摘要:

ABSTRACT–Recent interest in community care of schizophrenic patients has led to publication of a number of studies that deal with patients' rehabilitation in their families. Joint efforts of psychologists, psychiatrists and social workers have produced a number of techniques for collaboration with families of schizophrenic patients, including techniques based on the concept of expressed emotion. This concept is presented with reference to its spectrum consistency in time, generalizability to nonfamily setups, relationship to relapse, prevalence in disorders other than schizophrenia and usefulness in comparison to other concepts in family therapy of schizophrenia. Caution is urged in not incriminating the family in causing relapse, after the quiet abandonment of older theories that blamed families for initiating the illness of schizophrenic member

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1989.tb10262.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT–A structured interview designed to diagnose anxiety disorders according to DSM‐III (plus infrequent panic attacks and generalized anxiety disorder using DSM‐III‐R criteria) was given to 1110 people registered with 6 general practitioners (CPs), whether they consulted the doctor or not. As each citizen in Italy has to be registered with a GP, the sample was representative of the population. The interviews were carried out by the GPs, who were also third‐ or fourth‐year trainees in psychiatry. The lifetime prevalence and point prevalence were: 0.36% and 0.27% for agoraphobia; 0.90% and 0.72% for agoraphobia with panic; 1.35% and 0.27% for panic disorder; 0.63% and 0.45% for simple phobia; 0.49% and 45% for social phobia, 5.41% and 2.79% for generalized anxiety disorder; and 0.72% and 0.63% for obsessive‐compulsive disorder. These figures are lower than those reported in other surveys; possible explanations may be the use of a hierarchical diagnostic model and the fact that diagnosticians were psychiatrists instead of lay interviewers as in most studies in the United States. On the whole, 62% of anxiety cases consult a GP, 50% consult a psychiatrist and 7% are

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1989.tb10263.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT–Aggressive behavior during acute involuntary admission was related to ratings on the Brief Psychopathological Rating Scale, age, sex and global assessment in 38 patients. The best prediction model of aggressive behavior was achieved when predicting more serious incidents occurring during the first 8 days of admission. In this prediction model, high scores of hostility and anxiety, together with low scores of grandiosity significantly and accurately predicted more serious violent behavio

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1989.tb10264.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT–Of 301 first‐time admitted patients with delusional psychoses, 50 met DSM‐III criteria for major depressive disorder (MDD), 33 schizoaffective disorder, depressive type (SADD), and 94 schizophrenia. At personal follow‐up after 3–39 (mean 22) years, the SADD group was recorded in between on course and outcome variables, but closer to MDD. The findings in MDD and SADD were respectively: remission 66% vs. 42%, personality disorders 14% vs. 12%, anxiety disorder or alcohol abuse 2% vs. 6%, psychosis 18% vs. 36% (with bipolar development in 2% vs. 6%, paranoid disorder 2% vs. 3%, schizophrenia 4% vs. 3%). Chronic psychosis was recorded in 10% vs. 27%. No significant outcome difference was found between early onset MDD and SADD cases and those who fell ill at a higher age. The assumption that antidepressants may induce mania could not be confirmed. Normal premorbid personality seemed to predict a favourab

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1989.tb10265.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT–The aim of this study was to investigate the clinical characteristics and outcome of epileptic schizophrenia. A total of 106 patients with combined diagnoses of epilepsy and psychiatric disorder were identified; 20 were excluded and 70 agreed to participate. They were interviewed using the Schizophrenia and Affective Disorders Schedule ‐ Lifetime Version and psychiatric diagnoses were assigned based on Research Diagnostic Criteria. Thirty‐two subjects with additional diagnosis of schizophrenia were identified and compared with 31 functional schizophrenic patients matched for age. Both groups shared third person auditory hallucinations most in common, and delusions of passivity least; delusions of passivity occurred significantly more in functional schizophrenia. The global outcome was worse in epileptic schizophrenia and there was also evidence of significantly worse performance on the Mini‐Mental State Examination by the sam

