摘要:

For over a decade there has been a consensus that the diagnosis of schizophrenia should rest upon the presence of positive symptoms. Recently it has been suggested to give negative symptoms, which have played a prominent role in research, more diagnostic importance again. This study investigated the usefulness of that suggestion. In a sample of 489 inpatients covering the whole range of psychiatric diagnoses, the frequencies and prevalences of positive and negative symptoms were determined. Analyses of variance were calculated to assess the diagnostic validity of the different classes of symptoms. The study demonstrates that positive symptoms are of much higher diagnostic value than negative symptoms. A change of diagnostic procedures giving more importance to negative symptoms is discouraged.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09592.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Prospective long‐term follow‐up studies on patients with borderline personality disorder (BPD) have been uncommon. Clinical data suggest that their treatment is highly demanding and that short‐term results are sometimes limited. In this study, changes in symptoms and social management were monitored during a hospitalization period of 91 days (mean, range 21–296 days) and during a 3‐year follow‐up period in 62 patients admitted during 1989 to an open ward specializing in the psychotherapeutic treatment ofBPD.The patients were thoroughly evaluated, using various rating scales, at the beginning and at the end of the index admission and after the follow‐up period. Forty‐two patients (70%) participated in the follow‐up evaluation. Most patients suffered from overt anxiety and depressive symptoms at the beginning of hospitalization, and these declined significantly during hospital treatment. At the end of the follow‐up period, depressive and anxiety symptoms were at the same level as on discharge, as assessed by the Beck Depression Inventory and Hamilton Depression Rating Scale. Although treatment response was otherwise maintained, the patients often showed suicidal behavior. During the follow‐up period the sample clearly differentiated in two groups: those continually fit for work (33%) and those chronically incap

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09593.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

This study investigated associations between adolescents' perceptions of their family dynamics (McMaster Family Assessment Device, FAD) and depression, suicide thoughts and attempts. High school students (mean age 15.2 years) completed self‐report questionnaires including the Beck Depression Inventory (BDI), the FAD, questions about suicidal thoughts, plans and attempts, deliberate self harm, and selected life experiences. Univariate analysis showed that family dysfunction measured on the FAD is associated with thinking and planning suicide, deliberate self harm, suicide attempts, as well as severe depression (BDI ≥ 222). Despite this, stepwise regression indicated that family dysfunction influences suicide behaviors indirectly through other variables such as depression. The FAD is recommended as a useful addition to questionnaires seeking to identify vulnerability to both depression and adolescent attempted suicide in early detection stud

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09594.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Suicide risk was studied in a sample of 346 mood disorder inpatients, 92 of whom were admitted after a current suicide attempt. The overall suicide mortality after a mean observation period of 6 years was 8%. The potential of attempted suicide to predict suicide risk in hospitalized patients with mood disorders was studied by survival analysis after subgrouping on the basis of whether a current suicide attempt had occurred or not. The suicide risk the first year after attempting suicide was 12% (11/92), compared with 2% (4/254) in the mood disorder subgroup with no current suicide attempt. The long‐range suicide risk after a current suicide attempt in depression was 15% (14/92) as compared with 5% (13/254) among those without a current suicide attempt. It is concluded that a current suicide attempt in mood disorder inpatients predicts suicide risk particularly within the first year and should be taken very seriousl

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09595.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Seventy‐seven patients with a primary diagnosis of social phobia (DSM‐III‐R) were randomized to treatment with the reversible and selective monoamine oxidase type A inhibitor brofaromine (n= 37) or placebo (n= 40) for 12 weeks in a double‐blind trial. A fixed dose of 150 mg/day or a matching placebo was given after a 2‐week dose titration phase. Patients with additional diagnoses of simple phobia, generalized anxiety disorder, dysthymia or major depressive disorder currently in remission were accepted. Patients with other Axis I mental disorders were excluded. In the brofaromine group, 78% of the patients scored much or very much improved on the Clinical Global Impression scale compared with 23% in the placebo group. The anxiety and avoidance scores on the Liebowitz Social Anxiety Scale (LSAS) were significantly reduced in favor of brofaromine. The clinical effects were not significantly correlated with the plasma concentration of brofaromine. After 12 weeks the brofaromine group scored significantly Jower than the placebo group on a core depression part of the Montgomery‐Åsberg Depressid Rating Scale. After 12 weeks of treatment the brofaromine group had significantly higher total scores on the LSAS than an age‐ and gender‐matched group of healthy controls. The brofaromine group improved further during 9‐month follow‐up treatment period, whereas 60% of the placebo responders who continued long‐term treatment relapsed. The most common side effects in the brofaromine group were sleep disturbances

