摘要:

Psychiatric epidemiology has not until now reached the stage at which the individual's immediate social environment can be examined as a principal independent variable. That handicap may now be overcome by a recent development in social psychiatry: the systematic study of social bonds. Work in this area is providing a method for identifying those elements in social relationships which, when deficient, may be causally related to neurosis. There are considerable technical difficulties in teasing apart cause and effect. These can be tackled by designing intervention trials and by fitting structural equation models to longitudinal data. The evidence so far is at least consistent with, but cannot yet prove, the hypothesis that a deficiency in social bonds is a cause of neurosis.

ISSN:0022-3018    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A 40-item therapeutic community questionnaire, developed from a survey of experts, was used to assess the treatment needs and expectations of a group of 30 hospitalized psychiatric patients. The patients' attitudes regarding an ideal ward atmosphere were compared to those, as measured previously by the identical instrument, of the treating staff. The results indicated that psychiatric inpatients found the therapeutic community modality consistent with their needs and expectations. However, staff and patients were divided in attitude toward the therapeutic community concept. The staffs definition of therapeutic community was broad and exceeded the principles of the therapeutic community experts. The patients desired a more conservative approach which combined respect and responsibility with a ward structure that was unambiguous and less democratic. Studies of ward atmosphere as well as premature termination in psychotherapy indicate that such conflicts in viewpoint between patients and staff might have detrimental effects on hospital outcome. A negotiated approach to inpatient treatment is suggested as a means to establish greater autonomy, growth in self-esteem, sense of responsibility, and increased trust on the part of hospitalized patients.

ISSN:0022-3018    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The present report describes the initial development of a comprehensive self-report inventory for assessing dysphorias and their response to treatment. A review of the clinical literature and experience with both outpatients and inpatients indicated that numerous dysphoric qualities commonly burden the ongoing lives of depressed patients. A set of 20 dysphorias was considered representative of these burdens, and each was interpreted in the form of three self-descriptive items. The resulting 60-item inventory was administered to 110 newly hospitalized depressed patients and 83 matched controls. The responses of the depressed patients were intercorrelated and submitted to principal component factor analysis with varimax rotation. This analysis produced 16 interpretable factors involving 54 items with significant factor loadings (≥.40). Each factor was clinically recognizable. Fiftythree of the 54 factorially significant items distinguished between the depressed and control groups in the required direction (p<.01). Factor cluster scores were prepared for each factor. Normative distributions for the 16 factor cluster scores are presented for the depressed patients. The ability of the cluster scores to distinguish between the depressed and control samples was examined by a multivariate discriminant analysis. A very high degree of separation was indicated, and the cluster scores of suicidal depression and burdening of others had the greatest discriminating potential. A traditional discriminant classification procedure using the 16 cluster scores indicated that the clusters discriminated between the two groups quite well, with 89.1 per cent of the subjects assigned to their appropriate group.

ISSN:0022-3018    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

This paper presents the results of a clinical investigation of 20 patients seen at the mental health consultation clinic of the University of Ife Health Centre in Nigeria with a psychiatric illness associated with study among Africans. The investigation conducted consisted of indepth exploratory interviews, drug-assisted in some of the patients, and its aim was to determine the chronological sequence of events leading to the appearance of symptoms, to identify specific psychological and physiological factors which seemed to have been significant in the precipitation of the illness, and to make a formulation regarding the pathogenesis of the illness.A number of psychopathogenetic factors were identified. These included a nervous predisposing personality, high emotional/motivational drive for achievement, psychostimulant abuse, and sleep deprivation. A dynamic formulation is proposed as to how these factors might be operating. It is acknowledged that the brain fag syndrome is a multifactorially determined illness and that there is a need for further studies to confirm the observations made in the present study and to identify other factors of pathogenetic significance.

