摘要:

Clinical research has documented a bidirectional overlap between Tourette's disorder (TD) and obsessive-compulsive disorder (OCD) from familial-genetic, phenomenological, comorbidity, and natural history perspectives. Patients with Tourette's disorder plus obsessive-compulsive disorder (TD+OCD), a putative subtype, share features of both. The purpose of this exploratory study was to evaluate correlates of patients with TD, OCD, and TD+OCD to determine whether TD+OCD is a subtype of TD, OCD, or an additive form of both. Sixty-one subjects with TD, OCD, or TD+OCD were evaluated with the Structured Clinical Interview for DSM-III-R supplemented with additional modules. The three groups differed in the rates of bipolar disorder (p<.04), social phobia(p<.02), body dysmorphic disorder (p<.002), attention deficit hyperactivity disorder (p<.03), and substance use disorders (p<.04). These findings were accounted for by the elevated rates of the disorders in the TD+OCD group compared with the TD and OCD groups. These finding are most consistent with the hypothesis that TD+OCD is a more severe disorder than TD and OCD and may be more etiologically linked to TD than to OCD. These findings highlight the importance of assessment of the full spectrum of psychiatric comorbidity in patients with TD and OCD.

ISSN:0022-3018    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

This report on the Chandigarh Acute Psychosis Study examines the early course of affective disorders of acute onset in a developing country setting. Forty-one cases of acute onset affective disorder (17 depressive and 24 manic subjects) were assessed at intake and evaluated at selected intervals up to 1 year. The rates of recovery and relapse and episode duration were determined for both the depressive and manic groups, and the relationship between possible predictors of outcome and the duration of the index episode was examined. All subjects experienced full recovery within the 1-year period. At 1-year follow-up, 71% of depressive patients and 75% of manic patients demonstrated no symptoms or social impairment. For depression and mania, respectively, the mean episode duration was 14.2 and 10.2 weeks, and the rate of relapse was 18% and 21%. Overall, these outcomes are considerably more favorable than in comparable studies of affective disorders in developed settings. Our findings suggest that acuteness of onset may be a major prognostic factor in predicting the course of affective disorders.

ISSN:0022-3018    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Though social skills have been identified as an independent construct, recent studies have revealed that schizophrenic symptomatology and social skills are interrelated. The nature and extent of this relationship, however, are far from clear. To address this issue, we examined 33 schizophrenic outpatients participating in a rehabilitation program for an average of 10 months. The object of this study was to investigate to what extent behavior can be predicted by symptomatology and social skills, and whether social skills have a significant effect on outpatients' behavior independently of schizophrenic symptoms and vice versa. Regression analyses revealed good prediction of outpatients' behavior by conceptual disorganization and disorder of relating from the PANSS and, to a lesser degree, social skills. After having eliminated the influence of psychopathology on social skills and behavior, social skills variables still had significant predictive value for social competence, social interest, and irritability. These findings imply specific contributions of both symptomatology and social skills to future behavior of chronic schizophrenic outpatients.

ISSN:0022-3018    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The desire to acquire or increase financial compensation for a psychiatric disability is widely believed to introduce a response bias into patients' reports of their symptoms and their work performance. The hypothesized effects of compensation-seeking in inhibiting improvement from treatment are examined. Data from outpatient (N= 455) and inpatient (N= 553) programs for the treatment of posttraumatic stress disorder and associated disorders in the Department of Veterans Affairs were used to compare outcomes for veterans who were and were not seeking compensation. Outcome was measured as pre/post improvement in symptoms and work performance over the course of 1 year after the initiation of treatment. No compensation-seeking effect was observed among outpatients, but a significant effect was found for some inpatients. The effect for inpatients was manifested essentially by patients in a program type which was designed to have an extremely long length of stay, thus triggering a virtually automatic increase in payments. Like outpatients, inpatients in programs with a moderate length of stay did not manifest a compensation-seeking effect on improvement. Although not permitting a definitive explanation, the preponderance of the evidence favors the overstatement of symptoms rather than either the severity or the chronicity of the disorder as the most likely explanation for the compensation-seeking effect that was observed. For patients treated in standard outpatient and short-stay inpatient programs, compensation does not seem to affect clinical outcomes adversely.

ISSN:0022-3018    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The aim of this study was to compare the wives of Australian soldiers who had been imprisoned during World War II (POWs) with a control group of non-POWs' wives and also to compare the POWs and non-POWs themselves in respect to several psychological and family life characteristics on which differences might be expected to arise from the long-term effects of imprisonment. A random sample of 145 of these veterans and their wives completed several self-administered mood and family life scales, an inventory of somatic symptoms, questions about the impact of the war on the veteran in the postwar decades, and several social background questions. The POWs themselves were more depressed and reported more somatic symptoms and a greater postwar impact of the war than the non-POWs. However, these differences were not accompanied by concomitant differences among their wives. There was some evidence of an influence of the POW's mood on his wife's mood in significant correlations between husbands' and wives' depression and anxiety scale scores in POW couples alone. Otherwise, there was very little indication that the POW experience had any long-term effect on the marriage relationship as measured by the variables included in this study.

ISSN:0022-3018    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

We investigated the predictive effect of psychological defenses on the course of major depression in a subsample of psychiatric patients from a larger study. We tested the hypothesis that a group of eight defenses, associated with depression in previous research, would predict outcome of major depression. After an intake interview, 37 patients were rated on all DSM-III-R Axes, the SCL-90-R, and 28 defenses, using the Defense Mechanism Rating Scales. At 6-month follow-up interview, SCL-90-R and Global Assessment and Functioning (GAF) were redetermined on 34 (92%), 16 of whom had major depression at intake. Overall Defensive Functioning (ODF) significantly predicted GAF at 6-month follow-up over and above initial level of global functioning and presence of a personality disorder. The group of eight defenses were identified more often (p=.068) in depressed patients who improved less than predicted by their initial functional status. The high adaptive level defense, self-observation, was identified more often in those who improved more than predicted by their initial status. Our findings support the theory of a hierarchy of defenses, and the mediating effects of specific low and high adaptive level defenses on the course of a major depressive episode. Further research should examine passive aggression, acting out, help-rejecting complaining, splitting of self-images, splitting of others' images, projective identification, projection, and devaluation in relationship to the onset, course, and treatment response of depressive disorders.

ISSN:0022-3018    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The prototype model has been suggested as an alternative to the traditional categorical model of classification. A series of studies have been performed by Blashfield and his colleagues to identify cases that are prototypic of the DSM-III-R personality disorders. A case that led to diagnostic disagreement was based on the 1985 German movieZuckerbaby(“Sugarbaby”). In earlier research, the most popular diagnosis for the case was dependent personality disorder, although schizoid, schizotypal, and borderline were almost as frequent. In the current study, the case was presented in cumulative steps to 93 randomly selected clinicians. After each step was presented, clinicians were asked to diagnose the case. With the stepwise presentation format, borderline personality disorder was the most common diagnosis. Chi-square analysis showed that, if clinicians had chosen borderline as a diagnosis by step three, they were likely to keep this decision for the rest of the case. A social-cognitive model was used to explain these results.

ISSN:0022-3018    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1998

数据来源: OVID