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PubMed1992

[Divergent locus of control in East and West German students].

A comparative study was carried out on the psychological situation of students in East and West Germany after the political changes of 1989. Results concerning the direction of the locus of control are reported. East german students show a higher internal and external locus of control. This, as internal attributions are concerned, unexpected constellation is discussed under aspects of the specific political situation, correlations with signs of adjustment disorders and possible inherent menace to the psychological equilibrium of the east german students.

Adult↗
PubMed2004

[Depression and organic brain diseases in the elderly].

Depressive symptoms are observed in many organic brain diseases in the elderly, particularly in stroke, degenerative or vascular dementias and Parkinson's disease. In many cases, an accurate estimation of the respective part of neurobiological abnormalities, adjustment disorders, disability and narcissistic wounds related to the disease appears very difficult for the practitioner. Specific data on the therapeutical aspects of secondary depressive disorders remains quite scarce. The efficacy of antidepressant drugs may be less important in geriatric depression with cerebral disorders or "secondary depressions" than in primary ones. Consequently, electroconvulsive-therapy may appear as an interesting therapeutical option for these patients.

Aged↗
PubMed1992

Mental health service utilization by children in foster care in California.

An examination of Medi-Cal-paid claims was undertaken to assess the utilization of mental health services by children in California's foster care system. Using unduplicate counts of service use and diagnoses, it was determined that children in foster care account for 41% of all users of mental health services even though they represent less than 4% of Medi-Cal-eligible children. When partitioned into specific service categories, children in foster care account for 53% of all psychologist visits, 47% of psychiatry visits, 43% of Short Doyle/Medi-Cal inpatient hospitalization in public hospitals, and 27% of inpatient psychiatric hospitals. Expenditure for services paralleled utilization frequency. When compared to the non-foster care Medi-Cal-eligible child population, children in foster care have 10 to 20 times the rate of utilization per eligible child for selected services. For children in foster care, 75% of all diagnoses for billed service were accounted for by four diagnoses: adjustment disorders (28.6%), conduct disorders (20.5%), anxiety disorders (13.8%), and emotional disorders (11.9%), with clear age-related differences in the distribution of diagnoses.

Adolescent↗
PubMed1992

[Psychological adaptation to bone marrow transplantation].

Bone marrow transplantation, used with increasing success over the past ten years, is recognized as highly stressful. Physiological and psychological rehabilitation after treatment is often difficult. This paper outlines the psychological issues encountered by adult patients with haematological malignancies through a review of the adjustment disorders associated with bone marrow transplantation, their prevalence, symptomatology and predictive factors. Some guidelines are proposed for the prevention of the stresses associated with hospitalization.

Adaptation, Psychological↗
PubMed1991

Psychiatric consultation at Srinagarind Hospital: a report on 271 cases.

The author reviewed psychiatric consultations at a teaching general hospital over a two year period. Two hundred and seventy-one patients or 0.6 per cent of all admission were referred for psychiatric consultation. The referral rate from the medical and surgical departments were higher than that of other departments. The most common psychiatric diagnosis by psychiatric consultants was delirium, followed by adjustment disorder and mood disorders. The delirious patients were significantly older than the other groups. The delirious state was commonly caused by infectious diseases, diseases of the nervous system and sense organs and disorders of fluid, electrolyte and acid-base balance. Most of the patients who had two or more active medical problems would have greater incidence of delirium. The delirious patients tended significantly to have behavior that disturbed the therapeutic environment. Among the functional psychiatric disorder patients, 22.4 per cent manifested suicide attempts as the principal reason for admission to non-psychiatric wards. The study revealed that the consultee could give the proper psychiatric diagnosis in only 18.3 per cent of the delirious group, 21.2 per cent in other organic mental disorder group and 24.6 per cent in functional psychiatric disorder group. Most of the consultees described only the psychiatric symptoms of the referred patients and did not specify the psychiatric diagnosis. The most frequently stated reason for psychiatric consultation was for proper evaluation and management.

Adolescent↗
PubMed1991

Depression in the general hospital.

Depression in the general hospital is a challenging arena for nursing. Diagnosing depression tends to be difficult because of the overlapping somatic presentations of depression and medical illness. In working with this patient population, a thorough physical examination and diagnostic evaluation need to be completed to rule out pre-existing medical diseases and medications that could be inducing the depressive symptoms. Usually, medically ill patients are diagnosed with adjustment disorder with depressed mood that responds well to a combination of supportive psychotherapy and antidepressant therapy.

Depression↗
PubMed1990

Attempted suicide in the armed forces: a retrospective study of Norwegian conscripts.

In the easily surveyable and rather homogeneous military population of the Norwegian Armed Forces, a group of 112 male suicide-attempting conscripts was studied retrospectively. Compared to a normal conscript population, suicide attempters more often had troublesome backgrounds, had experienced psychiatric problems and abuse, and had previously more often attempted suicide. Diagnostically adjustment disorders, alcohol and drug abuse, and personality disorders predominated, whereas major affective disorders and psychotic disorders were rare. Methods of self-destruction employed were mostly drug ingestion and laceration. Personality disordered subjects tended to have lower suicidal intent than others.

Adolescent↗
PubMed1990

Depression and the cancer patient.

The prevalence of depression in cancer patients and the types of depressive syndromes which are commonly seen are now well known. At least 25% of hospitalized cancer patients are likely to meet criteria for major depression or adjustment disorder with depressed mood. Patients at highest risk for depression are those with a history of affective disorder or alcoholism, advanced stages of cancer, poorly controlled pain, and treatment with medications or concurrent illnesses that produce depressive symptoms. The clinical evaluation of the depressed cancer patient includes careful assessment of symptoms, mental status, physical status, and cancer treatment effects. Treatment includes short-term supportive psychotherapy, antidepressant medication, and, infrequently, electroconvulsive therapy. In this article the authors review the clinical picture of depression including concern about suicidal risk and discuss pharmacologic treatment modalities.

Adult↗
PubMed1987

[Psychotherapy and culture].

This is a follow-up study of a group of patients of Foreign origin for which an indication for analytic psychotherapy was found. The importance of mutual therapist-patient recognition is emphasized. It seems necessary that the patient masters the cultural and socio-economic environment in which he lives, in order to open himself up to an intra-psychic reality. Finally, we formulate the hypothesis that symptoms shown by the patient reveal indirectly adjustment disorders to the cultural environment.

Acculturation↗
PubMed1989

Alpidem, a novel anxiolytic drug. A double-blind, placebo-controlled study in anxious outpatients.

The anxiolytic activity of alpidem (150 mg/day) and its effects on psychomotor performances were compared with placebo in 60 outpatients. The trial was a double-blind, parallel group, and the two treatments were administered orally in three divided doses for 3 weeks. Eighteen male and 42 female patients (mean age, 39.6 years) suffering from generalized anxiety or adjustment disorder with anxious mood of at least 1-month duration entered the trial at the end of a 1-week placebo run-in period designed to exclude early placebo responders. Efficacy was assessed with the Hamilton rating scale for anxiety (HRSA), the state-trait anxiety inventory (STAI x 1: anxiety as state), a visual analogue scale (VAS), and clinical global impression (CGI). Psychomotor performance was assessed by the digit symbol substitution test (DSST). Alpidem was significantly more effective than placebo in decreasing the severity of anxiety, both in the physician's judgment [total HRSA (p = 0.007), psychic symptoms (p = 0.0040), somatic symptoms (p = 0.0002)] and in the patients' evaluation [STAI x 1 (p = 0.0001) and VAS (p = 0.0003)]. Psychomotor performance was improved by both treatments; there was no difference between results with alpidem and placebo at the DSST (p = 0.2801), but the improvement was almost twofold on alpidem. Side effects were negligible with both treatments and the efficacy index, obtained from the CGI, was significantly better with alpidem than with placebo after day 7 (at least p less than 0.03).

Adult↗
PubMed1989

Anxiety and stigmatizing aspects of HIV infection.

While it is not yet known what role anxiety may play in causing or exacerbating the immunologic aberration characteristic of acquired immune deficiency syndrome (AIDS), human immunodeficiency virus (HIV) infection is associated with a high incidence of psychologic and neuropsychiatric complications, including anxiety and adjustment disorders. The anxiety may be exacerbated by the isolation and fear patients may experience as a result of the stigma attached to the HIV diagnosis. The author addresses the consequences of anxiety related to the AIDS stigma and discusses appropriate psychiatric interventions.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Magnetic resonance tomography confirms the diagnosis of Hallervorden-Spatz disease].

We present the second description of an early diagnosed state of Hallervorden-Spatz disease (HSD) verified clinically and by means of magnet resonance imaging. Since the magnet resonance shows HSD specific transformations brain biopsy can be relinquished. In our case the early confirmation of a neurodegenerative disease (versus the presumption of a severe adjustment disorder as the case was presented) brought much relief in respect of the feelings of guilt to the family, although the long term prognosis is poor. The distinction between neurodegenerative diseases, demyelinisating diseases and HSD was possible considering the clinical signs and using the magnet resonance, which showed various pigments within the globus pallidum.

Adolescent↗
PubMed1987

Temporomandibular joint dysfunction and facial pain in children: an approach to diagnosis and treatment.

A model for the diagnosis and treatment of temporomandibular joint dysfunction and facial pain in children is presented. Emphasis is placed on systematic assessment of physical, psychologic, and behavioral factors when conservative medical therapy is inadequate for symptom relief. The model represents a multidisciplinary approach to patient care which is described through case presentations. The results of research on the incidence of primary psychopathology in 53 children and 322 adults evaluated during a 3-year period for temporomandibular joint dysfunction and facial pain are also presented. It was found that children were more likely to be psychiatrically impaired (25%) than adults (7%). Children had a variety of psychiatric diagnoses including depression, conversion and adjustment disorders, overanxious behavior, and anorexia nervosa. The benefits of a multidisciplinary approach are discussed in terms of the efficacy of this coordinated treatment effort in ameliorating symptoms.