ISSN:0022-3018    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Two methods were compared in determining the psychiatric diagnosis of 62 drug abusers applying for treatment: a) research associates using the Schedule for Affective Disorders and Schizophrenia (SADS) interview and the specified Research Diagnostic Criteria (RDC); and b) psychiatrists using open-ended interviews and making diagnoses based on the American Psychiatric Association's Diagnostic and Statistical Manual, Third Edition (DSMIII). On the basis of the SADS/RDC, 84 per cent, and on the DSM-III, 53 per cent of the drug abusers met the criteria for some current or past psychiatric disorder outside of the category of substance abuse disorders. Using an unstructured interview and the DSM-III, psychiatrists were less likely than research associates using the SADS/RDC to detect nonopiate substance abuse, depressive disorders, or anxiety disorders.To investigate the sources of diagnostic disagreement in the two most prevalent categories, drug use disorders and depressive disorders, reliability data based on the SADS/RDC were used. The results of this analysis suggest that use of a structured interview will enhance a clinician's reliability and thoroughness in detecting a substance use disorder. However, in diagnosing depressive disorders, use of a structured interview did not improve the fair but unacceptable level of diagnostic agreement noted between the SADS/RDC and DSM-III methods. This finding, possibly indicative of lability of moods in our sample drug abusers, points to the need for multiple assessments over time if affective disorders are to be reliably diagnosed in this population.

ISSN:0022-3018    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Among 97 chronic marijuana users, 9 per cent were found to have had multiple life problems as a consequence of their marijuana use when evaluated during a 5-year follow-up study. Operationally defined criteria for marijuana abuse are presented which are analogous to criteria commonly used in diagnosing alcoholism. These criteria identified marijuana abusers who manifested many problems from marijuana use, including fighting, panic attacks, and traffic tickets. This was in contrast to the majority of the chronic users who did not have multiple complications from tneir marijuana use. The marijuana abusers had used marijuana more frequently, had used greater amounts of marijuana, and had begun using it at an earlier age than nonabusers. A high rate of alcoholism was found in the abusers but was not statistically greater than in nonabusers. The objective criteria presented here offer a method for simple, prompt evaluation of potential problems from marijuana use.

ISSN:0022-3018    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The onset and evolution of symptoms were studied in a female patient with a history of recurrent depressive psychoses. In each episode, her psychotic decompensations were characterized by an orderly and progressive sequence including similar psychological or somatic precipitants, mounting anxiety, nystagmoid eye movements associated with panic, unfolding delusions, and olfactory hallucinations, culminating in a complete psychotic regression. The evolving sequence repeated during each episode in the present case is compared with that of a similarly stereotyped progression of symptoms in temporal lobe and Jacksonian seizures. Kindling is suggested as a model relevant to the understanding of both epilepsy and the functional psychoses. Detailed observation of the evolution of symptoms during psychotic episodes may provide important clues to the underlying pathological anatomy and physiology of psychotic illness.

ISSN:0022-3018    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Theformof criminal actions by young adult men was analyzed for evidence of symptoms indicative of dysfunctioning of the frontal lobe system (FLS), which myelinates late. The inability to switch the principle of action (POA) appropriately during an ongoing activity, when intervening circumstances call for such a switch, is one of the most characteristic signs of FLS dysfunction. The other major sign, the inability to plan, is apparently outgrown during childhood. Some criminal persons seem to show such an inability to switch POA, according to our clinical observation. It is hypothesized that there exists a subgroup of criminals who are unable to switch POA within a heirarchy of principles, and that they will be revealed by the already established Trail Making Test B (TMT-B), and by the new brief clinical Narratives Test (NT).The test results on 30 criminals corroborate the hypothesis. On the Narratives Test, 36 per cent, and on the Trail Making Test-B, 33 per cent of young adult men charged with criminal acts (serving sentences of up to 2 years) demonstrated specifically immature action behavior indicative of FLS dysfunctioning. There is a significant positive association (π= .68,p<.001) between the performance on the two tests.Probable etiological factors include a developmental lag in the myelinization of the frontal lobes, such as is associated with deprivation of practice in their functions; however, pathology, particularly due to trauma, has yet to be ruled out.

ISSN:0022-3018    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1980

数据来源: OVID