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Schneiderian versus Bleulerian schizophrenia and basic symptoms.

Using the 'polydiagnostic approach' method, the relationship between basic symptoms (BS) and Bleulerian and Schneiderian types of schizophrenia is studied. Eighty-six schizophrenic patients (RDC criteria) were studied using the Frankfurt Complaint Questionnaire for the evaluation of the BS. The patients were classified according to the type of symptoms predominant in Schneiderian (n = 32), Bleulerian (n = 12) and mixed (n = 42) schizophrenics. The patients with Schneiderian and mixed schizophrenia displayed more BS than those having Bleulerian schizophrenia. Significant differences (p less than or equal to 0.05) were found on the subscales of Perception (simple), Language, Memory, Motoric and Loss of automatism, in factors 1, 2 and 4, and in the total score. The results suggest that, from the perspective of the BS, Schneiderian schizophrenia is different from Bleulerian and that the BS may have the same production mechanisms as Schneider's FRS, the difference between them being in the different degree of phenomenological expression.

Adult↗

Schizophrenic autism. 2. Proposal for a nomothetic definition.

Since its introduction by E. Bleuler in 1911, the so-called 'basic symptom' autism has often been considered cardinally important within schizophrenic symptomatology. A lack of precise definition and hence of reliability, however, has eroded the former importance of this term, which cannot be found in modern diagnostic systems. Using a specific text-analytical method, we evaluated all accessible publications on schizophrenic autism, focusing on the descriptive-empirical approach. The entire material was then summed up in five essential points, providing a possibly more reliable (nomothetic) explication of the complex term of autism.

Affective Symptoms↗

Correlations between the clinical picture and the intentionality in schizophrenic and schizoaffective patients.

The results are presented of catamnestic research on 24 patients with the diagnosis of schizophrenia at the first clinical episode confirmed according to the ICD-10 criteria. The clinical picture rated with the Positive and Negative Symptoms Scale (Kay, Fiszbein and Opler, 1987) and with the BPRS, was correlated with the intentionality, which was rated with the InSka (IntentionalitätsSkala; Mundt, 1985). The transformation of the phenomenal significance into a numeric value enables the use of mathematical methods for the search of interactions inside the schizophrenic phenomenon. We found the following significant tendencies: (1) the negative syndrome score correlates with the residual intentionality; (2) the negative syndrome score correlates with the premorbid intentionality; (3) the clinical thought disturbance correlates with the premorbid speech content intentional profile.

Adult↗

Delusional repetitiveness--a peculiar form of delusional remembrance.

Delusional repetitiveness as a peculiar form of delusional remembrance is very rare in the literature and has not been considered in detail. the author presents a schizophrenic case with delusional repetitiveness and considers its features and meaning in treatment. The patient's feelings about a deadlock in treatment were substantiated in delusional repetitiveness. In repetitiveness, we should try to take a new look at the method of treatment and prepare ourselves for the interruption of treatment according to circumstances.

Adult↗

Musical hallucinations and musical imagery: prevalence and phenomenology in schizophrenic inpatients.

The discussion of auditory hallucinations in schizophrenia has traditionally focused on verbal auditory hallucinations, or 'voices'. Little attention, on the other hand, has been given to the phenomenon of musical hallucinations. In an effort to characterize the prevalence and phenomenology of musical hallucinations, 100 consecutive schizophrenic inpatients were examined for the presence of musical hallucinations and musical imagery. Sixteen patients responded positively, and were engaged in a more thorough interview. They were then divided into two groups: those with musical hallucinations, and those experiencing musical imagery. This determination was made based on the absence or presence, respectively, of volitional control, hypothesizing that lack of volitional control implies a true hallucinatory experience. When lack of volitional control was compared to the various other aspects of the experience, an association with religious content was demonstrated. Religious musical hallucinations also tended to be experienced as distressing, further supporting the hypothesis that the experience was hallucinatory rather than a product of volitional imagery. A selection of sample case vignettes is presented as well.

Adult↗

Patient-therapist sexual contact. I. Psychodynamic perspectives on the causes and results.

The problem of patient-therapist sexual contact is a substantial one, perhaps involving 5-10% of male therapists, and we suggest that the structure of psychotherapy and abundance of rescue fantasies make it inevitable. While skeptical of claims that there are any positive effects, we catalogue many negative effects: ambivalence and mistrust of subsequent therapists; patients doubting their own sense of reality; childhood trauma repeated and fixated instead of being interpreted; bondage to the offending therapist; original complaints of sexual dysfunction and problems in intimacy with men are exacerbated; burdens of guilt and shame carried by the patient; fantasy aspects of sexuality difficult to discuss in subsequent therapy, and the abrupt ending of the relationship leaving patient stranded and/or disorganized.

