摘要:

Previous studies have shown encouraging plasticity in some schizophrenic patients’ Wisconsin Card Sorting Test (WCST) performance while receiving detailed specific instructions on task and reinforcement. The present study examines the efficacy of a modified procedure for WCST administration that bound schizophrenic patients to use a conceptually driven cognitive strategy without any instruction or reinforcement. The schizophrenics’ results were also compared to those obtained with the same procedure from a matched control sample. By using this procedure, 63.2% of WCST schizophrenic poor performers dramatically improved their results. Schizophrenic poor performers who did not achieve remediation were of a younger age at onset and had more negative symptoms. This pattern was strictly associated with more perseverative errors on WCST that increased even more when the conceptually driven processing was forced. Our findings could have important implications for our understanding of the underlying cognitive deficit of the poor neuropsychological performance and allow the distinction of schizophrenic subtypes who show peculiar features that probably reflect a different pathophysiology and would potentially benefit from different modalities of treatment and rehabilitat

ISSN:0254-4962    

DOI:10.1159/000285030

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Given the close historical relationship between schizophrenia and dissociative disorders, namely multiple personality disorder, we assessed 27 ICD-10 diagnosed schizophrenic inpatients for dissociative symptoms using the German version of the Dissociative Experience Scale and compared them to a nonclinical control group matched for gender and age. Other self-report instruments covering general psychopathology, and an expert rating on the predominance of positive or negative schizophrenic symptoms, were also administered. Schizophrenic patients have significantly more dissociative symptoms than controls. Moreover, patients with a plus type of schizophrenia show significantly higher levels of dissociation than patients mainly exhibiting less productive symptoms. However, dissociative phenomena are only significantly correlated with delusions and hallucinatory behavior, and do not show any correlation with other positive symptoms of schizophrenia. Severe dissociative psychopathology is also associated with impairment in other psychopathological dimensions. The implications of these findings are discussed with regard to the theory of dissociation, the differential diagnosis between schizophrenia and dissociative disorders and a possible contribution of dissociative phenomenology to the clinical heterogeneity of schizophrenia.

ISSN:0254-4962    

DOI:10.1159/000285031

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The systematic detailed clinical studies regarding bodily complaints in schizophrenics are relatively few. This paper focuses on the longitudinal courses of hypochondriac-cenesthopathic (H-C) symptoms in schizophrenia. From a group of 183 subjects meeting DSM-III-R criteria for schizophrenia, who were observed for at least 5 years, 81 patients with H-C symptoms were selected. The pattern of the appearance of their H-C symptoms was investigated. There was a near equality in the incidence of acute type and chronic type H-C symptoms. This was also the case for the early and tardive types. On the other hand, the complex type was more frequent than the simple type. When the H-C symptoms occurred in the acute stage, there existed accompanying symptoms as a rule. Among the six clinical courses(subtypes) of H-C symptoms, the most frequent was the acute-complex-early type, the least frequent was the chronic-simple-early type.

ISSN:0254-4962    

DOI:10.1159/000285032

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Subjective experiences (SEs) in schizophrenia are sometimes neglected in operationalized diagnostics because schizophrenic patients often distort reality. Nevertheless, they sometimes report the peculiar nature of their experiences in a form of SEs. Two cases are presented to show the characteristic forms of SEs, which represent awareness of disturbed experiences of reality. They correspond to SEs in the third grade (SE3s), while SEs in the first grade consist of general subjective symptoms regarding mental and nervous conditions and those in the second grade indicate awareness of deficits in mental functions. Showing an intermediate nature between real and imaginary, SE3s as well as first-rank symptoms perplex patients in the initial stage of the illness. Labeling SE3s as symptoms might successfully reduce the distress and anxiety of patients and be helpful in introducing them to long-lasting pharmacotherapy.

ISSN:0254-4962    

DOI:10.1159/000285033

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We report the case of a 35-year-old man suffering from otosclerosis and unilateral auditory hallucinations as well as other psychotic symptoms that disappeared completely after surgery for otosclerosis. The patient experienced a change of his acoustic sensations: the tinnitus was transformed into music, and 4 months later the music changed into commenting and imperative voices. However, on both occasions the transformation from one form to another occurred during an alcohol withdrawal syndrome characterized mainly by vivid visual hallucinations. Some theoretical considerations on hallucinatory predisposition, development of hallucinations, and psychological factors determining psychotic symptoms will be discussed.

ISSN:0254-4962    

DOI:10.1159/000285034

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In a sample of 80 mothers of psychotic patients from Southwestern Greece, 85 % entertained strong metaphysical beliefs of a magico-religious nature concerning the cause of psychotic illness. This finding was more prevalent among the less educated. A comparable number of patients with magico-religious delusions had mothers who attributed their children’s illness to supernatural causes, a finding suggesting that family beliefs and attitudes influence the content of the patient’s delusional thinking. Resorting to exorcism or magic, alone or in combination with formal psychiatric help, was very common. Awareness of lay beliefs about psychosis and the proper handling of such beliefs by the treating psychiatrist may facilitate cooperation with the patient and his family, increasing the prospect of a more favorable outc

ISSN:0254-4962    

DOI:10.1159/000285035

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Twenty-two patients with a diagnosis of schizophrenia according to DSM-III-R and ICD-10 criteria, for whom the long-term courses of illness were all well documented, were classified by 4 independent investigators using Leonhard’s classification of endogenous psychoses. With regard to the large nosological groups of cycloid psychoses (including the subtypes of anxiety-happiness psychosis, confusional psychosis and motility psychosis), of unsystematic schizophrenias (including the subtypes of affect-laden paraphrenia, cataphasia and periodic catatonia), and of systematic schizophrenias (divided into systematic catatonias, systematic paraphrenias, and hebephrenias), it was possible to reach a high level of agreement in the diagnoses, representing a Cohen kappa coefficient of 0.82 and 0.89, respectively. In only 2 out of 22 patients were discrepancies observed in the assignment to the above-mentioned groups. This clearly shows the high reliability of Leonhard’s classification, which allows a differentiated diagnostic and prognostic judgement of schizophrenic psychoses according to the DSM-III-R and ICD

ISSN:0254-4962    

DOI:10.1159/000285036

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Forty-five outpatients interviewed by using the Structured Clinical Interview for DSM-III-R, Outpatient version and diagnosed as obsessive-compulsive disorder were evaluated in terms of form and content of obsessions and compulsions. Obsessive-compulsive phenomena were classified according to a system proposed by Khanna and Channabasavanna. Depressive disorder was the most common comorbid diagnosis found in 73.2% of patients. The most prevalent obsession themes were daily activities and dirt contamination themes (64.4 and 53.3%, respectively). Religious themes were infrequent (11.1 %) in the sample and Muslim culture seemed not to have a prominent impact on phenomenology of the disorder.

ISSN:0254-4962    

DOI:10.1159/000285037

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

There is substantial evidence of a significant correlation between life events (LE), socio-environmental factors and the occurrence of psychopathological disorders. This study investigates the possible influence of these variables on depression in children between the ages of 7 and 12 years. We have interviewed parents of 15 depressed and 30 control children, and used the Coddington lists of LE. From a statistical analysis of the response it emerged that what characterises depressed children is a higher number of undesirable and uncontrolled events in the recent past and a lower parent educational level. A few events in particular appear to be strong risk factors. The event ‘Outstanding personal achievement’, much more represented in the control group, seems to be a strengthening event and a stress modera

ISSN:0254-4962    

DOI:10.1159/000285185

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0254-4962    

DOI:10.1159/000285186

出版商:S. Karger AG    

年代:1997

数据来源: Karger