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[The communicating body--eating disorders and culture].

What is "culture" in eating disorders as culture-bound syndromes? The human body is a flesh-and-blood entity, but it also functions as a symbolic instrument. The body communicates about culture itself, about norms and boundaries. In this paper one central aspect in the phenomenology of eating disorders is emphasised: The subjective experience of lack of control and the sense of an overwhelming "chaos", both on the inner and outer level. On this basis rapid societal transitions are discussed as specific pathogenic factors. Sociocultural instability represents insecure conditions for construction of a healthy and stable identity. "The open body" is a relevant metaphor, with its dialectical relationship to the isolation and delimitation represented by eating disordered behaviour. With reference to history and geography the paper also discusses the pathoplasticity of eating disorders; how they change in time and space. Cultural analysis of eating disorders can contribute to a richer understanding of the complexity of the construction of meaning in these disorders, both across cultures and within our own cultural contexts.

Beauty Culture↗

Behavioral disturbances as an expression of severity of cerebral damage.

The present study was designed to validate our ongoing clinical observations, which reveal that distinct clusters of psychiatric symptoms tend to develop following mild or severe brain injury, independently of injury location. These clusters are termed "Extroversion" and "Introversion" syndromes respectively. The symptoms constituting each syndrome manifest themselves along four domains: behavior, personality, affect and cognition. The study sample included 85 brain-injured patients recalled for a follow-up examination 2-3 years after discharge from hospital. Classification into Extroversion and Introversion was done on the basis of a structured psychiatric interview. Severity of brain damage was independently assessed by combinations of five parameters: unconsciousness and PTA duration, cognitive deficiencies, communication and locomotor disorders. The results supported our clinical observations, suggesting that severity of brain damage could also be assessed by the nature of psychiatric symptomatology exhibited following the injury.

Adolescent↗

[Communication deviance and thought disorder in schizophrenia: a case study].

INTRODUCTION: Communication deviance (CD) means forms of communication that are hard to follow and that make difficult the consensual sharing of attention and meaning, and it has been hypothesized as a contributor to psychopathology of offspring, including schizophrenia. There is increasing evidence that CD may also trigger relapse of symptomatic illness in remission. We present a case with detailed sequence analysis, where we demonstrate disordered functioning in a family of a 27-year-old male patient with schizophrenia. METHOD: The patient and his parents participated in the Consensus Rorschach (CR) situation, a common problem solving task. Behaviour during the interaction was coded and analysed on different levels, including relational and symbolic level; and also, focusing on specific patterns of thought disorder. Results are in accordance with former findings that CD level is high in families of patients with schizophrenia. This type of communication was found to initiate transactional processes which resemble "games" aimed at gaining control over other family members. The content level of communication was frequently immature, and communication reflected pseudo-dependence as an only form of conflict resolution. CONCLUSIONS: Findings from the present study may be important from the perspective of secondary and tertiary prevention, and they reflect need for intervention focusing on the whole family.

Adult↗

Doctor-patient communication in rheumatological disorders.

Organized educational programmes and individual educational counselling are primary means by which health care providers equip rheumatic disease patients with the skills and knowledge necessary to monitor and manage variable symptoms. Many outpatients educational programmes were evaluated in the 1980s. In brief, well designed programmes are generally effective in improving knowledge and compliance with a regimen, and in reducing pain, depression, and disability. However, most persons with arthritis never use such programmes. Greater emphasis is needed on education of patients at the time of the clinical encounter, where the greatest opportunity lies for reaching the greatest number. Researchers have examined the dynamics of the doctor-patient interaction during the clinical encounter. Results show that: better information sharing leads to improved patient satisfaction, compliance, and health outcomes; information sharing could be greatly improved; and doctors and patients can be trained to improve information sharing, resulting in improved outcomes. A review of attribution and decision-making theory and the empirical literature on doctor-patient communication suggests a number of techniques that could be usefully incorporated into the management of each patient. These include: (1) encouraging patients to write down their concerns before each visit; (2) addressing each concern specifically, however briefly; (3) asking patients what they think has caused their problems; (4) tailoring treatments to patients' goals and preferences as possible; (5) explaining the purpose, dosage, common side-effects and inconveniences, and how to judge the efficacy of each treatment, including length of trial; (6) checking patients' understanding; (7) anticipating problems in compliance with treatment plans, and discussing methods to cope with common problems; (8) writing down the diagnosis and treatment plan to help patients remember; (9) giving out written materials that are now widely available; (10) reinforcing patients' confidence in their ability to manage their regimen; (11) using ancillary personnel in patient education; and (12) referring patients to organized programmes in the community.

Communication↗

Hallucinations in psychiatrically disordered children: preliminary communication.

In a retrospective study children with hallucinations and nonorganic psychiatric conditions were compared with matched controls. Hallucinations were found to be a rare symptom except in children with a diagnosis of psychosis of late onset where they were commonly present. Children with hallucinations were older than the majority of subjects seen in the Child Psychiatric Clinic. The perceptual symptoms were associated with precipitants of illness and mood changes. In the nonpsychotic subjects, they were also associated with symptoms suggestive of minor brain dysfunction. The results are discussed and ideas for future research suggested.

Adolescent↗

Methods for digital video recording, storage, and communication of movement disorders.

Video technology has now reached a level of sophistication that allows easy digitization. Digital video can be easily edited, reproduced, incorporated into databases, and posted on intra- and Internet sites for clinical use and demonstration purposes. Numerous methods exist for the production of digital video. This article synthesizes and simplifies the available methodologies in order to easily choose the technology that is the most appropriate for the movement disorder specialist's end use. Depending on available resources, issues such as cost, ease, and time to conversion are discussed. In addition, our experience with the use of one of the methodologies is briefly presented.

Humans↗