摘要:

Abstract:A psychophysiological hypothesis of the dream process during REM sleep called “a sensory image‐free association hypothesis” is proposed. It is assumed that a state with a sustained EEG pattern of drowsiness (non‐REM stage‐1) and muscle atonia produces a stream of disorganized and vague thinking as a background mentation during the REM sleep. The phasic excitation of the brain occurring concurrently with the burst of rapid eye movements (REMs) activates the hippocampal‐neocortical memory system and draws out sensory images from the memory reservoir of the brain. The dreamer makes a freely organized association about the successive sensory images and makes up a dream story. This hypothesis is compatible not only with the recent neurophysiological findings but also with traditional psychological interpretation of the dr

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00815.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:The Draft of “ICD‐10, Chapter V, Clinical Descriptions and Diagnostic Guidelines” was tested in a multicenter field trial in Japan. We have previously reported good results in suitability, confidence and ease of diagnosis, and adequacy of descriptions of the Draft. In this paper, the interdiagnostician reliability of the Draft is reported. Among the two‐character categories, “Schizophrenia, Schizotypal States and Delusional Disorders (F2)” (ICC = 30) and “Mood Disorders (F3)” (ICC =.80) proved reliable. “Neurotic, Stress‐Related, and Somatoform Disorders (F4)” was less reliable (ICC =.65). The ICCs of the 17 major categories (three‐character code) and the 21 subcategories (four‐character code) were also calculated. The finding that in Japan subtyping schizophrenia with ICD‐10 was more reliable than that made using DSM‐III Diagnostic Criteria supports the need to use a descriptive version of ICD‐10 as the basis for several versions serving different purposes. The nature of disagreements with unreliable categories was also investigated. The results are discussed with special reference to the changes in the final Draft of Chapter V, which contained a feedback of the results from field

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00816.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:The authors attempted to classify panic disorders into four types according to a clinical course and accompanying neurotic or depressive symptoms. The characteristics of each type are as follows; type I: a single panic attack is the only symptom, type11: only panic attacks occur frequently without any accompanying neurotic or depressive symptoms, type III: a recurrence of panic attacks and the gradual development of neurotic symptoms, such as anticipatory anxiety, generalized anxiety, agoraphobia, or hypo‐chondriasis, type IV: depressive symptoms develop in the course of recurring panic attacks. Type IV is further divided into three subtypes. Type IV‐1: depressive symptoms develop secondary to panic attacks and major depression later coexists with panic disorder. Type IV‐2: panic disorder continuously changed into major depression. Type IV‐3: panic attacks and depressive symptoms are seen independently. The most common types are type III and type IV‐1, and seem to be a core group of the panic disorder. Typical cases of each type are presented and underlying psychopathology is

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00817.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:In a national random‐sample survey, the views of 1,069 practicing clinicians, including internists, surgeons and psychiatrists, on panic disorder were surveyed by using a series of questionnaires. In spite of a high rate of clinical experience and agreements on the symptoms among clinicians, the nature of this disorder, such as a common descriptive diagnosis, and the preferred treatment have not been agreed upon by the Japanese medical community. Furthermore, respondents were questioned as to the preferred treatment for panic disorder, but no treatment was regarded as critical by a majority of clinicians. It is concluded that because of the high potential patient population with panic disorder, clinical research that will provide more adequate diagnosis and treatment for this disorder is necessary in Japa

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00818.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:The effectiveness of a psychiatric day care program was assessed in terms of the outcome at discharge for 79 clients. One‐third of the clients were employed, either full‐time or part‐time (in case of students, at school), during the postprogram period of three months or more. Another one‐third left the program prematurely with or without exacerbation of psychotic symptoms. Clients having premature termination were significantly less adherent to outpatient clinic visits and/or psychotropic medkation. Family's understanding of and cooperation in the program were significantly less favorable in clients with early termination. The possible strategies for reducing the dropouts were di

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00819.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:We present here a case of Klinefelter's syndrome with epileptic psychosis. The patient was a 30‐year‐old male, who suffered from epilepsy for 23 years. He showed auditory hallucination, delusion of reference and delusion of grandeur. At present there are some cases of Klinefelter's syndrome with various psychiatric symptoms, but there are few cases of Klinefelter's syndrome with epileptic psychosis. These various neuropsychiatric symptoms of the present case are thought to be associated with a specific effect of chromosomal abnormality through the cerebral dysfunct

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00820.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:We have had experience in treating tardive Tourette‐like syndrome on a chronic schizophrenic patient. The patient was a 38‐year‐old woman. A diagnosis of schizophrenia was made in 1971 and she received repeated medications for 17 years. In 1989, she began to show vocal tic with coprolalia and motor tic. The medications were haloperidol 18 mg, zotepine 200 mg, levomepromseine 100 mg, biperiden 3 mg and nitrazepam 10 mg at the beginning of Tourette‐like syndrome. We have tried to change the medications but this tardive Tourette‐like syndrome continued to hang on. However, the symptoms gradually improved after a change in drugs; cessation of biperiden 3 mg and the administration of clonazepam 3 mg. The present case suggested that tardive Tourette‐like syndrome might be a subtype of neuroleptic‐associated tardive syndromes which might be treated wi

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00821.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:Using the regression evaluation scale, 25 schizophrenic patients were classified into three groups of Dissolution/autism (DAUG), Dissolution +attachment (DATC) and Non‐regression (NRG). The regression of DAUG was of the type in which autism occurred when destructiveness emerged, while the regression of DATG was of the type in which attachment occurred when destructiveness emerged. This suggests that the regressive phenomena are an actualized form of the approach complex. In order to determine the factors distinguishing these two groups, I investigated psychiatric symptoms, mother‐child relationships, premorbid personalities and therapeutic interventions. I believe that these factors form a continuity in which they interrelatedly determine the regressive state. Foremost among them, I stressed the importance of the mother‐child relatio

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00822.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:This is a description of a computerized tomographic study of 45 non‐delusional depressed, 29 delusional depressed patients and 77 neurotic control subjects. The cerebral atrophy ratio (CAR) on the three different slices and the ventricular ratio (VBR) of the anterior horn and the body of the lateral ventricles were calculated, analyzed and compared using Student's t test. Compared to the control subjects, the non‐delusional depressive patients had greater CAR values than the controls but there were no significant differences of VBR values between the two groups. The patients with delusional depression had significantly larger CAR and VBR avlues than the non‐delusional depressives and control subjects. The delusiond depressives had greater brain atrophy than the non‐delusionals and it was suggested that organic cerebral factors may have etiological significance in the depressions, especially the delusional depr

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00823.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Abstract:A 19‐year‐old patient with I female appearance visited our department for treatment of bulimia nervosa. The patient had primary amenorrhea. Chromosomal studies revealed a 46XY karyotype, and the plasma testosterone level was in the range of normal adult males. The patient was diagnosed as having testicular feminization syndrome. The psychological backgrcund, such as severe anxieties concerning her body, was behind the eating disorders. Examinations revealed intraabdominal testes. A bilateral gonadectomy was performed, and no androgen receptors were detected in the suprapubic skin. After the gonadectomy, the patient's mental status became much more stable, and the ability to control her eating pattern was restored. Testicular feminization with bulimia nervosa is rare in Japan. The importance of mental support and a careful follow‐up to people with testicular feminization is being disc

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1992.tb00824.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY