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PubMedDate not supplied

[Nurses and burnout: a survey in an Emergency Department in the Lazio Region].

Nowadays, burnout represents a growing phenomenon in technologically advanced countries, so much so that there is now abundant literature available on this topic. The aim of our study was to assess the level of burnout in a group of 108 nurses working in an Emergency Department by means of the Maslach Burnout Inventory. This instrument is based on the concept that burnout presents 3 basic features: Emotional Exhaustion (EE), Depersonalization (DP) and Personal Achievement (PA). Results showed that a significant relationship exists between EE and DP, the working environment and the same social-demographic features, while the PA sub-scale was not found to be dependent on any of the social-demographic characteristics.

Adult↗
PubMed1991

[Development promoting environment--contributing factors in inpatient psychotherapy of children and adolescents].

Frame conditions especially in stationary psychotherapy with children and adolescents have the function of development-conducive 'play-pens'. As spaces which can be actively formed they offer room to make new experiences, but also serve as limits and friction surfaces with supporting ego-functions. Regarding the developmental phase of adolescence they also serve adolescents in their conflicts with parental authorities in the process of detaching and spiritualization and depersonalization of super-ego structures. Concerning various disorders adequately formed 'play-pens' also fulfill further specific therapeutic functions: Bordering functions for youths near psychoses, containing functions for borderline disorders and trianguling functions for youths who have disorders in detaching and individualizing.

Adolescent↗
PubMed1991

Burnout phenomenon and its occupational risk factors among Japanese hospital nurses.

To identify and evaluate recent working conditions and job content of hospital nurses in Japan, as well as the prevalence of the burnout phenomenon and the occupational risk factors responsible for it, a questionnaire survey was carried out. The subjects consisted of 898 nurses and 255 municipal service workers as the control group. Working conditions and workload burdens were more severe among nurses than among the municipal workers. The burnout phenomenon among the nurses was characterized by emotional exhaustion as well as depersonalization. Moreover, the rate ratio and multivariate analyses indicated that a great variety of occupational factors, not only interpersonal relationships, but the general working conditions and specific physical or mental workloads influenced the burnout phenomenon as well. Therefore, in examining measures dealing with the burnout phenomenon among nurses, it is considered important to evaluate the occupational factors systematically and comprehensively.

Adult↗
PubMed1991

Burnout, job stress, anxiety, and perceived social support in neonatal nurses.

Forty-nine nurses working in neonatal intensive care were surveyed by using measures of job stress, burnout, anxiety, and perceived social support. On the Maslach Burnout Inventory, they scored in a moderate range of burnout for emotional exhaustion and depersonalization and in a high range of burnout for sense of personal accomplishment. Stepwise regression analyses revealed that higher job stress scores, higher anxiety scores, perception of less supervisor (head nurse) support, and less experience were associated with higher burnout subscale scores.

Adult↗
PubMed1991

Prevalence of burnout among military dentists.

Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who do "people work" of some kind. Health care providers, including dentists, are at high risk for burnout because their occupations often require intense interactions between themselves and fearful, demanding patients on a daily basis. The purpose of this study was to assess the prevalence of burnout among military dentists practicing at a large installation using a standardized measurement device, the Maslach Burnout Inventory. Results indicate that the military dentists surveyed experience low to moderate levels of burnout. The military dentists sampled, in general, scored lower for burnout when compared to the norms of society and medicine.

Burnout, Professional↗
PubMed1977

[A new psychotropic drug: carpipramine, intermediate compound between 2 therapeutic classes].

An open clinical study was conducted with carpipramine in 100 hospitalized subjects presenting various mental disorders. The therapeutic results on symptoms were assessed both as a whole and with the help of a rating scale. Doses varied from 50 to 400 mg per day. Carpipramine seems to be particularly efficient on schizophrenias, 66 cases of which were tested. The best results were observed in hebephrenic forms and depressive syndroms during the illness; in these indications, carpipramine exerts a clear psychomotor stimulating activity which is useful in decreasing indifference, apathy and ideomotor slowness. Schizophrenias with paranoid delusions or depersonalization anxiety tend to be somehow aggravated. Carpipramine does not seem to be a true antidepressant despite its desinhibitory properties. The compound proves useful in deficits of the psychomotor tone such as those occuring in psychasthenia or the deficit syndrom which follows withdrawal from opiates. Clinical and biological tolerances seem to be excellent and extrapyramidal side effects are exceptional. Carpipramine may be considered as a strongly desinhibitory neuroleptic agent which bears some resemblance to antidepressants because of its psychoanaleptic effect. The authors raise the question of possible antipsychotic properties in higher doses in relation to pharmacological data and a bipolar, antipsychotic and predominantly desinhibitory, therapeutic action.

Anti-Anxiety Agents↗
PubMed1977

[Psychosensorial manifestations observed in psychotic patients treated with betamimetic drugs].

We report four observations of women who had acute or subacute psychotic crisis and who were stabilized without any manifestation. In order to delay delivery these women received during pre-partum high doses of beta-mimetic drugs (isoxsuprine and salbutamol). Such a prescription seems to have been responsible of acute and transient psychotic symptoms similar to those observed in drug-induced psychosis (derealisation preceeding depersonalization, visual and auditory hallucinations, anxiety). Recently Gluckman has described a similar case to those reported here. But in his case the conditions of coming out were different and there was a lack of psychotic antecedents. Previous works concerning "psychotic-like" effects of beta-blokers rise the question of possible psychodysleptic effects of beta-mimetic drugs.

Adrenergic beta-Agonists↗
PubMed1991

A stress management workshop improves residents' coping skills.

We describe the effectiveness of a stress management workshop designed for physicians. Of the 64 medicine, pediatrics, and medicine-pediatrics residents who agreed to participate in the workshop, the 43 who could be freed from clinical responsibilities constituted the intervention group; the 21 residents who could not be freed from clinical responsibilities were asked to be the nonintervention group. The ESSI Stress Systems Instrument and Maslach Burnout Inventory were administered to control subjects and workshop participants 2 weeks before and 6 weeks after the workshop. The half-day workshops taught management of the stresses of medical practice through: (1) learning and practicing interpersonal skills that increase the availability of social support; (2) prioritization of personal, work, and educational demands; (3) techniques to increase stamina and attend to self-care needs; (4) recognition and avoidance of maladaptive responses; and (5) positive outlook skills. Overall, the ESSI Stress Systems Instrument test scores for the workshop participants improved (+1.27), while the nonintervention group's mean scores declined (-0.65). All 21 individual ESSI Stress Systems Instrument scale items improved for the workshop, compared with eight of 21 items for the nonintervention group. The workshop group improved in the Maslach Burnout Inventory emotional exhaustion scale and deteriorated less than the nonintervention group in the depersonalization scale. We conclude that a modest, inexpensive stress management workshop was received positively, and can lead to significant short-term improvement in stress and burnout test scores for medicine and pediatrics residents.

Adaptation, Psychological↗
PubMed1990

Conceiving a child to save a child: reproductive and filial ethics.

I conclude that Mary and Abe's decision to conceive a child to save a child does not impose harm on persons or on relationships in the family. Nor does it evince a lack of respect for the child they have conceived. The ethical guidelines that support this conclusion can now be summarized. First, actions should not depersonalize or otherwise endanger personal relationships. Second, although ideally personal relationships are initiated and continued for their own sake, after a personal relationship has been established and sustained the motives for establishing it recede in importance. Third, the requirement of honesty looms especially large in the context of personal relationships. Fourth, privacy protects personal relationships in the family from intrusion by the state. Fifth, even if those with whom we stand in personal relationships are not fully rational or self-conscious, we should treat them with respect. Finally, persons often are called upon to make greater sacrifices in personal relationships. These principles represent only the barest beginnings of an ethics for filial relationships. Nonetheless, they mark progress in the direction of developing a more complete account. We should not suppose that ethics in the family always will be spontaneous or "natural". Over a century ago, Mill warned that nature and natural are "one of the most copious sources of false taste, false philosophy, false morality, and even bad law". Especially in the wake of medical advances, such as recombinant DNA and new reproductive technologies, the complexity of filial ethics will only increase. The demographics of an aging society will add further complexity to filial contexts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Psychopharmacological effects of cannabis.

The use of cannabis can lead to an acute toxic psychosis, 'flashbacks', depersonalization, derealization and marked cognitive and psychomotor impairment. Further research is needed to establish whether a functional psychosis can be provoked, aggravated or prolonged by cannabis intake. Perhaps of greatest significance among the physical sequelae is the potential to suppress the immune system, impair reproduction, produce respiratory disease and increase the risk of lung cancer.

Cannabinoids↗
PubMed1990

Patient attitude toward home uterine activity monitoring.

Forty private patients using a home uterine activity monitoring system and daily contact with nursing staff (Term Guard monitor and Tokos Perinatal Nursing Service; Tokos Medical Corp., Santa Ana, CA) were surveyed after delivery. Twenty-seven responses (67.5%) were obtained. The majority of the responding patients (81%) felt that the monitor helped their pregnancy and 92% would recommend it to family and friends. Eighty-five percent thought that the monitor and related nursing services would be something that they would use in future pregnancies. No subject concluded that the monitor depersonalized their obstetric care. Forty-one percent of the patients felt that the device was an intrusion into their life-style. Seventy-eight percent thought that the device was beneficial in their understanding of preterm labor and in learning to perceive their own baseline uterine activity. Almost 60% of the subjects noted that the monitor was useful in determining uterine activity because they did not perceive any contractions. Approximately 65% felt that unnecessary trips to the hospital for prolonged monitoring were prevented by the availability of 24-hour-a-day, 7-day-a-week emergency transmission and nurse contact. Nearly three-fourths of the patients felt that unnecessary calls to the physician were prevented by their ability to monitor. In summary, the services were well accepted by the patients and, despite the intrusion into their life-style, most felt that home uterine activity monitoring improved the outcome of their pregnancy.

Attitude to Health↗
PubMed1990

[Phenomenologic findings in melancholia in relation to empirical studies].

This psychopathological study about the experience of anxiety in 160 melancholic and 93 neurotic depressive patients (diagnostic criteria acc. to ICD-9) aims at reconsidering earlier findings about the anthropological essence of melancholia. Anxiety seems to be especially appropriate to examine changes in time experience emphasized by phenomenological authors. Only 5% of the melancholic patients spontaneously report on alterations of the experience of time. Self reports point to a "basic disturbance of temporal development" (von Gebsattel) in melancholia. The temporal structure of the experience of anxiety however, more depends on the respective content of anxiety than on the patient group examined. On the contrary the natural matter of course in dealing with hitherto familiar affairs gets lost more often in melancholia than in non-melancholic states: Anxiety about all and everything and anxiety related to depersonalization prove to be characteristic of melancholia, even with regard to the severity of depression. The data confirm that beyond changes of time experience a "separateness from the essential conditions of natural experience" (Binswanger) comes to light in melancholia.

Adult↗
PubMed1989

[Clinical aspects of paroxysmal states in children with depression].

In 81 depressed children aged 3 to 14 years the nonepileptic attacks could manifest the different psychopathological phenomena: 1, headaches before and after spells, non-systemic++ vertigo with imbalance and oculovestibular events with or without loss of consciousness; 2, orthostatic symptoms, syncope, cataleptoid seizures, Kloos seizures; 3, depersonalization and derealization episodes, deja vu and jamais vu states; 4, attacks with pain in the stomach and other organs, various other autonomic signs; 5, unsteady neurological signs: pareses, sensory, visual and speech disorders; 6, nightmares, oneiroid states, sleep-walking; 7, convulsive states, hyperkinesis; 8, psychomotor excitation and inhibition states; 9, behavioral spells with aggression. These states are differentiated from epileptic and hysterical attacks.

Adolescent↗
PubMed1989

Substance-induced dissociative disorders and psychiatric nosology.

Transient amnesias, fugues, twilight states, automatisms, depersonalization, and furors or explosive disorders can occur in association with, or be caused by, various medications or substance-induced organic brain states. Agents capable of precipitating dissociative-like states include alcohol, barbiturates and similarly acting hypnotics, benzodiazepines, scopolamine, clioquinol, beta-adrenergic blockers, marijuana and certain psychedelic drugs, general anesthetics, and others. The presentations of substance-induced dissociative states may resemble those of functional dissociative disorders, or organic and psychogenic dissociative factors may coexist and be intertwined or indistinguishable. Organic dissociative states are distinct from intoxication, amnestic disorder, frank delirium, or other organic mental disorders as specified in DSM-III and DSM-III-R, yet these diagnostic manuals have no inclusive category or coherent nosological approach to dissociative states not strictly psychogenic in etiology. Substance-induced and other organic dissociative disorders can have clinical, medicolegal, and neuropsychological significance. They provide a unique opportunity for the study of mind-brain relationships and should be included in psychiatric nosology.

Dissociative Disorders↗
PubMed1977

Changes in role perceptions by first-year dental students.

Dental education combines the learning of technical skills with the professional role of health care provider. The investigation compared first-year dental students perception of themselves, dental practitioners, dental school upper-class students, and patients. The study indicated that first-year students are more likely to identify with upper-class students than with dental practitioners. They also tended to see themselves as clearly different from dental patients. It is suggested that dental educators should recognize this fact in order to avoid the depersonalization of dental care delivery.

California↗
PubMedDate not supplied

[A case of lycanthropy with deadly violence].

After a short historical review of the contemporary medical literature, the authors analyze a new and original observation of lycanthropy. He is a 28 years old man, imprisoned for deadly violence, who has been showing, for many years, the belief of being transformed into a werewolf during depersonalization episodes when he presents a lycanthropic behaviour. Our observation is closer to hysteria and mythomania on an antisocial personality, although it seems difficult to place the mental pathology of this alcoholic recidivist delinquent into a nosographical frame.

Adult↗
PubMedDate not supplied

[A case of toxic psychosis caused by bromocriptine].

We present a short review of literature concerning the problem of bromocriptine-induced psychosis A case of toxic psychosis following treatment on bromocriptine in an acromegalic patient who had previously undergone hypophysectomy is also reported. On two occasions after having received low doses of bromocriptine for several months, the patient developed a psychotic syndrome characterized by violent behaviour, auditory hallucinations, paranoid misinterpretation, threatening delusions and depersonalization, which lasted several weeks. On treatment with neuroleptics, the symptoms gradually remitted. In the context of the reviewed literature, an outstanding feature of the case is the absence of psychiatric history, which is not frequent, but not unlikely in the published case-reports. This reassures the authors' on the unespecificity of psychiatric syndromes, broadly discussed in our own and other colleges' references.

Acromegaly↗
PubMed1989

Occupational burnout among correctional health workers. Perceived levels of stress and social support.

1. Approximately one third of the sample study fit Maslach's burnout profile, with low personal accomplishment, high depersonalization, and high emotional exhaustion. Perceived stress was a significant predictor of the sense of personal accomplishment and emotional exhaustion. 2. Both male and female subjects had low to moderate mean scores on the social support scale. Social support as measured in this study was limited to that received from coworkers and supervisors. 3. The results of this study point to a need for intervention in this setting. Specific interventions for decreasing stress and thus decreasing chances for burnout are discussed. 4. The development of a broad employee health care program is an example of a primary prevention intervention to decrease stress in this setting. Such a program would include instruction in methods of stress reduction and stress management, including exercise and relaxation techniques.

Adult↗