Schweizer Archiv fur Neurologie, Neurochirurgie und Psychiatrie = Archives suisses de neurologie, neurochirurgie et de psychiatrie最新文献

30 female patients with the diagnosis of "uterus myomatosus" and a control group of also 30 women with the diagnosis "descensus uteri et vaginae" were examined by a standardized questionnaire containing socio-economic, anamnestic and psychological data. To get information about their personality the "Freiburger Persönlichkeitsinventar" (Freiburg Personality Inventory), half-form A, was administered at the end of the interview. The age limits were 35 and 55 years. The main socio-economic results are the following: during childhood and adolescence the myom-patients lived mainly near towns (p less than 0,01). The women of this group have better relationships to their husbands than the descensus-patients (p less than 0,01) and the husbands of the myom-patients are more often (p less than 0,01) of the same age or younger than their women. 18 out of the 30 women of the myom-group (i.e. more than 50%) said that their wish to become a mother has not been fulfilled while this answer was given by none of the 30 descensus-patients (p less than 0,01). The question is discussed in how far the uterus-myom can be understood as a somatic expression of the frustrated wish to get a child, as a "compensatory growth". Beside this, the authors are aware of the fact that other aspects, f.e. hormonal factors, may be important.

Depression and faith are closely connected in Job. Struck by heavy buffets of fate and suffering from an incurable disease Job despairs of God. He ist no longer able to connect his suffering with his former experience of God. Whereas his friends exhort and rebuke him, Job feels to be innocent and expresses his despair in continuous laments and accusations in order to challenge God to give an answer. His ability "to transcend", his hope of "God, his friend" against "God, his enemy" saves him from resigned self-negation and total paralysis. In the care of Job it is safe to assume that there is no melancholy nor endogeneous depression, during which the power of faith and hope is often extinguished. The problem to what extent the category of hope and the ability of "transcending" in heaviest suffering and deep depression become especially relevant under the psychotherapeutic aspect, is an important question to be put to psychiatry and psychotherapy.

Our report describes the evolution of the outpatients' psychiatry in Lausanne. Here is mentioned the constant increase of consultations for new and former cases, and it is statistically shown that this augmentation is not only the result of the increasing population in the "Vaud District" (Canton de Vaud) but rather the consequence of the increasing number of patients with deeper investigations and treatments. It is true that the psychotherapeutic training was the most important in our outpatients' department, but the coming of psychotropic drugs has changed the treatment in certain cases and has developed mixed treatments. The creation of the Psycho-Social Center in the Psychiatric outpatients' department was the beginning of the social action in the institution, with the creation of an emergency department, consultations at the patients' home and treatment made by a team including doctors-outpatients' nurses-social assistants. We have checked that for many outpatients, very often in hard or psycho-reactive situations, there was no opposition between pharmaco-therapy or psychotherapy. So pharmaco-therapy and psychotherapy are often used separately or together in the outpatients' department through individual analytic psychotherapies, group or brief psychotherapies, relaxation, emergency treatments with perfusion of psychotropic and neuroleptic drugs.

A clinical observation is reported and gives the opportunity to discuss such notions as anosognosia, hemiasomatognosia, phantom limb, somatoparaphrenia... Considering cerebral asymmetry right hemispheric lesions could bring a feeling of strangeness in the living. This would result in a delusional elaboration then under left hemispheric control.

In 1875, the government of the Canton of Fribourg decided that a field study should be carried out on the number of mentally ill people in their territory. This happened in view of the construction of a new state mental hospital. With the support of members of the local administration, an experienced psychiatric expert examined 164 mentally ill persons, 147 at home and 17 in general hospitals and homes. In the author's report, the sick person's case history, his present state and proposals for treatment cover on average two pages per patient. Almost all of the mentally ill described in this report can quite easily be classified according to the main categories of modern nosology: there are 69 schizophrenics, 28 cases of affective psychoses, 28 mental retardations, and 39 further mental disorders, most of them identifiable as well. The case histories of the patients, too, correspond with the courses of mental illness as we know them today. There is a very high tendency to develop chronic symptoms. 25 patients lived temporarily or permanently like prisoners, locked in and/or tied up, some of them in repellent conditions. This study disproves the following hypotheses: 1. that the symptoms and the course of psychiatric illnesses have changed significantly since the last century, due to the development in civilisation; 2. that the absence of psychiatric hospitalism and psychiatric labelling prevents the worst and most characteristic kind of schizophrenic and affective disorders and their chronification; 3. that the mentally ill were better cared for in a pre-industrial and agricultural society without psychiatric care such as the community described in the Fribourg report.

211 persons consecutively seen for parasuicidal behavior by the various services of the CIMH (Central Institute of Mental Health) in Mannheim were investigated with regard to the seriousness of intention and the real risk to die. Seriousness and real risk to die were measured by a scale which was divided into two parts - the interviewer rating scale and the self-rating scale. The highest suicide risk was found in depressed patients. This group showed higher scores on the self- and interviewer rating scale than the non-depressed patients. It could be shown that the high risk of suicidal attempts of depressed patients cannot be explained by the older age of this group. However, it can be assumed that psychological factors, influencing the intention to die, are more important.