoses. However, some also showed moderate correlations between each other. Factor analysis revealed that the nine syndrome scores could be accounted for by three factors-anxiety and somatic, depression and obsessive-compulsive, and hysterical. These findings cast doubt on the nosological specificity of the recent categorization of neurotic disorders. Furthermore, the symptom constellations identified in this study may be culture-bound.

Adolescent↗
PubMed1980

Clinical and pharmacokinetic factors affecting response to phenelzine.

Sixty patients, 30 with depressive neurosis, 15 with anxiety neurosis and 15 with phobic anxiety states, were treated with the monoamine oxidase inhibitor, phenelzine, in two different dosage schedules for four weeks. All patients received an initial dose of 15 mg daily, increasing to 30 mg daily between the third and seventh day, but subsequently, using double-blind procedure, one group tooke the commonly prescribed dose of 45 mg daily and the other took 90 mg daily. Acetylator status was independently determined before the start of treatment. Each diagnostic group showed a similar response to treatment, but patients taking the higher dose improved significantly more than those taking normal dosage, and the rate of improvement, measured by weekly self-ratings, was also more rapid with higher dosage. Acetylator status did not affect clinical response. The results suggest that dosage is more important in determining clinical response to phenelzine in neurotic disorder than specific diagnosis or acetylator status.

Anxiety Disorders↗
PubMed1977

[Psychiatric aspects of low back pain (author's transl)].

Chronic low back pain is more significant from the psychiatric point of view than the acute pain. As a persistent pain of organic origin it leads to typical psychopathological symptoms ("algogenic psychosyndrome"). The algogenic psychosyndrome must be differentiated diagnostically from neurotic developments and masked depressions. Psychosomatic low back pain is a warning of failure in the accomplishment of professional or family duties and chronic and chronic inhibited aggression. - An interdisciplinary study of the courses of 50 patients operated on for prolapse of the lumbar intervertebral disk showed that the psychopathological picture and the pain syndrome are usually determined by several factors. The majority of neurotic disordered personalities developed symptoms of new syndromes after the operation.

Adult↗
PubMed1980

[Chronic neuroses and their treatment].

Research in epidemiological psychiatry begins to find methods which allow a sufficiently reliable and valid assessment of the prevalence and incidence of neurotic disorders. Neuroses seen by psychiatrists more often show a chronic development than those seen by general practitioners. Chronic neurotic patients run a higher risk of somatic disorder but rarely become addicts. A minority only of equally disturbed neurotics receives any kind of treatment. This is only partially explained by the uneven distribution of services by region and social class. --According to twin research results, whether a neurosis appears at all, and its severity and chronicity, seem to be less influenced by heredity than the "choice" of symptoms. Controlled research begins to outline indications for the various forms of psychotherapy. One of the most important results is that psychotherapy does not have to last long to be helpful. Many neurotics, however, remain ill in spite of being treated. Unfavourable familial and other psychosocial factors can sustain the disorder, whereas unforeseen changes in the life situation may occasionally lead to late recovery.

Chronic Disease↗
PubMed1989

[Sleep disorders in adolescents and youths with atopic dermatitis and its pharmacologic correction].

Clinical and actographic examinations of various sleep stages in 52 patients with atopic dermatitis have revealed a variety of sleep disturbances in the majority of cases. 56% of the examinees fell asleep with difficulty; it took them 1.5 times longer to fall asleep, vs. the normal subjects. Not deep sleep with frequent awakening at night has been recorded in 67% of the patients, and 42% did not feel rested after night sleep. The type of sleep disturbances depended on the clinical structure of mental disorders, that included asthenic (42%) and depressive (39%) disturbances with explosive, anxiety, and phobic symptoms. Patients with atopic dermatitis should be administered multiple-modality therapy carried out by a dermatologist and a psychiatrist. Besides the drugs for skin condition, psychotropic agents should be administered for 3-4 weeks. Combined therapy of neurotic disorders is most effective with tranquilizers (phenazepam, nitrazepam, radedorm or éunoktin).

Adolescent↗
PubMed1983

[Psychosomatic studies of chronic prostatitis].

The psychosomatic aspects of chronic prostatitis, especially the differentiation of the so-called vegetative urogenital syndrome from chronic state of infection isn't sufficiently clarified. That's why a study of 34 non-selected adult males with symptoms of chronic prostatitis has been undertaken to establish the incidence of infective urological and psychological factors. With urological, bacteriological and radiological examinations we found 44% of the patients with infective-prostatitis, 18% with subvesical disorders and 38% without any pathological findings. Comparing the group of patients with and without pathological urological findings in psychodynamic and testpsychological (Giessen-Test) examinations we couldn't see any significant difference. On the other hand they showed a significant difference compared with a control group of patients suffering from neurotic and/or psychosomatic diseases. Nearly all of our 34 patients showed neurotic disorders irrespective of the urological findings. A special characteristic of their pathogene psychodynamic seems to be the problems in male identity according to internalized disturbed father image. We discussed these results according to psychodynamic and interactional factors of origin and maintenance on chronic prostatitis.

Adult↗
PubMedDate not supplied

[Use of computerized psychodiagnostic methods for occupational orientation of adolescents with scoliosis].

The paper deals with the characteristic features and problems of professional self-determination in adolescents with scoliosis, studied by using computer and project psychological methods. A complex of methods revealed the following psychological characteristics in the adolescents of the study group: emotional-and-motivational direction, adequacy of job choice, mental tension, self-assessment, possible pain symptoms in neurotic disorders.

Adolescent↗
PubMed1994

[The sibling constellation in neurotic patients].

The authors compared the frequency of the positions among siblings in the neurotic and the control group. The investigation was performed on 582 persons, 435 of them had undergone treatment in the psychotherapeutic department for neuroses. The rest of them, the control group, had never been treated for neurosis. It does not seem that the position of the oldest, the youngest and the only child leads to neurotic disorders. The most risky position is evident by the middle sister. However, validity of these findings is limited by methodological reasons.

Adult↗
PubMed1998

Demographic features of patients seeking cosmetic surgery.

The demographic features of 415 patients seeking cosmetic surgery were investigated from a psychiatric point of view. Of the 415 patients, 198 (47.7%) were found to have mental disorders according to ICD-10 including: 17 with schizophrenia, 20 with other persistent delusional disorders, 33 with depressive episode, 47 with neurotic disorders, 42 with hypochondriacal disorder, five with paranoid personality disorder and 14 with histrionic personality disorder. The rate of subjects with poor social adjustment was 56.0%. It was noteworthy that such a considerable number of patients with mental disorders or with poor social adjustment had sought cosmetic surgery. Distinct gender differences were found: male subjects were characterized to have a greater number of mental disorders, especially dysmorphophobia (other persistent delusional disorders plus hypochondriacal disorder) and showed the narrow age range between teenage and young adult age when they were preoccupied with their 'deformity', and poor social function. A history of frequent operations was not considered to be an indicator for mental abnormality. The diagnostic issue in dysmorphophobia is briefly described.

Adolescent↗
PubMedDate not supplied

[Psychiatric disorders in a rural area: descriptive study of 2106 cases].

INTROD: Clinical samples gives a piece of information mediated by singular characteristics of the area (general practitioners, health services organization, needs of care feld by family or patient), but they are an important way in the study of psychosocial variables and their influence in pathways and morbidity of psychiatric disorders. MET: We obtained by SISMA survey (Information System for Mental Health in Andalucia) clinical and sociodemographic variables of a 2,016 Mental Health Center sample consulting during 40 months (attendance people = 90,368, rural area). We realized a descriptive and association study, with special attention to gender as modulating another factors related with health services use, diagnostic and clinical features. RES: ICD-10 Diagnostic groups of our sample was Affective disorders (F.3x) (36.5%, OR 1.99 for female), Neurotic disorders (F.4x) (29.75%, OR 2.01 for female) and Schizophrenia and related disorders (F.2x) (9.83%, OR 0.31 for female). The female-male ratio of our clinical sample was 1.70, incremented to 2.31 in geriatrics. Woman significantly consulted by themselves and men by their family. Married marital status was a help factor of psychopathology in women, as single status in men. Work activity and high or medium educative level was protective factors of psychopathology. CONCLUS: Clinical and sociodemographic variables we have seen, give us similar results to another spanish samples, too similar to actually accepted in Psychiatric Epidemiology. Female gender and class-linked vulnerability have an important influence as help-factors for specialized psychiatric treatment in our community.

Adolescent↗
PubMed1990

Psychiatric morbidity in schizophrenic relatives--use of Self-Reporting Questionnaires (SRQ).

A validated study of the Self-Reporting Questionnaire (SRQ-20) of the World Health Organization against ICD-9 was found to have good validation indices at the cut-off point of 5/6. The sensitivity was 84.8% and specificity 83.7%. However, SRQ-24 had poor validation indices and are too sensitive to detect psychotic illness. Twenty-three per cent of 264 schizophrenic relatives who had been staying together with them and or actively involved in their care for at least one year had neurotic disorders compared with 1% who had latent schizophrenia. The prevalence of psychiatric morbidity was higher in the first-degree relatives compared with non-first degree relatives.

