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In a review of mental health aspects of menopause, emphasis is laid on the psychiatric morbidity that precedes any somatic menopausal symptoms. Only sweating and hot flushes are directly related to the menopause. Complaints such as irritability, headaches, fatigue, depression, and ''mental imbalance'' increase prior to the menopause and decrease after it. Various situational factors have been considered as possible precipitants of emotional disturbances: a child marrying, or having 3 or more children. However, studies indicate that women in the year of the menopause were less likely to develop an episode of mental illness requiring admission to a hospital than at other times. Estrogens do improve symptoms of flushes, dryness and sweats. Changes in emotional imbalance are less clear. Women who come for treatment of menopausal symptoms may frequently be suffering from depression which makes toleration of these symptoms more difficult.
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PMID:Mental health aspects. 95 92

The youthful habits and family attitudes of medical students who later developed or died from one of five disease states were different from those of healthy classmate controls to begin with. In medical school, the total disorder group had significantly more nervous tension, anxiety, and anger under stress, had more insomnia, smoked more cigarettes, and took alcoholic drinks more frequently. Individual disorder group means were significantly different from each other. The mental illness group showed the most nervous tension, depression, and anger under stress and the malignant tumor group the least. The malignant tumor group resembled the healthy control group in these respects. The suicide, mental illness, and malignant tumor groups had low mean scores for closeness to parents, while the hypertension and coronary occlusion group means were slightly higher than the control group mean. Thus psychologic differences in youth have predictive potential in regard to premature disease and death.
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PMID:Precursors of premature disease and death. The predictive potential of habits and family attitudes. 98 20

The Chair of the University Nervenklinik in Homburg/Saar was held by Klaus Conrad from 1949-58 and by H.-H. Meyer, a former pupil and colleague of Kurt Schneider, from 1962-72. As the catchment area and admission policy of the clinic remained substantially unchanged throughout, comparison of the relative proportions of all admissions allocated to different diagnostic categories in 1949-58 and 1962-72 can be used to elucidate the similarities and differences between Conrad's and Schneider's diagnostic criteria. The results of this comparison indicate that Schneider's concept of schizophrenia was broader than Conrad's, and his concept of manic-depressive depression more restricted. More detailed comparisons are complicated by differences in nomenclature and in the varieties of functional mental illness recognized in the two periods. However, it seems that Conrad's concept of mania was wider only when the atypical schizophrenia-like psychoses diagnosed during the Conrad era were added to the Conrad-oriented cases of mania; when this was not done, the Schneiderian concept of mania was broader.
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PMID:Schneider-oriented versus Conrad-oriented psychiatric diagnosis in the same German clinic. 99 Jun 59

47 affectively ill psychiatric patients and their first-, second- and third-degree relatives were investigated by means of an interview and pedigree analysis to determine the incidence of psychiatric illness in their families. The percentage of psychiatric illness appeared greatest in families of bipolar and schizo-affective probands and least in families of unipolar depressives. In addition, we observed that often within a particular family constellation, more than one type of psychiatric illness (i.e., bipolar manic-depression, schizophrenia, alcoholism, etc.) was present. Morbidity risks varied from one affected family to another, indicating that the genetic risk components for some families are greater than for others. These findings are suggestive of multifactorial genetic disease but other genetic models are considered.
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PMID:Genetics of affective disorders. I. Familial incidence study of bipolar, unipolar and schizo-affective illnesses. 100 97

Many surveys of general populations have suggested a high untreated psychiatric morbidity, vairously referred to as mental illness, pre-clinical neurosis, minor neurosis, untreated depression, etc. An Index of Definition psychiatric disorders is described which incorporates cut-off points on the basis of symptoms rated in the Present State Examination. Eight degrees of definition are specified. At the "borderline disorder" level and above, disorders are sufficiently well defined to apply the CATEGO program of clinical classification. This procedure enables in-patients, out-patients and samples of the general population to be compared. Data from surveys in south-east London are presented in order to illustrate the technique. The main conclusion at this stage is that it is possible to identify, by strictly defined and repeatable procedures, a substantial proportion of people in the general population who have "borderline disorders" that can be tentatively classified in terms of the ICD. Whether it is clinically useful to do so requires further investigation. It is also suggested that techniques of this kind can be scientifically useful in comparing the level of morbidity in various populations, both referred and non-referred, and in testing theories concerned with the causes and treatment of various types of psychiatric disorders.
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PMID:A technique for studying psychiatric morbidity in in-patient and out-patient series and in general population samples. 100 81

