摘要:

During the years 1983–1984, an educational program was given to all general practitioners on the island of Gotland. This report evaluates changes in prescription habits from 1982 to 1985. To correct for general trends that occurred simultaneously, the prescription habits were compared to the habits in the rest of Sweden. Both on Gotland and in Sweden as a whole, the use of antidepressants increased from 1982–1985, but significantly more on Gotland. In 1982, the use of antidepressants was low on Gotland, 54% of that in the rest of Sweden. After the educational programs, Gotland reached 77% of the use in the rest of Sweden. In 1982, the use of lithium was 123% of that in the rest of Sweden. After the educational programs, the use of lithium was unchanged, and a small increase of 5.6% was seen in the rest of Sweden. After the educational programs, the prescription of sedatives on Gotland decreased (– 8.2%), and an increase of 4.5% was seen in the rest of Sweden. The use of major tranquilizers also decreased significantly (– 23%) on Gotland. Even in the rest of Sweden, a significant but much smaller decrease was seen: – 13%. On Gotland the frequency of hypnotics remained stable from 1982–1985, and a significant increase was seen in the res

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1990.tb03068.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The authors applied a statistical method to subclassify tardive dyskinesia (TD) in 71 psychiatric patients. Based on two‐step statistical procedures and findings reported previously, TD is considered to consist of 2 subgroups: a classical dyskinesic group and a dystonic group. Symptoms manifested in the former group are seen most frequently in the oral region while the latter group, which is usually called tardive dystonia, is manifested by movement disorders in the trunk and extremities, predominantly. Abnormal movements occurring in the facial region characterize a population whose members may belong to either grou

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1990.tb03069.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A predetermined set of 22 sociodemographic, psychosocial, clinical, neurocognitive and biochemical potential predictor variables was tested in 98 schizophrenic patients admitted for relapse. The patients were treated with neuroleptics, mostly with haloperidol, for 28 d. Ten of the 22 variables correlated significantly with the neuroleptic response. Using stepwise multiple regression analyses, an optimal combination of 5 predictors was found to be in hierarchical order: disturbances of premorbid adjustment, intensity of positive symptoms at admission, family history of schizophrenia, working ability during the year before admission and serum dopamine‐β‐hydroxylase. The 5 best predictors explained 29% of outcome variance, and all 22 variables together explained 35%. Such neurological characteristics as neurological soft signs, handedness, abnormal voluntary movements, spontaneous blink rate and cognitive impairment did not predict the treatment response. Several psychopathological, psychosocial and clinical predictors known from the literature could also be confirmed by cross‐vali

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1990.tb03070.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

This article describes an attempt to use a theoretical model of human interaction called the elementary pragmatic model to determine which communication style leads from a normal subject's interactive pattern to a schizophrenic's and, conversely, from schizophrenia to normality. Results of this experimentation reveal a clear correspondence with the data published in the literature on communication deviances and family therapy. The computer simulation indicates preferential ways of therapeutic intervention.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1990.tb03071.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

We studied whether regular treatment with tranquilizing and hypnotic drugs among 30,344 twins in Sweden 15–47 years old was associated with robust indicators of poor health. Longitudinal psychiatric diagnoses and subsequent suicides were analyzed with data from cross‐sectional health questionnaires. Women were almost twice as likely to report medication, even those with psychiatric inpatient diagnoses. Within each of mental, somatic, and lifestyle domains, medication was more frequent among those with multiple problems. The partial odds for medication for those with a diagnosis of psychosis were 11.81, affective disorder 10.94, neurotic or personality disorder 11.09, alcoholism 5.00, and drug addiction 13.92. We conclude that reported regular treatment with tranquilizing and hypnotic drugs in young Swedish adults was significantly associated with diagnosed and subjective somatic and mental health problems, and thus largely in agreement with current peer guidelines. The reasons why women were more often treated than men requires further st

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1990.tb03072.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Thirty depressed in‐ and outpatients received serial dexamethasone suppression tests (DSTs). Plasma dexamethasone and cortisol concentrations were drawn at 1600 on the day following a 1‐mg oral dose of dexamethasone. The first DST was performed after patients were drug‐free for a period of 1 week; the second, third, and fourth DSTs while patients received antidepressant medication. Dexamethasone and cortisol concentrations drawn in the drug‐free period correlated significantly. The cortisol to dexamethasone ratio changed significantly with time in DST nonsuppressors, suggesting that nonsuppression is associated with an altered pharmacodynamic response of the hypothalamopituitary‐adrenal axis to dexamethasone during depression. When dexamethasone concentrations from the drug‐free period were compared with those drawn during antidepressant treatment, no significant differences

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1990.tb03073.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Eleven patients with major affective disorder (DSM‐III) were investigated after a mean of 6.7 years on lithium prophylaxis and reinvestigated 7 years later, at which time they had discontinued lithium for a mean 2.3 years. Outcome was assessed by the Comprehensive Psychopathological Rating Scale, by relapse frequencies, by need for psychotropic medication and for inpatient treatment. The study period was associated with an increase in the rated score for depression, as previously observed also in lithium continuers. Although the relapse frequencies remained largely unchanged, a significantly increased number of inpatient treatment days indicated considerably more severe episodes after the discontinuation of lithium. Long periods without lithium were associated with higher doses of neuroleptic drug

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1990.tb03074.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The nosological status of major depression with mood‐congruent psychotic features was explored by a cross‐sectional demographic, clinical and biological assessment and a 7‐year prospective follow‐up of 2 samples of patients fulfilling, respectively, DSM‐III criteria for this condition and for major depression without psychotic features. The 2 patient groups did not differ with respect to demographic and historical features, response to DST and outcome. The global severity of the index episode was greater in psychotics. All nonpsychotics and 69% of psychotics were treated with antidepressants alone or in combination with benzodiazepines, whereas the addition of neuroleptics was required only in 31% of psychotics. A tendency towards an interepisodic diagnostic stability was verified in nonpsychotics more than in psychotics, but was less pronounced than that reported by the authors advocating the nosological autonomy of delusional depression. These data support the view that major depression with mood‐congruent psychotic features is not a distinct diagnostic entity, but rather a more severe depress

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1990.tb03075.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

In an age‐matched sample of male and female inpatient alcoholics(n= 518) of the same ethnic background, subjects under 35 years of age described significantly more problem areas than older age groups. Elderly subjects over 55 were the least articulate group. The first‐ever addiction treatment subjects reported the lowest mean number of years of problem drinking, the lowest mean Michigan Alcoholic Screening Test scores and the lowest mean daily alcohol intakes. They also displayed greater current social stability than the 2 readmission treatment categories. The general determinants of admission to this addiction unit centred around the experience of crises, social instability and psychological complaints. The most important specific determinants for the individual subject were the propensity to fight when drunk, followed by a positive parental history of excess alcohol intake. Criminal and occupational factors were infrequently encountered in female subjects, but widowhood was common in the older o

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1990.tb03076.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Plasma zinc levels were measured in 14 patients with primary affective disorder on admission to hospital; they were compared with plasma zinc levels in group of 14 age‐ and sex‐matched controls. A significant difference in zinc levels was found between the 2 groups. Plasma zinc levels of 9 of the depressed patients on admission to hospital and at the point of discharge were compared; a significant increase in zinc levels was detec

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1990.tb03077.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY