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At least 613 records · Page 34Linked to original sources
PubMed2006

Pharmacotherapy of pathological gambling: review of new treatment modalities.

Pathological gambling is classified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition as an impulse-control disorder. In the International Classification of Diseases of the WHO, pathological gambling is coded under the heading of 'Habit and Impulse Disorders'. Pathological gambling is a chronic, progressive disorder, which has a prevalence of 1-3.4% among western civilizations. The enormous personal and social consequences of this disorder include a high rate of suicide attempts, job loss, marital and family problems, legal problems, and criminal behavior. Recent studies have demonstrated that pathological gambling patients respond well to treatment with selective serotonin reuptake inhibitors, mood stabilizers and opioid antagonists. These findings support the idea that pathological gambling and other disorders of impulse control may be conceptualized as part of the obsessive-compulsive spectrum disorders or addictive disorders. This article will discuss possible treatment strategies according to different behavior patterns in pathological gambling and also remind the physicians who intend to treat this disorder of the possible diagnosis of pathological gambling.

Antidepressive Agents↗
PubMed1973

The writ writer.

Explore the source record for details and available documents.

Adult↗
PubMedDate not supplied

Malingering of PTSD: forensic and diagnostic considerations, characteristics of malingerers and clinical presentations.

OBJECTIVE: This paper aims to study the detection of individuals malingering posttraumatic stress disorder (PTSD) in criminal and civil situations. METHOD: A brief history of PTSD and its rise to prominence in legal circles are discussed. The characteristics of individuals who malinger and particularly those who fake PTSD are discussed. Diagnostic dilemmas inherent to the condition, such as the definition of a traumatic exposure, what constitutes a PTSD flashback and the potential for normal symptom exaggeration, are explored. RESULTS: The typical presentation of malingered symptoms is presented to help clinicians detect commonly seen malingering patterns. Suggestions for interview techniques, Minnesota Multiphasic Personality Inventory test values and sources of collateral information to help detect malingering are reviewed. CONCLUSION: The paper concludes with a review of the typical presentations of malingered PTSD symptoms and a reminder that physicians need to distinguish legitimate symptoms from faked or embellished presentations.

Diagnosis, Differential↗
PubMedDate not supplied

Anxiety-related somatic reactions during missile attacks.

During the Persian Gulf war the Israeli civilian population was the target of missile attacks that could have carried poison gas warheads. During the attacks all civilians were ordered to wear gas masks and move into sealed rooms. Four telephone surveys studied the somatic reactions to this anxiety-arousing situation. The percent of subjects reporting the somatic reactions declined from 38% after the first attack to 20% 12 days later. Somatic reactions were more prevalent among females than males, and among those who completed elementary school only compared to those with an academic education. A complex pattern of relationships between expectancies about chemical warfare attacks and somatic reactions is discussed.

Adult↗
PubMed1994

Effects of short chain fatty acids on gut morphology and function.

Short chain fatty acids (SCFAs) are the products of colonic bacterial degradation of unabsorbed starch and non-starch polysaccharide (fibre). They are important anions in the colonic lumen, affecting both colonocyte morphology and function. The three main acids (acetate, propionate, and butyrate) stimulate colonic sodium and fluid absorption and exert proliferative effects on the colonocyte. Experimental animal studies have shown that they promote adaptive responses to small intestinal resection and colonic anastomosis. Acetate increases colonic blood flow and enhances ileal motility. Butyrate has been shown to be the preferred energy substrate for the colonocyte and to be a potent differentiating agent in cell culture. Butyrate may also have a role in preventing certain types of colitis. A diet low in resistant starch and fibre, which will result in a low production of SCFAs in the colon, may explain the high occurrence of colonic disorders seen in the Western civilization.

Cell Differentiation↗
PubMed1995

[Psychosocial aspects of disseminated sclerosis].

Using multiple sclerosis as a model, it is demonstrated how a chronic neurological disorder has psychosocial consequences during the period between onset and diagnosis, at the time of diagnosis, and in the post-diagnostic period. The impact of the disorder on self-esteem, civil status, habitation, economy, social and leisure activities and need for help is described. It is concluded that it will increasingly be expected that the physician has knowledge of these relations.

Denmark↗
PubMed2004

Is the risk of bipolar disorder in twins equal to the risk in singletons? A nationwide register-based study.

BACKGROUND: A previous study demonstrated a higher rate of schizophrenia in dizygotic twins than in the general population, and a higher rate of schizophrenia in siblings of dizygotic twins than in siblings of monozygotic twins and singletons, pointing to a common genetic predisposition for dizygotic twinning and schizophrenia. The aim of the present study was to investigate whether these findings also apply to bipolar disorder. METHODS: Through record linkage between The Danish Twin Register, The Danish Psychiatric Central Register and The Danish Civil Registration System, the rate of bipolar disorder (diagnosed for the first time during admission to hospital) in dizygotic and monozygotic twins was compared with the rate in singletons, and the rate in siblings and parents of twins was compared with the rate in siblings and parents of singletons. RESULTS: The rate of bipolar disorder was the same in dizygotic twins, monozygotic twins and singletons as well as for parents and siblings of dizygotic twins, monozygotic twins and singletons. LIMITATIONS: The study is a register-based study, only including hospitalized patients. CONCLUSION: This study shows that there is an equal rate of bipolar disorder in twins and in singletons. Assuming that DZ twinning is under some genetic influence, a differential relationship between schizophrenia and DZ twinning on one hand and bipolar disorder and DZ twinning on the other hand may suggest differences in the genetic basis of the two diseases. The finding that the rate of bipolar disorder in monozygotic twins is the same as the rate of bipolar disorder in singletons supports studies finding no association between bipolar disorder and obstetric complications.

Adult↗
PubMed1994

Legal aspects of post-traumatic stress disorder.

The legal requirements for compensable injury in civil law gradually has loosened over the years from the physical effects of direct injury to include the emotional effects of direct injury, the emotional effects of witnessing injury to others, the emotional effects of knowing of injury to others, and a person's fear that he or she may become ill at a later date. Although a psychiatric diagnosis is not required to bring action, post-traumatic stress disorder (PTSD) has become the favored diagnosis in cases of emotional distress. Also, in criminal law, defenses based on PTSD have become increasingly common, being used as the standard defense in selected situations. The limits of the use of PTSD as a defense remain to be clarified; differing judgments have been made in similar cases by different courts.

Adult↗
PubMed1998

Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods.

BACKGROUND: The public perception that mental disorder is strongly associated with violence drives both legal policy (eg, civil commitment) and social practice (eg, stigma) toward people with mental disorders. This study describes and characterizes the prevalence of community violence in a sample of people discharged from acute psychiatric facilities at 3 sites. At one site, a comparison group of other residents in the same neighborhoods was also assessed. METHODS: We enrolled 1136 male and female patients with mental disorders between the ages of 18 and 40 years in a study that monitored violence to others every 10 weeks during their first year after discharge from the hospital. Patient self-reports were augmented by reports from collateral informants and by police and hospital records. The comparison group consisted of 519 people living in the neighborhoods in which the patients resided after hospital discharge. They were interviewed once about violence in the past 10 weeks. RESULTS: There was no significant difference between the prevalence of violence by patients without symptoms of substance abuse and the prevalence of violence by others living in the same neighborhoods who were also without symptoms of substance abuse. Substance abuse symptoms significantly raised the rate of violence in both the patient and the comparison groups, and a higher portion of patients than of others in their neighborhoods reported symptoms of substance abuse. Violence in both patient and comparison groups was most frequently targeted at family members and friends, and most often took place at home. CONCLUSIONS: "Discharged mental patients" do not form a homogeneous group in relation to violence in the community. The prevalence of community violence by people discharged from acute psychiatric facilities varies considerably according to diagnosis and, particularly, co-occurring substance abuse diagnosis or symptoms.

Adolescent↗
PubMed1988

Civil commitment in the psychiatric emergency room. III. Disposition as a function of mental disorder and dangerousness indicators.

In 251 evaluations observed in five California public psychiatric emergency rooms, patients who were retained, whether new to the system or having histories of hospitalization, rated higher on measures of danger to self, danger to others, and grave disability than patients who were released. They were also more severely symptomatic and more often given major diagnoses. The combination of dangerousness and mental disorder predicted disposition for 93% of new patients and 88% of recidivist patients. Impulsivity was the most influential aspect of mental disorder.

Adult↗
PubMed2006

Urbanicity during upbringing and bipolar affective disorders in Denmark.

