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PubMed1980

Adult psychiatric disorders in parents of hyperactive children.

The family histories of 140 children and adolescents with hyperactive child syndrome were compared with the family histories of 91 psychiatrically ill, age- and sex-matched patients who had a primary diagnosis other than hyperactive child syndrome. Parents of hyperactive children were more likely to have antisocial personality and Briquet's syndrome (hysteria) than were parents of nonhyperactive children; 11% of the hyperactive children had a parent with such a diagnosis. Parents of nonhyperactive children were more likely to have endogenous psychosis. The diagnosis of alcoholism did not significantly differentiate parents of the two groups of probands. These data support earlier studies and suggest a specific association between hyperactive child syndrome and the personality disorders of antisocial personality and hysteria.

Adolescent↗
PubMed1982

Problems of psychiatric practice in community mental health centers.

Initial enthusiasm about community mental health centers (CMHCs) has diminished. The participation of psychiatrists in CMHCs declined in the 1970s and may decline further. The author describes one center to highlight problems encountered by community psychiatrists: 1) unrealistic treatment expectations, 2) limitations of psychiatric knowledge, 3) need for a broad range of clinical expertise, 4) supervision of other CMHC clinicians, 5) limited funds and rehabilitation facilities, 6) complex medical and legal problems, and 7) lack of adequate training in administration. She suggests that the public be reeducated regarding realistic treatment goals, that CMHCs be allied with university departments of psychiatry, that funding be stabilized, and that community psychiatrists be given more support.

Ambulatory Care↗
PubMed1982

The acute administration ward as a therapeutic community.

The authors evaluated six acute short-stay admission wards in a community mental health center using the sociometric Ward Atmosphere Scale. There was an attempt to run three of the six wards as therapeutic communities. No differences were found on Ward Atmosphere Scale dimensions between the therapeutic communities and other types of programs, nor did the therapeutic communities conform to an empirically derived therapeutic community program dimension profile. Possible reasons for this failure and its implications for community mental health centers are discussed.

Acute Disease↗
PubMed1982

Are hysterical seizures more than hysteria? A research diagnostic criteria, DMS-III, and psychometric analysis.

In a double-blind study the authors compared severity of psychopathology and personality organization in three groups of patients: those with organic (neurogenic) seizures alone (N = 11), those who exhibited both neurogenic and psychogenic ("hysterical") seizures (N = 13), and those with pure psychogenic ("hysterical") seizures (N = 13). Patients with neurogenic seizures were found to have alcoholism, anxiety disorder, and minor affective disorder. Patients with mixed and psychogenic seizures had more severe psychopathology, including major affective disorders and major character pathology. Patients with mixed and psychogenic seizures also had a markedly higher incidence of suicide attempts and past history of psychiatric treatment.

Borderline Personality Disorder↗
PubMed1984

Development of an organic affective syndrome during a hyperbaric diving experiment.

The authors describe the clinical and pharmacologic management of a patient who developed an organic affective syndrome during a simulated deep-diving experiment. The physiological complexities of deep-diving research are reviewed, as well as the neuropsychiatric symptoms of the high pressure nervous syndrome.

Atmosphere Exposure Chambers↗
PubMed1984

Brain disease and psychiatric illness: when should a psychiatrist order a CAT scan?

Because psychiatric symptoms are frequently the earliest signs of CNS pathology, the author outlines the structural brain diseases that may underlie several psychiatric syndromes and describes the computerized axial tomographic (CAT) scan findings associated with those diseases. On the basis of an awareness of these conditions and a cost-benefit analysis, the following indications for CAT scanning of psychiatric patients are proposed: 1) confusion and/or dementia of unknown cause, 2) first episode of a psychosis of unknown etiology, 3) movement disorder of unknown etiology, 4) anorexia nervosa, 5) prolonged catatonia, and 6) first episode of major affective disorder or personality change after age 50.

Adult↗
PubMed1984

The dynamics of hospitalization in a defined population during deinstitutionalization.

In a sample of 1,032 psychiatric inpatients studied for 1 year, chronic patients (more than 6 months' inpatient stay) represented 17.4%, almost half of whom were discharged during a 2-year follow-up; an additional 19.4% died. The incidence of "new" long-stay patients was 8.6/100,000 population, which, if constant over time, would result in a net increase of long-stay patients. Most chronic long-stay patients had a diagnosis of schizophrenia or organic brain syndrome. The two diagnostic groups had strikingly different patterns of deinstitutionalization. Alcoholic patients and those with "other" diagnoses demonstrated chronic dependence on the hospital, characterized by short inpatient stays and high readmission rates.

Alcoholism↗
PubMed1986

Three cases of AIDS-related psychiatric disorders.

Psychiatric disorders related to acquired immune deficiency syndrome (AIDS) can take various and complex forms. The authors present cases of AIDS patients in whom paranoia, organic brain syndrome, depression, or suicidal ideation was present.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Psychiatric aspects of AIDS.

Acquired immune deficiency syndrome (AIDS) has neuropsychiatric and psychopathological complications: anxiety, depressive symptoms, and suicidal ideation are common. Patients may express anger toward ineffective medical care and perceived public discrimination, guilt about sexual practices or drug abuse, reactions to social isolation, and uncertainty about the implications of an AIDS diagnosis. CNS dysfunction and subsequent neuropsychiatric impairment are common and are initially characterized by decreased acuity, slowed mentation, and psychomotor retardation that can resemble depression. Marked global cognitive deficits, disorientation, and delusions ensue. The author discusses case management and outlines future clinical and research activities.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Who seeks mental health care in China? Diagnoses of Chinese outpatients according to DSM-III criteria and the Chinese classification system.

The authors gave DSM-III diagnoses to 116 Chinese psychiatric outpatients in Shanghai and compared them with the diagnoses of the same patients made by a Chinese psychiatrist according to Chinese criteria. Affective disorders were the most common DSM-III diagnoses, accounting for 26.7% of the sample. A full range of psychopathology, including schizophrenia, organic mental disorders, adjustment disorders, anxiety disorders, and paranoid disorders, was seen. Some consistent differences in diagnosis by Chinese and Western standards, especially in the area of major depression, were found. The authors discuss the implications for interpreting psychiatric studies from China and for future cross-cultural research comparing U.S. and Chinese diagnoses.

Adult↗
PubMed1992

Suicidality and HIV status.

Among psychiatric consultation patients, 322 AIDS patients were significantly less suicidal than 82 other HIV-positive patients and were comparable in suicidality to 1,086 patients with negative or unknown HIV status. AIDS patients had significantly more organic mental disorders. Organicity, denial, acceptance, and/or preoccupation with a fatal illness may reduce suicidality in AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Plasma and platelet excitatory amino acids in psychiatric disorders.

Plasma and platelet levels of excitatory amino acids were measured in 38 psychiatric out-patients and in 19 comparison subjects; the patients had DSM-III-R diagnoses of organic mental disorders (N = 3), mood disorders (N = 15), schizophrenia (N = 13), and anxiety disorders (N = 7). The glutamate plasma levels were significantly higher in the patients with mood disorders than in the comparison group.

Ambulatory Care↗
PubMed1993

Profiles and predictors of assaultiveness for different psychiatric ward populations.

OBJECTIVE: The authors examined associations between patient-related characteristics and assaultiveness on six different psychiatric wards to determine 1) the relative contributions of demographic, disorder-related, and diagnostic variables to prediction of assaultiveness and 2) how ward composition and type of victim affect prediction of assaultiveness. METHOD: Hospital records of 1,025 inpatients residing in psychiatric wards within a 6-month time frame were reviewed for evidence of assaultiveness. Data on all 260 assaultive patients and a sample of 136 of the nonassaultive patients were analyzed with multiple regression to predict assaultiveness scores for each ward and each victim category. RESULTS: The findings indicated high rates of assaultive patients and assaults on fellow patients. Multiple regression results produced different predictors of assaultiveness for different wards but not for different categories of assault victim within each ward. Overall, age and sex consistently failed to predict assaultiveness, whereas greater assaultiveness was significantly associated with a greater proportion of time hospitalized since first admission. The most powerful unique predictors of assaultiveness scores were diagnostic distinctions derived from data on coexistent diagnoses. The most assaults were by acute patients whose diagnoses excluded organic mental disorder but included either bipolar disorder or personality disorder and longer-stay patients whose exclusive diagnosis was organic mental disorder. CONCLUSIONS: This identification, albeit modest, of risk factors for assaultiveness on different wards nevertheless provides information fundamental to the management policies of psychiatric institutions. The findings caution against aggregating different ward populations for research on assaultiveness and endorse the usefulness of coexistent diagnoses for predicting assaultiveness.

Bipolar Disorder↗
PubMed1994

Diagnostic rate of comorbid personality disorder in elderly psychiatric inpatients.

Among 547 elderly inpatients grouped by DSM-III-R axis I diagnoses, the diagnostic rate of comorbid personality disorder varied four-fold, from 6% in patients with an organic mental disorder to 24% in those with major depression. The previously reported low prevalence of comorbid personality disorder in geriatric patients may be due to its lower rate of diagnosis among patients with organic mental disorders.

Aged↗