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PubMed1984

[Psychogenic vision disorders: a case report with psychosomatic findings].

The diagnosis of psychogenic visual disturbances, a phenomenon not so very rarely to be observed, is often made by an ophthalmologist, whereas the patients concerned will seldom consult a psychotherapist. We describe somatic, psychiatric and psychological data in 8 observed cases. Results of psychodynamic interviews point to underlying, especially oedipal conflicts. Slight confidence in one's own possibilities on the one hand and incomplete defence of urge on the other may here, too, lead to functional symptoms in special conflict situations. Need for and possibilities of careful diagnostic are discussed, as well as special courses of psychogenic visual disturbances and therapeutic changes.

Adolescent↗
PubMed1993

[Screening for psychogenic factors in functional dysphonia].

Psychosocial influences are now increasingly accepted to be important factors in the etiology of many diseases. The application of these findings is often not possible in clinical routine, especially because there is a lack of practical instruments for the diagnoses of psychogenic disorders. Based on previous investigations determining relevant psychogenic factors causing functional dysphonia, the goal of this study was to develop an easy-to-manage screening sheet for the estimation of psychogenic factors in the etiology of functional dysphonia. With this approach, physicians not trained in psychology are able to prove a suspect psychogenic disorder. Patients are forced to reflect on their disease by completing the sheet and thus may limit resistance to recognizing the true nature of their disturbance. Patients with pathological results can be sent effectively for further investigations and specialized therapy.

Adult↗
PubMed1990

[Short-latency brain stem evoked potentials to acoustic stimulation in psychogenic disturbances].

Short-latent stem evoked brain potentials in response to acoustic stimulation (SSEP to AS) as a research method was used to examine 27 patients with psychogenic disorders. The data obtained have shown that the SSEP curve underwent changes in the form of inhibition, fractionation, and lengthening of the components. Significant correlations were obtained between changes in SSEP in response to AS and the presence of not deep residual-organic disturbances, so-called "ground" in psychogenic disorders. The data obtained make it possible to suggest the use of SSEP in response to AS as an additional electrophysiological method for identification of the latent residual-organic "ground" for psychogenic disorders, which will favour the most adequate treatment of this patient's group.

Acoustic Stimulation↗
PubMedDate not supplied

[Psychogenic paroxysmal disorders in children].

INTRODUCTION: Paroxystic psychic disorders which imitate organic disorders of the nervous system may have peripheral effects, present as changes in level of consciousness or appear as paroxystic behaviour changes. DEVELOPMENT AND CONCLUSIONS: The types of crises of psychological origin are: tantrums, panic attacks, crises of psychopathic rage, onanism or masturbation, epileptic pseudocrises or pseudoconvulsions and Munchausen's syndrome. In general psychic crises are not frequent in infancy: tantrums are commoner in small children and the other conditions usually occur after puberty or during adolescence. The anamnesis is the most important factor in the correct diagnosis of psychogenic paroxystic disorders. Complementary studies are done in doubtful cases, to rule out different pathological processes which might be causing the paroxystic disorder. Amongst these investigations, we emphasize the importance of the video-EEG for differential diagnosis of paroxystic disorders in children.

Child↗
PubMed1994

[Inadequate utilization of somato-medical services by psychogenically ill patients].

Within the Mannheim Cohort Project on the epidemiology of psychogenic disorders 240 probands of a high risk sample (suffering from medium psychogenic impairment) were randomly selected from the general population and investigated with regard to their realized utilization of the medical and/or psychotherapeutic services of the health care system. On the basis of clinical criteria the probands were classified as case (n = 78) of psychogenic disorder or non-case (n = 162). Increased psychogenic impairment caused by psychoneurotic, character neurotic, or psychosomatic-functional disorders was primarily combined with an intensified utilization of the somatically oriented medical services. Only 2.5% of the cases indicated that the reason for their most recent visit to a physician was psychotherapeutic treatment. In view of the high percentage of psychogenic impaired patients in private practices and general hospitals this seems to be a particularly discrepant finding. In spite of the psychogenic nature of their complaints the cases were confronted with somatically oriented therapy offers like the non-cases. An increased psychogenic impairment did not lead to a qualitative alteration of the utilization of medical and/or psychotherapeutic services. Facing the fact that the utilization of somatically oriented medical services by psychogenic ill patients is still widespread but inadequate this finding is interpreted as indication for an essential demand of further studies on the determinants of psychotherapy acceptance.

Cohort Studies↗
PubMed1992

[Intensive psychiatric care of patients with psychogenic eating disorders].

The authors summarize their therapeutic results in anorexia nervosa achieved at the unit of specialized care for eating disorders at the Psychiatric Clinic of the First Medical Faculty, Charles University, Prague. They find that applications for hospitalization of these patients have a rising trend and that in recent years in the unit mainly patients with severe forms of these diseases are admitted. During the past 7 years in the unit a total of 147 patients were hospitalized. By comprehensive regime treatment 84% of the patients with bulimia nervosa. As to basic symptoms, in bulimia nervosa the results were achieved in vomiting and bulimic attacks and in anorexia nervosa as regards appetite, hunger and general attitude to food. Finally the authors summarize the advantages of the unit specialized care for psychogenic eating disorders.

Adolescent↗
PubMed1980

[Age and mental disorders with onset in the presenium and old age].

A study of 294 patients with psychogenic disorders appearing in the elderly, detected certain traits in the psychopathology and development of these disorders, depending upon their manifestation in the presenium or in senescence. Psychogenic diseases with an onset in senescence differed from those appearing in the involutional period by a more sluggish onset, monotonous, fragmentary, obliviated symptoms and a more favourable development. The differences in the symptomatology and development of psychogenic disorders corresponded to peculiar changes in the age basis of the mentioned periods of life.

Age Factors↗
PubMed1993

[Psychometric assessment of defense mechanisms: correlation between questionnaire and expert rating. Initial study of validity].

Within the limits of an epidemiological longitudinal field survey on prevalence and course of psychogenic disorders a high-risk-population suffering from medical psychogenic impairment was investigated. The study was conducted in order to verify an etiological multi-level-model of psychogenic disorders in relation to the socialempiric variables "critical life events" and "social support" as well as the depth psychological oriented construct "personality". Besides other instruments a self rating scale based on Vallant's hierarchical model of defense, i.e. the german adaptation of the DSQ (Defense Style Questionnaire) of Bond and coworkers, was used for the accurate measurement of relevant personality parameters. Although defense processes predominantly work unconscious, manifestations of defense mechanisms could be measured indirectly by means of the rating scale. Its essential dimensions separated clinical patients from a group of healthy controls. Furthermore an immature organisation of defense was found to be related to psychogenic impairment. Concerning self- and expert-rating a significant correlation between "immature defense" and the defense mechanisms "schizoid phantasy", "projection" and "acting out" was proved.

Adult↗
PubMed2005

Psychogenic tremor disorders identified using tree-based statistical algorithms and quantitative tremor analysis.

Detecting psychogenic tremors (PsychT) is often challenging. As there are no laboratory investigations or imaging techniques that can confirm the diagnosis, PsychT is identified on a clinical basis. We present a tree-based statistical algorithm derived from quantitative computerized tremor recordings as a novel method to help in the recognition of PsychT. The goal of this study was to show that objective data from computerized tremor recordings, when processed through a tree-based statistical algorithm, can be used to determine whether a patient can be classified as having PsychT.

Adult↗
PubMed1986

[Cognitive therapy of psychogenic sleep disorders: an explanatory and treatment approach].

First the paper presents an explanation for psychogenous sleep disturbances, basing on coincidence of psychophysiological and biorhythmical sleep patterns with special cognitive and emotional variables. Related thereto a concept for prevention and psychotherapy of these sleep disturbances is elaborated. Both concepts content five structuring elements, standing in a circular feed back relationship: 1. subjective misconceptions about the nature of sleep, 2. dysfunctional norms and goals for the own sleep, 3. cognitive misevaluations of the experienced sleep events, 4. development of a dysfunctional self concept, 5. development of dysfunctional patterns and goals of behavior for coping sleep problems. The elements display the structure for development and diagnosis of these sleep disturbances and for the preventive and psychotherapeutic work. Finally, related to this concept, therapeutic strategies were presented, basing on cognitive and behavior therapy.

Behavior Therapy↗
PubMed1998

Predicting extreme patterns of long-term course of psychogenic impairment: a ten-year follow-up.

This longitudinal study identifies predictors of course and etiologically relevant factors of psychogenic disorders. Since 1979, the Mannheim Cohort Project on the Epidemiology of Psychogenic Disorders has investigated neurotic spectrum disorders, personality disorders, stress reactions, and somatoform disorders in the normal population. Using these data, a cohort of probands suffering from moderate psychogenic impairment (N = 240; 121 men, 119 women) based on a representative sample of the urban adult population (N = 600; with cohorts 1935, 1945, 1955; gender distribution 1:1) of Mannheim, an industrial and university town in Germany, was followed up for almost 10 years. The cohort was investigated three times by psychodynamically trained physicians and psychologists. Tests were performed by means of cluster analysis. Different types of course of psychogenic impairment were identified. Both extreme types--the probands with the most positive and the most negative spontaneous long-term course--were investigated with regard to potential course-determining variables. Personality variables and conditions of early childhood development considerably influenced the spontaneous long-term course.

Adult↗
PubMed1998

[Missed somatic diagnoses--inexcusable, missed psychogenic somatic disorders--a gentleman's offense].

Overlooking somatic diagnoses is judged a serious failing, overlooking psychogenic somatization a minor mistake. This situation derives from the medical theory on which the physician bases his opinions, decisions and treatments. In this case, the mechanistic model deriving from the introduction of physics and chemistry into medicine in the 18th century. A 19 minute verbatim first interview illustrates how the biopsychosocial interview method serves to pinpoint psychogenic somatization in a woman who had been unsuccessfully examined and treated for four years, bringing the underlying blocked process of grief to light and making it the focus of therapy. Savings in time, cost and suffering are obvious.

Aged↗
PubMed1987

[Diagnostic results of pediatric-child psychiatric cooperation exemplified by the Pediatric Clinic of the Winterthur Canton Hospital 1971-1980].

This article reports on the diagnostic results of 232 patients who were examined in close collaboration by the paediatrician and the child psychiatrist at a Swiss children's hospital between 1971 and 1980. The main diagnosis was psychogenic disorders with mainly psychic symptoms in 53.9% of the cases, psychogenic disorders with mainly somatic symptoms in 37.1%, minimal brain damage in 11.2%, and disturbances of development in 8.6%. Psychosomatic symptoms as accessory findings were found in another 30%. Thus, functional somatic disorders were components of the polysymptomatic syndromes in more than 60% of the patients.

Child↗
PubMed1994

[Epidemiologic findings on the spontaneous long-term course of psychogenic disease over 10 years].

207 individuals were selected from a random sample of the adult urban population of Mannheim according to the criterion of medium psychogenic impairment (high-risk population) and investigated three times between 1979 and 1991 with regard to prevalence and severity of psychogenic disorders. In contrast to clinical investigations, the present data render statements on the spontaneous course of psychogenic disorders in the general population. The existing psychogenic impairment was determined by means of various operationalizations (symptomatology, ICD-diagnoses, severity of impairment). The available data indicate a high stability of psychogenic impairment in the spontaneous course. Group statistically the severity of impairment even increases in the long term course. However, different subtypes of course in the investigated high-risk population can be identified by a cluster analysis.

Adult↗
PubMed1977

[Psychopathology and the dynamics of psychogenic hysterical disorders arising in the presenile period and in old age].

As a result of the study of the nervous-mental state of 45 patients the author revealed considerable peculiarities of the clinical picture and the course of psychogenic hysterical disturbances depending on manifestations in the elderly or old age. It is shown that reactive hysterical states with the onset in the old age are distinguished by more elementariness, stereotypness, monotony of manifestations, absence of inclination for progression and transformation into a pathological development of a personality (what is frequently observed in the debut of hysterical disorders in the old age). The clinico-dynamic differences of psychogenic hysteria with the onset in presenium and old age are explained by different influence of common aged factors, climacteric and cerebro-vascular factors.

Age Factors↗