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PubMed1982

Female vulnerability to neurosis: the influence of social roles.

Studies of prevalence of neurotic disorders show women to be far more vulnerable than men. Biological factors cannot account for this marked sex difference; social factors are clearly implicated. Findings from a community study in London show that social roles, especially those relating to marriage, are implicated. It appeared that lack of employment outside the home was deleterious for both sexes, while a poor marital relationship was deleterious for women alone. Although care of young children was associated with neurosis in women, it did so by virtue of depriving women of employment outside the home.

Adolescent↗
PubMed2005

[Psychic maladaptation in patients with minor heart anomalies].

AIM: To analyse personality-mood features and variants of neurotic disorders in patients with minor anomalies of the heart (MAH) depending on phenotypic signs of dysembryogenesis. MATERIAL AND METHODS: Echocardiography, psychological questionnaire testing were performed in 120 patients (10 males and 10 females) aged 18-30 years with mitral prolapse and/or dislocated chords of the left ventricle. The control group consisted of 22 healthy volunteers. RESULTS: Patients with a differentiated syndrome of connective tissue dysplasia had more frequently hyperthymic, pedantic, anxious, cyclothymic and dysthymic types of accentuations which were more pronounced than in healthy subjects. CONCLUSION: With aggravation of connective tissue dysplasia syndrome, patients with minor anomalies of the heart show a tendency to psychic maladaptation.

Adaptation, Psychological↗
PubMed1993

'Neurosis' and the personal social environment. The effects of a time-limited course of intensive day care.

The Interview Schedule for Social Interactions (ISSI) was used to assess the social environment of 65 British inner-city patients suffering from severe neurotic disorder; all patients were offered a 12-week course of intensive day treatment with an educational and psychodynamic basis. Compared with a general population in Canberra, the neurosis sufferers had lower (morbid) scores on the ISSI for the extent and quality of their social relationships. Of the 34 subjects who completed treatment and attended for the post-treatment investigation, 21 attained a PSE score below the level for 'caseness'. Twenty-five subjects who attended for follow-up at 18-24 months had improved significantly on all four of the standard ISSI measures, although they had not done so immediately after treatment. This suggests that although symptoms may improve at the time of treatment, social relationships improve only over several months.

Adult↗
PubMedDate not supplied

[Changes of sense of coherence (SOC) after psychotherapy in neurotic patients].

UNLABELLED: Sense of coherence (SOC) is the central construct of the salutary model of health. Sense of coherence comprises comprehensibility, manageability and meaningfulness. AIM: The aim of the study was to check if the sense of coherence can change after psychotherapy in neurotic patients, if the value of the changes depends on the level of sense of coherence and if the obtained changes are stable. METHOD: 101 patients (32 males, 69 females, aged between 17 and 48 years) with neurotic disorders defined according to ICD-10 criteria were the subject of the study. This group of patients were hospitalized in the Neurotic Ward of the Psychiatry Department in Lublin. They took part in a 10-week psychotherapeutic programme. In the study, the authorized Polish adaptation of the Orientation to Life Questionnaire (SOC-29) by Antonovsky was used to measure the sense of coherence. Patients were examined prior to and on completion of the treatment programme. In the next stage of the study patients filled in the SOC-29 Questionnaire after six months. Dependent sample t-test was used in data analysis. RESULTS: Significant favourable changes were found in patients with a low SOC level. The increase of SOC was observed after a 10-week treatment. The increase was stable in examination after six months. Changes in sense of coherence in the group with high SOC level were not observed. The results suggest that the therapy can be more effective in patients with a low SOC level.

Adaptation, Psychological↗
PubMedDate not supplied

[Correlation of the clinical pharmacological action of a single dose of fenazepam with the EEG dynamics and pharmacokinetics].

Interaction between the clinical, EEG-effects and phenazepam concentration in the blood was studied in 111 patients with neurotic disorders after intake of the test drug dose (2 mg) administered singly and on the 14th day of the treatment. It was established that EEG changes commonly induced by benzodiazepines supervene primarily within the interval of 1 to 3 h after a single intake which correlates with the maximal degree of the tranquilizing, somnolent and myorelaxant drug action. It was demonstrated that the clinical and EEG-effects occur before attainment of the maximal phenazepam concentration and then become less potent, with preservation of the high blood drug level. Intake of the test dose during the treatment course is characterized, as compared with the effect of a single intake, by less marked clinical action of the drug and the lack of significant changes on the EEG and in the blood phenazepam concentration.

Adult↗
PubMedDate not supplied

[Therapeutic needs in psychiatric patients: a systematic review of the literature. I. General concepts and assessment measures. Needs for services].

OBJECTIVE: In Italy, mental health care is in phase of reorganisation. In this frame the measurement of users' needs may be a useful tool in planning individualised mental health service interventions and in their evaluation. Aims of the present study are (I) to highlight the basic concepts of 'needs for care' and give a brief description of the main needs assessment tools specifically developed for psychiatric patients; (II) to review studies assessing needs for mental health services in the general population; (III) to discuss the role played by the assessment of needs in planning mental health care. METHODS: Studies published in the international literature from January 1980 to June 1999 were reviewed. The studies were located through a computerised search of the databases MEDLINE and PsycLit; in addition, the reference lists of the studies located through the computerised search and the content of main international psychiatric journals were manually scanned in order to avoid possible omissions. Studies assessing needs for services and studies assessing needs on individual level were separately reviewed. Both groups of studies, in turn, were divided in studies assessing needs for mental health care in the general population and in psychiatric patients. RESULTS: Although most studies on needs for services used indirect methodologies and employed quite heterogeneous experimental design, they provide at large overlapping results. In the general population, about 60%-70% of patients with anxiety, depression and other neurotic disorders and 30%-40% of psychotic patients do not receive any specialist mental health care, suggesting that the majority of subjects suffering from a psychiatric disorder do not receive the mental health care they need. CONCLUSIONS: Unmet needs for services show a higher frequency in patients with neurotic and depressive disorders, indicating a shortage in services delivery that should be taken into account both by psychiatrists and mental health planners. Moreover, the finding that a large number of patients suffering from psychotic disorders do not receive any kind of mental health care is of particular relevance for planning mental health services, since these subjects are usually the most problematic and difficult to treat.

Health Planning↗
PubMed1986

Combination of psychotherapy and drugs in the treatment of neurosis. A controlled comparison of bromazepam and thioridazine.

Eighty out-patients with neurotic disorders were studied in an integrated treatment model combining psychotherapy and psychotropics in a "conjoint marital therapy" setting. The spouses, who seemed a healthy group, were used as reporters, as controls and as participants in the psychotherapy. The pharmacological trial was a double-blind, cross-over study, comparing bromazepam and thioridazine after a placebo period. Bromazepam was more effective in controlling different anxiety symptoms and demonstrated more potent activating properties than thioridazine. Hostility symptoms, however, responded better to thioridazine. These findings were confirmed by ratings performed by patients, spouses and the investigator. Differences in drug preference and drop-out rate showed the same tendency. Nine weeks' continuous treatment did not change the differences found in the cross-over study. No pharmacological rebound symptoms were observed after drug withdrawal. The personality of the spouses was related to the outcome in the patients. Moreover, there was an obvious positive interaction between the psychotherapy given and the drug treatment.

Adult↗
PubMed1981

Long-term treatment with diazepam. Investigation of consumption habits and the interaction between psychotherapy and psychopharmacotherapy: a prospective study.

In a prospective study over 6 months involving 54 psychiatric outpatients with neurotic disorders, the habits of diazepam or placebo intake and the attitudes towards psychotherapy and the medication were studied. The patients, divided into two groups, received in a double-blind setting either diazepam or placebo. They were also seen for psychotherapy every 14 days. The patients were advised to use the medication according to their personal needs but not to take more than 6 tablets of 6 mg diazepam (or placebo) daily. All patients showed controlled use of the drug. No dependency was observed. The patients stopped taking the medication gradually in each group, but faster in the placebo group. 18% of the placebo group and 52% of the diazepam group were 'high' consumers (more than 200 tablets within a period of at least 20 weeks). The intake of the drug was mainly dictated by the symptoms. A second important factor modifying the intake habits was the fear of possible adverse effects of the medication. At the end of the treatment period the attitude towards psychotherapy was more favorable than that towards psychopharmacotherapy irrespective of the drug taken. Long-term intake of diazepam did not lead to a decrease in the motivation of working through the existing problems. In contrast, the diazepam group felt less than the placebo group that medication could be a long-term solution for personal or social problems.

Adult↗
PubMed1987

Concurrent medical and psychiatric disorders among schizophrenic and neurotic outpatients.

The records of two groups of patients (358 schizophrenics and 69 neurotics), attending the community mental health center of the Johns Hopkins Hospital, were reviewed to assess the extent and severity of reported medical problems. Results indicate that 38% of the schizophrenics and 53% of the neurotics report medical problems, but schizophrenics present with serious medical problems more often than do the neurotics. The authors draw attention to the need for properly assessing the severity of these medical problems and for adequately coordinating psychiatric and medical care. Strategies to overcome these difficulties are suggested.

Adult↗
PubMed2004

Attempted suicide: factors leading to hospitalization.

OBJECTIVE: This study analyzes how sociodemographic and clinical characteristics influence the treatment decision for patients referred to a university hospital emergency room (ER) owing to attempted suicide. METHOD: Using a cross-sectional design, we monitored all patients admitted to a university hospital ER after attempting suicide, over a 3-year period (n = 404). Treatment decisions were categorized into 3 groups: inpatient treatment, outpatient treatment, and no further treatment. RESULTS: Older patients were more likely to be hospitalized, while women and patients with regular occupational activity were more likely to receive outpatient treatment. In logistic regression analysis, attempted suicide using aggressive methods, history of psychiatric inpatient treatment, and psychotic disorders were associated with inpatient treatment. Adjustment and neurotic disorders were related to outpatient treatment. CONCLUSIONS: The decision to hospitalize can be satisfactorily predicted by means of sociodemographic and clinical characteristics, while the number of patients assigned to outpatient treatment is underestimated. A triage that relies only on sociodemographic and clinical data as well as risk factors could result in too frequent admissions of patients after attempted suicide.

Adolescent↗
PubMed1979

WAIS test-retest reliability for a clinical out-patient sample.

WAIS test-retest reliabilities were calculated for a clinical out-patient sample with testing intervals varying from 1 to 10 yr. There was no relationship between test-retest interval and the stability of test scores and the correlations between IQs were quite satisfactory (Full Scale IQ = .897, Verbal IQ = .906, Performance IQ = .876). Reliabilities remained high even when the sample was divided by diagnosis into organic, neurotic, personality disorder, and schizophrenic subgroups.

Adolescent↗
PubMed1995

[Disordered partner relations in neurotic diseases and treatment with psychotherapy].

Couples with neurotic partner problems are characterized by considerable psychic and/or psycho-somatic complaints. Men usually judge the relationships with their spouses more satisfactory than women do. Women suffer more from conflicts in partner-relationships than men do responding to such conflicts with psychic and/or psycho-somatic complaints. Men are more disturbed by a conflict mobilizing therapy than women are. The strongest decrease of men's psychic symptoms can be found in the year after their therapy. Women's defence against psychic problems is less strong than men's. Decrease of women's symptoms can be found during therapy already. Character neuroses don't make psychic and/or psycho-somatic symptoms in a direct manner. Character neuroses rather give rise to conflicts with other people, and stress by those conflicts cause symptoms.

Adult↗
PubMed1993

[Empirical findings on the personality structure of borderline patients].

In the present study the question of personality structure in borderline patients is studied empirically. The "Diagnostic Interview for Borderlines" of Gunderson and Kolb is used to classify the patients. In an inpatient sample of borderline patients (n = 26) the clinical diagnoses of personality structure according to psychoanalytic criteria are investigated and compared to those of an inpatient sample of patients with neurotic disorders (n = 24). According to the results most of the borderline patients (88%) had received a diagnosis of a schizoid personality structure according to psychoanalytic criteria, in contrast to the neurotic patients. The results are compared to those of studies using descriptive psychiatric criteria.

