摘要:

Nine of 33 patients diagnosed as functional psychosis, who had negative neurological examinations and laboratory studies, showed gross pathological changes of the vermis when the cerebellum was exposed for implantation of a vermal stimulator. These findings motivated us to review the CAT scans done on 264 psychiatric patients as part of their work-up to rule out organic or structural aberration. Although 132 (50 per cent) of these scans were reported as abnormal, only 17 showed pathology of the cerebellum. With careful rereading with attention to the posterior fossa, however, the incidence of cerebellar vermal abnormality proved to be much higher. Of the 96 patients in the series who were diagnosed as functional psychosis, 31 showed pathology of the cerebellar vermis (22 of 65 schizophrenics and 9 of 31 patients with other functional psychosis). Scans of seven patients who had been diagnosed and treated as functional psychosis revealed tumors of the vermis. Scans were then obtained on 20 additional patients with a diagnosis of schizophrenia. These patients were selected at random from two psychiatric services, excluding only those patients who had findings suggesting organicity or who had histories of alcoholism or electroconvulsive therapy. Twelve of the 20 patients (60 per cent) showed atrophy of the vermis of the cerebellum. Thus a total of 34 of 85 schizophrenic patients (40 per cent) had scans showing pathology of the cerebellar vermis. These data are consistent with data from animal experiments that demonstrate a role for the cerebellar vermis in behavioral pathology and epilepsy.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Of 70 process schizophrenic patients clinically assessed and tested for reaction time, 40 showed reaction time crossover. Of the 40 with crossover, 53 of their first degree relatives were clinically assessed and tested. Five of the relatives, found to have psychotic symptoms, were analyzed separately. Also, 41 control subjects without personal or family history of psychiatric disturbance were clinically assessed and tested. The nondisturbed relatives had reaction time crossover (regular minus irregular) significantly greater than the (expected) negative values of the normal control subjects, but not significantly greater than a zero value within subjects. When disturbed and nondisturbed relatives were combined, greater differences indicative of crossover occurred. On the other hand, the relatives, as expected, did not show the slow mean reaction time characteristic of diagnosed schizophrenic patients.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The skin conductance responses of schizophrenics, neurotics, and normals to orienting stimuli were examined. Only the schizophrenic group showed a high incidence of absence of skin conductance orienting responses. A subdivision of the schizophrenic sample into those who did not show any orienting response and those who responded more than three times revealed significant differences in a dichotic listening shadowing task and symptomatology. The schizophrenic nonresponders as compared to the responders made more errors of omission in the dichotic listening task and showed a symptom pattern of low spontaneous activity and withdrawal. The lack of skin conductance responses in some schizophrenics was interpreted as a protective mechanism.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Spontaneously occurring mood states and various physiological indices were evaluated on three occasions in a group of eight healthy males. Results reveal that significant positive correlations exist among five of the six factors comprising the Profile of Mood States (POMS). This finding is related to previous research on the POMS and varied methodologies utilized in those reports. Reliable positive correlations of the POMS factors Depression and Tension with heart rate and diastolic blood pressure were obtained. The Anger factor of the POMS also correlated positively and significantly with heart rate. These findings are discussed in terms of the relationship between POMS factors and anxiety.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Clinical observations and studies of asthmatic patients have often concluded that there is a strong relationship between the degree of the patient's anxiety and the medical intractability of his illness. However, psychotherapeutic interventions designed to alleviate patient anxiety have been noticeably inconsistent in achieving meaningful alleviation of the patient's asthma. The present paper addresses this apparent paradox by positing the existence of two types of anxiety: a) asthma-specific anxiety, as indexed by Panic-Fear symptomatology scores of the Asthma Symptom Checklist; and b) characterological and pervasive anxiety, as indexed by Panic-Fear personality scores of the Minnesota Multiphasic Personality Inventory. In this study, long term medical outcome was found to be influenced by the combination of these types of anxiety. When high asthma-specific anxiety coexisted with high characterological anxiety, medical outcome following intensive long term medical treatment was exceptionally poor. In contrast, when high asthmaspecific anxiety coexisted with average levels of characterological anxiety, medical outcome was exceptionally good. These results are discussed relative to the theoretical distinctions between signal anxiety and anxiety concomitant with a lack of basic ego resources.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Classic formulations by Freud claim that the turning of hostility away from the object world and onto the ego is a crucial mechanism in the psychogenesis of depression. In light of Freud's “retroflexed anger” theory of depression, it follows that tricyclics would increase outward-directed hostility (hostility-out) and decrease inward-directed hostility (hostilityin). Previous research has not confirmed the expected relationship between verbalized affect and imipramine, but these studies did not verify that patients received a clinically effective dose. Using the Gotteschalk verbal sample technique, the present study measured hostility directed inward and outward of eight nondelusional endogenous depressives who received imipramine in placebo, subclinical, and clinical doses. Hostility-out was found to increase significantly only when patients obtained plasma levels of imipramine considered to be clinically effective (11). Hostility-in was unrelated to imipramine, but a nonsignificant trend of lowered anxiety was found for both subclinical and clinical plasma levels of imipramine. All of the changes in verbalized affect were observed within a postdrug period which predated overt clinical change. Hence, the relationship of subclinical and clinical plasma levels of imipramine to verbalized affect was considered to serve as a behavioral index of clinically effective plasma levels of imipramine which could be predictive of favorable outcome.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

There is much evidence that emotional stress can trigger both neurogenic and hysterical seizures in susceptible patients. We reviewed our experience with 37 patients whose seizures appeared to be precipitated at times by emotional stress and had not been controlled by anticonvulsant medication alone. Approximately 70 per cent of patients demonstrated substantial improvement in seizure control after psychiatric treatment and maintained this improvement during follow-up. The findings of this study suggest that patient characteristics associated with better prognosis include normal intelligence, partial (as opposed to generalized) neurogenic seizures, a diagnosis of hysterical seizures, a less severely abnormal EEG, and being hypnotizable. After psychiatric treatment, 32 per cent of patients had their anticonvulsant medication reduced and another 16 per cent had it discontinued.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A case report is described wherein the monoamine oxidase inhibitor phenelzine was administered for 10 months at different doses. Drug treatment in the initial part of the study was double blind. Weekly psychotherapy was instituted at the point of symptomatic recovery. At a reduced dose, in month 3, the patient experienced a relapse in depression. While platelet monoamine oxidase inhibition was greater than 80 per cent the patient was well, but at the point of relapse, inhibition was 14 per cent. Clinical ratings at relapse (Beck and SCL-90 scales) revealed greater readiness by the patient to report psychological discomfort compared with the original interview. The combined effects of psychotherapy and pharmacotherapy were felt to be responsible for this change. However, psychotherapy in this form and duration did not prevent relapse, which depended upon maintaining an adequate dose of phenelzine.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A young woman developed galactorrhea during treatment with a new dibenzoxazepine antidepressant, amoxapine. Both amoxapine and its active and major metabolite, 8-OHamoxapine, appeared in breast milk. More recent literature suggests that probably all antidepressants can appear in human milk.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

In the chronic abuser, diazepam (Valium) withdrawal can be a protracted event. In this report a case is presented of a 37-year-old Caucasian female who had been ingesting 60 to 80 mg of diazepam daily for 8 years. Twelve days following discontinuation of the drug, the patient continued to experience diarrhea, restlessness, emotional lability, and anxiety. Serial blood levels of diazepam and desmethyldiazepam were acquired and found to yield significant levels of desmethyldiazepam for 21 days and greater than trace amounts for 30 days. The results were interpreted as consistent with the slow release of the drug from peripheral storage sites. The prolonged period needed for detoxification in this patient raises important questions regarding the appropriate length of hospitalization or close supervision required to withdraw the diazepam addict.

ISSN:0022-3018    

出版商:OVID    

年代:1979

数据来源: OVID