摘要:

In 1950 López Ibor described a nosological entity called anxious thymopathy (‘timopatía ansiosa’). The origin of his description was the observation of recoveries of neurotic patients during psychotherapy which were not directly related to the psychodynamic process. Such a spontaneous fading of neurotic anxiety was suspected to be of an endogenous character. This led to the description of a vital anxiety, a mood disturbance similar to Schneider’s [1950] vital sadness present in endogenous depressions. Normal and pathological (vital) anxiety were thought to be different, vital anxiety having a biological origin, so that biological treatment was applied to it. In the course of the years, López Ibor came to the conclusion that anxious thymopathy was not an independent nosological entity, rather that vital (also called endothymic) anxiety was an element present in all forms of neurotic disorders integrated with personality and biographical factors. This research led to the concept of neuroses as mood disorders [López Ibor, 1966].

ISSN:0254-4962    

DOI:10.1159/000284226

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

A representative sample of 908 hospital records covering admissions between 1920 and 1982 for depression was analyzed in order to assess the switch rate to hypomania/mania. The results are the following: (1) Over the decades of this century there has been a substantial increase in hospital admissions in Zurich for both depression and mania, but the ratio remained constant. (2) Due to this increase the clinicians can observe more spontaneous switches from depression to mania, which favors the assumption of a causal relationship when treatment is applied. (3) 64 of the 908 patients (7.0%) admitted for depression switched to hypomania or mania. Hypomania was observed in 48 cases (5.3%) and mania in 16 cases (1.7%). (4) The analysis of predisposing factors to a switch has resulted in a simple finding. Bipolar patients (including schizomanics) have an 8-fold higher switch rate (28.9%) than the unipolars (3.7%). The switchers are equally distributed over the two sexes and do not differ in the frequency of a family history of affective psychoses, schizophrenia, schizoaffective disorders, or suicide. (5) Bipolarity correlates positively with ‘higher number of previous episodes’, with ‘readmitted’ and with ‘switch’. Therefore, studies selecting readmissions [Lewis and Winokur 1982] overrepresent switchers purposely. (6) A loglinear analysis together with some univariate strategies show that over the decades (from 1920 to 1982) there was no significant increase in switches of unipolar or bipolar patients. In conclusion, there is no evidence for a treatment-induced switch. This result is in line with Prien et al. [1973] and with Lewis and Winokur [1982].

ISSN:0254-4962    

DOI:10.1159/000284227

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

In a prospectively constructed study 29 patients with cardiac phobia were examined prior to hospitalization and again after a follow-up period of 2.5 years. When first examined a high percentage (82.8%) of these patients showed a depression in addition to suffering from anxiety symptoms. The findings demonstrate that an additional affective disorder constitutes a prognostically unfavorable factor, particularly in the case of a ‘secondary’ depression. Compared with patients suffering from a ‘primary’ depression these patients more frequently exhibited a chronic course of the depression (at the 1 % level of significance) and had a significantly smaller chance of being free of cardiophobic complaint (p = 0.002) at the last examination. An attempt to categorize cardiac phobia according to DSM-III revealed that the present classification does not provide a satisfactory solution. The frequent presence of a depression in these patients strongly indicates that a clarification of the controversial opinions which continue to exist with regard to a linkage between depressive disorders and anxiety disorders would need further research; in such studies it would seem preferable not to employ a hierarchic classification procedure, in view of the fact that all cross-sectional psychopathological symptoms should be taken into consideration. Our findings also point to the advisability of paying closer attention to course traits in studying this question.

ISSN:0254-4962    

DOI:10.1159/000284228

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

While psychogenic aspects in ulcerative colitis have been comprehensively studied, much less attention has been given to sequence and interaction of psychic and somatic factors in psychopathological description. Onset of schizoaffective and cyclothymic symptomatology in 20 ulcerative colitis patients proved to occur only after somatic manifestation. As later on organic and psychic relapse never occurred simultaneously, further discussion should be centered on two points: (1) Does schizoaffective cyclothymic axial syndrome occur separately from ulcerative colitis manifestation? (2) Or is there a common etiological, pathogenic base for both somatic and psychic symptoms?

ISSN:0254-4962    

DOI:10.1159/000284229

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The concept of neurotic depression was introduced in the early part of the 20th century. The concept has undergone many revisions, and recently was discontinued as a category in the DSM-III. In the past, neurotic depression was referred to as a nonpsychotic form of depression, a nonendogenous depression, as well as many other categories. The presence of various meanings has made it difficult to develop algorithms for neurotic depression; the findings substantiate the decision of the DSM-III not to continue the category of neurotic depression.

ISSN:0254-4962    

DOI:10.1159/000284230

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The author describes the 12-year history of a functional (endogenous) psychosis in a 25-year-old woman and the subsequent full social remission. The central symptom in the case history is the delusion that the patient has already lived through this life once. This delusion appears as the experience of reduplication, differing from that of déjà vu, based on mental automatism. It is accompanied by euphoria and the distortion of the future time perspective. The hypothesis of a disorder in the function of the limbic system arises as a possible pathophysiological explanation. Schizophrenic symptoms were absent and no defect was formed. This previously unknown syndrome presented by the use of the idiographic method may contribute to the widening of nomothetic nosological research.

ISSN:0254-4962    

DOI:10.1159/000284231

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The author discusses whether post-partum psychoses are to be considered as a clinical entity per se. The studies conducted in Lausanne seem to demonstrate that the authors of DSM III were correct in excluding this possibility – of all the patients with a post partum episode, 65% had one or several relapses without connection with the puerperium.

ISSN:0254-4962    

DOI:10.1159/000284247

出版商:S. Karger AG    

年代:1985

数据来源: Karger