ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09756.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

As part of the US National Institute of Mental Health Collaborative Program on the Psychobiology of Depression study, a subset of 460 randomly chosen relatives of affectively ill probands were compared to a control group matched by the acquaintanceship method. The rate of major affective disorder in relatives was found to be 36%; the rate among controls was 28%. Relatives were also found to have significantly higher rates of bipolar II disorder, any Research Diagnostic Criteria (RDC) affective disorder and any RDC mental disorder. All of these rates were found to be significantly higher when female relatives were compared with their acquaintances, but only the rate of any RDC mental disorder was higher when this comparison was made in men. The acquaintanceship method enabled the selection of a control group that closely resembled the relatives, probably to the extent of “overmatching”. When the match was evaluated to determine whether relatives tended to select comparably ill (or well) acquaintances, this was found to be the case only for alcoholic and never mentally ill relati

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09757.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The frequency of galactorrhea and the subjective response to it were investigated in 150 schizophrenic patients. The incidence rate was 14% and the prevalence rate 19%. More than half the women experienced galactorrhea in connection with their femininity, with this side effect of neuroleptic therapy being rated more often as a positive effect, especially as a reinforcement of feminine identity or as an expression of the ability to conceive children. The overall response to galactorrhea was positive among 43% and negative among 20%, with the remaining patients tending towards indifference.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09758.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

This article describes the general findings of the initial cross‐sectional stage of a prospective follow‐up study of all first episodes of schizophrenia that occurred in the Autonomous Community of Cantabria over a 2‐year period and that established contact with any mental health service. The project comprises: i) a 2‐year cross‐sectional stage, in which the sample was gathered and studied with structured psychiatric instruments such as the Present State Examination and the Scales for the Assessment of Negative and Positive Symptoms (SANS and SAPS), and; ii) a continuous follow‐up. We detected, in the risk age ranged of 15–54 years, an incidence of 1.9 per 10,000 inhabitants per year for schizophrenia and of 1.3 per 10,000 inhabitants per year for the S + CATEGO diagnosis, without any significant gender difference of morbidity. The mean age for the total schizophrenic population was 26 years, being significantly higher in women than in men. In contrast with what happens with marital status, type of household or urban/rural way of life, there was no gender difference in relation to the other sociodemographic variables. The way in which nosological and clinical variables are associated with first episodes of schizophrenia was also examined in this study. We found that 75% of patients reached a maximum CATEGO‐ID level, 71% received a S + CATEGO diagnosis, 59% presented first‐rank symptoms of schizophrenia and that the percentage of a schizophrenic negative syndrome, as identified by the SANS and SAPS, was very low. Finally, among the clinical variables investigated, only premorbid adjustment, personal history of mental illness and length of admission presented significant g

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09759.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The patients' opinions about their treatment are seldom solicited in psychiatry. We studied the opinions of 225 patients about curative factors in their treatment in a maximum security hospital: 90% answered the questions, which evaluated 38 forms of treatment. The patients received help from free walking in the hospital area in 98% of the patients, holidays in 93%, a personal psychiatric nurse in 91%, trips in 91% communication in 88%, personnel's support in 87% and a psychiatrist in 86%. Medication was considered helpful in 77% and even restriction or isolation in 36% of the patients. If the patient experienced help from the psychiatrist, the cross‐tabulation revealed that she or he also received help from many other treatment forms, even from the isolation. Help from the personal psychiatric nurse and medication depended on many other treatment forms. The most helpful treatment factors experienced were liberties and interactive treatment form

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09760.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The aim of this study was to investigate women who had first‐episode psychosis within 1 year after parturition. The Danish Psychiatric Central Register and the Danish Medical Birth Register were linked to identify all women admitted for the first time to a psychiatric department in Århus County with a psychotic episode. Fifty cases were found, giving a frequency of first‐episode psychosis within 1 year after delivery of 1 per 1000. First‐episode psychotic disease within the first month postpartum occurred in 1 case per 2000 deliveries. The age distribution corresponded to that of the background population, but the cases were primiparous more often than expected. The socioeconomic status was equal to that of a matched control group of obstetric patients. Birth complications did not occur more frequently than expected, but the probands had a higher risk of preterm delivery than the controls. The clinical picture of the index episode was that of manic‐depressive psychosis in nearly half of the cases, but no cases of schizophrenia were found. Sixty percent of the patients had a picture of severe depression, and 20% suffered from manic disorder. The follow‐up, 7 to 14 years later, was carried out by interviewing the general practitioners. Forty percent of the women had not preserved full working capacity due to mental disorder. Moreover, the follow‐up pointed to schizophreniform symptoms at the index episode as a predictor of incapacity to work. Recurrences were very common (60%), especially of the nonpuerperal type, and half of the recurrences belonged to the manic‐depressive disorders. Schizophrenia was diagnosed in one case at the follow‐up. Cases with exclusively puerperal episode

