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PubMed2005

Two cases of "cannabis acute psychosis" following the administration of oral cannabis.

BACKGROUND: Cannabis is the most commonly used illegal drug and its therapeutic aspects have a growing interest. Short-term psychotic reactions have been described but not clearly with synthetic oral THC, especially in occasional users. CASE PRESENTATIONS: We report two cases of healthy subjects who were occasional but regular cannabis users without psychiatric history who developed transient psychotic symptoms (depersonalization, paranoid feelings and derealisation) following oral administration of cannabis. In contrast to most other case reports where circumstances and blood concentrations are unknown, the two cases reported here happened under experimental conditions with all subjects negative for cannabis, opiates, amphetamines, cocaine, benzodiazepines and alcohol, and therefore the ingested dose, the time-events of effects on behavior and performance as well as the cannabinoid blood levels were documented. CONCLUSION: While the oral route of administration achieves only limited blood concentrations, significant psychotic reactions may occur.

Acute Disease↗
PubMed2004

Fluoxetine therapy in depersonalisation disorder: randomised controlled trial.

BACKGROUND: Despite anecdotal reports that serotonin reuptake inhibitors may improve depersonalisation, there is no proven efficacious treatment for depersonalisation disorder. AIMS: To investigate the efficacy of fluoxetine in the treatment of depersonalisation disorder. METHOD: Fifty-four people who met DSM-IV criteria for depersonalisation disorder were recruited through newspaper advertisements, and 50 were randomised to a 10-week, double-blind trial of fluoxetine 10-60 mg/day or placebo. Primary outcome measures were the Dissociative Experiences Scale-Depersonalisation Factor, the Depersonalization Severity Scale and the Clinical Global Impression-Improvement (CGI-I) scale. RESULTS: Intention-to-treat analysis revealed that fluoxetine (mean dosage 48 mg/day) was not superior to placebo except for a clinically minimal but statistically significantly greater improvement in CGI-I score in the fluoxetine group prior to covarying for anxiety and depression (2.9 v. 3.6). Depersonalisation was significantly more likely to improve if comorbid anxiety disorder improved. CONCLUSIONS: Fluoxetine was not efficacious in treating depersonalisation disorder, despite the commonly reported clinical use of serotonin reuptake inhibitors for this condition.

Adult↗
PubMedDate not supplied

Incest: some neuropsychiatric findings.

A review of the medical records of twenty-two patients who were the child or younger member of an incestuous relationship revealed a higher than expected incidence of abnormal neuropsychiatric findings. Seventeen patients had abnormal EEG's; six had clinical seizures; and eight of thirteen patients tested gave evidence of a low IQ or organicity. In addition, indications of impulsivity and depersonalization were frequently found in this group. It could be speculated that these neuropsychiatric handicaps create a vulnerability that enhances inappropriate relationships within a family and makes it more difficult for the person to resist an incestuous relationship.

Adolescent↗
PubMed1985

Temporal lobe signs and reports of subjective paranormal experiences in a normal population: a replication.

Correlations (r = 0.50) were found between the numbers of different psi (paranormal) experiences and the numbers of temporal lobe signs within a population of university students (n = 99). The strongest correlation of 0.60 occurred with a cluster of signs that are similar to symptoms reported by patients who show chronic foci in the mesiobasal temporal lobe. However, there were no significant correlations between numbers of different psi experiences and clusters of control items or a lie scale. Specific analyses of the 140 items of the inventory indicated only 23 reached statistical criterion (p less than .001). Of these 17 were direct temporal lobe signs that implied deepened affect, auditory-vestibular experiences (vibrations, hearing one's name called), olfactory auras, perseveration ("forced" thinking), depersonalization, and sense of the personal. Five items involved beliefs about exotic phenomena or philosophical ideas. Only one item was from a control cluster. These results support the hypothesis that mystical or paranormal experiences are associated with transient electrical foci within the temporal lobe of the human brain. The repeated occurrence of these experiences within normal individuals may be embedded within a more complex symptomatology of temporal lobe signs.

Adolescent↗
PubMed2006

Association between burnout and anger in oncology versus ophthalmology health care professionals.

The prevalence of burnout in oncology staff was compared with that of the ophthalmology staff, who normally present a low prevalence of burnout as described in this literature. The correlation of burnout with the emotion of anger was also investigated. Thirty-six subjects working in an oncology department and 32 working in an ophthalmology department were examined using the Maslach Burnout Inventory and the State-Trait Anger Expression Inventory. The oncology group showed higher mean scores on the MBI Emotive Exhaustion and Depersonalization scales with respect to ophthalmology staff. Correlation analysis showed that increasing burnout was associated with higher anger expressed towards the environment and loss of anger control. Anger, as a response to frustration, appears to be a feature constantly associated with the clinical expression of burnout and it should not be underestimated in theoretical and preventive contexts.

Adult↗
PubMed2005

[Effects of perception of client relationship on burnout among human service professionals].

The main purpose of this study was to investigate perception of client relationship by human service professionals and its possible relationship with burnout. One hundred sixty-five (165) human service professionals, nurses and careworkers, completed a questionnaire. Results indicated that they typically rated their relationship with clients to be better than the average, and thus showing an enhancement tendency in their perception. In addition, regression analysis showed that the main effects of positive evaluation of themselves and clients were found on burnout, but not on psychological stress reaction. Furthermore, positive client evaluation had a buffering effect on depersonalization in cases of interpersonal conflict with clients. These results suggested that perception of close relationship with clients was one of the most important factors for preventing burnout of human service professionals.

Burnout, Professional↗
PubMed2001

From inequity to burnout: the role of job stress.

This research examined burnout (i.e., emotional exhaustion, depersonalization, and lack of personal accomplishment) among 2 samples of Dutch teachers as a function of inequity and experienced job stress in 3 different exchange relationships (with students, colleagues, and the school). It was hypothesized that inequity would be linked to burnout through the stress resulting from this inequity. Analysis of a cross-sectional sample (N = 271) revealed that this was indeed the case. Findings were replicated longitudinally using an independent sample of 940 teachers. It is concluded that the often-reported effect of inequity on burnout can partly be interpreted in terms of elevated levels of job stress. Implications of the findings are discussed.

Achievement↗
PubMed2001

[The remarkable symptoms of the temporal lobe dysfunction].

From all the cerebral regions, except the orbito-frontal area of the frontal lobe, especially on the right hemisphere, the temporal lobe is the best connected region of the cerebral cortex with the limbic system. The disorders of the temporal lobe produce symptoms which affect many behaviors, like sexuality, visual perceptions, recognizing familiar faces, perception of emotional expressions, and even religious beliefs. They can also affect personal relationships, the perception of the "ego", with depersonalization and derealization phenomena; in short, behaviors which are essential to the human being.

Animals↗
PubMed1975

[Problems of toxic psychosis as illustrated on the example of the so-called LSD psychosis].

The effects of LSD are characterized by a number of disturbances of perception and experience, which can be observed in the fields of visual, spatial and temporal perception and of affectivity. We also see disturbances of experience, which can otherwise be observed only in psychoses, for example reduction or change of cognitive functions, but also depersonalization and euphoria. In atypical courses of intoxication ("horror-trips") anxiety and excitement are predominant. Atypical courses of intoxication may be interrupted by "talk down" and additional application of tranquilizers. In a certain number of LSD-users in our clinic we saw psychoses. We classify them into flash-backs, exogenic (toxic) psychoses and so-called "endoform psychoses". The latter implies three possible constellations: accidental coincidence of LSD-use and psychosis; pre-existing psychosis with symptomatic use of LSD as an attempt of self-treatment; finally the onset of a psychosis may be triggered by the use of the halluzinogen. From the symptomatological cross-section they cannot reliably be distinguished from real schizophrenia. An independent nosological unit "LSD-psychosis" does not seem to exist.

Anxiety↗
PubMed2003

Helping your patients overcome dental phobia.

Dental phobias stem from various sources and can lead to strongly conditioned fear responses. The following are the most common origins of dental fear: Previously painful or negative experiences during visits to a dentist's office. A severe discomfort with feeling vulnerable and/or out of control in a dental situation. A sense of embarrassment from dental neglect and fear of ridicule and/or belittlement. Scary anecdotes of negative dental experiences from family and friends. Negative, menacing portrayals of dentists in movies, television, newspapers, and magazines. A sense of depersonalization in the dental process, intensified by today's necessity for the use of barrier precautions, such as masks, latex gloves, and shields. A general fear of the unknown. Once you recognize the possible sources of your patients' fears, you will be in a much better position to help them identify and overcome their particular brand of dental phobia.

Attention↗
PubMed1992

Job stress and burnout in acute and nonacute pediatric nurses.

OBJECTIVE: To identify predictors of burnout in pediatric nurses and to compare the incidence of burnout, job stress, anxiety and perceived social support in acute and nonacute care pediatric nurses. DESIGN: Prospective correlational-descriptive methodology was used to predict high, moderate or low burnout from length of work experience, perceived work stress and social support and anxiety. SUBJECTS AND SETTING: Registered nurses (n = 121) employed full-time in neonatal and pediatric intensive care units and pediatric intermediate care units. MEASUREMENTS AND RESULTS: Measures of job stress, anxiety, experience, social support and burnout were compared in acute and nonacute care pediatric nurses. The overall mean incidence of burnout was in a moderate range for both acute and nonacute care pediatric nurses for the emotional exhaustion and depersonalization subscales and in the high range of personal accomplishment subscales of the Maslach Burnout Inventory. Analysis of variance revealed no differences between groups. However, when nurses were grouped by high, moderate and low burnout scores, chi-square analysis revealed significant differences. More acute care nurses reported high burnout and more nonacute care nurses reported low burnout. Discriminant function analysis revealed that job stress was the strongest significant predictor of burnout, followed by state anxiety, coworker support, trait anxiety and experience on the unit. CONCLUSIONS: Even though high burnout levels are more frequent in acute care pediatric nurses, burnout is a problem in both acute and nonacute care pediatric nurses. The pattern of results suggests that efforts directed toward reducing anxiety and job stress and increasing coworker support, particularly for less experienced nurses, might reduce burnout.

Adult↗
PubMed2003

A comparative study of burnout syndrome among health professionals in a Nigerian teaching hospital.

Burnout as a measure of stress has generated research interest in the past two decades. However, there is a dearth of research on this interesting and important phenomenon in Nigeria. This study compared burnout and its associated factors in various health professionals working at the University College Hospital, Ibadan, Nigeria. Two hundred and sixty health care providers were sampled from 5 main units: Theatre/Intensive Care Unit (ICU), Accident and Emergency (A & E), Oncology, Dentistry and General Outpatients Department (GOP), among others. Included were 104 nurses (40%), 83 doctors (31.9%), 21 pharmacists/pharmacy technicians (8.0%), 10 medical social workers (3.8%) and 42 nursing assistants (16.1%). Outcome measures included the Maslach Burnout Inventory (MBI), the 30-item General Health Questionnaire (GHQ) and the Spielberger State Trait Anxiety Inventory (STAI). Core findings indicated that nurses consistently reported higher scores on all measures of burnout: exhaustion (F = 3.60, df = 258, P < .05); accomplishment (F = 3.94, df = 258, P < .05) and depersonalization (F = 4.58, df 258, P < .01) when compared with other health care providers. Significant differences were also noted between nurses and all other care providers in total scores on the General Health Questionnaire (F = 6.54, df 258, P < .01) and the State Trait Anxiety Inventory (F = 1.91, df 258, P < .05), respectively. These results are discussed in relation to the existing literature on burnout in Nigeria. Further empirical study is highly suggested in view of dearth of studies on the occupational health of health care providers in Nigeria.

Adult↗
PubMed2002

The burnout risk for male caregivers in providing care to spouses afflicted with Alzheimer's disease.

In a review of the Alzheimer's and burnout literature, it seems apparent that Alzheimer's caregivers, especially male caregivers, are particularly subject to burnout. Male caregivers are seemingly more likely to experience the typical symptoms of burnout, namely: depersonalization, diminished personal accomplishment, and emotional exhaustion. Unfortunately, male caregivers also seem less inclined to seek out community services. In addition to reviewing the literature, this article also proposes some research questions for further study.

