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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The granting of abortions according to the psychiatric indication (PI) in West Germany is discussed. The PI is sharply differentiated from the emergency indication, which is of a social nature. These 2 indications merge in the case of psycho-social considerations. Possible psychological complications of the abortion operation itself should be considered in deciding whether an abortion should be granted, and a waiting period of at least a day should be allowed for both patient and physician before a definite decision is made. The indication for sterilization in conjunction with the abortion operation and the possibility of continuing therapy for those whose abortions are not granted are additional considerations or the decision on the suitability of the PI for a particular patient. The evaluation of suicidal tendencies is important for the psychological evaluation of abortion seekers. In general, cases of endogenous depression do not constitute a indication for abortion, while reactive depression may lead to depressive decompensation in a patient who has an unwanted pregnancy. The prognosis in such cases is especially hard to determine in younger patients. Character neuroses and alcoholism or similar diseases complicate the psychiatrical determination. In cases of schizophrenia and oligophrenia with good prognoses, abortion is not usually indicated. Most applications for abortion which are denied under the PI are of social character and belong under the emergency indication, e.g. serious physical illness of the mother, other handicapped family members, young, unwed mothers. These principles are illustrated with sample cases.
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PMID:[Psychiatric indications for pregnancy interruption]. 35 Aug 3

The change in paragraph 218 of the criminal code regarding abortion was responsible for new guidelines for the psychiatric evaluation regarding a therapeutic abortion is reported. The commonest indications were medical reasons such as exhaustion, and reactive depression. There was one case of schizophrenia, one case of affective psychosis, two attempted suicides, twenty reactive depressions, one character disorder, and one case of cerebral seizures. Five applications were approved. The follow-up evaluation of the women with the approved and dismissed applications for therapeutic abortions showed no physical or psychic abnormalities. A comparison with 88 German applicants showed similar results. The stringent evaluation of applications for therapeutic abortion is still necessary even after the change of the law.
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PMID:[Desire for therapeutic abortion in the dependents of foreign workers. Outpatients psychiatric evaluation (author's transl)]. 70 Mar 47

Amniocentesis, the obtaining of a small amount of amniotic fluid with fetal cells for testing, has made it possible to diagnose some diseases in utero early enough in pregnancy to permit abortion. The current major indications for prenatal diagnosis are Down's syndrome (Trisomy 21), numerous rare inborn errors of metabolism, and neural tube closure defects. Chromosoml screening in prisons has identified men with sex chromosomal abnormalities with higher frequency than in the general population, e.g., the XYY syndrome and the XXY or Klinefelter syndrome. Some of the disorders of sexual differentiation of behavioral interest range from hermaphrodites, the Turner syndrome, congenital adrenal hyperplasia, and testicular feminization. Depression and schizophrenia are 2 psychiatric disorders that are probably influenced by genetic factors but cannot be tested for at present. Behavioral syndromes associated with abnormal chromosomes or biochemical markers may be suitable for early detection int he future. There are many social and psychological problems in testing and counseling for genetic and chromosomal diseases.
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PMID:Intrauterine diagnosis and genetic counseling in psychiatry. 79 88

Many studies in developed countries show a high frequency of psychological distress among women attending gynecology clinics. The aim of this study is to assess the prevalence of psychiatric morbidity among 239 women attending a gynecology clinic at Ilorin Maternity Hospital in Nigeria. The aim also was to test the validity of using the 30-item version of the General Health Questionnaire (GHQ-30) as a screening tool. Clinical diagnoses were recorded according to the International Classification of Diseases-Ninth Edition (ICD-9). Psychiatric morbidity was determined according to the method of Deshpande. Literate respondents used a self-administered GHQ-30 and illiterate respondents were interviewed with the GHQ-30. The psychiatric interview was conducted by a research psychiatrist. Patients were grouped into 1) patients with symptoms diagnoses according to ICD-9, 2) cases with subdiagnostic syndromes, and 3) patients without significant psychiatric symptoms. A basic demographic profile of patients is given. Obstetrics and gynecologic data reveal that 31.3% were nulliparous, 44.5% had between 1 and 4 children, and 24.5% had 5-8 children. 64.4% reported regular menses, 21.9% reported scanty menstrual flow, and 64.4% had a normal flow. 17/6% reported a history of induced abortion, and 43.4% reported previous spontaneous abortion. 23.6% had primary infertility and 28.3% had secondary infertility; infertility was the most common complaint. A score of 5 or higher on the GHQ-30 indicated a psychiatric case. 35/2% were found to suffer from definite psychiatric morbidity. An additional 6.4% had severe psychiatric symptoms. Of the psychiatric diagnoses, 34.1% were for neurotic depression, 24.4% for anxiety, 25.7% for adjustment reaction, 12.2% manic depressive psychosis (depressed type), 2.4% phobic state, and 1.2% schizophrenia. Psychiatric morbidity was found to be unrelated to age, marital status, religion, education, occupational group, or duration of marriage. Symptoms such as irregular menses, pelvic pain, ad having no children were factors significantly associated with psychiatric morbidity; this pattern is supported in the developed country literature. Policy should be directed to a preventive and biopsychosocial model of health care.
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PMID:Psychiatric morbidity in a gynaecology clinic in Nigeria. 161 88

