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PubMed1978

Transcultural aspects of psychiatric patients in Qatar.

The illness behaviour of Qatari psychiatric patients is defined by the nature of their symptomatology. The importance of somatic symptoms in determining the patient role and patient-doctor relationship is discussed in the light of cultural characteristics of the Qatari community. Delusory cultural beliefs related to possession, sorcery and envy provide a conceptual framework for explanation of many disorders. Inter-generational conflict is an important factor in neurotic disorders. Failure to report symptoms in an abstract fashion is characteristic of qatari patients. The cultural and religious heritage absorbs many behaviours which would otherwise be considered symptomatic of psychiatric disorder.

Culture↗
PubMed1981

Prepubertal endogenous major depressives hyposecrete growth hormone in response to insulin-induced hypoglycemia.

Insulin tolerance tests (ITT) were carried out during illness in 27 drug-free prepubertal children with emotional disorders: 10 fit unmodified Research Diagnostic Criteria (RDC) for major depressive disorder endogenous subtype, 10 fit RDC for nonendogenous major depressive disorder, and 7 fit DSM-III criteria for nondepressed neurotic disorders. The endogenous depressed group hyposecreted growth hormone (GH) in this test as compared to the other groups. Since GH hyposecretion in response to ITT is a characteristic of adult endogenous depressives, the data support the validity of the diagnosis of prepubertal endogenous major depressive disorder and the hypothesis of similarity of prepubertal and adult major depressions.

Blood Glucose↗
PubMed1996

Psychiatric disorders in gynaecological, surgical and medical departments of general hospitals in an urban and a rural area of Austria.

A total of 728 patients admitted to the medical, gynaecological and surgical departments of one urban and one rural general hospital in Austria were investigated for psychiatric morbidity. Using the Clinical Interview Schedule and its case criteria, the prevalence of psychiatric morbidity was found to be highest in medical departments (38.2%), followed by surgical departments (32.5%), and lowest in gynaecological departments (20.7%). Among medical and surgical patients, dementia and substance abuse disorders were the most frequent psychiatric categories, while in gynaecological departments neurotic disorders showed the highest frequency. For the sample as a whole, single status (i.e. unmarried, widowed or divorced), lower social class and rural catchment area of the general hospital predicted a high prevalence of psychiatric morbidity in a logistic regression analysis, while complications of childbirth, pregnancy or the puerperium, and diseases of the skin or the musculoskeletal system showed a negative association with psychiatric illness.

Adolescent↗
PubMed2004

[Premorbid period of anorexia nervosa].

Premorbid period of anorexia nervosa was studied in 96 female patients. In 64 cases (group 1) anorexia nervosa was as a separate disease and in 32 cases (group 2)--as a syndrome of endogenous mental disorder. In group 1 premorbid period was characterized by the features of neuropathy and residual organic disorders in combination with accumulation of subjects with personality disorders in the patient's family that promoted development of prolonged neurotic disorders. In group 2 there was hereditary psychosis load, high frequency of obstetrical and other perinatal complications, overvalued ideas and predisposition to autistic games and fantasying. In both groups, psychopathological peculiarities included typical affective, obsessive-phobic, hypochondriac, cenesthopathic and behavioral disorders, of a stable character often provoked by psychotraumatic events.

Adolescent↗
PubMed1988

[EEG frequency analyses in children and adolescents with obsessive-compulsive neuroses].

A controlled clinical study was conducted of 25 girls and boys (mean age: 12;7 years) with obsessive-compulsive disorders and 26 patients (mean age: 13;4 years) with other neurotic disorders. None of the subjects had any organic brain disorders. The question addressed was whether there are any EEG findings specific to the group of patients with obsessive-compulsive disorders, as several authors have reported. The EEG frequency analyses (power spectra) showed abnormal findings (fronto-temporal dysfunction and/or electrobiologically delayed maturation) in two thirds of the subjects with obsessive syndromes. The difference between the two groups was not significant, however. Thus the hypothesis of specific EEG patterns in obsessive-compulsive disorders could not be supported.

