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PubMed1999

[Affective disorders and syndrome formation].

Investigation of affective disorders in different psychopathologic syndromes allows to evaluate their role in the processes of syndrome formation and prognostic value. Affective disorders developing in different diseases (nosologies) within relevant psychopathologic syndromes determine main peculiarities of the disease course as well as severity of damage to mental activity.

Depressive Disorder↗
PubMed2001

[The population treated in the general psychiatric sector in 1993 and 1998. Clinical and demographic evolution].

BACKGROUND: The French information system in public psychiatry sectors does not collect morbidity data for the population being treated, estimated as more than a million persons in 1997. Consequently, two surveys were financed by the "Direction Générale de la Santé" and carried out in 1993 and 1998 in order to specify clinical, social and demographic characteristics of the patients. These surveys allowed a follow-up of evolutions according to the pathology and mode of treatment in a context where outpatient treatments are becoming increasingly frequent. METHODS: A census of the patients was made at a given moment, between one and fifteen days according to the mode of treatment. One sector out of two was surveyed, using a systematic selection process. The ICD-10 was used for diagnosis reference. The same methodology was applied in 1993 and 1998. Comparisons were made with the data supplied by the sectors annually and with the data concerning the general population in order to calculate rates per age groups. RESULTS: Between 1993 and 1998, the number of patients increased by +37% in outpatient care, and in part time care, and decreased by -12% in full time care. Rates for patients increased for all age groups in outpatient and part time care, more particularly for the 35 to 49 years old. Conversely, rates decreased in full time care, above all for patients over seventy. In each mode of treatment, the number of patients presenting mood disorders and neurotic disorders increased more than the average, and the proportion of patients with organic mental disorders and mental retardation decreased. Evolutions were different according to the mode of treatment schizophrenia, schizotypal and delusional disorders, and disorders of adult personality and behaviour. CONCLUSIONS: Recourse to outpatient care and part time care increased considerably over five years but evolutions were markedly different from one diagnosis to another. In full time care, the decrease more particularly concerned certain pathologies and age groups. Three phenomena, with possible interactions, could explain the evolutions observed: the population liable to have recourse to psychiatric care is increasing, health policies have changed and care supply has become diversified, and recourse to psychiatric care is now increasingly accepted.

Adult↗
PubMed2002

Dementia Due to Head Trauma: An obscure name for a clear neurocognitive syndrome.

This paper questions the DSM IV TR criteria for Dementia Due to Head Trauma (DDHT). We studied 20 consecutive traumatic brain injury (TBI) patients and checked them for this criteria. We found the diagnosis criteria to be oversensitive and lacking in specificity, consequently raising the possibility for all subjects who have sustained severe TBI to be diagnosed with dementia. A careful analysis of data and literature showed that nearly half of these patients were able to return to work after undergoing an intensive and holistic rehabilitation program, indicating a reversal of the "dementia". Severe head injury produces a set of multiple cognitive deficits that shouldn't be considered dementia. The term "Severe Neurocognitive Disorder" is suggested for use instead of DDHT for the cognitive deterioration of severe TBI patients.

Adult↗
PubMed1975

[Fluctuations in the memory capacity of patients with schizophrenia and traumatic psychoses].

The authors studied fluctuations of the memory volume on the basis of the original method of the memory analysis using 50 series which consist of 10 words following each other in every 30 seconds. Three groups included normals, schizophrenic patients (paranoid form, the initial stage of remission) and patients with posttraumatical psychosis in the period of recovery. It was demonstrated that the level of the memory volume fluctuations was over and with a greater swing in the patients than in the normals. The lowest memory level was found in the patients with traumatical pscyhoses.

Humans↗
PubMed1975

[Long-term development of neurotic and reactive disorders. Catamnestic study on the influence of social factors].

This study enters into the framework of long term catamnestic researches realised at Hopital de Cery in Lausanne. In this work, the evolution of neurotic and reactionnal disorders in old age has been studied through the direct catamnestic examination of 35 patients who outlived 65 years of age. The accent has been particularly put on social and psychological evolution in regard to 15 variables responding to 2 fondamental hypotheses; it is the conducting clue of the work. After discussion concerning the working method and the selection of survey material, the author is analysing the 35 patients' main caracteristics at the time of their first hospitalisation. He is also taking interest on the patients' social surroundings during their childhood until they were 15. The notion of "broken-home" is largely discussed. The various evolutive aspects are firstly treated apart and then all together in regard to 15 mentioned variables. The various results are making the subject of statistic validation.

Affective Symptoms↗
PubMed1977

[Acute disease conditions and emergency situations in psychiatry].

Beyond a fundamental observation of the characteristics of acute illnesses and emergencies in psychiatry (symptomatology, progression and personality as a pathogenic factor), pathogenic conditions (somatic causes, personality, environment) are described together with typical syndromes and therapeutic principles.

Acute Disease↗
PubMed1977

[Encephalic syndrome following trauma of the cervical vertebrae in childhood].

