摘要:

Elementary aspects of the usefulness and impact of chaos theory to an understanding of schizophrenia are discussed. In addressing the question ‘Is there chaos in schizophrenia?’, attention is limited to schizophrenic psychosis. A differentiated view of chaos as metaphor, analogy and mathematical/physical concept is presented with emphasis upon how the latter may apply to empirical knowledge of schizophrenic psychosis. The typical behavior of both psychotic schizophrenic patients and general chaotic systems, and the dynamical analysis of time-series data extracted from such systems, are reviewed. A general hypothesis connecting chaos and schizophrenia is introduced and analyzed. Arguments are provided in favor of the hypothesis at sociological, psychological, and biological scales of manifestation. This makes possible a model-independent ‘chaos theory approach’ to schizophrenia and the criteria necessary to test it. Some consequences of this approach are briefly considered. The original question is rephrased with the technical language of chaos theory: ‘Are chaotic attractors diagnostic markers for schizophrenia?’ or ‘Is schizophrenia a dynamical disease?’. A few implications of viewing schizophrenia as a dynamical diseas

ISSN:0254-4962    

DOI:10.1159/000284713

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The reliability and usefulness of the Scale for Assessment of Thought, Language and Communication was evaluated in a group of psychotic in-patients. A very high inter-rater reliability (0.75–1.0) and an optimum rate-rerate reliability (0.50–1.0) were found on the individual items of the scale as well as the global rating. Since the scale has a good scope in different clinical and research settings, it was necessary to evaluate its reliability at a place other than where it originated. This study confirms its usefulness in the field of both clinical practice and resea

ISSN:0254-4962    

DOI:10.1159/000284714

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Thirty-nine relatives of schizophrenic patients, who had been rated as high on Expressed Emotion (EE) during the patients’ admission for an acute episode, were re-rated on EE 9 months after discharge from the index admission. Electrodermal activity was recorded from the patient during a 15-min period when the relative was absent and a similar period while the relative was present. Recording took place during the index admission and at a 9-month follow-up. A comparison was made between those patients whose relatives remained high EE at follow-up (Stables) and those whose relatives change to low EE (Decreasers). No differences were apparent between these two groups, however, differences were found within groups. At admission both groups showed an increase in electrodermal measures from the relative-absent period to the relative-present period. At 9-month follow-up, the Stables still exhibited this direction of change, whereas the Decreasers showed a decrease in electrodermal activity between these period

ISSN:0254-4962    

DOI:10.1159/000284715

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Of a large sample of patients with paranoid psychoses consecutively admitted to the Psychiatric Department, University of Oslo, during a period after World War II, 10 patients (6.3%, 9 women and 1 man) became ill through accusations of unpatriotic conduct during the war. The psychosis seemed precipitated in connection with legal procedures against the patient in 3 cases, and against close relatives in 2 patients. In 2 cases mixed precipitating events were present, while the psychosis in 3 cases had a connection with the woman being intimate with occupation soldiers. Discharge diagnosis according to DSM-III was schizophrenia (n = 2), schizophreniform disorder (n = 4), schizoaffective disorder (n = 1), major depressive disorder (n = 1), mania (n = 1), and atypical psychosis (n = 1). The patients have been followed up twice, with a mean 31 years of observation. Course and outcome varied, mostly according to the diagnosis. Most patients had a favorabe global outcome, although they had a tendency to keep up their social isolation. None of the patients felt they had done anything wrong or regretted their behavior during the war.

