Acta psychiatrica Scandinavica
-
Acta Psychiatr Scand · Jan 1997
ReviewA critical review of genetic studies of schizophrenia. I. Epidemiological and brain studies.
Family, twin and adoption studies suggest that susceptibility to schizophrenia is based at least to some extent on genes. The results of these studies vary and depend greatly on the diagnostic criteria used. ⋯ According to a large Finnish adoption study, the patient-family interaction has an even more important role in the origin of schizophrenia than purely genetic factors. Interaction between the genetic factors on the one hand and physical, psychological and psychosocial factors on the other hand is emphasized.
-
Acta Psychiatr Scand · Jan 1997
Psychosocial factors and completed suicide in personality disorders.
The aim of the present study was to investigate the relationships between personality disorders (PD) and various psychosocial factors in a random sample (n = 229) of suicides with psychological autopsy-based DSM-III-R diagnoses representing the total 1-year suicide population in Finland. Background social factors and social interaction factors for 56 suicide victims with a PD diagnosis were compared with those of 56 age- and sex-matched non-PD diagnosis victims. The groups were similar with regard to marital status, socio-economic status, parental divorce, broken home before the age of 16 years, parental suicide attempts, and proportion of subjects living with parents. ⋯ Although the groups did not differ with regard to complaints of loneliness before suicide, the lonely PD suicide victims had experienced more interpersonal loss and/or conflict than the lonely non-PD suicide victims. The PD suicide victims were very similar with regard to psychosocial factors, irrespective of sex, age, Axis-I comorbidity, or the cluster type of the PD. Only living alone was more common in young PD suicide victims, and male PD subjects had less often had confidants or friends with whom they shared common interests.
-
Acta Psychiatr Scand · Oct 1996
Dropping out of psychiatric treatment: a prospective study of a first-admission cohort.
This study examined patient and treatment variables associated with patients dropping out of psychiatric treatment, drop-outs' reasons for terminating treatment, and the relationship between drop-out and patient satisfaction. The term "drop-out' was defined as termination of treatment despite therapeutic need. In a cohort of 131 first-admission psychiatric patients, 26% of these subjects dropped out of treatment during the first year. ⋯ The drop-outs were markedly less satisfied with both the outcome and various aspects of the treatment process than those who did not drop out. The most common reasons given by the drop-outs for terminating treatment were dissatisfaction with care (44%) and no need for further treatment (20%). Greater knowledge of the factors related to drop-out might increase the likelihood of keeping patients in treatment.
-
Acta Psychiatr Scand · Feb 1996
Catatonia. II. Treatment with lorazepam and electroconvulsive therapy.
Case material and retrospective studies support the use of both lorazepam and ECT in treating catatonia, but few prospective investigations exist and none employ quantitative monitoring of response. In this study we test their efficacy in an open, prospective protocol, and define a "lorazepam test' with predictive value for treatment. Twenty-eight patients with catatonia were treated systematically with parenteral and/or oral lorazepam for up to 5 days, and with ECT if lorazepam failed. ⋯ Four patients failing lorazepam responded promptly to ECT. It is concluded that lorazepam and ECT are effective treatments for catatonia. The rating scale has predictive value and displays sensitivity to change in clinical status.
-
We followed the prescription of psychotropic drugs by primary health care physicians over a 3-year period. The material consisted of 1000 randomly selected adult primary health care patients. At least one psychotropic drug was prescribed to one third (n = 307) of the sample during the follow-up period. ⋯ The most important predictor for prescribing psychotropic drugs was recognition of mental problems at the initial survey, but age and marital status also had an association with the prescription. No gender difference was found after controlling for mental problems. Psychotropic medication was also prescribed to 13% of the patients who had no sign of mental disorder.