The author, by explaining and taking the "encephalic syndrome", which was first described in 1949 by Bärtschi and Rochaix, as a base, gives a detailed description of a corresponding syndrome for the age of childhood. After discussing the clinical symptomatology, course of disease, etiology, and pathogenesis, he describes the method of differential diagnosis that allows a clear distinction to be made between the encephalic syndrome and commotio cerebri and commotio spinalis. From a stock of 50 patients with vertebragenic headache it was possible to isolate 5 cases with encephalic syndromes due to cervical vertebral column traumata. The actual number of such cases would doubtless be much higher if it would be possible for pediatric neurologists to examine all cases of craniocerebral traumata in children. The clinical characteristic - according to anamnestic, actual clinical, and catamnestic findings - was a chronical and progressive symptomatology of headache after the disappearance of symptoms of commotion with resistance to therapy with conservative agents since this is a vertebragenic type of headache ("cervical migraine") caused by either a blockade of the upper cephalic joints or insufficiency of ligaments. The necessity of establishing a specific diagnosis arises from the fact that this allows the ailment to be treated by methods of manual and physical therapy, relieving both mother and child from the diagnosis of damage to the brain, which is highly disadvantageous to them from a social prognosis point of view.

Brain Concussion↗
PubMed1975

Some aspects of psychiatric morbidity in the out-patient population of a general hospital.

A preliminary report on certain aspects of psychiatric morbidity in persons attending the medical out-patients department of the Institute of Post-graduate Medicine, Dacca, have been presented. Out of 652 cases who have been interviewed, 31% had purely psychogenic conditions, 45% were suffering from purely organic diseases and 14.8% complained of symptoms of both organic and psychogenic features. No apparent underlying aetiology have been detected in 8.6% of cases. Of the psychogenic group, neurotic disorders comprised the largest number in the sample; anxiety state and sexual neurosis in males were the commonest neurotic disorders. When the mixed groups are included, 44% of males and 49.8% of females had symptoms which were either purely psychogenic in nature or had conspicuous psychogenic component. Reason for such a high percentage of psychogenic component has been discussed. Most of the patients attending the out-patient department were within the age of 21 to 40 years. Attendance in the number of older age persons were less in the psychogenic group than with organic conditions. Further, in females a significant difference was observed between psychogenic and organic group patients above and below the age of 40 years. Patients younger than 40 years were more in purely psychogenic group compared to organic conditions. Most of the patients have been found to be married both in psychogenic and organic group. However, there was significant difference in attendance rate of single males in the psychogenic group were somewhat over-represented in the sample in comparison to purely organic group. There was no relation of marital states in cases of females.

Adult↗
PubMed1976

[Hyperbaric oxygen therapy in the clinical treatment of mental disorders accompanying severe cranio-cerebral trauma].

The author examined 20 patients with severe brain damage. Under the influence of hyperbaric oxygen therapy there was a more rapid restitution of consciousness and a relatively short development of soporous and comatose conditions. Disoders of the Korsakoff syndrome type in such conditions had an abortive development as well (4--7 days). In cases of developing delirious states the use of hyperbaric oxygen therapy demonstrated a clearing of consciousness and a disappearance of psychotic disturbances, already following the first session.

Alcohol Amnestic Disorder↗
PubMed1976

Finding medical reasons for psychiatric behavior.

Medical disease was the cause of the primary disability in the majority (61.2 percent) of 116 elderly psychiatric patients treated at Bellevue Hospital Center. A change in behavior signaled the onset of medical illness with acute brain syndrome. The history that documented a change in behavior was derived from sources other than the patient. It is important to obtain such history during admission evaluation of elderly persons who are confused or whose memory is impaired. Multidiciplinary services enabled many patients to improve so that they could return home rather than being institutionalized. Had such services been available before their admission, many patients might have avoided hospitalization. As a result of this study, the geriatrics unit at Bellevue Hospital Center began to devote its efforts to elderly persons in the community.

Acute Disease↗
PubMed1992

[Effect of diagnostic habits on the incidence of psychiatric diagnoses].

In this study, we analyzed the frequency of ICD-9-diagnoses in 2,868 inpatients (spanning 3 consecutive years) who had been admitted to the Psychiatric Hospital at the University of Tübingen. "Paranoid schizophrenia" (15.8%), "endogenous monopolar depression" (11.2%), "alcohol dependency" (9.9%), "neurotic depression" (6.5%) and "schizoaffective psychosis" (5.3%) turned out to be the most frequently diagnosed illnesses. The diagnosis of 6 mental illnesses described more than 50% of our patient population. In a concurrent study physicians employed at the hospital filled out a questionnaire about their diagnostic style. According to the data physicians were not aware of their narrow diagnostic style. A comparison of physicians within each ward resulted in moderate diagnostic agreement insofar as their diagnoses was based on 4-digit-ICD-categories. When using 3-digit-diagnostic main categories, diagnostic agreement appeared to be higher.

Affective Disorders, Psychotic↗