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At least 793 records · Page 44Linked to original sources
PubMed1975

Influence of psychiatric training, medical qualification, and paramedical training on the rating of abnormal behaviour.

The psychiatric ratings, using the In-Patient Multi-dimensional Psychiatric Scale, of (1) a group of over 200 psychiatrists from the British Isles, (2) third year psychology students, (3) trainee sister tutors, (4) general practitioners attending a postgraduate course in psychiatry, and (5) a group of new registrars at the Maudsley Hospital, were compared. The first hypothesis, that, whereas the non-psychiatrists would rate similar levels of symptoms, the psychiatrists would tend to rate lower than other professional groups, was upheld. The second, that the pattern or profile of symptoms as shown by the IMPS syndromes would differ little between the groups, was also upheld. The third hypothesis, that because of their special training in the recognition of synptoms, psychiatrists would tend to show greater intra-group agreement on the levels of symptoms that the other groups, was not upheld. Some possible reasons for the findings are discussed. The importance for a screening schedule, designed to be used by non-psychiatrists for the detection of psychiatric illness, of the finding that non-psychiatrists rate higher levels of symptoms than psychiatrists, is also discussed.

Adult↗
PubMed1976

Clinical significance of plasma chlorpromazine levels. I. Plasma levels of the drug, some of its metabolites and prolactin during acute treatment.

Seventeen acute psychotic patients were studied in the course of chlorpromazine (CPZ) treatment. Blood samples were taken weekly both before and two hours after the morning CPZ dose. Plasma levels of CPZ, CPZ sulphoxide (CPZ SO) monodesmethylated CPZ (NOR1CPZ) and 7-hydroxy CPZ (7OH CPZ) were estimated by gas chromatography. Plasma prolactin, luteinizing hormone, testosterone and oestrogens were measured by radioimmunoassay. Six of the seven patients who showed no clinical improvement had plasma CPZ levels equal to or higher than those of patients who improved. 'Non-responders' has a greater proportion of CPZ SO in pre-dosage samples. The occurrence of parkinsonian side effects was associated with a mean plasma CPZ of greater than 50 ng/ml and a mean plasma prolactin of greater than 30 ng/ml two hours after dosage. The elevation of prolactin preceded the onset of parkinsonian symptoms by 1-2 weeks. There was a significant positive correlation between mean plasma prolactin and mean plasma CPZ levels. The prolactin response may prove a useful index of the central antidopaminergic effect of neuroleptic drugs.

Acute Disease↗
PubMed1989

Levels of adaptation and narcissistic psychopathology.

Why, one might reasonably query, do some narcissistic characters serve time as seemingly successful presidents of corporations while others serve time as seemingly impaired inpatients on psychiatric units? I will offer some observations on this unusual clinical phenomenon and suggest that it is useful to distinguish between two clinical presentations of narcissistic character psychopathology, which I will call, for the sake of expedience, Level 1 and Level 2. I will then examine 1) how an understanding of the dimensions of empathic abilities, paranoia, levels of depression, grandiosity, and defensive uses of denial and disavowal can lend a broad explanatory range to the understanding of these levels, and 2) how we can assess both successful and unsuccessful adaptation to the outer world and the inner world in narcissistic disorders. Moreover, it is important to distinguish between being well adapted and being emotionally healthy, which are quite different in meaning and intent. I use the term Level 1 to refer to the more poorly adapted presentation, and the term Level 2 to refer to the more successfully adapted narcissistic presentation. Characteristics of Level 1 narcissistic pathology dispose a patient to an adaptation that is similar to the description of the narcissistic patient who is often described as borderline; characteristics of Level 2 narcissistic pathology dispose a patient to a high-flying and superficially successful adaptation in which the patient can competently navigate the occupational and social demands of an external world despite the presence of severe object relational impairments. While a difference in adaptation is highlighted, emotional well-being is not within the exclusive province of either's characteristic adaptive skills.

Adaptation, Psychological↗
PubMed1978

Charting as a multipurpose treatment intervention for family therapy.

This paper discusses the behavior modification technique of charting as a double-bind communication. Though the procedure was initially employed as a step in demonstrating operant conditioning (7) and later in diagnosis of the antecedents and consequences maintaining undesired behavior (8), it also proved one of the more powerful therapeutic interventions. Literature reviews on treatment programs for obesity (6) and behavioral approaches to marital therapy (2) support this contention. Its efficacy can be explained by integrating the viewpoints of behaviorist and family therapy approaches espoused by Haley (4) and Weakland et al. (9). Following are brief case reports in which charting resulted in quick and sometimes dramatic change.

Adolescent↗
PubMed1997

Personality and personality disorders predict development and relapses of major depression.

The aim of this study was to investigate the role of personality deviations in the development and relapses of major depression. The study is based on an investigation of an initial sample of 298 psychiatric out-patients, who were re-evaluated after 6 years when the sample included 253 patients. SCID-R was used for assessment of possible relapses and new cases, and a logistic regression analysis was used to determine the best prediction of the recurrence of depression. Borderline personality disorders and dependency predicted relapses. In addition, borderline personality disorders, together with avoidant personality disorders, predicted the development of new cases. Comorbid clinical syndromes appear to be of no importance. These findings suggest that the comorbidity with personality deviations accounts for the chronicity and poor prognosis in major depression.

Bipolar Disorder↗