Escolar Documentos
Profissional Documentos
Cultura Documentos
Social Psychiatry
Edited by
Vladimir Hudolin
"Dr. M. Stojanovic" University Hospital
Zagreb, Yugoslavia
"Proceedings of the Eighth World Congress of Social Psychiatry, held August 16-22,
1981, in Zagreb, Yugoslavia."
Bibliography: p.
Includes index.
1. Social psychiatry-Congresses. 1. Hudolin, Vladimir. Il. Carleton, John L., 1925-
III. Title. [DNLM: 1. Community psychiatry-Congresses. W3 W05385M 8th 1981s]
RC455.W68 1981 616.89 83-4058
ISBN 978-1-4684-4537-4 ISBN 978-1-4684-4535-0 (eBook)
DOI 10.1007/978-1-4684-4535-0
v
vi PREFACE
Vladimir Hudolin
CONTENTS
xi
xii CONTENTS
Alcoholism 707
Vl. Hudolin
xviii CONTENTS
Contributors 843
Index 853
SOCIAL PSYCHIATRY TODAY
Vladimir Hudolin
l
2 VL. HUDOLIN
Summary
John L. Carleton
The Santa Barbara Psychiatric Medical Group
Santa Barbara, Ca.93105
9
10 J. L. CARLETON
REFERENCES
SOCIAL PSYCHIATRY
George A. Vassiliou
19
20 G. VASSILIOU
Jules H. Masserman
27
28
Vladimir Hudolin
Introduction
31
32 VL. HUDOLIN
If the factors mentioned previously are the cause
of most mental disorders, it would be normal to expect
that contemporary psychiatry should devote due care to
them. There are many who reject such an activity of
psychiatry as, according to them, this would mean a
transition of psychiatry onto alien grounds and mixing
of psychiatry and politics.
Subject of Discussion
Political Psychiatry
Summary
WORLD SUICIDE
Jules H. Masserman
Northwestern University
Chicago, u. s. A.
37
38 J. H. MASSERMAN
The United States and the Soviet Union now have ready
for instant launching over 40,000 atomic fission (1 to 20
megaton) and hydrogenfusion (20 MT to 100 MT) nuclear
devices ranging in destructive power from 50 to 5,000 times
those dropped on Japan. Britain, France, India and China
have over 10,000 more and, according to reliable intel-
ligence, additional ones are being planned or assembled
in Argentina, Iraq, Pakistan, Israel, South Africa and
possibly elsewhere.
.1%
40 60 80 100
TIME (YEARS)
Current Activities
SELECTED PUBLICATIONS
PSYCHIATRIC DIAGNOSIS
Jules H. Masserman
Northwestern University
Chicago, Illinois, u.s.A.
49
50 J. H. MASS ERMAN
zt:r::l
1-3
H
PHYSICS MEDICINE PSYCHIATRY CURRENT PENETRATIONS
"':!
H
Po'lsession: Taxonomict Good/evil/Yin/Yanq ()
~: ~ Gods send Disease
Marduk/Ptah/Ormazd/ Aaron/Job "Whom the qods would "Psychodynamic" (Narcissism) en
u Vishnu/Izanaqi/Yaweh Healing: Witch docto~st des;roy they first make ~ _!2: Sin, Cain, Dionysus, Loki. 1-3
H~
...~ Amulets/Kings. mad • (Cambyses, ~ Satan
"'~~ Or Destroy Touch Nebuchadnezzar) ~ ~: Osiris, MOses, Zoroaster, ~
Tiamat, Seth, >1 Buddha, Apollo, Jesus c:::
Ahriman Siva Thor !!l!:!.!:l!.!= Cos/Knidos/ ~: Temples of Amon : en
' ' Lourdes/ Jesus .!! demons ~ supereso: Ra, Brabma, zeus,
Montserrat Relics of Saints Wotan, Yaweh, Allah
Sorcery - Shamans
0
"':!
Asklepian Humors Imhotep (2800 B.c.) (t Mystic "C
Ionic Elements en
Earth, air, fire, blood/phleqm/yellow Theophrastus (300 B.C.)~~ Epilepsy/stroke/seizure t<
water black bile (o Faith Therapies
Mendelejeff Tables .§!!!a (130-200 A.D.) Are=us ~50~130) a (s 11 g~!;~=~~i~c~::~~~q, prayer
g
u samhn clay ---maiiTil- YP -thymi l ~ H
Atomic series
J 5 r 0 Hospitals
Quantum Progression w.svdenham (1629-89) • p c~4A'Bf - H• Krame r i Religious denominations and ~
~ P otons _ 1 ctro 8 tow. osier (1892), sponsorships
r e e n et ;;r,--- c. Linne (1707-78) ami ~
~ Radioactivity ~aum (1963) ~erial aids ()
to 1CD9 (Vesan!a/vecordia)
E. Kraepelin/E. Bleuler t:l
S. Freud,et al. DSM III H
:,r:.
Newton/Einstein Hippocrates/Osler/ Maimonides/Meyer !!.Y!lli• ~
Planck/Heisenberg Dubas Menninger/Sartorius ~a-Bohr: Horseshoe 0
Schroedinqer/Dirac Pathogenic: To Medical Vectors add (simJ;:ol of Ishtar "for qood en
genetic/traumatic/toxic Pathogenic Experiences: luck ) H
CosmiC Forces:
Gravity/electro- infectious/neoplastic adverse uterine infant- Einstein: en
magnetism ' "I cannot believe that God
t k cl Precipitatinj Stresses: ile, familial, sexual, plays dice with the Universe•
s rong1wea nu ear physiologic psycho- ethnic, educational/ m
Interactions social marital, occupational/ ~Taxonomic:
relativity/quanta vs juristic 'iii Matter-
~ predictability !! Res·tstiiices counterer by f . antimatter I New~n "'a
~ indeterminancy age, race, consfi tution, Coping Canaci·ti·es: light~ corpuscles
~ induced immunities. Huygen s •ether waves •
ot Asymptotic enhanced by talents/skills/resources de Broglie ...8 wave photons
J integrations? Available Therayies utilized by
cost,compatibiiit es, or-therapies: (7 R""'a) Separately named mesons,
countereffect&, ethical, Medical, social, neutrinos, quarks, and many
!:f:!a~ social para- existential other sub atomic •particles•
l11
w
54 J. H. MASSERMAN
Psychiatric Therapies
Host importantly, in accord with the integrative
systems approach to diagnosis, psychiatric treatment
will become correspondingly comprehensive and dynamic.
I have elsewherelO discussed its interlocking parameters
as these "seven'R's": (1) the reputations of the therapist
(2) the establishment of rapport, (3) the relief of
symptoms, (4) a review of-the patient's traumas, vulnera-
bilities and coping capacities, (5) re-educative insights
64 J. H. MASSERMAN
SUMMARY
REFERENCES
MENTAL ILLNESS
Norman Rosenzweig
Department of Psychiatry
Sinai Hospital of Detroit
Detroit, Michigan
67
68 N. ROSENZWEIG
SUMMARY
REFERENCES
Tatjana Sikic-Sivik
Psychiatric Clinic
Centrallasarettet
Uddevalla, Sweden
77
78 T. SIKIC-SIVIK
/ \
- more playing I
- strengthening of ego I
+'
I I
u II PRACTICII'-G (sep. ind.) ,{ .§ c \ eyeUe M~.iUation bew:een man.ia and depJteM.io~
"'""' E
"
_!)" !::'0 !': Mi\NO-DEPRESS. I !h";{Vtae:Uvd~ - apath~a~ .~>evVte anuety, _-~>u-te-tdcU'
- init. instinct neutraliz.
0 -~ {-.... ., ·VI ,... PSYCHOSIS I aot d~stJwet-tve tendeneu.~>, pVt~eeut-ton -tdeM,
I 'U - fusion
a
" +'
.--< - omnipotency ~ '(;' ~ t I 6eel-tng.~> o6 omn"-roteney - notftmgneM
Lt Lt .... \
w .s:0 "' - separation anxiety Ill 0 +' C» X
I ., . , \
~ ..!: Ltc GJ c
- object preferences ..... Q.•riLt 0
Vl
<(
- increasing ego needs \
~I PARANOID 1 the ~Vt.~>eeut<on wokld .i-1> .~>tkuetoked,
I
I DIFFERENTIATION (beginning of PSYCHOS! S I anuety '. ag~k"-.!>-1>"-0il, .~>elOde-1>-t}[ttCt"-Oil
CL +' \ hcU'lue"-»at"-Oil.!>
u separation-individuation proc) "'II.L
-~ E I
"
_!)" - symbios cilmination ., ....
I t.!:l
.J 0 -~ "' "'""'! u
I'U - cathexis of object SCHIZOFRENIC \ anx.iety, pVt[,e<~-u:Uon .ideM, .~>evVte kela-
+' a .....
.s: Lt·r-"'1
0 "
<( ....... - symbiotic shell c +' 0 PARANOIA \ t"-on-Cl.i.!>tok anee.!>, d~Mdat"-Oil, haUu-
0
I c ...
0CL "' \ <C"-»at.ioM, depek.~>onCiluat"-o•t
~I ·~ a.
"'0 - primary narcissism
SCH!ZOFRENIA \ b.izaMe behav.iook, !li.imakbpltoee.!>.~>-
- objectlessness 1 ~hnk"-"9• thought- ~tM anee.!>,
VI - autoeroticism
VI 1 mappllopk.iate outbM.!>U, hateue.inat.iaa
" E
.--<"
- oral pass! vi t y I'~-~ 1 depVt.!>anaUzation, 1?"-".ie, eata.!>tkoph!f
I ·~ - normal autism 'U
+''U
" 1 6eef"-ng.~>, make-bel"-eue-wokld,
u 0 - autistic shell 1 hypoeondk-ia -
.~ t: I I
_!) - monopoly of biologic needs I
0 I- I
I
"'
=======================================;/-====== m\_===============================:=================================
NORMAL PSYCHO-SEXUAL DEVELOPMENT DEFENCE PSYCHIC DISEASE SYMPTOMS
======================================== ======================================================~========
GENESIS: PSYGlOSES
GIARACTER DISORDERS f--,3
NEUROSES
(/)
H
::>;:
H
Fig. l. Relation between psychic disorders and disturbances in the n
psychosexual development. I
(/)
H
<
H
::>;:
- strengthening of superego \ lj
- competition play;
- re3tructuring
w - ritual "justice" ploys c:
G.l C: H
~' ·rl~ C: ma.Upufa.t.iv~ outbuMt~. -!u.idde-thh.eatJ..
- justice impOrtant -tevenge6uU-tu!;jtuLUon, gu-tU 6eel-t119-1
~ -~.:: .;: >-.
