The First Seventy Admissions to an Adolescent Unit in Edinburgh: General Characteristics and Treatment Outcome

1975 ◽  
Vol 126 (4) ◽  
pp. 380-389 ◽  
Author(s):  
R. Framrose
Keyword(s):  
Treatment Outcome ◽  
Personality Disorder ◽  
Psychiatric Morbidity ◽  
Antisocial Behaviour ◽  
Poor Response ◽  
Normal Families ◽  
List Type ◽  
Therapeutic Regime ◽  
History Of ◽  
Family Psychopathology

Summary1.The clinical functioning of the Young People's Unit, Edinburgh is described. This involves a relatively permissive, democratic ‘milieu‘. Psychotherapeutic efforts are devoted to the resolution of family psychopathology and the achievement of maturational progress for the adolescent.2.Data on the first seventy admittions to the Unit were examined. Two-thirds of the patients were diagnosed ‘developmental crisis’; the majority of these also had a personality disorder.3.Assessments of family functioning showed high levels of disturbance and psychiatric morbidity among the parents. The adolescents had mutually good, positive relationships with their opposite-sexed parents, but markedly negative ones with the same-sexed parents. This was not in accordance with the usual findings in ‘normal’ families. Delinquent and impulsive patients showed uniformly negative family attitudes.4.A simple estimation of treatment outcome at discharge gave results comparable to those of other units, with 70 per cent of patients rated as improved. Neurotic and psychotic patients had a relatively better outcome. Tension-discharge personality disorder and a history of very disruptive or antisocial behaviour were associated with poor outcome.5.The poor response of very disturbed, impulsive adolescents to this type of therapeutic regime is discussed. These individuals do not appear to have sufficient personality resources and organization to benefit from this type of treatment. Emerging from this is a suggestion for an increased provision of specialized units offering containment and intensive care to the very disturbed adolescent.

Lack of quality assurance in forensic psychiatry: false positive prevalence of antisocial personality disorder among norwegian inmates on preventive detention

2011 ◽  
Vol 26 (S2) ◽  
pp. 797-797
Author(s):  
H. Vaeroy
Keyword(s):  
Quality Assurance ◽  
Personality Disorder ◽  
Antisocial Personality Disorder ◽  
False Positive ◽  
Antisocial Behaviour ◽  
Antisocial Personality ◽  
Axis Ii ◽  
Positive Diagnosis ◽  
False Positive Diagnosis ◽  
History Of

IntroductionA Norwegian government publication (1) claims a prevalence of around 50% of Antisocial Personality Disorder (APD) in a small group of male detainees on preventive detention. The present study population is recruited from more or less the same population as those among whom a 50% prevalence of APD has been claimed (1). Norwegian forensic investigators rarely (17%) apply psychometric tools to confirm their clinical diagnosis (2).AimsTo confirm the diagnosis of APD applying SCID axis II. Methods: Fifty six inmates were available at the prison. Twenty eight were willing to participate (50%). Two were excluded. Thus, 26 (46%) inmates participated. DSM IV, SCID axis II was applied.ResultsNone of the 26/56 matched the APD criteria, mainly failing to fulfil the diagnosis of Conduct Disorder (CD) before the age of 15 years. All the inmates had a history of antisocial behaviour.ConclusionsTo explain the claim of around 50% APD in view of the present results, close to 100% APD should be found among the remaning thirty non-participating inmates. We consider this unlikely.A diagnosis of APD based on the history of antisocial behaviour alone represents a pitfall. Lack of quality assurance could lead to false positive diagnosis. The need for a standardized approach and quality assurance in Norwegian forensic psychiatric evaluations seems nevessary to avoid false positive diagnosis.

scholarly journals Venipuncture Induced Complex Regional Pain Syndrome Presenting as Inflammatory Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Punit Pruthi ◽  
Pramod Arora ◽  
Manoj Mittal ◽  
Anugrah Nair ◽  
Waqia Sultana
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Inflammatory Arthritis ◽  
Young Male ◽  
Pain Syndrome ◽  
Poor Response ◽  
History Of ◽  
Diagnostic Modalities ◽  
Musculoskeletal Ultrasonography ◽  
The Right

Venipuncture is one of the most commonly done medical procedures. We report a unique case of a 23-year-old young male who presented with features suggestive of inflammatory arthritis. The symptoms, which initially started on the right side, also involved the other side after a few weeks. Although the patient’s symptoms and signs were simulating inflammatory arthritis, he had atypical features like poor response to anti-inflammatory medicines and normal laboratory parameters. His musculoskeletal ultrasonography was also not suggestive of arthritis. His history was reviewed and on direct questioning he revealed a history of venipuncture for blood sample withdrawal, done from right antecubital region for routine health check on the day prior to the onset of symptoms. Complex regional pain syndrome was suspected and triple-phase radioisotope bone scan was done which was highly suggestive of this diagnosis. The patient was managed with multidimensional approach and responded very well to the treatment. Complex regional pain syndrome is usually not thought of in the initial differential diagnosis of inflammatory arthritis. In this report we highlight the need to elicit the often overlooked history of trivial trauma like venipuncture, especially in atypical cases of arthritis. Also the role of newer diagnostic modalities in such cases is emphasized.

Factors associated with borderline personality disorder in major depressive patients and their relationship to bipolarity

2013 ◽  
Vol 28 (8) ◽  
pp. 463-468 ◽  
Author(s):  
J.M. Azorin ◽  
A. Kaladjian ◽  
M. Adida ◽  
E. Fakra ◽  
R. Belzeaux ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Age At Onset ◽  
Borderline Personality ◽  
First Episode ◽  
Contributory Factor ◽  
Structured Interviews ◽  
Major Depressive ◽  
History Of ◽  
Depressive Patients

AbstractObjectiveTo analyze the interface between borderline personality disorder (BPD) and bipolarity in depressed patients comorbid with BPD.MethodsAs part of National Multi-site Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 19 (3.9%) had comorbid BPD (BPD+), whereas 474 (96.1%) did not manifest this comorbidity (BPD−).ResultsCompared to BPD (−), BPD (+) patients displayed higher rates of bipolar (BP) disorders and temperaments, an earlier age at onset with a family history of affective illness, more comorbidity, more stressors before the first episode which was more often depressive or mixed, as well as a greater number and severity of affective episodes.ConclusionsThe hypothesis which fitted at best our findings was to consider BPD as a contributory factor in the development of BP disorder, which could have favoured the progression from unipolar major depression to BP disorder. We could not however exclude that some features of BP disorder may have contributed to the development of BPD.

Phlegmonous gastritis in 2 yearling horses

2022 ◽  
pp. 104063872110650
Author(s):  
Julie B. Engiles ◽  
Francisco A. Uzal ◽  
Mauricio A. Navarro ◽  
Virginia B. Reef ◽  
Susan J. Bender
Keyword(s):  
Clinical Signs ◽  
Poor Response ◽  
Abdominal Ultrasound ◽  
Mucosal Injury ◽  
Response To Treatment ◽  
Bacterial Populations ◽  
Proliferative Enteropathy ◽  
Mucosal Involvement ◽  
Phlegmonous Gastritis ◽  
History Of

Phlegmonous gastritis was diagnosed in 2 yearling fillies that were presented with a 1-wk history of fever, lethargy, and hypoproteinemia, associated with a previous diagnosis of equine proliferative enteropathy based on clinical signs and PCR assay detection of Lawsonia intracellularis in fecal samples. Abdominal ultrasound revealed enlargement of the stomach and expansion of its submucosal layer with hypoechoic fluid, as well as thickened hypomotile small intestinal segments. Given the poor prognosis and poor response to treatment, both horses were euthanized, one on the day of presentation and the other after 3 wk of intensive medical management including a combination of antimicrobials, analgesics, and intravenous colloids. At autopsy, acute mural gastritis characterized by severe submucosal edema with suppurative inflammation (i.e., phlegmonous gastritis) and necroulcerative enteritis compatible with the necrotizing form of equine proliferative enteropathy were identified in both horses. The gastric inflammation was associated with thrombosis and mixed bacterial populations, including Clostridium perfringens, that were confined to the submucosa without evidence of mucosal involvement; toxin genes compatible with C. perfringens type C were identified in one case. Human phlegmonous gastritis is an uncommon, often-fatal pyogenic infection that is often associated with mucosal injury, bacteremia, or immunocompromise. Our finding of this unusual gastric lesion in 2 horses with similar signalment, clinical disease, and spectrum of postmortem lesions suggests a similar etiopathogenesis that possibly involves local, regional, or distant hematogenous origin, and should be considered a potential complication of gastrointestinal mucosal compromise in horses.

Man with bilateral inguinal lymphadenopathy

2018 ◽  
Vol 35 (8) ◽  
pp. 522.1-522
Author(s):  
Charlotte Delcourt ◽  
Jean Cyr Yombi ◽  
Halil Yildiz
Keyword(s):  
Lymph Node ◽  
Physical Examination ◽  
Sexual Intercourse ◽  
Vital Signs ◽  
List Type ◽  
Cat Scratch Disease ◽  
Night Sweats ◽  
History Of ◽  
Inguinal Lymphadenopathy ◽  
Lymph Node Tuberculosis

Clinical introductionA 37-year-old man with history of lymph node tuberculosis presented with bilateral inguinal swelling with night sweats but no fever for 2 weeks. He had a cat but he had no history of scratches. He had an extraconjugal sexual intercourse a few weeks before. Physical examination revealed 5 cm tender, erythematous and painful bilateral inguinal adenopathy (figure 1A) and a small ulceration at the base of the penis (figure 1B). Vital signs were normal.Figure 1(A) Inguinal lymphadenopathy. (B) Ulceration at the base of the penis.QuestionWhat is the most likely diagnosis?ToxoplasmosisTuberculosisCat-scratch diseaseLymphogranuloma venereumSyphilis

scholarly journals New Evo-SETI results about civilizations and molecular clock

2016 ◽  
Vol 16 (1) ◽  
pp. 40-59 ◽  
Author(s):  
Claudio Maccone
Keyword(s):  
Probability Density ◽  
Molecular Clock ◽  
Modern Human ◽  
Peak Time ◽  
List Type ◽  
Type Number ◽  
Death Time ◽  
Evolution Of Life ◽  
History Of ◽  
Life On Earth

AbstractIn two recent papers (Maccone 2013, 2014) as well as in the book (Maccone 2012), this author described the Evolution of life on Earth over the last 3.5 billion years as a lognormal stochastic process in the increasing number of living Species. In (Maccone 2012, 2013), the process used was ‘Geometric Brownian Motion’ (GBM), largely used in Financial Mathematics (Black-Sholes models). The GBM mean value, also called ‘the trend’, always is an exponential in time and this fact corresponds to the so-called ‘Malthusian growth’ typical of population genetics. In (Maccone 2014), the author made an important generalization of his theory by extending it to lognormal stochastic processes having an arbitrary trend mL(t), rather than just a simple exponential trend as the GBM have.The author named ‘Evo-SETI’ (Evolution and SETI) his theory inasmuch as it may be used not only to describe the full evolution of life on Earth from RNA to modern human societies, but also the possible evolution of life on exoplanets, thus leading to SETI, the current Search for ExtraTerrestrial Intelligence. In the Evo-SETI Theory, the life of a living being (let it be a cell or an animal or a human or a Civilization of humans or even an ET Civilization) is represented by a b-lognormal, i.e. a lognormal probability density function starting at a precise instant b (‘birth’) then increasing up to a peak-time p, then decreasing to a senility-time s (the descending inflexion point) and then continuing as a straight line down to the death-time d (‘finite b-lognormal’).(1)Having so said, the present paper describes the further mathematical advances made by this author in 2014–2015, and is divided in two halves: Part One, devoted to new mathematical results about the History of Civilizations as b-lognormals, and(2)Part Two, about the applications of the Evo-SETI Theory to the Molecular Clock, well known to evolutionary geneticists since 50 years: the idea is that our EvoEntropy grows linearly in time just as the molecular clock. (a)Summarizing the new results contained in this paper: In Part One, we start from the History Formulae already given in (Maccone 2012, 2013) and improve them by showing that it is possible to determine the b-lognormal not only by assigning its birth, senility and death, but rather by assigning birth, peak and death (BPD Theorem: no assigned senility). This is precisely what usually happens in History, when the life of a VIP is summarized by giving birth time, death time, and the date of the peak of activity in between them, from which the senility may then be calculated (approximately only, not exactly). One might even conceive a b-scalene (triangle) probability density just centred on these three points (b, p, d) and we derive the relevant equations. As for the uniform distribution between birth and death only, that is clearly the minimal description of someone's life, we compare it with both the b-lognormal and the b-scalene by comparing the Shannon Entropy of each, which is the measure of how much information each of them conveys. Finally we prove that the Central Limit Theorem (CLT) of Statistics becomes a new ‘E-Pluribus-Unum’ Theorem of the Evo-SETI Theory, giving formulae by which it is possible to find the b-lognormal of the History of a Civilization C if the lives of its Citizens Ci are known, even if only in the form of birth and death for the vast majority of the Citizens.(b)In Part Two, we firstly prove the crucial Peak-Locus Theorem for any given trend mL(t) and not just for the GBM exponential. Then we show that the resulting Evo-Entropy grows exactly linearly in time if the trend is the exponential GMB trend.(c)In addition, three Appendixes (online) with all the relevant mathematical proofs are attached to this paper. They are written in the Maxima language, and Maxima is a symbolic manipulator that may be downloaded for free from the web.In conclusion, this paper further increases the huge mathematical spectrum of applications of the Evo-SETI Theory to prepare Humans for the first Contact with an Extra-Terrestrial Civilization.

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