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PubMed1991

[Mental state of patients with restricted forms of pulmonary tuberculosis].

The procedure of the multimodality personality investigation (MMPI) to examine the mental status and personality traits of 61 patients with newly diagnosed pulmonary tuberculosis of limited extent. The clinical and psychodiagnostic examination has revealed the following general types of a response to the disease: alienation from the people around, depressive reaction (18%), negative attitude to treatment (16.1% of the patients refused treatment and 13.1% refused surgical treatment), social adaptation impairment, neglect of the generally accepted behaviour patterns and schizoid personality traits. Along with this, the individual forms of a response to disease detection were determined. They were manifested by a number of symptom complexes: hypochondriac (13.6%), anxiety-depressive (18.4%) and paranoid (9.1%). These mental disorders gravely affected the patients and made treatment of the basic disease more complicated. A long-term conservative treatment aggravated depression and hysterical and schizoid personality traits. The mental status and the types of response were shown to differ from the same reactions in somatic patients with other abnormalities.

Adolescent↗
PubMed1987

[Paranoid conspiratory delusion].

Taking paranoid conspiratory delusion as example, it is attempted to describe the connection between structure and content of delusions. Inspired by Freuds interpretation of the case Schreber, the cathexis of socially recognized meanings with subjective interest is described as a matrix of cathexis. Delusion is seen as a "filling" of "cathexis-holes".

Cathexis↗
PubMed1971

Folie à deux.

Explore the source record for details and available documents.

Humans↗
PubMed1977

[Pathodynamics of symbiotic psychoses].

The definition and division of symbiontic psychoses (induced insanity, folieà deux,, psychosis of association) and their significance for the genesis of delusional developments are referred to at the beginning of the paper. After a presentation of environmental reactions on delusion, personality traits and mutual dependence in the predominance-subordination relationship of the partners of delusional symbioses are pointed out. The isolation of this symbiosis against the environment and its influence on this loneliness by twos are demonstrated. Besides the described suppositions, the primary delusion is essential for the pathodynamics of symbiontic psychoses because the delusional structure of the primary delusion, its compositional elements and especially the delusional motif are decisive for the transformation of a symbiosis which is still stable into a pathological we-formation. 5 case histories illustrate the pathodynamics of symbiontic psychoses.

Adult↗
PubMed1983

Psychiatric syndromes in Huntington's disease.

Thirty patients with Huntington's disease, a genetically transmitted neuropsychiatric disorder that can be diagnosed reliably, were evaluated systematically for psychopathology, followed for extended periods, and treated with psychopharmacological medications when necessary. DSM-III criteria were used for establishing syndromic diagnoses. Twenty-four individuals demonstrated substantial behavioral abnormalities, including affective and schizophrenic syndromes, changes of personality, and disorders that could not be classified adequately. Pharmacotherapy was modestly beneficial in some cases. Consideration of the array of behavioral disturbances encountered in this pathogenetically unified disorder suggests that a dimensional approach to symptom classification might prove more useful heuristically than present typological methods.

Adult↗
PubMed1993

A comparative study of paranoid and schizoid personality disorders.

OBJECTIVE: Family studies have demonstrated a higher rate of schizoid personality in the families of probands with schizophrenia and a higher rate of paranoid personality in the families of probands with delusional disorder. The authors sought to investigate the familial characteristics of probands with schizoid and paranoid personality disorders and to delineate the clinical characteristics of the two groups. METHOD: Records of 351 inpatients with discharge diagnoses that included the term "schizoid personality" or "paranoid personality" were examined to identify patients who met DSM-III-R criteria for schizoid personality disorder (N = 34) or paranoid personality disorder (N = 19). Comparisons were made between the two groups with respect to clinical symptoms, familial characteristics, and longitudinal course. RESULTS: The authors found that probands with schizoid personality disorder were hospitalized at an earlier age than probands with paranoid personality disorder, had more intervention before the index admission, and had greater morbidity following the index admission. They also found that descriptors of the two syndromes tended to congregate in the respective family material, but the differences were not statistically significant. Differences in the familial prevalence of schizophrenia were also not statistically significant. CONCLUSIONS: These familial data do not support the hypothesis that schizophrenia congregates in the families of probands with schizoid personality disorder. Possible explanations for this finding are discussed.

Adult↗
PubMedDate not supplied

Black-white differences in psychopathology in an urban psychiatric population.

The study was conducted in a psychiatric setting that services a large metropolitan population. It relied on the semi-structured Initial Evaluation Form which is completed by expert trained clinicians and which is geared to a comprehensive evaluation along the lines stipulated in DSM-III. The symptoms of a large sample of white and black patients are compared. The study relied on an Analysis of Variance (ANOVA) procedure which controlled for age, gender and education and concentrated exclusively on ethnic differences in clinically homogenous subgroups. The sample was partitioned into relatively pure groups of DSM-III diagnoses that are frequent in the population, including schizophrenia, affective and anxiety disorders, dementia, paranoid and manic disorders. Prominent black/white differences in psychopathology were noted, but in only a few instances included items generally thought of as typical of a specific disorder. Some differences appeared to be due to selection factors and others raised the question of alternate expressions of psychopathology among blacks as versus whites. The significance of the results obtained is discussed together with questions requiring further research. Some of the issues involved in the study of black/white differences in psychopathology are critically analyzed.

Adult↗
PubMed1997

The comorbidity of alcoholism and personality disorders in a clinical population: prevalence rates and relation to alcohol typology variables.

This study assessed prevalence rates and overlap among Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; DSM-III-R; American Psychiatric Association, 1987) personality disorders in a multisite sample of 366 substance abusers in treatment. In addition, the relation of antisocial personality disorder (APD), borderline personality disorder (BPD), and paranoid personality disorder (PPD) to alcohol typology variables was examined. Structured diagnostic interviews and other measures were administered to participants at least 14 days after entry into treatment. Results indicated high prevalence rates for APD and non-APD disorders. There was extensive overlap between Axis I disorders and personality disorders, and among personality disorders themselves. APD, BPD, and PPD were linked to more severe symptomatology of alcoholism and other clinical problems. However, only APD and BPD satisfied subtyping criteria, after controlling for other comorbidity. Implications for classifying alcoholics by comorbid disorders are discussed.

Adult↗
PubMed1999

Psychiatric co-morbidity among male heroin addicts: differences between hospital and incarcerated subjects in Taiwan.

AIMS: To examine the differences in psychiatric co-morbidity between hospital and incarcerated groups of heroin addicts in Taiwan. DESIGN: Life-time prevalence of DSM-III-R-based coexisting psychiatric disorders, including personality disorders, were surveyed. SETTINGS: A psychiatric hospital and two prisons. PARTICIPANTS: Two hundred and sixty heroin users who were incarcerated in prisons, and 47 heroin users who voluntarily sought help in a psychiatric hospital were interviewed by board-certified psychiatrists. MEASUREMENTS: Using two psychometric instruments, the Psychiatric Diagnostic Assessment (PDA) and the Structured Interview for DSM-III-R Personality Disorders (SIPD-R), psychiatric co-morbidity was assessed. FINDINGS: Different life-time rates of coexisting psychiatric disorders among heroin addicts in different settings were found: 83% of hospital subjects and 66% of incarcerated subjects were diagnosed as having at least one coexisting axis I or II disorder. The most prevalent coexisting DSM-III-R defined axis I disorders were additional substance use disorders (alcohol and methamphetamine), while the axis II disorder was antisocial personality disorder. The hospital group had a significantly higher prevalence rate of mood disorder (p < 0.001), paranoid personality disorder (p < 0.05) and antisocial personality disorder (p < 0.001) than the incarcerated group. CONCLUSIONS: We suggest that heroin addicts with coexisting psychiatric disorders receive relevant psychiatric treatment. Those with personality disorders, especially the antisocial type, should be considered for specialized therapeutic community programmes instead of incarceration.

Adult↗
PubMed1998

Demographic features of patients seeking cosmetic surgery.

The demographic features of 415 patients seeking cosmetic surgery were investigated from a psychiatric point of view. Of the 415 patients, 198 (47.7%) were found to have mental disorders according to ICD-10 including: 17 with schizophrenia, 20 with other persistent delusional disorders, 33 with depressive episode, 47 with neurotic disorders, 42 with hypochondriacal disorder, five with paranoid personality disorder and 14 with histrionic personality disorder. The rate of subjects with poor social adjustment was 56.0%. It was noteworthy that such a considerable number of patients with mental disorders or with poor social adjustment had sought cosmetic surgery. Distinct gender differences were found: male subjects were characterized to have a greater number of mental disorders, especially dysmorphophobia (other persistent delusional disorders plus hypochondriacal disorder) and showed the narrow age range between teenage and young adult age when they were preoccupied with their 'deformity', and poor social function. A history of frequent operations was not considered to be an indicator for mental abnormality. The diagnostic issue in dysmorphophobia is briefly described.

Adolescent↗
PubMed2004

Offspring of parents with schizophrenia: mental disorders during childhood and adolescence.

Although offspring of parents with schizophrenia are at risk for schizophrenic illness as adults, little is known about their pattern of symptoms as children and adolescents. Lifetime Axis I and II DSM-III-R diagnoses were made for 116 young people (ages 12-22). Forty-one subjects had a parent with schizophrenia, 39 had a parent with a nonschizophrenic mental disorder, and 36 had parents with no mental illness. Schizophrenia spectrum disorders occurred at higher rates among young people with a parent with schizophrenia (17.1%) than in other young people (5.3%), even after controlling for mental disorder in the nonproband parent. Schizophrenia and schizotypal personality disorder occurred exclusively in offspring of parents with schizophrenia. Offspring of parents with schizophrenia were also at increased risk for avoidant personality disorder but not paranoid personality disorder. Although lifetime anxiety disorders were common in all young people regardless of parent diagnosis, current anxiety disorders were more prevalent for the adolescent offspring of parents with schizophrenia. These data strongly suggest familial vulnerability to schizophrenia spectrum disorder that is observable before adulthood, particularly for males.

Adolescent↗
PubMed1991

Twin concordance for DSM-III-R schizophrenia.

The monozygotic (MZ)/dizygotic (DZ) concordance rates for schizophrenia and the relationship between schizophrenia and schizophrenic spectrum disorders were studied in a sample of 31 MZ and 28 DZ schizophrenic probands and their co-twins. All subjects were personally interviewed with structured diagnostic instruments and classified according to DSM-III-R criteria. The concordance rates of 48% for MZ twins and 4% for DZ twins indicate a genetic transmission of DSM-III-R schizophrenia. In addition to the schizophrenic co-twins, 3 MZ co-twins had a noneffective psychotic disorder, thus supporting the hypothesis that genes are involved in the development of Axis I schizophrenic spectrum disorders. Schizotypal and paranoid personality disorders were observed in both MZ and DZ co-twins. These disorders may be familially related to schizophrenia, but a genetic relationship was not confirmed for the Axis II spectrum disorders. A substantial number of MZ co-twins of schizophrenic probands had no mental disorder.

Adult↗
PubMed1985

A family study of schizophrenic and normal control probands: implications for the spectrum concept of schizophrenia.

Morbidity risks for mental illness were determined in 750 first-degree relatives of chronic schizophrenic and normal control probands. Psychiatric disorders that were more frequent in relatives of schizophrenic probands than in relatives of normal control probands were chronic schizophrenia (5.8% versus 0.6%), schizotypal personality disorder (definite, 14.6% versus 2.1%; probable, 12.1% versus 6.5%), and paranoid personality disorder (7.3% versus 2.3%). The data suggest that schizotypal and paranoid personality disorders are genetically related to schizophrenia. The implications for schizophrenia research are discussed.