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09761.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Data from 7 psychiatric hospitals with defined catchment areas were analyzed; 14,195 episodes of treatment in acute psychiatry wards were recorded within 30 months. During their stay in hospital 196 patients died, 174 from natural causes and 22 by suicide, compared to the expected 32 deaths. Standardized mortality ratios (SMRs) were calculated for the different diagnostic and age groups, mortality risk being highest in organic mental disorder (SMR 7.59, followed by functional psychoses (SMR 4.55) and the “other disorders” (alcoholism, neurotic and related disorders, SMR 3.25). Roughly one half of the 196 deaths were due to cardiovascular disorders and pneumonia. In patients with nonorganic psychiatric syndromes, suicide was the most frequent cause of death (21 of 58 fatalities). With regard to the elevated mortality risk of patients with acute mental illness, a reduction of fatality rates from natural and unnatural causes should remain a major objective of hospital care in psychia

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09762.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Male‐to‐female (M‐F) transsexuals differ consistently from female‐to‐male (F‐M) transsexuals in their sociodemographic characteristics, cross‐gender and sexual history and the degree to which personality disorder is concomitant to their transsexuality. As a group, female‐to‐male transsexuals are more homogeneous. Both groups are impaired in their mental functioning, but the male‐to‐female population is more mentally disordered. In a comparison between Dutch transsexuals and their Belgian counterparts, the latter were shown to have

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09763.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

In 1880, Jules Cotard reported a clinical state he believed was a new type of agitated melancholia. A statistical analysis has been carried out of 100 cases of Cotard's syndrome to determine how this clinical concept has fared since its inception. In terms of clinical profile, no difference was found between men and women or between underlying diagnostic categories; age seemed to increase the likelihood of developingdélire des négations.Depression was reported in 89% of subjects; the most common nihilistic delusions concerned the body (86%) and existence (69%). Anxiety (65%) and guilt (632) were also common, followed by hypochondriacal delusions (58%) and delusions of immortality (55). An exploratory factor analysis extracted 3 factors: psychotic depression, Cotard type I and Cotard type II. The psychotic depression factor included patients with melancholia and few nihilistic delusions. Cotard type I patients, on the other hand, showed no loadings for depression or other disease and are likely to constitute a pure Cotard syndrome whose nosology may be closer to the delusional than the affective disorders. Type II patients showed anxiety, depression and auditory hallucinations and constitute a mixed group. This new grouping cuts across the more traditional view and may have therapeutic implications. Authors, in general, have considereddélire des négutionsas a syndrome rather than a new disease and do not seem to support the view that the completeness of the syndrome is a function of presence or severity of depression. The view thatdélire des négutionsrefers only to the delusion of being dead has also curried little favour as it is likely to waste inform

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09764.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The efficacy of moclobemide (378 mg ± 76 mg/day) and fluoxetine (36 mg ± 8 mg/day) in preventing relapse was studied during 12 weeks of continuation treatment after a 6‐week initial trial. Fifty‐nine patients with Hamilton Depression Rating Scale (HDRS) scores of 16 or less were enrolled; 29 continued to receive moclobemide and 30 fluoxetine. Efficacy was measured using a 17‐item HDRS, the Montgomery‐Åsberg Depression Rating Scale and the Clinical Global Impression. Improvement in quality of life was measured using a Medical Outcome Study Short‐form General Health Survey and the 15D Measure of Quality of Life. Twenty‐three per cent of the patients in the fluoxetine group dropped out of the study and 10% in the moclobemide group. Two patients (7%) in the moclobemide group and one (3%) in the fluoxetine group suffered a relapse. Health status and quality of life improved in both drug groups during a 12‐week continuation period. The reports of adverse events fell to one third during the continuation phase. The results indicate that benefits may be gained from extending

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09765.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY