Rivista di patologia nervosa e mentale最新文献

This report deals with developing a psychotherapy with an adolescent mother who had difficulty accepting her new-born child. Descriptive elements are discussed as well as theoretical considerations regarding maternity during adolescence. More specifically, motherhood, a potentially disturbing event, capable even of producing psychosis, is studied in a person whose behaviour in relation to reality is predominantly on an acting level. Our account focuses on this theme and seeks examine how pregnancy, an important emotional event, can cause serious mental disturbances, when it is acted-out.

58 patients suffering from anxiety neurosis were divided into two groups, matched for age, sex, marital status and symptomatology. In a double-blind trial of 4 weeks' duration one group (28 patients) received alprazolam 0.75-3 mg/day and the other (30 patients) received lorazepam 3-12 mg/day. Both groups showed a steady and significant reduction in anxiety levels as measured by Hamilton Anxiety Rating Scale and Clinical Global Impression scores at 0, 1, 2 and 4 weeks. However, there was no significant difference in measured anxiety levels between the two groups at any stage. Fewer side effects were reported in the alprazolam treatment group, with the mental confusion symptom occurring significantly less often.

A through review of the literature relating to the schizoaffective psychoses was undertaken; the considerable variety of criteria used for diagnosis accounts for the diversity of the results obtained by various researchers. In order to identify a homogeneous group of schizoaffective patients, four parameters, on which the literature is in agreement were formulated. These have enabled us to isolate 27 schizoaffective subjects and to compare them with two control groups: 25 cases of schizophrenia and 26 cases of maniac-depressive psychosis. On the basis of the symptomatological and social variables considered (age of onset, cultural level, social adaptation, family history, early and recent events, response to short-term pharmacological treatment, symptomatology during the observation period), we believe that we are able to distinguish schizoaffective subjects from both schizophrenic and dysthymic subjects.

The authors report the clinical, instrumental and histopathological data observed in a 27 year old man, who died 20 months after the onset of a rapidly progressive neurological syndrome referable to a multitopic brain damage. The clinical picture, which at its fully developed stage was represented by supranuclear ophthalmoplegia, cerebellar ataxia, akinetic-rigid parkinsonism with axial dystonia and dementia, appeared consistent with the diagnosis of P.S.P. The histological examination showed degenerative changes of varied degree in the cerebellum, the brain-stem and the basal ganglia, but the neurofibrillary tangles characteristic of P.S.P. were not found, either with electron-microscopy. The case presented considerable difficulties regarding its nosological classification. Nevertheless, the lack of neuropathological findings of storage disease as well as the particular location of the degenerative lesions have induced the authors to consider it as an atypical form of sporadic O.P.C.A. in the field of M.S.A.

This study examines the psychological and psychopathological reactions that may appear in a man when his partner aborts. The small amount of literature that exists on the subjects was examined, and several men were, interviewed at the time their partners aborted voluntarely. It turns out that in spite of the man's lack of recognition of any reactions (reinforced by current attitudes and by the scant psychological and medical interest in the subject), there is considerable emotional involvement in the lost parenthood, both for the man and the woman. As revealed by the interviews, this involvement may manifest itself in persecutory or depressive anxiety and psychosomatic symptoms. Moreover, but very rarely, real and typical psychopathological symptoms may appear, such as depression and behavioural disorders. The appearance of these reactions is linked to the problems and conflicts aroused by prospective fatherhood, leading to a comparison between the experiences of fuliwed fatherhood and those of fatherhood lost.

The myenteric plexus is the neuronal complex that regulates the motility of the gut; a brief review of its pathology is presented in this paper as well as a tentative etiopathogenetic classification. Disorders of gut innervation include congenital (e.g. Hirschsprung's disease) or acquired diseases; the latter can be idiopathic or related to a more general pathological involvement of the whole organism as in the case of bacterial toxins, diabetes mellitus, Riley-Day disease and primary orthostatic hypotension. In view of the fundamental similarity of the myenteric plexus to the central nervous system, the study of this organ can be useful both for diagnosis of degenerative diseases of the central nervous system (i.e. via rectal biopsy) and for gaining a better etiopathogenetic insight into peripheral and central nervous system disease.

In order to evaluate personality modifications toward greater concreteness and a consequent reduction of fantasizing in subjects undergoing chronic haemodialytic treatment, the Shalling Sifneos Personality Scale (S.S.P.S.) was administered to a group of patients undergoing dialysis and to two control groups: one consisting of patients with chronic hepatitis and the other of healthy subjects. The S.S.P.S. measures the alexithymic traits of the personality. Subjects undergoing dialysis scored significantly higher than chronic hepatitis patients and healthy subjects; the latter group had the lowest scores. The alexithymic score, moreover, appears to be directly correlated with the duration of dialysis. It is suggested that the prominence of the alexithymic phenomenon may be related to defense mechanisms against recurrent anguish about dying and to the tendency to assume certain characteristics of the particular therapeutic regimen, such as concreteness and rationality, so as to be able to tolerate the aggressive aspects of the treatment.

The investigators have examined the literature dealing with the psychic symptomatology that generally accompanies tetanic and spasmophilic phenomena, particularly the psychic and characterological substratum of patients affected by such symptoms. By focusing their inquiry on the spasmophilic symptoms displayed by neurotic patients, rather than on the psychic disturbances of patients with spasmophilic symptoms, the following considerations emerge: The widely held view that psychic disturbances in spasmophilic patients can be fitted into the classic picture of asthenic, anxious or depressive disorders is not tenable. The erethistic syndrome with its characteristics of generalized irritability and hyperexcitability, described by us in 1966, is the one most frequently exhibiting spasmophilic symptoms. Therefore, nervous erethism encompasses the most important characteristics of erethistic neurosis as well as of spasmophilia. A connection between the psychological and biological aspects of neurotic conditions is again foreseeable, especially in the light of recent discoveries on normocalcemic spasmophilia. In conclusion, it is intriguing to speculate that the neuropsychic disturbances of spasmophilia fit into the larger conception of nervous erethism and that the psychic and somatic phenomena of both have the same biological origin.

The Authors present a case of bilateral internal carotid artery thrombosis (BICAT) with a minimal symptomatology and whose neurological examination was consistently negative. The angiographic investigation revealed that the major supratentorial vessels were bilaterally filled via the vertebro-basilar system. Although it is now generally accepted that there are occasional cases where bilateral occlusion may be compatible with adequate vital functions, the Authors think that it is extremely rare to find a case as neurologically intact as theirs.

A case of postencephalitic parkinsonism is described. The patient, 27 years old, was affected by encephalitis lethargica 15 years prior to the appearance of the extrapyramidal syndrome on the right side of his body. Based on data in the literature, the possibility is discussed that postencephalitic parkinsonism may still be present and may manifest itself sporadically.