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PubMed2001

[Dreams and interhemispheric asymmetry].

The dreams of 103 children and adolescents, aged 10-17 years, have been studied. The test group included 78 patients with neurotic disorders; control one consisted of 25 healthy subjects. Dream features, which were common for those with preferentially left asymmetry profile both in patients as well as in healthy subjects, were: less expressed novelty factor and frequent appearance of rare phenomena, such as "déjà vu in wakefulness", reality, "mixed" (overlapped) dreams, prolonged dreams in repeat sleep, frequent changes of personages and scenes of action. Left-hander dream peculiarities, being detected only in neurotic patients but not in healthy subjects, emerged as lucid phenomena deficit, "dream in dreams" and "dream reminiscence in dream" syndrome, which have been found only in left-handers. Right and left hemispheres seem to contribute in different ways to a dream formation. In authors believe that the left hemisphere seems to provide dream origin while the right hemisphere provides dream vividness, figurativeness and affective activation level.

Adolescent↗
PubMed1999

Geographical analysis of the risk of psychiatric hospitalization in Hamburg from 1988 - 1994.

The analysis of the geographical distribution of hospital cases is obviously important for the purpose of planning hospital services, but it is of even greater significance in the planning of psychiatric services. This concern motivated our seven-year-long study, which examined hospitalization risks among various categories of psychiatric disorders in the major German city of Hamburg. Our database encompassed 77% (n = 64,000) of all psychiatric admissions in a total of 41 hospitals, most of which are general hospitals. In order to carry out the geographical analysis we employed a new statistical method based on a mixture distribution model. According to our findings, the strongest indications of an increased frequency were among male cases of schizophrenia, drug abuse and organic psychoses, and female cases of neurotic disorders, personality disorders, drug abuse and schizophrenia. We found that some areas are exposed to a risk of hospitalization for these diagnostic categories which is more than 50% above the reference. Contrary to other authors we did not identify an increased frequency of admission concentrated in the inner-city area for any of the diagnostic groups. The risk of hospitalization for schizophrenics was almost entirely associated with the close proximity of psychiatric units, while the risks for neuroses and personality disorders, as well as alcohol and drug abuse, appeared to be concentrated in areas of low social status. However, a statistically relevant correlation between an increased risk of hospitalization and low social status could be determined only for drug abuse and alcoholism. In the end, we did identify two areas in which there was an increased risk of hospitalization for several diagnostic groups, and this information will undoubtedly facilitate the planning of hospital and psychiatric services. The fact that our findings deviate to some extent from other authors - especially with respect to neuroses and personality disorders, but also to addiction - can be attributed to the inclusion of psychiatric cases from general hospitals in our geographic analysis.

Adolescent↗
PubMed1987

[Clinico-psychopathological characteristics of the mental disorders at a neurotic level detected in patients at a general polyclinic].

Examination of patients observed at a general somatic outpatient centre showed that 31.2% of the patients had mental disorders of the borderline level. Most commonly occurring among the psychopathological syndromes were atypical affective conditions with definite somatization of mental disturbances, which was expressed in massive somatic sensations (senestopathies), vegetative irregularities, and somatic pathology of the functional character. Such conditions made up 62.7%. The given syndromologic type is defined as senestopathic-hypochondriac depression which is subdivided into two variants depending on the nature of the symptomatology. The study has shown that the revealed psychopathological syndromes of the borderline level predominantly refer to the endogenic process of low intensity and less frequently to personality pathology at the stage of decompensation.

Ambulatory Care↗
PubMed2001

Etiological factors of mental disorders among members of the Polish military forces.

OBJECTIVE: This project attempts to establish possible links between psychosocial factors and mental disorders among Polish professional soldiers. MATERIALS AND METHODS: The examined group consisted of 1,785 professional soldiers hospitalized in the psychiatric department of the 107th Military Hospital in Walcz in the years 1982 to 1984, 1986 to 1989, and 1993 to 1996. The study was based on analysis of accessible medical files. Special attention was paid to diagnosis, age, year of service, garrison size, position, and motivation to remain in military service. The International Classification of Diseases, Tenth Revision, diagnostic scheme was used. RESULTS: Neurotic disorders were the most often diagnosed psychic disturbances in all groups of professional soldiers. More than half of the soldiers hospitalized from 1986 to 1989 became unfit for further military duty because of their mental disturbances. This study confirmed statistical links between dismissals of professional soldiers and motivation, age, or job seniority. Also, we found a link between military positions and increased psychiatric morbidity among soldiers. Personality disturbances, maladaptive syndromes, and substance-related disorders dominated at command positions in all years investigated. CONCLUSION: The results showed the necessity of further elaborations of preventive and new treatment rules, leading to a diminution of mental disturbances among professional soldiers in Poland.

Adult↗
PubMed1993

[Sexual stimulation and the female orgasm].

Questionnaire data regarding mode of sexual stimulation were collected in 200 women treated for neurotic disorders and 100 female health professionals and counselors. Clitoral stimulation was the source of female orgasm in 90% of subjects, while three quarters achieved orgasm also by means of vaginal stimulation. The anterior wall of the vagina seemed to be slightly more important than the posterior one. One third of the respondents reported effective stimulation in the depth of the vagina with cervical tapping. Stimulation in the area corresponding to the alleged G spot was acknowledged as effective by 10 to 20%. The sexual responsiveness of neurotic patients was generally somewhat lower than responsiveness of health professionals and counselors.

Female↗
PubMed2005

Higher-order dimensions of personality disorder: hierarchical structure and relationships with the five-factor model, the interpersonal circle, and psychopathy.

Two studies examined the higher-order factor structure of DSM-IV personality disorders using the International Personality Disorder Examination in male forensic psychiatric patients. In Study 1 (N = 168), exploratory factor analysis at the level of individual personality disorder criteria indicated nine primary factors. Exploratory and confirmatory factor analyses of these first-order factors supported a hierarchical structure in which two of three second-order factors covaried to yield a third-order factor. The two resulting superordinate factors were labelled Anxious-Inhibited and Acting Out. In Study 2 (N = 160), we used exploratory and confirmatory factor analyses to test hypotheses of common dimensions underlying these superordinate factors of personality disorder and superordinate factors of the five-factor model of personality, dimensions of the interpersonal circle, and psychopathy. Of three common factors, one combined Anxious-Inhibited disorders, "neurotic introversion," and hostile-submission. The other two factors of Acting Out/ psychopathy and antagonism/hostile-dominance covaried to yield a superordinate factor. Possible substrates underlying two superordinate dimensions common to normal and abnormal personality were identified in the theoretical literature.

Adult↗
PubMed1993

[Diagnosis and treatment of depressive syndromes in general practice of established neurologists. Results of an empirical study].

Data on 9956 patients concerning the diagnosis (ICD-9) and treatment of depressive syndromes were collected in psychiatric office practice. About 50% of the patients were over 50 years of age. Among all depressive disorders, neurotic and endogenous depression were found to have the highest prevalence. Amitriptyline and Doxepin were preferred in psychopharmacological treatment. Supportive Psychotherapy was practised extensively while highly structured psychoanalytical or behavioural forms of psychotherapy were relatively rare. The discussion emphasizes a methodological and epidemiological research perspective.

Adult↗
PubMed2004

[Quality of life in unipolar depressive and bipolar affective patients].

OBJECTIVE: To assess subjective quality of life (QOL) of subjects with unipolar depressive and bipolar affective disorders. METHODS: 153 consecutive psychiatric in-patients were assessed with standardized interviews. Prior to discharge QOL was assessed with WHOQOL-bref. With the help of multivariate statistics, the effect of illness and biographical factors on four domains of QOL (physical health, psychological, social relationships and environment) was analyzed. RESULTS: 103 patients suffered from unipolar depression, 51 from bipolar affective disorder (30 fulfilled criteria for a mixed or pure manic episode). With the exception of the domain environment for (mixed) manic patients, all patients reported lower QOL in all domains than was reported for the general population according to the German test manual. Multivariate analyses revealed that the chosen variables explained between 11.1 % (social relationships) and 33.6 % (psychological) of the variance of the QOL domains. The domains "psychological" and "environment" were first of all explained by the presence of a (mixed) manic episode, while the best variable to predict "physical health" was presence of comorbid neurotic disorder. The depression score had little additional effects on QOL. CONCLUSIONS: We found little support that the QOL domains of the WHOQOL-bref in affective disorder are only hidden depression scores, as has been argued before. Therefore, QOL could be an interesting construct to better understand differences between subjective evaluation and (supposedly) objective psychopathology in bipolar affective disorders.