~1-3
- solution of oedip. complex U 111 0 VI (})+' :;x:.o
<( 0 111 C VI C QJ hypoeho11M.ie a phob.le .ideM
- castration fear (boys) ....... Cl.l 0 G.l •t-i ·o-t
:r: 0. Lot •...t '-' 0 X
penis envy (girls) 111 OH-• C phob.iM -!tAuetu-ted phob.ie .ideM a11d anx-iety ~
.... G.l 0 QJ 0
Cl.""'c
- oedipus compl. culmination '"01-<t...S...::l- en
u - sibling rivalry -!tAuetu-ted h~aeho11M.ie .idea-!
- further developm. of skills ex erne -!el6eenteJtedne.&-!
0
c: ' t"%j
- !ncr. of secondary process
_J
- superego strengthening c~g-~ c hyf"~t-!e.v..it.iv.ity,
6atigue, -1t.ight
_J
- developing of gender ident. o ~"
-~
o-
'-'
g ~ g- -~ ~
' '"eU!lMthen-ia hypoehoiUliiu, Mmat.ie -!ymptom-!,
'U
en
<( - identity-loss anxiety uneM.ine.&-1, 6ee6lene.&-! ....::
:r: - "plaster-age" ~ ~ g~ ~ -~ ' ;&' 0
a_
- masturbation ~~~5~.2. 0+.::;, ::r:
I
voyeurism 0
I - exhibitionism 5 eo def"V<Mmr.l.i.za.t.ion, deJtea.l.iza.t.ion,
I
I - developing second.norcisslsm :;J "-!pl-tt pV<Mot 11 _h!{-!teJt-tei:fl ':I-tt~" . ~
I
I - genital cathexis :! ~ 5 \ h~poehonM.ut. -tn6V<-toHt~ft"eel-tng-! z
I z
0 - intesive bonding to adults
' ,_ ~ ,2 ~ c: \ -1ewal-4e<M, anh.iety, phob.UU, a&6eeted ~
<( IV SELF & OBJECT CONSTANCY M\ ~ -~ -~-;:: s \ d.t.Moe.ialion, y-!tV<.iea.l 6-U:.I., depV<Mn. H
::E \ .~ g'~ :; t "'"~ c, hypoehoiUlii.ip. 0
- developing compassion \ ~ .., ~ " .... t7 '*""' ~"" ~"' I
- need to control others
"'"-0 g~ ~ ~ § ~'f. ~'0 {>¥:- ...,~"' anx-iety, gu-ilt- 6eel.tng, or:o<J-th.ia, 1-3
>- - stubbornness, no-saying '-"" .... ,.._ J --!..u"'-t:::"e:::.td=a.l:::,.:t:::e:::":::d,e'-'""'e-t:::"e.&:::- ::r:
,_ - incr. identity ' ~
~t:> q_'-0'
0_,-§- ,s6- - . I:Ij
~
,_ - identi fl vat! on 5 "'.:':~ ~~ 'l.~ ~li-~'* / eompuU.ive aeu, e~.ive thoughq, 0
<(
z - imitation
w ..r: \ c'f_,., ,S., '-;{il / gu.tlt-&eel.tng-1, phob.ie .ideM
0 - reduced omnipotency " ~
+'
al
:r:
:; 5\ (or:s~,~·/
- developing speech j .._ .., c: c: '\~LV,.
15 ears 18 ears
sublimation isolation isolation sublimation
identification intellectualizing regression intellectualizing
repression identification rationalizing identification
rationalizing rationalizing intellectualizing rationali::ting
displacement sublimation sublimation isolation
regression regression (anxiety) regression
/ (anxiety) (anxiety) (anxiety)
Fig. 3.
SUMMARY
Olayiwola A. Erinosho
Department of Sociology
University of Ibadan
Ibadan, Nigeria
83
84 0. A. ERINOSHO
II
til
~
1. Feel anxious about something or someone 1. 969 .729
"'
(')
2. Think people are saying all kinds ::r:
H
of things behind back 2.448 .620 :J::o
3. Bothered by special fears 2.562 .685 1-3
:::0
4. Depressed to the point where it affects H
(')
daily activities 2.738 .564
2.719 .582 til
5. Nervous or uneasy or tense ~
6. Feel hopeless 2.759 .514
7. Feel so restless and could not sit for long 2.512 .622 ~
1-3
8. Bothered by special thoughts 2.620 .605 0
9. Feel alone even among friends 2.707 .587 ~
10. Personal worries get respondent down and
physically ill 2.735 .548
11. Feel nothing is worthwhile anymore 2.772 .489
12. Troubled by witchcraft 2.815 • 49.4
13. Feel as if nothing worked out the way
the respondents would want it to 2.485 .632
00
U1
86 0. A. ERINOSHO
III
*Significant at .05
The signs in parentheses indicate the direction of relationship when the correlation matrixes were
examined.
00
.._J
88 0. A. ERINOSHO
IV
REFERENCES
Jules H. Masserman
Northwestern University
Chicago, Ill.
U.S.A.
93
94 J. H. MASSERMAN
Brief Therapies
Crisis Therapies
Behavior Therapies
Psychosomatic Therapies
Psychoanalysis
Psychopharmacotherapy
Hospital Therapy
Comparative Studies
Cautionary Comments
Comprehensive Surveys
*Emphasis mine.
PSYCHIATRIC THERAPIES lOS
SUMMARY
REFERENCES
THERAPIES
Jules H. Masserman
Northwestern University
Chicago, U.S.A.
