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A patient with recurrent, life-threatening water intoxication secondary to compulsive water drinking is described. This patient responded well to nearly 1 g of propranolol daily with a decrease in her drinking behavior, reduced sensation of thirst, and a reduction in her delusional thinking. The rationale for the choice of propranolol with this patient is reviewed.
Thought disorder was studied in 21 paranoid and 24 non-paranoid schizophrenics fulfilling the research diagnostic criteria using the Thought, Language and Communication Scale. Chronic paranoid schizophrenics more often had tangentiality. Other thought disorders were similar in paranoid and non-paranoid schizophrenics.
Speech samples from 71 patients in four diagnostic groups were analyzed by two quantitative methods of speech content analysis, the results of which were entered into a discriminant analysis to test whether patients could be accurately classified back into their appropriate diagnostic groups. These classifications were compared with classifications made by two psychiatrists, blind to the patients' diagnoses, who read transcripts of the speech samples. The results suggest that data from the systematic quantification of lexical choice can be used to classify patients into their respective diagnostic groups and that this classification compares favorably with that done by psychiatric raters.
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Some defendants desire to be punished. Sometimes psychotic motivations underlie punishment-seeking behavior; sometimes they do not. The defendant's clinical status is relevant to his competency to stand trial and to waive other rights. These issues are illustrated by presentation of a case of a defendant who sought punishment. The importance of psychiatric assessments of these defendants is emphasized.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Several studies have shown that source-monitoring errors are related to verbal hallucinations in schizophrenia. An exploratory pilot study has been carried out to investigate the possibility of training patients in how to avoid errors in source-monitoring. One patient with paranoid schizophrenia and persistent thought insertions was trained for 6 hours to use mnemonic techniques to compensate specific deficits in source-monitoring. Results show that the patient was able to improve his performance and maintain the acquired progress at a 1-month follow-up assessment. These preliminary results are interesting for developing a larger controlled study of cognitive remediation of source-monitoring deficits.
OBJECTIVE: Most studies of violent behavior among psychiatric patients focus on inpatients or patients recently discharged from psychiatric units. To explore violent behavior among patients living in the community, the authors examined the prevalence of homicidal behaviors in a general psychiatric outpatient population. METHODS: During an intake evaluation, 517 outpatients completed several self-report instruments that included a detailed survey of past and current homicidal behaviors covering homicidal ideation, plans, and attempts. Demographic and clinical characteristics of patients with and without a history of homicidal behaviors were compared. RESULTS: Twenty-two patients (4 percent) reported a past homicide attempt. Patients who reported homicide attempts could be distinguished from patients with no homicidal behaviors by the presence of other aggressive behavior such as suicidal ideation and suicide attempts by themselves and their family members and by elevated current measures of interpersonal sensitivity, hostility, and paranoid ideation. CONCLUSIONS: The rate of homicide attempts in the general outpatient population studied was considerably lower than the reported rates of assault among inpatients. The relationship between past and current episodes of aggressive behavior reinforces the importance of including a careful assessment of past history of violent behaviors as part of the routine psychiatric evaluation.
The coincidence between panic disorder and depression is a well known phenomenon. However, only few studies investigated the coincidence of panic disorder with schizophrenia. This may in part be explained by the fact that both positive and negative symptoms of schizophrenia may mask the clinical symptoms of a panic disorder. We report on a female patient suffering both from agoraphobia with panic disorder and paranoid schizophrenia according to ICD-10. The productive psychotic symptoms responded well to treatment with a low dose of zotepine, whereas the panic disorder was effectively treated with a combined therapy with imipramine and cognitive behavioral therapy. Although it has to be questioned whether the coincidence between panic disorder and schizophrenia reflects two different diagnostic entities, the occurrence of symptoms of a panic disorder in schizophrenia deserve further attention because these may be treated efficiently by a specific pharmacotherapy and psychotherapy.