Phobic disorders in the elderly

Article Abstract:

Within clinical populations of elderly people, phobic disorders are not frequently seen, even though phobias are generally common among the elderly. Phobias therefore run the risk of being ''hidden'' causes of illness in the population. The results are reported of a controlled study of phobias in the elderly designed to investigate their clinical importance and to evaluate the role of socioeconomic and psychosocial factors in their development. A total of 60 confirmed cases of phobic disorder were identified and a control subject matched for age and sex was paired with each. Several differences were found between phobics and nonphobics. For instance, phobics were more likely than nonphobics to have neurotic symptoms (e.g., obsessions, compulsions) and to have an additional chronic psychiatric disorder other than phobia. Most phobics had more than one fear and they reported a higher rate of contact with their general physicians than nonphobics. Interestingly, only one of the phobics reported seeking psychiatric care. While sociodemographic data did not generally differ between phobics and nonphobics, it was curious that phobics reported having lost a parent before age 18 significantly more often than nonphobics. Agoraphobia, a fear of being in a crowded public situation from which it would not be easy to exit, was a common phobia, either as a primary fear or one of several fears present. It was associated with late onset (after age 65), and often occurred after a serious illness or another traumatic event. Anxiety-like symptoms (though not attributable to anxiety) were present in these cases. It is suggested that phobic disorders in the elderly are substantially important and deserving of greater attention from health care providers and social service workers. The subjects in this study, despite severe symptoms in many cases, were not receiving any appropriate treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Aged, Elderly, Demographic aspects, Phobias

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Negative symptoms in chronic schizophrenia: relationship to duration of illness

Article Abstract:

The so-called ''negative,'' or ''deficit'' symptoms of schizophrenia include flat moods, alogia (loss or lack of speech), apathy, lack of pleasure, and attentional impairment. These symptoms have been the subject of increasing research attention of late, but their relationship to schizophrenia remains unclear. Some consider the presence of negative symptoms in schizophrenics to be associated with the condition in its chronic aspect, having a later onset but greater prevalence over time. Others characterize negative symptoms as associated with the residual phase of schizophrenia, or the baseline to which schizophrenics return after an acute phase of active (''positive'') symptoms. The frequency and distribution of negative symptoms are reported for 40 schizophrenic patients; the symptoms were examined with respect to the duration of illness and the number of episodes of illness a patient had. Three measures of negative symptoms were used: the Scale for the Assessment of Negative Symptoms, the Positive and Negative Syndrome Scale, and the Negative Symptoms Rating Scale. The three scales yielded highly consistent ratings of negative symptoms in these patients. However, the presence of negative symptoms was not significantly correlated with duration of illness or the number of episodes of acute symptomatology. The data suggest that negative symptoms are not indicative of chronicity, nor do they characteristically have late onset or greater prevalence over time. They simply seem to be a component of the ''schizophrenic syndrome.'' (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prognosis, Schizophrenia, Symptomatology, Signs and symptoms

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From categories to contexts: a decade of the 'new cross-cultural psychiatry'

Article Abstract:

In late 1977, the view that the manifestation of depression is the same across cultures received its first serious challenge, on the basis that Western classifications were not necessarily free to cross culture boundaries. It was suggested that personal, interpersonal, and cultural reactions to disease must be accounted for. This technique of recognizing social and cultural influences draws upon those developed in the field of anthropology, as modern psychiatry lacks a theory to address these variables. Traditionally psychiatrists have complained of cultural variables as confusing and masking the true disease process. Important to note, however, is that behavior labelled abnormal in the West is not necessarily so labelled elsewhere. The assumption of universality of behavior patterns implies a biological mechanism; any illness pattern has one biological explanation. The 'new cross-cultural psychiatry' demonstrates how arbitrary current thought is and opens a virtual new world which needs exploration in order to more completely understand the social and cultural influences that shape health and mental health in a given society. No longer should we simply describe mental illness with culture-bound categories. Behavior and thought should be interpreted in the context in which they are presented. (Consumer Summary produced by Reliance Medical Information, Inc.)

History, Identification and classification, Psychology, Pathological, Psychopathology, Categorization (Psychology), Psychiatry, Transcultural, Transcultural psychiatry

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