摘要:

A lucky chance more than 30 years ago revealed the remarkable efficacy of single inhalations of high concentrations of carbon dioxide in eliminating or markedly reducing free-floating anxiety. The reduction of anxiety lasts for days, weeks, or longer—well beyond the persistence of carbon dioxide in the body. The effects are explicable on the hypothesis that free-floating anxiety is anxiety conditioned to continuously present sources of stimulation, such as background noise or the awareness of space or time, and that the anxiety response habit is weakened when the anxiety is inhibited by the competition of responses that carbon dioxide induces. More recently, it has become apparent that inhalations of carbon dioxide, applied in a different manner, are effective in overcoming maladaptive anxiety responses to specific stimuli, e.g., social stimuli. The substance is also proving to be a valuable resource in the treatment of the common variety of panic attacks.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Previous research using the visual span of apprehension procedure has interpreted the performance deficits commonly demonstrated by schizophrenic subjects as indicative of a core, central processing deficit. Gjerde recently suggested that the attentional problems of schizophrenic subjects may be associated with excessive levels of arousal. The present study was designed to explore the relationship between arousal level in normal subjects and their performance on the span of apprehension task. Consistent with Gjerde's proposals, the normal subjects who expressed high levels of trait anxiety were significantly and selectively impaired on the more complex conditions of the task, a performance pattern similar to that exhibited by schizophrenic subjects in previous research. These data illustrate the influence that arousal level may exert on tasks purporting to reflect attentional abnormalities among schizophrenic subjects.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Establishing the usefulness of DSM-III for psychotherapy will probably require numerous studies. This paper reports a feasibility study for one kind of investigation: the use of clinical records to survey the DSM-III diagnoses and therapy outcome of 30 patients who had outpatient psychotherapy. We were interested in a) what range of DSM-III diagnoses was represented by patients in outpatient therapy; b) whether judgments of diagnosis and outcome could be made reliably from clinical records; c) how well patients in the therapy fit DSM-III diagnoses; d) if patients did not fit well, why not? We found that a) an exploration of the relationship between DSM-III diagnosis and outcome from clinical records is feasible; b) a relatively wide range (13) of DSM-III diagnoses was represented by the 30 patients; c) 80% of the patients fit well or moderately well into a DSM-III diagnosis; d) most of the 20% who did not fit well represent the class of problems of living, which does not mean, however, that their problems were minor or unimportant; e) in some cases the diagnosis—even when it fit the patient well—did not express the essence of the problem for which he or she was to be treated; f) there was a small correlation (.19) between the patient's rating on axis V and therapy outcome. The findings are discussed in terms of the pro and con arguments that have been made about DSM-III.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

This study has demonstrated that among low-income, relatively unacculturated Mexican- American households, a high level of expressed emotion on the part of key relatives significantly increases the risk of relapse for remitted schizophrenics who return home to live with their families after hospital discharge. This cross-cultural replication of earlier research findings in London and southern California suggests that critical, hostile, or emotionally overinvolved attitudes and behaviors may be general major stressors that adversely influence the fragile adaptation of schizophrenic individuals in diverse cultural settings. The finding of a lower prevalence of high levels of expressed emotion among Mexican-American compared to Anglo-American and British households lends support to the hypothesis that intrafamilial behaviors may account for different schizophrenic outcomes in different cultures.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

In a prospective 2-year follow-up of 37 young acute schizophrenics, we examined the predictive significance and relative contribution of historical, genealogical, course, and clinical dimensions. Patients were evaluated multidimensionally at index admission and after 21 to 33 months, at which time 19 cooperated in follow-up involving clinical, functional, psychometric, and objective outcome measures. Multiple regression analysis found that combinations of 3 to 4 index variables significantly predicted 13 of 14 outcome measures, yielding multipleRvalues between .63 and .93 (&OV0639;=.78). In total, a set of eight parameters contributed in explaining the outcome variance. The strongest overall predictor of favorable outcome was baseline negative syndrome. Other significant predictors were good premorbid school functioning, favorable prior disposition, sudden onset of illness, nonparanoid subdiagnosis, family history of alcoholism, psychomotor retardation, and depression. Accordingly, a patient's premorbid adjustment, course of illness, and presenting clinical profile provided nonoverlapping sources of outcome prediction. Of these three dimensions, it was proposed that the prognostic significance of the clinical profile may be phase specific, carrying different implications when assessed in the acute vs. chronic stage of illness.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

We undertook a retrospective survey of assaultive behavior in 140 psychiatric inpatient research volunteers who had not previously responded well to neuroleptic treatment. Fortyone of 97 patients with schizophrenia became assaultive during their hospitalization, whereas only four of 43 patients with other diagnoses became assaultive (p< .0001). Most assaults were not a significant threat to the attacked person, but a small number were highly dangerous. Assaultive patients were significantly younger, and a greater proportion had a previous history of violence, compared with nonassaultive patients. A previous history of violent behavior was linked to more previous hospitalizations, indicating that such behavior might be associated with a poor prognosis.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Two patients are reported with the acute onset of pathological crying following right inferior frontal brain damage. Both had severe endogenous depession and neither had pseudobulbar palsy. These and other cases argue that two organic brain diseases—one structural and the other “physiopharmacological”—may interact to produce pathological display of affect that cannot be accounted for by traditional neurological explanations. A pharmacological mechanism for the rapid amelioration of pathological affect by tricyclic medications and its possible relationship to the newly discovered descending motor systems of the brain that use norepinephrine and serotonin as neurotransmitters is offered. These cases also suggest that pathological affect is a valuable clinical indicator of an underlying major depression in some brain-injured patients.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

An index sample of neurological patients diagnosed as clinically depressed (83) was compared with a “major depression” sample (43) and a “neurological sample” (44) who were free from psychiatric disorder. There was no difference in global Hamilton Scores between the index and the major depression sample. The latter, however, more often exhibited family and personal history of psychiatric illness, early awakening, guilt, suicidal ideas, shorter index episodes of depression, and better response to treatment. The three samples were followed up for a period of up to 5 years. The index sample did worse on follow-up than did the depressed and the neurological samples. The disease profiles of both the index and neurological samples were similar, but there were more cases of epilepsy in the former. The index sample responded badly to conventional antidepressant treatment. It is concluded that the presence of chronic affective disorder in the neurological patient has an adverse effect on prognosis.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Patients with borderline personality disorder were found to have a significantly greater number of soft sign neurological abnormalities when compared with a group of normal control subjects. Sensitivity analysis revealed that the presence of two or more soft signs differentiated the two groups statistically. The authors speculate that nonfocal soft sign neurological abnormalities may reflect underlying central nervous system dysfunction, which may in turn be associated with the development of borderline personality disorders.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Seventy-six subjects with the primary diagnosis of complex partial seizures with a unilateral temporal lobe focus were examined for the presence of hyperreligiosity. Fifty-one subjects had a left temporal lobe seizure focus and 25 had a right temporal lobe seizure focus. In addition to the temporal lobe epilepsy (TLE) groups, two reference groups were also examined. The first consisted of 31 subjects with primary generalized seizures. The second control group consisted of 27 subjects with documented pseudoseizures and no objective evidence of recurrent epileptic seizures. In all cases, the documentation of seizures or pseudoseizures as well as the localization of the seizure focus was accomplished through simultaneous videotaped recording of the 16-channel scalp EEG tracing and the concurrent overt behavior during the ictal phase. The results of this study fail to support the hypothesis that individuals with TLE are characteristically hyperreligious during the interictal state. There were no significant group differences between the left vs. the right TLE groups, nor were there any significant group differences between the two TLE groups vs. the two comparison groups.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID