[Hyperventilation syndrome in bronchial asthma, essential hypertension and organic neurosis. Clinical picture and external respiration function]. / Giperventiliatsionnyi sindrom pri bronkhial'noi astme, gipertonicheskoi bolezni i organnom nevroze. Klinicheskaia kartina i funktsiia vneshnego dykhaniia.

The external respiration function was studied in 100 patients with hyperventilation syndrome (HVS) divided into 3 groups: 40 patients with HVS and bronchial asthma (group 1) consisting of 15 males and 25 females (age median--45 years, 25 percentile--37 years, 75 percentile--53 years); 39 patients with HVS and essential hypertension (group 2) consisting of 8 males and 31 females (age median 49, 25 percentile--40 years, 75 percentile--57 years); 21 patients with HVS without concurrent somatic diseases of group 3 (7 males, 14 females, age median 45 years, 25 percentile--28 years, 75 percentile--45 years). It is shown that different disorders of pulmonary ventilation correspond to different clinical manifestations of HVS. Thus, in bronchial obstruction (group 1) HVS manifests with "weak respiration", in restrictive pulmonary disorders (group 2) HVS manifests as "heavy respiration", in high parameters of bronchial permeability (group 3)--"shallow respiration".

[Neurotic disorders in adolescents with vegetative dysfunction]. / Nevrozopodibni stany u pidlitkiv z vehetatyvnymy dysfunktsiiamy.

The main disorders in juveniles who are resident in the zone of small doses of ionizing radiation are vegetative dysfunctions. Of these, there prevail vegetovascular dysfunction comprising 45.7%, with neurocirculatory and vegetovisceral dysfunctions occurring less frequently (26.3% and 19.7% respectively). The major proportion of juveniles present with neurosis-like states, asthenic and asthenodepressive ones being the most common type.

Psychiatric morbidity and the presence and absence of angiographic coronary disease in patients with chest pain.

OBJECTIVE: To assess psychiatric morbidity in coronary angiogram patients. METHOD: A psychiatric assessment of 200 consecutive chest-pain patients was performed the day before coronary angiography in a double-blind study design. The sample included 132 men (mean age 57.2 years, SD 9.5) and 68 women (mean age 59.8 years, SD 8.9). A Structured Clinical Interview for DSM-III-R was used to obtain psychiatric diagnosis. The 21-item Beck Depression Inventory, the 20-item Toronto Alexithymia Scale and a four-item Life Satisfaction Scale were used to assess mental symptoms. A coronary angiography with obstruction of a coronary artery by more than 50% was considered to indicate angiographic coronary disease. RESULTS: Mental disorders were found in 28% (95% CI 14-41) of the patients with normal angiographic findings (n=47) and in 24% (95% CI 17 - 30) of the patients with angiographic coronary disease (n=153). Furthermore, no difference was found between these two groups in other rating scales assessing mental symptoms even when adjusted for the New York Heart Association class, duration of chest-pain symptoms or exercise capacity. CONCLUSION: Psychiatric morbidity may not be associated with angiographic findings in patients with chest pain.

Prevalence of panic disorder in cardiac outpatients.

OBJECTIVE: To evaluate outpatients from Toronto-area cardiology clinics for panic disorder (PD) and investigate differences between patients with and without PD. METHOD: Participants were diagnosed using both standard DSM-IV criteria and an altered formulation that identified a more fearful panic group. RESULTS: There was a prevalence of panic disorder (12.5%) in cardiac outpatients in keeping with previous studies. Patients with PD did not differ significantly from other patients with regard to the presence of significant heart disease. The higher prevalence of palpitations found in patients who met criteria for PD compared with those who did not reflects previous findings. PD cases did not differ significantly in family history from respondents without the disorder, but the more fearful group did (P < 0.05). CONCLUSION: PD often presents with cardiac symptoms, especially palpitations, and is often comorbid with heart disease.

Neurocirculatory asthenia: a reassessment using modern psychosomatic criteria.

The purpose of this study was to assess the prevalence of mental illness and to evaluate the quality of life of patients with neurocirculatory asthenia. A consecutive series of 80 patients who satisfied the diagnostic criteria developed by Kannel et al. for neurocirculatory asthenia was included in this study. Patients underwent a psychiatric diagnostic research interview and extensive psychometric evaluation, with both observer and self-rated scales for depression, anxiety, phobic symptoms, quality of life and abnormal illness behavior. In 47 patients (59%), a psychiatric diagnosis (mainly an anxiety disorder) antedated the onset of neurocirculatory asthenia, which was thus defined as secondary, also because cardiorespiratory symptoms were part of the mental symptoms. In the remaining 33 patients (41%) neurocirculatory asthenia was the primary disorder. Patients with secondary neurocirculatory asthenia reported significantly higher levels of anxiety, depression, social phobia, abnormal illness behavior and an impaired quality of life compared with patients with primary neurocirculatory asthenia. This latter did not significantly differ in these variables (except for depression) from healthy control subjects matched for sociodemographic variables. At a 1-year follow-up, patients with primary neurocirculatory asthenia had a much better prognosis than those with secondary neurocirculatory asthenia. The results indicate the feasibility of the primary/secondary distinction based on the time of onset of mental and cardiorespiratory symptoms in neurocirculatory asthenia. Since only about one quarter of the patients were found to suffer from decreased energy and fatigue according to specified criteria, the terms neurocirculatory asthenia and effort syndrome should probably be discarded.

[Effect of organic solvents on functional nervous system disorders]. / Funktsionalnye rasstroistva nervnoi sistemy pri vozdeistvii organicheskikh rastvoritelei.

Examination of 953 workers exposed to low concentrations of chlorbenzene, tricresol and dimethylfonnamid revealed such functional neural disorders as cardiovascular neurosis. Chlorbenzene and tricresol resulted in hypertonic cardiovascular neurosis, dimethylformamid--in hypotonic one. Occurrence of cardiovascular neurosis grew with the longer length of service.

[10 years' incidence of positive diagnostic decisions in functional heart disease in acute clinic treatment]. / 10-Jahres-Häufigkeit positiver Diagnosestellung funktioneller Herzerkrankung in der akutklinischen Behandlung.

An unexpected low percentage of 0.89 per thousand (43 Patients) with the diagnosis of neurocirculatory asthenia could be documented in a clinical database of 48.114 patients with representative data of diagnostic and therapeutic procedures in West German hospitals. As expected, mean manifestation age in male patients was the age group of 20 to 39 years. Only 4.1% of the neurotic patients were committed to the hospital with this diagnosis. These data document the representative diagnostic behaviour towards neurotic chest pain patients in acute hospitals and probably reveal a serious underestimation of the real prevalence. There is evidence that for these patients the diagnostic strategy is weak and distorted by some systematic bias.

Specificity concepts reflected by psychoanalytic epidemiology.

The issue of whether there are specific constellations of intrapsychic conflicts, personality structures and symptom patterns within the general population is investigated by means of a representative epidemiological field cohort study. Out of a population of 600 adults three groups are compared: probands who are suffering from functional cardiac symptoms, those who are suffering from headaches and a sample of 'healthy' probands. The interview protocols of these probands were examined to identify typical conflict patterns. Finally the raters had to give a 'blind' overall diagnosis. Six criteria differentiating the 3 samples were identified and the 'blind' overall ratings were compared with the actual diagnosis. The results are discussed with regard to a hypothesis from the literature.

[Comp]arison of the frequency of psychovegetative disregulation in pupils of 13-18 years from Budapest and from the country]. / Vergleich der Håufigkeit Psychovegetativer Dysregulation bei 13- bis 18jährigen Budapester und Dorfschülern.

The authors have studied the frequency of psychovegetative disregulation at the model of two groups of pupils of 13-18 years from primary and secondary schools, the one consisting 1271 pupils from Budapest, the other 1197 ones from the country. The mentioned phenomenon has been found at 29,7% of the Budapest model, and at 15,6% of the country model. According to the results of our investigation the aetiology of clinical picture is multifactorial. Urbanisation, psychosocial factors like conflicts in family life, unpleasant school surroundings and school stress play an important role in it. A further significant factor is unfavourable way of life: inadequate night rest, life poor of motion, consumption of stimulants. The authors sum up the tasks to be accomplished in order to prevent psychovegetative disregulation.