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A prospective study of patient assaults on nurses in a provincial psychiatric hospital in Canada.

A 27-month prospective study was conducted of patient assaults on nurses in a Canadian psychiatric hospital. Rates were low (4% of the patients committing an assault) and the injuries mostly trivial. Schizophrenics accounted for 43% of attacks, but when allowance was made for the disproportionate number of patients in the hospital with this diagnosis, individuals with mental retardation or dementia were approximately twice as likely to be assaultive as schizophrenics. Repeat assaulters (greater than 4 attacks) were more likely to be suffering from paranoid schizophrenia.

Adolescent↗

Temperament and character inventory in homicidal, nonaddicted paranoid schizophrenic patients: a preliminary study.

This study assessed the personalities of 13 murderer schizophrenics using Cloninger's Temperament and Character Inventory, controlling different factors such as institution, treatment, detention or loss of liberty, and can discriminate between schizophrenic patients involved in homicide, schizophrenics with no past violent behavior, paranoiac murderers, and imprisoned murderers with no psychiatric history. Results show significantly that murderer schizophrenics had significantly higher scores on the subscale, Self-transcendence, than other groups, which suggests that Self-transcendence as measured may be an aggravating factor for schizophrenia and may be found in the personality of schizophrenic subjects who performed homicidal acts. This dimension constitutes a way and an additional element for diagnosis not available with the DSM-IV criteria. It may help understanding and predicting violent behavior among schizophrenic patients.

Adult↗

Psychiatric phenomena in dementia of the Alzheimer type.

Psychiatric symptoms and behavioral disturbances are of importance in dementia of the Alzheimer type (DAT) but have been relatively neglected by researchers. The main psychiatric symptoms are disorders of thought content (delusions and paranoid ideation), disorders of perception (hallucinations and misidentifications) and disorders of affect (depressed and elevated mood). They occur commonly in DAT, and there is evidence that they may indicate subtypes of the disorder in view of their demographic, structural, and prognostic correlates. Personality changes are very common, and these may be the earliest manifestation of dementia. Behavioral disturbances tend to be associated with advanced dementia and are particularly disruptive to caregivers. Structural correlates suggest that some behaviors are a direct result of brain damage. Psychiatric and behavioral features in DAT are important, as they may serve as a model for symptomatology in functional psychiatric disorders.

Aged↗

Paranoia in a nonclinical population of college students.

The present study examined the incidence of paranoid ideation in a nonclinical population. A sample of 324 college students completed a questionnaire assessing their personal experiences of paranoia, with an emphasis on the cognitive, behavioral, and affective components of their experience. They also completed a general measure of paranoia in nonclinical samples, the Fenigstein and Vanable Paranoia Scale, and the Rosenberg Self-Esteem Scale. A total of 153 participants reported an experience of paranoia, which included a clear statement of planned intention to harm. This group scored significantly higher on the Paranoia Scale than those who reported no experience of paranoia. Furthermore, greater levels of paranoid ideation were associated with lower self-esteem. The present findings suggest that paranoia is a common human experience, and are consistent with the idea of continuity between normal and abnormal experience.

Adolescent↗

Children's perceptions of deviance and disorder.

First-, fourth-, seventh-, and eleventh-grade boys and girls were interviewed on the topic of deviant behavior among their peers. They were also asked to make deviance judgments on 2 story characters whose behaviors exemplified qualities that typically evoke an attribution of psychological disorder on the part of adult judges. 1 story described loss of control and aggression, the other a distorted and paranoid perception of social reality. The pattern of reaction to the stories was consistent with age-related shifts in the basic for deviant status. First graders largely failed to think in terms of group norms. The transition from the middle grades to adolescence was marked by greater emphasis on social consensus--both in psychological perspective and group behavior.

Adolescent↗

Can personality traits predict pathological responses to audiovisual stimulation?

The "Pockemon shock" is the most famous accident in the history of the broadcasting industry in Japan. Based on the experiences of this unfortunate accident from famous animation program "Pocket Monster", this study focused on the psychology and psychosomatics of the patients. A head-mounted display was used as the three-dimensional image presentation device and "Descent", a free software shooting game, was used as the software. Ten healthy adult male volunteers were used in this experiment after obtaining their informed consent. The oxygen metabolic change in the anterior lobe of the brain was measured by near infrared spectroscopy and recorded on an electrocardiogram. The mental scaling tendency of the object was analyzed using the type A behavior pattern and the hostility scaling. The Cook and Medley hostility (HO) scale from the Minnesota multiphasic personality inventory (MMPI) was also used in this experiment. From this scaling methodology, the paranoid scale, cynicism scale, lie scale, social support quality and social support quantity were calculated. All measured time series data were kept in the normal range, and no fatal arrhythmia or epilepsy were observed during experiments. In some cases, the brain oxygen metabolism may completely differ for the objects of Type A and Type B behavior patterns. On the whole, correlation did not become significant in type A scaling and hostility scaling. In a comparison of the percent changes of the HF in HRV with lie scaling, significant negative correlation was observed. The social support quantity was calculated from Cook and Medley, and significant negative correlations were observed with percent changes of LF/HF in HRV. The lie scale and social support quantity are opposite scaling. The sympathetic nervous system and parasympathetic nervous system have an opposite function also. Therefore, our results showed an interesting phenomenon, when considering the relationship between the autonomic function and the pathophysiological reaction to the audiovisual stimulations. As for the photo sensitive epilepsy, it was reported to be only 5-10% for all patients. Therefore, 90% or more of the cause could not be determined in patients who started a morbid response. The results in this study suggest that the autonomic function was connected to the mental tendency of the objects. By examining such directivity, it is expected that subjects, which show morbid reaction to an audiovisual stimulation, can be screened beforehand.

