ABSTRACT
A random sample (n = 80) of depressive and CHD general hospital inpatients of both sexes assessed fellow patients via a questionnaire (Mink) based on a qualitative pilot study. The results document the central role of hospital roommates in determining inpatient experience. Except for depressive males, all patients, regardless of their sex and diagnosis, experienced the presence of roommates as desirable and helpful. The stress factor, on the other hand, received a much lower rating. The main expectation was emotional relief, although the individual accentuation differed considerably. Putting one's complaints in perspective proved to be particularly important. At the same time, it became evident that patients, mainly males, had a fear of their roommates causing additional stress by illness, problems and disturbing behaviour. Male patients placed more emphasis on informational support aspects and, if possible, depended on spouses for stabilisation of their emotional balance. Female patients, on the other hand, described their relationships to roommates as being characterised by trust and understanding. At the same time, the inability to be alone was mentioned as a stress factor, particularly by the depressive females. The response pattern of the CHD patients also differed according to sex.
Subject(s)
Coronary Disease/psychology , Dysthymic Disorder/psychology , Interpersonal Relations , Patients' Rooms , Sick Role , Social Support , Adaptation, Psychological , Adult , Aged , Female , Gender Identity , Humans , Male , Middle Aged , Patient Satisfaction , Personality Inventory , Pilot ProjectsABSTRACT
BACKGROUND: Our aim was to study the influence of psychotherapy in addition to a standardized corticosteroid treatment on the somatic and psychosocial course of Crohn's disease. METHODS: In a prospective, randomized multicenter study 108 of 488 patients received either drug treatment or, in the intervention group, additionally psychotherapy in the first half of the 2-year follow-up period. RESULTS: Eighty-four patients (77.8%) completed the somatic and 81 (75%) the psychosocial follow-up. Twenty-three per cent of the control group and 30% of the psychotherapy group showed episode-free courses; 29% and 17%, respectively, underwent surgery due to failure of drug treatment. The main analysis, which was based on subranking by number, duration, and severity of relapses, failed to show significant differences between the two groups (P = 0.125). The same result was obtained for the psychosocial status after 1 year in the main target criteria depression, anxiety, psychosocio-communicative status, and quality of life. CONCLUSIONS: The confirmatory analysis did not prove significantly better courses after additional psychotherapy. There was a tendency towards fewer operations.
Subject(s)
Crohn Disease/therapy , Psychotherapy , Adolescent , Adult , Anti-Inflammatory Agents/therapeutic use , Combined Modality Therapy , Crohn Disease/physiopathology , Crohn Disease/psychology , Female , Glucocorticoids/therapeutic use , Humans , Male , Middle Aged , Prospective Studies , Quality of Life , SteroidsABSTRACT
Compared to the hysterical structure, the following characteristics are more frequent in schizoids: they are illegitimate, are born late after several siblings and are quiet and shy as children. The mother is irascible, the father aloof; on the other hand, the parental combination "mother and father affectionate" is more common. The father is often absent in early childhood, and there is the additional stress caused by changes of residence. In their earliest childhood memory, the mother and father are named as central reference persons. According to the impairment score, the schizoids are more severely disturbed. In contrast, hysterical patients have young mothers that taboo sexuality and irascible fathers; they criticize the mothers more and also idealize the father. The hysterically structured individual is an only child or has few siblings. As children, these patients are well-behaved, lively, athletic, have many friends, fight and compete with siblings. In their earliest childhood memory, they name other adults--not family members--and topics centering on possession and contact. Their childhood is affected by stress arising from the death of the father and other close reference persons as well as from flight experiences. The results make it possible to describe a markedly different line of development in the structure groups and a greater degree of stress due to various risk factors in the schizoids.
Subject(s)
Histrionic Personality Disorder/psychology , Neurotic Disorders/psychology , Schizoid Personality Disorder/psychology , Adult , Female , Humans , Life Change Events , Male , Parent-Child Relations , Personality Development , Psychoanalytic Theory , Psychophysiologic Disorders/psychology , Social Adjustment , Social EnvironmentABSTRACT
16 patients suffering from acne conglobata were prospectively examined by means of analytical interviews and 5 psychometric procedures before and 6 months after oral treatment with 13-cis retinoic acid (isotretinoin). In comparison with a control group of psychosomatic patients, acne conglobata patients are more frequently affected by childhood influences leading to a neurotic personality structure already before the outbreak of acne; the patients more often complain of disturbed social contact, depressive moods, or general disorders. After successful treatment with isotretinoin, we observed augmented self-confidence and positive aggressiveness, on one hand, and increase of anxiety depressive moods, and general complaints, on the other. These effects are not drug related in a pharmacological way. These observations suggest the influence of psychic factors in the pathogenesis of acne conglobata. Regarding the medical management of these patients, it should be considered that psychic and psychosomatic disorders might be intensified after successful drug therapy.
Subject(s)
Acne Vulgaris/drug therapy , Adaptation, Psychological , Personality Development , Tretinoin/therapeutic use , Acne Vulgaris/psychology , Adolescent , Adult , Female , Follow-Up Studies , Humans , Isotretinoin , Male , Neurotic Disorders/psychology , Parent-Child Relations , Personality Tests , Psychophysiologic Disorders/psychologyABSTRACT
38 schizoid and 70 hysterical patients with neurotic disturbances are compared with regard to social data, intelligence and triggering situation. Schizoids are more frequently single, childless and live alone, while hysterics are married, remarried or divorced, have one child and live with their partner and the child. With nearly the same education and intelligence, schizoid patients are more often workers/skilled workers, pupils/apprentices/students or have no profession; hysterically structured individuals, being predominantly women, are more frequently housewives. Nearly half of the most frequent triggering events are equally distributed in both structure groups; these are particularly events signalling a change during development, which, in degree of severity, can just as well be minor threshold situations as serious reverses. With an earlier age of onset, schizoids decompensate significantly more often in "developmental stages", whereas hysterical patients are more likely to do so in connection with events of "love-sexuality" and those which provoke hysterical anxieties. Of the 15 most frequent events, only 6 each occur in either the schizoids (starting school, puberty, moving away from home, entering into a heterosexual relationship in terms of a casual encounter, beginning an apprenticeship or studies, failure in a test) or the hysterically structured individuals (vacation, marriage, pregnancy/delivery, marital disharmony, extra-marital relationship and severe illness of the patient).
Subject(s)
Histrionic Personality Disorder/psychology , Life Change Events , Schizoid Personality Disorder/psychology , Social Behavior , Adult , Female , Histrionic Personality Disorder/therapy , Humans , Intelligence , Male , Psychoanalytic Therapy , Schizoid Personality Disorder/therapy , Sick Role , Social EnvironmentABSTRACT
This part examines the symptoms and diseases of neurotics with either a schizoid (38) or a hysterical (70) personality structure, comprising 5% and 10% respectively of the first admissions in 7 years. Compared to the hysterical structure, schizoids more frequently show the following characteristics: they are men and have as their secondary component a mixed character structure, an earlier age of onset, a longer duration of illness but earlier referral for psychotherapy. They suffer mainly from psychic symptoms--depressive states and contact difficulties as the indicating signs. Further complaints are defective concentration, feelings of apprehension and difficulty in working, also bulimia and the inability to breathe deeply. They were mostly born between 1940 and 1959. Their relatives suffered from psychiatric disorders. Compared to the schizoids, hysterically structured individuals are almost exclusively women, their second most important structural component being obsessive-compulsive. They develop their illness later, have it for a shorter time and are referred for psychotherapy later. Their indicating signs manifest themselves more often somatically, less frequently as anxiety states or phobias. The symptoms occur simultaneously in several organ systems, particularly the respiratory tract, the gastrointestinal tract and the musculoskeletal system. Common symptoms are dyspnea and/or hyperventilation tetany, nausea, weight gain, frigidity and fluor as well as crying fits. They formerly suffered from gynecological disorders and had to undergo operations. They were mainly born between 1920 and 1939. Their relatives had cardiac disorders and their symptoms were identical or similar to those of their father.
Subject(s)
Histrionic Personality Disorder/diagnosis , Schizoid Personality Disorder/diagnosis , Adolescent , Adult , Diagnosis, Differential , Female , Histrionic Personality Disorder/psychology , Humans , Male , Middle Aged , Psychophysiologic Disorders/diagnosis , Schizoid Personality Disorder/psychology , Sick RoleSubject(s)
Constipation/psychology , Diarrhea/psychology , Adolescent , Adult , Child , Child Rearing , Child, Preschool , Defense Mechanisms , Diagnosis, Differential , Female , Headache/psychology , Humans , Infant , Male , Mother-Child Relations , Obsessive-Compulsive Disorder/psychology , Personality Development , Sleep Initiation and Maintenance Disorders/psychologyABSTRACT
In order to answer the question of whether an interrater's stable facts make it possible to differentiate between neurosis, 50 psychosomatics (asthamatics) were compared with 50 psychosomatics (asthmatics) were compared with 50 psychoneurotics including 25 cases of anxiety neurotics and 25 phobics. The age at the time the patient became ill, the age at the time of the scientific investigation, length of illness, psycho- and psychosomatic pre-illnesses, former hospitalizations, primordial and accompanying symptoms, social facts, types of the conflict situation which triggered the illness and the results of intelligent tests were correlated with the main variabilities: neurosis, sex, character structure and tests for statistical significance: psycho and psychosomatic neurosis as well as anxiety neurosis and phobia are different from one another in numberous variabilities.