REFERENCES
William Gray
REFERENCES
Yoshio Sakamoto
145
146 Y. SAKAMOTO
REFERENCES
Pavlos Kymissis
During the past four years the author has been teach-
ing and supervising the program of Family Therapy at
Mount Sinai Hospital Services at Elmhurst Hospital in
151
152 P. KYMISSIS
only for the therapist but for the patient too. Psycho-
therapy is the process where two people are talking to
each other, but hopefully one of them knows what he is
talking about. The government and third party payers are
asking us to explain what we are doing and also request
the development of goal-oriented, time-framed, concrete
treatment plans.
REFERENCES
OF THERAPEUTIC OBJECTIVE
Yukio Ishizuka
165
166 Y. ISHIZUKA
1. IN TOUCH
2. AT PEACE
3. IN CONTROL
(INTIMACY)
-------------
(ONE TO ONE RELATIONSHIP)
1. ANXIOUS, PANICKED
(INTIMACY) (ACHIEVEMENT)
1. FEELING WORTHLESS
HUMILIATION
(SELF)
4. MISERABLE, DESPAIRING
(INTIMACY) (ACHIEVEMENT)
1. IN TOUCH:
2. AT PEACE:
3. IN CONTROL :
(INTIMACY) (ACHIEVEMENT)
REFERENCES
"THERAPEUTIC PROCESS"
Yukio Ishizuka
175
176 Y. ISHIZUKA
THOUGHT
((0\~
ACTION FEELING
--.J7
(oJ
COGNITION
REFERENCES
A CONFRONTATIONAL APPROACH
Ilse v. Colett
1. The Problem
185
186 I. V. COLETT
4. Case Examples
6. Conclusion
Ilse v. Colett
I. INTRODUCTION
195
196 I. V. COLETT
and insist that the symptoms are not the problem. The
details of my response to symptoms varies from patient
to patient, but the key is always to de-emphazise them.
SUMMARY
REFERENCES
PATIENT'S VIEW
Nikolas Manos
207
208 N. MANOS
relation of monetary issues to treatment and suggest
charging at least a token fee to the patient4.
Method
Results
No of No of No of
answers % answers % answers %
Therapist's
view 10 35 0 0 18 65
Patient's
view 4 14 13 51 10 35
210 N. MANOS
No of No of No of
answers % answers % answers %
Therapist's
view 16 58 2 7 10 35
Patient's
view 1 3.5 3 11 24 85.5
SUMMARY
REFERENCES
INTRODUCTION
THE POPULATION
RESULTS
1. Financial difficulties 23
2. Lack of fringe benefits 20
3. Loneliness and isolation 10
4. Lack of gauge of success 5
5. Lack of exercise 4
6. Stresses on my family 3
DISCUSSION
SUMMARY
REFERENCES
TO CREATIVITY
Jane Pearce
Therapy
223
224 J. PEARCE
Creativity
Acculturation
Tenderness
Validation
A Sense of Urgency
Hannu Naukkarinen
Tammiharju Hospital
Tarnmisaari, Finland
INTRODUCTION
SYMPTOMATOLOGY
SUMMARY
REFERENCES
Hannu Naukkarinen
Tammiharju Hospital
Tammisaari, Finland
INTRODUCTION
HISTORY
237
238 H. NAUKKARINEN
Table 1. Course of music therapy at Sibelius-Academy
CONCLUSION
SUMMARY
REFERENCES
INTEGRATED PSYCHOTHERAPY
**Private Practice
Vancouver, Canada
243
244 F. KNOBLOCH AND J. KNOBLOCH
I
40 I
\
\
30 \
\
2o 'r--1
Simple score
10
I II III IV 1 2 3 Weeks
before Lobe~ after discharge in Prague
VZ+Z
z
60t----"
50
40
30
20
··./'>··'··. _,._ --· --- vz
10 . '•,• .,__ _..:-<,:::--·' •. --·- N
ZH
o---o Admission
BO o--c Discharge
G---{) 2 Years
10
V)
w
0::::
0 w
u
V)
I .50
1-
.001 .000 .000
~0- ,C•l .GOC XS
80
V)
10
w
0::::
0 &0·
u
V)
I
1- 50
80 IN PATIENT
V)
w
10
0::::
0
u '0
V)
I
1- 50
REFERENCES
Stanley Schneider
Summit Institute
Jerusalem,Israel
255
256 S. SCHNEIDER
sample of normal adolescence. Or as the statisticans
would say a type I error - error on the side of calling
a sick person healthy.
" ... the basic hard work of social therapy will remain,
wherever impaired people are gathered into institutions and
other people are engaged to look after them. They will
260 S. SCHNEIDER
always have the choice, whether the experience of living
in the institution will be (deliberately or inadvertently)
crippling and institutionalizing or whether it can be a
liberating opportunity for personal growth.
REFERENCES
Clinic of Psychiatry
Postgraduate Medical School
Budapest, Hungary
263
264 I. FAZEKAS ET AL.
patients we can, during the diagnostic and therapeutic
work, find some who belong to the borderline category.
We do not present here full details of classifying and
diagnosing patients as borderlines and do not allude to
the perplexities and difficulties of this activity.
Simply, we are considering here those patients who pre-
viously had various kinds of traditional psychiatric
diagnoses (i.e. when they were hospitalized in other psy-
chiatric departments), but who have some common features
in their behavior, in their object relations and in the
affective-emotional net of transference-countertransfer-
ence reactions elicited by them that make us think they
are borderlines.
267
268 J. M. LOMAX-SIMPSON
The Structure
The Process
The Content
273
274 I. V. COLETT
!.WORK AS A SOCIALIZER
CONCLUSION
SUMMARY
REFERENCES
INTRODUCTION
283
284 M. J1.1ADIANOS AND C. STEFANIS
DEVELOPMENTAL ISSUES
a. Organizational Problems
Intervention Strategies
DISCUSSION
SUMMARY
REFERENCES
291
292 P. C. MISRA AND J. CAMERON
AIMS
DESCRIPTION
RESULTS
Table 1. Diagnoses.
Depressive Illness 98
Anxiety State 51
Schizophrenic Illness 47
Personality Disorder 17
Mental Subnormality 4
Paranoid State 4
Organic Brain Syndrome 1
(Head Injury)
Total = 228
A PSYCHIATRIC DAY HOSPITAL 295
DISCUSSION
COMMENT
SUMMARY
ACKNOWLEDGEMENTS
REFERENCES
Prem c. Misra
CONCLUSION
REFERENCES
Introduction
301
302 S. VIDOVIC ET AL.
team is the first to establish contact with the patient,
is often his most frequent contact and knows the patient
better than anyone else. Every one of the members and
co-workers in such a team have their obligations in
relation to the work with the patients in the preventive
or therapeutic program. However, our greatest interest
lies in the position of the visiting nurse and the role
she plays in the protection of mental health.
Results
Conclusion
Summary
Robert J. Kleiner
Temple University
Philadelphia, u.s.A.
INTRODUCTION
Although this paper has a number of aims and objec-
tives, perhaps the most important objective is to show
how the concept of the "Social Network," as we have come
to use it, evolved. In addition, we will show how the
concept influenced the research program, that we have been
carrying out, and its development. At the outset, it is
necessary to indicate how our use of the concept differs
from the prevailing usage in the literature. For our pur-
poses, the "Social Network" is a group of individuals who
interact with each other, and maintain an ongoing stable
set of relationships. The network, as a consequence of
the sustained interaction, takes on some of the qualities
of a social system, e.g., class and status characteris-
tics, value consensus, a system of rewards and punish-
ments, cohesion, goals and aspirations, etc. The social
network may also be seen as a micro social system. This
concept is to be distinguished from the macro social
system concept which refers to larger segments of society
or even to the total society in which an individual is
functioning.
307
308 R. J. KLEINER
II
III
IV
ACKNOWLEDGEMENTS
REFERENCES
Tom S¢rensen
Psychiatric Department 6 A
Ulleval Hospital
University of Oslo
INTRODUCTION
329
330 T. S0RENSEN
of such different preliminary goals for the quality of
life is an empirical question.
SATISFACTION
Table 1. Happiness. In %.
J. A. 15 62 24 34
S. A. 13 31 56 32
p • H• 17 30 52 23
332 T. S~RENSEN
J. A. 21 68 9 34
S. A. 19 57 22 32
p • H. 4 70 17 23
J. A. 37 25 28 9 0 32
s. A. 20 27 27 20 6 30
P. H. 18 23 27 32 0 22
RESIDENTIAL CONDITIONS FOR LONG-TERM PATIENTS 333
J. A. 64 24 12 ( 2. 6) 32
s. A. 57 24 19 ( 2. 9) 30
P. H. 16 36 48 ( 5 . 2) 22
SEMANTIC DIFFERENTIAL
J. A. + 0.63 + 0.68 32
S. A. - 0.41 - 0.41 27
p. H. - 0.43 - 0.51 21
0.35 0.38
334 T. S~RENSEN
3 13 84
13 25 63
27 23 50
SUMMARY
ACKNOWLEDGEMENT
REFERENCES
Tom S~rensen
University of Oslo
Ulleval Hospital
Norway
INTRODUCTION
In an earlier paperl, presented in this symposium,
it was described how a group of former long-term psychi-
atric patients reported a higher quality of life compared
to groups living alone or still living in the psychiatric
hospital.
The working hypothesis is that the main condition
for establishing a high quality of life is living in a
situation where the optimal balance between having oppor-
tunities for freedom and self-fulfillment and having a
stable support in the social network is maintained.
The present paper will examine some aspects of the
social-network situation of a group of former psychiatric
patients now living 3-4 together in joint apartments
compared with former patients living alone and a group
still living in the hospital.
The results should be viewed as preliminary, based
on the first completed interviews. (2/3 of the total
material).
