摘要:

The evidence for an increased incidence of rates of depressive conditions, defined as depressed mood, depressive syndromes or depressive disorders, is reviewed. Findings from prospective studies, family genetic studies, community surveys, repeated cross‐sectional surveys, admission data and suicide statistics are summarized. Methodological problems and difficulties in the analysis and interpretation of these results are then summarized. Because converging results from studies conducted with various designs, sampling and measurement strategies are convergent, it is concluded that the increase over time of depressive phenomena is a plausible finding. However, its magnitude remains unknown and is probably smaller than sometimes claimed. Furthermore, studies have failed to demonstrate that the increase in rates was specific to depressive conditions. Finally, it is noted that these epidemiological enquiries have failed to provide cues on the possible mechanisms underlying these secular change

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb01571.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Single photon emission tomography with the intravenous blood flow marker99mTc‐exametazime was carried out in 14 acutely ill drug‐free schizophrenic patients from whom P300 event‐related potential, smooth eye pursuit eye tracking and verbal fluency were measured within a few days of scanning. Smooth pursuit eye movement abnormality correlated significantly with abnormal tracer uptake in superior pre‐frontal cortex on the right and left and inferior pre‐frontal cortex on the left. Abnormal eye movement was also associated with higher tracer uptake in left anterior cingulate and left posterior cingulate. P300 latency was significantly correlated with higher tracer uptake in left superior pre‐frontal and left parietal regions. Verbal fluency performance was negatively correlated with tracer uptake in left frontal region. Eye tracking abnormality in schizophrenia is associated with bilateral frontal lobe disturbance and P300 latency increase with left‐sided frontal and temporoparietal dysfunction. There was, however, a significant inverse relation between eye tracking abnormalities and abnormal perfusion in the left anterior cin

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb01572.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The relationship of attempted suicide to demographic characteristics, current and lifetime psychiatric diagnoses, clinical history, and current symptoms was assessed in a sample of 184 recently hospitalized psychotic patients. Forty‐three patients (23%) had an attempt history, and 28 (15% of sample; 65% of attempters) made an attempt during the episode for which they were hospitalized. Demographic characteristics did not distinguish attempters from nonattempters. Variables significantly associated with having ever attempted suicide were current diagnosis of unipolar major depressive disorder but not bipolar; lifetime major depressive episode; a history characterized by a less acute onset, lower pre‐admission psychosocial functioning, and episodes of physical violence; and a symptom picture characterized by greater depression, hopelessness, negative symptoms, hallucinations and less thought disorder. Those with a current attempt had significantly higher rates of lifetime history of major depression and less physical violence than those with past attempts only. The potential importance of the data for predicting future suicidal acts is discus

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb01573.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

In this study a newly developed Self‐rating Inventory for Posttraumatic Stress Disorder (PTSD) is presented. The instrument consists of 47 items, reflecting DSM‐III‐R criteria, associated features and items corresponding to the disorder of extreme stress not otherwise specified. All items are phrased in a trauma‐independent way and are measured on an intensity scale. The instrument was validated on 76 subjects with war‐related trauma and 59 psychiatric outpatients, one third of whom were traumatized. Test‐retest for the scale was 0.90. The coefficient alpha appeared to be 0.96 for the 47‐items scale and 0.92 for the 22 DSM‐III‐R subscale. The scale correlated significantly with the Clinician Administered PTSD Scale, the Mississippi Scale for Combat‐related PTSD, the MMPI PTSD subscale and the Impact of Event Scale. The overall efficiency of the Self‐rating Inventory for PTSD was comparable to the overall efficiency of the Mississippi Scale and superior to the MMPI PTSD subscale. Factor analysis on the 22 DSM‐III‐R items showed 4 factors, representing numbing, intrusion, avoidance and sleeping problems. It is concluded that the Self‐rating Inventory for PTSD is a powerful instrument for diagnosing PTSD in survey research. The instrument appears to be capable of differentiating not only between PTSD and non‐PTSD subjects but also between traumatized non‐PTSD subjects and non

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb01574.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The objective of this study was a) to compare patterns of drug use in fatal and nonfatal overdoses and b) to find out if toxic drugs are overrepresented in overdoses with fatal outcome. A total of 179 cases of fatal overdoses in Switzerland (population 6.6 million) were compared with 269 medically treated self‐poisoners from the agglomeration of Berne (population 301,630). Because of frequent multiple drug use, all the different compounds taken singly or in combination with other drugs were recorded and grouped according to drug types. The patterns of the frequencies of drugs used were remarkably similar in both groups. The majority of the drugs were psychotropics (81% in fatal and 68% in nonfatal overdose). Twenty‐nine completed suicides were the result of drug combinations specifically recommended by EXIT. In the remaining cases benzodiazepines were used most frequently in both attempted and completed suicide, often in combination with other drugs or alcohol. Barbiturates were the only drugs recorded significantly more often in fatal overdoses (9%vs3%). No significant difference was found for tricyclic antidepressants (13%vs10%), or other types of drugs. The results are consistent with our assumption that drugs with higher toxicity would be overrepresented in overdoses with fatal outcome. Barbiturates, which are well known to be dangerous in overdose, were clearly associated with fatal overdoses, but not tricyclic antidepressants. This, in our view, suggests that the risk of prescribing tricyclic antidepressants should not be overestimated. The frequent use of benzodiazepines in completed suicide, however, indicates that there are no truly safe drugs in overd

