[On the problem of neuroses of compulsive movements in school children].
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Because of the widely varying symptomatology seen in the neuroses, questions have been raised about whether they constitute a realistically defined category of illness. The authors followed 4074 Navy enlisted men diagnosed as neurotic between 1966 and 1969 and compared disposition decisions and posthospital outcomes for four major neurotic subtypes (anxiety, hysterical, depressive, and phobic-obsessive-compulsive). Neurotic patients as a group were also compared with patients in other diagnostic categories. Although posthospital outcomes were found to differ among the four neurotic subtypes, the differences were not large when compared with the differences between the neuroses as a group and other major diagnostic categories. Those findings suggest that the neuroses are a distinct group with regard to outcome, and that the use of this diagnostic category should not be abandoned without further study.
Determination of ABO blood types was carried out in 72 (35 female and 37 male) patients with obsessive-compulsive neurosis, 73 (35 female and 38 male) patients with phobic neurosis, 75 (54 female and 21 male) patients with hysteria and a random sample of 600 individuals (268 female and 332 male) drawn from the general population. Results provide evidence of: (1) a positive association between obsessive-compulsive neurosis and blood type A and a corresponding negative association between the former and blood type O; (2) a positive association between phobic neurosis and blood type O and a corresponding negative association between the former and blood type A, and (3) a positive association between hysteria and blood type A and a corresponding negative association between the former and blood type O. Moreover, sex does not appear to modify the ABO blood type distribution in our patients with obsessive-compulsive neurosis, phobic neurosis or hysteria. These findings might be considered as supporting the view that hereditary factors in the neurotic individual may influence the clinical form of his neurosis.
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Until the 1850s, obsessive-compulsive phenomena were considered to be a variant of the old notion of insanity. Around this time they became a separate disease: first, as a member of the old class of the neuroses; then, briefly, as a variant of the newly formed notion of psychosis; and finally, as a neurosis proper (in the post-1880s sense). These changes reflected theoretical shifts in the definition of the grand psychiatric categories. After 1860, organic causal hypotheses for OCD included dysfunctions of the autonomic nervous system and cortical blood supply. Psychological hypotheses suggested the OCD might result from volitional, intellectual, or emotional impairment, the last of which predominated after 1890. Issues relating OCD to personality types and hereditability were dealt with in terms of the degeneration theory. By the late 1880s, OCD achieved full clinical and nosological definition.