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PubMed1999

The psychosocial effects of amblyopia study.

PURPOSE: The purpose of this study was to assess the psychosocial effects of growing up with and living with amblyopia and to determine whether patients with amblyopia but without strabismus encounter psychosocial problems similar to those encountered by individuals with strabismus. METHODS: A 20-question survey focusing on medical background, education, self-image, history of amblyopia, treatment of amblyopia, and effects of amblyopia on work, school, friendships, and self-esteem was provided to patients with amblyopia but not strabismus at Saint Louis University Eye Institute and at the University of Iowa Department of Ophthalmology. In addition, patients were evaluated in terms of somatization, obsession-compulsion, interpersonal sensitivity, depression, and anxiety. Results for patients with amblyopia were compared with those of strabismic, normative, and psychopathologic groups using the Hopkins Symptom Checklist (HSC). RESULTS: Twenty-five patients with amblyopia but without strabismus or previous surgery responded. A significant number of patients felt that amblyopia interfered with school (52%) and work (48%) to some degree and were generally affected in their lifestyle (50%). Fewer were affected in their play of sports (40%) or were influenced as to their job choice (36%). Patients with amblyopia as a whole had a greater degree of somatization, obsessive-compulsive behavior, interpersonal sensitivity, depression, and anxiety than patients with strabismus and HSC control subjects. Differences between patients with amblyopia and those with strabismus were not statistically significant (P > .05), but differences between patients with amblyopia and HSC control subjects were significant (P < .05) in each category. Patients with amblyopia, however, were less symptomatic in these areas than HSC Anxious and HSC Depressed groups. CONCLUSION: Psychosocial difficulties related to amblyopia affect individuals' self-image, work, school, and friendships. Amblyopia has a significant effect on psychosocial functioning and warrants aggressive screening, prevention and treatment during the amblyogenic years.

Adolescent↗
PubMed1994

Gilles de la Tourette syndrome.

Gilles de la Tourette syndrome is a neurological disorder characterized by the presence of motor and vocal tics. Other associated features include complex motor and vocal tics, obsessive compulsive behavior and attention-deficit disorder. Although initially thought to be a rare condition, it now appears that the gene for Tourette syndrome may be present in as many as one in a thousand people, and is transmitted as an autosomal dominant trait. However, many individuals carrying the gene may exhibit only minimal symptoms. Neuropathophysiology of Tourette syndrome is unknown but investigations have suggested that the cause may be an abnormality either in the dopaminergic or endorphin receptor system within the basal ganglia. Treatment of Tourette syndrome involves education and counseling of the patient and family. Medications such as neuroleptics, serotonin-reuptake inhibitors, and stimulants are available to treat the manifestations of Tourette syndrome and need to be individualized for each patient.

Humans↗
PubMed2005

Executive functioning in children with autism and Tourette syndrome.

The main aims of this study were to investigate if children with high-functioning autism (HFA) and children with Tourette syndrome (TS) can be differentiated in their executive functioning (EF) profile compared to normal controls (NCs) and compared to each other and to investigate whether children with HFA or children with TS and a comorbid group of children with both disorders are distinct conditions in terms of EF, Four groups of children participated in this study: HFA, TS, comorbid HFA + TS, and a NC group. All children were in the age range of 6 to 13 years. The groups were compared on five major domains of EF: inhibition, visual working memory, planning, cognitive flexibility, and verbal fluency. Children with HFA scored lower than NC children on all the EFs measured. Children with TS and NC children showed the same EF profile. The HFA group scored lower than the TS group for inhibition of a prepotent response and cognitive flexibility. Children with HFA performed poorer than children with comorbid HFA + TS on all functions, with the exception of inhibiting an ongoing response, interference control, and verbal fluency. Children with TS and children with comorbid HFA + TS could not be differentiated from one another in terms of EF. This study indicates that EF deficits are highly characteristic of children with HFA in comparison to children with TS and NC. The results suggest that for the comparison between HFA and TS groups, it is important to take into account comorbidity. A reevaluation of the EF hypothesis in children with TS is suggested.