Adolescent↗
PubMedDate not supplied

[Changes in the recurrence rate of neurotic symptoms].

The frequency of neurotic disorders' symptoms measured by symptom check-list in those admitted for specialist treatment, varied significantly even in a time-span of more than ten months (studies 1979-1999).

Adult↗
PubMed1999

[Psychological features of patients with bronchial asthma during long-term basic therapy at the "Asthma School"].

AIM: To evaluate changes in psychological status of bronchial asthma (BA) patients in the course of the basic treatment (BT) and attending "Asthma-school". MATERIALS AND METHODS: 107 patients with BA were observed for 2 years. 26 of them had BA stage II (group 1), 54 had stage III (group 2) and stage IV was in 27 patients (group 3). The criteria of PQBI (personal questionnaire of the Bekhterev Institute) and MMPI (Minnesota Multiphasic Personality Inventory) were used. Also, clinical symptoms and external respiration (ER) were studied. RESULTS: 2 years of treatment led to a decline in clinical symptoms (p < 0.001) and ER (p < 0.05) in patients of groups 1 and 2. Their attitude to the disease and treatment has also improved in many cases (p < 0.05). In all the groups the number of patients with neurotic reaction decreased (p < 0.05). In group 3, more patients had sensitive and egocentric reactions (p < 0.05). CONCLUSION: BT and studies in "Asthma-school" brought about harmonic changes in personality and attenuation of neurotic disorders without application of routine psychotherapeutic methods.

Adolescent↗
PubMed1975

[Long-term development of neurotic and reactive disorders. Catamnestic study on the influence of social factors].

This study enters into the framework of long term catamnestic researches realised at Hopital de Cery in Lausanne. In this work, the evolution of neurotic and reactionnal disorders in old age has been studied through the direct catamnestic examination of 35 patients who outlived 65 years of age. The accent has been particularly put on social and psychological evolution in regard to 15 variables responding to 2 fondamental hypotheses; it is the conducting clue of the work. After discussion concerning the working method and the selection of survey material, the author is analysing the 35 patients' main caracteristics at the time of their first hospitalisation. He is also taking interest on the patients' social surroundings during their childhood until they were 15. The notion of "broken-home" is largely discussed. The various evolutive aspects are firstly treated apart and then all together in regard to 15 mentioned variables. The various results are making the subject of statistic validation.

Affective Symptoms↗
PubMed1979

MMPI correlates of looking left or right during mental tasks.

Correlated directionality of eye movements during mental tasks with MMPI profiles of 22 women and 16 men evaluated for mild neurotic disorder. Directionality of eye movements was correlated with MMPI scales at above chance levels, which suggests that the phenomenon of eye movement directionality relates to objective measures of personality.

Adult↗
PubMed1990

[The psychological analysis of neurotic and psychosomatic disturbances].

The present paper demonstrates that up to a definite moment both groups of the patients manifest approximately the same neurotic disorders. However, the differences in the motivation sphere, frustration tolerance, the mechanisms of psychological defence and the clinical characteristics play an important role in the development of neurosis or psychosomatic disease.

Adolescent↗
PubMed1991

[Aspects of psychologic disorders in Japanese students].

The present study discusses the reasons which moved 88 students during one year from April 1987 till March 1988 to make their first spontaneous visit to the Department of Psychiatry in the Health Service Center of Tokyo University. The number of patients amounted to 0.60% of the total student enrollment during the period mentioned. The sufferings which motivated their visits could be phenomenally divided into two sectors. The first sector was related to the individual problems of the students and could be sub-divided into somatic and psychic spheres. To the other sector belonged the social or intersubjective relationships with either a general or a special point of reference. The majority of cases (ca. 70% of all patients) fell into the individual sector. Some reasons for this distribution are discussed. Among the patients there was a large percentage of freshmen. This seems to be due to the internal and external milieu changes caused by entering the university life. The ICD-9 diagnosis showed that ca. 80% of the patients exhibited Neurotic disorder and Adjustment reactions. This raises the question of applicability of ICD-9 to minor ailments, frequent among the clients of a Student Health Center. The dominant source of troubles motivating students to seek psychiatric help appeared to be problems connected with the academic life, like entrance into the university, examinations, choice of field of study, and graduation.

Adjustment Disorders↗