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PubMedDate not supplied

[A case of toxic psychosis caused by trichloroethylene].

A case of chronic intoxication by trichloroethylene--it is a liquid generally used as a fat solvent--is described in a young man aged eighteen who had been inhaling it for months while he was doing his military service. Hallucinatory symptoms--visual as well as verbal ones--appear over a slightly confusional basis but he also suffers from several psychotic symptoms like the feeling of a threat to his ego, depersonalization and some others. He is explored and evaluated by means of specific tests for psychotics--such as the Frankfurt psychopathological inventory which was introduced in Spain by these very authors. Structural and psychopathological relations among different types of psychoses--mainly those which are purely hallucinatory and the schizophreniform ones--are discussed based on their our doctrinal theories quoted in the bibliography.

Adolescent↗
PubMed1988

[Ontogenetic aspect of sensory-perceptive disorders in mental diseases].

Based of study of 1595 files of patients with various mental diseases ranging from preschool to senile age groups, an analysis is presented of age peculiarities of perceptive and psychosensory disorders, perception distortions in depersonalization-derealization symptoms, illusions, hallucinations. The incidence of different kinds of sensory-perceptive disorders in a number of mental diseases is collated. Ontogenetic features of sensory and perceptive disorders are juxtaposed with these functions' normal ontogenesis.

Adolescent↗
PubMed1988

Procedural skills in flexible sigmoidoscopy and colonoscopy for the family physician.

Procedural skills in flexible sigmoidoscopy and colonoscopy are widely accepted as diagnostic and therapeutic tools that assist physicians as they attempt to understand the biological and behavioral elements of undifferentiated gastrointestinal illness. Data support the ability of family physicians to perform and teach some of these endoscopic skills. Although one major contribution of these procedures is in the prevention of premature colorectal cancer mortality, other important patient care benefits are emerging for the office-based physician. Breadth of care enhances our most important therapeutic tool--the doctor/patient relationship. Unnecessary referral contributes to fragmentation and depersonalization of the health care system. Family physicians are urged to examine and acquire new procedural skills appropriate for their community. The process of privileges is discussed.

Colonoscopy↗
PubMed1988

[Hofmannsthal and the gliding out of this world].

In the sphere of language, Hugo von Hofmannsthal was already in his childhood talented by nature. His first poems and essays he wrote when he was 17 years old, his first drama ("The Death of Tizian") in his 18th year. From the beginning he followed the great tradition of the theatre of Vienna. His lyrical creations end already before he turned 30 years. At this time the dramatist begins with the reception of the medieval mystery plays, Calderon and the greek-oriental myths. The phenomena of gliding-out-of-the-world are found before this time, in the period of his very own spiritual conceiving. They show a remarkable inclination to abandon the world of reality (Wirklichkeit, koinos kosmos): gliding into the world of dream and trance, of phantastic tales, of magic and demonia, of depersonalization and dilusion, of dying and of death (idios kosmos). These tendencies vanish when Hofmannsthal turns to more conventional topics.

Attitude to Death↗
PubMed1988

Burnout and stress among employees at a state institution for mentally retarded persons.

The effects of burnout of 192 employees of a state institution were examined to determine whether these problems were different from conditions resulting from stress. Each subject completed a packet including the Maslach Burnout Inventory and Ivancevich's Job Stress Scale. For all groups, high burnout emerged in the form of low personal accomplishment, with moderate degrees of burnout measured by the Burnout Inventory subscales Emotional Exhaustion and Depersonalization. One of the stress variables (underutilization) correlated significantly with one Burnout Inventory subscale (Emotional Exhaustion). Results generally indicated that stress and burnout were separate constructs that can be best thought of as distinct entities.

Adult↗
PubMedDate not supplied

Symptoms of depression in old people in Finland.