Borderline Personality Disorder↗
PubMed1990

The identification of psychiatric disorders in children who fail to attend school: a cluster analysis of a non-clinical population.

Interviews were conducted with parents of 100 children taken to a 'school attendance committee', because of persistent failure to attend school. Clinical assessment of the attendance problem was carried out so that children were categorized as 'school refusers' (N = 24), 'truants' (N = 53), 'both refusers and truants' (N = 9), or as 'neither' (N = 14). Any ICD-9 psychiatric disorder was separately identified. Cluster analysis of information collected in a standard way indicated that there was a group of children with the features of 'school refusal' who often had generalized neurotic disorders as well and who were mostly girls, another group with the features of 'truancy' all of whom had conduct disorders who were mainly boys, and a third cluster of children who were usually 'truants' but less often psychiatrically disturbed. The study provided evidence for the existence of school refusal with and without generalized neurotic disturbance in a non-clinical population.

Absenteeism↗
PubMed2006

Changes in stability of first-admission psychiatric diagnoses over 14 years, based on cross-sectional data at three time points.

BACKGROUND: Stability of diagnoses over time is an important criterion of reliability of any diagnostic system. AIMS: To compare the stability of diagnoses among hospitalized psychiatric patients over 14 years, based on cross-sectional data at three time points. METHOD: Diagnoses extracted from the National Psychiatric Case Register concerning psychiatric patients first admitted during 1989 (n=2996) were compared to those who were admitted during 1996 (n=3021) and 2003 (n=4041). Stability of diagnostic categories was measured by positive predictive value of admission diagnosis at discharge from hospital. RESULTS: There was no significant difference in diagnostic stability for most diagnostic categories between 1989 and 1996 patient cohorts. However, over the seven following years (cohort 2003) the diagnostic stability had been substantially increased: by 19% for affective disorders, by 18% for childhood disorders, by 17% for organic conditions, by 14% for neurotic disorders, by 12% for both schizophrenia and drug and alcohol dependence. CONCLUSIONS: In long-term perspective, reliability of most diagnostic categories of mental disorders has clearly improved.

Adolescent↗
PubMed1991

[The problems, mental disorders and quality of life of rheumatoid arthritis patients].

There were 157 patients with rheumatoid arthritis. Of these, only 65 patients (41.4%) failed to show any factor at the disease onset, which could be estimated as provoking. Psychoemotional factor was most common (in 47.7% of cases). Later the indicated factor played a more important part: only 5.1% of the patients denied or doubted it. In most cases, the distress was caused by family relations. There was an appreciable difference in the intensity of the problems in family and single patients. Affective disorders (neurotic and hypopsychotic depressions) were mostly recorded among mental disorders. The life quality determined in accordance with the self-estimation of the "health" and happiness" noticeably depended both on biological factors (pain intensity, the degree of damage to the bones and joints, and the disease stage) and on social factors--the educational level and social position. The degree of personality merits defined according to the self-estimation of the "mentality" and "character" appeared higher in persons with higher education and in patients suffering from erosive arthritis. The data obtained provide evidence for the necessity of psychosomatic orientation of practicing physicians.

Arthritis, Rheumatoid↗
PubMed1994

The burden of care of schizophrenia in Malay families.

Deinstitutionalization has shifted much of the burden of care of chronic schizophrenia from mental institutions to the family. The aim of this study is to asses the prevalence of mental disorders among 210 primary carers of Malay schizophrenic patients, explored the burden and hardship experienced by them. This is a two-stage psychiatric screening procedure. All the cases suspected from initial screening with WHO Self-Reporting Questionnaires (SRQ-20) were called for clinical interview. Patients' behavioural problems and the burden of relatives were assessed by the Social Behaviour Schedule and the Interview Schedule respectively. It was found that about 23% of the carers developed neurotic disorders resulting from the stress; nearly half of them had neurotic depression. Despite their burden, they do not complaint about it. Neurotic carers compared with non-neurotic carers had significantly more subjective burden and distress related to the product of active psychosis. The carers were generally able to tolerate the negative symptoms of schizophrenia. The number of problem behaviours and previous admissions were significantly correlated with the severity of burden.

Activities of Daily Living↗