Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DEPERSONALIZATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed1984

[Unusual dreams in epileptics].

The author discusses bizarre dreams characteristic of epileptics and never occurring in normal subjects which have an important practical implication especially for early detection of epilepsy and the prevention of severe forms of the disease. This group of dreams includes vivid nightmares with vital fear, dreams not infrequently transforming into pro-dream states; persistently repeated stereotyped dreams and dreams with invariably the same unpleasant sensations representing an isolated aura of subsequent epileptic attacks. Diagnostically important may also be dreams with the symptoms of derealization and depersonalization, vague dream images and the deja vu phenomenon.

Adult↗
PubMed1983

Autoscopy: the experience of oneself as a double.

Autoscopy is thought to be a rare phenomenon in which a person visualizes or experiences a veritable hallucinatory image of his double. It may be more common than has hitherto been thought, however. It has no general pathological significance compared with its counterpart, the Capgras syndrome, where there is the experience of the object as a double, but it can occur in psychotic and borderline states and in afflictions of the central nervous system. Autoscopy has been known since ancient times but came into prominence only in the nineteenth century, both in the romantic literature of the double and in neuropsychiatric research. This paper details its history in literature as well as in psychiatry and neurology and also offers clinical examples from the author's caseload. It is the contention of the author that the phenomenon is far more common as an intrapsychic (nonhallucinatory) experience and that it is especially common in dreams. Autoscopy can ultimately be considered the quintessence of a "Cartesian artifice" in which one mind-body ("I") is caught in the act of regarding its compatriot self as a mind-body with sufficient distance as to register the ultimate meaning of self-recognition. A theory is offered that autoscopy is a special form of depersonalization which may be related to the "split-brain" phenomenon neurophysiologically and which is due to special forms of splitting and projective identification psychically.

Adult↗
PubMedDate not supplied

Hospital care grievances and psychosocial needs expressed by PWAs: an analysis of qualitative data.

Despite the growing number of HIV-related hospital admissions, reports of hospitalization experiences of persons with AIDS has been sparse. As part of a larger quantitative study to assess how arrangements of care of patients with AIDS are related to quality of care, the authors analyzed qualitative data collected during interviews with 50 patients hospitalized for HIV-related complications. The responses are suggestive of problematic hospital care issues and indicate psychosocial concerns. Overarching themes emerged of communication deficits and depersonalizing behavior. This research can help healthcare professionals develop increased sensitivity to patients' perspectives of their circumstances. More extensive research is needed to evaluate and improve the experiences of patients during hospitalization for HIV-related illness.

Acquired Immunodeficiency Syndrome↗
PubMed1997

[The psychopathology of paroxysm-like disorders in endogenous mental diseases].

45 patients with endogenous mental disorders were observed: 11 with manic-depressive psychosis and 34 with shift-like progredient schizophrenia. The peculiarity of the cases observed was the presence of paroxysmal-like disorders (PD) in clinical picture of the disease. 8 variants of PD were established: 1) with vegetative disorders, 2) with affective disturbances, 3) with obsessions, 4) with sensopathies and depersonalization, 5) with impulsive drives, 6) with alterations of consciousness (similar hysteric twilight type), 7) with hallucinations, 8) with development of manifestations of Kandinskiĭ-Clérambault's syndrome. The duration of PD varied from several seldom till a few hours, while their frequency from 1-2 in a year till several in twenty four hours. Paroxysmal-like states were accompanied by anxiety, fear or by low- differentiated sense of discomfort and "suppression", but second subjective affective feeling was neutral or even pleasant. The phenomenon which might be called as the anxious waiting for the fit was also marked. The observations of combinations of different variations of PD in one person as well as the cases of including of elements one variant in the picture of the other one permitted one to suggest the presence of a single pathobiological basis for PD rise.

Adult↗
PubMed1986

Childhood near-death experiences.

We nonselectively interviewed 11 patients aged 3 through 16 years who had survived critical illnesses, including cardiac arrests and profound comas. Any memory of a time they were unconscious was considered to be a near-death experience (NDE) and was recorded. Seven of these children had memories that included being out of the physical body (six patients), entering darkness (five patients), being in a tunnel (four patients), and deciding to return to the body (three patients). We also interviewed 29 age-matched survivors of illnesses that required intubation, narcotics, benzodiazepines, and admission to an intensive care unit. None of them had any memories of the time they were unconscious. In our study population, NDEs were clearly associated with surviving a critical illness. The elements of NDEs reported are similar to those previously described in adults. No children described elements of depersonalization as part of their NDEs. A core NDE, triggered by the process of dying or resuscitation efforts, may be a natural developmental experience. We present a neurophysiologic hypothesis as to the cause of NDEs.

Adolescent↗
PubMed2004

Resident burnout.

Intense work demands, limited control, and a high degree of work-home interference abound in residency training programs and should strongly predispose resident physicians to burnout as they do other health care professionals. This article reviews studies in the medical literature that address the level of burnout and associated personal and work factors, health and performance issues, and resources and interventions in residents. MEDLINE and PubMed databases were searched for peer-reviewed, English-language studies reporting primary data on burnout or dimensions of burnout among residents, published between 1983 and 2004, using combinations of the Medical Subject Heading terms burnout, professional, emotional exhaustion, cynicism, depersonalization and internship and residency, housestaff, intern, resident, or physicians in training and by examining reference lists of retrieved articles for relevant studies. A total of 15 heterogeneous articles on resident burnout were thus identified. The studies suggest that burnout levels are high among residents and may be associated with depression and problematic patient care. However, currently available data are insufficient to identify causal relationships and do not support using demographic or personality characteristics to identify at-risk residents. Moreover, given the heterogeneous nature and limitations of the available studies, as well as the importance of having rigorous data to understand and prevent resident burnout, large, prospective studies are needed.

Burnout, Professional↗
PubMed1998

Assessment of burnout for Chinese human service professionals: a study of factorial validity and invariance.

The present study used both exploratory and confirmatory factor analytic procedures to assess the factorial and construct validity of the MBI in Chinese human services professionals (N = 612). The classic three dimensions of burnout were supported, and the deletion of Items 12, 14, and 22 yielded a better fitting model. This new 19-item MBI for Chinese resembled the original 22-item MBI in the pattern of factor correlations and yielded satisfactory internal consistency estimates. Tests of equivalence of item measurements and theoretical structure of the revised 19-item MBI were also performed across gender. Results supported the invariance of the three-factor structure for men and women. Only items measuring the Depersonalization dimension were equivalent, whereas items of the Emotional Exhaustion and Lack of Personal Accomplishment dimensions were partially invariant across gender.

Adult↗
PubMed1997

Human anatomy: a foundation for education about death and dying in medicine.

In most medical schools, little curricular time is devoted to the art of medicine, and this is particularly evident with respect to death education. We make a case for including education on death and dying in medical schools, specifically its early introduction in the anatomy course. Studies indicate that whereas dissection of cadavers is an exciting discovery for most students, for many it is traumatic and if not addressed, students may use depersonalization and denial as their approach to suffering. The dissecting experiences in two different medical schools are described. The University of Massachusetts program developed in a traditional curriculum and explores humanistic issues with lectures and group discussions. Parallels are drawn between dissection and patient care, and coping styles are discussed openly. In the problem-based curriculum at Dalhousie Medical School, death and grief are discussed in the first week of medical school, and students are given information about the body donor program and support systems for students. This program is part of a longitudinal curriculum on death and dying. In both schools, students tour the dissecting rooms before the course begins and organize memorial events for body donors at the end of the academic year. These examples illustrate how death education can begin early in the medical curriculum and contribute to the development of practitioners who are sensitive to broader issues of human mortality.

Anatomy↗
PubMed1998

The relationship between staff burnout/distress and interactions with residents in two residential homes for older people.

OBJECTIVE: The main hypothesis was that staff burnout/distress would be negatively associated with the quantity and quality of social interactions between staff and residents. The subsidiary hypothesis hypothesis was that 'perceived involvement in decision-making' among staff would be positively associated with the quantity and quality of staff-resident interactions. DESIGN: Cross-sectional and within-group. Standardized self-report questionnaires completed by staff; and non-participant, time-sampling observation and coding of staff-resident interactions. SETTING. Two independent (not-for-profit) residential care homes for older people in the UK. PARTICIPANTS: 18 out of 24 residential workers completed questionnaires. MEASURES: The 12-item General Health Questionnaire (GHQ-12); the Maslach Burnout Inventory (MBI); the Perceived Involvement Personal Questionnaire (PIPQ); and the Quality of Interactions Schedule (QUIS). RESULTS: Staff who reported higher levels of personal accomplishment (ie lower levels of burnout on the personal accomplishment subscale) exhibited significantly more staff-resident interactions; and staff who perceived more involvement in decisions relating to their work showed significantly fewer negative staff-resident interactions. Staff distress, emotional exhaustion and depersonalization were not found to be significantly related to the quantity or quality of staff resident interactions. CONCLUSIONS: The results provide some support for the hypotheses. It appears that levels of personal accomplishment and perceived involvement in decision-making among staff may significantly influence the quantity and quality of staff-resident interactions in residential settings. However, the causal relationships are uncertain, and replication of these findings is required in other contexts.

Adult↗
PubMed1998

Burnout: current knowledge and relevance to old age psychiatry.

OBJECTIVES: To review the literature on burnout and consider its relevance to old age psychiatry and the role of the consultant. DATA SOURCES: Medline and PsychLit computerized databases. DATA SYNTHESIS: Burnout is a syndrome of emotional exhaustion, depersonalization and decreased sense of personal accomplishment which is recognized in people working in the human service professions and can have adverse effects on the workforce. There is little evidence of unique stressors related to care of elderly mentally ill people. Burnout is likely to be modified by workplace interventions. Relevant areas for intervention are political and social, organizational and management, training and personal issues. Support to consultants and their continuing professional development need to be radically reviewed.

Aged↗
PubMed1993

Complex partial epileptic signs as a continuum from normals to epileptics: normative data and clinical populations.

Over a 10-year period, a total of 447 men and 624 women between 18 and 61 years of age were administered an inventory whose items describe experiences that are similar to those evoked by electrical stimulation of the temporal lobes. Empirically determined factors contained experiences of sensory enhancement, affective-dissociation, ego alien intrusions, and literary emphasis. Using this population as a reference, T scores for these clusters were calculated for special normal populations (poets, drama students, false pregnancies) and for clinical groups (post-traumatic stress, anxiety-depersonalization, exotic dissociations, and complex partial epilepsy). Whereas only mild elevations (50 < T < 65) in indicators of temporal lobe signs and symptoms were noted in the special groups, moderate (65 < T < 75) and severe (T > 79) elevations were noted in the clinical populations.

Adult↗
PubMed2006

Preventing occupational stress in healthcare workers.

BACKGROUND: Healthcare workers can suffer from occupational stress which may lead to serious mental and physical health problems. OBJECTIVES: To evaluate the effectiveness of work and person-directed interventions in preventing stress at work in healthcare workers. SEARCH STRATEGY: We searched the Cochrane Depression Anxiety and Neurosis Group trials Specialised Register, MEDLINE, PsychInfo and Cochrane Occupational Health Field database. SELECTION CRITERIA: Randomised controlled clinical trials (RCT) of interventions aimed at preventing psychological stress in healthcare workers. For work-directed interventions interrupted time series and prospective cohort were also eligible. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed trial quality. Meta-analysis and qualitative synthesis were performed where appropriate. MAIN RESULTS: We identified 14 RCTs, three cluster-randomised trials and two crossover trials, including a total of 1,564 participants in intervention groups and 1,248 controls. Two trials were of high quality. Interventions were grouped into 1) person-directed: cognitive-behavioural, relaxation, music-making, therapeutic massage and multicomponent; and 2) work-directed: attitude change and communication, support from colleagues and participatory problem solving and decision-making, and changes in work organisation. There is limited evidence that person-directed interventions can reduce stress (standardised mean difference or SMD -0.85; 95% CI -1.21, -0.49); burnout: Emotional Exhaustion (weighted mean difference or WMD -5.82; 95% CI -11.02, -0.63) and lack of Personal Accomplishment (WMD -3.61; 95% CI -4.65, -2.58); and anxiety: state anxiety (WMD -9.42; 95% CI -16.92, -1.93) and trait anxiety (WMD -6.91; 95% CI -12.80, -1.01). One trial showed that stress remained low a month after intervention (WMD -6.10; 95% CI -8.44, -3.76). Another trial showed a reduction in Emotional Exhaustion (Mean Difference or MD -2.69; 95% CI -4.20, -1.17) and in lack of Personal Accomplishment (MD -2.41; 95% CI -3.83, -0.99) maintained up to two years when the intervention was boosted with refresher sessions. Two studies showed a reduction that was maintained up to a month in state anxiety (WMD -8.31; 95% CI -11.49, -5.13) and trait anxiety (WMD -4.09; 95% CI -7.60, -0.58). There is limited evidence that work-directed interventions can reduce stress symptoms (Mean Difference or MD -0.34; 95% CI -0.62, -0.06); Depersonalization (MD -1.14; 95% CI -2.18, -0.10), and general symptoms (MD -2.90; 95% CI -5.16, -0.64). One study showed that the difference in stress symptom level was nonsignificant at six months (MD -0.19; 95% CI -0.49, 0.11). AUTHORS' CONCLUSIONS: Limited evidence is available for the effectiveness of interventions to reduce stress levels in healthcare workers. Larger and better quality trials are needed.

Health Personnel↗
PubMedDate not supplied

Clinical experience with levonantradol hydrochloride in the prevention of cancer chemotherapy-induced nausea and vomiting.

Reports suggesting that delta 9-tetrahydrocannabinol (THC) had a potent antiemetic effect in patients treated with cancer chemotherapeutic agents led to the synthesis of other cannabinol derivatives with possibly less side effects. We report here our initial observations with the antiemetic levonantradol in 12 patients with advanced solid tumors receiving cytotoxic polychemotherapy. All patients had a history of vomiting and nausea without successful treatment with standard antiemetic drugs in previous, identical chemotherapy cycles. No other antiemetic or psychoactive drugs were given. Patients received 1 mg levonantradol i.m. 2 hours before as well as 2 and 6 hours after cytotoxic treatment. When compared to the last course of chemotherapy with alternate antiemetic drugs, we found that 11/12 patients had less nausea and vomiting when treated with levonantradol. 8/12 Patients considered the antiemetic treatment with levonantradol better than the one given before. The following side effects were observed: 4 patients complained of pain and local irritation after injection. 2 patients showed a fall in blood pressure, especially orthostatic hypotension. 8 patients complained of sedation and drowsiness. 7 patients experienced psychic side effects, such as decrease of vigilance and reaction, altered sense of timing, body image distortions and even depersonalization. Levonantradol is a potent antiemetic drug but its applicability, especially in outpatients, may be complicated by a high incidence of side effects.

Antiemetics↗
PubMed1986

Burnout among intensive care nurses.

The purpose of this study was to examine the relationship between intensive-care nurse burnout and demographic variables. The Maslach Burnout Inventory measured six components of burnout; emotional exhaustion frequency and intensity, depersonalization frequency and intensity, and personal accomplishment frequency and intensity. The sample (N = 89) was drawn from an army medical center. The variables, nursing, age, sex, military status, level of education, and length of time in nursing correlated with more than one aspect of burnout (p less than .05). Older age, less than a baccalaureate degree, female, and civilian status described the intensive care nurse who was less prone to burnout. Further study of the relationship between nurses and burnout is required.

