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PubMed1981

[Diagnostic approach to psychogenic processes--an attempt to differentiate psychodynamic patterns (author's transl)].

An attempt is made to define "emotional reactions", a disease concept in child and adolescent neuropsychiatry which encompasses all processes of psychogenic origin. Emotional reaction, which is defined as psychophysical perturbation of short duration induced by trauma or some other event, is distinguished from neurotic reaction, one of the forms of an unconscious psychodynamic process, and from abnormal personality development, which encompasses all factors affecting psychological development, i.e. deprivation, stimulation, as well as abnormal field and environmental conditions. The differentiation between these 3 processes, which are based on entirely different psychodynamic patterns, has diagnostic and, of still greater importance, therapeutic implications.

Adolescent↗
PubMed1995

[Personality structure and subjective illness concepts of phobic anxiety neurotic patients. Qualitative comparison of 12 individual analyses of initial psychotherapy interviews].

Verbatim transcripts of 12 psychotherapeutic interviews with patients suffering from phobia and panic disorders were examined, focussing on subjective theories of illness, biography, and descriptions of the own personality. The results of our qualitative content analysis allow the reconstruction of some central features of these patients, like characterizing the own personality as normal and without any problems in a stereotype way (1), at the same time feeling wrong understood and exploited from other persons (2), feeling as an outsider and left alone (3), and being no more able to compete with others (4). These and other findings are discussed in the context of psychoanalytic concepts of phobia and panic disorders.

Adult↗
PubMed1994

Adaptive styles in adolescents with psychosomatic illness.

Repressive defense style, characterized by low levels of self-reported distress and high levels of defensiveness, has been well studied in adult patients. This study identified four adaptive styles (repressor, impression manager, low anxious, and high anxious) in an adolescent psychosomatic patient sample (n = 120) by standardized psychometric examination. Adolescents with an active medical diagnosis on DSM III-R axis III or with an axis I diagnosis associated with physical symptoms (conversion disorder, somatization disorder, and psychological factors affecting physical condition) were more likely to be repressors. Those with affective disorders were more likely to be impression managers. Implications for pediatric and psychiatric management are discussed.

Adaptation, Psychological↗
PubMed1994

[Protracted hypochondriacal reactions (based on the type of hypochondriacal development) in myocardial infarct patients].

Clinical follow-up, MPT, clinical and instrumental cardiological evidence is available for 30 postmyocardial infarction patients. They exhibited hypochondriac reactions which persisted for more than 6 months. Three types of such reactions were recognized: somatization (I), cenesthetic (II), overvalued (III). I reactions were associated with homonomous body sensations, anxious and conversion disorders, avoidance behavior. II reactions cover heteronomous sensations with attendant autoaggressive behavior. Patients with reactions III had dominant ideas of complete health recovery, delirium-like fantasies. It is established that I reactions arise in personalities with neurotism radical, reactions II in those with rigidity and eccentric behavior, reactions III in patients with rigidity and conformity.

Angina Pectoris↗
PubMed1994

[Morton metatarsalgia. Results of surgical treatment in 54 cases].

This syndrome, which involves nerve compression, is probably often overlooked and is, therefore, more frequent than supposed. It is characterized by pain of the forefoot, especially the 3rd and 4th toe, and is induced by pressure of the intermetatarsal space, or extension of the metatarsophalangeal joints. Results of the present study suggest that it can be successfully treated by surgery. Fifty-four patients--mostly women in midlife--had undergone operation by dorsal excision of the "neuroma" which had been performed under local anaesthesia in a bloodless field. Forty of the patients (74.1%) had recovered completely within an observation period of 1-6 years. Four (7.4%) demonstrated significant, and another 4, only slight improvement. In 6 cases (11.1%), surgery failed. The 6 unsuccessful cases had not exhibited any preoperative disturbance to the sensibility of the 4th toe. They showed, rather, symptoms of conversion disorder with depressive features, e.g. increased nocturnal suffering which is atypical for Morton's metatarsalgia. It is concluded that the accuracy of diagnosis according to strict criteria is decisive for surgical outcome.

Adult↗
PubMed1977

Adolescent psychiatric emergencies.

The adolescent in a psychiatric crisis is best seen alone first, to preclude observer bias. Emotionally charged areas of discussion must not be avoided. Suicidal and homicidal threats or attempts are challenging emergencies. Working with parents is essential for effective management. Is the fire-setter retarded or psychotic? Family therapy is often the treatment of choice in sexual "emergencies." Bizarre behavior should suggest drugs, severe anxiety or psychosis. School phobia is a particularly complex problem.

Adolescent↗
PubMed1998

Difficulty walking. A presentation of idiopathic juvenile osteoporosis.

Idiopathic juvenile osteoporosis is a rare condition that may present as difficulty walking. Difficulty walking represents a challenging differential diagnosis in pediatrics. Diagnostic studies are usually oriented to rule out neuromuscular etiologies or, once organic causes have been reasonably discarded, conversion disorders. We describe 2 patients who presented with difficulty or inability to walk due to idiopathic juvenile osteoporosis, a rare disease unfamiliar to most physicians. However, early diagnosis in patients can avoid extensive testing and prolonged hospitalizations.

Child↗
PubMed1998

[The pharyngeal anxiety syndrome: globus perception and pharyngeal sensations as an oligosymptomatic abortive form of an anxiety disorder? Nosologic, diagnostic and therapeutic aspects, illustrated with a case].

Since the introduction of the modern psychiatric diagnosis systems anxiety disorders have been intensively discussed. As clinical subtypes in panic disorder the cardial type and the vestibular type are widely accepted. We describe in a case report another of these subtypes, the pharyngeal type; it is characterised by symptoms that are related to the pharynx such as feeling a lump in the throat, swallow disturbance or pain in the pharynx region. It may therefore be called "throat-anxiety syndrome" or "phagophobia". Nosological implications are also discussed.

Adult↗
PubMed1977

Depressive disorders and religious conversions.

The sparse psychiatric literature concerning religious conversions is reviewed. Four case histories of diagnosed depressive illness followed by religious conversion are presented. In two obsessive-compulsive patients, the religious experience failed to resolve the depression, and both ended in suicide. Two hysterical personalities had a resolution of depressive symptoms following the religious experience. The authors suggest that religious conversion dynamically strengthens repression in hysterical persons, but in some cases fails to resolve obsessive isolation of affect and ambivalence.

Adult↗
PubMed1993

Pragmatic impairments in adults with childhood diagnoses of autism or developmental receptive language disorder.

Audiotaped conversational samples from adults diagnosed as having autistic disorders (n = 15) or developmental receptive language disorders (n = 17) in childhood were transcribed and analyzed using methods based on those of Bishop and Adams (1989). Subjects with autism showed substantially greater pragmatic impairment not explicable by generalized impairment of verbal skills. This was mainly due to autistic subjects' greater difficulty in forming context-relevant communicative intentions; in contrast, pragmatic impairments arising from failures in translating intentions into spoken utterances (i.e., impairments at the level of execution) did not distinguish between the groups. In both diagnostic groups, impairment in forming appropriate communicative intentions was closely related to more generalized impairment of reciprocal social behavior.

Adolescent↗
PubMedDate not supplied

[Disorders in the conversion of fibrinogen to fibrin in patients with multiple myeloma].

A prolonged thrombin clotting time was found in 15 of 85 patients with multiple myeloma. Among those with abnormal clotting time in 9 cases (60.0%) the M protein was classified as IgG-lambda, in 1 (6.6%) as IgA-lambda, in 2 (13.3%) as IgG-kappa, and in 3 (20.3%) as IgA-kappa. There was no correlation between the prolongation of thrombin time and occurrence of bleeding. The reptilase clotting time was parallel to the thrombin time. The addition of calcium chloride partially corrected both clotting times. The isolated M proteins IgG-lambda and IgG-kappa from patients with prolonged thrombin time at the concentration of 25-50 mg/ml inhibited the polymerization of fibrin monomers but had no effect on the amidolytic and proteolytic action of thrombin.

Fibrin↗
PubMed1998

Treatment efficacy: voice disorders.

This article reviews the literature on the efficacy of treatment for voice disorders primarily using studies published in peer-reviewed journals. Voice disorders are defined, their frequency of occurrence across the life span is reported, and their impact on the lives of individuals with voice disorders is documented. The goal of voice treatment is to maximize vocal effectiveness given the existing disorder and to reduce the handicapping effect of the voice problem. Voice treatment may be (a) the preferred treatment to resolve the voice disorder when medical (surgical or pharmacological) treatments are not indicated; (b) the initial treatment in cases where medical treatment appears indicated; it may obviate the need for medical treatment; (c) completed before and after surgical treatment to maximize long-term post-surgical voice; and (d) a preventative treatment to preserve vocal health. Experimental and clinical data are reviewed that support these roles applied to various disorder types: (a) vocal misuse, hyperfunction and muscular imbalance (frequently resulting in edema, vocal nodules, polyps or contact ulcers); (b) medical or physical conditions (e.g., laryngeal nerve trauma, Parkinson disease); and (c) psychogenic disorders (e.g., conversion reactions, personality disorders). Directions for future research are suggested which maximize clinical outcomes and scientific rigor to enhance knowledge on the efficacy of voice treatment.

Adult↗