Adult↗
PubMed1995

The prevalence and costs of psychiatric disorders and learning disabilities.

BACKGROUND: The economic burden of psychiatric disorders and learning disability is assessed in order to aid decisions on priorities for research funding. METHOD: A wide variety of data sources both on prevalence and on the usage and costs of relevant services were used to measure the economic burden of each condition. RESULTS: Despite methodological problems and problems with the data, an attempt is made to estimate the relative economic burden imposed by each condition. No attempt is made to sum up the costs for each condition across the agencies and individuals involved. CONCLUSIONS: Our findings show that learning disability, schizophrenia and neurotic conditions (including depression) are major burdens on the National Health Service; senile dementia and depression in older people impact largely on local authority social services. Senile dementia, schizophrenia and learning disability are also heavy charges on the social security system. It is also notable that the large numbers with less severely disabling neurotic disorders generate a burden that, according to our figures, is comparable to schizophrenia and other psychotic disorders.

Adolescent↗
PubMed1990

[Mental health care for mentally ill employees. Part 1. Detection of mental disorders].

A mental health program was commenced in 1957 in an electric power company which has about 360 offices and 17,000 employees scattered throughout Kyushu (excluding Okinawa). During a period of 30 yr from 1957 to 1986, a total of 949 mentally ill employees sought consultation regarding various mental health problems. The mean annual number of new cases that sought consultation was 32, giving a rate of 0.19% of the number of employees as of the end of year. The rate increased with length of service and reached 4.4% of the initially employed number after 25-29 yr of service. In addition to cases of direct interview, indirect consultation was sought from family members and/or superiors of the employees. About one-half of this number later sought direct interview, but the remaining cases remained as latent cases in places of work. Psychiatric diagnoses of the subjects by interview included neurotic disorders, alcoholic mental disorders (alcoholic psychoses and dependence), schizophrenic psychoses, affective psychoses, personality disorders, epilepsy and other non-organic psychoses (reactive psychoses).

Adolescent↗
PubMed1996

[Vertigo and anxiety disorders--results of interdisciplinary evaluation].

BACKGROUND: Vertigo is a common symptom that often remains unexplained despite extensive medical evaluation. Psychiatric and psychosomatic disorders are usually considered after all somatic causes of vertigo have been ruled out. METHODS: Eighty-three patients referred to neurological or psychosomatic outpatient treatment received an extensive neurootologic and psychosomatic evaluation: one (or two) diagnostic psychiatric psychodynamic exploration(s), a structured interview, psychometric tests (SCL-90-R, STAI-G X2 and GBB). The patients were divided into four diagnostic groups: psychic causes only (psychogenic group), neurootologic causes only (somatic group), both diagnoses (psychosomatic group), neither diagnosis (group IV). RESULTS: Twenty-three patients had organic vertigo, thirty-nine patients had psychogenic vertigo and in seventeen cases a vestibular lesion initiated the development of a neurotic disorder, particular anxiety disorder. Most of the patients of the psychogenic and psychosomatic group had anxiety or phobic disorders. The patients with psychogenic or psychosomatic symptoms of vertigo generally report a higher level of subjective distress; the periods of disability are significant longer. CONCLUSIONS: The study suggests that assessment of psychiatric and psychosomatic symptoms should always accompany, not follow, neurootologic evaluation of vertigo. An early interdisciplinary therapy should be started to prevent the chronicity of the symptomatology.

Adult↗
PubMed1994

Multicenter double-blind study of moclobemide and maprotiline.

A randomized double-blind, multicenter 6-week study was undertaken in 80 depressed patients to compare the effects of moclobemide, a selective and reversible monoamine oxidase-A inhibitor (300 mg daily), and maprotiline (75 mg daily). Efficacy was assessed by Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI). Tolerability was assessed by adverse events reports. After 6 weeks of therapy, both groups of patients showed significant improvement in HDRS and CGI. Speed of onset of action was faster with moclobemide (significant difference at week 3, p = 0.025). There was a significant reduction of depression ratings (HDRS) in both the moclobemide and maprotiline group in all types of depression according to ICD-9 criteria (major depressive disorder, neurotic depression and adjustment-prolonged depressive reaction). Significantly fewer patients in the moclobemide group reported adverse events (28.9% compared with 70.2%) including weight gain (2.6% compared to 21.6%). Anticholinergic side effects were less frequent with moclobemide. It is concluded that both drugs are at least equivalent in terms of therapeutic efficacy, but moclobemide is better tolerated.

Adult↗
PubMed2002

Psychiatric sequelae in atomic bomb survivors in Hiroshima and Nagasaki two decades after the explosions.

BACKGROUND: Atomic bomb exposure was an extraordinarily stressful event. Although little epidemiological research has been performed on the psychiatric effects of the bombings, many medical descriptions of the survivors suggest that there was an increase of various symptoms that implied autonomic ataxia or neurosis-like disorders. The psychiatric effects of exposure to the atomic bomb explosions in Hiroshima and Nagasaki were assessed in this study. METHOD: From a self-administered medical questionnaire completed between 1962 and 1965 by 9421 informed and consenting Adult Health Study subjects, some questions congruent with the DSM-IV diagnostic criteria for generalized anxiety disorder and somatization disorder were selected and used as indicators of anxiety symptoms and somatization symptoms. The prevalence of psychiatric symptoms in relation to age, sex, city (Hiroshima vs. Nagasaki), acute radiation symptoms, exposure status (in city or not in city), ground distance from hypocenter, disease history, and death of family members were analyzed. RESULTS: A higher prevalence of anxiety symptoms (odds ratio, 1.73) and somatization symptoms (odds ratio, 1.99) was observed in those with acute radiation symptoms than in those without them. The prevalence of anxiety symptoms and somatization symptoms among people who were in the city at the time of the explosion was significantly higher than among those who were not in the city. Among the former, prevalence was lower among proximally exposed people than among distally exposed people. Symptom prevalences were also affected by age, sex, and city. Although disease history such as neurotic disorder and ulcer were risk factors for anxiety symptoms and somatization symptoms, the increased prevalence of anxiety symptoms and somatization symptoms in association with atomic bomb exposure was independent of disease history and the death of family members. CONCLUSION: The prevalence of anxiety symptoms and somatization symptoms was elevated in atomic bomb survivors even 17-20 years after the bombings had occurred, indicating the long-term nature of the psychiatric effects of the experience. Psychiatric sequelae were independent of physical sequelae.

Adult↗
PubMed1998

Psychological health and well-being: why and how should public health specialists measure it? Part 1: Rationale and methods of the investigation, and review of psychiatric epidemiology.

BACKGROUND: There are cogent reasons why public health specialists should take an active interest in and measure the psychological health and well-being of populations. The literature was searched and reviewed with the aim of evaluating survey instruments that would enable public health specialists to measure the psychological health and well-being of populations. METHODS: The search and review were restricted to instruments that were applicable to adults of working age, and that did not focus on psychotic disorder or organic brain disorder. An attempt was also made to identify instruments that were designed to measure some form of positive well-being and could be applied in population-based surveys. Detailed evaluation was then carried out of two or three instruments that appeared representative of a particular field or approach. RESULTS: The literature search revealed three major fields of research, 'Psychiatric Epidemiology', 'Stress Studies' and 'Subjective Well-being'. Accordingly, the results of the review are presented under these three headings. Results pertaining to commonly used survey instruments in the field of 'Psychiatric Epidemiology' are presented. (Those on 'Stress Studies' and 'Subjective Well-being' are presented in Part 2 of this study.) CONCLUSIONS: Although some questionnaires in the field of 'Psychiatric Epidemiology', such as the General Health Questionnaire and the HAD Scale, offer a valid and convenient means of measuring degrees of neurotic disorder in a population, they do not measure any form of positive well-being. In Part 2, methods of measurement from the other two fields are reviewed and overall conclusions are drawn about the options available to public health specialists.

