摘要:

The neuropsychiatric effects of insular damage in humans have not previously been examined. We therefore examined the neuropsychiatric impairment in seven patients with left insular stroke, six patients with right insular stroke, six patients with left hemisphere noninsular stroke, and six patients with right hemisphere noninsular stroke. Between 4 and 8 weeks after acute stroke, patients were administered a neuropsychiatric battery. Patients with right insular lesions had a greater frequency of subjective anergia and underactivity (Fisher's exactp= .002) as well as tiredness (Fisher's exactp< .002) compared with patients with non-insular lesions or left insular lesions. Subjective feelings of impaired energy or drive after right insular damage may result from disconnection between the insula and the frontal lobe or the anterior cingulate cortex, structures that have been associated with willed action and motor behavior.

ISSN:0022-3018    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Patients with epileptic seizures (ES) and especially those with temporal lobe epilepsy (TLE) share many symptoms with patients with pseudo-epileptic seizures (PES), and the differentiation between them is often difficult. There is growing evidence that a subgroup of PES patients suffer from a dissociative disorder. It is recognized that dissociative symptoms pertain to both psychological and somatoform components of experience. Questionnaires assessing dissociation might provide positive criteria for the diagnosis of PES. In this study, the Dissociation Questionnaire (DIS-Q) and the Somatoform Dissociation Questionnaire (SDQ-20) were administered to patients with ES (TLE, non-TLE) and PES. To control for the influence of general psychoneurotic complaints, the SCL-90 was administered. Apart from this, answers on a trauma questionnaire were related to the diagnosis. Results showed that PES patients scored significantly higher on the SDQ-20, also after correction with the SCL-90, and no difference was found on the DIS-Q. Also, PES patients significantly more often reported sexual traumatic experiences. A logistic regression revealed that results on the SDQ-20 have no independent value in addition to the contribution of gender, age, age at seizure onset, and the presence of sexual abuse in the prediction of the diagnosis. In conclusion, somatoform and not psychological dissociative symptoms are characteristic for PES patients in comparison to ES patients. Other measures are needed within the framework of the differential diagnosis between PES and ES.

ISSN:0022-3018    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This study determines patient characteristics that predict early hospital readmission in schizophrenia and evaluates the extent to which inpatient staff accurately predict these readmissions. Adult inpatients with schizophrenia or schizoaffective disorder (N= 262) were evaluated at hospital discharge and 3 months later to assess hospital readmission. At hospital discharge, inpatient staff were asked to identify which patients were likely to be readmitted during this period. Comparisons were made between patients who were or were not readmitted and between readmitted patients who were or were not identified by staff as likely to be readmitted; 24.4% of the sample were readmitted within 3 months of hospital discharge. Early readmission was associated with four or more previous hospitalizations (85.7%vs.57.7%,p= .004), comorbid substance use disorder (60.3%vs.35.5%,p= .0006), major depression (40.6%vs.26.8%,p= .04), absence of a family meeting with inpatient staff (58.2%vs.41.8%,p= .02), and prescription of a conventional rather than an atypical antipsychotic medication (93.7%vs.83.8%,p= .045). Twelve of the 63 readmitted patients were correctly predicted by staff to rehospitalize. Staff tended to overestimate the risk of rehospitalization in patients with a poor therapeutic alliance, low global function, or initial involuntary admission and to underestimate the risk in patients with alcohol use disorders or four or more previous psychiatric hospitalizations. Early rehospitalization is common in schizophrenia and difficult to predict. Greater emphasis on comorbid alcohol use disorders and a history of multiple previous admissions may help clinicians identify patients at greatest risk for early rehospitalization.

ISSN:0022-3018    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Selective attention in patients after an attempted suicide was investigated to find out whether a specific attentional bias for suicide-related materials exists and to clarify the possible role of emotions in the bias. Thirty-one patients who had previously attempted to commit suicide and 31 control participants took part in a modified Stroop task. The suicidal patients took significantly longer to name the colors of suicide-related words compared with other words, whereas color naming times of the control participants did not differ for suicide-related, neutral, positive, or negative words. Therefore, the attentional bias exhibited by suicidal patients was highly specific. There was no relation between the bias and measures of anxiety, depression, or hopelessness, whereas suicidal ideation correlated significantly with the attentional bias.

ISSN:0022-3018    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

There is research evidence to suggest the presence of dysfunctional cognitions in anorexia nervosa and bulimia nervosa that are not related to food, weight, or shape. These maladaptive cognitions have not been addressed by the conventional cognitive behavioral models of etiology or therapy. This study aimed to assess the impact of unhealthy core beliefs on eating disorders and their symptoms. Twenty restricting anorexics, 10 bulimic anorexics, 27 bulimics, and 23 normal controls completed Young's Schema Questionnaire. Eating behaviors and attitudes were also measured. The results indicate that both anorexic and bulimic women had significantly higher levels of unhealthy core beliefs than comparison women, but the clinical groups only differed on one individual core belief (entitlement). However, there were different patterns of association between core beliefs and eating psychopathology in anorexic and bulimic women. It is suggested that future clinical practice should incorporate core beliefs as a potential element in the assessment and treatment of eating disorders.

ISSN:0022-3018    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

We developed a lifetime severity index for cocaine use disorder and examined its predictive validity of posttreatment outcome using data from the national Drug Abuse Treatment Outcome Study. The index, based on 28 items, considered frequency of use, recency, dependency, and attempt to quit. A higher value of the index, indicating greater severity, predicted a greater likelihood of relapse (the odds ratios were 5.7 for high severity and 4.4 for medium severity, relative to low severity) and shorter time to relapse. Similarly, the polytomous logistic analysis indicated that the index predicted levels of posttreatment cocaine use (odds ratios of daily use were 47.8 for the high severity and 18.8 for medium severity; the corresponding odds ratios of weekly use were 6.75 and 5.10 and for less-than-weekly use were 3.35 and 3.57). The index can be a useful measure for both clinical and research purposes.

ISSN:0022-3018    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1999

数据来源: OVID