The study describes common symptoms of depression and age and sex differences in these symptoms in elderly Finns. The symptoms were assessed on the basis of the 22-item Hamilton Rating Scale for Depression (HRSD), and comparisons were made between the symptoms of those diagnosed as depressed and those diagnosed as not depressed in clinical investigations. The most common symptoms in depressed men were general somatic symptoms, initial insomnia, loss of interest in work and activities, middle insomnia, and depressed mood. In depressed women, the most common symptoms were psychic anxiety, general somatic symptoms, initial insomnia, loss of interest in work and activities, and depressed mood. In both these groups the lowest occurrences were found for compulsory symptoms, paranoid symptoms and depersonalization. The symptomatology was most severe in the oldest age group: depressed mood and many somatic symptoms were more common in depressed older male and female age groups than in younger groups. Sex comparisons showed that many symptoms were more severe in depressed women than in depressed men: depressed mood, feelings of guilt, psychic anxiety, somatic anxiety and diurnal variation of symptoms were more common in depressed women. Retardation was the only symptom that was more common in depressed men. Loss of libido did not belong to the symptomatology of depression in the oldest female age group, but in men and in younger female age group it could in some cases indicate occurrence of depression.

Age Factors↗
PubMed1988

The exclusion of intimacy in the sexuality of the contemporary college-age population.

The sexual mores of the contemporary college population have undergone some fundamental changes in the past twenty-five years. Converging evidence from a variety of reliable sources obtained from a wide range of seemingly adjusted subjects, including personal interviews by the author, indicates that sexual involvement between partners of the opposite sex has been sporadic, episodic, without commitment, and accompanied by a deliberate effort of both partners to suppress tender, romantic feelings and intimacy. The sources of this situation are linked to changes in five domains: the ethos, the ascent of women, advances in contraceptive methods, residential mobility, and changes in child-rearing patterns. This premeditated restraint of affect has led to a noticeable diminishment of gratification derived from sexual union. It has contributed to sexual apathy, to discord, and a substantial rise in the incidence of two types of psychiatric disturbance--depersonalization and derealization. Sexual union, instead of enhancing sociability, acts as a barrier and inhibitor of enduring attachment and a sense of continuity. The repercussions on the social fabric are unexplored and merit systematic study. It is suggested that the prevailing sexual conventions of college-age youth clash with the fundamental urge to form human attachments; diminish and often shut out the experience of passion in sexual unions; and bring about inner turmoil that weakens self-confidence. As a result, it is concluded that the prevailing college-age mores are maladaptive on the individual as well as the interpersonal level. In due time, they will be replaced by more fitting conventions. This process of replacement can be hastened by an appropriate educational intervention involving younger age groups.

Adult↗
PubMed1988

[Clinical picture and treatment of torpid schizophrenia with senestopathic and depressive disorders].

Several years of study of senestopathy combined with subdepressive affective disorders in 38 patients with sluggish schizophrenia enabled the authors to describe the peculiarities of the natural history of these signs. The complicating senestopathy most frequently alternated with the periods of tactile or visceral hallucinations, rarely with depersonalization events. In subdepressive disorders, adynamia prevalent originally, vital signs appeared at the height of the disease and further on adynamia became manifest. Potentiation and evolution of senestopathy always correlated with the intensity of affective disorders. Combined therapy using low doses of the psychotropic drugs proved effective.

Adult↗
PubMed1987

Tactics vs strategy in practice.

This very brief introduction to the concept of tactics and strategy in practitioner/client conversations will, I hope, stimulate veterinarians to interest themselves further in developing these and other communications skills. Clients frustrated by automatic bank tellers, electronic supermarket checkout stations, and similar depersonalizing machines, will place ever-increasing value on their scarcer and scarcer human contacts. The more proficient we are in relating well to other people, the more successful we will be in practice.

Communication↗
PubMed1986

[Ordering laboratory tests: their quantity and causes of variations among physicians].

To establish whether some physicians contribute more than others to the alarming increase in laboratory related expenditure, 317 consecutive medical files established by 10 residents of an outpatient clinic were analyzed. The expense incurred in establishing a diagnosis varied, according to the physicians involved, by a factor of 4.9 for back pain and 2.6 for acute respiratory illness. The difference is even more striking when the various types of investigation are analyzed (blood count, ESR, X-rays). It is therefore possible to group physicians according to their individual tendency to order tests. This classification is not related to age, sex, former professional experience or sub-specialty in internal medicine. There is a significant correlation (Spearman's test) between this classification and the approach to medicine, as evidenced by analysis of the content of an interview on medical practice. These interviews were conducted double blind, recorded and transcribed to determine psychological traits. Physicians who order a large number of tests are characterized by a high index of uncertainty, as evidenced by the large number of hesitant expressions and a tendency to cut the interview short, showing off to compensate for lack of self-assurance, depersonalized reference to patients, few references to the interviewer, difficulty in establishing a true dialogue. These characteristics can be considered to form a coherent entity which shows that even the material aspects of medical practice are strongly influenced by the physician-patient relationship.

Attitude of Health Personnel↗
PubMed1986

Burnout experienced by recent pharmacy graduates of Mercer University.

The degree of burnout experienced by graduates of the Mercer University Southern School of Pharmacy from 1973 to 1983 was studied. Questionnaires were mailed to 1000 alumni, representing 850 Bachelor of Science (B.S.) and 150 Doctor of Pharmacy (Pharm.D.) graduates. Three components of burnout--emotional exhaustion, depersonalization, and personal achievement--were measured using the Maslach Burnout Inventory to determine relationships between burnout and primary work setting, primary work activity, and type of degree (Pharm.D. or B.S.). The response rate was 41%. The respondents experienced a moderate degree of burnout. Those pharmacists working primarily in community chain store settings reported greater levels of burnout than those working in hospital or institutional pharmacies, independent community pharmacies, academia, and home health care. Respondents who performed primarily nondistributive duties (direct patient care, drug information, teaching or research, and management or administration) experienced lower levels of burnout than those involved primarily in drug distribution. Pharmacists holding the Pharm.D. degree were involved to a greater extent in nondistributive positions and experienced a lower degree of burnout than the pharmacists holding a B.S. degree only. Pharmacists in nondistributive roles appear to be less affected by burnout than pharmacists performing traditional distributive activities.

Burnout, Professional↗
PubMed1986

[Clinical features of acute phobias with somatovegetative disorders in neuroses and slowly progressive schizophrenia].

Comparison of the clinical characteristics of acute phobic states involving marked vegetosomatic disorders in schizophrenic and neurotic patients have shown that these conditions present two clinically different syndromes--true phobias of the neurotic genesis and vital depersonalization of the endogenic nature. Severity of vegetosomatic disorders is associated with the predominant impairment of the vital levels of psyche.

Acute Disease↗
PubMed1986

[Thalamic dementia after a unilateral hemorrhagic lesion of the right pulvinar].

A 68 year-old man with a history of right thalamic hemorrhage demonstrated radiologically in the pulvinar and posterior portion of the dorsomedian nucleus developed a clinical picture of severe physical sequelae associated with major affective, behavioral and psychic disorders. Affective manifestations were a permanent anxiety-depression state contrasting with indifference to his surroundings. Behavioral changes included marked apathy, inertness and hypersomnia, together with occasional clastic agitated episodes and verbal and gestural stereotypies and soliloquies. Psychic sequelae were psychotic in nature: depersonalization crises, delusions of persecution, multisensorial hallucinations and absurd acts.

Aged↗
PubMedDate not supplied

For an overall approach to prevention: basic critical considerations.

This article pleads for a comprehensive approach to the prevention of drug abuse, one which involves individuals throughout their lives and takes account of their psycho-social characteristics and spiritual values, as well as of differences among individuals. Certain drug abuse prevention programmes are identified as being counterproductive, such as inconsistent and incongruous programmes of the media that glamorize the life of celebrities who are abusing drugs, or drug information material that concurrently publicizes the use of legal drugs. Depersonalized drug education programmes have also proved to be counterproductive. Assistance and rehabilitation programmes for drug dependent persons and programmes for prevention of drug abuse among the young population, particularly children, should be provided simultaneously to avoid being caught up in a "vicious circle of assistance", brought about by disinterest in prevention and unrealistic expectations of society. The emphasis of prevention programmes should be on people rather than on drugs themselves. It is apparent that, up to now, development programmes have not succeeded, as universal remedies, for drug problems in replacing traditional values that ensure the cohesion of society. Any such programmes should be evaluated carefully to determine which aspect of development may be a cause of drug abuse and which prevents it. Recent associations of young people seeking spiritual values and helping drug addicts to stop taking drugs and to be reintegrated into society are among the most promising approaches because they involve young people in helping youngsters of their own age rather than promoting intervention by formal institutions. The family is also one of the promising community resources that can be utilized for the prevention and reduction of drug abuse.