1. The author reviews some current concepts concerning the definitions and uses of the concepts of health and illness. Starting from the definitions in Psychiatry, "normality" is considered from the statistic, the normative and the clinical standpoints, and as a part of a continuum stretching from health to illness. Several approaches are analyzed, among which Wittaker's, who sets forth the following indicators of normality: a) self-knowledge; b) self-esteem; c) self-security; d) capacity for giving and receiving affection; e) satisfaction of corporal needs; f) productivity and capacity for happiness; g) lack of tensions and of hipersensitivity. 2. The concept of illness as an operative concept is also analyzed, leading to the following statements: a) it is inexistent in non-biological sciences; b) it appears in social sciences only through extrapolation; c) in medicine it means the breacking of homeosthasis; d) in psychology and dynamic psychiatry it means the abnormal stressing of normal mechanisms, common to all persons. 3. The concept of health as equilibrium is also analyzed, with the following precisions: a) equilibrium is defined within a system as affecting the whole of it, and implying transformation and self-regulation; b) homeosthasis is a case of equilibrium for steady complex systems; c) adaptation is the maintenance of equilibrium when there are exchanges with the evironment. 4. Finally, those concepts are applied to mental illness and its limits, and the following criteria are set forth: a) amount of anguish; b) depression related to its motives, intensity, persistence and frequency; c) regression to previous development stages; d) use of defense mechanisms in an inadequate or stereotyped way.
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PMID:[The concept of health and disease]. 101 39

Discriminant function analysis was employed to study the ability of the Geriatric Mental Status interview to distinguish between patients diagnosed by the project as having an organic brain syndrome or a functional psychiatric disorder. In both New York and London, patients with organic brain syndrome scored significantly higher (p less than 0.05) than those with functional disorders on the factors of impaired memory, disorientation and incomprehensibility and significantly lower on the factors of depression and somatic concerns. Discriminant functions calculated from data on the New York and London patients separately significantly distinguished not only the patients on whom the functions were based but the patients in the other sample as well.
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PMID:Distinctions between organic brain syndrome and functional psychiatric disorders: based on the geriatric mental state interview. 102 2

A series of sixty-one patients with depressive symptoms were treated with trimipramine in single nightly dosages. Analysis of the data indicated that a favourable outcome was likely to be associated with the following features: absence of gastro-intestinal complaints; absence of hypochondriasis; a level of anxiety not more than the average for psychiatric patients; absence of situational palpitation; possession of a stable work record; and possession of a family history positive for psychiatric disorder. These features are not claimed to be specific to treatment with trimipramine. Age, sex, out-patient/in-patient status and the over-all degree of depression were not found to be relevant. Trimipramine was associated with a favourable outcome in 64% of all cases treated, and in 73% of primarily depressive conditions.
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PMID:A profile for trimipramine. 102 41

An attempt was made to relate the outcome of surgery to psychosocial factors in an unselected series of 30 male patients with duodenal ulcer. Though statistically significant differences did not emerge on the psychosocial parameters studied, patients with good surgical results were less likely to give histories of preoperative anxiety or depression or to show evidence of these at interview. They also had lower ratings on Hamilton Rating and Deprivation Scales, and were more likely to have hopeful expectations of operation and positive attitudes towards previous medical treatment. Patients with psychiatric illness or psychological deprivation having sugery for chronic duodenal ulceration, can expect almost as good a surgical result as those without these difficulties. They are unlikely to show increased psychiatric morbidity, postoperatively.
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PMID:Psychological factors as a prediction of success in duodenal ulcer surgery. 106 33

The post cardiotomy state is typically delirious and although organic factors are important it is multi-determined. Cerebral ischaemia has been implicated in the development of psychological disorder after resuscitation but longer term neurotic disorders also occur. Affective disturbances, particularly depression, are associated with the coronary care experience. The following conditions are directly related to an increased incidence of psychological disorder: age, loss of sleep, sensory deprivation, stressful experiences, pre-operative morbidity (both physical and mental), the severity of both surgical trauma and the post-operative medical state. For both the staff who administer intensive therapy and the patient who receives it there are unique psychological hazards, the management of which depends largely on mutual understanding and support.
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PMID:The psychiatric aspects of cardiac intensive therapy: a review. 110 11


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