[Work disability as chronifying factor of neurotic disorders].
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Forty-one patients seen in general practice with neurotic symptoms who failed to respond to conventional psychotropic medication were placed on a regimen of phenytoin. The modal dosage was 50 mg 3-times daily and treatment ranged between 6 to 19 weeks. The results, assessed on a 30-item symptom checklist, indicated that 35 (85%) of the 41 patients improved, 32 (78%) to a statistically significant degree. Few side-effects were reported and occurred in only 6 patients on a higher dosage of 200 mg per day. It is suggested the phenytoin is a drug with therapeutic potential in long-standing neurotic conditions.
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The quality and quantity of interpersonal relations were investigated by a special questionnaire to discover the connexion of psychonervous disorders with the contact behaviour. The psychonervous disorder was measured by a screening method, which examines the neurotic status. 361 patients of an urban population were asked by the questionnaire. 309 questionnaires of the probably neurotic patients and non neurotic patients were analyzed with respect to the differences between the two groups patients. Probably neurotic patients felt more stressed. They are more directed to the family members. The contact behaviour of the probably neurotic patients is more restrained in profession and also in free time than the behaviour of the non neurotic patients. The fewer agreement between reality and desire of the contact behaviour is typical for the probably neurotic patients. The intention of the conclusions was to help them to develop a feeling of interpersonal contentment.
The results of a clinical examination of 73 neurotic patients engaged in intense intellectual activities are presented. The questions of the etiology, pathogenesis and clinical course of neurotic disturbances are discussed. Attention is drawn to the obligate nature of the vegetative dysfunction manifestations.
Self-acceptance as a correlation between real and ideal self-concept distinguishes neurotic patients from paranoid schizophrenic patients. This fact may support the hypothesis that these groups of patients are characteristic of different personality traits.
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338 members of engine crews were observed. 159 were found to have neurotic and anxious-phobic reactions before any clinical nosology. It was established that misunderstanding between engine driver and his helpmate, autonomic dysfunction, individual features of character and family conflicts play the main part in the development of neurotic reactions.
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