Adolescent↗
PubMed1978

Automated classification of MMPI profiles into psychotic, neurotic or personality disorder types.

A Fortran program has been developed which can objectively classify Minnesota Multiphasic Inventory (MMPI) profiles as being psychotic, neurotic, personality disorder, or indeterminate types. The method used is a set of configural rules, 'Henrichs' rules for males'. The only input data required are K-corrected T scores, which are the end product of standard scoring techniques. To automate these rules it was necessary to rewrite them so that all decisions were the result of arithmetic comparisons or logical tests using only and, or and not. In particular, examination of the Welsh code, which many rules required, had to be stimulated by the use of several sorted arrays. The program has been carefully tested and is in the use in our computer lab.

Diagnosis, Computer-Assisted↗
PubMed2005

Changes in mental disorder distribution among suicide attempters in mid-west area of Kanagawa.

To clarify changes in mental disorder distribution in suicide attempters, a comparison was made between the period when an economic recession started (1992, 1993) and the period when the recession became serious (2000). The subjects were 212 suicide attempters admitted to the Emergency Medical Center of Tokai University Hospital during a 2-year period between 1992 and 1993 (group A) and 255 suicide attempters admitted during a 1-year period between January and December 2000 (group B). Mental disorders were classified according to the International Classification of Diseases (10th revision; ICD-10). Distribution was compared between groups A and B and significant differences were observed in mental disorder distribution (P < 0.001). The percentages of subjects with depression, those with neurotic disorders, and those with other disorders were higher in group B than in group A. Conversely, the percentage of subjects with schizophrenia was lower in group B than in group A. Mental disorder distribution in suicide attempters significantly changed. However, it was not certain that this change was related to the economic recession and increased unemployment in Japan.

Adult↗
PubMed1981

[Psychiatric disorders during adolescence (author's transl)].

The psychopathology of adolescence shows three areas of dysfunction: 1. maturity deficits with an attitude of protest, loss of motivations, conversion symptomatology, 2. hypochondriac symptoms, obsessive-compulsive features, dysphorias, intellectual-physical handicaps, 3. antisocial behaviour, delinquency, neglect, addiction. 3. different courses can be distinguished longitudinally: 1. a double peak course with a disorder during childhood and adolescence with antisocial behavior, personality disorders and neurotic developments, 2. disorders during childhood which improve later (enuresis, encopresis, tics), 3. psychosis, maturity crisis, depressive reactions, obsessive compulsive syndromes.

Adolescent↗
PubMed2002

Development of an integrated model of personality, personality disorders and severe axis I disorders, with special reference to major affective disorders.

A unidimensional model of the relationships between normal temperament, psychopathic variants of it and the two main forms of so-called endogenous psychoses (major affective disorders and schizophrenia) was derived from Kretschmer's constitutional typology. It was, however, not confirmed by means of a biometric approach nor was Kretschmer's broad concept of cyclothymia as a correlate of physical stoutness on the one hand and major affective disorders on the other supported by empirical data. Yet the concept of the 'melancholic type' of personality of patients with severe unipolar major depression (melancholia) which resembles descriptions by psychoanalysts could be corroborated. This was also true for the 'manic type' of personality as a (premorbid) correlate of predominantly manic forms of a bipolar I disorder. As predicted from a spectrum concept of major affective disorders, the ratio of traits of either type co-varied with the ratio of the depressive and the manic components in the long-term course of such a disorder. The two types of premorbid personality and a rare variant of the 'manic type', named 'relaxed, easy-going type', were conceived as 'affective types' dominating in major affective disorders. They are opposed to three 'neurotoid types' prevailing in so-called neurotic disorders as well as in schizophrenic psychoses. The similarity among the types can be visualized as spatial relationships in a circular, i.e. a two-dimensional, model (circumplex). Personality disorders as maladapted extreme variants of personality are, by definition, located outside the circle, mainly along its 'neurotoid' side. However, due to their transitional nature, axis I disorders cannot be represented adequately within the plane which represents (adapted as well as maladapted) forms of habitual behaviour (personality types and disorders, respectively). To integrate them into the spatial model of similarity interrelations, a dimension of actual psychopathology has to be added to the two-dimensional plane as a third (orthogonal) axis. The distance of a case from the 'ground level' of habitual behaviour corresponds with the severity of the actual psychopathological state. The specific form of that state (e.g. manic or depressive), however, varies along one the axes which define the circumplex of habitual behaviour. This three-dimensional model is, by its very nature, more complex than the unidimensional one derived from Kretschmer's typological concept, but it is clearly more in accordance with empirical data.

Affective Disorders, Psychotic↗
PubMed1998

Season of birth in psychiatry. A review.

Numerous studies suggest that seasonal birth may play a pathogenic role in the development of mental disorders. A birth excess of 10% during winter and spring has been shown in schizophrenia. The few studies carried out on affective disorders revealed a significant increase of births in the first quarter of the year in bipolar disorders and major depressive disorder. Subjects with seasonal affective disorder show a peak of births in May. Data on personality, eating and 'neurotic' disorders are less consistent. At the moment there are no data in the literature about anxiety disorders.

Autistic Disorder↗
PubMed1978

[Relationship between psychiatric diagnosis and social or medical data in a child mental health center (author's transl)].

The aim of the present study is to point out the most significant sociodemographic and medical parameters related to psychiatric diagnoses, such as registered at the Alfred-Binet Child Mental Health Center (Paris). Statistical analysis shows the specific tendencies of each diagnosis and their similarities. Some diagnoses are particularly associated to negative aspects of the investigated parameters. This is true for psychotic disorders whereas normal variations are linked to positive aspects. Between these two extremes, neurotic disorders, the most numerous, are located in a middle position for all the investigated variables.

Adult↗
PubMedDate not supplied

[Therapeutic possibilities regarding somatoform disorders in soldiers].

The authors used the ICD-10 classification and presented the most common psychopathological syndromes from the category "neurotic disorders connected to stress and somatoform disorders" present amongst recruited soldiers. Recruitment to the army is a "situation which is endangering to the mental health" (from the Act on mental health protection), however socio-political changes that took place in our country are an additional factor which can lead to such disorders. The limitations in treatment of these disorders, which are due to army specifications, cause for the majority of those soldiers affected to be unable to carry out their duty. As a consequence of this, civil units carry out the therapeutic processes. Particular attention, amongst the other disorders described, is attributed to the so-called organ neuroses. The authors stress upon the need for psychoprophylactic actions which would reduce the health consequences of being recruited into the army.

Adaptation, Psychological↗
PubMed2001

[Mental disorders in patients with benign prostatic hyperplasia].

310 patients with benign prostatic hyperplasia have been studied. Their mental state being analyzed by clinical and psychometric methods using Spilberger and Hamilton scales. Neurotic disorders have been reported in all the patients: 53.8% having neurasthenic syndrome, 30% anxiety- or astheno-subdepressive syndrome, 16.2% neurotic hypochondriac symptomatology. After treatment with minor neuroleptics, antidepressants and tranquilizers, patients' psychic state improved, even when the objective urologic data remained unchanged. Treatment of mental disorders makes it possible to prepare a patient for the operation and to improve quality of life of patients with benign prostatic hyperplasia before the operation.

Aged↗
PubMedDate not supplied

[Hysterical psychosis: clinical aspects and disease course].

30 patients admitted to our psychiatric service with the initial diagnosis of psychogenic psychosis, dissociative psychosis or hysterical pseudo-psychosis are studied anamnestically and in their catamnesis (average follow up 5.1 years). The objective of the study was to see if these disorders are independent nosologic entities or are masking other ones, such as affective, schizophrenic or neurotic disorders. In this study we found a greater percentage of women (3/1) with a previous hysterical personality in more than 50%; many of the patients were hospitalised in order to clarify the diagnosis; in 70% we found psychogenic triggers; a greater predominance of an abrupt onset of the disorder (which would favour the concept of reaction); 60% had fluctuating symptoms (not so common in endogenous psychosis). In almost 100% there was a complete remission during the hospitalization period (average 22.7 days), which would bring them closer to the present concept of brief reactive psychosis. With a follow up of an average of five years, the diagnosis is maintained in 93.3% of the cases. The majority of the patients fulfilled the criteria for hysterical psychosis as defined by Hollender and Hirsch. We think that these disorders are well delimited, both clinically and nosologically, not having received up until now an exact placing in modern classification systems (DSM-III, ICD-10, etc.).

Diagnosis, Differential↗
PubMed1997

Psychological disorders in Singaporean national servicemen.

Young able-bodied male Singaporeans are required to undergo national service. The majority are able to cope with military training without developing any psychological disorders. A small group, however, are unable to handle the rigours of military training. They are identified, diagnosed and managed appropriately so that they can continue to serve national service within their capability. Three types of psychological disorders are highlighted in this paper. Type 1 cases refer to those with psychotic and neurotic disorders and they are usually downgraded to serve in non-combat vocations. The severe psychotics are exempted from service. Type II cases refer to those with stress-related disorders which are temporary conditions amenable to treatment. Many of them can return to their previous functioning level once their stress-related problems are resolved. Type III cases refer to those who capitalise on their existing physical conditions by complaining or exaggerating their psychological symptoms hoping to prolong their medical condition so that they can get an easy way out. These cases, which are in the minority, require firm handling, limit-setting and counselling so that they can learn to address their problems appropriately without resorting to psychological symptoms. Emphasis is given to the diagnostic approach and treatment of all 3 types of disorders, particularly the stress-related disorders. The roles of unit personnel and family members in providing a corroborative account of the servicemen's behaviour, work performance and inter-personal relationship are given special emphasis in the management of soldiers with psychological problems.

Adult↗
PubMed1983

Bipolar outcome in the course of depressive illness. Phenomenologic, familial, and pharmacologic predictors.

Twenty percent of a cohort of 206 outpatient depressives with no past bipolar history switched during prospective observation. These 41 probands developed manic periods on the average of 6.4 years (median 4, range 1-25) after their first depressive episode. The change in polarity occurred throughout the life span, but was most common in adolescence and early adulthood. The following variables were found useful in predicting this outcome: onset less than or equal to 25 years, bipolar family history, loaded pedigrees, precipitation by childbirth, hypersomnic-retarded phenomenology, and pharmacologically-mobilized hypomania. Although the respective sensitivities of these findings were relatively low (32-71%), their specificities ranged from 69% to 100% for bipolar outcome; the diagnostic specificity of any 3 of these variables when combined was 98%. When compared with nonbipolar depression, bipolar disorder was seldom chronologically secondary to nonaffective psychiatric disorders. These findings suggest that many young depressives with lethargy and oversleeping are not manifesting a "neurotic" disorder, but rather a precursor of primary bipolar affective disorder. Finally, a psychotically depressed adolescent or young adult with positive bipolar family history should be observed for eventual bipolar outcome, especially when the clinical presentation is that of stupor.

Adolescent↗
PubMed1990

The spectrum of mood disorders.

The problem of classifying mood disorders still lacks an acceptable solution. Interrater reliability studies have shown that this problem is more prevalent in mood disorders compared with other psychiatric conditions. Historically the problem originates from the distinction between Geisteskrankheiten and Gemütskrankheiten (mental and mood disorders) because the domain covered by the word mood has been progressively reduced. The fact that neurotic disorders are "emotional disorders" further complicates this field. The words anxiety and depression refer to a disorder, to a symptom, and to everyday feelings. A failure or difficulty in the distinction between these three meanings leads to nosological confusion. In recent years, the notion of a spectrum of mood disorders has gained acceptance. According to this, the diverse disorders are placed on a point that is more or less close to one of the extremes. Something similar occurs in the unipolar-bipolar distinction, in which the bipolar II or atypical and bipolar III occupy a central place on the spectrum. Cluster analysis and other mathematical techniques have helped to clarify the outlook, but there is a need for a biopsychosocial perspective and for a deeper understanding of the natural history of these disorders.

Adult↗