Adult↗
PubMed2007

Burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients: a cross-sectional nationwide survey in Japan.

PURPOSE: To determine the prevalence of burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients in Japan and to explore associated factors related to end-of-life care. METHODS: Questionnaires were mailed to 1436 Japanese clinical oncologists and palliative care physicians with a request to complete the Maslach Burnout Inventory (MBI), the General Health Questionnaire (GHQ-12), and to report on individual factors, including confidence in patient care. High levels of burnout and psychiatric morbidity were identified using cut-off scores of the MBI and GHQ-12. RESULTS: A total of 697 physicians returned the questionnaires (response rate, 49.6%). Twenty-two percent of the respondents had a high level of emotional exhaustion, 11% had a high level of depersonalization, 62% had a low level of personal accomplishment, and 20% had psychiatric morbidity. Clinical oncologists showed a significantly higher psychiatric morbidity than palliative care physicians. Confidence in having sufficient time to communicate with patients was significantly associated with all the burnout subscales. CONCLUSIONS: A low level of personal accomplishment was relatively high among Japanese physicians compared with previous studies. Insufficient confidence in the psychological care of patients was associated with physician burnout rather than involvement in end-of-life care.

Adult↗
PubMed2005

Physician-patient communication among Southern European cancer physicians: the influence of psychosocial orientation and burnout.

Physician-patient communication is a critical factor for comprehensive care in oncology. Although a number of studies have been carried out in Northern Europe and the US on this subject, no data are available in Southern European countries. As a part of a multicenter Southern European Psycho-Oncology study (SEPOS), the present investigation was conducted to examine communication skills and related variables (i.e. psychosocial orientation, and burnout) among 125 physicians from Italy, Portugal, and Spain. The Self-Confidence in Communication Skills (SCCS) scale was given to assess physicians' perception of their communication skills and the Expected Outcome of Communication (EOC) scale was administered to examine the physicians' expectations about the effects of communicating with their patients. Doctors' psychosocial orientation was measured by using the Physician Belief Scale (PBS) and burnout was measured by using the Maslach Burnout Inventory (MBI). Although the physicians reported receiving minimal training in communication during their education, they tended to perceive themselves as skilled in patient communication, apart from some areas (e.g. dealing with denial, managing uncertainty, assessing anxiety and depression, and promoting patient-family openness). Low psychosocial orientation and burnout symptoms (i.e. emotional exhaustion, depersonalization, and poor personal accomplishment in their job) were associated with lower confidence in communication skills and higher expectations of a negative outcome, following physician-patient communication. The results suggest that there is a need for training cancer physicians in communication and for increasing a more definite psychosocially oriented approach in cancer care in Mediterranean countries.

Adult↗
PubMed1989

A question of medicine answering. Health commodification and the social relations of healing in Sri Lanka.

Biomedicine although institutionally powerful in Sri Lanka has not been able to depersonalize illness or promote a notion of treatment efficacy disconnected from social relations. An ideology of healing crosscuts the trend toward health commodification. This paper focuses on three concepts fundamental to the interactive dynamics of treatment efficacy: constitution, habit, and power of the hand. A movement between two distinct types of health care seeking behavior is described. One is inspired by finding the right medicine fix, the other by finding a practitioner having a sensitivity toward one's sense of person and all this entails.

Adolescent↗
PubMed1988

Prolonged disturbance of consciousness with periodic EEG discharges after fulminant hepatitis.

Prolonged disturbance of consciousness associated with periodic EEG discharges developed in a 57-year-old male after fulminant hepatitis. He had repeated episodes with mutism and depersonalization, each lasting for 1-2 days. There were periodic EEG discharges during each episode. The atypical triphasic wave was a constituent of periodic EEG discharges together with spike and sharp waves, which suggests that the atypical triphasic wave has an epileptogenic factor as do spike and sharp waves. The effectiveness of anticonvulsants on the disturbance also suggests that there was an epileptogenic factor in the causation of the disturbance of consciousness.

Cognition Disorders↗