Alternatives of pathomechanism of psychasthenia-associated depressive reaction.
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85 students and 72 medical and surgical patients, aged between 16 and 24, and 48 mature-aged clerical and executive workers, aged between 29 and 60, were administered a written version of a scale measuring transient thought disorder, the Eysenck personality questionnaire and the EMBU questionnaire on parental rearing methods. It was found that there were differences between samples on frequency of depersonalisation, and that a majority of the young adult sample had had two or more depersonalisation experiences. Those who had experienced the greater degree of transient thought disorder had had fathers who were more intolerant, unaffectionate and unstimulating, and mothers who were more intolerant, unstimulating and rejecting. Transient thought disorder was related significantly to both psychoticism and particularly to neuroticism on the EPQ in the young, but not the mature adult, sample. It is suggested that it arises as a function of remote and uninvolved parents and is related to uncertainty about identity.
The case of a woman with severe neurosis, seen in once weekly psychotherapy over a period of 3 years, illustrates many of the characteristics of pseudohallucinations: their relation to personality, to sensory deprivation and isolation, and to developmental factors. It also suggests that there may be more than one type of pseudohallucinatory experience.
Capgras syndrome is characterized by a delusion of impostors who are thought to be physically similar but psychologically distinct from the misidentified person. This syndrome is generally thought to be relatively rare. Most of our knowledge about Capgras syndrome derives from single case studies and small series of cases usually from diagnostically heterogeneous groups. In this article, a series of 31 patients suffering from both paranoid schizophrenia and Capgras syndrome is described. Issues pertaining to the phenomenology of Capgras syndrome, the possible relation between Capgras syndrome and other delusional misidentification syndromes, and a neurobiological hypothesis aimed at explaining Capgras syndrome are discussed.
Psychiatric symptoms are heterogeneous and differ in origin, structure and clinical expression. These differences are frequently ignored both clinically and in research. Thus, patients may be described as being anxious or as having delusions, with little realisation that different aspects of the structure of symptoms are being depicted. Neglect of differences in structure between symptoms has also naturally resulted in the neglect of differences in structure between superficially 'same' symptoms. A model is offered here which provides a means of classifying heterogeneity on the basis of five levels of clinical differentiation which, in turn, carries implications for underlying symptom structure. At the 1st level, symptoms can be differentiated in terms of the conventional category 'form' but which is in fact a composite of criteria. At the 2nd level, symptoms may be separated by differences in diagnosis which may alter structure; it is suggested that one way of capturing these is to assess the qualitative dimensions of the form. At the 3rd level, differentiation can occur on the basis of sensory modality, and, using hallucinations as an illustration, it has been shown that this is a weak and confused criterion. At the 4th level, symptoms can be differentiated on the basis of abstract criteria, often of historical origin, for which there is little empirical evidence. At the 5th level, the main criterion is difference in content. That not all symptoms will be susceptible to a fivefold analysis reinforces the argument that symptoms are structurally different and that these differences have psychometric and research implications.
The concepts of disorders of body image are reviewed from three aspects: sociocultural, neurological and psychiatric disorders. Particular attention is paid to the construct of body dysmorphic disorder as defined in the DSM III-R and the separation of this from somatic delusional disorder. The recognition of associated psychopathology will frequently lead to successful treatment before too much time is spent on fruitless attempts at treatment of the presenting complaint.
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Explore the source record for details and available documents.
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The authors report results of rediagnoses of 128 cases from two decades (1932-1941 and 1947-1956) by clinicians using the Research Diagnostic Criteria as guidelines and compare these results to rediagnoses by clinicians in a previous study using more general guidelines. Although hospital records indicated an increased frequency of schizophrenia over the two decades, the rediagnosticians found no change or a decrease. Severity of symptoms did not change during the two decades, but patients in the second decade showed more borderline symptoms, leading to more diagnostic disagreement. The authors conclude that changes in diagnostic criteria and pateints' conditions influence admission trends for schizophrenia.