摘要:

Several studies have reported on comorbidity between depression and anxiety. The present study investigates the occurrence of anxiety symptoms during an episode of unipolar depression. The authors administered the 15-item Rating Scale for Anxiety States of Hamilton (HAM-A) to 73 depressed inpatients categorized according to DSM-III criteria into minor (300.40,309.00), major depression without (296.X2) and with (296.X3) melancholia. Principal-component (PC) anylsis revealed three inter-pretable PCs: a somatic anxiety, a depression-anxiety overlap, and an anxious mood-behavior factor. Subjects with major depression showed significantly higher ratings on total HAM-A score, the three above PCs, and on all HAM-A items (except general somatic muscular and genitourinary symptoms) than subjects with minor depression. A cluster analysis generated two stable, qualitatively distinct clusters: i.e. one with severe anxiety and one with no or minimal anxiety; the six most discriminating symptoms were: tension, behavior at interview (general or physiological), respiratory, genitourinary and autonomic symptoms. Up to 95.4% of patients allocated to the severe anxiety cluster were major depressives. The results suggest that major depression may be divided into two qualitatively distinct classes, i.e. major depression with and without anxiety features.

ISSN:0254-4962    

DOI:10.1159/000284842

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We describe the case of a patient who, after a traumatic experience at the age of 12, had a series of anniversary depressive episodes at 16, 17, 18 and 19 years of age, followed by a series of anniversary manic episodes at the ages of 21,23, 24, 25 and 26 years. All of these episodes occurred almost always a few days before or after the date of the accident and only when the patient was residing in his home town, the place of the traumatic event. The case fulfills the DSM-III-R criteria for seasonal mood disorder, but differs from previously described cases in that: (a) both depressive and manic episodes developed at the same time of the year, and (b) the illness was precipitated by psychosocial factors rather than climatic conditions.

ISSN:0254-4962    

DOI:10.1159/000284843

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The compatibility of the classification systems ICD-10 and DSM-III-R was investigated in a sample of 100 psychiatric inpatients with severe affective and psychotic disorders. Four independent raters assessed diagnoses by means of checklists from psychopathological descriptions of case records. Congruence between ICD-10 and DSM-III-R was good for depressive disorders with agreement rates above 80% and fair for bipolar disorders with rates above 60%. Less consistent findings were obtained for schizophrenia with rates of 57.5% for ICD-10 diagnoses and 82.6% for DSM-III-R diagnoses. Agreement for schizoaffective disorder was below 40% and thus insufficient. The results indicate that even small differences in the definitions of mental disorders may result in considerable inconsistencies.

ISSN:0254-4962    

DOI:10.1159/000284844

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The relationship between anorexia nervosa (AN) and sociocultural factors is examined. Anorexia nervosa was first described in the West and was reported as particularly rare or absent in Eastern cultures. However, the frequency of its presentation has increased worldwide over the past two decades, probably as a consequence of changes in cultural norms and concepts of feminine beauty and an increasing inflow of Western values into other countries. Sociocultural factors are important in the development of AN in psychologically vulnerable young females, although other factors may also be implicated.

ISSN:0254-4962    

DOI:10.1159/000284845

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The correlation of clinical and demographic variables of thought disorder was studied in 45 Research Diagnostic Criteria (RDC) schizophrenics. Thought disorder was assessed by the scale for the assessment of Thought, Language and Communication (TLC). Negative thought disorder was significantly correlated with the rural background. Individual TLC items like Distractible speech, Illogicality, Clanging, Neologisms, etc. were correlated with the literate group and perseveration with the illiterate group. No significant correlation was noted between thought disorder and clinical variables.

ISSN:0254-4962    

DOI:10.1159/000284846

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We investigated the age distribution of the typus melancholicus (TM) score, measured by Kasahara’s scale, in 119 outpatients with major depression and in 600 workers without a history of depression. In the patient group, the score was, regardless of age, always constant at a high level. The TM score for the control group increased with aging and was in most age groups significantly lower than that for the patient group. This result suggests that a higher TM score on the scale would be a risk factor and a possible trait marker of major depression.

ISSN:0254-4962    

DOI:10.1159/000284847

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

This study on a delusional misidentification patient with both Frégoli symptoms and intermetamorphosis investigates the cognitive structure of others and of the self-representations with a new clustering method (HICLAS conjunctive model). Results show that this patient, free from face recognition disorders, shows severe structural anomalies in the mapping of misidentified others, and of the self. Disturbances in the cognitive structure and person identification are discussed in reference to a psychopathological explanation of the misidentification syndrome.

ISSN:0254-4962    

DOI:10.1159/000284848

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In psychiatry, the new classification of diseases, the ICD-10/ chapter V(F), will be introduced worldwide in the near future. As in the USA in the case of the DSM-III, psychiatrists will have to change their diagnostic procedures from traditional typology to criteria orientation. 83 West German psychiatrists in practice, who were unfamiliar with the use of criteria-oriented diagnostic systems, documented not only the ICD-9 diagnoses of 10,902 depressive patients but also their DSM-III diagnoses. A comparison between the results of the diagnostic distribution of this sample and a smaller sample diagnosed by well-trained interviewers reveals that, to a great extent, systematic mistakes were made, especially by confounding typological and criteria-oriented diagnostic entities. In a vulnerable period of changing diagnostic procedures, such as during the introduction of ICD-10, facilities for training and discussion should be supplied.

ISSN:0254-4962    

DOI:10.1159/000284849

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The formation of delusional beliefs is elucidated by the expressed experiences of 75 delusional patients. It is found that such beliefs may develop regardless of the presence (64%) or absence (20%) of anomalous experiences. Patients within the same diagnostic category remember it very differently. Many patients (71%) find a simple and reassuring way of understanding and relating to the external world by the formation of delusional beliefs. To many patients (47%) the delusional theme remains unchanged from the start and from one psychotic episode to another, while to other patients (24%) the theme changes in a hierarchical way. It is suggested that the formation of delusional beliefs is caused by impaired two-way communication or metathinking and that the delusional theme indicates the severity of cognitive dysfunction or mental disorder.

ISSN:0254-4962    

DOI:10.1159/000284850

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The persistence of delusional beliefs may to a marked degree influence the patients’ global functioning. It is therefore clinically relevant to search for predictors of this course. In a study sample of 75 delusional first admitters such demographic, social and clinical variables were investigated which concern the course during 8 years. A number of variables had predictive value, e.g. characteristics of the delusional beliefs themselves such as theme and dimensions, absence of mood disturbance and subjective thought disorder but not hallucinations. The variables of diagnosis (schizophrenia according to the ICD-10 or the DSM-III-R at discharge from first admission) was a highly significant predictor of which only the following variables had a significant and independent predictive value: living alone, no psychosocial stressor, main delusion of persecution, and main delusion other than reference. In spite of the diagnostic uncertainty among first admitters the new systems of classification provide diagnostic categories as the most significant predictor of persistent delusional beliefs. Two logistic regression models for prediction are presented. In the presence of all independent predictors, the persistence of delusional beliefs is predicted for 94% of the present patient sample.

ISSN:0254-4962    

DOI:10.1159/000284851

出版商:S. Karger AG    

年代:1994

数据来源: Karger