Distinguishing between neurosis and psychosis: discourses on neurosis in colonial Korea

This article analyses the origins and formation of medical and social discourses on neurosis in colonial Korea. With the introduction of Western medicine after the Opening of Korea in 1876, neurasthenia and hysteria began to be understood as neurotic diseases, and their importance was further highlighted during the colonial period of 1910-45. The article also addresses the role of neuropsychiatry in forming discourses on neurosis. In medical communities during the colonial period, the main source of these discourses gradually shifted from internal medicine to neuropsychiatry. In particular, Korean neuropsychiatrists distinguished between neurosis and psychosis as a way to reinforce their authority. Neuropsychiatrists tried to explain the temperamental and environmental factors of neurosis from a psychoanalytic standpoint.

Shared and specific genetic risk factors for lifetime major depression, depressive symptoms and neuroticism in three population-based twin samples

BACKGROUND

Vulnerability to depression can be measured in different ways. We here examine how genetic risk factors are inter-related for lifetime major depression (MD), self-report current depressive symptoms and the personality trait Neuroticism.

METHOD

We obtained data from three population-based adult twin samples (Virginia n = 4672, Australia #1 n = 3598 and Australia #2 n = 1878) to which we fitted a common factor model where risk for 'broadly defined depression' was indexed by (i) lifetime MD assessed at personal interview, (ii) depressive symptoms, and (iii) neuroticism. We examined the proportion of genetic risk for MD deriving from the common factor v. specific to MD in each sample and then analyzed them jointly. Structural equation modeling was conducted in Mx.

RESULTS

The best fit models in all samples included additive genetic and unique environmental effects. The proportion of genetic effects unique to lifetime MD and not shared with the broad depression common factor in the three samples were estimated as 77, 61, and 65%, respectively. A cross-sample mega-analysis model fit well and estimated that 65% of the genetic risk for MD was unique.

CONCLUSION

A large proportion of genetic risk factors for lifetime MD was not, in the samples studied, captured by a common factor for broadly defined depression utilizing MD and self-report measures of current depressive symptoms and Neuroticism. The genetic substrate for MD may reflect neurobiological processes underlying the episodic nature of its cognitive, motor and neurovegetative manifestations, which are not well indexed by current depressive symptom and neuroticism.

A Big Five facet analysis of sub-clinical dependent personality disorder (Dutifulness)

This study aimed to examine a Big Five, normal personality trait, "bright side" analysis of a sub-clinical personality disorder: Dependency Personality Disorder. Around 6000 British adults completed the NEO-PI-R which measures the Big Five personality factors at the domain and the facet level. They also completed the Hogan Development Survey (HDS) which has a measure of sub-clinical Dependency Personality Disorder called Dutiful as one of its eleven dysfunctional interpersonal tendencies. Correlation and regression results confirmed many of the associations between the Big Five domains and facets and sub-clinical Dependency. The Dutiful (Dependent) scale from the HDS was the criterion variable in all analyses. The results showed that those high on Dutiful are highly unstable Neurotic, Agreeable people who are low on Openness. They are Anxious, Compliant, Self-Conscious, Unassertive and Vulnerable. It is thus possible to assess subclinical personality disorder "dark-side" traits, like Dutifulness, in terms of normal "bright-side" traits. Limitations of the study are acknowledged.

Postviral Syndrome-How can a Diagnosis be Made? A Study of Patients Undergoing a Monospot Test

Eighty-nine of 150 patients having a Monospot test filled out a questionnaire about their illness, and the General Health Questionnaire. They completed a follow-up questionnaire 6 months later. Twelve (8%) had a positive Monospot. Twenty-eight of 83 serum samples tested (34%) were positive for VP1 enteroviral antigen. Forty of the patients had a self limiting illness, 13 had a definite diagnosis (excepting glandular fever), 14 had a possible postviral syndrome, 10 had recurrent sore throats/flu, and 12 had a chronic non-specific illness. Patients with a specific diagnosis were less likely to complain of aching muscles/joints, sore throat, tiredness or loss of concentration. Their GHQ scores were lower, although this just failed to reach significance (P=0.08), and they scored significantly lower on the somatic symptoms subscale (P=0.022). Overall 72% scored above the GHQ threshold for ‘psychological caseness’ which is higher than in other studies. Sixty-five per cent of the sample questioned at 6 months felt that their illness started with a viral infection. The methodological problems involved in making a diagnosis of postviral syndrome are discussed.

Hospital Patients who Wear Tinted Spectacles - Physical Sign of Psychoneurosis: A Controlled Study

The wearing of tinted spectacles by patients is often said to be a marker of psychopathology but without supportive evidence. To investigate the validity of this observation the personalities of 20 medical hospital patients who wore tinted spectacles were compared, by means of a self-report inventory, with those of 20 controls who were age, sex, and diagnosis matched. There was a significant increase in the level of psychopathology in the tinted spectacle group, both in terms of an index of global psychological distress; the General Severity Index, and nine primary symptom dimensions measured by the inventory.

[Alienation: Differential Psychopathology of Ego-Disturbances]

Alienation, i. e. disorders of the inner experience of integrity, continuity, and agency, represents a feature of both psychotic and non-psychotic disorders. Thereby, ego disturbances are thought to be specific for schizophrenia. Depersonalisation, in contrast, has been reported in schizophrenia as well as a neurotic, probably distinct syndrome. The differentiation of psychotic vs. non-psychotic alienation is often all but trivial. The present paper provides an overview of the historical roots and the psychopathological conceptualizations of alienation. Clinically relevant features of psychotic alienation are highlighted. Experience of passivity, loss of authenticity and disturbances of striving and volition appear as psychotic characteristics.

