摘要:

Transsexualism is a challenging entity posing diagnostical, etiological, ethical and moral questions with no general consensus of opinion and a controversial management policy. The present article tries to deal with these questions by drawing a parallel with another psychiatric syndrome in which there is also a disturbance in body image, namely anorexia nervosa. The parallel is at the level of clinical presentation, psychodynamic etiology and their common socioepidemic dimension.

ISSN:0254-4962    

DOI:10.1159/000284965

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The production of association word to stimulus words, which was found to be correlated with conceptual disorganization, as clinically measured by the Brief Psychiatric Rating Scale, was developed as a quantifiable measure of formal thought disorder. Associative word production in patients with affective psychoses (acute episodes of mania or schizoaffective disorder) was found to be higher in a statistically significant manner than in patients with acute episode of paranoid schizophrenia. The production of associative words in the two groups of acutely psychotic patients was significantly higher than in normal subjects, unipolar depressed, or residual schizophrenic patients. These quantitative differences reflected qualitative differences in the pattern of the production of word associations. Indeed, while patients with paranoid schizophrenia showed a sinusoidal-like type of oscillation in associative word production, patients with affective psychoses were characterized by exponential-like phases in associative word production. Associative word production may thus serve as a simple quantitative test for differentiating formal thought disorder in acute psychoses between patients with mania and patients with schizophrenia.

ISSN:0254-4962    

DOI:10.1159/000284966

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Compared to the general population, one consistent finding in schizophrenia research is a significant surplus of schizophrenic births in the winter/spring months. There is little evidence that this is attributed to statistical artefacts. The ‘harmful effects’ hypothesis offers the most plausible explanation for this phenomenon. Exogenous harmful effects, predominant during the cold season, may affect the developing immature fetal brain and thus constitute some of the factors predisposing to schizophrenic breakdown in adulthood. Neuropathological and epidemiological studies point to the second trime-non of gestation as the crucial period of fetal brain maturation. Recently, some studies found that the surplus in schizophrenic winter/spring births is mainly due to sporadic forms. In contrast, patients with high genetic risk of the disease even tended to have a birth deficit during this period. This suggests that schizophrenia is not a disease entity but consists of etiologically distinct subgroups on which the influence of genes and/or environment has to be weighted differently. On the one hand, in sporadic forms of the disease exogenous noxious agents may be of major etiological importance. On the other hand, in fetuses at high genetic risk neurodevelopment may already be disturbed due to a genetic defect and additional environmentally noxious agents can cause abortions, stillbirths and sudden infant deaths.

ISSN:0254-4962    

DOI:10.1159/000284967

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

This study investigates the view of 2 samples of psychiatrists about pseudohallucinations (PH) and their perceived value in clinical practice. Among UK and Irish consultant psychiatrists, 87% expressed belief in PH, but 63% thought that the concept was confusing and only 58% thought PH were clinically useful. Recently appointed consultants were more positive about PH. One-third of respondents were sceptical; and even the more enthusiastic gave variable and inconsistent responses. Many psychiatrists do not value the concept of PH or do not use it. Those who do favour it use it inconsistently. The concept gives rise to much confusion, and is weak because it is defined negatively. It should be abandoned in favour of a more precise clinical approach to describing false perceptions.

ISSN:0254-4962    

DOI:10.1159/000284968

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

A patient with chronic schizophrenia who had visual hallucinations of lilliputian nature is described. The authors review the studies on prevalence of visual hallucinations in schizophrenic patients and suggest that visual hallucinations may be more common in schizophrenia than previously acknowledged. The authors suggest a routine enquiry about visual hallucination in clinical practice and emphasize the need for further research under controlled conditions.

ISSN:0254-4962    

DOI:10.1159/000284969

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The goal of this study was to describe patterns of diagnosis and to explore the extent to which diagnosis changes during first-in-life psychiatric admissions. All 2,998 first admissions to Israeli psychiatric wards in 1989 were studied. Diagnosis did not change in at least 60% of the cases. Diagnoses in order of stability were: mental retardation (84%), substance abuse (82%), organic conditions (77.5%), neurotic (75%), schizophrenia (74%), personality disorders (73%), affective (68%), childhood (55%), paranoid (45%) and V-codes (22%). There was less change in diagnosis for patients over 45 (37.5%), than for patients aged 19–44 (43.2%) and 15–18 (57.8%). Diagnoses assigned at admission to first hospitalization are not likely to change during that hospitalization.

ISSN:0254-4962    

DOI:10.1159/000284970

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The Frankfurt Complaint Questionnaire (FCQ) is a self-assessment instrument designed to evaluate the subjective experiences (SE) of psychotic patients. It is composed of 98 yes-no items grouped in ten phenomenological subscales. The original validation of the FCQ included a factor analysis with a four-factor structure. No further studies of factor validity have been carried out. The present study aimed to replicate the factor structure of the FCQ in a Spanish sample. The sample was composed of 286 consecutively admitted patients due to a recrudescence of their psychotic symptoms. They were evaluated through a semistructured interview for schizophrenia and diagnosed according to DSM-III-R criteria. Organic mental disorders were excluded. Sixteen patients who failed to fulfill the FCQ were excluded. The sample finally comprised 270 patients. A factor structure of FCQ items comprising 25 factors was found. The first factor obtained the highest explained variance, and most items obtained their highest load on the first factor. These results strongly suggest a unidimensionality underlying FCQ items. A new scale composed of 18 items was derived from those with higher weights in the first factor. The new scale of SE was presented in a Likert format to demonstrate their frequency and intensity more clearly.

ISSN:0254-4962    

DOI:10.1159/000284971

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Both from the clinical and mathematical perspectives, symptom recognition has received less attention than disease recognition. To redress this balance, it is imperative that multidimensional models are constructed for each and all mental symptoms. This paper offers one such model for ‘hallucinations,’ and a set of prototypical data comparing the performance of pattern recognition techniques (cluster and discriminant analyses) and neural networks (Kohonen and backpropagation). It is concluded that multidimensional models are less wasteful of information than (current) categorial ones. Because of this and of the fact that symptom structure is likely to be ‘isomorphic’ with the brain region where the corresponding signal is generated, it is recommended that multidimensional models are preferentially used in neurobiological research.

ISSN:0254-4962    

DOI:10.1159/000284972

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Psychodynamic clinical studies as well as empirical research have pointed out the importance and the specificity of object relations in eating disorders. Given this, the aim of this work was to identify the presence of significant differences in the object relations patterns, as described by the Parental Bonding Instrument (PBI), between anorectic and bulimic subjects. PBI was administered to 42 anorectic female and 26 bulimic female subjects, consecutively admitted to the Eating Disorders Outpatient Unit of H San Raffaele of Milan. Profile analysis revealed the presence of significant (T2 = 11.3453, d.f. 3,64, p = 0.017) qualitative differences in PBI profiles between anorectic and bulimic subjects. The most striking difference was represented by the bulimics’ view of their parents as both caring and overwhelming, which contrasted with the anorectics’ perception of their parents as absolutely car

ISSN:0254-4962    

DOI:10.1159/000284973

出版商:S. Karger AG    

年代:1996

数据来源: Karger