[Possible psychotic evolution of traumatic experience; paraphrenic syndrome beginning as fear neurosis].
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The following is a study of psychiatric emergencies in a General Hospital in Madrid (Spain). The Psychiatric Emergency Service of the Ramón y Cajal Hospital in Madrid received a total of 3,693 patients in 1988. This was 3.4% of patients seen in the General Emergency Service. The study is based on an analysis of the variables that influence a recommendation of hospitalization and their statistical significance. Hospitalization was recommended more frequently in males and those with diagnoses of depression, alcoholism and schizophrenic or paranoid disorders.
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The concept of social competence covers emotional, cognitive and behavioral abilities in the field of interpersonal communication and behavior patterns to cope with practical problems of life. Under the specific conditions of age, aging, and diseases in one part of the elderly, a loss of psycho-social competence may reduce the ability and quality of independent living. To improve social competence in old patients, an age-adapted assertiveness-training, based on the Assertiveness Training Program was proved in a group of psychogeriatric inpatients in a controlled study. In the self-rated activities of daily living and state-anxiety as well as in observer-rated self-confidence and assertiveness, the training group showed significant improvement compared to the controls.
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We delineate the case history of a 74-year-old female patient. On the occasion of acute physically established psychoses in this case, we were able to detect a primary hyperparathyroidism due to adenoids of the epithelial body. This critical psychopathological condition developed from a psychosyndrome, most likely seeming as senile schizophrenia, and which had previously existed for four years. It will be discussed whether these chronic schizophrenia-like symptoms and signs can be explained by hyperparathyroidism.
Based on the experience gained with psychoneurological examinations of 436 patients suffering from circulatory encephalopathy, the author reviews problems of its efficient classification and distinguishes the type of its clinical course (slow-progressing, rapid-progressing, galloping and remitting) and the clinical variety of the neuropsychic defect (mnemonic, affective, paranoiac). Describes methods of differentiated treatment of circulatory encephalopathy, carried out with regard to the patients' age, individual response to the drugs and selective influence of the latter ones on the structure of the neuropsychic defect.