The General Health Questionnaire and Eysenck's Three-Dimensional Model of Personality

A sample of 115 men and women between the ages of 20 and 60 completed the 30-item General Health Questionnaire together with the short-form Revised Eysenck Personality Questionnaire. The data indicate psychological distress so assessed is correlated .43 ( p<.001) with Neuroticism and –.26 ( p<.01) with Introversion but is unrelated to Psychoticism scores.

Neuroticism, Extraversion, and Paralinguistic Expression

The purpose of this study was to test the associations among neuroticism, extraversion, and paralinguistic expression. The relevant literature provides ample information on the association between personality traits and voice intensity, pitch, pace of speaking, frequency of pauses, slips of the tongue, and other speech impediments. The author attempted to verify and supplement work reported previously. Scores for 100 persons (56 women, 44 men; M age = 21.5 yr., SD = 1.5) were analyzed with respect to two aspects of personality, neuroticism and introversion-extraversion. To analyze the paralinguistic properties of speech, elicited oral messages were examined, i.e., a fairy tale told by the examinees. While the analysis did not give unambiguous evidence that the assumptions were correct, it indicated singular and statistically significant relations of introversion and neuroticism with speech fluency impediments.

Exploring the Relationship Between Premorbid Personality and Dementia-Related Behaviors

The purpose of the current study was to investigate whether premorbid personality traits (i.e., neuroticism, extroversion, openness, agreeableness, and conscientiousness) can predict behavioral and psychological symptoms of dementia (BPSD). In particular, agitation-related behaviors were examined. The current study used convenience sampling from 14 residential care facilities in Melbourne, Australia. Demographic and health data, cognitive ability, BPSD, and premorbid personality characteristics were collected from 62 female and 27 male older adults. Close informants of participants were asked to provide premorbid personality data (i.e., before the development of dementia) using the NEO-Five-Factor Inventory. Residential care staff used the Cohen-Mansfield Agitation Inventory to rate agitation-related behaviors over a 2-week period. Correlational analyses revealed associations between premorbid agreeableness and verbally nonaggressive behaviors, and between premorbid conscientiousness and verbally nonaggressive behaviors. Although the findings provide some support that premorbid personality shapes problematic behaviors exhibited in dementia, they are inconsistent with previous research and the hypotheses were generally not supported.

NICE recommendations for psychotherapy in depression: Of limited clinical utility

In 2009/10 NICE partially updated its guidelines on the treatment and management of depression in adults. Due to methodological shortcomings the recommendations for psychotherapy must be treated with caution. Despite recognising the heterogeneous and comorbid nature of depression, and the limitations of depression as a unitary diagnostic category, NICE treats depression as if it were a unitary entity differentiated only by severity. The guidance ignores important aetiological factors such as trauma, loss and maltreatment, personality and interpersonal difficulties. It excludes the largest naturalistic studies on clinical populations treated in the National Health Service on the grounds that they are observational studies conducted in heterogeneous groups with mixed neurotic disorders. It unquestioningly accepts that the "brand" of psychotherapy has construct validity, and ignores psychotherapy process research indicating significant commonalities, and overlap, between treatment modalities and evidence that individual practitioner effects are larger than the differences between treatment modalities. It fails to consider patient differences and preferences, which are known to influence uptake, completion and response. It takes an exclusively short-term perspective on a chronic relapsing disorder. It does not consider the evidence for longer-term treatments. It is of special concern that NICE misrepresents the findings of its own systematic review by implying that CBT and IPT are superior treatments. NICE's systematic review actually found no evidence of superiority between CBT, IPT, psychodynamic psychotherapy, or counselling. Based on the exclusion of much clinically relevant research demonstrating the effectiveness of psychodynamic psychotherapy and counselling many commentators have alleged a bias towards CBT in the guidance. With regard to service delivery NICE proposes the replacement of psychiatric assessment and individualised treatment plans, with an unproven stepped-care model. These clinical and theoretical limitations, perceived bias in the selection of studies, neglect of patient differences, preferences and values, misrepresentation of results of the systematic review, and the proposal for an unproven service delivery model together seriously undermine the validity of the guidance. The guidance, lacking validity is of questionable use, it undermines patient autonomy, professional expertise and, ultimately, patient welfare.

[HEALTH STATUS AND DEVELOPMENT OF CHILDREN BORN USING IVF]

In the work the analysis of incidence, the dynamics of physical development during the first year of life among 28 children born using IVF was conducted. It was found out that during the first year of life these children have certain patterns of growth and development, as well as a wide range of diagnosed pathology. Thereby observing children of this category should be optimized.

Personality characteristics of patients seeking cosmetic rhinoplasty

BACKGROUND

Rhinoplasty is one of the most common cosmetic surgeries performed on the face. Cosmetic surgery is performed not only to change the appearance, level of satisfaction, and self-confidence of the patient, it may also reflect specific personality patterns. The goal of this study was to investigate the personality characteristics of individuals seeking cosmetic rhinoplasty.

METHODS

Thirty patients referred for rhinoplasty and 30 healthy age- and gender-matched controls were enrolled in this case-control study. All participants filled out the Millon Clinical Multiaxial Inventory 3rd edition and the data were analyzed using ANOVA and Fisher's exact test.

RESULTS

Twenty-four (80 %) females and 6 (20 %) males were evaluated. Dependent, histrionic, and narcissistic personality disorders were seen in 2, 3, and 8 patients in the case group, respectively. The number of individuals with narcissistic personality traits was significantly higher in the case group than in the control group (p < 0.001).

CONCLUSION

Narcissism is the most common psychological trait that motivates patients to seek a rhinoplasty. Personality disorders are not very common among individuals seeking rhinoplasty in Iran.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Treating without diagnosis: Psychoanalysis in medical settings in Argentina

This article is part of a larger research project, the aim of which is to understand the discursive conditions of access and adherence to an outpatient mental health service at a public hospital in Buenos Aires, Argentina. The focus is on the historical conflict between medical discourse and psychoanalytical discourse as it emerges in the negotiation of treatment and diagnostic sequences at first consultations. It can be seen that patients who are socialized in medical discourse--and even in psychiatric discourse--expect the usual procedure in which a diagnosis, however transitory, is offered first and then followed by a treatment recommendation. However, psychoanalysts, in contrast, tend to reject diagnostic labels and offer treatment without further justification. This has an impact on the adherence of patients, and we can argue for the need to negotiate with medical discourse in order to guarantee engagement and continuity in treatment.

Self-stigma and suicidality in patients with neurotic spectrum disorder - a cross sectional study

BACKGROUND

Self-stigmatization is a step-by-step process during which the person uncritically accepts the societal negative evaluation and applies it to himself. Relation between self-stigma and suicidality in neurotic disorders is not known. The aim of our study was to find connection between self-stigma and the level of suicidality in neurotic spectrum disorders.

METHOD

It was a cross-sectional study of 198 inpatients with pharmacoresistant neurotic spectrum disorders hospitalized at the psychotherapeutic ward of the Department of Psychiatry, University Hospital Olomouc. Patients were diagnosed using the ICD-10 research diagnostic criteria. The assessments included Internalized Stigma Of Mental Illness (ISMI), Beck Depression Inventory-second edition (BDI-II), objective and subjective Clinical Global Impression (CGI), Morin sleep scale, Dissociative Experience Scale (DES) and Montgomery and Asberg Depression Rating Scale, item 10 Suicidal Thoughts (MADRS item 10 suicidality) for the assessment.

RESULTS

The subjective rate of suicidality and also the objective rate of suicidality were strongly positively correlated with the total score of ISMI. There were also significant correlations with all subscores except for the correlation between the BDI 9 and the sub score Resistance against stigma, which barely missed the level of statistical significance.

CONCLUSIONS

More attention should be paid to self-stigma in neurotic patients, especially in those with suicidal thoughts and tendencies.

Self-stigma in psychiatric patients--standardization of the ISMI scale

OBJECTIVE

Self-stigma in psychiatric patients is an issue deserving both research and therapeutic attention. The objective of the present study was to evaluate the psychometric properties of a Czech version of the Internalized Stigma of Mental Illness (ISMI) scale assessing the levels of self-stigma in individuals with mental disorders.

METHODS

It consists of 29 items classified into 5 subscales, namely alienation, stereotype endorsement, perceived discrimination, social withdrawal and stigma resistance. The study group comprised 369 patients with a mean age of 41.5±13.3 years, of whom 210 (56.6%) were females.

RESULTS

The most frequent diagnosis was neurotic disorders (46.1%), followed by affective disorders (18.4%), substance use disorders (13.3%), psychotic disorders (10.8%), personality disorders (9.5%) and organic disorders (1.6%). Reliability of the scale was evaluated by internal consistency analysis (α=0.91), the split-half method (Spearman-Brown coefficient: 0.93) and test-retest at 3 weeks from the first measurement (N=17; r=0.90, p<0.05).

CONCLUSION

Exploratory factor analysis of the scale was performed, its validity was verified and norms were established that were based on T-scores and sten scores for the entire scale and individual subscales. The Czech translation of the ISMI has adequate psychometric properties.

Family environment, personality, and psychological symptoms in adults sexually abused as children

The current study examined the relationships between family environment characteristics, personality traits, and current psychological symptoms in adults with a history of child sexual abuse. Family environment characteristics, personality traits, and psychological symptoms in 18 abused and 18 nonabused college students were examined using ANOVAs and MANOVAs. Pearson product moment correlations were also performed. Results indicated significantly more dysfunctional family environment characteristics (inflexibility, poor cohesion, family dissatisfaction, and poor family communication) in the abused versus the nonabused group. There were significantly higher levels in the personality traits of neuroticism and openness to experience in the abused group; however, there were no significant differences in psychological symptoms when comparing the two groups. The implications of the results and areas of future research are discussed.

[Premorbid border-line mental disorders in adolescents and young-aged people]

The aim of the study was to determine the predictive value of some types of premorbid state for the development of border-line mental diseases (neurotic disorders and personality disorders). We examined 579 school students and 523 university students. The study comprised two stages: primary examination and follow-up (2 years). Some forms of premorbid mental disorders and their impact on the development of border-line mental diseases were described. The predictive value of different premorbid disorders was estimated.

The network structure of human personality according to the NEO-PI-R: matching network community structure to factor structure

Introduction

Human personality is described preferentially in terms of factors (dimensions) found using factor analysis. An alternative and highly related method is network analysis, which may have several advantages over factor analytic methods.

Aim

To directly compare the ability of network community detection (NCD) and principal component factor analysis (PCA) to examine modularity in multidimensional datasets such as the neuroticism-extraversion-openness personality inventory revised (NEO-PI-R).

Methods

434 healthy subjects were tested on the NEO-PI-R. PCA was performed to extract factor structures (FS) of the current dataset using both item scores and facet scores. Correlational network graphs were constructed from univariate correlation matrices of interactions between both items and facets. These networks were pruned in a link-by-link fashion while calculating the network community structure (NCS) of each resulting network using the Wakita Tsurumi clustering algorithm. NCSs were matched against FS and networks of best matches were kept for further analysis.

Results

At facet level, NCS showed a best match (96.2%) with a ‘confirmatory’ 5-FS. At item level, NCS showed a best match (80%) with the standard 5-FS and involved a total of 6 network clusters. Lesser matches were found with ‘confirmatory’ 5-FS and ‘exploratory’ 6-FS of the current dataset. Network analysis did not identify facets as a separate level of organization in between items and clusters. A small-world network structure was found in both item- and facet level networks.

Conclusion

We present the first optimized network graph of personality traits according to the NEO-PI-R: a ‘Personality Web’. Such a web may represent the possible routes that subjects can take during personality development. NCD outperforms PCA by producing plausible modularity at item level in non-standard datasets, and can identify the key roles of individual items and clusters in the network.

The prevalence and correlates of neurotic disorders among undergraduates at a mainland Chinese university

OBJECTIVES

To study the prevalence and risk factors of neurotic disorders (NDs) among Chinese university students.

METHODS

Stratified random sampling was used to select students who were interviewed using the World Health Organization Composite International Diagnostic Interview Version 3.0 to diagnose psychiatric disorder and collected socio-demographic, and family structure and environment data. The response rate was 90 % (N = 1,843). The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) criteria were used to diagnose NDs. We used logistical regression to evaluate the links between NDs and selected correlates.

RESULTS

The prevalence of NDs was 25.6 % (lifetime), 15.7 % (12-month), and 6.8 % (30-day) among the university students with no significant gender differences in these rates. No family structure characteristics were related to 12-month prevalence of NDs (P > 0.05). In contrast, family environment factors including a history of family disputes (OR 1.562, CI 1.108-2.203), parental mental health problems (OR 1.800, CI 1.379-2.349), and absence of care in childhood (OR 1.916, 95 % CI 1.331-2.759) were associated with higher prevalence rates of NDs.

CONCLUSIONS

Our findings show a high prevalence of NDs in this sample of Chinese undergraduates. Social environment factors, in the student's family of orientation, were significantly associated with the prevalence of NDs. These findings support the importance of negative family experiences during childhood and adolescence and increasing vulnerability to NDs.

[Role of various risk factors in the development and diagnosis of recurrent pain in adolescents--students of cadet corps]

Randomized single-blind case--control study is performed. In total, the cadet corp students with recurrent functional abdominal pain and headaches are examined. The paper shows the role of various risk factors in the occurrence of these states. Diagnostic validity is evaluated. Multifactorial genesis of the studied pathology is proved. The essential role in the formation of the psychological characteristics of personality, neurotic states and autonomic dysfunction is shown. Several constitutional characteristics of the organism were not diagnostically significant.

Psychogenic skin excoriations: diagnostic criteria, semiological analysis and psychiatric profiles

Psychogenic excoriations are also called neurotic excoriations, dermatillomania or skin picking syndrome. We proposed diagnostic criteria and then performed a study of the psychiatric profiles of outpatients with psychogenic excoriations and the circumstances around the creation of these excoriations. Although the results must be interpreted with caution because the study was performed with only 10 patients, interesting data is provided about the onset of psychogenic excoriations, the behaviour of picking, and comorbidity. Common or specific characteristics were identified according to type of case. The majority of patients associated first excoriations with personal problems. Four patients reported abuse in childhood or adolescence. This study confirms that skin picking is an impulsive reaction and does not belong to the obsessive-compulsive disorders: impulsivity is defined by ineffective or failing control resulting in uninhibited behaviour.

The cerebellum link to neuroticism: a volumetric MRI association study in healthy volunteers

Prior research suggests an association between reduced cerebellar volumes and symptoms of depression and anxiety in patients with mood disorders. However, whether a smaller volume in itself reflects a neuroanatomical correlate for increased susceptibility to develop mood disorders remains unclear. The aim of the present study was to examine the relationship between cerebellar volume and neurotic personality traits in a non-clinical subject sample. 3T Structural magnetic resonance imaging scans were acquired, and trait depression and anxiety scales of the revised NEO personality inventory were assessed in thirty-eight healthy right-handed volunteers. Results showed that cerebellar volume corrected for total brain volume was inversely associated with depressive and anxiety-related personality traits. Cerebellar gray and white matter contributed equally to the observed associations. Our findings extend earlier clinical observations by showing that cerebellar volume covaries with neurotic personality traits in healthy volunteers. The results may point towards a possible role of the cerebellum in the vulnerability to experience negative affect. In conclusion, cerebellar volumes may constitute a clinico-neuroanatomical correlate for the development of depression- and anxiety-related symptoms.

[Christa Kohler's "communicative psychotherapy" as an integrated psychotherapeutic concept and its biographical, scientific and historical context]

"Communicative psychotherapy" was developed in the 1960s by the East German psychotherapist and psychiatrist Christa Kohler (1928-2004) for the treatment of "neuroses". Similar to established present-day psychotherapeutic methods, such as cognitive behaviour therapy, it combined diverse therapeutic approaches into an integrated treatment programme. This included individual and group therapy, exercise, work and occupational therapy. In contrast to modern psychotherapeutic practice, communicative psychotherapy was based on a firm system of values, namely socialist ideals. According to this system, psychological breakdown was viewed and treated ideologically. In addition, any lack of conformity with the East German system was likewise regarded as a psychopathological deviation, which should be subjected to psychological treatment. The latter concept requires a critical analysis from a current-day perspective. For the first time, this paper concentrates on Kohler's work on neuroses and the theory and practice of her communicative psychotherapy, albeit without neglecting Kohler's other scientific works, her biographical information and her Stasi documents.

[Comorbide somatic pathology in servicemen with neurotic disorders]

Prevalence and structure of comorbidity a somatic pathology in military men with neurotic disorders was studied. It was established that 40,4% of surveyed noted concomitant somatic pathology, the structure of which was dominated by gastro-intestinal tract (26,8%), and pathology of the cardiovascular system (21,6%). It is shown that concomitant somatic pathology provided aggravating effect on clinic neurotic disorders in serviceman, making it difficult to diagnose mental disorders. The greatest risk concomitant a somatic pathology was marked in patients with depressive and somatoform disorders. Indicates the need for specialized standards of care for persons with comorbid mental and somatic disorders.

[Comorbid neurotic disorders in opioid-dependent patients]

Necessity of distinguishing between psychopathology of opioid dependence itself and co-occurred neurotic (ICD-10 item F4) disorders is caused by the need to choose an adequate therapy. The prevalence and types of comorbid neurotic disorders among opioid-dependent patients in sustained full and partial remission are described.

The MMPI-2 neurotic triad subscales and depression levels after pharmacological treatment in patients with depressive disorders - clinical study

BACKGROUND

Affective disorders provide for one third of the main causes of psychiatric inpatient care, both in male and female subjects. An early diagnosis of the disease with precise identification of the character of its particular symptoms are key important factors for the efficacy of treatment. The goal of the study was an identification of possible associations between scores of the neurotic triad in the MMPI-2 test (hypochondria - Hs, depression - D, hysteria - Hy), evaluated at initial hospitalization period with remission degree assessed by the Hamilton Depression Rating Scale (HDRS), following eight weeks of treatment with SSRI.

SUBJECTS AND METHODS

A group of 50 subjects took part in the study. The MMPI-2 test and HDRS were used in the study. The HDRS was performed at the therapy onset and reapplied after 8 weeks of its continuation. The MMPI-2 test was applied at the beginning of treatment.

RESULTS

Higher scores in Hs (p=0.007), D (p=0.021) and Hy scales (p=0.001) are associated with the higher degree of depression, measured by the HDRS at the therapy onset. The highest performance in Hs scale (p=0.003) and Hy scale (p=0.001) evaluated on admission, was associated with the highest depression level after pharmacological treatment.

CONCLUSION

The higher the degree of hypochondria and hysteria symptoms, measured by the MMPI-2 test at the onset of therapy in patients with depressive disorders, the higher severity of depression is being found after 8 weeks of therapy with SSRI agents, measured by the HDRS scale.

[Diagnosis of reduction of reserves of mental adaptation in flight personnel and associated psycho-correction of preneurotic violations]

The study shows that widespread distribution and low detectability of the early stages of reduction of reserves of mental adaptation in troop echelon of aviation specialists conditions the necessity for outpatient screening and psycho-correction of violations of the state, indicating a decrease in adaptive capacity of the individual. According to the authors, the use of the complex rehabilitation measures of personality-oriented individual and group psychotherapy helps to leveling of manifestations of preneurotic violations, correction of stress-producing reduction of psycho-physiological functions in the system of professionally important qualities for pilots, and has a significant positive impact on the adaptive capacity of individual pilots in general. As a result, digestion of the psycho corrective course by pilots leads to positive dynamics of their mental state, which is confirmed by objective data.

[Symptom checklist S-III]

AIM

Symptom checklists enable clinicians and researchers to quickly estimate the probability of neurotic disorder presence. To pursue this goal, they should include a possibly limited number of items, describing symptoms most prevalent in the disordered population. Fluctuations in that prevalence force researchers to prepare new variants of checklists every few years, therefore the next (current) version of the checklist "S" for screening has been prepared.

METHOD

The Symptom checklist S-III includes items regarding occurrence and intensity of 82 symptoms, chosen according to their highest prevalence in 1872 patients diagnosed before admission to psychotherapy in the years 2004-2008, because of neurotic disorders. There is the "truthfulness scale" included in the checklist, which enables an estimation of reliability of answers. Norms are calculated in the groups of 301 non-patients and 508 patients before admission to psychotherapy in 2009-2010.

RESULTS

The cutoff point between Global Symptom Levels (OWK) in the nonclinical population and patients before admission to psychotherapy is estimated, and the value of 146 points for both men and women is suggested.

CONCLUSIONS

Symptom checklist S-III has satisfactory psychometric properties and can be applied in a quick diagnosis of neurotic disorders occurrence.

Proportion of general factor variance in a hierarchical multiple-component measuring instrument: a note on a confidence interval estimation procedure

A confidence interval construction procedure for the proportion of explained variance by a hierarchical, general factor in a multi-component measuring instrument is outlined. The method provides point and interval estimates for the proportion of total scale score variance that is accounted for by the general factor, which could be viewed as common to all components. The approach may also be used for testing composite (one-tailed) or simple hypotheses about this proportion, and is illustrated with a pair of examples.

Ridge structural equation modelling with correlation matrices for ordinal and continuous data

This paper develops a ridge procedure for structural equation modelling (SEM) with ordinal and continuous data by modelling the polychoric/polyserial/product-moment correlation matrix R. Rather than directly fitting R, the procedure fits a structural model to R(a) =R+aI by minimizing the normal distribution-based discrepancy function, where a > 0. Statistical properties of the parameter estimates are obtained. Four statistics for overall model evaluation are proposed. Empirical results indicate that the ridge procedure for SEM with ordinal data has better convergence rate, smaller bias, smaller mean square error, and better overall model evaluation than the widely used maximum likelihood procedure.

Sexual orientation and psychiatric vulnerability: a twin study of neuroticism and psychoticism

Recent evidence indicates that homosexuals and bisexuals are, on average, at greater risk for psychiatric problems than heterosexuals. It is assumed with some supporting evidence that prejudice often experienced by nonheterosexuals makes them more vulnerable to psychiatric disorder, but there has been no investigation of alternative explanations. Here we used Eysenck's Neuroticism and Psychoticism scales as markers for psychiatric vulnerability and compared heterosexuals with nonheterosexuals in a community-based sample of identical and nonidentical twins aged between 19 and 52 years (N = 4904). Firstly, we tested whether apparent sexual orientation differences in psychiatric vulnerability simply mirrored sex differences-for our traits, this would predict nonheterosexual males having elevated Neuroticism scores as females do, and nonheterosexual females having elevated Psychoticism scores as males do. Our results contradicted this idea, with nonheterosexual men and women scoring significantly higher on Neuroticism and Psychoticism than their heterosexual counterparts, suggesting an overall elevation of psychiatric risk in nonheterosexuals. Secondly, we used our genetically informative sample to assess the viability of explanations invoking a common cause of both nonheterosexuality and psychiatric vulnerability. We found significant genetic correlation between sexual orientation and both Neuroticism and Psychoticism, but no corresponding environmental correlations, suggesting that if there is a common cause of both nonheterosexuality and psychiatric vulnerability it is likely to have a genetic basis rather than an environmental basis.

[Neurosis as a mental disease--controversies surrounding insurance certification]

In the years 2008-2009, experts from the Department of Forensic Medicine in Katowice issued a dozen of expert opinions on the nature of the neurosis, addressing the question whether neurosis is a mental disease as understood under the general insurance conditions or whether neurosis is a mental disease as such. All the submitted cases involved policemen who had been diagnosed as neurotic and were refused insurance payments since the insurance company claimed payments could not have been effected due to the diagnosis of mental disease, meaning neurosis in the discussed cases. The plaintiffs invoked the fact that medical terminology describes such states as "mental disorders". In the article, the authors present the adopted model of opinionating, make an attempt at explaining the controversy and discuss the subtleties of medical terminology and the core differences between the terms "mental disorder" and "mental disease" as employed in medico-legal opinionating in such cases.

[Features of fractal dynamics EEG of alpha-rhythm in patients with neurotic and neurosis-like disorders]

Fifty-five patients with neurotic and neurosis-like disorders and 20 healthy controls, aged 17-64 years, have been examined. The basic research method was electroencephalography (EEG) with the fractal analysis of alpha power fluctuations. In patients, the changes in the fractal structure were of the same direction: the decrease of fractal indexes of low-frequency fluctuations and the increase of fractal indexes of mid-frequency fluctuations. Patients with neurosis-like disorders, in comparison to those with neurotic disorders, were characterized by more expressed (quantitative) changes in fractal structures of more extended character. It suggests the presence of deeper pathological changes in patients with neurosis-like disorders.

Neuroticism, cognitive ability, and the metabolic syndrome: The Vietnam Experience Study

OBJECTIVES

The purpose of this study is to explore the association of neuroticism with the metabolic syndrome, separate components of the metabolic syndrome, and the number of components of metabolic syndrome an individual possesses. The purpose of this study is to examine also the extent to which any associations are accounted for by sociodemographic factors, health behaviors, and cognitive ability.

METHOD

Participants were 4208 men drawn from the Vietnam Experience Study. From military archives, and a later telephone interview and psychological and medical examination, sociodemographic, health behavior, cognitive ability, neuroticism, and health data were collected. Neuroticism and cognitive ability were assessed with standardized tests during the medical examination. Presence of the metabolic syndrome was based on body mass index, fasting blood glucose or a diagnosis of diabetes, high blood pressure or taking antihypertensive medication, high-density lipoprotein cholesterol, and triglyceride levels.

RESULTS

Neuroticism was positively associated with the occurrence of the metabolic syndrome and several of its components in both age-, and sociodemographic- and health behavior-adjusted analyses. Many associations were accounted for by individual difference in cognitive ability. Neuroticism was robustly associated with the number of components of the metabolic syndrome after adjustment.

CONCLUSIONS

Individuals with higher neuroticism scores had a higher prevalence of the metabolic syndrome and a larger number of its components. On the whole, differences in cognitive ability appeared to partially mediate the relationship between neuroticism and the metabolic syndrome.

Neuroticism as a common dimension in the internalizing disorders

BACKGROUND

Several theories have posited a common internalizing factor to help account for the relationship between mood and anxiety disorders. These disorders are often co-morbid and strongly covary. Other theories and data suggest that personality traits may account, at least in part, for co-morbidity between depression and anxiety. The present study examined the relationship between neuroticism and an internalizing dimension common to mood and anxiety disorders.

METHOD

A sample of ethnically diverse adolescents (n=621) completed self-report and peer-report measures of neuroticism. Participants also completed the Structured Clinical Interview for DSM-IV (SCID).

RESULTS

Structural equation modeling showed that a single internalizing factor was common to lifetime diagnosis of mood and anxiety disorders, and this internalizing factor was strongly correlated with neuroticism. Neuroticism had a stronger correlation with an internalizing factor (r=0.98) than with a substance use factor (r=0.29). Therefore, neuroticism showed both convergent and discriminant validity.

CONCLUSIONS

These results provide further evidence that neuroticism is a necessary factor in structural theories of mood and anxiety disorders. In this study, the correlation between internalizing psychopathology and neuroticism approached 1.0, suggesting that neuroticism may be the core of internalizing psychopathology. Future studies are needed to examine this possibility in other populations, and to replicate our findings.

[Factorial structure of the general health questionnaire (GHQ-30)]

The General Health Questionnaire (GHQ) was designed by Goldberg in the 1970's as a screening instrument to provide information on the mental wellbeing. Although it is widely used as a unidimensional instrument, factor analyses tend to suggest that it contains more than one dimension.

AIM

The purpose of this paper is to review the factor-analytic research that has been carried out with regard to the 30-item General Health Questionnaire (GHQ-30) and to present the results of the analysis of our research.

MATERIAL AND METHODS

A total of 623 patients suffering from neurotic disorders and somatic illnesses were included into the study, 130 men and 493 women at the age ranged from 17 to 85 years old. A total score was calculated with Likert's method. The principal factor analysis with orthogonal varimax normalised rotation was used. Results. The GHQ-30 was found to have high internal consistency as a scale and high item-total correlations for most of the items. The factorial analysis showed that three factors labelled as the followed can be abstracted from the scale: depression and anxiety, interpersonal relations, general functioning. These factors jointly account for 58% of the variance.

CONCLUSIONS

Results showed both multifactorial (at the level of a lower order) and unifactorial (at the level of an upper order) structure of the GHQ-30.

[Instability of personality characteristics and personality disorders during the lifespan: effects for assessment in older adults]

The instability of personality characteristics and personality disorders during the lifespan is the topic of this literature search. It concerns the effects of this instability for personality assessment in older adults. Five longitudinal studies, based on the Big Five model of Costa & McCrae, support the hypothesis that personality characteristics change during the lifespan. Neuroticism, extraversion and openness decrease with age. In contrast, altruism and conscientiousness increase with age. One longitudinal and three cross-sectional studies of personality pathology indicate age-specific changes in the expression of (mal) adaptive personality characteristics. Besides that, nearly one third of the DSM criteria for Axis II personality disorders are insufficiently applicable to older people, based on a large cross sectional study. Therefore the temporal instability of personality characteristics and the limited validity of the Axis II criteria complicate personality assessment in older adults. Improvements could be found in major standardization studies of personality questionnaires in elderly patients in mental health care and nursing home care. Significant changes in the DSM, such as the development of an age specific and multidimensional approach to personality disorders is also recommended.

Profiles of recreational activities of daily living (RADL) in patients with mental disorders

BACKGROUND

Activities of daily living, play a key role in the measurement of functional health as defined by the International Classification of Functioning, Disability and Health (ICF) and in prevention and treatment of mental or somatic illnesses. From a clinical context it is important to discriminate between basic "activities of daily living, ADL", "intentional activities of daily living, IADL", and "recreational activities of daily living, RADL". While ADL and IADL have gained much attention in dementia, the elderly, or severe somatic illnesses, there is a lack of research on RADL, which are important in depression, anxiety, or other neurotic disorders.

SUBJECTS AND METHODS

154 unselected inpatients of a department of behavioral and psychosomatic medicine filled in the "Check List of Recreational Activities" to assess the rates and profiles of RADL.

RESULTS

Patients reported on average 19.3 (s.d. 7.0) activities (range 4 - 40), i.e. males 21.3 (s.d. 6.5, 9 - 34) and females 18.9 (s.d. 7.1, 4 - 40). Most frequent RADL were passive and unspecific activities like "watching tv" (93.4%). Least frequent were activities which need special skills or preparation like "horse back riding" (0.7%). Low rates were also found for activities which are in the centre of inpatient occupational therapy like "ceramics" (4.7%) or "silk-painting" (2.6%). There are differences between sexes but not in respect to age (18 to 60), sick leave and unemployment, or diagnostic status. When patients were asked what they would like to do in the future, the same activity profile emerged as when looking at what they had done in the last month

CONCLUSION

The data give a reference profile for recreational activities, help to define what can be considered a normal frequency and spectrum of RADL, and, by this, can guide therapeutic interventions.

Body image distortion, perfectionism and eating disorder symptoms in risk group of female ballet dancers and models and in control group of female students

BACKGROUND

The aim of this research was to examine differences among two groups of girls, models and ballerinas (with risk factors - experimental group) and young students (control group), in body image preception, body mass index, neurotic perfectionism, body - image distortion and simptoms of eating disorders.

SUBJECTS AND METHODS

The research was conducted with 91 participants divided in two groups, control group - 55 students at University of Sarajevo and experimental group - 13 professional ballerinas, 23 professional models. During this research work we used several measuring instruments: Body mass index; Body Mass Index - Silhouette Matching Test; Neurotic Perfectionism Questioner; Eating Disorders Inventory.

RESULTS

In this study statistically significant differences occur between these two groups of girls which are related to body - image perception and objective position on the body mass index chart. All 91 participants saw themselves as obese. Statistically significant differences occur in body - image distortion and simptoms of eating disorders in the experimental group, they have high scores on body - image distortion, on eating disorders inventory and neurotic perfectionism simptoms.

CONCLUSION

Based on th results in this study, we may conclude that there are groups of people who have risk factors for developing some kind of eating disorder, so it would be desirable to create a preventive intervention for young ballerinas and models, but also for those people who coach them, trainers, instructors and managers. For other population groups with risky behavior such as young children, a prevention plan and modifications of cultural influences on people's opinion of body image are extremely important.

Hyperventilation response in the electroencephalogram and psychiatric problems in children with primary monosymptomatic nocturnal enuresis

OBJECTIVES

The aim of this study was to determine the frequency of an increased hyperventilation (HV) response in the electroencephalogram and to compare the results of psychometric assessments and electroencephalography (EEG) patterns in children with and without primary monosymptomatic nocturnal enuresis and in dry siblings of enuretics. We also compared the results of psychometric assessments and EEG patterns between enuretic and non-enuretic children.

MATERIAL AND METHODS

The study included 89 children divided into three groups: 41 with primary monosymptomatic nocturnal enuresis, their 29 dry siblings and 19 with no history of voiding dysfunction (controls). Resting EEG changes were evaluated in all children. In addition to a psychiatric evaluation, the Maudsley Obsessive Compulsive Questionnaire, the Beck Child Depression Inventory and the State and Trait Anxiety Inventory for Children were used to assess obsessive-compulsive disorder, depression and anxiety, respectively.

RESULTS

The time at which real words were first spoken occurred significantly later in enuretic children (p<0.01). The frequency of EEG abnormalities was significantly higher in the enuresis group and in their dry siblings than in the control group (p<0.01). Additionally, as an indicator of cortical dysmaturity, an increased HV response was observed more often in enuretic children and their dry siblings than in the control group (p<0.001). Anxiety scores for the enuretic children were higher than those for the controls (p<0.01). There was no significant difference in psychiatric problems between the enuresis and control groups (p>0.05).

CONCLUSIONS

The increased frequency of a high-level HV response in resting-state EEG recordings and the anxiety scores suggested that delayed cortical maturity and high anxiety may be important factors in the pathogenesis of primary monosymptomatic nocturnal enuresis. The HV responses in the dry siblings of the enuretic children may emphasize the relationship between insufficient cerebral maturation and the genetic origin of nocturnal enuresis.

Midlife Neuroticism and the age of onset of Alzheimer's disease

BACKGROUND

There may be important public health implications of increasing our knowledge of factors associated with age of dementia onset. The pre-morbid personality domain of Neuroticism constituted an interesting and theoretically plausible, yet uninvestigated, candidate for such an association. We aimed to examine whether midlife Neuroticism was associated with earlier age of onset of Alzheimer's disease (AD).

METHOD

This was a case-comparison study of 213 patients with probable AD. Detailed clinical information was collected for all patients including age of onset of dementia symptoms. One or two knowledgeable informants rated each patient's midlife personality retrospectively using the Neuroticism, Extraversion, Openness Five-Factor Inventory (NEO-FFI) questionnaire. The relationship between midlife Neuroticism and age of dementia onset was evaluated using both correlational analysis and backward linear regression analysis.

RESULTS

Midlife Neuroticism predicted younger age of dementia onset in females but not in males. The association found in females was independent of pre-morbid history of affective disorder.

CONCLUSIONS

This finding and its potential mechanism warrant further investigation.

Mental disorders and personality traits as determinants of impaired work functioning

BACKGROUND

Both mental disorders and personality characteristics are associated with impaired work functioning, but these determinants have not yet been studied together. The aim of this paper is to examine the impairing effects that mental disorders and personality characteristics (i.e. neuroticism, locus of control and self-esteem) have on work functioning.

METHOD

Data for a representative sample of 3570 working people were derived from the first two waves of the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a prospective cohort study in the Dutch adult population.

RESULTS

Higher neuroticism, more external locus of control and lower self-esteem were each significantly associated with subsequent impairment in work functioning, independently of any effects from mental disorders. Associations between mental disorders and subsequent work impairment disappeared once personality traits were taken into account. Personality traits did not moderate the relationships between mental disorders and work functioning.

CONCLUSIONS

Working people with vulnerable personalities have a greater risk of impaired work functioning, independent of the risk from any mental disorder they may have.

Impairments in cognition across the spectrum of psychiatric disorders: evidence from a Swedish conscript cohort

It is well established that cognitive deficits are an almost invariable component of the schizophrenia syndrome. Much less is known about the association of cognitive deficits and the range of psychiatric disorders. The current study made use of a Swedish conscript cohort which included an IQ assessment and full psychiatric evaluation at conscription of all 18- to 19-year-old males. It was found that reduced intellectual functioning was found in association with psychosis and neurotic disorders including depression, personality disorders, alcoholism, and drug dependence. The effect was particularly strong for alcoholism. This presumably represents a combination of premorbid deficits (as demonstrated in those who developed schizophrenia some years later) plus coincident impairments. The direction of causality of this latter association is likely to be both forward and reverse. Different cognitive subtests showed varied strengths of association: "mechanical ability/knowledge," which might reflect planning and reasoning more than the other subtests, had the strongest effect. Cognitive deficits are widespread in psychiatric disorders and should be taken into account in clinical interactions.