Comprehensive psychiatry
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The utility of DSM-IV criteria for pain disorder was investigated within a consecutive sample of 90 chronic pain patients aged between 18 and 65 years. In this sample, 65.6% (n = 59) fulfilled diagnostic criteria for DSM-IV pain disorder. Of the patients with DSM-IV pain disorder, 22% fulfilled additional criteria for depressive disorder, 6.8% for hypochondriasis, and 23.7% for any other DSM-IV diagnosis. ⋯ Despite the presence or absence of a general medical condition, there was no significant difference between pain disorder associated with both psychological factors and a general medical condition (code 307.89) and pain disorder associated with psychological factors (code 307.80) with regard to the pain duration, intensity, and type and the level of disability and educational level. The formulation of a distinct psychiatric entity for pain conditions may improve the consideration of psychosocial factors in the pathogenesis and clinical cause of pain. However, with regard to our data, the distinctive validity of different subtypes of pain disorder as provided by DSM-IV awaits further clarification.
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Comprehensive psychiatry · Sep 1999
Agreement between hospitalized adolescents' self-reports of maltreatment and witnessed home violence and clinician reports and medical records.
Seventy-one consecutive psychiatrically hospitalized adolescents (34 males and 37 females) were systematically asked about their experiences of sexual abuse, physical abuse, and witnessing home violence using a reliable 46-item self-report measure of maltreatment, the Traumatic Events Questionnaire-Adolescent Version (TEQ-A). Subjects' responses were compared with a "best-estimate" source consisting of data from child protective service and police reports, medical records, and clinician interviews. ⋯ Disclosures were highest for sexual abuse (86%) and lowest for witnessing home violence (68%). The results show that psychiatrically hospitalized adolescents' self-reports of maltreatment experiences generally concur very well with best-estimate sources.
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The purpose of the study was to examine the association between the subjective sleep quality and pain threshold in fibromyalgia. Sixteen patients with fibromyalgia were included in the study. ⋯ The pain threshold was negatively correlated with the scores for subjective sleep quality, habitual sleep efficiency, and sleep disturbance and the PSQI global score. We conclude that there is a negative correlation between pain and sleep disturbance: increased pain sensitivity is associated with greater sleep disturbance.
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Comprehensive psychiatry · Mar 1999
ReviewFlashbulb memories and other repetitive images: a psychiatric perspective.
The term "flashbulb memory" was used by Brown and Kulik in 1977 to refer to the vivid recollections that humans may have of events considered to be of particular significance to the individual or group. These memories are described as having a photographic quality and as being accompanied by a detail-perfect apparel of contextual information (weather, background music, clothes worn, etc.) pertaining to the time and place where the event was first known. They may even evoke emotions similar to the ones felt upon hearing the news. ⋯ Psychiatrists, however, should consider flashbulb memories as being members of a broad family of experiences that include drug flashbacks, palinopsia, palinacusis, posttraumatic memories, and the vivid and haunting memories experienced by subjects with some forms of mental disorder (e.g., phobias, panic attacks, obsessional disorder, phantom-limb phenomena, and depressive melancholia). All of these experiences share clinical features such as paroxysmal repetition, sensory vividness, a capacity to trigger emotions, dysphoria, and a tendency for the rememberer to shift from the role of actor to that of observer and for the reminiscence to become organized in a stereotyped narrative. Some of these clinical phenomena are discussed, and the suggestion is made that seeking phenomenological and neurobiological common denominators to all of these experiences may be a superior research strategy versus studying flashbulb memories alone.
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Comprehensive psychiatry · May 1997
Comparative StudyA comparative analysis of Minnesota Multiphasic Personality Inventory profiles of anorexia nervosa at hospital admission, discharge, and 10-year follow-up.
The assessment of personality variables measured by the Minnesota Multiphasic Personality Inventory (MMPI), was compared in a sample of 52 female inpatients with anorexia nervosa at the time of hospitalization, discharge from hospital, and 10 years after treatment. Admission MMPI scores were significantly higher than scores both at discharge and 10 years later. There were no significant overall differences between discharge and follow-up evaluation. ⋯ There was no significant difference on admission MMPI scores between the four outcome groups; however, patients who recovered had a greater decrease in MMPI scores at the 10-year follow-up study compared with poor outcome patients. The long-term outcome of anorexia nervosa was largely unrelated to the severity of psychopathology during the acute phase of the illness. These results suggest that persistent personality features are best measured following treatment of acute symptomatology of anorexia nervosa.