Epidemiologic Studies↗
PubMed1999

Non-steroidal anti-inflammatory drugs with adverse psychiatric reactions: five case reports.

Adverse drug reactions of non-steroidal anti-inflammatory drugs (NSAIDs) are quite prevalent, but there are few reports about possible adverse psychiatric reactions, which may be ignored or underestimated. We describe here five psychiatric outpatients, two with major depressive disorders, one bipolar disorder, one schizophrenic disorder and one anxiety disorder, who were treated with NSAIDs for pain due to rheumatoid arthritis, osteoarthritis or other painful neuromuscular conditions. All five patients developed a moderate to severe depressive state, three patients became obviously paranoid, and four had either thoughts of suicide or an attempt while undergoing co-administration of NSAIDs. The psychiatric symptoms remitted when the NSAIDs were stopped. The depressive and paranoid symptoms returned on seven occasions of re-use or re-challenge with the same or a different type of NSAID in all five patients. When the NSAIDs were stopped again, the patients had another remission of the adverse psychiatric reactions, and eventually recovered to their baseline mental states in clear temporal relationships. The cases presented suggest that NSAIDs can induce or exacerbate idiosyncratic reproducible adverse psychiatric symptoms in certain vulnerable patients, including those with a variety of psychotic or neurotic disorders, and also in elderly persons, but these undesirable side-effects were generally transient and disappeared on withdrawal of the NSAIDs.

Adult↗
PubMedDate not supplied

[The therapeutic efficacy and the effect of gidazepam and fenazepam on the psychophysiological status and on the performance of operators with mental disorders at a neurotic level].

The effect of placebo and gidazepam on the state, psychophysiological predictors of the quality of the operator's performance and its results in individuals with neurotic reactions was studied (test dose 20 mg 7-day course, 40 mg daily, 24 individuals), as well as the effect of gidazepam and phenazepam (42 individuals with neurotic and neurosis-like states; gidazepam test doses 20 and 50 mg, 14-day course, 40 and 100 mg daily; phenazepam test doses 0.5 and 1 mg, 14-day course, daily dose 2 mg). The generally accepted methods of clinical and psychophysiological examination were applied. Gidazepam in the doses under study did not yield to phenazepam in therapeutic activity. A single and a course administration of gidazepam improved the parameters of the psychophysiological state and the efficacy of the operator performance in patients with neurotic reactions and in those with neurotic and neurosis-like states. This makes it possible, whenever necessary, to recommend this drug for the treatment of the indicated disorders in the working operators.

Adult↗
PubMed1990

[Cytotoxic activity of blood serum in borderline conditions].

A study was made of cytotoxic activity of blood serum from 118 patients with borderline neuropsychic disorders (neurotic depression, neurosis, psychopathy, pathologic development of the personality on the basis of organic injury to the brain). Material of 114 mentally and somatically healthy donors served as control. Balb mouse thymocytes and organ culture of the rat brain were employed as test objects. ++Anti-thymus activity (ATA) was measured according to the cytotoxic index, whereas neurotoxic activity (NTA) by inhibition of 3H-cholesterol incorporation. The patients and donors groups differed by distribution of persons with high and low values of NTA and ATA. However, according to the mean level of blood serum cytotoxic activity such a difference was revealed only in respect to NTA. The determined parameters are related in a different way to the patient's age and similarly to the disease standing. The intensity of ATA and NTA was different in different nosological subgroups. An interrelationship was established between the clinical and biological dynamics, supporting a possibility of the use of the given tests as predictors of the therapeutic efficacy and the depth of homeostasis derangement.

Adult↗