The history of 'nervous disorders' from 1600 to 1840, and a comparison with modern views

Article Abstract:

In the 18th and 19th centuries, a complaint for which there was no clinical basis was called a nervous disorder. Many of these disorders caused great distress for sufferers, but there was no treatment to be offered because no cause could be found. Complaints of bodily symptoms in the absence of disease are still defined as 'nervous conditions'. Early explanations ranged from an imbalance of bodily fluids (humours) to infections of the uterus, liver, or spleen. Also popular were religious explanations, the idea of evil spirits taking possession of the mind, or that symptoms were induced by witchcraft. The search for physical causes of mental disease began in the 17th century. When blood was discovered to circulate throughout the body, the concept of an imbalance in humours was largely abandoned. Nervous disorders were then concluded to be the result of a malfunctioning organ, even though it was hard to explain how a disorder of one organ could lead a variety of symptoms. The explanation offered was that other organs acted in sympathy with the affected organ, either by direct contact or by diffusion of an offensive vapor or humour that contaminated other organs. Researchers grappled with this for the next two centuries. By the early 18th century, the prevalence of nervous disorders motivated a continued search for the underlying causes. Temperament was suggested as a predisposing factor, which was considered to be something people were born with. Environmental factors, such as lifestyle, could affect temperament as well. Physiological causes of nervous disorders remained elusive, and this area, as well as environmental factors, is still the focus of research in nervous disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

History, Nervous system diseases

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Borderline and schizotypal disorders in children and adolescents

Article Abstract:

Despite the significant effect that the characteristics of borderline personality disorder (BPD) appears to have on children and adolescents, there has been little consistency or clarity to its definition in these populations. There is even some question as to whether or not BPD is the same disorder in children and adolescents as it is in adults. There is evidence that symptoms of 'adult' BPD exist in childhood. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), these include mood instability, difficulty in interpersonal relations, and poor self-image. Even so, whether BPD is a valid diagnosis in children is not established. With regard to adolescents the situation is much the same. Even though older adolescents may exhibit personality traits more similar to adults in many ways, it is also possible that symptoms of personality disorders evident in adolescents are transient and specific to the developmental stage, its stresses, and the person's ability to transcend them. There is no evidence that they will carry through to adulthood. Personality disorders, by definition, are pervasive and do not readily change, if they can be altered at all. With regard to schizotypal personality disorder, which is related to borderline personality disorder but resembles schizophrenia in some ways, evidence is equally as weak that it exists in children and adolescents, despite the appearance of symptoms consistent with the adult diagnosis. Research needs to focus on the development of diagnostic criteria not by adaptation of established adult criteria but by the categorization of behavior of adolescents and children and the empirical study of these categories. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Personality disorders, Schizotypal personality disorder, Borderline personality disorder in children

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Confusions concerning sleep disorders and the epilepsies in children and adolescents

Article Abstract:

Misdiagnosis of the sleep disorders and epilepsy is common. This is due, in part, to the relatively little attention given these topics in medical schools. There are several manifestations of misdiagnosis: sleep disorders are sometimes not differentiated from each other; sleep disorders may be incorrectly diagnosed as epilepsy; or epilepsy may be treated as a sleep disorder. Better professional education regarding the clinical symptoms of sleep disorders and epilepsy, and more accurate reporting of the episodes by affected individuals and their families, will make recognition easier and more accurate. It is also possible, given that epilepsy affects at least one percent of children and sleep disorders affect more, that children exhibit behavior suggesting that both epilepsy and some sleep disorder are present. Emotional problems, characteristic of children with epilepsy, may themselves cause sleep disturbance. Parents are encouraged to observe their children's behavior as accurately as possible in order to aid in proper diagnosis of disturbed behavior, with the help, if necessary, of equipment such as overnight video recordings and sleep recordings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Epilepsy, Child psychology, Sleep disorders, Psychological methods, Diagnosis, Differential, Differential diagnosis

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