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb01575.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This study describes the development of post‐stroke depression (PSD) prospectively during the first year post‐stroke in 285 unselected stroke patients. An appropriate unselected population‐based control group without cerebral pathology is included for comparison. Psychiatric assessment with the Hamilton Depression Rating Scale (HDRS) was undertaken unmodified. PSD was defined as HDRS ≥ 13. The one‐year incidence of PSD among the 209 survivors able to communicate reliably at 1 month was 41%. Most cases develop within the first months following stroke (79%), the frequency of new cases of PSD at one year being 5%, a level comparable to that in the control group. Depressed and nondepressed stroke patients consistently scored 4 points greater on total HDRS than in the corresponding

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb01576.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The ABC schizophrenia study aims at investigating sex differences in age of onset, symptoms and course of schizophrenic and paranoid disorders. For this purpose, we used case register data from Denmark and Mannheim and a directly examined sample of first admissions (ABC sample). The Danish case register sample included less clinical diagnoses of schizophrenia and more schizophrenia‐related disorders (acute paranoid reaction, paranoid states and borderline schizophrenia) than the Mannheim data (case register and ABC sample). The problem therefore was whether the two datasets are comparable and the results are valid. For this reason a randomized, stratified sample of 116 patients was drawn from the Danish case register sample. The case notes of these 116 patients were requested from the hospitals where the patients had been treated and analyzed by means of a scoring sheet based on the Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS). The use of operationalized diagnoses of the CATEGO program, based on PSE items, which are integrated in IRAOS, demonstrated that the samples of the Danish and the Mannheim case registers and the directly investigated ABC sample have comparable diagnostic distributions. Possible explanations for the differences between the clinical and the CATEGO diagnoses in the Danish case register may be the frequent use of diagnoses of borderline schizophrenia and reactive psychoses (previously called psychogenic psychoses), and above all a more narrow concept of schizophrenia; in Denmark, schizophrenia is diagnosed relatively late, i.e., after the presence of enduring negative symptoms, and thus mostly after the appearance of residual state. These diagnostic preferences may help to explain the fall in first admission rates for schizophrenia – above all in women – in Denmark and the low incidence rates of schizophrenia by first contact within the WHO determinants of outcome study. The earlier hospitalization of men could be replicated as well as the course of treatment (readmissions and discharges) of schizophrenic men and women over 10 years after first admi

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb01577.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

In psychodynamic milieu treatment, the relations between patients and nurses are the main tools for understanding and helping the patients. For this reason, it is important to construct methods to follow the development of relations and to study characteristics of helpful and nonhelpful relations. In this article, a checklist with feeling words given to nurses and aides in psychiatric treatment facilities is presented and its measurement properties are described. The analysis showed that the checklist as a whole measures the amount of emotional arousal in a reliable way. The individual feeling words have acceptable variance. A factor analysis gave a limited number of factors that are clinically understandable. The checklist seems to be well worth further study.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb01578.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The prevalence of dyskinesia in a randomly selected set of 61 mentally handicapped women with a range of diagnoses, levels of IQ and exposure to neuroleptics was assessed using the Abnormal Involuntary Movements Scale (AIMS). Overall, 64% of patients had dyskinesia on the AIMS. There was no correlation with neuroleptic exposure, although 43% of patients had been significantly exposed. There was no correlation between the presence of dyskinesia and the original handicapping diagnosis, and there was no increase in dyskinesia as the patients age increased. There was a significant increase in dyskinesia as IQ fell. This study backs the contention that there is a close association between cognitive impairment and movement disorder.

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb01579.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This study evaluated the severity and symptom profile of posttraumatic stress reactions of 202 adults exposed in 1988 to political violence in Azerbaijan and/or the earthquake in Armenia. High rates of severe posttraumatic stress reactions were found among the most highly exposed individuals, irrespective of the type of trauma. There was no difference in symptom profile for subjects exposed to earthquake versus violence. These similarities in severity and symptom profile may be attributable to common features of the exposures, which included experiencing life‐threat and witnessing injury, mutilation and death. Recent prior exposure to violence contributed to the severity of reaction to the earthquake. The high rates of chronic and severe posttraumatic stress reactions in Armenia constitute a major public mental health proble

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb01580.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY