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PubMed1985

Life skill training: psychoeducational training as mental health treatment.

Fifty-four patients of a Veterans Administration Medical Center were assigned to either a life-skill training program that emphasized psychoeducational instruction and skill building or to a group counseling control condition. Subjects assigned to life-skill training were provided with 28 hours of instruction in interpersonal communication, purpose in life problem solving, and physical fitness/health maintenance. Control subjects received equal time engaged in psychiatric treatment that emphasized the analysis and exploration of personal problems, but with no direct coping skill training. Significant differences between the two groups were found on measures of interpersonal communication and meaningful purpose in life. Both groups received lower staff ratings on psychopathological behavior and demonstrated improvement on ratings of health and physical fitness upon completion of treatment. Twelve- and 24-month follow-up data that include rehospitalization rates are presented for each group.

Adaptation, Psychological↗
PubMed1986

The validity of MMPI subtle and obvious items in psychiatric patients.

This study was designed to assess the validity of four clinical scales with and without subtle items; and the relative validity of obvious and subtle items. Criteria were questionnaire, mental status, diagnostic, and drug treatment measures; subjects were 73 psychiatric inpatients. Across criteria, the results indicated that the validity of the full scales was not improved by the removal of subtle items; and with the exception of the PD scale, subtle items generally were found to be of similar convergent validity and possibly superior discriminant validity. These findings have implications for psychometric theory and test construction strategies.

Adolescent↗
PubMed1988

The WAIS-SAM: a comprehensive administrative model of modified WAIS procedures.

The WAIS-SAM (Ste. Anne's Method) is a procedure designed to reduce standard WAIS administration time and is applicable in virtually all cases. In order to evaluate the usefulness of the WAIS-SAM, the WAIS records of 80 male hospitalized war veterans (aged 55 to 82) were rescored in accordance with the WAIS-SAM procedure. Results were evaluated by Resnick and Entin's (1971) three validation criteria. Correlation between the WAIS-SAM and standard WAIS FSIQ was significantly high (.997) and satisfied the first criterion. A high degree of agreement between WAIS-SAM and WAIS (95%) in the classification of subjects into IQ categories satisfied the third criterion. The second criterion, however, was not met due to meager, though significant, mean differences. Despite this, it was concluded that the overall clinical value of the WAIS-SAM was demonstrated.

Aged↗
PubMed1987

The impact of diagnostic misclassification on the pattern of familial aggregation and coaggregation of psychiatric illness.

Family studies in psychiatry have traditionally been interpreted as if psychiatric diagnoses were made without error. This is unlikely to be true. The first section of this paper presents a model, based on several simplifying assumptions, which examines the impact of diagnostic misclassification on patterns of familial aggregation and coaggregation of two disorders. In the second section, the model is illustrated by examining the effect of varying misclassification rates on the patterns of aggregation and coaggregation in four simulated family studies of psychotic illness. Misclassification is considered which is equal or unequal for the two disorders, which is the same in probands and relatives or greater in relatives and which occurs between disorders of similar or quite different population risk. Misclassification in the range which commonly occurs in psychiatry can produce substantial effects on the observed pattern of familial aggregation and coaggregation. Furthermore, the proportion of diagnosed cases which are misclassified varies widely depending upon whether an affected individual is from the general population or is a relative of an individual affected with the same or a different psychiatric disorder. The third section of the paper illustrates a method for examining the fit of the proposed model to observed data and "correcting" for the effects of misclassification in family studies. For example, the familial coaggregation between bipolar illness and schizophrenia in a recent large family study can be entirely explained by the observed rates of diagnostic misclassification between the two disorders. The results of the proposed model strongly suggest that diagnostic misclassification should be considered in the interpretation of family studies of psychiatric illness.

Adjustment Disorders↗
PubMed1988

The severely mentally ill in general hospital psychiatric units.

Analysis of data from the NIMH Survey of Discharges from Non-Federal General Hospitals found that severely mentally ill patients (those with schizophrenia, other psychoses, paranoia, and major affective disorders) became an increasingly larger proportion of general hospital discharges between 1970 and 1980, with more change observed between 1975 and 1980. This seems to confirm that general hospital care is replacing at least some of the care previously provided in State mental hospitals. There has been an increase in beds in nongovernment-owned general hospitals and a decrease in beds in state hospitals. In addition, while discharge referrals from government general hospitals for severe patients were made predominantly to state hospitals in 1970, in 1980 this was rarely the case.

Adult↗
PubMed1987

Living with psychiatric patients: implications for the mental health of family members.

Current treatment policy has resulted in large numbers of ex-hospitalized psychiatric patients residing with family members in the community. However, little is known about the emotional consequences for family members. This paper focusses on the relationship between level of chronic strain, as indexed by 'objective' and 'subjective' family burden, and extent of psychological distress among family members of ex-hospitalized psychiatric patients. This relationship is assessed within a multivariate model that also considers eventful experience as an additional source of stress and social support and mastery as potential stress mediators. We found the variable of mastery, or sense of personal control, to be by far the most powerful predictor of distress among family members. When mastery was considered in regression analyses the modest correlations between 'objective' and 'subjective' family burden and distress scores disappeared. However, assessment of interactions indicated that strain is independently associated with distress among those subjects who scored relatively low on the mastery scale. Our most general conclusion is that the presence of some patients tends to be associated with substantial psychological costs for some families.

Adaptation, Psychological↗
PubMedDate not supplied

The cycloid type and its differentiation from core schizophrenia: a phenomenological approach.

The heterogeneity within schizophrenia or the group of schizophrenias remains a vexing and limiting problem. An alternative to the "classic" explanatory construct of a schizophrenic unitary psychosis is the current concept of a positive/negative dichotomy with or without mixed type. However, the validation by findings from brain imaging, specificity, and prognostic validity of these multiple-entity approaches are still uncertain. Psychopathology is challenged to identify discrete types as homogenous as possible, providing closer relationship to distinct disease processes. Such types are to be defined by one or more axial syndromes, syndromes in an essential, not correlative, sense. One of these types is embraced by the term cycloid psychosis, implying a good prognosis. Using an integrative phenomenological methodology, the present study is able to show the specific quality of phenomena occurring in this type to pinpoint their "inner" relationships and to demonstrate cycloid syndromes as axial syndromes in the phenomenological sense. Thus, it is shown that positive symptoms in the cycloid type are different from those in core schizophrenia. In addition to the quality and inner coherence of the constituent elements, the absence of structural deformations of (1) emotional expression and affect, (2) thought, and (3) movement impulses and sequences is the decisive specificity feature that allows differentiation of the cycloid type from poor-prognosis core schizophrenia. These syndromes of structural deformations are the axial syndromes of core schizophrenia, occurring with or without "productive" (positive) phenomena. Its conceptualization makes a contribution to the actual negative-symptom discussion shifting the perspective from a low specific level (e.g., abulia) to phenomena of higher specificity. On the basis of a precise definition of cycloid axial syndromes, previous operationalization suggestions are reviewed and evaluated, and an alternative approach is outlined. Finally, it is hypothesized that the cycloid type may be a primary neurotransmitter disease, while core schizophrenia seems closer to the pathophysiological mechanisms described in Stevens' theory.

Affective Symptoms↗
PubMed2006

[A case of neuropathy mimicking Guillain-Barré syndrome after arsenic intoxication].

INTRODUCTION: Chronic arsenic toxicity is a global health problem affecting millions of people. Acute arsenic poisoning is less frequent and it is most often lethal. Therefore, its consequences are not well known, more precisely its neurological consequences. OBSERVATION: We report a case of Guillain-Barré-like syndrome and encephalopathy after acute arsenical poisoning in a 50 year-old man. After 4 month follow-up, the improvement was slow and limited with persistent motor and proprioceptive deficits. DISCUSSION: The most frequent neurological complication induced by acute arsenical poisoning is a distal, symmetrical, sensory, axonal polyneuropathy. Yet the clinical course and the electrophysiological findings may also suggest a Guillain-Barré like syndrome. Moreover, the chelating is not very effective on the neurological complications. CONCLUSION: Any discrepancies in the clinical course of a Guillain-Barré syndrome shall lead to reconsider the diagnosis. The association of gastro-intestinal disorders, skin lesions, and encephalopathy and mood disorders leads to discuss intoxication with heavy metal and more precisely with arsenic. Moreover, the chelating is not very effective on the neurological complications.

Acute Kidney Injury↗
PubMedDate not supplied

Arylsulfatase A levels in patients with chronic alcoholism.

BACKGROUND: The goal of this study was to find the association between low arylsulfatase A (ASA) activity and psychiatric disorders in chronic alcoholic patients. METHODS: The study was carried out in 30 chronic alcoholic patients (27 male, 3 female); age range was 25-65 years. There were 20 normal controls (18 males, 2 females), and age range was 24-67 years. ASA and routine aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activity laboratory tests were measured in blood serum from all patients and control subjects. RESULTS: Alcoholic patients with psychiatric disorders have ASA average values of 68.25 nmol/mL/4 h. This is less than averages found in the alcoholics without psychiatric disorders group (82.48 nmol/mL/4 h) and the control group (90.8 nmol/mL/4 h). There were no statistically significant differences among the three groups studied. Alcoholic subjects with elevated activity of AST and ALT (n = 10) have ASA activity average values of 134.82 nmol/mL/4 h), which is 48.8% higher than the control group (90.6 nmol/mL/4 h). These means show statistically significant differences (p <0.05). CONCLUSIONS: Results indicate an association between low serum ASA activity and alcoholism. The appearance of psychiatric manifestations could be related to the low activity of this enzyme in chronic alcoholic patients. Alcoholic patients with elevated enzyme activity of AST and ALT in sera also have elevated sera arylsulfatase A (ASA) activity. We consider that these findings may be useful for evaluating the psychiatric state as a prognosis in chronic alcoholic patients, and should be a routine laboratory test in alcoholic patients.

Adult↗
PubMed1992

Psychiatric phenomena in dementia of the Alzheimer type.

Psychiatric symptoms and behavioral disturbances are of importance in dementia of the Alzheimer type (DAT) but have been relatively neglected by researchers. The main psychiatric symptoms are disorders of thought content (delusions and paranoid ideation), disorders of perception (hallucinations and misidentifications) and disorders of affect (depressed and elevated mood). They occur commonly in DAT, and there is evidence that they may indicate subtypes of the disorder in view of their demographic, structural, and prognostic correlates. Personality changes are very common, and these may be the earliest manifestation of dementia. Behavioral disturbances tend to be associated with advanced dementia and are particularly disruptive to caregivers. Structural correlates suggest that some behaviors are a direct result of brain damage. Psychiatric and behavioral features in DAT are important, as they may serve as a model for symptomatology in functional psychiatric disorders.

Aged↗
PubMed1989

Older adults' perceptions of psychopathology.

In this study, 40 older female and 40 older male community volunteers (age range = 60-78 years) read fictional case descriptions of a healthy person and of individuals with one of five types of psychopathology (paranoia, depression, dementia, hypochondriasis, and alcohol abuse). In each group, 1/2 of the volunteers read descriptions of an older woman and 1/2 read analogous descriptions of an older man. Participants rated the psychological disturbance of the stimulus individuals. The hypothesis that older women would rate symptoms of psychopathology of elderly people as more severe than would older men was not supported. Normal stimulus individuals were typically perceived to be extremely healthy, thus, strongly accounting for a main effect of pathology type. The five psychopathology conditions also were viewed differentially in terms of severity. These results suggest that older women are no more perceptive of psychopathology than are older men.

Age Factors↗