摘要:

104 patients diagnosed as having an organic mental disorder due to infection were classified according to DSM III criteria. The vast majority of patients (76%) fulfilled the criteria of delirium, 6 % that of organic hallucinosis, while others had to be classified as affective, personality or delusional syndrome. We found a great instability of syndromes causing classification problems. A classification rule is suggested, which we called ‘compromise of clinical reality’.

ISSN:0254-4962    

DOI:10.1159/000284491

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The diagnostic and prognostic significance of somatic manifestations in various depressive conditions is discussed with special reference to the somatic complaints in masked depression. The experience presented is based on 788 depressive patients studied in three different psychiatric services of a Greek rural district – an inpatient, an outpatient and a mobile unit service. Headache was found to be on top of the symptom checklist in both outpatient and mobile unit population. Musculoskeletal complaints and dizziness had also a high incidence and to a lesser degree gastrointestinal, cardiovascular and genitourinary symptoms. Though the incidence of all other somatic complaints increased with age and was higher in inpatients, headache was a prominent symptom in younger patients, too, and in outpatients, proving to be also an early diagnostic phenomenon for an underlying depression. The mental health mobile unit saw the greatest percentage of neurotic depressives, who also presented the highest incidence of headache (62.63%). The efficacy of that service for tracing such cases and the need for cooperation with the primary health care for better preventive measures are stressed.

ISSN:0254-4962    

DOI:10.1159/000284492

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

In an investigation of 70 chronically mentally ill patients in a district psychiatric hospital, 11 cases were discovered which had been diagnosed up to now as schizophrenia, but could now be diagnosed as being of organic origin. In group 1 (cases 1–6) there are dementive states after toxic, inflammatory or early childhood brain damage and familial epileptic malady with slowly progressive brain atrophy. They were easy to recognize clinically in their organic psychosyndromes, dementia, neurological symptoms and CT findings showing extensive, massive brain damage. In group 2 (cases 7–11), in contrast, there are patients with chronic psychoses of remittent course, with brain findings indicative of centrencephalic damage. On superficial examination they give a schizophrenic picture, but can be differentiated from this by the absence of schizophrenic personality changes and thought disturbances, and also by the form of the hallucinations. These are distinguished by their plastic character, and show the criteria which Schroder had already pointed out 60 years ago for the differentiation of exogenous and endogenous hallucinations.

ISSN:0254-4962    

DOI:10.1159/000284493

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Psychological distress was observer-rated with the Brief Psychiatric Rating Scale (BPRS) and self-rated with the Symptom Questionnaire (SQ) every other week for a 6-month period in 9 apparently remitted bipolar patients attending a lithium clinic. Substantial clinical fluctuations in psychopathology were observed with both rating methods. Compared to normal control subjects, patients suffering from bipolar disorder displayed significantly higher BPRS and SQ anxiety, somatization and total distress scores.

ISSN:0254-4962    

DOI:10.1159/000284494

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Fifty randomly selected Chinese schizophrenic patients with denial of lineage were investigated. This delusion concerns the generation of parents, sisters, but not the offspring. Twenty-four of them manifested delusion of high-ranking lineage or of distinguished leadership lineage. Denial of lineage, involving the delusion of high-ranking lineage and the delusion of leadership lineage, may occur at the onset or during the course of schizophrenia. The clinical characteristics of this delusion are described and its concept, diagnosis, differential diagnosis, course and also possible mechanism are discussed. One possible mechanism is of psychodynamical origin. Emotional conflicts resulting from dissatisfaction of the primary need of being loved from birth may contribute to the onset of the denial of lineage. The second possible mechanism is a sociocultural fact. Far Eastern culture is based on the clan whereas occidental culture is based on the self. Thus can observe the denial of lineage in the Far East, but in the Occident we can experience instead the idea of surmounting our self so as to be god or now to experience the omnipotence in form of technical ideas, e.g. the rays.

ISSN:0254-4962    

DOI:10.1159/000284495

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The concept of ‘quality of life’ has had a paradigmatic effect in psychosomatic medicine by focussing on the measurements of psychological distress. This concept has been phenomenologically described under such names as discomfort and psychological boredom. Elements of fatigue, anxiety and depression seem to be core symptoms of dysfunctions in quality of life. An objective and nomothetic approach to quality of life has been demonstrated in this review when referring to the instrumental use of rating scales, e.g. the General Health Questionnaire. Furthermore, it has been recommended to follow the multiaxial approach of DSM-III including dimensions of personality, psychosocial stressors and social functioning.

ISSN:0254-4962    

DOI:10.1159/000284496

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Despite the high prevalence of medical illness in the mentally ill population, little is known about the health attitudes of patients with combined medical and psychiatric disorders. We compared the health attitudes of a group of inpatients with concomitant medical and psychiatric illness, a group of physically healthy psychiatric inpatients, and a group of normals. The instrument used was the Illness Attitude Scales, a self-rating scale designed to explore beliefs which can be responsible for hypochondriacal attitudes. A self-rating scale of psychological distress, the Symptom Questionnaire, was administered as well. Compared to normals, psychiatric patients displayed more hypochondriasis. There were no significant differences in psychological distress or health attitudes between patients with concomitant physical and psychiatric disorder and physically healthy psychiatric patients.

ISSN:0254-4962    

DOI:10.1159/000284497

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

In this study prognoses about the posthospital vocational achievement behavior of 55 first admitted depressive patients were made at the time of discharge. With a structured and standardized questionnaire the patients themselves, the treating physicians, and the nurses were interviewed. As a first step of analysis the prognoses of the three groups were compared with each other and tested in respect of differences. This comparison was made with other psychiatric diagnoses too, whereby endogenic depressive patients and neurotic depressive patients were discriminated. In the second step of analysis the prognoses of the three ‘rater groups’ were compared with the real vocational reintegration of 1 year after discharge. The result was that the prognoses of the treating physicians and the nurses were more compatible with reality than those of the patients themselves.

ISSN:0254-4962    

DOI:10.1159/000284498

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Memories of parental rearing behaviour were assessed by the EMBU in 61 epileptics and 151 healthy controls. The occurrence of the first crisis during the childhood was an inclusion criterion for patients. Epileptics, as compared with controls, rated their fathers and mothers as less stimulating, their fathers as less performance oriented and affectionate, and their mothers as more tolerant. Moreover, the score on the subscale ‘favouring subject’ for both fathers and mothers was higher in epileptics. As patients with and without interictal psychopathological features were compared, the scores on the subscales ‘overprotective’ and ‘favouring subject’ for mothers and ‘abusive’ and ‘depriving’ for fathers were higher in the former subgroup, whereas that on the subscale ‘performance oriented’ for fathers was higher in the latter. No significant difference was observed among patients suffering from the various subtypes of epilepsy. These results are consistent with the idea that parents of epileptics tend to encourage passivity in their children, have low expectations as regards their ability to operate effectively, and treat them in a more indulgent way because of their disability. Furthermore, they are in line with the reported association between maternal overprotectiveness and problem behaviour in epileptics.

ISSN:0254-4962    

DOI:10.1159/000284499

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Among 162 consecutive adult Chinese new psychiatric patients, the proportion of Chinese immigrants was not significantly higher, compared with the 1986 by-census results. However, the proportion of immigrants with predominant somatoform symptoms was significantly higher (p < 0.02), and that of immigrants with predominant paranoid symptoms was almost significantly higher (p = 0.052) than the corresponding proportions of immigrants without these symptoms. Evidence was given suggesting that the increased proportion of paranoid immigrants was probably due to social selection, while the increased proportion of somatoform immigrants could be explained by the social causation theory.

ISSN:0254-4962    

DOI:10.1159/000284500

出版商:S. Karger AG    

年代:1987

数据来源: Karger