ISSN:0254-4962    

DOI:10.1159/000284054

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

This study deals with the question what schizophrenic patients think about their psychosis after remission. Literature is reviewed and the results of a standardized study of 40 remitted patients are presented. Integrating ways of assimilation are separated from isolating ones. The way of assimilation is rather independent of the duration of illness, hospitalization, treatment, and their particular social situation. The method of psychotherapeutic treatment to be applied in a certain case has to take the individual way of assimilation into account. Possibilities of refined indication will have to be considered.

ISSN:0254-4962    

DOI:10.1159/000284055

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In order to elucidate the ‘masked’ nature of psychiatric illness in the elderly, subjects attending a suburban community day centre were screened for organic and functional psychological illness and also administered an illness behaviour questionnaire. For those subjects, non-organically impaired, the probable functional psychiatric cases were compared with the other attenders. There were no differences between the groups on the scales indicating denial and psychological mindedness, but the probable cases scored significantly higher on affective inhibition, indicating a conscious suppression of feelings. These findings not only provide objective data which support the previous clinically observed ‘masked’ nature of psychological illness in the elderly, but also give the clinician guidance in elucidating such ‘masked

ISSN:0254-4962    

DOI:10.1159/000284056

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

After a brief description of the principal findings which emerge from the studies on expressed emotion (EE), the author puts forward a few critical thoughts based on a systemic orientation. He explains why the variable EE evaluated on the basis of the Camberwell Family Interview (CFI) does not sufficiently reflect the dynamic reality of the family interactions and, in particular, he criticises the establishment of a linear causality relationship between family EE and the development of the individual illness. He shows the limitations of psycho-educational programmes while acknowledging their place in the overall supportive family therapies.

ISSN:0254-4962    

DOI:10.1159/000284057

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In this study we have examined four parts of the 5th revision of the World Health Organization schedule for Standardized Assessment of Depressive Disorders (WHO/SADD-5): (I) items that cover the present depressive state; (II) items that cover the psychiatric history; (III) a global assessment scale for the severity of depression, and (IV) the current ICD-9 diagnosis. Our analysis was based on a comparison of the interobserver reliability of item combinations leading to DSM-III, RDC, Newcastle and Melancholia Scale classifications of patients with depressive disorders. To facilitate these combinations we had added 4 items to SADD: (a) quality of depression, (b) persistence of depression, (c) reactivity of symptoms, and (d) accusations of others. Our results showed that WHO/SADD-5 has an acceptable degree of interobserver reliability both at the levels of global assessment of severity of depression and ICD-9 diagnosis, whereas the item combinations obtained lower intraclass coefficients. However, the item analysis focused on two SADD subscales of acceptable interobserver reliability: a severity scale of 16 items selected from our Melancholia Scale, and a diagnostic scale of another 10 items selected from the two Newcastle Scales.

ISSN:0254-4962    

DOI:10.1159/000284058

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

We have examined the applicability of the Hamilton Anxiety Scale (HAS) and our Melancholia Scale (MES) on a group of patients suffering from cardiac disease. They were assessed before surgery and again 1, 3, and 6 months after the operation. The results showed that the median for this group of patients even preoperatively was below the cut-off scores for both rating scales with a monotonous fall in score on the follow-ups. Item analysis showed that it was the psychic or cognitive symptoms of the HAS rather than the somatic symptoms of anxiety that explained the score variation. On the MES it was symptoms like depressed mood, psychic anxiety, pains, emotional and intellectual retardation rather than symptoms of guilt, motor retardation or suicidal impulses that were present. From both scales a total of 10 items emerged which were considered to measure generalized anxiety (Generalized Anxiety Scale). When the patients were classified into groups by a global assessment according to their ability to verbalize preoperative anxiety it was found that patients who were less able to verbalize had the lowest rating scale score. It was argued that preoperative anxiety is an introspective perception of fluctuating somatic manifestations of anxiety, whereas the rating scale procedure focuses on the persistent or cognitive part of anxiety which mostly is retrospectively perceived.

ISSN:0254-4962    

DOI:10.1159/000284060

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

We investigated the clinical features of schizophrenic syndromes first manifested after the age of 50. By comparison with the schizophrenic syndromes first manifested before the 50th year of life we found: (1) late schizophrenia is characterized by rich psychotic productive syndromes (delusions and hallucinations); (2) disturbances of thought are rare; (3) depression, euphoria and anxiety show no difference between the two groups; (4) females are much more represented than males; (5) social isolation is not more common in late schizophrenia than in non-late schizophrenia.

ISSN:0254-4962    

DOI:10.1159/000284061

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Schneider’s first rank symptoms (FRS) among schizophrenics in Karachi are compared with samples from Saudi Arabia and the UK. Although the incidence of one or more FRS were very close to Saudi Arabia, the individual FRS were different, and somatic passivity was similar to the UK. It is concluded that cultural factors are more important than religious affinity in determining symptomatology. The results could be due to selection of schizophrenic patients on Western parameters. The place of FRS in developing countries and the changing concept of schizophrenia is discusse

ISSN:0254-4962    

DOI:10.1159/000284062

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In addition to genetic findings and treatment response, the course prognosis is also meant to be a possible validating criterion for diagnosis and diagnostic systems. In our study we used the polydiagnostic approach (i.e. the simultaneous application of various criteria for diagnosing a given disorder to one and the same population) to test the ability of several diagnostic systems to create homogeneous groups regarding the course (episodic/chronic). We applied Schneider’s FRS, ICD-9, DSM-III, Spitzer’s RDC and the Vienna Research Criteria to 90 patients with the diagnosis of delusional syndrome (aside from any nosological classification), who underwent 6–9 years of follow-up. At the index examination, schizophrenia was most frequently diagnosed with Schneider’s FRS, which apparently encompasses a very heterogeneous group of patients regarding psychopathology and course. Diagnostic systems which allowed the diagnosis of affective disorders despite the presence of mood-incongruent delusional symptomatology (DSM-III, RDC, Vienna Criteria) or offered the diagnosis of schizoaffective disorder (DSM-III, RDC) succeeded in separating subgroups with an episodic course on a statistically significant level. In ICD-9 this significance appeared only after exclusion of the schizoaffective cases from the group of schizophrenias. Our data thus uphold the old rule of thumb that affective symptomatology apparently has a very high prognostic value regarding the course of the illness and is in this respect superior to productive symptomatology (such as delusions and hallucinations), still taken to be pathognomonic for schizophrenia by some of the diagnostic criteria under study. This aspect warrants further investigation and should be taken into account in the development and improvement of diagnostic manuals (e.g. ICD-10,

ISSN:0254-4962    

DOI:10.1159/000284063

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Self-reported stress factors in migraine headache were examined from a cognitive-behavioral point of view. 18 migraine patients completed the Rathus Assertiveness Schedule and the Fear Survey Schedule. In addition, the migraine sufferers reported on all factors, either psychological or physical, which they felt were associated with headaches, answered a ‘secondary gain’ question, and completed a set of questions composed by the author. In conflict with more traditional viewpoints, migraine sufferers do not report themselves to be atypically reactive to ambiguity, uncertainty, or major life changes. Factors which do appear to be involved are quite diverse, and include tension over performed assertiveness behaviors, concern with perfectionism and evaluation, and reactions to small life changes. The impossibility of a cause and effect analysis is noted, and the quantity of reported stress factors is discussed as an argument for the author’s concept of homeostatic reconditi

ISSN:0254-4962    

DOI:10.1159/000284064

出版商:S. Karger AG    

年代:1984

数据来源: Karger