Adolescent↗
PubMed2000

The Collaborative Longitudinal Personality Disorders Study: reliability of axis I and II diagnoses.

Both the interrater and test-retest-retest reliability of axis I and axis II disorders were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). Fair-good median interrater kappa (.40-.75) were found for all axis II disorders diagnosed five times or more, except antisocial personality disorder (1.0). All of the test-retest kappa for axis II disorders, except for narcissistic personality disorder (1.0) and paranoid personality disorder (.39), were also found to be fair-good. Interrater and test-retest dimensional reliability figures for axis II were generally higher than those for their categorical counterparts; most were in the excellent range (> .75). In terms of axis I, excellent median interrater kappa were found for six of the 10 disorders diagnosed five times or more, whereas fair-good median interrater kappa were found for the other four axis I disorders. In general, test-retest reliability figures for axis I disorders were somewhat lower than the interrater reliability figures. Three test-retest kappa were in the excellent range, six were in the fair-good range, and one (for dysthymia) was in the poor range (.35). Taken together, the results of this study suggest that both axis I and axis II disorders can be diagnosed reliably when using appropriate semistructured interviews. They also suggest that the reliability of axis II disorders is roughly equivalent to that reliability found for most axis I disorders.

Diagnosis, Differential↗
PubMedDate not supplied

[Genetic factors in the onset of schizophrenia].

The importance of inheritance in the development of schizophrenia was recorded in classic papers by Kraepelin and Bleuler. These observations have been confirmed by the contemporary research. In this paper, we summarize the results of genetic-epidemiological studies that include family, twin and adoption studies, as well as the results of segregation analysis and molecular-genetic research. Family studies indicate increased morbidity risk in the relatives of patients with schizophrenia, that augments with the degree of relation. Twin studies also suggest the importance of genetic factors demonstrating higher rates of concordance for the disorder in monozygotic (MZ) than in dizygotic (DZ) twins and consistent MZ/DZ ratios across the studies. Adoption studies provide further evidence for genetic vulnerability, showing an association between biological relatives separated at birth. The concept of "schizophrenia spectrum" is based on the observation of the familial aggregation of several hierarchically defined disorders in relatives of schizophrenic probands. Schizophrenia, schizoaffective disorder, schizotypal and paranoid personality disorder, other nonaffective psychoses and psychotic affective disease, according to this concept, represent manifestations of varying severity, of the same underlying vulnerability, which is transmitted within families. The results of segregation analyses support rather polygenic than monogenic inheritance, if schizophrenia is genetically homogeneous. However, the possibility of genetic heterogeneity augments the interest for searching for vulnerability genes with linkage. The results of linkage studies, indicating association between schizophrenia and markers on chromosomes 5, 6, 8 and 22, have not yet been replicated on independent samples of probands. Recent findings indicate that schizophrenia may be caused by unstable DNA (the expansion of trinucleotide repeated sequences at the disease locus). This could explain the departure from Mendelian inheritance, highly variable phenotype and wide ranging age of onset in schizophrenia. Further research in this field could not only clarify the mode of the transmission of the liability for schizophrenia and the relationship of genetic and environmental factors in the development of the disorder, but also determine which characteristics, behavior and physiological variables schizophrenia genes code for. This would, in addition, contribute to our understanding of the biological basis of schizophrenia.

Humans↗
PubMed1985

[Paranoid reactions and psychoses of the involutional age].

The first part of the paper gives a view of paranoid conditions and the criteria used for differentiation using the international classification of diseases of the world-health organisation. With this background the paranoid psychoses occurring characteristically during midlife are presented in their typical expression. In the second part using own investigations the characteristic course is presented using syndromal and course-related criteria. In the third part of the paper the relationship of this psychoses to midlife from psychological and sociological viewpoints will be addressed with the conclusion to extrapolate from the total group of paranoid psychoses. In the closing fourth part they will be mentioned as characteristic examples of a multidimensional therapeutic endeavour.

Aged↗