摘要:

No single cause is likely to be of supreme importance in the etiology of Anorexia nervosa, but personality factors continue to attract researchers' attention. This paper is a review of evidence on the subject, covering psychometric, interview, and projective investigations. Significant methodological problems exist in the literature, but do not suffice to explain findings of obsessive and inhibited features intermixed with impulsivity, and a high prevalence of defined personality disorders. Adding to previous work by Cloninger and Strober we suggest that vulnerable individuals are temperamentally incapable of coping with the challenges of adolescence by anything other than repetitive, reward seeking behavior. In a social environment that greatly emphasizes thinness as a criterion for self‐worth and success, the outcome may be Anorexia nervos

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05809.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05875.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05840.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05876.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Although maintenance neuroleptic treatment reduces the risk of relapse in schizophrenia, that risk remains substantial. Maintenance neuroleptics following first schizophrenic episodes are valuable in reducing the relapse rate but may be associated with occupational disadvantage. In first episodes the early introduction of neuroleptic treatment may be important in later reduction of relapse rate. Response to placebo during a psychotic episode does not predict sustained wellbeing without neuroleptics. Long‐term follow‐up indicates that some schizophrenic patients will remain relapse‐free and that there are patients who remain well without neuroleptics, but it is not possible to select those for whom prophylactic neuroleptics will not reduce the risk of re

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05858.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

From the time of Hippocrates, the problem of persistently depressed mood has been recognised clinically. The first modern description of dysthymia was by Kahlbaum. who distinguished it from the fluctuating mood of cyclothymia. However, there has been continuous difficulty in separating low‐grade depressive disorder from an abnormal personality trait. DSM‐II defined chronic depression as a personality disorder, but Akiskal subsequently reclassified it as a mood disorder. In DSM‐III, all chronic depression lasting more than two years was defined as ‘Dysthymic disorder’. DSM‐III‐R brought together dysthymic and cyclothymic disorders into an affective category. ICD‐10 dysthymia subsumes a number of categories which include recurrent depression of mood. The primary distinction between Dysthymia and Major Depressive Disorder is that Dysthymia is chronic, but symptomatically less severe. A number of unresolved problems remain in relation to its nos

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05877.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The first central pharmacodynamic action of chlorpromazine to be described was sedation without narcosis. The antipsychotic action and extrapyramidal symptoms were observed later. Sedation can be separated into nonspecific sedation (drowsiness, somnolence) and specific sedation (psychomotor inhibition and psychic indifference). Both types are parts of the clinical profiles of classical neuroleptics. The sedative properties of neuroleptics may contribute to the overall efficacy in the treatment of psychotic patients, depending on the clinical situation. In most patients, however, sedation is only needed for a short period, or not at all. The drug induced sedation may adversely affect the patients' well‐being and functional capabilities. The term neuroleptic‐induced deficit syndrome (NIDS) has been coined to focus attention on the adverse mental effects of neuroleptics. NIDS still needs to be properly defined and to be differentiated from the deficit syndrome of schizophrenia and postpsychotic depression. Assessment methods are needed to establish the incidence and prevalence of NIDS, to evaluate the importance of NIDS in the overall treatment outcome in psychoses and to facilitate development of better antipsychotic age

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05825.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

In addition to other factors such as type and duration of treatment, patient‐ and illness‐related variables and other psychosocial features, side effects are known to exert a significant influence on the compliance with antipsychotic treatment. This has been demonstrated for extrapyramidal motor side effects and akathisia, sedation, weight gain and sexual dysfunctions. Other adverse events interfering with the patients' social roles also interfere with the patients' willingness to comply with treatment. It is important to acknowledge this not only in the acute treatment of schizophrenia but especially during maintenance and prophylactic treatment. Compliance can be considerably improved by a) adequately informing the patient about the risks and nature of side effects and b) by recognizing and treating side effects, since prevention of adverse events is not easily achieved. An underestimation of the influence of side effects on compliance will often lead to treatment failures that are erroneously attributed to treatment resista

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05859.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Dysthymic disorders are a major category among the mood disorders but the concept is not widely understood in many parts of the world, where it is often considered as a new name for familiar categories, such as neurotic depression, depressive personality or even neurasthenia (which is still a frequent diagnosis in many Far East countries). The purpose of this chapter is to compare the definitions of Dysthymic Disorder that are contained in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM‐IV) with the definitions in the International Classification of diseases Tenth Edition (ICD‐10). The two systems are in fact quite congruent both in their overall approach and their specific contents; this has resulted from the fact that many of the DSM‐IV Task Force and Work Group members have participated in the ICD‐10 expert committees and many of the ICD‐10 experts have been advisors to the DSM‐IV revis

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05878.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Acute extrapyramidal syndromes (EPS) are one of the major limitations to effective neuroleptic treatment. These disorders have both motor (objective) and mental (subjective) aspects, which must be considered in any evaluation and differential diagnosis of treatment‐related side effects. The disorders of akathisia, acute dystonia and parkinsonism have unique features that are best understood in the context of a careful assessment of patient characteristics, drug factors and temporal aspects. Though acute EPS are commonly explained on the basis of dopamine D, receptor antagonism, data from several lines of study raise important questions about this hypothesis. The roles of receptor subtype specificity, brain region selectivity and ratios of different receptor subtype antagonism are discussed. New and novel antipsychotic drugs with low rates of EPS are important clinical advancements that will increase patients' ability to participate in therapy and rehabilitation and thus improve their quality of lif

ISSN:0001-690X    

DOI:10.1111/j.1600-0447.1994.tb05826.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY