Janus, Roman god of doorways.
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Biomedical subjects
Publications and source records attributed to G C Lyketsos.
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The hostile personality characteristic of dominance was shown to be significantly lower in a group of 34 male patients with essential hypertension than in a general illness control group (n = 17) in the USA. This replicates a previous finding from research in Greece into this and other conditions of presumably psychogenic origin. Nonspecific neurotic syndromes (as identified by the Present State Examination, a semistructured interview) were more prevalent in hypertensives than in controls, but no clear neurotic cases were found. Levels of the prostaglandins 6-keto prostaglandin F1A and thromboxane B2 did not differ significantly between groups, but the former was positively correlated with dominance in the control group. An interpretation of these results in terms of the repressed hostility theory is offered.
The psychopathology and disabilities of a group of institutionalised elderly schizophrenics were compared with those of a group of non-schizophrenic elderly, and with younger schizophrenics reported in a parallel study and in the literature. Elderly schizophrenics showed significantly more psychopathology and disability than the non-schizophrenic elderly; however, they exhibited less psychopathology than younger schizophrenics. Disability among elderly schizophrenics was not correlated with chronicity of institutionalisation or psychopathology. There was a suggestion that disability among elderly schizophrenics may be due to organic deterioration.
This paper reports studies of patients with the following disorders: peptic ulcer, hypertension, bronchial asthma, irritable bowel syndrome (IBS), ulcerative colitis (UC), urticaria, psoriasis and alopecia. The investigations focused on dysthymic states, measured by Foulds' Scale of Anxiety and Depression (SAD) and--except for the first three disorders--the Present State Examination (PSE). On the SAD, all the above groups scored significantly higher than somatically ill controls in anxiety, and all except ulcer patients scored significantly higher in depression. The PSE designated more than half of these patients as cases, except in the psoriasis group. Most patients were assigned to the PSE syndromes of anxiety states or neurotic depression, with the former being more common in UC and urticaria, and the latter more common in IBS, alopecia and rheumatoid arthritis. The variation within skin diseases and within gastrointestinal diseases suggests that neurotic symptoms are typical of each disease rather than of the system involved in the disturbance.
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Two experimental groups of patients with ulcerative colitis (UC) and irritable bowel syndrome (IBS) were compared for hostile personality characteristics and dysthymic states with physically ill patients. Both experimental groups were found to be less dominant, more intropunitive, more anxious and more depressed than the control group. IBS patients, however, were more dominant and less intropunitive than UC patients. Low dominance has been associated with psychosomatic illnesses, and high intropunitiveness with neurotic formation. Both UC and IBS patients have been found to be severely neurotic, a fact reflecting the concurrence of the psychosomatic and neurotic defences in these diseases. More IBS patients had premorbid psychiatric symptoms in comparison with controls and UC patients.
Three experimental groups of patients with urticaria, psoriasis and alopecia were compared for hostile personality characteristics, states of anxiety and depression, neurotic syndromes and stress with a control group of patients with other skin diseases. The patients from each experimental group were found to be less dominant, more intropunitive, more extrapunitive and more neurotic than the control group. The following neurotic syndromes differentiated the experimental groups: non-specific anxiety states in urticaria patients; neurotic depression in the patients with alopecia, and a variety of neurotic syndromes in the psoriasis patients. All experimental groups scored significantly higher than the controls in stress experienced during the year preceding the onset or the exacerbation of the illness.
An investigation of eating disorders in a population of chronic schizophrenic patients confirmed that there is a distinction between eating disorders of psychotics and eating disorders of the young. All the DSM-III criteria of eating disorders, except one, were observed among the psychotics although no patient fulfilled the necessary criteria for an eating disorder diagnosis except for one anorexic woman. All varieties of schizophrenic eating disorder were reported: in two-fifths of the patients eating disorders were associated with delusions and in one sixth with hallucinations; more than half of the patients had deviant eating behaviour which was not associated with any thought or perceptual disorders. Schizophrenic eating disorders were common, yet not disturbing to the social life of the open mental hospital or to that of the community surrounding it.
Patients with bronchial asthma were compared with physically ill patients as to personality traits and dysthymic states. Asthmatics were less dominant and more intropunitive, more anxious and more depressed than the control group. Low dominance or dependent social attitude and inhibited hostility was correlated with low vital capacity (FVC).
A comparison of a group of chronic schizophrenics with controls showed that: the patients had significantly less interest in sex, frequency of intercourse, and satisfaction from sex; the percentage of individuals with sexual dreams and sexual fantasies did not differ between the two groups; the severity of psychopathology influenced frequency of intercourse and satisfaction from sex, and the length of institutionalization influenced interest in sex; the schizophrenics had a variety of sexual disorders, but there was a significant difference between the sexes in disturbances of thought and perception; and, significantly more male schizophrenics, in comparison with females, had sexual dysfunction associated with pharmacotherapy, but feminization in the males was far from predominant. The patients' sexual disorders are not disturbing to the social life of the open mental hospital or the community surrounding it.
Hostility towards self and others often precipitates admission to hospital of the schizophrenic patient. A follow-up study of 24 newly admitted schizophrenic patients during eight weeks of treatment indicated high intropunitiveness and extra-punitiveness at admission which decreased concurrently with psychopathology. The larger change was in intro-punitiveness, resulting in an increase in the original predominance of extra-punitiveness. The various measures of hostility were not predictive of response to treatment at eight weeks. Comparisons between the schizophrenic group and a group of depressed patients indicated significant differences in the expression of hostility. At admission the schizophrenic patients are less intro-punitive and more extra-punitive than the depressed patients, these differences disappearing after eight weeks of treatment. This finding tends to support the psychodynamic view of projective and introjective mechanisms in these two illness groups.
A critical review of the post-war development of the prevention of chronic mental disorders in Greece offers useful information for the future. Present-day experience and knowledge--both in Greece and internationally--allow plans to be made on a national scale. A careful study of priorities will enable the appropriate measures to be financed and applied in stages, thus ultimately benefiting the chronic mental patient.
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Sixteen depressed in-patients from a hospital in Athens were assessed using the Hamilton Rating Scale and the Hostility and Direction of Hostility Questionnaire. Comparison of admission, discharge and mid-treatment scores showed that: (1) There was a larger drop in depression score in the first half of treatment. (2) Hostility scores, except for extrapunitiveness, decreased significantly over time, larger changes occurring in the first half of treatment. (3) Comparisons with British scores showed that during illness there were no significant differences between British and Greeks, though the latter tended to be more extrapunitive. At recovery, the Greeks were significantly more extrapunitive. The movement of hostility in depressive illness, the validity of the HDHQ and need for national norms are discussed.