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At least 865 records · Page 48Linked to original sources
PubMed1997

Hoarding symptoms in patients on a geriatric psychiatry inpatient unit.

BACKGROUND: While collecting may be a normal behaviour, hoarding is a symptom of various psychiatric disorders, including obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD). Although anecdotal reports suggest that hoarding is not uncommon in geriatric psychiatry populations, its psychopathological correlates in such samples have not been well characterised. METHODS: The presence of clinically significant hoarding symptoms was screened for in 100 consecutive patients in a geriatric psychiatry inpatient unit. Both patient and collateral histories were obtained. When hoarding symptoms were present, a detailed history of their phenomenology was obtained by means of a structured questionnaire and the response of hoarding symptoms to treatment during hospitalisation was monitored. RESULTS: Clinically significant hoarding was found in 5/100 subjects. Four of these 5 patients met DSM-IV criteria for schizophrenia (paranoid subtype), with onset of symptoms coinciding with increased symptoms of dementia. The fifth patient met criteria for bipolar disorder (manic episode), also had symptoms of dementia, and had a lifelong history of hoarding. Hoarding behaviours responded to antipsychotic treatment in 3 of the 5 patients. CONCLUSIONS: A history of hoarding may be useful in many psychiatric patients, but psychopathological correlates of this symptom are likely to vary with age. In a geriatric psychiatry inpatient population hoarding was associated not with OCD or OCPD, but rather with paranoid schizophrenia and increasing symptoms of dementia. Dopamine blockers appeared useful in decreasing hoarding in some patients, raising interesting questions about the neurobiology of this symptom.

Aged↗
PubMed1994

[A case of Cushing's disease: hallucinatory paranoid state preceding physical symptoms].

A 39-year old woman presented with hallucinatory paranoid state, particularly with erotomania, around September, 1988 (at the age of 39), and was hospitalized in a mental hospital for 9 days from May 1, 1989, to receive major tranquilizer therapy. At admission, the leukocyte count was 10,400/mm3 showing a mild leukocytosis, and there was temporary adynamia in the upper extremities. Thereafter, mild leukocytosis persisted intermittently. On May 12, 1989, the patient visited the Department of Neuropsychiatry, Kansai Medical University, and clinical examinations revealed mental symptoms including insomnia and erotomania, delusion of reference and auditory hallucination without persecutory taint. She showed clear consciousness and well understanding. Characteristically, her expression and behavior were smooth and emotional communication was available. There were neither alterations in her basic mood, nor flaccid association of idea. No abnormalities were seen in the hair and skin, and buffalo hump was not observed. Blood examination revealed a leukocyte count of 10,700/mm3, suggesting a mild leukocytosis. According to the patient, the menses have been regular. Although major tranquilizer therapy has been maintained, she gradually developed emotional instability, and tended to show fatigue and regressive changes in her personality. She was hospitalized in a mental hospital from October 25, 1989 to July 24, 1991. Since 1990, when she was in the hospital, she gradually developed obesity, hypertension, acne, and diabetes mellitus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1994

The relationship between discharge readiness inventory scales and the brief psychiatric rating scale.

OBJECTIVE: Important relationships exist between chronic psychiatric patients' symptoms of disorder and their readiness to be discharged from inpatient treatment. Behavioral rating scales can supplement clinical decision making by standardizing information about patients' functioning. The authors assessed whether two different behavioral measures described the same dimensions of disordered behavior in an older chronic patient population. METHODS: Multivariate correlation analysis (canonical analysis) was used to assess relationships between items on the Brief Psychiatric Rating Scale and the scales in the Discharge Readiness Inventory. RESULTS: Three significant correlation variates were found. The variates reflected patterns of positive psychiatric symptomatology with a low level of psychosocial competence, a low level of symptomatology with a low level of psychosocial competence, and paranoid symptomatology with a high level of psychosocial competence. CONCLUSIONS: The presence or absence of psychiatric symptomatology and possibly the type of symptomatology are relevant in assessing patients' readiness for discharge.

Activities of Daily Living↗
PubMed1988

Psychiatric home care.

Overall, psychiatric home care fills a gap in the mental health continuum of care. This health care delivery system integrates the skill of the psychiatrist with the specialized skill, knowledge, and abilities of the psychiatric nurse. Nurses bring with them a complete armamentarium with which to effectively monitor and change dysfunctional behavior. Through teamwork, clients receive coordinated services aimed at keeping them active and functional in their most treasured and familiar environment, their home.

Adult↗
PubMed1996

Childhood adversity, attachment and personality styles as predictors of anxiety among elderly caregivers.

The purpose of this study was to examine the ways in which childhood adversity, attachment and personality styles influenced the likelihood of having an anxiety disorder among aged caregivers for terminally ill spouses. We also sought to determine how childhood adversity and attachment/personality styles jointly influenced the likelihood of developing an anxiety disorder among aged caregivers. Data were derived from semistructured interviews with 50 spouses (aged 60 and above) of terminally ill patients. The Childhood Experience of Care and Abuse (CECA) record provided retrospective, behaviorally based information on childhood adversity. Measures of attachment and personality styles were obtained from self-report questionnaires, and the Structured Clinical Interview for the DSM-III-R (SCID) was used to determine diagnoses for anxiety disorders. Logistic regression models estimated the effects of childhood adversity, attachment/personality disturbances, and the interaction between the two on the likelihood of having an anxiety disorder. Results indicated that childhood adversity and paranoid, histrionic and self-defeating styles all directly increase the odds of having an anxiety disorder as an elderly spousal caregiver. In addition, childhood adversity in conjunction with borderline, antisocial and excessively dependent styles increased the likelihood of having an anxiety disorder. The results indicate the need to investigate further the interaction between childhood experiences and current attachment/personality styles in their effects on the development of anxiety disorders.

Aged↗
PubMedDate not supplied

[Carbamazepine-fluvoxamine interaction. Consequences for the carbamazepine plasma level].

The current practices concerning psychotropic drugs use plasma levels for the therapeutic adaptation and for the prevention of overdose and side effects. We observed, among two patients treated with constant dosages of carbamazepine (CBZ), that the addition of fluvoxamine (FLV) has increased significantly plasma levels of CBZ. The first patient, suffering of an affective bipolar trouble (ICD-10), was hospitalized for major depression. His admission treatment was CBZ (800 mg/day) and cyamemazine (75 mg/day). The introduction of the FLV (200 mg/day) was justified by the symptomatology. Then, plasma levels of CBZ increased progressively. No clinic or biological side effect was observed. Rapidly, CBZ oral dosages were decreased, but the plasma levels of CBZ reached the therapeutic window only when the FLV prescription was definitively stopped. The other patient was hospitalized for an acute exacerbation of a paranoiac disorder. He was treated with haloperidol for this episode. For five years, he received CBZ for neuralgia of the Trigeminus. The emergence of a depressive disorder justified a FLV treatment. From the introduction of FLV, plasma levels of CBZ were significantly increased. The reduction, then the stop of the FLV treatment, has allowed the standardization of plasma concentrations of CBZ. Three similar studies were found in the literature. The danger of this interaction was notified in two studies (one case each). Furthermore, in the third study (three cases) was put forward the hypothesis of a new therapeutic pathway. this hypothesis was suggested by the fact that these two medications were proposed independently to treat impulsive behaviors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

The effect of milenperone on the aggressive behavior of oligophrenic patients. A double-blind placebo-controlled study.

The antiaggressive action and the side effects of a new neuroleptic, milenperone, were evaluated in 21 oligophrenic patients by means of a double-blind randomized pilot study in comparison with placebo. Only 3 patients appeared to be psychotic, 2 from the milenperone group and 1 from the placebo group. In this study, milenperone was added to the existing psychotropic medication as an adjuvant. The test substance was administered in a dose of 2 X 10 mg daily for 6 weeks. The results were evaluated by means of the Paranoid Belligerence Scale and the improvement of the target symptoms were visualized on the Visual Analogue Line. Although, in the last 3 weeks of the study, the aggressiveness scores had decreased more in the milenperone group than in the placebo group, the difference between both studied groups was not significant. This lack of clear result may probably be ascribed to the high standard deviations, together with the small number of patients per group. The severity and frequency of the side effects remained almost unchanged during the investigation and were independent of the substance administered: milenperone or placebo.

Adult↗
PubMed1988

Abortion in adolescence.

