ABSTRACT
INTRODUCTION: A series of factors have been identified, linked to the prognosis of the schizophrenia, such as the form of the starting point, the existence of the causing factors, time of evolution, personal and familiar psychiatric antecedents, the civil state, the working situation, the sex, the social class, age of onset and kind of symptomatology. METHODOLOGY: T look into such factors in a sample of 65 schizophrenic patients, it was collected some information about all the variables and relative data in the clinic history, in a formal way, during the admission of the patient in the year 1987/88. In February, 1993, all the cases have been revised and have been qualified as "the best prognosis" or "the worst prognosis", according to some points, such as number of re-admissions, actual symptomatology, level of social and laboural operation. The total sample of patients was dichotomied according to the prognosis variable and the two sub-samples were compared in respect to all the variables related to the prognosis. RESULTS: The factors associated with a "best prognosis", include the situation of the laboural activity and the biggest level of adaptation in the previous year to the admission. The presence of self-reference delusion, hallucinations and insomnia, have been associated with a "worst prognosis". CONCLUSIONS: It hasn't been possible to reply, in this study, with the prognosis of the schizophrenia, giving evidence of the methodological difficulties and the heterogeneous results in this kind of studies.
Subject(s)
Schizophrenia/diagnosis , Adult , Female , Humans , Male , Middle Aged , Psychiatric Status Rating ScalesABSTRACT
"Burn-out" is a kind of assistential laboral stress which affects the professions which involve an interpersonal relationship with beneficiaries of the job, such us health workers. It originates emotional alterations which lead to feelings of emptiness and personal failure or laboral inability. The revisions about studies of mental disorders in health workers fall upon such laboral stress and remark that in such professional people there is a bigger prevalence of disorders because of the use of substances and of depression. To analyse the mental disorders in health workers by means of the retrospective study of a sample in a general hospital which asked for a psychiatric consultation, sociodemographic variables, clinico-diagnostic and variables related to laboral activity were analysed. The sample is constituted by 112 patients of an average age of forty years old and preferentially females (79.5%). In the sample, some professions are represented above all expectations; they are nurses, physicians, the laboral category of "boss and managers" and the laboral regimen of "permanents". The more frequent psychiatric disorders were the adjustment disorders and code V, the affective disorders and the anxiety disorders (23-33%), the disorders caused by the use of substances and the psychotic disorders are limited (5%). The laboral activity was considered an important factor in 43% of the cases and the mental disorder caused laboral inability, transitory or permanent in half of the patients. It is detected a relationship between the diagnostic and variables such as sex, laboral category, laboral inability, psychosocial stress level and GAF and there hasn't been detected any association between mental disorders and age, profession, laboral regimen and laboral stress.
Subject(s)
Burnout, Professional , Health Personnel/psychology , Mental Disorders/diagnosis , Adult , Female , Humans , Male , Mental Disorders/epidemiology , Middle Aged , Prevalence , Psychiatric Status Rating Scales , Severity of Illness Index , Spain/epidemiologyABSTRACT
Ferro metabolism abnormalities have been related to behavioral and intelectual performance, depression and low response antidepressants in adults. For studying the clinical meaning of those abnormalities in psychiatric patients, sideremia, transferrin and transferrin saturation level were determined in 228 in-patients. The results show a decreased sideremia and transferrin saturation level in elder patients, and more severe abnormalities in patients with a history of somatic disorders and in those with current somatic pathology associates to psychiatric pathology. There is an increasing cortisol postdexametasona in low transferrin patients, as the only data that relate ferro metabolism and depression. Relation between ferro metabolism and: response to treatment, neuropsychological performance and others demographic, clinical, developmental and biological features of the studied have not been detected.
Subject(s)
Iron/metabolism , Mental Disorders/metabolism , Metabolic Diseases/drug therapy , Adolescent , Adult , Aged , Dexamethasone/metabolism , Dexamethasone/pharmacokinetics , Dexamethasone/therapeutic use , Diagnosis, Differential , Female , Humans , Hydrocortisone/metabolism , Hydrocortisone/therapeutic use , Male , Mental Disorders/diagnosis , Mental Disorders/psychology , Middle Aged , Mood Disorders/diagnosis , Mood Disorders/metabolism , Mood Disorders/psychology , Psychiatric Status Rating Scales , Psychophysiologic Disorders/etiology , Transferrin/analysis , Transferrin/metabolism , Transferrin/therapeutic useABSTRACT
On the basis of the hypothetical utility of clonazepam (CLN) for the treatment of affective disorders, by means of previous references and etiopathogenic hypothesis like the Kindling phenomenon we have been developing a study in order to evaluate that usefulness and efficacy which, includes 32 patients with affective disorders; 23 of them with a diagnosis of bipolar disorder (manic) the greatest part of the subjects had been previously treated with lithium antidepressants or neuroleptics, and clonazepam was introduced because of an inadequate response, treatment intolerance or searching for a specific effect. Our results suggest a prevalence of partial and good responses (85%) The same in the objective evaluations as in the subjective ones being the levels of response higher than in previous treatments. The study supports the use of CLN in the treatment of patients who suffer from affective disorders, particularly in hypomanic episodes.
Subject(s)
Clonazepam/therapeutic use , Mood Disorders/drug therapy , Adolescent , Adult , Aged , Drug Evaluation , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
Present and classic observations allow us to relate the obsessive-compulsive disorder (OCD) with different structural and functional anomalies, disorders and neurological findings which let us elaborate etiopathogenic and therapeutic hypothesis. From this and from our experience in the study about soft neurologic signs (SNS) in psychiatry, we explored 20 patients with OCD (DSM-III), compared with 28 phobic disorders and 20 healthy controls, following a SNS protocol and picking up demographic and clinical variables. We besides administered intellectual efficiency exams (WAIS) and neuropsychological tests (Benton/Bender), blind to the SNS exploration. The OCD group showed a higher global incidence of SNS, and especially more alterations in movement's coordination in upper extremities and balance with a trend to show more anomalies in dominance-laterality. This higher incidence of SNS didn't correlate with age, familiar or personal psychiatric history, indicators of neuropsychological impairment and pharmacotherapy. Men with OCD showed more SNS than women did, and as men have higher schooling rates, we found a relationship between SNS and schooling. OCD group showed a trend to be more intelligent than healthy controls, reaching significant higher scores in verbal than in manipulative scales. This lower manipulative score could relate with SNS, suggesting a possible concordance or significant relation with neurobiologic hypothesis, but not supporting neuroevolutionary and organic impairment theories as OCD etiopathogenesis.
Subject(s)
Neuropsychological Tests , Obsessive-Compulsive Disorder/physiopathology , Educational Status , Female , Humans , Intelligence , Male , Models, Neurological , Models, Psychological , Movement , Neurologic Examination , Obsessive-Compulsive Disorder/etiology , Phobic Disorders/physiopathologyABSTRACT
The existence of seasonal variations in the dexamethasone suppression test (D.S.T.) has been remarked. In a sample of 345 patients with affective symptomatology and various psychiatric diagnostics, patient with major depression have higher non suppression levels in spring and winter; a similar but stronger seasonal variations is observed in patients with melancholic and patients with psychotic syndrome showed a similar tendency. In patients with diagnostics different from depression (dementia, schizophrenia, mania, anxiety disorders), the non suppression level is higher in winter. Some similarities with the contributions of other authors are observed but in general disagreements are more frequent, which suggests us the influence of latitude and geo-climatic changes, since the seasonal variability can not be explained by means of seasonal changes in demographic or clinical variables, as diagnostic or psychiatric syndrome.
