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PubMed2001

The epidemiology of mental disorders in the U.S. Navy: the neuroses.

As part of a series of investigations into the occurrence and outcome of mental disorders in the U.S. Navy, this study was designed to determine first hospitalization incidence rates for neurotic disorders in an initially healthy young adult population and to determine the duration of acute illness, severity, and posthospital outcomes in terms of military performance and premature personnel losses. Data on first hospitalizations for neurotic disorders were extracted from automated medical record data files for all active duty Navy personnel admitted between 1980 and 1988. Incidence rates were calculated for major demographic subgroups, and career history records provided a 4-year follow-up of service-related outcomes. Overall incidence ranged from a low of 3 per 100,000 for obsessive-compulsive disorders to a high of 58 per 100,000 for other neurotic disorders/neurotic disorders not otherwise specified (NOS). The phobia and depressive groups had the poorest prognoses for continued service, and the NOS and anxiety groups had the best prognoses.

Adolescent↗

PubMed1984

A symptom profile of patients with multiple personalities, including MMPI results.

Patients with multiple personalities are excellent hypnotic subjects, a capability demonstrated both clinically and on a standard hypnotizability test. They tend to experience a plethora of symptoms associated with anxiety states, hysteria, obsessional neuroses, phobic states, depression and mania, schizophrenia, alcoholism, sociopathy, and hyperactivity--although there are exceptions to this profile. Both males and females suffer from this disability, and an MMPI profile for female multiples is described.

Adult↗

PubMed1982

An Operationalized Multisymptomatic Model of Neuroses (OMMON): toward a reintegration of diagnosis and treatment in behaviour therapy.

Experimental results from a sample of 216 patients with four different "symptom-neuroses" show that 65% to 90% of these patients have different combinations of multiple symptomatology. With a background of these data, we present an Operationalized Multisymptomatic Model of Neuroses (OMMON), based on self-rating assessment of these patients on 4 symptom scales. Individual ratings on each scale are dichotomized into (+) or (-) results with regard to defined cut-off points and the model is derived from their 16 mathematically possible combinations. Subsequent analysis of these data (from a single test application) with our Varying Cut-Off Point Assessment (VACOPA) leads to hypotheses regarding causal symptom interactions and prediction of symptom changes over time, easily evaluated by repeated test application. In treatment research the model seems suitable to: (a) build more homogeneous diagnostic groups; (b) operationalize varying degrees of "neurotic" disturbance, from "normal" via "client" to "patient"--independently of existing illness theories; (c) support prognoses of individual developments within and without treatment; (d) specify treatment aims and optimal sequences of interventions; (e) monitor predicted outcome; (f) reconsider earlier apparently contradictory outcome studies; (g) evaluate theoretical concepts regarding "neurotic" symptom formations in neuroses, psychoses, and psychosomatic disturbances. For treatment purposes, OMMON should only be used together with "clinical" hypotheses; its prognostic potential can be increased by additional application of our Operationalized Multivariate Model of Motivation (OMMOM). All three diagnostic approaches may be used for mutual evaluation.

Adolescent↗

PubMedDate not supplied

[New proposals for the development of the concepts of neurotic anxiety, major depression and panic attack].

An accumulation of research results, laboratory and clinic, leads to revise the classification of disorders of anxious nature (anxiety disorders according to the DSM-III). An empirical confirmation allows to separate anxious states from panic attack and phobic behavior constituting a component separated from generalized anxiety, exaggerated emotional reactions to stress agents and obsessive-compulsive disorders. The response to pharmacotherapeutic agents and the important number of anxiety depression and mixed depression tends to make permeable the separating line between the nosological entities anxiety and depression. The observations of subjects suffering from endogenous anxiety obliges to revise the classification by introducing three varieties of neurotic anxiety: phobic endogenous anxiety, endogenous anxiety without phobic formation, and exogenous anxiety. Endogenous anxiety is close to the concept of anxious thymopathy. By its pragmatic conception, modifications obtained by psychoactive agents are used (antidepressants of the group imipramine and IMAO, classical benzodiazepines and alprazolam, provocation controlled in laboratory) in order to strengthen innovating hypotheses and allow to elaborate useful treatment strategies for neuroses.

Agoraphobia↗

PubMed1988

[Neurosis and melancholia].

Melancholias (endogenous depressions) are also observed in neurotic persons, in character neuroses (personality disorders) as well as symptomatic neuroses. The neurotic disorders are demonstrable before, to some extent during and also after the melancholic phase. From casuistics, melancholias, particularly in cases of anxiety neurosis, cardiac neurosis, compulsion neurosis and depressive neurosis are reported on. The frequency of this concurrence is difficult to determine. Instead of making a diagnosis under any circumstances, it is nosologically more conclusive and clinically more beneficial to start from two independent diseases, which interfere in one patient.

Adult↗

PubMed1981

The Middlesex Hospital Questionnaire: a validity study with American psychiatric patients.

The Middlesex Hospital Questionnaire (MHQ) was used as a screening test for psychiatric disorder in 169 new outpatients. The profile obtained on the six subscales of the MHQ was strikingly similar in this American sample compared to four previous British reports. The MHQ significantly differentiated between diagnostic groups, most particularly between neuroses and personality disorders. Moreover, 75 per cent of the patients could be correctly classified as either neurosis or personality disorder on the basis of their MHQ total and subscale scores. The MHQ appears to be particularly useful in identifying phobic disorders, and the phobia subscale consistently discriminated between anxiety-phobic states and other diagnostic groups.

Adult↗

PubMed1983

[Types of adrenograms in neuroses].

A total of 714 adrenograms (graphic depiction of adrenalin and noradrenalin excretion in relation to the circadian rhythm) obtained from neurotic patients were analyzed. The authors succeeded in ascertaining the differences of their types in patients suffering from hysterical neurosis, neurasthenia and obsessive neurosis. The adrenographic method is believed to be capable of serving as an additional diagnostic criterion in the differential diagnosis of these pathological forms.

Circadian Rhythm↗

PubMed1984

[Residual states in the clinical picture of neuroses].

A study of the clinical picture of residual disturbances in 90 patients with various forms of neuroses showed that residual neurotic states are a regular stage of the timecourse of protracted neuroses with a favourable course. At this stage the differences between individual forms of neuroses become less conspicuous. Mild, fragmented clinical manifestations are presented in the form of two types: a monosymptomatic and a more complicated polysymptomatic one. The latter type of residual states is more dynamic which is reflected in both a tendency to their reduction and transformation into a monosymptomatic state and a possibility of a neurotic relapse.

Asthenia↗

PubMed1989

[Internal picture of the disease and its value for psychological diagnosis of neuroses].

The clinical and experimental psychological methods were employed to study the structure and mechanisms of the internal picture of the disease in 305 patients afflicted with neuroses. Four varieties of the internal picture of the disease were outlined depending on the characteristics of the emotional and cognitive aspects of the disease experiencing. Each of these varieties is marked by the originality of the personality mechanisms within the "I" system, neurotic conflict, and psychological defence. The described typology of the internal picture of the disease expands the possibilities of multidimensional diagnosis aimed at differentiated therapy of neurotic patients.

Adult↗

PubMed1980

[Choice of symptoms in neuroses. Hysterical and obsessive-phobic neuroses].

This publication is a first attempt to verify our hypothesis that symptom choice in the classical neuroses depends on a disequilibrium between assimilation and accommodation, in the Piagetian sense, of reflective thinking. Results of tests derived from classical paradoxes of Western thought, from genetic psychology and from a neuropsychological test of the habituation of the alpha-blocking response support the following hypothesis; the reflective thinking of hysterical patients appears dominated by a primacy of assimilation and that of obsessional patients by a primacy of accommodation.

Alpha Rhythm↗

PubMed1982

[The evaluation of neuroses findings and treatment possibilities on 615 ambulatory psychotherapy patients].

For 615 neurotic and psychosomatic patients who visited two outpatient psychotherapeutic institutions for initial diagnostic interviews the diagnosis of neurosis was made according to the "Psychischer and Social-Kommunikativer Befundbogen" (PSKB; psychic and social-communicative findings sheet) and supplemented by evaluations based up on prognostic scales. This study presents an overview on the frequencies of symptom as well as personality characteristics in these patients. With regard to prognosis and indication of therapy, special emphasis is placed upon those characteristics which provide information concerning the interaction between patient and examiner.

Ambulatory Care↗

PubMed1975

[Season and psychiatric disease (author's transl)].

Clinical experience shows that certain psychiatric patients have to be hospitalized more frequently during certain periods of the year. We compared the data of the hospitalisation of 17268 psychiatric patients, hospitalized over a period of 13 years (1956-1969) with the time of the year. Schizophrenics are hospitalized mostly during the warm period, least during the cold period, regardless of their sex. The same can be said about the diagnostic subgroups (paranoics, catatonics, hebephrenics, schizophrenia simplex) and the periodic depressions and depressions of involution. Reactive and neurotic depressions and depressions of exhaustion, neurotics (crisis during puberty, neuroses of character, obsessional and anxiety neuroses), arteriosclerotics and psychopaths do not show an even pattern of distribution. Male alcoholics, too, do not show a maximum of admissions. Female alcoholics are admitted more during the warm periods, less often during the cold periods. Drug addicts, too, show a minimum in winter, an even level over the rest of the time of the year. It is suggested that the patterns of admissions for certain psychiatric patients are to be explained by the different sensibility of meteorological factors.

Alcoholism↗

PubMed1984

[Comparative study of the clinical dynamics of neuroses with variable expression of the hypochondriacal syndrome].

A comparative clinico-statistical study of 149 neurotic patients revealed the distinctive characteristics of the clinical time-course of neuroses with marked hypochondriac disturbances. These were expressed in the specific premorbid features, "a reactive form" of neurosis, the presence of paroxysmal psychovegetative disorders, the symptoms pathognomonic for a given form of neurosis, and the characterological reactions in the initial period. In patients without hypochondriac emotions, the initial period was determined by astheno-depressive reactions. In the subsequent stages of the disease this difference became less prominent and was expressed only in the predominance in patients with hypochondriac disturbances of such features as egocentrism, reticence, weakness, fatigability, and importunity.

Adult↗

PubMed1978

[Carpipramine in neuroses].

Having outlined the limits of drug-therapy in neuroses, where it may support psychotherapy, a treatment the use of which is still questioned by some, the authors review the rare publications involving the indications of Carpipramine in neurotic syndroms. Active upon symptom patterns consisting essentially of asthenia, inhibition and psychomotor impairment, raising the level of activity, stimulating enthusiasm and relational activity, Carpipramine would appear to represent a new advance in the treatment of some neurotic syndroms, partially encompassing the border-line indications of anti-depressants and those of certain disinhibitory neuroleptic agents.

Adjustment Disorders↗

PubMedDate not supplied

[Handwriting expression of 2 major neuroses: hysteria and obsessive disorder].

In psychopathology, an interesting approach consists of observing the essential characteristics of already recorded entities. Very few works have been devoted to the rapport existing between graphological productions, personality structure and mental illness. This work concerns the handwritings observed in hysteric patients, diagnosed as such after taking into account case history and clinical interview. Our aim is to show the essential points which characterize this particular pathological structure. The stable features of hysteria are verified in graphic items. From, movement and ordonnance of such handwritings serve as useful aides in identifying the stages of maturation of the Ego. The graphological expressions observed in patients presenting with obsessional neurosis significantly contrast, however, with those encountered in the preceding personality structure (Hy). A comparison of these two different series demonstrate the utility of this work in clinical psychiatry.

Adult↗

PubMed1976

Unexpected recoveries from chronic severe psychiatric illness during treatment by psychological modes.

Four patients with psychotic illnesses and two with obsessional neuroses made unexpected recoveries attributable to psychological processes. They had been ill for periods ranging from 6 months to 19 years before first seen. All had physical therapies of several kinds including one who had approximately 500 ECT and another who had bimedial lobotomy. Follow-up after recoveries ranged from 6 to 24 years. In two cases psychotherapy (psychoanalytically orientated) was significant. Changed family dynamics, the support of a psychopomp, and the mobilisation of previously unrealized ego-resources were other significant psychological processes. Exhaustive re-evaluation of patients resistant to physical therapies is urged.

Adult↗

PubMed1983

[Clinical picture and features of the dynamics of vegetative crises in patients with neurotic disorders].

The author studied 115 patients with principal clinical forms of neuroses and neurotic developments of personality, with the clinical picture characterized by vegetative crises. Using clinical follow-up examinations of patients and specially designed questionnaires, the characteristic features of the clinical picture and the time-course of vegetative crises were investigated. The findings showed the dependence of the crisis structure on the character of the main neurotic syndrome and the relationship between the structure of crises and permanent vegetative disorders in patients. The time-course and regularities of the manifestations of the major components of the crisis were studied in relation to the stage of neurotic disorders--neurosis and neurotic development of the personality.

Adrenal Medulla↗

PubMed1990

The genetics of six neurotic disorders: a twin study.

Persons who had met criteria for specific anxiety or depressive neuroses during their lifetime were identified from a sample of 446 pairs of adult twins. Although there was a genetic contribution to neuroticism and to symptoms, there was no inheritance of specific disorders. This concurs with previous work in a sample from the same Australian Twin Registry and with those from a Norwegian sample. It is concluded that while there is a genetic contribution to the predisposing trait, and therefore to the intermittent appearance of symptoms, this contribution is obscured by the grouping of symptoms into diagnoses and by the help seeking which is a prerequisite to clinical diagnosis.

Adolescent↗