ABSTRACT
The authors examine the clinical history of two women whose first symptoms of anorexia nervosa appeared at the ages of 20 and 30 years respectively. Their illness remained stationary for many years then suddenly became fatal after a series of severe metabolic disturbances. These occurred after a period of 26 years in the first case, and 11 years in the second. This illustrates the concept that the prognosis of anorexia nervosa is not as good when the first symptoms appear at an advanced age, and also that a vital prognosis can be established in certain cases according to percentages that are variable but no negligible. A survey of what has been written to date seems to confirm this.
Subject(s)
Anorexia Nervosa/mortality , Adult , Anorexia Nervosa/complications , Female , Humans , Time FactorsSubject(s)
Emergency Services, Psychiatric , Hospitals, General , Mental Disorders/therapy , Mental Health Services , Admitting Department, Hospital , Ambulatory Care , France , Hospitalization , Humans , Interprofessional Relations , Mental Disorders/diagnosis , Physician's Role , Referral and Consultation , Transportation of PatientsABSTRACT
Anesthesists often ask for withdrawal of psychotropic treatment a few days before surgery. Usually they do not differentiate among the various classes of psychotropic drugs. Some drugs, including MAO inhibitors and reserpine-like agents, can induce or precipitate accidents; however, this does not occur with other types of antidepressants, neuroleptics and minor tranquilizers. The authors review the psychiatric risks related to such withdrawals; these risks are to be considered. They report that in 8,210 ECT under general anesthesia (among which 5,688 were done without psychotropic withdrawal) there was no occurrence of severe accidents.
Subject(s)
Anesthesia, General , Psychotropic Drugs/administration & dosage , Anesthesia, General/adverse effects , Anesthetics , Drug Interactions , Electroconvulsive Therapy , Humans , Long-Term CareABSTRACT
The purpose of this survey was to know better the image of mental illness among the public. A 28 items questionnaire tried to summarize the main set-ideas usually held in this respect. It was submitted to a group of medical students. The answers obtained indicate quite clearly the force and continuity of some of these set-ideas: more complicated illness, often incurable, of which the number is constantly increasing; bad reputation of electrochocs. They also show an evolution of the state of minds concerning the differenciation of different types of illnesses, the alleged origins of mental illnesses and eventually the role and importance of psychotherapy in their treatment. Eventually a "free-opinions" section, underlined the common interest for the social condition of the mental patient, the responsibility of social factors in the genesis or the appearance of his troubles and above all for the "character" of psychiatrist. Conclusions drawn from this survey only have a relative value, but are encouraging enough to justify a larger and deeper one.
Subject(s)
Attitude of Health Personnel , Mental Disorders , Prejudice , Psychiatry , Students, Medical , France , HumansABSTRACT
During 12 years, we have effected 6,982 electroshocks with anesthesia and celocurine (N.D.) on 713 patients, i.e. 7.25% of the total hospitalized patients. 62% of them (440) were all this time under antidepressant drugs and 38% (273) were not. We observed 16 minor incidents ten (2.27%) among those under treatment and six (2.19%) among the others; of these 16 incidents, 11 led to an interruption of the treatment for safety. The association of antidepressant drugs with electroshock under anesthesia and celocurine (N.D.) does not present any real danger.
