SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Delusional jealousy is an important subject for forensic psychiatry because of its well-known association with violence, especially as directed toward spouses. In this article, we report a study of 20 individuals who suffered from delusional jealousy. Important biopsychosocial parameters, the relation between jealousy and aggression, and directions for future study are explored.
The aim of this study is to test the feasibility and the efficacy of a cognitive and behavior therapy manual for auditory hallucinations with persons suffering from schizophrenia in a French-speaking environment and under natural clinical conditions. Eight patients met ICD-10 criteria for paranoid schizophrenia, 2 for hebephrenic schizophrenia and 1 for schizoaffective disorder. All were hearing voices daily. Patients followed the intervention for 3 to 6 months according to their individual rhythms. Participants filled up questionnaires at pre-test, post-test and three months follow-up. The instruments were the Belief About Voice Questionnaire--Revised and two seven points scales about frequency of hallucinations and attribution of the source of the voices. Results show a decrease of voices' frequency and improvement in attributing the voices rather to an internal than to an external source. Malevolent or benevolent beliefs about voices are significantly decreased at follow-up as well as efforts at coping with hallucinations. Results should be interpreted with caution because of the small number of subjects. The sample may not be representative of patients with persistent symptoms since there is an over representation of patients with benevolent voices and an under representation of patients with substance misuse.
A 33-year-old man presented with a 10-year history of psychosis and an imaginary companion; he carried a past diagnosis of chronic schizophrenia. He responded quickly to neuroleptic and was noted to be an easily engageable person. It is argued that despite his first-rank Schneiderian symptoms, the patient may not best be conceptualized as having schizophrenia. Specific treatment recommendations are made, predicated on this man's developmental history, his attachment and separation behavior, and his response to a structured social milieu.
This study compared suicidal patients with assaultive behavior to suicidal patients without assaultive behavior. Of 667 suicidal male patients admitted to psychiatric hospitals during the study period, 90 (14%) were assaultive at the time of or just prior to admission, while of the 893 female suicidal patients admitted, 60 (7%) were assaultive. Male assaultive suicidal patients were more likely than non-assaultive males to be referred to hospitals by the law and mental health services, while female assaultive patients were more likely to be 34 years of age or younger and to have primary psychiatric diagnoses of paranoid schizophrenia, alcohol or drug abuse, or psychotic organic brain syndrome. For both sexes, assaultive suicidal patients were more likely to have delusions, hallucinations, feelings of suspicion or persecution as well as anger, belligerence, agitation and anti-social behavior. There was no significant difference between assaultive and non-assaultive suicidal patients in regard to the frequency of depressive symptoms.
An open clinical trial with Haloperidol Decanoate was carried out in order to determine its therapeutic efficacy, side effects, and tolerance. The sample population was a 30 male-and-female-psychotic-patient group (15 in-patients and 15 out-patients treated at a private psychiatric institution). A marked stabilizing effect with no relapses was observed. Therefore, it can safely be said that Haloperidol Decanoate helped in controling these patients satisfactorily, and getting a positive social reintegration.
OBJECTIVE: Psychotic symptoms occur in 30%-60% of individuals with Alzheimer disease (AD) with psychosis (AD+P). AD+P identifies a distinct AD phenotype, with increased severity of cognitive impairment and a more rapid cognitive decline. Using factor and cluster analysis, we previously proposed two subtypes of patients with AD+P, one characterized by misidentifications and hallucinations (Misidentification), the other by persecutory delusions (Paranoid). We hypothesized that these two groups differed in their patterns of cognitive impairment, compared with AD subjects without psychosis. METHODS: Subjects (N=119) with possible or probable AD were assessed with a comprehensive neuropsychological test battery at the time of initial presentation. Psychotic symptoms were ascertained with the CERAD Behavioral Rating Scale. Cognitive test scores were compared among groups by use of general linear-regression models, with age, education, and duration of illness entered as covariates. All results were corrected for multiple comparisons. RESULTS: The Misidentification group was significantly more impaired than the Non-Psychotic group on tests of verbal fluency and visuospatial function. The Paranoid group did not differ from the Non-Psychotic group on any test. CONCLUSIONS: These results support the identification of the Misidentification and Paranoid groups as distinct subgroups of AD+P. The ability to detect meaningful biologic associations of AD+P in future studies would be enhanced by separate analysis of the Misidentification and Paranoid phenotypes.
In order to check the concurrent validity of the Differential Personality Inventory (DPI), the authors gave the test to 60 psychiatric patients (25 men, 35 women), who also were observed and rated on Lorr and Vestre's Psychotic Inpatient Profile. Patients also took Whitaker's Index of Schizophrenic Thinking (WIST), a test that measures thought disorder. The patients received higher scores on appropriate scales of the DPI than did a normative group (N = 370) of university students. We predicted that six of the DPI scales would correlate with relevant criterion measures (Lorr-Vestre scales and WIST); in five of six instances such correlations were statistically significant. We conclude that the DPI discriminates psychotics from normals and that among psychotics it has a moderate power to discriminate among types of psychotic behavior.