SOCIAL SUPPORT
Epidemiological studies give evidence that social
support is essential for the health an well-being in
various crises in human life2,3. The support is taken
care of by the social network. The distribution of
339
340 T. S¢RENSEN
THE NETWORK-QUESTIONNAIRE
J.A. 24 42 28 6 33
S.A. 50 33 10 7 30
P.H. 52 30 13 4 23
342 T. S¢RENSEN
J.A. 52 28 17 4 29
s.A. 28 38 24 18 29
p • H. 32 36 23 9 22
Network Anchorage
J.A. 0 0 36 64 33
S.A. 0 0 43 57 30
P.H. 0 5 20 75 20
NETWORK PARTICIPATION AND NETWORK ANCHORAGE 343
(mean (1-9)
CASE A
Prior to Discharge
CASE B
SUMMARY
ACKNOWLEDGEMENT
REFERENCES
Athens University
Department of Psychiatry
Eginition Hospital
Athens, Greece
INTRODUCTION
RESULTS
Schizophrenic
psychosis 388(39.5) 258(28.1) 322 (49. 8) 121(26.9)
Affective
psychosis 60 ( 6. 1) 115(12.5) 67(10.2) 96(21.3)
Organic Brain
Syndrome 57( 5.8) 58( 6. 3) 55 ( 8.5) 16( 3.5)
Personality
disorder 30 ( 3.0) 15 ( 1. 6) 40( 6.2) 10( 2.2)
Soma to form
disorders 13( 1. 3) 139(15.1) 10 ( 2.2)
Mental
Retardation 20 ( 2.0) 15 ( 1. 6) 8 ( 1. 2) 18( 4.0)
Psychomotor
Agitation 7 ( 0.8) 6 ( 0.6)
Non-Psychiatric
Cases 15 ( 1. 5) 21 ( 2.4) 7 ( 1.1) 11( 2.5)
600
50
500
50
00
~ 400
H
u 50
z
~
300
0
~ 50
~
~
200
~
50
100
50
Time of Illness
Onset Emergencies O.P.D. Cases
x2=127.27 DF 4 p <.00001
PSYCHIATRIC EMERGENCIES IN ATHENS 355
Primary Cause of
Emergencies O.P.D. Cases
Referrals*
Subjective
complaints 586 44.0 259 40.8
Self mutilation
tendencies 80 6.0 17 2.6
Aggression-
-Agitation 262 0.2 13 2. 1
Thought-percep-
tion disorders 131 9.8 153 24.2
Other 373 28.0 192 30.3
N % N %
State Mental
Hospital 699 36.6 137 12.5 836 27.8
Social Sec. Org.
Psychiatric
[J)
Hospital 183 9.6 12 1.1 195 6.4
~ Eginition Hasp.
I'll O.P.D. 409 21.3 409 13.6
!-!
!-! General Hasp. 58 3.0 19 1.7 77 2.5
m Private Psychi-
44 atric Clinic 54 2.8 6 0.5 60 1.9
ClJ
~ Other Psychiatr.
Institution 8 0.5 28 2.5 36 1.1
Day Hospital 2 0.2 2 0.6
C.M.H.C. 3 0.3 3 o.o
Pharmaceutical
~ Intervention +
~ Consultation 361 18.9 74 6.8 435 14.4
!-!
~Consultation 54 2.9 805 73.4 859 28.6
& Refused Inter-
~ vention 82 4.4 11 1.0 93 3.1
DISCUSSION
SUMMARY
REFERENCES
Introduction
361
362 I. PATKAI ET AL.
Year of entrance
to college No.of cases No.of attendances
1979-freshmen 45 87
Month Sep.Oct.Nov.Dec.Jan.Feb.Mar.Apr.May
No.of attendances 5 36 53 25 3 34 35 18 18
CRISIS PREVENTION - HUNGARIAN STUDENT HEALTH SERVICE 363
No of No.of
Group of students Mean
students events
Requested consulta-
tion with a psycho-
logist 16 118 7.37
Requested consulta-
tion with a psychi-
atrist 12 76 6 .25
Complaining but no
consultation request 41 212 5.17
Results
Symptom No. of
Rank Percentage
students
1. Nervousness or
shakiness inside 41 37.3
2. Your feelings
being easily hurt 40 36~4
3. Worrying or stewing
about things 34 30.9
5. Feeling easily
annoyed or irritated 33 30,0
7. Headaches 31 28.2
8. Difficulty in making
decisions 30 27.3
Psychosomatic Frequency
Syndrome Factor
Depression 86
Anxiety 83
Somatization 71
Irrascibility 69
Obsessive-compulsive syndrome 59
1. Divorced 0.0058
2. Increased arguments with
fiance or boyfriend/girlfriend 0.0205
3. Move to another city 0.0284
4. Serious arguments with
husband/wife 0.0365
5. Fail important exam or course 0.0361
6. Retirement (unwanted) 0.0415
*By t test
Acknowledgements
REFERENCES
Clinic of Psychiatry
Postgraduate Medical School
Budapest, Hungary
371
372 L. DOME ET AL.
375
376 K. J. ALDERMAN ET AL.
such as long working hours with inadequate diet and
reduced leisure time, etc.
Date of birth
Sex
Marital status
Length of employment
Region of work
Job type/grade
Entry into present grade
M.H.Q. items
Job satisfactio n items:
N = 7,237
Low High
Senior Engineers 2 8
Technical Officers 5.6 7.8
Other Engineers 7.6 12.1
M.H.Q.
SCORES
30
25
20
2.8-
/
2.6. ,/
/
2.4.
2.2-
2
MEAN 1.8
1.6
SPELLS
1.4
UNCERTIFIED 1. 2 -
1
All::iENCI::. 0.8-
0.6.
0.4
0.2.
SUMMARY
20
19
18
17
LOJ
16
-- ----
Nt:AN 15
14 .......
NUMBER 13
12
OF DAYS '
11
10 ' ' '
----
CERTIFIED
9 ' ''-HIGH
Ai!SENCE, 8.
7
6
5
4
3
2
1
NEVE
RARELY FAIRLY OFTEN
Grace I. Odiase
Introduction
383
384 G. I. ODIASE
Purpose
Methodology
Results
Seventy-five adherents were interviewed prospectively
fof the survey. Forty (53.33%) were males and 35 (46.7%)
were females. They were aged between 21 and 80 years.
