ABSTRACT
Anorexia nervosa (AN) has serious negative effects on multiple organs and systems of the human body. As patients often do not make their eating disorder the subject of discussion, the physician is forced to rely on the physical examination and laboratory parameters as diagnostic hints. Obvious signs of AN are a body mass index (BMI) below 17.5 kg/m, dry and scaly skin, lanugo, edema, acrocyanosis, petechias, dental problems, and low blood pressure. However, because the often complex laboratory alterations can be difficult for the general psychiatrist to interpret, this article presents some useful guidelines. The plasma of patients with AN often shows alterations in laboratory parameters and appetite regulators, including electrolytes, liver enzymes, leukocyte count, hemoglobin (Hb), leptin, neuropeptide Y (NPY), triiodothyronine (T3), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, ghrelin, pancreatic polypeptide (PP), tumor necrosis factor-alpha (TNF-alpha), and cortisol. Medical problems secondary to AN or due to the treatment itself may lead to further laboratory abnormalities. To date, despite these associated laboratory alterations, the diagnosis of anorexia is a clinical one, based on weight and specific psychopathology.
Subject(s)
Anorexia Nervosa/blood , Anorexia Nervosa/diagnosis , Appetite Regulation/physiology , Blood Chemical Analysis , Anorexia Nervosa/psychology , Body Image , Body Mass Index , Diagnosis, Differential , Electrolytes/blood , Hormones/blood , Humans , Medical History TakingABSTRACT
Nervous and immune system interact through many different messenger substances such as neurotransmitters, cytokines or neuropeptides. For instance, neuropeptides are capable of affecting the metabolism of cells belonging to the immune system. Conversely, cytokines such as tumor necrosis factor (TNF)-alpha, interferon (IFN)-alpha and IFN-gamma, contribute to the receptor resistance of neuropeptides, reduce the availability of amino acids which are needed for the synthesis of neurotransmitters or show neurotoxic effects. Other cytokines like granulocyte-colony stimulating factor (G-CSF) may be highly attractive candidates for the treatment of neurodegenerative conditions. Cytokines are decisively involved in the pathophysiology of psychiatric disorders such as depression, schizophrenia or anorexia nervosa as well as in neurological, respectively neurodegenerative diseases like Parkinson's or Alzheimer's. This connection between the immune system and the pathogenesis of psychiatric disorders leads to the concept that immunomodulatory drugs which are already in use for various diseases related to the immune system may also be efficient in the treatment of psychiatric disorders. This article is supposed to give an overview over the current concepts and possibilities since hopefully these hypotheses lead to new therapeutical strategies for psychiatric patients in the future.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Cyclooxygenase 2 Inhibitors/therapeutic use , Neurodegenerative Diseases/drug therapy , Neurodegenerative Diseases/immunology , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Animals , Humans , Neurodegenerative Diseases/physiopathology , Oxidative Stress , Psychiatry/trendsABSTRACT
OBJECTIVE: A majority of the population regards unconscious conflict as a possible cause for depression or schizophrenia. We examine to what extent people associate psychoanalytical concepts with this term. METHOD: Population-based telephone survey (n = 1010), open questions about the meaning and origin of the term unconscious conflict. RESULTS: 5 % gave a definition with clearly psychoanalytical elements, another 13 % perceived an internal conflict. 24 % thought of a conflict between persons, 23 % had no answer. Regarding the origin of the term, 4 % associated Freud or psychoanalysis, 27 % psychology. For both questions, answers closer to Freudian ideas were more common in West compared to East Germany. CONCLUSION: A concretised understanding far from Freud's original conception of unconscious conflict dominates, which is even stronger in the former communist parts of Germany. Psychoanalytical terms do not necessarily carry a psychoanalytical significance with the public.
Subject(s)
Conflict, Psychological , Freudian Theory , Public Opinion , Unconscious, Psychology , Adult , Aged , Concept Formation , Data Collection , Depressive Disorder/psychology , Female , Germany , Humans , Interviews as Topic , Male , Middle Aged , Schizophrenic Psychology , Socioeconomic FactorsABSTRACT
OBJECTIVE: To provide a systematic review of target-group oriented interventions aimed at reducing the stigma surrounding mental illness. METHODS: An electronic literature search was carried out based on PubMed. In addition, the reference lists of included studies were examined and other sources like the internet were used. RESULTS: 51 studies could be identified, over half of them being targeted at school students. There was a large variation in the format of the various interventions. One half of interventions were based exclusively on education, the other half on a combination of education with contact with someone with a mental disorder. The vast majority of studies reported positive intervention effects. However, in several studies the effect did not persist over a time period of a few months. It appears easier to improve knowledge or to change misconceptions of mental disorders than to reduce the tendency to distance oneself from people with mental illness. When directly comparing the effect of interventions based exclusively on education with those combining education with facilitating contact with people with mental disorders, the latter proved more effective. CONCLUSION: A remarkable number of targeted interventions aimed at reducing the stigma attached to mental illness have been carried out. However, due to methodological limitations no definite assessment of the effect of these interventions is possible at the present time. There is a pressing need for research that adheres more closely to the methodological standards of evaluation research.
Subject(s)
Health Education , Mental Disorders/psychology , Prejudice , Psychological Distance , Public Opinion , Austria , Humans , Outcome and Process Assessment, Health CareABSTRACT
AIM: We want to determine the influence of psychoanalysis on social psychiatry today and 30 years ago. METHOD: Systematic analyses of all articles appearing in Psychiatrische Praxis in 1974, 1975, 2004, and 2005. RESULTS: While almost one in five articles referred to psychoanalysis or Freud 30 years ago, currently this hardly occurs at all. CONCLUSION: The social-scientific claims of psychoanalysis often heard in the 1970 s play no role in current social psychiatry. Psychoanalysis is also losing significance as a method of social psychiatric patient care.