Adaptation, Psychological↗
PubMedDate not supplied

[Schizophrenia and subjectivity].

Recently, the group of symptoms known as "subjective experiences" of schizophrenia has raised a growing interest. These phenomena have been shaped through concepts like depersonalization-derealization, mental automatism, disorders of the self and autism. The authors propose to review these syndromes, as well as their relationship with subjectivity understood as consciousness of the self (or self-awareness) and the shortcomings due to such a relationship. To finish, we will provide some hints into psychopathology understood as a technique of production of intelligibility which will hopefully help to provide a better grasp of the process described above.

Cognition Disorders↗
PubMedDate not supplied

[Burnout: rising interest phenomenon in stressful workplace].

Many stressful situations, particularly strong and long time lasting, can induce the burnout syndrome. The definition "burnout" refers to emotional and exhausting conditions related to working environment. Since 70'ties, many studies, have focused on this topic, have assessed that this condition is much more frequent in some particular professional categories: teachers, physicians, nurses, social workers, policemen, judges (the so-called helping professions). The main syndrome characteristics are: physical and emotional fatigue, depersonalization, frustration for unsuccessful professional realization and reduced personal accomplishment in competence and productivity with decreasing critical sense towards working field. The Maslach Burnout Inventory (MBI) has been the most popular instrument for measuring burnout in medical research. The coherence of many studies results on helping professions in different countries, leads to the conclusion that basically burnout is a psycho-social phenomenon of international relevance. These studies have also identified personal, relational and environmental risk factors susceptible to prevention.

Burnout, Professional↗
PubMed1986

Anxiety attacks in a patient with a right temporal lobe meningioma.

The role of neurologic factors leading to the appearance of anxiety attacks is incompletely understood. The case of a 69-year-old woman with no previous psychiatric illness who began to experience frequent anxiety attacks is described. These attacks were later associated with depersonalization and visual perceptual disturbances. The symptoms disappeared following the discovery and removal of a right temporal lobe meningioma.

Aged↗
PubMed1985

[Clinical dynamics of cenesto-hypochondriacal neurosis-like disorders in schizophrenia with onset in adolescence (clinico-catamnestic study)].

For 10-15 years the authors studied the time-course of neurosis-like disturbances in 46 patients with schizophrenia manifested in adolescence with cenesthopathic symptomatology (23 patients presented the cenesthopathic-hypochondriac syndrome, in 17 cenesthopathia was attended by phobias, in 6 it was combined with manifestations of derealization and depersonalization). The study showed that in 87% of the observations the disease ran continuously (torpidly in 29, by the type of the simple form in 5 and by the type of the paranoid form in 6 patients), in 13% of the patients the disease ran a paroxysm-progressive course. In 10-15 years the clinical picture in half of the patients continued to be characterized by the leading cenestho-hypochondriac symptomatology, in one-fourth of patients cenestho-hypochondriac disturbances were transformed into hallucinational-paranoid, in another one-fourth of patients into either psychosis-like or apathoabulic (by the type of the simple form) symptomatology. The authors discuss the degree of progression of the disease in different variants of its course, the social and marital status of patients, the specificity of personality changes and peculiarities of disease relapses.

Adolescent↗
PubMed1984

Psychosis in borderline personality disorder.

Do patients with borderline personality disorder (BPD) display psychotic symptoms as part of their syndrome? This question has important theoretical significance, since it bears on the question of whether BPD lies 'on the border' of psychotic functioning, or whether it is unrelated to psychotic disorders. A review of available evidence suggests that 'narrowly defined' psychotic symptoms, such as those included under the DSM-III definition of psychosis, are rare in BPD. Furthermore, when such symptoms have been reported in BPD, they may have been attributable to a concomitant, possibly independent, disorder suffered by the patient, such as substance abuse or major affective disorder. Broadly defined psychotic symptoms, such as depersonalization, are much more often reported in BPD, but many of these symptoms have also been reported frequently in patients with non-psychotic disorders and in normals. Finally, the prevalence of factitious psychotic symptoms in BPD has not been systematically investigated. Thus, the evidence for psychotic symptoms in BPD remains equivocal.

Adolescent↗