BACKGROUND: It has been suggested that known or suspected risk factors for schizophrenia may also be of importance for other psychoses, but the empirical evidence regarding this is limited. Urbanicity of place of birth and during upbringing has been shown to be related to the risk of schizophrenia. Few studies of urbanicity in relation to bipolar affective disorder exist. OBJECTIVE: To investigate the potential association between urbanicity at birth and during upbringing and the risk of bipolar affective disorder. METHOD: Using data from the Danish Civil Registration System, we established a population-based cohort of 2.04 million people born in Denmark during 1956-1986, which included information on place of residence during upbringing. Bipolar affective disorder in cohort members was identified by linkage with the Danish Psychiatric Central Register. RESULTS: Overall, 2232 people developed bipolar affective disorder during 1971-2001. We found evidence of an increased risk associated with residence in the provincial city; individuals, who at the 15th birthday lived in the provincial city, had a risk of 1.23 (1.08-1.41). This increased risk was explained solely by an increased risk associated with residence in Aarhus; at the 15th birthday, people residing in Aarhus - the largest of the three Danish provincial cities - had a 1.83 (1.56-2.14) increased risk of bipolar affective disorder (p < 0.001). Urbanicity during upbringing (p = 0.13) had no significant effects on the risk of bipolar affective disorder. CONCLUSIONS: We found no evidence of a dose-response relationship between urbanicity at birth (and during upbringing) and the risk of bipolar affective disorders in Denmark, but found some evidence that the diagnostic practices used in Aarhus differed from the rest of Denmark.

Adolescent↗
PubMed2004

[Effect of psychotherapy on autonomic balance in VDT-operators with somatoform disorders].

BACKGROUND: The omnipresence of stress-inducing factors that stems from the permanent development of our civilization results in a constantly growing number of people with neurotic disorders. Computer technology, a very new labor technique, has become a stressful factor. Stressful factors initially affect the central nervous system, which modifies vegetative functions. The autonomic balance can be a measurable indicator of disease severity. MATERIALS AND METHODS: The study group consisted of 50 VDT-operators with neurotic disorders. Twenty five healthy VDT-operators formed the control group. The autonomic balance was investigated with Holter monitoring. Each of the 50 neurotic VDT-operators were qualified for a 3-month psychotherapy. RESULTS: The analysis of Holter recordings proved that the applied model of psychotherapy significantly reduced the number of sympathicotonics in favor of normotonics in the study group (p < 0.01). CONCLUSIONS: The Holter analysis can be considered as a reliable indicator of the effect of psychotherapy.

Autonomic Nervous System↗
PubMed2002

[Civil and criminal suits concerning PTSD in Japan].

In civil and criminal trials in Japan, post-traumatic stress disorder (PTSD) issues have recently become a common topic of debate. In both types of (civil and criminal cases) judgments have been either affective or negative to PTSD. Contributing factors to the diagnosis of the accused that is identified to suffer from PTSD vary between cases. The difference in the establishment of the diagnosis for PTSD between psychiatrists reflects an aspect of the current situation in Japan where they have not used perfectly obvious and clearly defined diagnostic criterion, including ICD-10 and DSM-IV. To resolve this problem, a simple, clear and objective criterion of PTSD must be established. Instead of criterion that may take a long time to be established, a checklist can be used to relate PTSD with legal matters, as well as to determine liability in damages of the accused in civil cases and punishment in criminal cases.

Accidents, Traffic↗
PubMed2003

Expert testimony in sexually violent predator commitments: conceptualizing legal standards of "mental disorder" and "likely to reoffend".

The most recent type of civil commitment for dangerous sex offenders is found under the sexually violent predator laws. Forensic psychiatrists or psychologists must render an opinion as to whether the sex offender has a diagnosed mental disorder and, as such, represents a risk to public safety if released from custody into the community. Thus, expert testimony provided by these professionals has taken a central role in the commitment determinations. There is considerable debate as to what disorders predispose individuals to sexual recidivism and what the term "likely" signifies. In this article, the authors explore the debate in terms of whether Antisocial Personality Disorder is a qualifying diagnosed mental disorder for classification as a sexually violent predator and how a likely threshold of risk of sexual recidivism can be conceptualized.

Antisocial Personality Disorder↗
PubMed1993

Coping of school-age children in the sealed room during scud missile bombardment and postwar stress reactions.

Children's coping behaviors in the sealed room (a shelter against chemical and biological weapons) during scud missile attacks in the Persian Gulf war were examined in relation to postwar stress reactions. Three weeks after the war, 5th, 7th, and 10th graders (N = 492) completed questionnaires assessing coping behaviors and emotional responses in the sealed room, as well as current stress reactions and posttraumatic stress disorder (PTSD). Despite an underlying feeling of tension, the dominant emotional stance in the sealed room was one of detached optimism. Common forms of coping involved information seeking, checking, and wishful thinking. Emotion-focused coping such as avoidance and distraction strategies was associated with less postwar stress reactions than persistence at direct problem-focused actions once the minimal actions available had been undertaken. Fifth graders were found to use less emotion-focused and more problem-focused coping strategies than were the 7th and 10th graders.

Adaptation, Psychological↗