ISSN:0254-4962    

DOI:10.1159/000284716

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

A sample of 46 schizophrenic patients (26 men and 20 women) from a night clinic (N subjects) with an average age of 21.7 years at the time of first manifestation of the illness and a sample of hospital inpatients (H subjects) matched for diagnosis, sex, and age were followed up from 1971/1973 to 1983. The average age of the patients in 1983 was 40 years. The course of the illness and the pattern of hospitalization were investigated by personally questioning each patient and by scrutinizing all the case history records and other relevant documents; for each clinical cycle of illness, consisting of an overt phase followed by a quiescent interval, a case control sheet was filled out. The duration of illness was 18 years for the N subjects and 15 years for the H subjects. Longitudinal analysis of these years of illness in both patient samples showed a marked decrease in the number and duration of overt phases and stays in hospital, but a progressive aggravation of residual symptomatology during quiescent intervals and a progressively decreasing ability to work and earn a living. Covariance analysis (multiple classification analysis) with four covariables (age at first manifestation of the illness; residual symptomatology during quiescence in the first 4 years of illness; duration of overt phases in the first 4 years; length of hospital stays until actual or fictitious admission to the night clinic) showed no significant differences between the course of the illness in the 2 patient samples, but it did reveal a significantly greater reduction in the night clinic patients’ total duration of hospitalization, so that in their case the night clinic evidently served as a substitute for hospital treatmen

ISSN:0254-4962    

DOI:10.1159/000284717

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The present study tried to discriminate acute (n = 25) and chronic schizophrenics (n = 25) from borderline patients (BLP; n = 30) on the basis of deviant verbalizations as assessed by the Holtzman Inkblot Technique (HIT). A 30-card version of the HIT was used. It was possible to separate BLPs and schizophrenics with quite good results: 77% of the BLPs, 80% of the acute schizophrenics and 92% of the chronic schizophrenics could be classified correctly based on the less severe deviant verbalizations (DVs) which were more frequent in the BLPs and based on the most severe forms of DVs, i.e. Incoherence, neologism and Perseveration (which were more frequent in the schizophrenic patients). Furthermore, it could be demonstrated that BLPs can be separated from neurotics using the 30-card version of the HIT, the resulting scores being nearly as high as those on the basis of the 45-card version. In another comparison, neurotics (n = 30) were discriminated from normals (n = 35) using the less severe DVs, which were more frequent in the neurotics: here, 74% of the normals and 73% of the neurotics could be classified correctly.

ISSN:0254-4962    

DOI:10.1159/000284718

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Psychopathological reactions to fatherhood are probably not so infrequent as they would seem from psychiatric literature. In a material of paranoid psychoses, impending or newly established fatherhood was considered the main precipitating factor in 4 patients (i.e. 2.4%), compared with 7% of the female psychoses precipitated by pregnancy, childbirth or nursing. Two of the men were batchelors, insecure and inhibited, feeling compromised or helpless in the new situation. Two men were married, passive, avoidant in their personality, strongly dependent on their wives. The course and outcome varied according to the diagnoses; 2 cases having a favorable and 2 an unfavorable course and outcome. Physicians, including psychiatrists, should bear in mind that fatherhood is a possible precipitating factor for paranoid psychoses in male patients.

ISSN:0254-4962    

DOI:10.1159/000284719

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The influence of diurnal variations of mood (DVM) and sleep disturbances on treatment response was investigated in 42 patients with major depressive disorder (not SAD) under the treatment of either bright white light (2,500 lx) or dim red light (50 lx). We found only a slight influence in certain subscales of DVM and no influence of sleep disturbances. These results are discussed under a clinical point of view and with respect to phase shift theories of depressive disorders.

ISSN:0254-4962    

DOI:10.1159/000284720

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

To assess the structural stability of positive and negative symptom ratings, we rated 40 schizophrenic inpatients on the Brief Psychiatric Rating Scale (BPRS) and the Scale for the Assessment of Negative Symptoms (SANS) at medication-free baseline and after 4 weeks of neuroleptic treatment. Positive symptom variables consisted of six BPRS items, and the negative symptom variables consisted of the five SANS subscale global scores. On principal components analysis, a three-factor, oblique-rotated solution resulted, with a negative symptom factor, a positive symptom factor, and an unstable behavioral agitation factor. The pre- and posttreatment factor loading patterns were similar. The findings suggest that BPRS-positive symptom items and the SANS measure distinct clinical dimensions and that the construct is stable, as demonstrated by minimal structural change with time.

ISSN:0254-4962    

DOI:10.1159/000284721

出版商:S. Karger AG    

年代:1991

数据来源: Karger