Excessive dependency has been hypothesized to be both a risk factor and a complication of depression. The purpose of this study was to test the specificity of the relationship between DSM-III-R dependent personality disorder (DPD) and depressive disorders. Two hundred subjects were independently administered the Structured Clinical Interview for DSM-III-R (SCID) and the Personality Disorder Examination (PDE) face-to-face by two experienced clinicians. Comorbidity of DPD and axis I disorders of five different types was examined. Dependent personality disorder was associated with mood disorders, both bipolar disorder and major depression, but was also associated with several anxiety disorders, bulimia, and nonaffective psychotic disorders. Dependent-personality disorder was associated with borderline, avoidant, schizotypal, obsessive-compulsive, narcissistic, and paranoid personality disorder made no significant additional contribution to the association between personality disorder and axis I disorder. These results suggest the DPD represents maladaptive traits and behaviors that cut across a range of personality psychopathology and are related to a variety of types of psychological distress. Thus, a specific++ relationship od DPD to depression was not supported.
Heiby's 1982 self-reinforcement questionnaire (a measure of the ability to reward oneself selectively for constructive behaviors or efforts and to nurture a positive self-image by means of a supportive internal speech) was administered to 12 normal controls (psychiatric nurses), 11 paranoid schizophrenic patients (DSM-III--R), 8 bipolar patients currently manic (DSM-III--R), and 12 inpatients treated for substance abuse (DSM-III--R). No significant mean differences were found on analysis of variance. The means of the groups of psychiatric inpatients and of normal persons are comparable to means of other samples of normals, e.g., college students or factory workers, reported in the literature.
Cocaine has become the recreational drug of abuse of the eighties. The prevalence of cocaine has been manifesting increases in intoxications and poisonings. Acute overdoses have been associated with hyperthermia, agitation, paranoid ideation, status epilepticus, ventricular fibrillation, ventricular tachycardia, myocardial infarction, coma, and death. This is the first reported case of cocaine intoxication resulting in severe hyperthermia, bizarre behavior, rhabdomyolysis, and acute renal failure. Treatment consisted of cooling via iced intravenous fluids, nasogastric lavage with ice water, and benzodiazepine sedation. To our knowledge, there is no case report which supports the allusions that cocaine intoxication may cause rhabdomyolysis and acute renal failure.
OBJECTIVES: This study aims to examine the psychometric properties of the Chinese version of the Alzheimer's disease behavioral pathology rating scale (CBehave-AD) and the behavioral profile of Chinese patients with AD. METHODS: Seventy-one subjects with NINCDS-ADRDA diagnosis of probable and possible AD were assessed for validation of the CBehave-AD. A behavioral symptom frequency checklist, the Chinese version of the Blessed Roth dementia scale (CDS) and the Cantonese version of the Mini-Mental State Examination (CMMSE) were used for comparison. An extended sample of 120 AD patients was then evaluated with the CBehave-AD. RESULTS: High correlations between the CBehave-AD and checklist scores were found (paranoid and delusional ideation, hallucinations, activity disturbances, aggressiveness and diurnal rhythm disturbances). The scale also demonstrated satisfactory inter-rater and test-retest reliabilities. The mean (SD) CMMSE score of the 120 patients was 9.4 (7.1). Among them, 32% have delusions, 15% had hallucinations, 54% had activity disturbances, 61% had aggressive behavior, 44% had sleep disturbance, 24% had affective disturbances, 19% had anxiety and phobias. Delusional ideation was significantly associated with hallucinations, aggressiveness, and affective disturbances. Diurnal rhythm disturbances were associated with activity disturbances and aggressiveness. CBehave-AD total scores were not significantly correlated with severity of AD, but individual symptom categories showed different pattern of correlation. Delusions, hallucinations, anxiety and phobias were significantly correlated with dementia staging. CONCLUSION: The findings suggest that the CBehave-AD is a valid assessment tool for behavioral disturbances in patients with AD. Variable associations between different symptom categories and dementia staging suggest a need for further exploration of the complex interactions between behavioral and cognitive disturbances in dementia.
To obtain an insight into the development of a new pharmacotherapy that prevents the treatment-resistant relapse of psychostimulant-induced psychosis and schizophrenia, we have investigated in the mouse the effects of selective serotonin reuptake inhibitors (SSRI), fluoxetine (FLX) and paroxetine (PRX), on the established sensitization induced by methamphetamine (MAP), a model of the relapse of these psychoses, because the modifications of the brain serotonergic transmission have been reported to antagonize the sensitization phenomenon. In agreement with previous reports, repeated MAP treatment (1.0 mg/kg a day, subcutaneously (s.c.)) for 10 days induced a long-lasting enhancement of the increasing effects of a challenge dose of MAP (0.24 mg/kg, s.c.) on motor activity on day 12 or 29 of withdrawal. The daily injection of FLX (10 mg/kg, s.c.) or PRX (8 mg/kg, s.c.) from 12 to 16 days of withdrawal of repeated MAP administration markedly attenuated the ability of the MAP pretreatment to augment the motor responses to the challenge dose of the stimulant 13 days after the SSRI injection. The repeated treatment with FLX or PRX alone failed to affect the motor stimulation following the challenge of saline and MAP 13 days later. These results suggest that the intermittent and repetitive elevation of serotonergic tone may inhibit the expression of the motor sensitization induced by pretreatment with MAP. It is proposed that clinically available serotonin reuptake inhibitors could be useful for preventing the recurrence of hallucinatory-paranoid state in drug-induced psychosis and schizophrenia.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Involuntary admission of a patient deemed dangerous may be motivated by a wish to protect the patient and others from potential violence-or by a practitioner's wish to limit personal liability. Evidence is offered to suggest that the practice of defensive psychiatry is not uncommon, and a case demonstrating the role of professional self-protection in an involuntary commitment decision is presented. Procedural modifications in the commitment process are proposed as a means of protecting patients' civil liberties.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.