摘要:

ABSTRACT–Content analysis of biographic interviews with endogenous and neurotic depressives shows that problems in a partnership carry particular weight as triggers of depression. In this respect, however, separations and the death of a partner play a comparatively less important role. Neurotic depressives become significantly more often depressive because of partnership‐related events than endogenous depressives. Also in qualitative respects the causes for depression differ between the two groups: in endogenous depressives a threat of real loss often triggers depression, whereas neurotic depressives fall ill more frequently as a result of disappointments and injuries caused by the partner. Accompanying differences in the course of the partnership, the choice of partner and the premorbid personality are discus

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb01259.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT–A total of 206 depressive patients (176 outpatients and 30 in‐patients) underwent a dexamethasone suppression test (DST). Resting levels of serum growth hormone (GH), plasma vasopressin (AVP) and plasma homovanillic acid (HVA) were also measured in a proportion of the patients. Fifty‐seven per cent of the endogenous patients showed nonsuppression of cortisol in the DST, while 92% in the nonendogenous group showed normal suppression. The diagnostic confidence of a positive test was 83 %. The sensitivity and specificity of the test was slightly higher among inpatients than outpatients, and serum cortisol value at 4 p.m. was more useful than the morning value. No significant correlation was found between severity of the depression as measured by the Hamilton Rating Scale for Depression and serum cortisol. In single subjects there was, however, an obvious correlation. The levels of serum GH, plasma AVP and plasma HVA did not differ in the endogenous and nonendogenous groups, and there was no correlation between serum cortisol in the DST and the concentrations of the other hormones or HVA in p

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb01260.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT–A total of 61 clinical suicides, all of them fulfilling the Research Diagnostic Criteria for a depressive disorder, were examined with regard to the psycho pharmacological treatment they received at the time of their suicide. Scarcely half were treated with antidepressants, and only a small minority were optimally treated. One of the reasons for this therapeutic inadequacy lies in a discrepancy between the clinical and RDC diagnoses. An improvement in diagnostic practice, in the sense of paying more attention to the presence of a depressive syndrome, along with an improvement in psychopharmacological treatment, could contribute to a reduction in the clinical suicide rate, which has recently been observed to be increasin

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb01261.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT–A representative selection of 2,283 persons, 18‐65 years old in “former” Stockholm County were examined by psychiatrists in 1970–71. The total non‐response was 12%, The 12‐month prevalence of mental disorders in relation to social class (I‐III), marital status and immigration was estimated. The “psychiatric diagnoses ofmoderate and severe degree”were significantly more prevalent in social class III (14% and 2.7%) than in I (6.9% and 0.6%) and II (9.8% and 0.9%) and significantly more prevalent among single (16% and 4.6%) than among cohabiting persons (9.6% and 1.0%), The mental disorder/immigration relationship should here be interpreted with certain reservations. One significant difference was noted: the “psychiatric diagnosis ofsevere degree”was significantly more prevalent for men born in Sweden (1.5%) than for

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb01262.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT–A representative selection of 2,283 individuals, 18‐65 years old, in “former” Stockholm County, were examined by psychiatrists in 1970–71. The total of non‐participants was 12%. The alcohol consumption pattern and the prevalence of the diagnosis alcoholism for the last 12 months are reported. Significantly more men than women confirmed “very high” and “high” consumption, respectively. The diagnosis alcoholism was given to 4.8% men and 1.4% women. Significantly more women in social class I than in II and III, as significantly more men in social class I than in II stated “very high” or “high” consumption. Social consequences of alcohol consumption, in the form of entries in the Penal Register of the National Board of Excise (Kontrollstyrelsens straffregister) for the years 1965–71, were, on the other hand, found significantly more frequently among men in social class III th

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb01263.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT–In a consecutive series of 257 alcoholics from an out‐patient department 53 were judged as assaultive and 38 as suicidally inclined at the clinical examination 20 years ago. At the follow‐up the assaultive alcoholics had a 3.3 times increased mortality rate, the suicidally inclined 1.9 times and the others 1.7 times compared with the general population. The assaultive alcoholics had an increased rate of suicides, intoxications and other alcohol‐related deaths compared with other alcoholics. Repealed assaultive behaviour was uncommon. It is concluded that a skilled psychiatric evaluation of assaultive behaviour in alcoholism has an important predictiv

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb01264.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT–Seventy‐three agoraphobic and 31 social phobic women, all rated unsuitable for insight‐oriented psychotherapy, were compared regarding family and personal history, intelligence, personality and factors pertaining to the disorder. The same patients, with 11 men included in the social phobic group, were also compared regarding response to four randomly assigned types of treatment given over a 3 month period, with a 9 months' follow‐up. The following differences were revealed: 1) Social phobias were associated with a higher social class of the parental home, higher education, higher scores on verbal intelligence, and a higher social class of the patient. 2) Social phobics scored higher on the personailty factor, aggressive non‐conformance, otherwise there were no differences in the personality factor. 3) Agoraphobias were associated with mother working outside home during the patient's childhood, neurotic symptoms in childhood, and current economic difficulties. Agoraphobics more often gave experience of death as a cause of the disorder. 4) Social phobias started at an earlier age. 5) Target phobia and the global rating were of equal severity in the two syndromes, but the agoraphobics had higher ratings on free anxiety and depersonalization. 6) Social phobics responded better to prolonged exposure in vivo, while agoraphobics responded better to supportive therapy of dynamic type, or to a simple basal therapy. Social phobics more often wanted the therapists to give advice and

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb01265.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT–The prophylactic effect of lithium was studied prospectively in 63 patients with recurrent affective disorders. Lithium treatment was started at recovery from a current episode of illness when the patients were able to participate in the decision to start long‐term treatment. The median treatment time was 23.7 months and the mean serum lithium concentration approx. 0.63 mmol/1. Comparison with equally long control periods before lithium showed that the treatment resulted in statistically significant reductions in number of episodes, number of months ill, and number of months hospitalized. There were 40 (63%) responders (frequency of episodes during lithium lower than before lithium) and 23 (37 %) non‐responders (frequency of episodes during lithium higher than or the same as before lithium). Females responded slightly better than males. Responders scored significantly higher than non‐responders in the psychasthenia and muscle tension subscales of the Karolinska Hospital Personality Inventory. Both responders and non‐responders showed falls in CPRS during lithium treatment, the fall was statistically significant in the responders. During the first 4 months of lithium treatment the responders showed a significant rise in serum calcium, while serum calcium remained unaltered in the non‐responders. These variables may be predictive of response to long‐term lithium treatment. The low numbers of patients who discontinued treatment and the even serum levels of lithium suggest that good compliance to treatment was achieved with the pre

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb01266.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT–One hundred and one bipolar patients with at least two episodes during the 2 successive years prior to lithium received continuous lithium treatment for 2 years. The prophylactic efficacy of lithium increased from 60% to 73% when patients with individual standard deviations of plasma lithium of more than 0.2 mM/1 were excluded. Most of the good responders showed individual mean plasma lithium levels from 0.5 mM/1 to 0.79 mM/

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb01267.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

ABSTRACT–Two hundred and sixteen psychiatric patients (183 men and 33 women) hospitalized in Set. Hans Hospital were treated with clozapine between 1971–1983. All had been treated previously with one or more neuroleptic(s) and had either failed to respond adequately, or their response was limited by side effects. Eighty‐five patients were treated exclusively with clozapine, while the remaining 131 received additional medication, mainly other neuroleptic drugs. The mean clozapine dosage was 317 mg/day (range 50‐1200), and the mean duration of treatment was 2 3/4 years (range 1/12‐12). The tolerability to clozapine was determined by an evaluation of haematological changes, pronounced side effects and mortality. One patient treated with clozapine (8 months) and nitrofurantoin (8 days) developed a reversible granuiocytopenia. One patient (treated with a combination of drugs) had clinically insignificant depression of the leucocytes and three of segmented granulocytes. Seven had a reduction in thrombocytes. Two patients developed cardiac insufficiency, and four epileptic seizures. None of the patients treated exclusively with clozapine developed neurological side effects. A global estimation of therapeutic effect revealed that clozapine alone or in combination with other neuroloptic drugs was significantly better than previous antipsychotic therapy, although 47‐63 % of the patients showed no change. It is concluded that clozapine is a potent antipsychotic drug offering particular advantages in the treatment of schizophrenic patients with a pronounced symptomatology and tendency towards developing extrapyramidal side effects. Caution is advised in patients with cardiac insufficiency and epilepsy. There appears to be a slight risk of granuiocytopenia, and therefore the present monitoring of WBC should continue in order to prevent this reaction and to obtain more complete information regarding risk of granu

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1985.tb01268.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY