1,720,983 research outputs found
A single case report of current surgery for chronic back pain and its implications concerning a diagnosis of Munchausen syndrome
Full text linkA SINGLE CASE REPORT OF RECURRENT SURGERY FOR CHRONIC BACK PAIN AND ITS IMPLICATION CONCERNING A DIAGNOSIS OF MUNCHAUSEN SYNDROME.
No full textWhile undergoing treatment in the psychiatric depart-
ment,4.C., a 40-year-old white male, who had arrived in
the casualty department complaining of an uncontrol-
lable anxiety attack and in a state of fluctuating con-
sciousness, was found to be suffering from a psy-
chopathological condition characterized by pathologi-
cal lying, gambling, compulsive restlessness, a long
clinical history of chronic back pain, with multiple inva-
sive diagnostic investigations and repeated surgery for
disc hernia with relative complications, culminating in
the fitment of a fixed neurostimulator, a slowdischarge
morphine pump and the patient being granted a full dis-
ability pension. The continual increases in the doses of
morphine suggested a tendency towards drug addic-
tion.
After providing a brief overview of lhe historical back-
ground and current concepts relating to the relation-
ship between factitious disorders, malingering and
hysteria, the authors discuss the differential diagnosis
of the case, suggesting a diagnosis of Mùnchausen
syndrome (the hypothesis best supported by the clini-
cal evidence). This diagnosis, although the subject of
much academic debate, is, unfortunately, still not fre-
quently encountered in the medical literature, with the
result that even today it has a strong clinical, relational
and social impact
Searching for adherence in minor mental disorders: ethical warnings and clinical precations
No full textEvaluation of positive and negative symptoms in chronic schizophrenia: An interrelationship study among SANS/SAPS, PANSS and InSka rating scales
No full textAim. The aim of the study was to evaluate the degree of statistic correlation of some of the best known instruments used for the assessment of the positive and negative symptomatology of schizophrenic patients. Methods. The evaluation rating scales PANSS, SAPS/SANS and InSka in the Italian version have been used. The scales have been submitted, through the joined interview method, to 28 DSM-IV schizophrenic patients living in some community units of our department, with at least 5 year illness. We have used the scores resulting from the submission of each rating scale to get to the definition of the syndrome diagnosis following the rules stated by each author. We have then compared these diagnosis (syndromic diagnosis interrelation), the simple scores of each subscale (subscale interrelation) and the subscales of PANSS and SAPS/SANS for the structure correlation evaluation. Results. A substantial positive correlation among the tools used has been noticed. This correlation was higher for the negative syndrome diagnosis (Spearman's p=0.503; P<0.01) and for the correlation between the subscales evaluating the negative symptoms (Pearson's r=0.668; P<0.01). The correlation between very different instruments such as the scale of evaluation of the apathy syndrome and the scale of evaluation of the PANSS general psychophatology has proved statistically significant (Pearson's r=0.689; P<0.01). Conclusion. Even if based on a poor sample, the results seem to support the research hypothesis and to confirm the litterature data. On the basis of our experience we can confirm the validity of the support given by these instruments both in research and in clinical practice
Trattamento sanitario obbligatorio: uno studio osservazionale in due SPDC del DSM di Varese
No full textDissociative alterations of the consciousness: A preliminary study = Alterazioni dissociative della coscienza: Uno studio preliminare
No full textAim: Over the last few years much discussion has taken place as to whether dissociation can be considered a transnosological phenomenon associated to other important psychiatric problems or whether it should be classified as an individual nosological category. In fact, dissociative phenomena are not infrequent in a number of psychiatric illnesses, which has led some authors to hypothesize the apparent lack of specificity in the spectrum of dissociative symptoms. Methods. Our study examines patients observed during the year 2004 at UOP 2 directed by the University at A.O. Ospedale di Circolo e Fondazione Macchi in Varese, where dissociative alterations of the consciousness were found to be present, which, according to a primary distinction (Janet) were of a non psychotic nature. Having confirmed the real manifestation of dissociative states using the Dissociative Experience Scale II (DES II) together with clinical diagnosis, made with the DSM-W-TR and the ICD-10, extraneous to psychosis groupings, the study likewise underlines the fact that dissociative alterations of the consciousness are also to be seen in numerous diagnostic categories. Results. The aim of this paper is to search for significant pathogenic events of both a traumatic nature (bereavement, childhood abuse, adoption, war) and also an anthropological-cultural nature (migration from foreign countries) which could possibly correlate to the alterations in consciousness observed. Conclusion. In order to have a clearer phenomenologlcal understanding of dissociative states, three levels of increasing gravity relative to the alterations of the state of consciousness were arbitrarily introduced: fluctuating, altered, and dissociated. These levels were verified by a rising score on the DES II scale
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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