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This paper handles with semiological and physiopathological aspects in relation with conversion and anosognosia symptoms. The author suggests the existence of a common physiopathological mechanism in both clinical pictures, in base of a stated paralelism of symptoms and clinical profile.
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Milton H. Erickson (1901-1980) renovated the study and practice of therapeutic hypnosis. The author first presents a synthetic overview of Erickson's original work and its spread. He then illustrates this with excerpts from observations of six of his own patients which correspond to the progressive integration of an ericksonian approach into a classical psychiatric practice in a general hospital setting.
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Changes in political or religious beliefs among POWs and hostages have often been attributed to "brainwashing" or "coercive persuasion." The cases reported have usually involved people held involuntarily. Since the publication of DSM-III, the authors have noted frequent usage of the term "atypical dissociative disorder" in civil lawsuits by plaintiffs seeking damages from groups or cults they joined voluntarily. The effects of "psychological captivity" are claimed to be comparable to the effects of involuntary participation in instances of kidnapping or being taken prisoner. The authors suggest that voluntary and involuntary activities are fundamentally dissimilar and that the use of DSM-III is problematic in these cases.
The authors have examined 106 patients with hypochondriac states developing in the presence of various mental diseases. The patients are divided into three nosological groups: psychogenic, exogenic-organic, and endogenic. Variants of the hypochondriac syndrome occurring in each group of the disease are described. Characteristics of the time-course of hypochondriac symptomatology and the stages of the formation of hypochondriac disturbances in relation to their classification with one or another nosological group are outlined.
Three case histories of men who suffered posttraumatic stress disorders after committing homicides are presented. These men were relatively young and had chaotic childhoods and minimal criminal histories. Each had killed a woman with whom he had a significant but intensely turbulent emotional relationship. The killings all occurred during altered mental states that were unrelated to the use of drugs or alcohol. The clinical significance and some of the medicolegal implications of this phenomenon are discussed.
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Do patients with borderline personality disorder (BPD) display psychotic symptoms as part of their syndrome? This question has important theoretical significance, since it bears on the question of whether BPD lies 'on the border' of psychotic functioning, or whether it is unrelated to psychotic disorders. A review of available evidence suggests that 'narrowly defined' psychotic symptoms, such as those included under the DSM-III definition of psychosis, are rare in BPD. Furthermore, when such symptoms have been reported in BPD, they may have been attributable to a concomitant, possibly independent, disorder suffered by the patient, such as substance abuse or major affective disorder. Broadly defined psychotic symptoms, such as depersonalization, are much more often reported in BPD, but many of these symptoms have also been reported frequently in patients with non-psychotic disorders and in normals. Finally, the prevalence of factitious psychotic symptoms in BPD has not been systematically investigated. Thus, the evidence for psychotic symptoms in BPD remains equivocal.
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This article depicts the therapy of a child whose lack of language is related both to cognitive deficiencies and psychological conflicts. The relation between the two, the place of gesture in his symbolic system and the factors of evolution are the main points examined hereafter.
Research conducted over the past decade indicates that a wide range of psychological and interpersonal problems are more prevalent among those who have been sexually abused than among individuals with no such experiences. Although a definitive causal relationship between such difficulties and sexual abuse cannot be established using current retrospective research methodologies, the aggregate of consistent findings in this literature has led many to conclude that childhood sexual abuse is a major risk factor for a variety of problems. This article summarizes what is currently known about these potential impacts of child sexual abuse. The various problems and symptoms described in the literature on child sexual abuse are reviewed in a series of broad categories including posttraumatic stress, cognitive distortions, emotional pain, avoidance, an impaired sense of self, and interpersonal difficulties. Research has demonstrated that the extent to which a given individual manifests abuse-related distress is a function of an undetermined number of abuse-specific variables, as well as individual and environmental factors that existed prior to, or occurred subsequent to, the incidents of sexual abuse.
Psychogenic loss of consciousness often leads to clinical situations where making decisions is difficult and psychiatric consultation becomes necessary. The function of the consultation/liaison-psychiatrist consists in rendering information from the psychosocial context comprehensible after establishing a first contact with the patient and his family and after the first psychiatric assessment. In a second step, the CL-psychiatrist then may make further recommendations how to deal with the patient, possibly not only in a patient-centered, but also team-centered manner. This article demonstrates a possible approach and differential diagnosis in the light of two clinical case reports. The theoretical part defines and classifies psychogenic loss of consciousness. It then deals with disorders of consciousness in epilepsy and the psychodynamics of psychogenic seizures as a subconscious expression of unbearable or unsolvable conflicts.