Adolescent↗
PubMed2003

Recidivism in stalking and obsessional harassment.

Despite the rapidly growth of mental health attention focused on the phenomenon of stalking, no empirical research to date has attempted to assess the frequency of repeat offending or attempted to identify predictors of recidivism. A total of 148 stalking and harassment offenders who were court-ordered to undergo a mental health evaluation were followed for a period of 2.5-13 years in order to assess the frequency of repeat offenses and the variables that differentiated high versus low risk offenders. Recidivism data were obtained from a variety of sources, including criminal justice records, mental health records, and reports from probation officers and victims. A number of potential "predictor" variables were selected on the basis of the existing recidivism literature in other criminal justice populations. Frequency analysis were used to identify variables that significantly differentiated offenders who did and did not reoffened while survival analysis was used to analyze the impact of these covariates on time to reoffense. A total of 49% of the offenders reoffended during the follow-up period, 80% of whom reoffended during the first year. The strongest predictors of recidivism included the presence of a personality disorder, and in particular, a "Cluster B" personality disorder (i.e., antisocial, borderline, and/or narcissistic). In addition, those offenders with both a personality disorder and a history of substance abuse were significantly more likely to reoffened compared to either of these risk factors alone. Surprisingly, the presence of a delusional disorder (e.g., erotomania) was associated with a lower risk of reoffender. The findings are discussed in terms of the legal system and treatment implications.

Adult↗
PubMed1997

Three years on clomipramine: before and after brain SPECT study.

A case is presented of a patient diagnosed with attention deficit disorder, obsessive thinking, anger outbursts, and depression who had a SPECT study prior to treatment and after 3 years of treatment on clomipramine. The follow-up SPECT study showed marked improvement overall in the cerebral perfusion of the brain. At rest marked overactivity was noted in the anterior medial aspects of the frontal lobes, along with "patchy" (increased and decreased) uptake throughout the cortical and subcortical areas of the brain. After treatment for 3 years on clomipramine at 225 mg a day, the follow-up SPECT study revealed a normalization of activity in the anterior medial aspects of the frontal lobes as well as no patchy uptake cortically and subcortically as noted in the study prior to treatment. The clinical usefulness of the SPECT study as it relates to this case is discussed.

Anger↗
PubMed2001

Mood as input and catastrophic worrying.

The authors describe 3 experiments investigating a "mood-as-input" approach to understanding catastrophic worrying. Experiment 1 found that induced negative mood increased the number of steps emitted in both a catastrophizing interview procedure and a positive iteration task. Experiment 2 found that the number of items that worriers emitted in an iterative item generation task was dependent on the stop rules specified by the procedure. Experiment 3 found that manipulating the stop rules for catastrophizing had differential effects on worriers and nonworriers, depending on the nature of the stop rules specified. These results suggest that mood provides information about continuing or terminating the catastrophizing process that is interpreted in the context of the stop rules for the task. It is argued that the mood-as-input hypothesis accounts for the facts of exacerbated catastrophizing in worriers better than explanations couched in terms of either mood congruency effects or worriers possessing a generalized perseverative iterative style.

Adult↗
PubMed2003

Les passions de l'ame: on obsessive and harmonious passion.

Passion is defined as a strong inclination toward an activity that people like, that they find important, and in which they invest time and energy. Two types of passion are proposed: obsessive and harmonious. Obsessive passion (OP) refers to a controlled internalization of an activity in one's identity that creates an internal pressure to engage in the activity that the person likes. Harmonious passion (HP) refers to an autonomous internalization that leads individuals to choose to engage in the activity that they like. HP promotes healthy adaptation whereas OP thwarts it by causing negative affect and rigid persistence. Results from four studies involving more than 900 participants from different populations supported the proposed conceptualization.

Adaptation, Psychological↗
PubMed2001

Mutations in the gene encoding epsilon-sarcoglycan cause myoclonus-dystonia syndrome.

The dystonias are a common clinically and genetically heterogeneous group of movement disorders. More than ten loci for inherited forms of dystonia have been mapped, but only three mutated genes have been identified so far. These are DYT1, encoding torsin A and mutant in the early-onset generalized form, GCH1 (formerly known as DYT5), encoding GTP-cyclohydrolase I and mutant in dominant dopa-responsive dystonia, and TH, encoding tyrosine hydroxylase and mutant in the recessive form of the disease. Myoclonus-dystonia syndrome (MDS; DYT11) is an autosomal dominant disorder characterized by bilateral, alcohol-sensitive myoclonic jerks involving mainly the arms and axial muscles. Dystonia, usually torticollis and/or writer's cramp, occurs in most but not all affected patients and may occasionally be the only symptom of the disease. In addition, patients often show prominent psychiatric abnormalities, including panic attacks and obsessive-compulsive behavior. In most MDS families, the disease is linked to a locus on chromosome 7q21 (refs. 11-13). Using a positional cloning approach, we have identified five different heterozygous loss-of-function mutations in the gene for epsilon-sarcoglycan (SGCE), which we mapped to a refined critical region of about 3.2 Mb. SGCE is expressed in all brain regions examined. Pedigree analysis shows a marked difference in penetrance depending on the parental origin of the disease allele. This is indicative of a maternal imprinting mechanism, which has been demonstrated in the mouse epsilon-sarcoglycan gene.

Adolescent↗
PubMed1998

Dentofacial disharmony: psychological status of patients seeking treatment consultation.

A sample of 194 patients whose dentofacial disharmonies were severe enough to warrant an orthognathic surgical treatment option completed the SCL-90-R, a 90-item assessment tool used to measure current level of psychological distress. Two global and nine primary dimension scores of psychological distress were computed. The average interpersonal sensitivity, psychoticism, and obsessive-compulsive dimension scores were higher than the nonpsychiatric patient population norms for both males and females, but the confidence intervals for these dimensions were still in the upper end of the normal range of functioning (< 1 SD above the normative mean). No statistically significant differences by gender or age group were observed. Over 15% of the patients were clinically elevated on obsessive-compulsive behavior, interpersonal sensitivity problems, hostility, paranoid ideation, and psychoticism; and 24.7% qualified as a positive diagnosis for a psychiatric disorder. It appears that a surprisingly large number of individuals with dentofacial disharmonies who are seeking treatment consultation are experiencing a level of psychological distress that warrants intervention.

Adolescent↗
PubMed2000

Obsession of hearing music: from the viewpoint of Morita theory.

We present two typical cases among five Japanese students who have complained of hearing music. They were found among 638 student case reports during 4 years at the mental health service center of a preparatory school. We diagnosed the complaint of hearing music as a symptom of obsession. Morita therapy was an effective treatment for this symptom. We discuss the characteristics of the symptom as an obsession and the therapy in the light of Morita theory.

Adolescent↗
PubMed2002

Dissociative and associated psychopathological symptoms in patients with epilepsy, pseudoseizures, and both seizure forms.

PURPOSE: A controversy currently exists regarding the significance of dissociation and conversion in the pathogenesis of pseudoepileptic seizures. After the abolition of the term "hysterical neurosis" from the current diagnostic systems, these seizures were diagnosed as either Dissociative Disorders (ICD-10) or in the DSM IV as Somatoform disorder, most often of conversion type. Recent studies of patients with Dissociative Disorders found that most patients also had conversion symptoms. METHODS: In the present study, 60 patients of an outpatient clinic for epilepsy were assessed for the presence of dissociative symptoms and general psychopathologic symptoms by using the German version of the Dissociative Experience Scale (DES) and the Symptom Check List (SCL-90-R). RESULTS: The patients with pseudoepileptic seizures showed a significantly higher incidence of dissociation (p < 0.0098) and general psychopathologic symptoms (p < 0.0083). Depression, anxiety, and obsession were dominating psychopathologic symptoms in all patients. CONCLUSIONS: The significantly higher incidence of dissociation in the patients with pseudoepileptic seizures suggests dissociation in the pathogenesis of these seizures.

Adult↗
PubMed2004

Clinical features and associated psychopathology in a Tourette syndrome cohort.

OBJECTIVE: This study explored in detail the association between tic symptomatology, related clinical variables, and psychopathology in 91 consecutive adult TS subjects from a UK clinic. METHODS: Consecutive patients from a specialized Tourette clinic who met the DSM-III criteria for TS were evaluated using standardized rating scales for Tourette syndrome and other psychopathology. RESULTS: The male female ratio in our cohort was 1.8:1. Significantly more males had an earlier age at onset of TS and history of birth complications. Obsessive compulsive behaviors in the patient was positively correlated with presence of attention deficit hyperactivity disorder and self-injurious behaviors. With regard to adult psychopathology, principal components factor analysis yielded two factors, 'obsessionality' and 'anxiety/depression', which accounted for 72% of the variance. CONCLUSION: Our results support the high occurrence of anxiety, depression and obsessionality in adult TS subjects.

Adolescent↗
PubMed2004

[Stalking: problems in differentiation between aberrant social behaviour and mental disorders].

The concept "stalking" refers to willful, malicious, and repeated following or harassment of another person that threatens her or his security. Although there is nothing new about the occurrence of this conduct it has been discussed in psychiatry more intensely in recent years. As a result there are a few attempts at classification, without any claim of general validity. Patterns of stalking behaviour reflect a wide spectrum from aggressive actions in the course of conflicts in a relationship to schizophrenia. Thus, it is not adequate to classify this as a psychiatric disorder per se. Thorough diagnostic assessments are mandatory before introducing legal measures, whereas if these are omitted, the term "mental disorder" may be inappropriately used in a wider sense. This may entail unfavourable consequences to be discussed in this paper.

Adult↗
PubMed2005

[Psychiatric significance of stalking].

AIMS: To provide an overview on the psychiatric significance of stalking and the implications for the health care system. RESULTS: Stalking is a widespread phenomenon and can result in significant health care problems. CONCLUSION: In the future physicians will have to deal with this problem in a professional manner.

Crime↗
PubMed1989

Positron emission tomography in psychiatric and neuropsychiatric disorders.

PET is potentially the most powerful tool yet available for the direct, in vivo investigation of the biologic basis of psychiatric and neuropsychiatric disorders. The fulfillment of its potential rests on the development of methodologies and study design appropriate to psychiatric disorders. To date, findings in both schizophrenia and affective disorder, using protocols largely based on resting state data acquisition, suggest altered regional metabolism. These approaches need to be extended, particularly by the application of protocols that utilize PET to obtain longitudinal data under controlled experimental situations. In two conditions traditionally ascribed to psychologic causes, OCD and PD, there is intriguing evidence of specific biologic abnormalities, which, if confirmed, would lead to a fundamental revision of their nosologic status. In neuropsychiatric disorders PET findings, although preliminary in nature, offer an alternative paradigm to traditional clinicopathologic correlations by suggesting that clinical impairments relate to physiologic effects at sites distant from structural lesions.

Anxiety Disorders↗
PubMed1983

Running--an analogue of anorexia?

We have explored the apparent similarity between patients with anorexia nervosa and a subgroup of male athletes designated as "obligatory runners." Case examples are provided from interviews with more than 60 marathon and trail runners. Obligatory runners resemble anorexic women in terms of family background; socioeconomic class; and such personality characteristics as inhibition of anger, extraordinarily high self-expectations, tolerance of physical discomfort, denial of potentially serious debility, and a tendency toward depression. Anorexic women and members of their families are often compulsively athletic, and obligatory runners may demonstrate a bizarre preoccupation with food and an unusual emphasis on lean body mass. We speculate that both phenomena could represent a partially successful--albeit dangerous--attempt to establish an identity. These preliminary observations will require further study for validation.

Adult↗