Neurotic Conditions Research Articles

Augmented respiratory relief. A new use of CO 2 therapy in the treatment of phobic conditions: a preliminary report on two cases.

Respiratory relief (R.R.) appeared to be a simple and rapid treatment for specific phobias and for the phobic components of more complex neurotic conditions (Orwin, 1971). The basic hypothesis was that the R.R., satisfying an intense need to breathe, if simultaneous with the presentation of a phobic stimulus, would inhibit the degree of anxiety previously provoked and that this inhibition would persist. The need to breathe was induced by voluntary restriction up to maximum voluntary respiratory arrest (M.V.R.A.). As in conventional desensitization (Wolpe, 1958), a hierarchy was drawn up and the patients were desensitized using R.R. instead of relaxation. Carbon dioxide-oxygen mixtures were introduced because CO2is known to stimulate respiration, and it was expected that by intensifying the need to breathe the speed and effectiveness of treatment would be increased by the augmented respiratory relief (A.R.R.).

Depression: Comparative Studies of Normal, Neurotic, and Psychotic Conditions

The title of this work might lead us to expect a comprehensive text on depressive illness, but this is not the author's intent. Edith Jacobson is an outstanding psychoanalytic clinician and theoretician. This book is a collection of her papers on the psychoanalytic conceptualization and treatment of depression, as it appears in normal mood swings and in neurotic and psychotic personalities. Furthermore, the book is not designed to be a comprehensive study of all psychoanalytic views of depression. Rather, it records the struggles of one particularly gifted person to understand depression within the framework of classical Freudian psychoanalytic theory and the ego-psychological studies of Heinz Hartmann. In all of the papers Dr. Jacobson presupposes familiarity with classical psychoanalytic concepts and with the influential work of Hartmann. The book starts with a 40-page paper on the psychoanalytic theory of affects. Some readers may have difficulty following Jacobson's theoretical exposition. For them

Functional Localization of Overstrained Neural Processes Due to Their Collision

Experimental neurosis is the result of overstrained force and mobility of neural processes in the cortex. It leads to the disturbance of the normal balance between excitation and inhibition. This conclusion is based on the numerous investigations of I. P. Pavlov and his students and successors, who studied the causes of neurotic conditions, the role of the type of nervous system, and the significance of the strength and mobility of neural processes.

Lysergic Acid Diethylamide (LSD 25) and behaviour therapy

This paper deals with the problems involved in the treatment of complex neurotic conditions. A seventh feature is added to Wolpe's list of the six features that make a neurosis complex. The use of Lysergic Acid Diethylamide (LSD 25) in the treatment of such difficult cases is discussed and three cases are presented.

THE EFFECTS OF SOME CENTRAL NERVOUS SYSTEM DEPRESSANTS ON CONFLICT BEHAVIOR IN DOGS

Conflict behavior induced by punishing the animal's approach to food has been frequently studied in cats or rats as a means for evaluating the effects of drugs upon neurotic conditions. In 1945 Masserman and Yum (1) showed that alcohol prevented the development of neurotic behavior in cats and abated the neurotic behavior. A similar result was obtained by Conger (2) in rats. Jacobsen and Skaarup (3), modifying the technique described by Masserman, introduced a method which permits evaluation of drug effects upon behavior with ease. They found that benzilic acid aminoester derivatives, especially benactyzine, have a clear-cut normalizing effect in cats. Recently Naess and Rasmussen (4), Geller and Seifter (5), and other workers proposed newer procedures which allowed more objective evaluation of drugs upon behavior. This paper describes a method for inducing conflict behavior in dogs, and the effects of some drugs upon the conflict behavior.

The clinical and theoretical importance of EEG rhythms corresponding to states of lowered vigilance

1. 1. States of lowered vigilance are characterized by EEG rhythms corresponding to the period of transition from awakeness to sleeping. Their appearance in the EEG may, however, be infraclinical. 2. 2. The author distinguishes four stages of reduced vigilance and describes their morphological appearance, dynamics, reactibility to external stimulation and responses to methods of activation. 3. 3. Signs of lowered vigilance are most common in narcolepsy and hypersomnia, in organic diseases of the mesodiencephalic region especially those of traumatic, inflammatory and neoplastic origin, in psychomotor epilepsy and in neurotic conditions of all kinds as well as in “vegetative dystonia” including constitutional spasmophilia. 4. 4. The states of lowered vigilance show a marked resemblance to Pavlov's hypnotic phases. 5. 5. It is suggested that signs of lowered vigilance are due to insufficiency of the subcortical mechanisms of activation; these are of particular importance in causing neurotic symptoms.

Lipaemic turbidity curves in neurotic patients.

The course of turbidity curves in patients suffering from chronic neurosis in the stage of decompensation is marked, as compared with healthy controls and acute neurotic conditions, particularly by a higher level of turbidity and a delayed return of the turbidity to the initial level; occasionally the shape of the curve reminds of the so-called vegetative type of blood sugar curves. These changes are not influenced by an altered gastric evacuation nor by age. The mechanisms responsible for the development of the anomaly described are discussed and the authors draw attention to the significance of emotions.

The reactions of general practitioners to a psychiatric abstracting service.

In conclusion and summary then, the Carrier Clinic Abstracts of Psychiatry for the General Practitioner seems to be fairly successful in meeting a recognized need of the general practitioner for practical information and guidance about commonly encountered psychiatric disorders. It is apparently also serving a function which is not quite as well recognized as a need by the average general practitioner–namely the need to develop partial insight into personal reactions and into doctor-patient interactions regardless of the nature of the presenting complaint. The editors and abstracting committee would be advised to develop their searching and abstracting techniques in two different directions. First, they have to recognize that a wealth of practical material of direct value to the general practitioner sometimes lies obscured beneath a mass of technical detail and highly professional idiom which is frequently only intelligible to the specialist and his specialized cohort–and sometimes not even to them. It is the task of the editors to discover, translate and edit the relevant portions of these articles and present them to the general practitioner in readable, yet still accurate, form. Second, they have to seek out, condense and collect under one roof the more significant of those non-specialist psychiatric articles which lie scattered from time to time throughout the 3,000 or so medical journals which appear regularly somewhere in the world. Here the problems are primarily those of wise selection and good condensation. From the point of view of prospective authors the urgent need seems to be for concise and up to date information on the various problems associated with state and voluntary commitment procedures for mental patients. The other area where more articles are required is that of practical "know-how," a sort of do-it-yourself manual for the family physician who has to cope with a wide variety of direct and reactive neurotic conditions in his general practice. Included in this latter type of article would be the provision of information and warning signs which might advise the physician when to consider seeking more specialized psychiatric help elsewhere.

Control of petit mal by acetazolamide.

We preface this short communication by emphasizing that it originates as a by-product from some work that is still in progress at the Burden Institute on the balance of electrolytes in various normal psychological and neurotic conditions. This research is chiefly being conducted by McLeod, Morrison and Fosbrooke, in the Biochemical Department, and Grey Walter in the electrophysiological laboratory.

THE MYTH OF THE PSYCHOPATHIC PERSONALITY

1. The concept of psychopathic personality is at present in a transitional state. While most clinical workers in the field still move at the superficial descriptive level, some attempt for delimitation is already being made, though it is still mainly at the descriptive level; while a few, as yet in great minority, are attempting to interpret the reaction in terms of underlying dynamics, emphasizing motivation rather than behavior. 2. One of the greatest difficulties in the whole situation is that the majority of writers do not offer adequately worked up case material, which therefore precludes a dynamic formulation. 3. Some workers appear to get away from the previously held concept that the condition is hereditary and constitutional. Instead, the emphasis on psychogenesis appears to be gaining ground. Unfortunately, this remains for the most a statement without casuistic material to support it. 4. Equally, the grouping is being more and more narrowed, and some workers exclude from the consideration of psychopathy the psychotic reaction types, even if and when they have an undoubted antisocial and delinquent character. But the great variety of hysterical and neurotic conditions are still grouped with psychopathy, when these conditions include some definite anti-social and delinquent behavior. 5. On the basis of carefully studied material and due consideration being given to dynamics of the situation, the following reorientation is offered, namely: a. That what is commonly diagnosed now as psychopathic personality should be divided into two main groups: the symptomatic or secondary psychopathy, and primary, essential, or idiopathic psychopathy. b. Under the heading of symptomatic or secondary psychopathy are to be included those cases of psychoses and neuroses that have a strong antisocial or delinquent aspect, and the case in question should be put into its proper clinical heading (psychosis or neurosis as the case may be). Thus a case may be diagnosed as manic-depressive psychosis, hypomania, antisocial delinquent trends. The term psychopathic, therefore, may be completely eliminated from this group of cases as being only confusing. c. The clinical worker who puts emphasis on motivation rather than behavior will have no difficulty uncovering pointed psychogenesis in all these cases. By the same token they are amenable to psychotherapeutic treatment and therefore offer a far more hopeful outlook than is currently given to psychopathic cases. d. In the remaining small group are to be put those individuals who do not fit at all into any of the cardinal reaction types; above all they seem to lack any psychogenetic aspect even when definite effort has been made to elicit the same. They form a disease of its own designated as anethopathy, a specific mental disease, characterized by a special personality organization having in particular a virtual absence of any redeeming social reaction: conscience, guilt, binding and generous emotions, etc., while purely egoistic, uninhibited instinctive trends are predominant. They are as close to the constitutional as can be found. The term psychopathic personality may be omitted from these cases too. 6. With the larger number of psychopathic personality cases being properly put under the respective headings of the cardinal reaction types, and the balance being put in a new group designated anethopathy, nothing remains of the original concept of psychopathic personality, for which reason it should be completely deleted from psychiatric nosology. The term may be left entirely for lay use. 7. A number of cases have been cited demonstrating the various types of psychopathic personality with emphasis on the dynamics of the situation.

THE BLOOD IN PSORIASIS

The etiology of psoriasis has been the impelling motive for much elaborate research and the occasion of many hypotheses. These hypotheses have invoked every conceivable irregularity in the human economy, including the diet, sensitization, both bacterial and fungous infection, neurotrophic, endocrine dyscrasia, anaphylaxis and heredity. All sorts of appellations have been assigned to this disease. For instance, Schamberg 1 referred to it as the dermatologic mystery, and while he expressed a belief in familial incidence, he did not favor the theory of heredity. He assigned rheumatism, gout, defective elimination, defective assimilation of food, pancreatic disease, digestive and nutritional disorders, disturbances of the nervous system, fright, shock, neurotic conditions, tuberculosis, endocrine disturbances, parasitism and disorders of metabolism as possible causes of this mystery. Of this group of possible causes, he expressed the belief that the rheumatism is so often associated with the disorder that it must have some relation

The Differentiation of Psychotic from Neurotic Conditions

The Differentiation of Psychotic from Neurotic Conditions

ETIOLOGY AND DIAGNOSIS OF GASTRIC AND DUODENAL ULCER.

Acute gastric ulcer and the so-called abrasions of the mucous membrane of the stomach are identical in their morbid anatomy and pathology. As a rule these are superficial and extend wholly or through a part only of the mucosa. They are not uncommon and many occur in chronic circulatory disturbances due to heart and arterial disease and to cirrhosis of the liver. They may be postoperative events, especially in abdominal section. They appear in cachectic states due to chronic diseases and are not infrequent in the new born. They may appear in certain neurotic conditions, especially in women. These acute erosions are soft, sometimes blood stained, often multiple, frequently consist of mere slits in the mucous membrane, may be so small as to escape detection and usually would not exceed 4 mm. in diameter. The largest may be dignified by the name of an ulcer. These acute processes are important

MEDICO-LEGAL NOTES.

HYPNOTISM. The subject of hypnotism continues to attract great attention, both in the public journals and at the meetings of learned societies. At a recent meeting of the Medico Legal Society of New York a committee made a preliminary report, and this was, at a later meeting, discussed by the members. Dr. E. P. Thwing said: The trance sleep is not a disease, although neurotic conditions predispose to it. Nor does sensitiveness to hypnotic influence imply small brain power. Hypnotism is not necessarily productive of harm, and in many cases in medical practice has proved valuable. There was a decided difference of opinion as to the value and propriety of public exhibitions of hypnotism. Several such exhibitions have been given in this city, some of which have attracted attention from physicians as well as from the curious and investigating public. Dr. Paul Gibier, the well-known head of the Pasteur