Sexual attitudes and behavior of adolescent females have been the topic of much interest over the past decade. Feelings about contraception, conception, and abortion have been described in relation to the adolescents' beliefs about the possibility of becoming pregnant, who will or will not "protect" them, and the influence of significant others on their decision making. This study explores differences in 35 women who had abortions during their teenage years with 36 women whose abortions occurred after the age of twenty. A demographic questionnaire, the Millon Clinical Multiaxial Inventory, and the Beck Depression Inventory were completed by women who were members of a patient-led support group. Premorbid psychiatric histories, the decision-making process itself, and distressing symptoms postabortion are reported. Specific differences in perceptions of coercion, preabortion suicidal ideation, and nightmares post-abortion were found in the adolescent group. Antisocial and paranoid personality disorders as well as drug abuse and psychotic delusions were found to be significantly higher in the group who aborted as teenagers. Hypotheses regarding the influences of adolescent development on mother/child relationships, power struggles, and the use of fantasy as a coping device are explored.

Abortion, Induced↗
PubMed1992

The Type A belief system: relationships to hostility, social support, and life stress.

Certain core beliefs may underlie the Type A behavior pattern, predisposing individuals to health problems and impaired interpersonal relationships. Previous studies have revealed that the Type A Cognitive Questionnaire (TACQ), a self-report measure reflecting these beliefs, is indeed related to emotional distress. The current study assessed the TACQ's relationship to aspects of the interpersonal environment, including perceived social support and stressful events. It also investigated the TACQ's relationship to subtypes of hostility (ie, cynicism and paranoid alienation). Subjects were 111 college undergraduate volunteers. As hypothesized, the TACQ was significantly related to poor quality of social support and to greater perceived life stress. The TACQ appeared more strongly related to cynicism than to paranoid alienation. Findings were generally more pronounced for males. The discussion suggests that Type A beliefs may predispose individuals to health problems through impaired interactions with their interpersonal environment.

Achievement↗
PubMed1993

["Running amok"--content analytic study of 196 news presentations from industrialized countries].

We performed a content analysis study based on 196 reports in the German press published during the last decade on acts of violence designated as "going berserk" or "running amok (amuck)" and meeting defined criteria. With less than one person per one million men per year running berserk or amok, this is a very rare act of violence, albeit a very dangerous one involving 1.3 deaths and 1.7 injuries per case. Offenders differ from the normal population in regards to the small percentage of women (5%) and high unemployment (40%), and from other violent offenders in that they are normally occupationally well-qualified. Severe psychiatric disorders are overrepresented. A total of 108 cases were classified according to specific syndromes either by specialists or experts on the spot, or on the basis of a description of the signs and symptoms. Of the syndrome-related acts, the most dangerous offences were committed by 10 delusionally ill and 2 psychopathic individuals. 30 less dangerous offenders suffered from paranoid-hallucinatory syndromes. 28 crimes committed in a state of intoxication and 11 "crimes of passion" were the least dangerous. Another 25 persons with an extensive incidence of suicide in the family, without any apparent pre-existing psychiatric disorder, may have gone berserk in the course of a depressive syndrome. Although psychotically ill individuals tend to overreact more often following a minimal slight, under delusions or with no apparent reason at all, on the whole the causes for both the psychotic and other offenders are of a serious nature. Object loss and private disputes on the one hand and social conflicts on the other were of approximately equal significance. The relationship between the offender and his victim is more essential for the course of the occurrence than motives or the type of the psychopathological syndrome. If only family members are attacked, the offenders have usually been inconspicuous, elderly individuals, two thirds of whom can not be allocated to a given syndrome and may be depressive. They kill deliberately and on-target, do not merely injure their victims--hardly ever, in fact--and then commit suicide practically without exception. If strangers are the target of violence, the crimes are generally committed by younger, passive-aggressive, psychopathic, paranoid or intoxicated offenders. They kill only about half of their victims, but injure many, also causing a great deal of damage. They rarely commit suicide.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed2002

Links between body mass index, total body fat, cholesterol, high-density lipoprotein, and insulin sensitivity in patients with obesity related to depression, anger, and anxiety.

OBJECTIVE: Define links between psychosocial parameters and metabolic variables in obese females before and after a low-calorie diet. METHOD: Nine female obese patients (age 36.1 +/- 7.1 years, body mass index [BMI] > 30 kg/m2) were investigated before and after a 6-week low-calorie diet accompanied by behavior therapy. Blood lipids, insulin sensitivity (Bergman protocol), fat distribution (by dual-energy X-ray absorptiometry [DEXA]), as well as psychological parameters such as depression, anger, anxiety, symptom load, and well-being, were assessed before and after the dieting period. RESULTS: The females lost 9.6 +/- 2.8 kg (p < .0001) of body weight, their BMI was reduced by 3.5 +/- 0.3 kg/m2 (p < .0001), and insulin sensitivity increased from 3.0 +/- 1.8 to 4.3 +/- 1.5 mg/kg (p = .05). Their abdominal fat content decreased from 22.3 +/- 5.5 to 18.9 +/- 4.5 kg (p < .0001). In parallel, psychological parameters such as irritability (p < .05) and cognitive control (p < .0001) increased, whereas feelings of hunger (p < .05), externality (p < .05), interpersonal sensitivity (p < .01), paranoid ideation (p < .05), psychoticism (p < .01), and global severity index (p < .01) decreased. Prospectively, differences in body fat (percent) were correlated to nervousness (p < .05). Waist-to-hip ratio (WHR) differences were significantly correlated to sociability (p < .05) and inversely to emotional instability (p < .05), whereas emotional instability was inversely correlated to differences in insulin sensitivity (p < .01). DISCUSSION: Weight reduction may lead to better somatic risk factor control. Women with more nervousness and better sociability at the beginning of a diet period may lose more weight than others.

Adipose Tissue↗
PubMed2001

A 22-year retrospective analysis of the changing frequency and patterns of religious symptoms among inpatients with psychotic illness in Egypt.

BACKGROUND: The aim of the present study was to assess the changes in frequency and pattern of religious symptomatology in a sample of psychiatric inpatients in Egypt suffering from some form of psychotic illness over the time span from 1975 to 1996. METHOD: A sample of 5275 files of psychotic inpatients at Behman psychiatric hospital in Cairo, Egypt, admitted between 1975 and 1996, were scrutinized for the presence or absence of "religious" symptoms. All the files with religious symptoms from this sample (n=632) and an additional 281 comparison files were analyzed. RESULTS: Significant fluctuations in the frequency of religious symptoms over the period of the study were noted. The frequency of religious symptoms peaked in the mid-1970s to early 1980s, and again in the early and mid-1990s, relative to other time periods. Further analyses of changes in the frequency of specific religious themes or symptoms revealed that religious behaviors (i. e., increased reading of religious texts, preaching, and other types of overt religious expression), in particular, showed significant and consistent patterns of change. CONCLUSIONS: These findings were interpreted in light of the fluctuating emphasis on religion and religious affiliation in everyday life in Egypt during the period of the study. While the overall frequency of religious delusional themes in Egypt is sensitive to societal changes across time, the specific content of these delusions remains stable. On the other hand, the relative salience of behavioral modes of pathological religious expression is highly influenced by changing patterns of religious emphasis in Egyptian society.

Adult↗
PubMed1996

Object relations and nursing care of persons experiencing psychosis.

Object-relations theory explains human behavior in terms of a person's inner experiences of others, which are called objects. Internalization of relationships, projective identification, and containment are concepts within object-relations theory that help to explain the confusing and frustrating behavior of acutely psychotic patients. These concepts also provide a framework for understanding the reactions of nurse clinicians to psychotic behaviors. This article explains the basic principles of object-relations theory, illustrates the concepts through a case study, and proposes nursing interventions from an object-relations perspective.

Female↗
PubMedDate not supplied

[Psychopathology of violent behavior in mental disorders].

The frequency of violent behaviour in mental hospitals has been increasing in recent years. A number of factors may be responsible. Violent and dangerous patients are sent to hospitals, quite often against their will. This may lead to conflicts and assaults against the staff members. There are many factors, both in present situation and in biography, conductive to violent behaviour: unfavourable experiences in childhood (neglect, cruelty, sexual exploitation), psychopathic structure of premorbid personality, frustrations, and eventually deformations of world perception caused by psychotic symptoms. Various mental disorders may lead to the violent behaviour, but it is most frequently observed in exacerbation of paranoid schizophrenia, in young males, particularly in cases with systemized delusions, emotional turmoil and anger. Introduction of a person (nurse, physician, family member, other patient) into psychotic world may also lead to the attack. In particular cases it is difficult to foresee violent behaviour, but some indicators are known. There are very few investigations on the role of the staff in violent behaviour of patients. The danger may be brought by criticism, refusal and rejection, compulsory drug administration, undue limitations of the patient's liberty, or the opposite--no reaction to violations of institutional regulations. Psychopathology of the staff may also encourage the violent behaviour: inability to solve the transference and countertransference, reaction formation and denial are the most important. Fear exaggerates the feeling of danger and induces the staff members to avoid the patient, diminishing the possibility of influence and control of the patient's disturbed behaviour. Recurrent violent behaviour may be connected with brain pathology, so the modern diagnostic procedures may be indicated in such cases.

Brain Diseases↗
PubMed1985

The effect of milenperone on the aggressive behavior of psychogeriatric patients. A double-blind placebo-controlled study.

The antiaggressive action and side effects of a new neuroleptic, milenperone, were evaluated in 20 non-psychotic psychogeriatric patients by means of a double-blind randomized pilot study in comparison with placebo. In this study, milenperone was added to the existing medication as an adjuvant. The test substance was administered in a dose of 2 X 5 mg daily for the first 3 weeks, in a dose of 2 X 10 mg daily for the following 3 weeks. The addition of milenperone to the preexisting medication decreased the aggressiveness scores, significantly on the Paranoid Belligerence Scale, not significantly on the Visual Analogue Line. The improvement of the aggressiveness scores on the Paranoid Belligerence Scale was only significantly apparent when the dose was doubled. In spite of the association with milenperone, the severity and frequency of the side effects did not increase during the investigation.

Aged↗
PubMed1975

Loxapine succinate: a controlled double-blind study in chronic schizophrenia.

Loxapine succinate was compared to chlorpromazine in a 12-week double-blind study of 50 hospitalized chronic schizophrenic patients. Statistical analyses of BPRS scores showed significant improvemement for several items and factors in both groups of patients. Both drugs significantly decreased severity of illness on the CGI scale. On the NOSIE scale, "manifest psychosis" was improved significantly with chlorpromazine and "global severity" with loxapine succinate. There were no significant treatment differences in BPRS, CGI, or Nosie items or factors or in the reduction of overall psychopathology. The side effects associated with the study drugs differed little with respect to incidence, number, severity, and type. The most frequently reported symptoms in both groups were behavioral, extrapyramidal, and sedative. Analyses of vital signs and clinical laboratory data revealed no evidence of serious untoward effects.

Adult↗
PubMed1976

Sleep analysis during drug-free weekends in chronic schizophrenic patients.

The authors made a polygraphic registration of the night sleep in a sample of 14 chronic schizophrenic patients who for several months (mean 8 months) have been on a stable, relatively low maintenance dosage of neuroleptics administered according to the drug-free weekend schedule (two consecutive drug-free days at the weekend). During this treatment none of them showed a relapse or deterioration (BPRS, CGI, and NOSIE rating scales were applied periodically). Their only complaint was of sleep deterioration during the drugfree weekend nights, especially during the second night. The polygraphic night-sleep pattern of each patient was studied during two consecutive weeks. No difference was found between the adaptation night on medication and the consecutive night on medication during the first week, and between the adaptation and readaptation nights on medication during two consecutive weeks. There was no difference in any sleep parameters between the nights on medication and the first drug-free nights. There was a signifcant difference in the total sleep time between the nights on medications and the second drug-free nights. No difference was found in any other sleep parameters in nights analysed as a blocks and in the distribution of NREM and REM stages in the first vs. the second half of the night when B3 was compared with A2. The practical implication is, that to avoid any change in nocturnal behavior it is preferable to withdraw the medication on two nonconsecutive days in the week. The evaluation of both daily and nocturnal behavior seems to be a useful tool in evaluating the first sign of the drug-withdrawal syndrome.

Adult↗
PubMed2006

Psychotic-like experiences and interpersonal violence in the general population.

BACKGROUND: Research on the association of psychopathology and violence has mainly focused on severe but rare mental disorders, especially psychotic disorders. However, evidence is growing that psychotic disorders are continuous with common psychotic-like experiences in the general population. This study aimed to examine the association of psychotic-like experiences with violence in a general population sample. METHODS: In 38,132 adult participants of the 2001 US National Household Survey on Drug Abuse, the association of psychotic-like experiences with violent behavior were examined. RESULTS: Psychotic-like experiences were reported by 5.1% (N = 2,584) of adults in the community. These experiences were associated with increased risk of attacking someone with the intent of hurting that person (Odds Ratio [OR] = 5.72), intimate partner violence (OR = 4.97), arrests for aggravated assault (OR = 5.12), and arrests for other assault (OR = 3.65). The risk of violence increased with the number of psychotic-like experiences. Unusual perceptual experiences and paranoid ideations were more consistently associated with violence. CONCLUSIONS: The link between psychopathology and interpersonal violence appears to expand beyond the limits of severe mental disorders and to include more common psychotic-like experiences in the general population.

Adolescent↗