Prognosis Of Illness Research Articles

II. Prognosis and Outcome of Mental Illness 1890–1900 in Ontario

RésuméCes deux articles présentent l'analyse des dossiers de tous les malades admis dans un hôpital psychiatrique de l'Ontario entre 1890 et 1900.Dans le premier article, on rapporte que les psychiatres du 19ième siècle utilisaient un système de classification des maladies mentales très simpliste, un diagnostic de manie ou de mélancolie étant posé chez presque tous les malades psychiatriques. Le diagnostic était une décision reposant essentiellement sur les symptômes, la mélancolie étant caractérisée par des tendances suicidaires et la manie par des tendances agressives. De plus, la classification ne représentait pas une démarche très systématique; par exemple, les hallucinations constituaient le symptôme principal de la plupart des admissions, quelque soit le diagnostic. La cause du trouble mental était encore moins en rapport avec la classification. Une révision extensive du système de classification de cette époque était nettement nécessaire.Dans le second article, on discute des facteurs reliés au pronostic et à l'évolution de ces malades. Des 824 malades de l'échantillon étudié, environ 30% sont décédés à l'hôpital, 15% furent transférés ailleurs, 1% se sont évadés, 18% étaient encore dans l'hôpital en 1910, alors que 36% avaient récupéré et été libérés. Il y avait peu de différence dans les résultats chez les deux sexes. Les personnes les plus susceptibles de récupérer étaient jeunes et pouvaient recevoir un support financier de leur famille. Les malades masculins, professionnels ou travailleurs spécialisés, étaient aussi plus susceptibles d'être libérés. Chez la femme, être une ménagère représentait un facteur important de récupération. En résumé, les éléments prédictifs de succès thérapeutique vers la fin du 19ième siècle n'étaient pas nécessairement des variables cliniques (diagnostic, étiologie), mais plutôt des variables sociales tel que la source de support financier et l'occupation.

Role of stress in the prognosis of mental illness.

Role of stress in the prognosis of mental illness.

Role of stress in the prognosis of mental illness.

Role of stress in the prognosis of mental illness.

MYOCARDIAL SARCOIDOSIS

In this review article, clinical features characteristic of myocardial sarcoidosis including illness course, prognosis and treatment strategies are discussed. The pearl of settling the diagnosis of cardiac sarcoidosis is to consider cardiac involvement in all sarcoidosis patients, electrocardiographic and echocardiographic evidence is of greatest importance.

Diagnostic value of electrocardiographic abnormalities observed in subjects accidentally exposed to cold

Electrocardiograms were recorded in 5 patients accidentally exposed to cold. All 5 patients came from either a poorly heated room or the open air. Usually there was some alteration of mental function or ability to walk, resulting in prolonged exposure to cold. The characteristic electrocardiographic findings in hypothermia are bradycardia, atrial fibrillation, muscle tremor artifact, prolongation of the QRS complex with “J” or “Osborn” waves and prolongation of the Q-T interval. In these patients changes ranged from mild to severe. Follow-up tracings were obtained in 3. The electrocardiogram can be of considerable value in revealing hypothermic states with low “core” temperature. Severe electrocardiographic changes are easily detected and usually are associated with a grave underlying illness and poor prognosis. Milder degrees of hypothermia result in recognizable electrocardiographic changes that can be helpful in evaluating a recorded low rectal temperature.

Comprehensive care following multiple, life-threatening injuries. Treatment of an adolescent boy.

Psychosocial factors and features of personality development may play a crucial role in influencing the course of a child's illness and ultimate prognosis. Our concept of comprehensive care involves the systematic consideration of these factors. We regard such consideration to be well within the realm of the pediatrician's competence. What appears to be necessary is awareness of the psychosocial reactions that normally take place within the ill child and his family and how these reactions may affect his recovery. In many instances, this awareness can enable the pediatrician to institute appropriate prophylactic measures without resorting to psychiatric consultation or utilizing special psychiatric techniques. The following case report concerns a teen-age boy. He sustained severe injuries in an accident resulting in marked permanent disabilities. He spent a total of 7½ months in the hospital, the first month of which was characterized by repeated life-threatening complications. We will attempt to demonstrate, by

OBSESSIONAL NEUROTICS: A LONG-TERM FOLLOW-UP.

In a paper in theAmerican Journal of Psychiatry,Chapman (1963) states categorically that no extensive follow-up investigations of neurotic patients exist. So long as we do not know the prognosis of neurotic illness, every evaluation of the results of therapy is impossible. Most psychiatrists feel that they help their patients, but one does not know with certainty.

Psychosis occurring in the senium; a review of an industrial population.

Roth and his associates (1952, 1955, 1956) making observations on the classification and prognosis of psychotic illness occurring in elderly people found that the majority of patients fell into five main diagnostic categories; about half were cases of affective psychosis, most of which responded to E.C.T., and the rest suffered from arteriosclerotic and senile psychosis, paraphrenia and delirium. All the groups, with the exception of the senile psychotics, showed a considerable proportion of physical illness, particularly the cases of affective psychosis whose first attacks occurred after the age of sixty years. Most of the cases of delirium were physically ill and of the paraphrenics 30 per cent. were either blind or deaf.

Cutis Anserina: Its Significance in the Prognosis of Mental Illness

The autonomic nervous system activity that has been observed to accompany grand mal epilepsy does not occur consistently with the seizures produced by electric convulsive treatment. The dilated pupils, flushing, lacrimation and gooseflesh which appear during the tonic spasm of the electrically induced seizure, and which are the outward manifestations of the autonomic storm within, are often not readily observed because of their transience; they begin to fade almost as soon as they appear and may be gone with the onset of the clonic spasm. Different patients exhibit them in different degrees and the same individual may show changes in the amount of autonomic response over a course of treatments.

Rorschach scores, prognosis, and course of illness in pulmonary tuberculosis.

Rorschach scores, prognosis, and course of illness in pulmonary tuberculosis.