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1989.tb10266.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT–A retrospective study of the demographic and clinical characteristics of 73 consecutive patients aged 60 years and over admitted for the first time into a psychiatric hospital in Nigeria shows that they constituted about 5% of all admissions over a 2‐year period. While the majority (58%) were aged below 70 years, 8% were aged over 80 years, with more females than males living to the older age groups. Single status, separation and divorce were more common among males; widowhood was more common among the females. A high illiteracy rate of 86% was recorded, with more males than females being literate. More than 84% belonged to the 2 lowest socioeconomic classes. There was a significant difference in the distribution of diagnostic categories, with senile dementia, affective psychosis, neurotic disorders and paranoid states more common among the females, while arteriosclerotic dementia and schizophrenia were diagnosed more often among the males. Functional psychosis (49%) was the largest diagnostic category, followed by organic psychosis (30%), while neurotic disorders (10%) ranked third. Within the functional psychoses, paranoid states (30%) predominated, followed by affective disorders (14%) consisting mainly of depressive symptoms; 6% presented with schizophrenic illness; and 11% presented with physical illness with associated psychiatric manifestations. There was a long delay before referral to hospital, associated with use of alternative medical facilities (traditional and spiritual healers). The probable sociocultural antecedents and medical and social implications of these findings are discus

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1989.tb10267.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT–Corresponding categories for anxiety disorders, as defined by the classification systems of the ICD‐9 and the DSM‐III‐R, were compared in a selected sample of 114 outpatients. An unequivocal category‐to‐category correspondence could not be demonstrated for any diagnosis. Anxiety states in ICD‐9 were closely related to generalized anxiety and panic disorder in DSM‐III‐R, and most patients diagnosed as phobic according to ICD‐9 one of the specific phobia diagnoses of DSM‐III‐R. To some degree, diagnostic discrepancies were caused by coexisting symptoms of phobia, panic attacks and/or generalized anxiety within patients. A new technique is introduced to adjust corresponding proportions according t

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1989.tb10268.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT–The aim of this study was to analyze the clinical utility of monitoring plasma levels, since the utility of monitoring is not yet well established. After a washout period, 30 schizophrenic patients were given fixed doses of haloperidol for 3 weeks. A U‐shaped second‐grade polynomic relationship (R = 0.69) was found between steady state of haloperidol and percentage improvement in total score on the Brief Psychiatric Rating Scale. The interval of effective concentrations was between 12 and 59 ng/ml. Fourteen of the 15 patients who had a steady state of haloperidol within that therapeutic interval were responders: only 5 out of the 15 patients below the therapeutic interval were responders. None of the 5 patients who had concentrations below 8 ng/ml was a responder. Furthermore, responder patients showed a steady‐state level of haloperidol significantly higher than that of nonresponders. These data suggest that plasma levels of haloperidol are predictors of therapeutic response in schizophrenic di

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1989.tb10269.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT–A case note study of 518 alcohol‐dependent (DSM‐III) inpatients examined their reported past history of prescribed psychotropic drug use patterns between 1973–1985. The subjects were cross‐matched for gender, age and admission date and stratified into 3 time periods. The characteristics of psychotropic medication recipients were compared with those patients who reported no use of licit medications. Statistical analysis by logistic regression indicated that there was a significant relationship between the past use of psychotropic drugs with a parental history of excessive alcohol intake, the higher levels of MAST scores and the occurrence of past parasuicide events. Patients in their middle years (35–54) tended to have significantly less psychotropic drugs than the younger or older age groups. The female (70%) to male (48%) ratio of past psychotropic use was 1.4:1. Gender differences were also noted in the use of antidepressants and illicit

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1989.tb10270.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT–Personality traits and personality disorders in 298 consecutive outpatients with pure major depression, major depression with dysthymic or cyclothymic disorder, pure dysthymic or cyclothymic disorder and other disorders were investigated. Patients with dysthymic or cyclothymic disorder alone or in combination with major depression showed more self‐doubt, insecurity, sensitivity, compliance, rigidity and emotional instability. They were more schizoid, schizotypal, borderline and avoidant according to MCMI and had a higher prevalence of DSM‐III Axis II diagnoses, and more borderline, avoidant, and passive‐aggressive personality disorders, as measured by SIDP. All in all, dramatic and anxious clusters of personality disorders were more frequent among patients with dysthymic‐cyclothymic disorders in addition to major depression than among patients with major depression only. The findings elucidated the close connection between the more chronic affective disorders and the personality disorders, irrespective of any concomitant diagnosis of major d

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1989.tb10271.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY