ABSTRACT
OBJECTIVE: To present the problems possibly associated with psychological sequelae of accidents and make proposals for appropriate therapy. MAJOR POINTS: Accidents experienced by the victim as threatening, whether associated with immediate physical or mental impairment or not, often trigger multiple psychological reactions, and may lead to psychological disorders of either a temporary or a permanent nature. Accident-related psychological symptoms or problems are almost regularly overlooked during the acute medical treatment phase. Not until psychological symptoms become evident are psycho-diagnostic and therapeutic measures undertaken. If such psychological problems, which may often manifest in physical symptoms or behavioral changes, are not recognized early on and vigorously treated, recovery of the patient may be appreciably impaired. CONCLUSIONS: The care-providing physician should expect psychological accident sequelae and give consideration to them in his overall treatment plan.
Subject(s)
Accidents/psychology , Psychophysiologic Disorders/diagnosis , Somatoform Disorders/diagnosis , Stress Disorders, Post-Traumatic/diagnosis , Accidents, Traffic/psychology , Adult , Diagnosis, Differential , Expert Testimony/legislation & jurisprudence , Humans , Male , Multiple Trauma/psychology , Psychophysiologic Disorders/psychology , Somatoform Disorders/psychology , Stress Disorders, Post-Traumatic/psychologyABSTRACT
This report is an evaluation of a questionnaire sent to 160 psychosomatic institutions in West and East Germany. There are 4 types of institutions and 3 types of therapy concepts. The outer and inner conditions of these various types of institutions are differentiated, for instance ownership, number of beds, diagnoses of patients, as well as the relationship between patients and staff and the existent technical equipment.
Subject(s)
Hospitals, Psychiatric/supply & distribution , Psychophysiologic Disorders/therapy , Psychotherapy/trends , Germany , Health Services Needs and Demand/trends , Humans , Patient Care Team/trends , Psychophysiologic Disorders/epidemiology , Psychophysiologic Disorders/psychologyABSTRACT
A 16-year-old physically and mentally retarded male developed a complete Klüver-Bucy syndrome similar to that demonstrated in animal experiments and characterized by so-called psychic blindness, oral tendencies, hypermetamorphosis, emotional disturbance, and hypersexuality after severe brain trauma with loss of consciousness and a transitory hemiplegia. In addition, transitory oral and grasp reflexes were observed. Despite the severity of the clinical symptoms, the patient was able to realize and report on his subjective experience of the reflex and on the instinct-motivated behavior associated with the Klüver-Bucy syndrome. In the case described, two basic behavior patterns could be differentiated, each influencing drive and the abnormally increased sexuality. The first phase of the illness was dominated by relatively constant automatic reactions. These had the character of pre-determined instinctive behavior and were more or less emotionally neutral. In the second phase of the illness, the instinctive behavior became less evident and the patient was able to respond more normally to his sensory-motor impulses. Also, emotional experience such as frustration, pleasure, and displeasure regained their meaning for the patient.
Subject(s)
Brain Injuries/complications , Neurocognitive Disorders/physiopathology , Reflex, Abnormal/physiopathology , Sexual Dysfunction, Physiological/physiopathology , Visual Perception/physiology , Adolescent , Automatism/physiopathology , Eating , Emotions/physiology , Female , Humans , Instinct , Male , Motor Activity/physiology , SyndromeABSTRACT
A 39-year-old woman developed generalised paralysis, reversible organic brain syndrome, and cardiac dysrhythmias after 15 years of laxative abuse. Under continuous and cautious administration of potassium the cardiac rhythm became normal within four days and two days later the paralysis and organic brain syndrome almost disappeared. The cause of the psychiatric symptoms is thought to be cerebral potassium deficiency and an abnormal sodium/potassium equilibrium. Other clinical signs and symptoms due to extreme potassium depletion are presented. The importance of Na+/K+-activated membrane ATP-ase in myocardium and CNS is discussed.
