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The mental concept of puerperal psychoses is considered as having important determinants in body image disturbances. A case is presented of a woman who had had postpartum psychiatric disorders after the birth of each of her two daughters, and who suffered a relapse in identification with her parturient younger daughter.
A case is presented of a patient telepathically perceiving a stressful event in the analyst's life. Evidence for this is a dream of the patient that embodied a similar content and affect. It is hypothesized that the patient's telepathic ability derived from his self-effacing character trend, which determines an act of perception.
If the homosexual-heterosexual range is a continuum, individuals at the midpoint should be characterized by equal frequency, equal pleasure, and relatively random sex choice of their partners. A small sample of bisexuals, self-identified according to these criteria, was interviewed. If these individuals are typical, sexual choice is dichotomous, rather than continuous, and inferences based on a continuum are untenable.
Compulsive shopping and spending, an impulse disorder, form a specific psychodynamic complex with common developmental precursors of pathological narcissism. Compulsive shopping and spending are distinguished from other symptomatic uses of money and impulsive acts. Four cases illustrate some psychodynamic considerations and therapeutic implications.
Hyponatremia/hypoosmolemia causes marked morbidity and prolongs hospital stays in a significant subset of schizophrenic patients. Case reports with methodological limitations suggest clozapine ameliorates this water imbalance. To more conclusively assess this possibility, we completed a 24-week open-label study in 8 male polydipsic hypoosmolemic schizophrenic inpatients. Subjects were treated initially for 6 weeks with a conventional neuroleptic, which was replaced by 300, 600, and 900 (if tolerated) mg/day of clozapine for sequential 6-week periods. On clozapine, mean plasma osmolality rose an average of 15.2 mosm/kg (95% CI: 5.5-25.0). Dosage of 300 mg/day of clozapine was sufficient to normalize plasma osmolality and was generally well tolerated. Clozapine appears to be the first effective pharmacotherapy for severe water imbalance in schizophrenia.
Neuropsychiatric features characterize frontotemporal dementia (FTD). The authors evaluated the neuropsychiatric features of 53 FTD patients and retrospectively applied the Consensus Criteria for this disorder. Only one-third of the patients met Consensus Criteria for FTD on presentation. Most had early disengagement with poor insight; however, more than half retained socially appropriate interpersonal conduct and emotional expression. Supportive features, including compulsive-like acts and speech changes, were common presenting features, and 20% developed the Klüver-Bucy syndrome on 2-year follow-up. Consensus Criteria for FTD offer guidelines for diagnosis, but further refinement is needed, particularly for patients who lack early changes in social interpersonal conduct.
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Eight chronic schizophrenic inpatients received adjunctive fluoxetine (20 mg/day) for a mean of 10.6 weeks in an open clinical trial. Clinical state improved in all patients. Violent incidents decreased, while participation in programs and socialization increased.
Fifty-one percent of a sample of 105 female state hospital patients were found to have been sexually abused as children or adolescents. In the majority of cases, hospital staff were unaware that the patients had histories of sexual abuse, and only 20 percent of the abused patients believed they had been adequately treated for sexual abuse. Sixty-six percent of the abused patients met the diagnostic criteria for posttraumatic stress disorder, although none had received that diagnosis. Compared with patients who had not been sexually abused, abused patients were significantly more likely to have 17 of 32 symptoms commonly linked with sexual abuse. Every patient who was positive for six symptoms--compulsive sexual behavior, chemical dependency, sadomasochistic sexual fantasy, sexual identity issues, chronic fatigue, and loss of interest in sex--had been sexually abused.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This case report illustrates how a serious identity problem is crucial in dynamically understanding this rare sexual dysfunction. Ten retarded ejaculators treated by the author tend to be extremely compulsive and neurasthenic, with a failure to develop basic trust reflected in an obvious or concealed paranoid stance toward life. They exaggerate the destructive potential of their anger, perceive women as being invasive, possessive and controlling and lack basic sexual knowledge. Differences with the dynamics of the other male sexual dysfunctions are outlined. The successful treatment outcome in eight cases was greatly influenced by the partner's personality.