Risk of schizophrenia in character disordered patients

Article Abstract:

A long-term (15-year) study was conducted on 105 patients with character disorders who had been hospitalized at a tertiary inpatient care facility. These patients had not been responsive to previous treatment and were considered chronically disabled by their mental disorders. All exhibited symptoms of character disorder 7.5 to 8.4 years prior to the hospitalization period. The portion of these individuals at high risk for the developing schizophrenia was found to be 17 percent (18 patients). The symptoms corresponded with criteria described in the Diagnostic and Statistical Manual for Mental Disorders for schizotypal personality disorder. However, all of the people in the sample group had underlying organic disorders such as AIDS, which had to be considered in the diagnosis. It was concluded that three common characteristics which were observed in the 18 patients early on can be correlated with the development of schizophrenia: perceptual distortions such as suspiciousness and magical thinking (the attribution of abnormal powers to thoughts or actions), social isolation, and lower I.Q. Lower intelligence quotient was usually accompanied by a general lack of normal adaptive behavioral skills. Transitory delusional episodes and family history were also predictive of schizophrenia. The idea of a personality type which is susceptible to schizophrenia was reenforced. Other limitations of the study included the fact that few details were provided in the data used and only one investigator reviewed the records so the possibility of bias exists. Unfortunately, no continued follow-up occurred after the first episodes of schizophrenic behavior were observed, so any additional confirmation of these conclusions is not possible.

Case studies, Diagnosis, Health risk assessment, Schizophrenia, Schizotypal personality disorder

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Long-term outcome of obsessive-compulsive disorder with psychotic features

Article Abstract:

Seven male patients with chronic, severe obsessive compulsive disorder (OCD) and psychotic-like features were followed-up for 15 years. Their long-term outcomes were compared with those of 163 schizophrenic patients and 44 patients with depressive disorder. They were diagnosed according to criteria set by the Diagnostic and Statistical Manual of Mental Disorders for OCD. Histories of these men revealed a great deal of isolation and extremely poor social and occupational skills. Their obsessive-compulsive rituals tended to be bizarre. For example, a 31-year-old patient felt compelled to rifle through any garbage he encountered in order to search for lost valuables. Eventually this led to searching through his own excrement. For 10 years, a 35 year-old man refused to leave his home without first spending an entire day removing all his facial hair and ''dead skin'' with tweezers. Over the 15-year span, the amount of time spent in psychiatric hospitals for relapse was 15 percent for OCD patients, 45 percent for schizophrenic patients and seven percent for depressed patients. Schizophrenic and OCD patients demonstrated a similar degree of long-term disability. Both groups were employed less than 30 percent of the follow-up time, and both had active symptoms for almost 80 percent of the time-span. Depressed patients were employed for 63 percent of this period, and were symptomatic 57 percent of the time. Twenty-nine percent of the OCD patients, 46 percent of the schizophrenic patients and 69 percent of the depressed patients were rated as achieving a moderate to good re-entry into community life. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prognosis, Obsessive-compulsive disorder, Obsessive compulsive disorder

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Frieda Fromm-Riechmann, 1889-1957

Article Abstract:

Psychiatrist Frieda Fromm-Reichmann was noted for pioneering the use of therapeutic relationships for treating mentally-ill patients. She combined classical Freudian psychoanalysis and Sullivanian interpersonal analysis to establish a more comprehensive method of treatment for bipolar disorder and schizophrenia, while working at the Chestnut Lodge Hospital in Rockville, MD. Her book 'Principles of Intensive Psychotherapy' details her works in the field of psychodynamic psychotherapy.

Biography, Psychiatrists, Fromm-Reichmann, Frieda

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