摘要:

Reigning views on psychiatric nosology regard as “too subjective” certain features of diagnosis which respected psychiatrists have reported and several empirical studies have confirmed. We describe two of these persistent “mysteries” of psychiatric nosology: rapid diagnoses and the praecox feeling. We then demystify these mysteries by explicating the workings of “typification” in the diagnostic process. The criteria of disorders which are provided by classification manuals, such as DSM-III, are shown to presuppose such typifications. Psychiatric typification, although a preconceptual skill, can be rendered fully scientific and objective.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Illness behavior in panic disorder was examined by comparing the coping strategies of female primary care patients (34 with panic disorder, 30 with simple panic, and 78 without panic.) Relationships of coping and distress were also examined within each group. The groups differed significantly on the Ways of Coping Checklist, anxiety (SCL-90 and Zung scales), depression (SCL-90 and Beck scales), and number of phobias. The panic disorder group used proportionately less problem-focused and more wishful thinking than the other groups. Within the panic disorder group, anxiety and depression were correlated negatively with problem-focused coping and positively with wishful thinking, and number of phobias was correlated negatively with the seeking of social support and positively with wishful thinking. Most importantly, when an attempt was made to statistically separate panic patients with multiple phobias from those without multiple phobias, coping was a better marker than was distress. These results emphasize the importance of cognitions in illness behavior and anxiety disorder.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The Mini Mental State Examination is a useful screen for the detection of cognitive disorders among psychiatric patients. In the absence of a developmental disability, the inability to perform satisfactorily on the Mini Mental State (MMS) (score < 24) is likely to be related to delirium, dementia, or affective disorders. The mildly retarded or learning disabled should perform satisfactorily (>24) on the MMS but may show impairment with delirium, dementia, or affective disorders. In the absence of a psychiatric disorder, it takes moderate mental retardation (IQ < 55) or severe reading disability with IQ < 70 to produce an MMS score of less than 24. The MMS should not be considered a screen for mental retardation, because retarded individuals can function adequately (>24) on the MMS.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Seventy-eight sexual assault victims who sought treatment within 1 month of their assaults were compared with 40 victims who delayed seeking treatment. Demographic, rape situation, and psychiatric history characteristics were examined as were postrape symptom profiles and responses to treatment. More of the delayed treatment seekers were raped by a “friend,” and fewer used physical means to defend themselves against the assailant. With respect to symptomatology, delayed treatment seekers reported considerable rape-related distress and were more anxious and significantly more fearful than were recent rape victims. Implications for clinical practice and for the tailoring of services for victims of sexual assault are suggested.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

This paper presents two sets of data that suggest a weak but specific placebo response in agoraphobia. First, analyses in 20 agoraphobic patients given single-blind placebo over a 2- week period, without the customary confound of instructions for exposure to phobic situations, revealed a statistically significant reduction in panic and phobic symptoms. However, symptoms remained in the moderate to severe range and functioning was virtually unchanged. Second, comparisons between six agoraphobic patients receiving double-blind placebo and six others receiving “no pills,“ matched for age, sex, and exposure treatment, revealed a significant placebo effect over an 8-week period. Implications for clinical research are briefly discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

To determine whether depression and neuroleptic-induced parkinsonism confound the clinical assessment of negative symptoms in schizophrenics, we evaluated 45 outpatient schizophrenics for depression, parkinsonian symptoms, and negative symptoms using standard clinical rating scales. Neuroleptic and anticholinergic dose and plasma activity were also determined. Associations between negative symptoms and these clinical and drug variables were examined using a multivariate statistical model.Negative symptoms were significantly correlated with several parkinsonian symptoms, some vegetative features of depression, and with anticholinergic dose. No significant correlations were found between negative symptoms and cognitive features of depression, or neuroleptic and anticholinergic plasma activity. These findings suggest that assessment criteria for negative symptoms, depression, and drug-induced parkinsonism overlap in treated schizophrenics. Strategies for differentiating these clinical syndromes are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The psychostimulant drugs methylphenidate (MPH) and dextroamphetamine (DEA) have proven efficacy in clinical populations whose primary symptoms include disorders of attention, impulse control, and locomotor hyperactivity. These medications have also been shown to influence in a positive manner cognitive functioning, particularly in the areas of sustained attention and memory. In light of these facts, the psychostimulants MPH and DEA were administered in separate trials to a young man who suffered from similar symptoms secondary to a chronic closed head injury. The medication trials were doubleblind, placebo-controlled, dose-response studies. Cognitive functions, particularly memory and attention, improved in the active drug conditions. In addition, there was a consistent, positive drug effect across behavioral assessments. This case study emphasizes the importance of studying psychostimulant effects in patients with neuropsychological and behavioral sequelae of closed head injury; it also presents an appropriate methodology for evaluating psychostimulant effects in a clinical research setting.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Monoamine oxidase inhibitors (MAOIs) are being used more frequently in the treatment of various psychiatric and neurological disorders. Although adverse effects of MAOI treatment are widely known, withdrawal symptoms are less well known. They include nausea, sweating, palpitations, nightmares, and psychosis. Withdrawal reactions from combination therapy with an MAOI and another agent are seldom described. Reported here is the occurrence of myoclonic seizures after the abrupt discontinuation of phenelzine and alprazolam. Alterations in the GABA and serotonin neurotransmitter systems as a result of withdrawal of the MAOI and the benzodiazepine may account for the seizures.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Drug toxicity associated with a drastic increase in blood level developed when a trade preparation was inadvertently substituted for generic nortriptyline. There is a good deal of speculation that different preparations of psychotropic medications may differ substantially in bioavailability, but the frequency of variability of clinical and toxic effects is not clear. Bioinequivalence should be considered as a possible cause of otherwise unexplained changes in response to a psychoactive drug, especially if benefits and side effects are correlated with blood levels.

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1987

数据来源: OVID