China's population is increasing at a rate of 12 million/year and the population doubled from 1949 to 1982. By the end of the century there will be 1 billion 300 million people when the land resources can accommodate only 680 million inhabitants. The policy of 1 child aims only at curtailing this growth by a system of awards and penalties. Contraceptives are free and widely available. As a result there are 32 million single children, and there is concern about the future care of the elderly. Since 1949 health care has improved. The infant mortality rate decreased from 200/1000 in 1949 to 34/1000 in 1982. Average life expectancy rose from 35 to 68 years. There are 2 million hospital beds and over 4 million medical personnel. Contagious and infectious diseases were eliminated in the 1950s, however, 60 million Chinese suffer from endemic disease, especially from snail fever. 40 million women use IUDs. There are 144 medical schools with 144,000 students. 1,200,000 paramedics provide primary care in the communes. There is an acute shortage of nurses because of its lowly status. Dependents pay 50% of health care while it is free for workers. Health education campaigns are widespread (1 child only, stop smoking). The elderly are cared for by their children, but grandparents also take care of grandchildren. Retirement age is 55 or 60 depending on gender and type of work. Professional visits were made to the Beijing Traditional Chinese Medicine Hospital (gallstone treatment with herbs, heat-producing moxibustion for blood circulation), Norman Bethune Hospital, (suction and prostaglandins for abortion), Dongying Commune, Hebei Medical College (25 specialties for postgraduate students), Shandong Psychiatric Hospital in Jinan (treatment of acute psychoses, schizophrenia, or mania), the Provincial Hospital Jinan (cesarean operations are done with acupuncture anesthesia), Jinan School of Health (nursing curriculum demonstration), Shanghai First Social Welfare Home for the Elderly, and to several factories.
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PMID:Aspects of health care in China. 250 88

The article reports upon the characteristics of 300 abortion applicants in Arkansas manifesting significant stress from unwanted pregnancy between May 1, 1970 and June 30, 1971. The sample is limited by the fact that all of these women had been willing to seek medical aid. Patients ranged from ages 13-47, 131 of them ages 17-21. 35% had had some college education; another 29% were high school graduates. 50.6%, 20.6%, and 27.3% were single, divorced, and married, respectively. 59.6% of the patients were primiparas. 18.3%, 9.6%, and 12.3% were classified as being neurotic, having psychophysiologic tendencies (gastrointestinal problems, obesity, chronic headaches), and having sociopathic features (passive-aggressive, frankly rebellious, delinquent, antisocial, alcoholic), respectively. 12 women had noticeable schizoid features; 4 women had mildly active schizophrenia. Fathers of the women were usually blue-collar workers (55.3%) or white-collar workers (24.6%). The most frequent ordinal sibling position among the women was oldest child (38%). Parental instability (1 or both parents lost through death, divorce, father usually away working, chronic alcoholism, etc.) was reported by 39.6% of the patients. Patients' attitudes toward the unwanted pregnancy included dislike of inexpediency of the situation (82.6%), self-depreciation (55.6%), and aversion (28.6%). Precipitated psychiatric disorders were for the greatest part mild. Manifesting symptoms included depression (66.7%), anxiety (21%), and mixed anxiety and depression (12.2%). Suicidal threats and gestures were made by 22 and 8 patients, respectively. In summary, the study reveals a group of predominantly Caucasian women from unstable, middle-class urban families who were going through an adjustment reaction to adolescence or adult life.
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PMID:Abortion applicants in Arkansas. 426 12

This presentation about lack of communication on contraception between staff and patients in an outpatient mental hospital consists of 7 parts: 1) an exposition of the authors' hypothesis; 2) the subject matter and method of this study, i.e., analysis of recorded staff interviews; 3) a description of the transcripts on a textual level; 4) an inventory of staff opinions classified by the key words: "contraception, abortion, mental patient, relatives, psychiatrist and responsibility;" 5) an "analysis of structures" implied by these themes; 6) "incarnations of contraception," i.e., 12 typical histories of mental patients given or denied contraception or abortion; and 7) a conclusion. The hypothesis is that contraception speaks precisely to therapists in the repetitive relationship implied constantly by the psychotic course, in terms of desire, identity, bodily organization and structure of speech. This study is based on 10 recorded conversations between a female intern and individual hospital staff members, prompted by a newspaper article about a young psychotic given oral contraceptives without her knowledge. The transcripts revealed denial of the issue, depersonalization, projection and delegation of responsibility to others. When grouped into the 6 key words, the opinions uncovered a vast somatic field, confusion couched in metonymic figures of speech, such as using the term "woman" for "mental patient," moral, genital and sexual connotations. Mental patients were depersonalized; parental roles were confused in speaking of contraception for the patients; physicians were considered judges; responsibility was denied for the patients and avoided generally. The authors' structural analysis took the form of a diagram with responsibility in the center, always preceded or followed by contraception and abortion, and by the triangle psychiatrist-relatives-patient (or mother, young person or woman). Maternity or relationships were always excluded. The 12 anecdotes included hysteria, schizophrenia, hypochondria, obsession, drug abuse, latent homosexuality, repeated pregnancies, self-induced abortions, sterilization, abortion, pills, injections and castration without the patients' consent, or with their ambivalince toward these procedures. Thus, contraception resulted in structural reversals in both patients and staff, involving the fundamental access to genitality for patients and defensive constructions by staff, which is not surprising in a cultural milieu which confuses sexuality and procreation.
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PMID:[The problem of contraception in young psychotics treated in a day care hospital]. 444 86

An attempt is made to identify and document the problems of comparative evaluation of the more recent studies of psychiatric morbidity after abortion and to determine the current consensus so that when the results of the joint RCGP/RCOG study of the sequelae of induced abortion become available they can be viewed in a more informed context. The legalization of abortion has provided more opportunities for studies of subsequent morbidity. New laws have contributed to the changing attitudes of society, and the increasing acceptability of the operation has probably influenced the occurrence of psychiatric sequelae. The complexity of measuring psychiatric sequelae is evident from the many terms used to describe symptomatology and behavioral patterns and from the number of assessment techniques involved. Numerous techniques have been used to quantify psychiatric sequelae. Several authors conclude that few psychiatric problems follow an induced abortion, but many studies were deficient in methodology, material, or length of follow-up. A British study in 1975 reported a favorable outcome for a "representative sample" of 50 National Health Service patients: 68% of these patients had an absence of or only mild feelings of guilt, loss, or self reproach and considered abortion as the best solution to their problem. The 32% who had an adverse outcome reported moderate to severe feelings of guilt, regret, loss, and self reproach, and there was evidence of mental illness. In most of these cases the adverse outcome was related to the patient's environment since the abortion. A follow-up study of 126 women, which compared the overall reaction to therapeutic abortion between women with a history of previous mild psychiatric illness and those without reported that a significantly different emotional reaction could not be demonstrated between the 2 groups. In a survey among women seeking an abortion 271 who were referred for a psychiatric opinion regarding terminations of pregnancy were compared with 82 patients referred directly to a gynecological department. Termination caused little psychiatric disturbance provided the patient wanted an abortion. Cases of severe psychiatric outcome in the form of psychosis, severe depression, and schizophrenia have been reported. The outcome for women who were refused an abortion and the effects on the children born as a result have been discussed in several studies. In 1 survey, 24% of 249 women who were refused abortion were significantly disturbed after 18 months. Many studies comment on the value of counseling in the abortion decision, but few comparison studies have actually evaluated abortion counseling. A large amount of previously reported research on the psychiatric indications of abortion may be unreliable because women seeking abortions on mainly social grounds used to have to show psychiatric disturbance in order to obtain a legal abortion.
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PMID:Psychiatric sequelae of induced abortion. 670 3

Evaluation of the ultrastructural changes in embryonic brain cells was made according to the intensity of two complexes--destructive and compensatory-proliferative. They were correlated with a number of clinical parameters (features of mother's disease, the condition at the moment of abortion, peculiarities of treatment, etc.). It was established that for schizophrenia, unlike other diseases, the compensatory-proliferative complex of changes is more typical. The most pronounced changes in brain ultrastructures were noted in embryos of the patients with acute psychotic states or in the decompensation stage in psychopathlike schizophrenia course. No correlation between the form of the disease course and intensity of mother's treatment was established.
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PMID:[Relationship between ultrastructural pathology of the embryonal brain and features of the course and treatment of schizophrenic mothers]. 745 20

With desinstitutionalization, the social life of psychiatric patients and particularly that of psychotics has arisen in new terms over the past twenty years. In particular, relationships and sexuality of these patients are manifest realities to which few studies are devoted. 61 schizophrenic and 21 bipolar women (18-45 years of age, mean 34 in-or outpatients) were interviewed with a battery of instruments (PANSS, Carpenter's criteria of schizophrenia with deficit syndrome, axis V of DSM-III-R) and with a semi-structured questionnaire related to clinical data, sexuality, relationships, children and motherhood. Half of the schizophrenic women have an active sexual life, and children. The study provides information about the reproduction rate of schizophrenic women, the precocity of their pregnancies and the outcome of their children. The study also treats these women's ability to rear their children, their desire to have children and any hospitalizations during the perinatal period. These results, as well as those related to abortion and contraception, are discussed in the light of those of the bipolar control group.
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PMID:[Psychotic women and their children]. 761 28


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