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09596.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

We followed the prescription of psychotropic drugs by primary health care physicians over a 3‐year period. The material consisted of 1000 randomly selected adult primary health care patients. At least one psychotropic drug was prescribed to one third (n= 307) of the sample during the follow‐up period. The most commonly used drug category was that of benzodiazepines, which was prescribed to 24% of the sample. An antidepressive was prescribed to 8%, a neuroleptic to 2% and “other psychotropic drugs” to 10% of the sample. The most important predictor for prescribing psychotropic drugs was recognition of mental problems at the initial survey, but age and marital status also had an association with the prescription. No gender difference was found after controlling for mental problems. Psychotropic medication was also prescribed to 13% of the patients who had no sign of mental d

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09597.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The phenotypic indicators of the genomic imprinting model were applied to clinical psychopathology data on 100 bipolar (BP) I probands and their families. The paternal transmission was associated with a significantly younger age of onset of the BP illness in probands and a higher rate of affective disorders in first‐ and second‐degree relatives. The effect of the sex of the transmitting parent on age of onset in probands decreased but remained significant when controlling for the effect of the probands' age at investigation. Probands' sex had no significant influence on their age of onset. The severity of the BP illness in probands in terms of number of illness episodes and annual frequency was not influenced by the sex of the transmitting par

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09598.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

This study investigates the effects of perceived family environment on clinical outcome among patients in Spain who suffer from schizophrenia. Forty‐five consecutively admitted DSM‐111‐R schizophrenic patients were assessed monthly with the Brief Psychiatric Rating Scale during a 9‐month period. Patients and parents rated the family environment through the Family Environment Scale (FES). FES factors were considered separately for each family member, since parents' and patient's perceptions of the family environment were weakly correlated. Stepwise multiple regression analysis showed that patients' perceptions of family control and intellectual‐cultural orientation predicted rehospitalization. Patients' and mothers' ratings of family control and fathers' scores of conflict and moral religious emphasis predicted psychotic relapse. However, fathers' scores of family cohesion predicted higher negative symptoms. Prior admissions, age of onset and use of depot medication tended to predict outcome in conjunction with the family

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09599.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

In order to elucidate the psychiatric comorbidity of patients in alcohol and other substance use disorder treatment we examined a representative sample of such patients in Iceland (249 men and 102 women). Over 70% of pure alcoholics and over 90% of polysubstance users had comorbid diagnoses, a prevalence higher than in the Epidemiological Catchment Area study in the United States, but similar to clinical studies from North America. The most prevalent disorders were: affective (33%), anxiety (65%), antisocial personality disorder (28%) and psychosexual dysfunction (20%). Pure alcoholics and polysubstance users in studies on psychiatric comorbidity should be separated. Anxiety and affective disorders influence treatment seeking. Findings concerning the impact of psychiatric comorbidity on course should be comparable between North America and Europe.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09600.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Centro de Atención Psicosocial in León, Nicaragua is a psychiatric outpatient unit that has developed a group‐oriented model of working, in which 80% of all visits are in groups: first‐admission groups, insight‐oriented group psychotherapy, psycho‐educative, family groups and relatives groups. The aim of the present study was to analyze patient characteristics and make a preliminary study of improvement, compliance and patient satisfaction in a 1‐year perspective. One hundred consecutive visits were assessed, 44 of them first admissions. They were assessed according to all axes of DSM‐III‐R plus the Structural Clinical Interview for DSM‐III Disorders. A 1‐year follow up was conducted on 39 of 41 selected patients within the major diagnostic groups. One of 4 patients had a psychotic disorder where schizophrenia dominated. Among nonpsychotics major depression, anxiety and adjustment disorders were most frequent. Personality disorders were common (80%) among nonpsychotic patients, paranoid, obsessive‐compulsive, passive‐aggressive and masochistic personality disorders dominating. The illiteracy rate was 10%, but 50% had high school or university background. Severity of mental disorders and functional level did not differ between educational levels. There was a strong male dominance in all diagnostic, socioeconomic and educational level strata and few old patients. Improvement in functional level was clinically and statistically significant in all groups, and more than two thirds were very satisfied with the

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1995.tb09601.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY