Acta psychiatrica Scandinavica
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The phenomenon of self-immolation was studied in 22 young people, mostly students, who had indulged in this act to protest against the decision of the Government of India to enlarge the scope of reservations in jobs and educational institutions. Within a short span of time of arriving at one of the two treatment centres after attempting self-immolation, the subjects were interviewed and assessed on a semi-structured interview schedule to elicit sociodemographic and attitudinal data. The subjects were also rated on the Brief Psychiatric Rating Scale, Pierce's Suicide Intent Scale, the Superego Paranoia Depression Scale, the Hostility and Direction of Hostility Questionnaire, the PGI Locus of Control Scale and the Alienation Scale. ⋯ Most were ambitious, aggressive, hostile and felt alienated. The absence of manifest psychopathology sets this group apart from cases of deliberate self-harm arising in the context of psychiatric morbidity. Thwarted ambitions, a sense of alienation and intropunitive hostility can lead to protest which at times becomes altruistic and results in self-immolation.
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Acta Psychiatr Scand · Dec 1997
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialLong-term efficacy and safety of milnacipran compared to clomipramine in patients with major depression.
Milnacipran is a new antidepressive drug, a combined noradrenaline/serotonin (NA/5-HT) reuptake inhibitor, which has been suggested to be as effective as and better tolerated than tricyclic antidepressants. Since long-term studies are lacking, we compared the efficacy, safety and tolerability of milnacipran and clomipramine in a double-blind, randomized, parallel-group study setting during 26 weeks of treatment in patients with major depression. A total of 107 patients were treated with either milnacipran (n=52) or clomipramine (n=55). ⋯ Dry mouth was significantly less frequently reported by the milnacipran-treated patients during the early and later phases (weeks 6 to 26) of the study, while insomnia was more common in the milnacipran group during weeks 1 to 6. In conclusion, milnacipran appeared to be less effective than clomipramine in the long-term treatment of depression. The side-effects of the drugs differed to a certain extent, and milnacipran tended to be somewhat better tolerated than clomipramine.
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An association between personality disorder (PD) pathology, including symptoms of all PD types and Axis I disorders, and suicidal behaviour was studied in a series of 90 non-schizophrenic, non-bipolar in-patients of both sexes without mental retardation or organic brain syndrome. All of these patients, who scored positively on the SCID-II-PQ, were interviewed with the PDE and SCID-P, and with the Structured interview for the study of childhood trauma provided with supplementary items reflecting suicidal behaviour. Mood disorders were found to be significantly correlated with cluster C pathology (PD pathology always being expressed by dimensional PDE scores) and eating disorders were significantly correlated with cluster B pathology in women. ⋯ In women a strong correlation was found between suicidal behaviour and history of childhood trauma, especially sexual abuse. The results of this study indicate that there is some specificity with regard to the Axis I/Axis II association, more so in relation to PD clusters than in relation to the individual PD types. However, the relationships between PD pathology and Axis I disorders and suicidal behaviour are complex, and they differ between the sexes.
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Acta Psychiatr Scand · Nov 1997
Comment Letter Randomized Controlled Trial Comparative Study Clinical TrialThe impact of treatment resistance on depressive relapse following electroconvulsive therapy.
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Acta Psychiatr Scand · Jun 1997
The Dynamic Assessment Interview: testing the psychodynamic assessment variables.
The Dynamic Assessment Interview (DAI) is a semi-structured interview with anchored scales to rate patients; suitability for psychodynamic psychotherapy. The DAI was inspired by the Personality Assessment Interview developed by Selzer et al. in 1987 and it introduces from the beginning of the assessment interview an explicit focus on the patient's immediate interactions with the interviewer. Seven theoretical derived variables are assessed, namely psychological mindedness, capacity for self-observation, capacity for empathy, tolerance of frustration, motivation, response to confrontation, and ability to contain and work with affect. ⋯ The patient's personality organization ad modum Kernberg is measured from a global assessment of the interview. The present paper describes the DAI and presents its psychometric properties. An acceptable level of inter-rater agreement was found for the theoretically derived variables and for the personality organization diagnosis, with intra-class correlations or kappa coefficients ranging from 0.68 to 0.80.