Adult↗

The Tao, psychoanalysis and existential thought.

The purpose of this paper is to clarify some existing misunderstandings in the area of psychotherapy, existential approach and the Eastern Tao (Zen Buddhism, Confucianism, Lao-tzu, Chuang-tzu) by showing the common elements between Eastern Tao and psychoanalysis, and existential thought. The author compared the goal of Tao practice, namely, Zen Buddhism, Confucianism etc. with that of Western psychoanalysis, humanistic psychology and transpersonal psychotherapy. He concludes that these goals are the same and that the names are different. He also compared the procedures and processes of psychoanalysis and Zen practice. Sudden enlightenment and gradual training in Zen practice were compared with insight and 'working through' in psychoanalysis. Zen emphasis on relationship, ego strength and interpretation was linked with similar topics in psychoanalysis. The results of Zen practice and the central features of every psychoanalytic treatment were examined and found the same, that is, the resolution of, or transcending of, love (dependence) and hate (hostility). The description of a mature analyst and that of a Boddhisattva were compared and found the same. A trace of neurotic motivation remains but they are not influenced by it in helping others. The problem of theory and reality was discussed and strong emphasis on reality was described; in other words, the goal is directed at reality and theory is only a means pointing at reality. If you see the reality, you should forget the theory.

Buddhism↗

Frontal and temporo-parietal lobe contributions to theory of mind: neuropsychological evidence from a false-belief task with reduced language and executive demands.

A model of the functional and anatomical basis of belief reasoning is essential for understanding the relationship between belief reasoning and other cognitive processes in both normal development and pathology. Studies of brain-damaged patients can give valuable insights into the nature of belief processing but pose unique methodological problems. The current study addresses these problems by using a nonlinguistic belief-reasoning task with substantially reduced executive demands. A case series of 12 brain-damaged patients is presented. The belief-reasoning errors of four patients with damage to the prefrontal cortex appeared to arise from these patients' executive function problems. The belief-reasoning errors of three patients with damage to the temporo-parietal junction could not easily be accounted for in this way, raising the possibility that this brain region has a necessary role in representing beliefs, rather than handling the executive demands of belief-reasoning tasks. We discuss the importance of gaining empirical evidence about the scope of ''theory of mind'' impairments, and the important role for neuropsychological studies in this project.

Adult↗

Intrapsychic structural effects of psychiatric research.

The authors observed that many psychotic patients on a clinical/research ward incorporated various aspects of research organization into their own evolving intrapsychic structures. This process had either beneficial or deleterious clinical effects, depending on the attributes of the research and the specific mental functions to which these attributes became attached. The observations resulted in the development of a set of recommendations for maximizing the therapeutic usefulness of this phenomenon and minimizing its countertherapeutic drawbacks.

Adaptation, Psychological↗

Overview: the sex of the therapist.

Research studies about the relevance of therapist gender to assessment, duration of treatment, and satisfaction with treatment or its outcome provide no clear, replicable results salient to decision making. Psychoanalytic and other clinical writings deal with the impact of clinician gender on the course or outcome of psychotherapy. Effects appear to depend on many factors, including the type and goal of psychotherapy, the patient's developmental level, the early relationship with parents, and the nature of object relationships and specific conflictual areas, as well as the therapist' sensitivity and value system regarding gender issues. No specific conclusions as to optimal patient-therapist matches on the basis of therapist sex appear warranted.

Adolescent↗

Delusions: when to confront the facts of life.

Research indicates that patients do not hold delusions with as fixed a certainty as has been believed. Confrontation with reality may have an important role in the evaluation and treatment of delusional patients. The authors suggest four factors that may help predict the value of reality confrontation in a given clinical situation: 1) how understandable the delusion is in the context of the patient's life, 2) the degree of conviction with which the patient holds the delusion, 3) the phase in development of the delusional beliefs, and 4) the diagnosis of the patient.

Adaptation, Psychological↗

The role of social relationships in the recovery from psychotic disorders.

Little attention outside the therapeutic setting has been given to specifying the aspects of social relationships that might be helpful for patients recovering from psychotic episodes. The authors studied 20 patients who had been hospitalized for a psychotic episode for 1 year following discharge to examine the role their social relationships played during this period. The data show that 12 functions of social relationships were important and that there were two phases of social needs--convalescence and rebuilding--over the recovery period. The authors discuss the theoretical and clinical implications of these findings.

Adult↗