Adolescent↗
PubMed1981

Diagnosis and treatment of dementia in the aged.

Dementia affects an estimated 5 percent of the population 65 years of age and older, with 20 percent being affected at 75 years or older. Although the most common forms, primary degenerative and multi-infarct dementia, currently lack specific treatments, it is estimated that a thorough diagnostic evaluation will uncover a treatable cause in 10 percent to 20 percent. The differential diagnosis includes benign senescent forgetfulness, depression, adjustment disorder, paranoid states, amnestic syndrome, delirium, drug effects, systemic illnesses and intracranial conditions. The approach to each patient involves a history, physical examination, mental status evaluation and laboratory tests that focus on identifying treatable conditions. When no specific treatments are available, however, symptomatic treatments, including pharmacotherapy, environmental management, family supports and psychotherapy, can offer relief for both patients and their families and improve the daily functioning of the elderly patient with dementia.

Aged↗
PubMed1995

[Psychiatric consultation service in a university clinic. An empirical study of characteristic performance].

In Germany, there is growing interest in consultant psychiatry on a scientific and practical level. On the other hand, very few results have been reported concerning the tasks and functions of consultant services. This study was conducted in the Lübeck University Hospital to evaluate psychiatric consultant interventions by assessing referral rates, reasons for referrals, psychiatric diagnoses and recommendations. A total of 5334 consultations from 7 years (1983-1989) was analyzed, and a sample of 1000 consultations was taken. Over the years, a continuous increase in the consultation rates can be observed, with suicide and alcoholism as important focuses. The most frequent diagnoses were adjustment disorders, organic disorders and alcoholism. Psychopharmacological intervention, referral to the psychiatric/psychosomatic ward, and short practical advice were the most frequent recommendations. The results are discussed in the context of the international literature.

Adult↗
PubMedDate not supplied

Analysis of psychiatric referrals and interventions in an oncology population.

PURPOSE/OBJECTIVES: To review nurse-generated, inpatient psychiatric referrals to the psychiatric consultation liaison nurse (PCLN) in a comprehensive cancer center. DESIGN: Retrospective records review. SETTING: National Cancer Institute-designated comprehensive cancer center in the eastern United States. SAMPLE: 102 psychiatric referrals/consults from an inpatient adult unit. METHODS: Retrospective chart review of all referrals over a one-year period. MAIN RESEARCH VARIABLES: Reason for referral, assessment data, and nursing interventions. FINDINGS: Five major psychological problems constituted reasons for referrals: depression (31%), anxiety (26%), adjustment disorder (24%), "difficult to care for" (13%), and delirium (6%). Follow-up with a mental health care provider occurred with 84% of the patients. Interventions were directed at patients and staff members together, patients and family members, and staff members only. CONCLUSIONS: Oncology nurses are the most consistent observers of patients' emotional responses. A PCLN can facilitate development of necessary skills for identifying and caring for patients at high risk for psychiatric problems. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses may not always be able to identify specific psychiatric diagnoses, but they are skillful in the recognition of significant psychological distress in patients. Development of the PCLN role can facilitate assessment and intervention in patients needing additional help.

Adolescent↗
PubMed1993

[Analysis of the relation between socioeconomic factors and suicidal behavior].

The paper explores case histories of 128 patients hospitalized for suicide attempts at the Institute of Neurology, Psychiatry and Mental health in Novi Sad for a period of two years. The analysis of relevant suicidological data was carried out with the aim of determining the significance which SOCIOECONOMIC factors play in gene-rating suicidal behavior. Under the item "occupation/employment" most frequent were "workers" 21.88 per cent, followed by unemployed persons--17.19 per cent, while those on social welfare constituted 16.4 per cent. Financial poverty as the motive for suicide attempt is most often encountered among unemployed ones and those on social welfare. In the total sample, this poverty was registered in 19 cases (14.84 per cent). It is interesting that this motive is more often present in younger persons, where mean age for those on social welfare is 28 and for the unemployed ones is 29 years. The diagnosis most often found in these groups is "Adjustment Disorder with Depressed Mood (309.00)", no psychotic episodes were found. With respect to alcohol dependence, it is much less present among those on social welfare than in the rest of the sample. Therefore, financial poverty is not negligible factor of suicide risk. This finding directly confirms that financial poverty as suicide generator has so far not been researched sufficiently or is evidently on the rise, at least in our society.

Adult↗
PubMed1994

[Early intervention and treatment of depressive and manic states among university students].

Early intervention and treatment of manic and depressive states at university mental health service are described. Frequency of depression among the population of university students is about 0.1-0.2% and has increased during the last 10 years. The diagnoses of depressive states according to DSM-III-R are as follows; adjustment disorder with depressed mood (50%), major depression (20-30%), dysthymia (20%), and bipolar disorder (5-8%). Some plans for early intervention are discussed, including screening and consultation from the teaching staff and parents. Concerning treatment, it is important to support their academic problems caused by their mental disorders in close cooperation with their parents and their teaching staff.

Adult↗