Adolescent↗
PubMed1968

The LSD syndrome. A review.

lsd (lysergic acid diethylamide) is a powerful bio-active substance related to serotonin in structure. Its actions generally affect autonomic, sensory and psychological functions. Autonomic stimulation is varied. Sensory responses are usually visual, involving heightened and distorted color perception and fusion of sensory impressions. Psychological responses include a feeling that a unique experience is occurring; feelings of depersonalization; pronounced fluctuation of mood; time and space distortions; autistic phenomena; fluctuation of aggressive drives (usually reduction); and spontaneous reoccurrence of the lsd experience. THE SUBJECTIVE RESPONSES CAN BE RELATED TO THREE BASIC PHENOMENA: (1) expectation; (2) loss of characteristic modes of perceptual and cognitive patterning; and (3) hypersuggestibility. THE MAJOR ADVERSE REACTIONS ARE: (1) chronic drug dependence including subsequent personality changes and depressive reactions; and (2) acute ego dissolution. These reactions usually occur in already emotionally ill people. Most of these users fall into two groups, those with unresolved identity problems and those with severe ego abnormality. The majority of adverse reactions are of the chronic drug dependence type and are usually seen in adolescents and young adults who have not negotiated the age-appropriate tasks of forming and integrating the various identities that are the composite of their life experiences.lsd helps alleviate these stresses via some of its psychological properties as discussed. It also provides a nidus for the formation of a subculture where goals for social, sexual and vocational achievement are lower and idiosyncratic modes of adaptation are better tolerated. A smaller group of users who have serious reactions such as psychosis, rage reactions, homicidal and suicidal ideation are usually found to have preexisting ego abnormality such as ambulatory schizophrenia, chronic impulse disorders and borderline states. Although adverse reactions most often appear to be related to pre-morbid psychopathology, this is not invariably so. Further, there is as yet no reliable method to determine who will have an adverse reaction and what the nature of that reaction will be.

Color Perception↗
PubMed1981

Panic attacks. A review of treatments and pathogenesis.

In the psychiatric literature, panic attacks have been considered as part of the clinical manifestations of anxiety neurosis, agoraphobia, functional cardiovascular disturbances, and the phobic depersonalization syndrome. Even though recurrent spontaneous panic attacks are described in these entities, the importance ascribed to them has been minor one. Therefore, panic attacks are poorly understood from a psycho-physio pathological point of view. In the past years, new trends in the nosology of psychiatric disorders have grouped the recurrent spontaneous panic attacks under the heading "panic disorder and agoraphobia with panic attacks." In this view, we present the results of the controlled pharmacological trials on patients complaining of panic attacks. Some relationships between panic attacks, panic disorder, and agoraphobia are discussed.

Adrenergic beta-Antagonists↗
PubMed1981

[Psychopharmaceuticals in chronic pain].

Since the introduction of psychotropic drugs, especially carbamazepine (Tegretol), antidepressants and neuroleptics, the treatment of all chronic and severe pain has been decisively improved. Psychotropic drugs have an analgesic effect, and potentiate and economize analgesics. The essential advantage is the absence of dependence during long term treatment. The alleviation of pain is caused by "depersonalization of the pain" or by a "pain removing effect" through a favourable influence on central pain perception and sensation. They prevent the sometimes fatal vicious circles: pain leads to anxiety leads to depression leads to pain etc. or: pain leads to increased central nervous excitability leads to psychic reaction leads to pain etc. The antidepressants induce a change in the central metabolism of serotonin and noradrenaline. Serotoninergic and noradrenergic (pain)-inhibitory neurons are involved in the analgesic effect of exogenous and endogenous opiates. Some neuroleptics (e.g. haloperidol) have a stereospecific binding capacity to opiate receptors and have an opiate-agonistic effect.

Anticonvulsants↗
PubMed1978

[Clinical features of manic-depressive psychosis with organic brain defects].

The authors studied the clinical picture of manic-depressive psychoses in 71 patients who had signs of an organic brain lesion (both anamnestically and clinically), which were confirmed by X-ray and EEG data. It was established that these patients more frequently exhibit atypical forms of affective conditions (anxious--depersonalizational syndromes, angry mania). As a rule, they also have a significant amount of supplementary psychopathological signs in the syndrome structure (dysphorea, obsessions, depersonalization). Such conditions quite often are refractory to therapy and require special therapeutical approaches.

Bipolar Disorder↗