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PubMed1978

Anorexia nervosa in boys.

The literature on primary anorexia nervosa in the male is reviewed and the case histories of 3 new patients are reported. Most surveys comment on the rarity of the syndrome in the male, with the sex ratio in the range of 1 in 10 to 1 in 20. The patients reported here had certain features in common. All the mothers and fathers were overweight, but obesity was marked only in the fathers, who also showed moderate to severe degrees of alcoholism. The mothers were oversensitive, insecure individuals, and the marriages suffered in proportion to the severity of the husband's alcoholism. Preoccupation with food was observed on home visits. There was overt mutual hostility between each father and anorexic son; the boys showed pronounced obsessional traits in their personalities. Dieting in order to ameliorate real or feared obesity was a first step in the development of the syndrome in each boy. In the past 3 years an equal number of boys and girls (new patients) have been referred for treatment in the psychiatric unit. Speculative reasons for this are discussed.

Adolescent↗
PubMed1998

Stalking. Part I: An overview of the problem.

OBJECTIVE: This paper is the first of a 2-part review on the topic of stalking. It outlines the behaviours involved, epidemiology, motivation of offenders, and mental health consequences for the victim. METHOD: Computerized literature searches were used to identify relevant papers from psychiatric and legal journals. Publications by victims' and women's organizations provided additional information. RESULTS: Up to 1 in 20 women will be stalked during her lifetime. The majority of victims are female, while the offenders are usually male. Stalking behaviours range from surveillance to threatening aggressive or violent acts. The majority of stalking relates to failed intimate relationships. Stalkers may also suffer from erotomania or obsessional love with a primary psychiatric diagnosis. Victims may experience anxiety, depression, guilt, helplessness, and symptoms of posttraumatic stress disorder (PTSD). CONCLUSION: Stalking is a serious offence perpetrated by disturbed offenders. It can cause major mental health consequences, which are often poorly understood by society.

Adult↗
PubMed2006

Recurrent absence status epilepticus (spike-and-wave stupor) associated with lamotrigine therapy.

We report on the aggravation of absence seizures by lamotrigine leading to absence status epilepticus in a child. The patient is a 10-year-old girl with a history of absence seizures, learning disabilities, and hereditary neuropathy with liability to pressure palsies. Lamotrigine (up to 12 mg/kg/day) was prescribed after a brief course of valproate was associated with restlessness. Long-acting methylphenidate was also administered. The initial response to lamotrigine appeared to be excellent. The first episode of absence status epilepticus occurred during a febrile illness while lamotrigine was being gradually discontinued. Following this event, lamotrigine dose was increased to 10 mg/kg/day and methylphenidate was continued. Six weeks later, a second absence status epilepticus episode ensued without fever. Sulthiame and clonazepam were substituted for lamotrigine, whereas methylphenidate therapy was continued. A psychiatrist prescribed risperidone 1 month later owing to obsessive-compulsive behavior. Nine months later, she remained free of absence seizures. Whereas the first absence status epilepticus event could have been triggered by fever, the second episode occurred while the daily lamotrigine dose was being increased. Moreover, the patient is seizure free following lamotrigine discontinuation. Hence, it is quite possible that lamotrigine caused seizure aggravation and absence status epilepticus in this child.

Anticonvulsants↗
PubMed1998

Obsessional neurosis: a nosographic innovation by Freud.

Freud refers in a paper published in 1895 to the phobias of obsessional neurosis. James Strachey, the editor of the Standard Edition of Freud's works, comments on this as follows: The term obsessional neurosis (Zwangsneurose) makes its first published appearance in this sentence...Lowenfeld... attributed the origin of both the term and the concept to Freud. Freud himself gave no indication at this point that he was introducing a new term. It was not until 1896 that he described obsessional neurosis as his nosographic innovation. The following questions are examined in the paper: Is it true that Freud coined the term obsessional neurosis? If so why is this fact so little known? What were the views of German-language neuropathology and psychiatry in the period around 1895 concerning the symptoms subsumed by Freud under obsessional neurosis, and in what respects did Freud's contribution differ from that of his colleagues? This paper is concerned exclusively with German-language psychiatry and neuropathology; it makes only isolated reference to their French counterparts. Furthermore, it focuses solely on the symptom that Freud placed at the core of obsessional neurosis, namely obsessional ideas.

Classification↗
PubMed2005

Women's experience of violence during stalking by former romantic partners: factors predictive of stalking violence.

This study investigated female experiences of physical violence during stalking by a former romantic partner. It aimed to identify factors that were predictive of such stalking violence. Two hundred and twenty female undergraduates who defined themselves as victims of stalking following the dissolution of a romantic relationship completed a short questionnaire. From their responses, 11 predictor variables were considered. These were self-reported relationship experiences of physical and sexual violence, intentional damage to participant's property, partner jealousy, isolation, monitoring, criticism and insults by the former partner, former partner's drug and alcohol abuse, and specific threats of violence while being stalked. The dependent variable in the study was whether stalking violence occurred; 35.9% (79/220) of participants experienced stalking violence. Logistic regression analysis revealed that there were statistically significant independent associations between threats, partner jealousy, and former partner drug abuse and stalking violence.

Adult↗
PubMed2001

'Here's the weavery looming up': verbal humour in a woman with high-functioning autism.

A case study of Grace, a 29-year-old woman with high-functioning autism, is presented. Grace is unusual for a person with autism in that she produces a great deal of humorous and creative word play. She is also unusual in that she writes and then audio-records 'letters' to her family, and produces copious cartoon-like drawings which she annotates, with the result that multiple examples of her humour are available in permanent form. We present examples of Grace's use of puns, jokes, neologisms, 'portmanteau' words, irreverent humour, irony, sarcasm and word play based on her obsessional interests. The examples are used to illustrate the forms and content of Grace's humour, and are discussed in relation to current theories of autism and of normal humour.

Adult↗
PubMed1977

Writer's cramp--a rational approach to treatment?

The history of writer's cramp is reviewed, and the study of ten cases described. Nine of the patients were male with obsessional personalities, and involved in a conflict with some bearing on the act of writing. Treatment by psychotherapy and re-education produced either temporary or little improvement; biofeedback, used in six cases, produced some benefit in four, of which only one relapsed. Although no statistical weight can be attached to the results of so short a series, biofeedback appears to offer a promise of response which merits further investigation. The use of the electromyograph is discussed also as a means of discriminating between tension and tremor in such cases, with particular reference to their psychosomatic meaning.

Adult↗
PubMed1984

Happy families?

Sixteen consecutive patients with anorexia nervosa were studied and compared with a control group of other patients coming to an adolescent service, matched for sex and admission status. The anorexic group were not significantly different from the controls in social class and I.Q., and had a male-to-female ratio of one to four. However, they were significantly more likely to have perfectionistic personality traits and to profess to be happy with their families; these families had few external stresses, were very close, and had a high degree of exclusivity.

Adolescent↗
PubMed1990

Anorexia nervosa and baby gazing.

The uncommon behaviour of baby gazing is described in a patient who had also suffered three episodes of anorexia nervosa. The baby gazing responded to joint therapeutic interviews leading to the patient and her husband resolving their different views about having a family and the patient becoming pregnant. Even then there was a minor recurrence of anorexic behaviour which yielded to treatment.

Adult↗
PubMed1999

'Obsessions' in children with autism or Asperger syndrome. Content analysis in terms of core domains of cognition.

BACKGROUND: We report a survey of the content of obsessions in children with autism spectrum conditions. We use the term 'obsessions' narrowly, to indicate strong, repetitive interests. We predicted that obsessions would not cluster randomly, but rather would occur significantly more often in the domain of 'folk physics' (an interest in how things work), and significantly less often in the domain of 'folk psychology' (an interest in how people work). These predictions were tested relative to a control group of 33 children with Tourette syndrome. AIMS: To examine the content of autistic obsessions, and to test the theory that these reflect an evolved cognitive style of good folk physics alongside impaired folk psychology. METHOD: Ninety-two parents returned a questionnaire designed to determine the subject of their child's obsessional interests. The results were analysed in terms of core domains of cognition. RESULTS: Both predictions were confirmed. CONCLUSIONS: These results suggest that impaired folk psychology and superior folk physics are part of the cognitive phenotype of autism. A content-free theory of obsessions is inadequate.

Asperger Syndrome↗
PubMed2005

Lifetime prevalence and impact of stalking in a European population: epidemiological data from a middle-sized German city.

BACKGROUND: There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in European countries. AIMS: To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims, and the impact of stalking on current psychological well-being in a German community sample. METHOD: A postal survey was conducted with a sample randomly selected from the population of a middle-sized German city; 679 people (400 women, 279 men) responded. The survey included a stalking questionnaire and the WHO-5 well-being scale. RESULTS: Almost 12% of the respondents (n=78, 68 women, 10 men) reported having been stalked. A multiple regression analysis revealed a significant effect of victimisation on psychological well-being. CONCLUSIONS: This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health are significant, suggesting that the phenomenon deserves more attention in future community mental health research.

Adaptation, Psychological↗