Acoustic Stimulation↗

Abuse of "BRON": a Japanese OTC cough suppressant solution containing methylephedrine, codeine, caffeine and chlorpheniramine.

1. The paper describes the mental disturbances of 44 abusive cases of "BRON," an over-the-counter (OTC) cough suppressant solution containing methylephedrine, codeine, caffeine, and chlorpheniramine. 2. Major psychiatric symptoms observed included hallucinatory-paranoid state and affective disorder. There also were groups which exhibited a combination of the two states and abuse only. 3. The hallucinatory-paranoid state group had a relatively small BRON usage amount, short usage term and few withdrawal symptoms. The affective disorder group, in contrast, had large usage amount, longer usage term, and showed significant autonomic nerve disorders during withdrawal. These tendencies were seen more clearly in the mixed state group. 4. The hallucinatory-paranoid state group showed little or no physical dependence, while that of the affective disorder group was thought to be firmly established. Thus, in the former group, methylephedrine was considered the major behavior modifying drug, while in the latter, it was thought to be codeine.

Adult↗

Thought disorder and schizophrenia: isolating and timing a mental event.

This study explored the ability of nonparanoid schizophrenic, paranoid schizophrenic, and mixed psychiatric control (manics and schizoaffectives) patients to perform on two types of conceptual, speeded inference (SI) tasks, which differ in type of abstraction process required. The subjects (N = 30) were grouped into high and low levels of thought dysfunction, as measured by the Whitaker Index of Schizophrenic Thinking (WIST). There were no differences among the three clinical groups on the conceptual, SI tasks. Reaction times differed reliably across the two SI tasks. High-WIST subjects were impaired on SI accuracy. Significant impairment in accuracy was demonstrated by high-WIST time and error groups on the more complex SI tasks. Information processing deficit was demonstrated in terms of encoding phase and reaction time in problem-solving of the three diagnostic groups as a function of WIST levels.

Adult↗

Psychometric analysis of the cultural mistrust inventory with a Black psychiatric inpatient sample.

An important empirical question is whether the Cultural Mistrust Inventory (CMI) can be used to measure cultural aspects of paranoia in Black psychiatric populations. Research on cultural mistrust in psychiatric populations is essential for tests of hypotheses regarding the misdiagnosis of African Americans. The purpose of this study was to assess the reliability and validity of the CMI in a sample of African American patients recently admitted to a psychiatric hospital. The reliability assessment revealed that the CMI total scale is a reliable measure. Factor analytic results indicated that a single global dimension underlies CMI scores. The CMI also showed good convergent validity with a measure of nonclinical paranoia and discriminant validity with measures of self-esteem and social desirability. This study provides reasonable evidence that use of the CMI with psychiatric patients is psychometrically sound.

Adult↗

The metamorphosis of 'culture-bound' syndromes.

Starting from a critical review of the concept of 'culture-bound' disorders and its development in comparative psychiatry, the authors present the changing aspects of two so-called culture-bound syndromes as paradigms of transcultural metamorphosis (koro) and intra-cultural metamorphosis (Salish Indian spirit sickness), respectively. The authors present recent data on epidemics of koro, which is supposedly bound to Chinese culture, in Thailand and India among non-Chinese populations. Neither the model of Oedipal castration anxiety nor the model of culture-specific pathogenicity, commonly adduced in psychiatric and ethnological literature, explain these phenomena. The authors' data on Salish Indian spirit sickness describes the contemporary condition as anomic depression, which is significantly different from its traditional namesake. The traditional concept was redefined by Salish ritual specialists in response to current needs imposed by social changes. The stresses involved in creating the contemporary phenomena of koro and spirit sickness are neither culture-specific nor culture-inherent, as postulated for 'culture-bound' syndromes, rather they are generated by a feeling of powerlessness caused by perceived threats to ethnic survival.

Anthropology, Cultural↗

Behavioural disturbances following Japanese B encephalitis.

Clinically, Japanese B encephalitis (JBE) is often overlooked as its occurrence in Western countries is rare. However, its neurological, cognitive and psychiatric sequelae constitute a major public health problem in the Far East where JBE is endemic. European and American subjects may however experience the JBE when returning from a Far East journey. In such cases, misdiagnosis is frequent because of the unawareness of psychiatrists and physicians. The present review, therefore, documents the behavioural and cognitive sequelae of JBE. This reactivates the debate concerning the vaccination against the virus all the more that the literature enlightens the importance of the vaccination for those who undertake frequent and extensive tourist excursions to the Orient but still discusses it for occasional travellers. Following is a case-report of a young western European post-graduate student who has contracted JBE by experiencing an acute febrile delirium during an unusual short stay in South East Asia. Pyramidal syndrome, Parkinsonism and amnesia were the prominent acute deficits. Whereas these faded in great part during convalescence, emotional and behavioural instability associated with affective involvement, obsessive-compulsive symptoms and cognitive impairments appeared. A partial recovery was however obtained with neuroleptics, lithium and following electro-convulsive therapy. Organic personality syndrome was persistent and thereafter constituted the main sequelae syndrome. Hypersomnia and several enuretic episodes persisted.

Adult↗