Most represented in the sample were those aged between 41
and 50 years~ they formed 37.33% of the sample (Table 1).
out of the 75 adherents, 38 (c.51%) were backsliders
from the Orthodox churches and other sects in Benin City,
while only 2.66% were previously Moslems. As earlier
stated in this paper, many deserted their original
churches of choice for a church group that has a more
realistic approach to their every-day problems.
Duration of Membership
Membership duration among adherents in the sample
ranged between 1 and 40 years. Table 2 indicates that
there was a mean of 16.7 years duration, a range of 39
years, a standard deviation(SD) of 10.04 years, and a
correlation coefficient, (r) of +0.05 between duration
of membership and the incidence of bringing sick and
disturbed persons for healing.
112 32 0 5.23
MEMBERSHIP, TYPES OF ILLNESS AND RELATIONSHIP 389
Table 4.
Relations N MD MD2
Father 2 - 5 125
Mother 2 - 5 25
Son 13 6 36
Daughter 10 3 9
Grandchild 4 - 3 9
Brother 13 6 36
Sister 14 7 49
Cousin 11 4 16
Husband 2 - 5 25
Wife 3 - 2 4
Friend 26 19 361
Neighbor 7 - 0 0
Co-Wife 1 - 6 36
Co-Tenant 1 - 6 36
Houseboy 2 - 5 25
House~irl 1 - 6 36
Totai: 112 2 728
Mean = 7.0
Range =25.0
SD = 6.75
R =+O. 3
Discussion
Those adherents aged 41-50 years were most represen-
ted in the sample. While this group of persons is not
necessarily the most numerous in the population of Benin
City Federal Office of Statistic22 they bear a lot of
socio-economic responsibilities for their immediate
nuclear families, parents, other dependents and them-
selves.
Forty (53.33%) of the adherents were Christian and
Muslim backsliders from other churches and mosques. It
is clear from the findings of this research that a good
percentage of adherents who form the sample had backslid
from other orthodox churches and mosques.
The range between the shortest and longest span of
membership of the aladura church was 39 years. There
was a mean of 16.7 years, a standard deviation of 10.04
years and a correlation coefficient (r) of +0.05 between
duration of membership and the bringing of sick and dis-
turbed persons for healing.
Highest on the list of diseases for which patients
sought help were mental illness, infertility and malaria
in order of magnitude. Though the mean per illness was
3.5, this finding could be different if the diagnoses
were prospectively done by a Mental Health team. It
should be borne in mind, too, that the diagnoses were
strictly limited to the adherents' retrospective report
of the illness for which the sick and disturbed persons
sought help. The priests mode of treatment consisted
mainly of prayers and holy water. Even though adherents
confirm that sick and disturbed persons visited other
sources of treatment such as the hospital and drug stores
eventually, they attributed their cure to the aladura
church. Viewed against the socio-economic background
and the level of education of the adherents the mode of
treatment (prayers and 'holy' water) is cheap and almost
free so that all sick and disturbed persons brought for
healing could afford the treatment fee. Other members
of the church help in finding solution to other problems
raised. Compared with the traditional healing methods or
Western medicine the aladura form of treatment is cheaper
though not necessarily as effective since such water
contains no medication. Also, those whose illnesses pre-
sent with emotional problems may respond to the psycho-
therapeutic effect of the aladura priest's mode of treat-
ment of telling others their problems, singing and danc-
ing to release emotional tension. Leiderman23, Marin24 and
392 G. I. ODIASE
Ebigbo and Tyodzua25 elaborated in detail the psychothera-
peutic effect of such treatment, Most of the patients
if well treated reciprocate by becoming members of the
church. The mean per type of relationship was 7, there
was a range of 25 and a standard deviation (SD) of 6,75.
Also, the product moment coefficient of correlation (r)
between relationship and the incidence of bringing sick
and disturbed persons for healing in the aladura church
was +0.3.
Conclusion
SUMMARY
Acknowledgements
REFERENCES
**Psychiatric Hospital
Rab, Yugoslavia
399
400 Z. MARINIC AND M. JURIC
Subsequently some questions began to kindle interest,
e.g. the duration of the patients' hospitalization
periods, from which parts of the country came more cases
of psychoses and from what parts the cases of alcoholism,
for how long the patients remained at home, what were the
results of treatment in comparison with the other hospi-
tals, what progress was made in the work and to what
extent, etc. These were only some of the questions origi-
nating at that time to which it was not easy to give a
reply because of the fact that the answers were buried
in heaps of filed case histories and that all the infor-
mation compiled there could not be presented without
prolonged and tiresome extracting of data from these
files. It was then realized that only centrally stored
files, readily available and containing information on
the identity of the patients, the number of hospitaliza-
tions, the bearers of the hospitalization costs, the
place of residence of the patients etc. would satisfy
the requirements and make possible programmed and planned
development, serving at the same time to verify our own
work.
Conclusion
PROCESS IN SUICIDE
Dept. of Psychotherapy
National Institute of Sports Medicine
Budapest, Hungary
403
404 B. BUDA
REFERENCES
Psychoneurological Dispensary
Russe, Bulgaria
409
410 J. TZANKOV AND M. ATANASSOV
100
10 : 1
98
80 t----1
77
83 87
,_____...., ~
67 72
60 70
54"'
40
20
40
20 11 12 11
,___, 11
9
~ HEN
1% =4 nun
55
50
45
40
35
30
25
20
15
10
513
510
\ WOMEN
480 \ ----
450 \
MEN
420 \
390
\
360
\
330
\
300
\
270
\
240
\232
210
\
180 \
150 \
120 \
90 '90
.....
61 .....
60
5
.....
30
29
70
60
5 11 16 22 16 49
--- --
30 4 4 5 3
9~
21-30 31-40 41-50 51-60 61-89
414 J. TZANKOV AND M. ATANASSOV
A
s A G F
E
X 14 15 16 17 18 19 20 IN ALL
13
w 9/0 52/0 75/0 89/1 87/0 69/0 63/0 62;0 506/1
1
M 1/0 3/0 5/0 7/0 9/0 8/0 10/0 43/0
1/0 1/0
2 w
M
w 1/0 1/0
3 1/1 4/4
M 1/1 2/2
w 2/2 2/2
4
M
w
5
M 1/1 1/0 2/1
w 1/1 1/1
6
N
w 1/0 1/0
7
M 1/0 1/0 2/0
w
8
M 1/0 1/0
w 1/0 1/0
9
M
w
10
M
11
w
M
8 w 1/1 1/1
M 1/1 111
9
w
M 1/0 1/0 2/1 4/1
w
10
M 1/1 1/1
11 w 1/1 1/1
M
1.
2.
3.
\JOMEN
~
L_j
Depressive endogenes
MEN
7.
Depressions advanced age 8.
Reactive depressive 9.
-
13-30 31-50
WZ1
51-89
~
Alcoholismus chronicus
Psychosis schizoaffective
Schizophrenia
4. Neurosis depressive 10. Psycho-organic syndromes
5. Other neurosis 11. Epilepsia
6. Psychopathic and 12. Light stages of intellectual
accentic personalities lack
EPIDEMIOLOGICAL AND SOCIAL ASPECTS OF SUICIDAL ACTS 417
M 36 10 1 12 2 8 2 13 117 18
~ 13
IN
All 440 2 227 2 71 2 47 2 24 2 22 19 831 29
Table 10.
Conclusions
REFERENCES
Wagner-Jauregg-Krankenhaus
Linz
Austria
425
426 W. SCHONY ET AL.
(Suicide Rate)
120
11 0
100
90
80 "
70 l', v/ ''--
60
\ I
/
' I
A
\
50 \/ I \
\
__ ...., v
40
/
,- ., ..... _- .............
''
, _____ /
30 /
/
/
20 /
/
-/
10
/ ',
-14 -19 -24 -29 -34 -39 -45 -49 -54 -59 -64 -69 -74 -79 -84-89 90+
men n= 883 11
total n=1242 13
Poisoning, solid
fluid material 46= 5,2% 55= 15,3% 101= 8,1%
Exhaust gases
other gases 52= 5,9% 12= 3,3% 64= 5,2%
Hanging/
Strangulation 479= 54,2% 165= 46,0% 644= 51,9%
Cutting, stabbing
objects 22= 2,5% 7= 1,9% 29= 2,3%
- - - 1978 00
c::
H
1979 ()
60
-- H
"I -- 1980 ~
50
40
30
-~..,.
..- . .._ -._,,_·-/...,.....,..,
.
.....,._.
20 .... ------
-·-~.,
.~ .~ ---. .. _ - ---- -
__ .......:_._,_'.... . .,.. .
- --
10
January February March April May June July August September Oct. Nov. December
1.0
"'
430 W. SCHONY ET AL.
abs. %
SCH 50 19,3
Organic disorders 62 23,9
MDK 42 16,2
Neuroses
Abnormal personalities 96 37,1
Other unknown 9 3,5
259 100
up to 1
week 31 (18,5) 7 (7,8) 38 (14,7)
6
weeks 92 (54,8) 60 (65,9) 152 (58,7)
months
3 23 (13,7) 15 (16,5) 38 (14,7)
6
months 9 ( 5,4) 2 ( 2 1 2) 11 ( 4 1 2)
1
year 4 ( 2,4) 3 ( 3,3) 7 ( 2,7)
more than 1 year 5 ( 3,0) ( -- ) 5 ( 1,9)
other/unknown 4 ( 2 1 4) 4 ( 4 1 4) 8 ( 3 1 1)
SUMMARY
REFERENCES
ATTEMPTED SUICIDES
433
.,.
w
.,.
.<:
::s:
H
t'i
trJ
<:
~
t-3
tlj
~
~
0
Cll
c::::
Table 2. Correlation Between Geomagnetic Fluctuations and Attempted H
(')
Suicides H
0
tlj
Cll
"Stormy" days "Calm" days Higher frequency
(Fridays, Satur- (Fridays, Satur- of att. suicides
Period of days, Sundays, Mon- days, Sundays, Mon- during "stormy"
investi- days and holidays days and holidays days compared
gation excluded) excluded) to "calm" days
1978-1980
1978
""'w
01
436 D. MIHOV AND V. MILEV
persons (3441), who had attempted suicide by self-poison-
ing with different medicaments and other toxic substances
and who had been urgently hospitalized afterwards. We
excluded from our material all attempted suicides during
the big national holidays and the days immediately
preceding and following. Some of our past studies3
proved that during public holidays other factors which
partially decrease and sustain suicidal impulses, are
involved.
SUMMARY
REFERENCES
1. A. D. Pokorny and R. B. Mefferd, Geomagnetic
fluctuations and disturbed behaviour, J.
Nerv. Ment. Dis,, 142:140 (1966). -
2. R. Danneer;:Der Einfluss geophysikalischer
Faktoren auf dieSelbsmordhaufigkeit, Arch.
Psychiat. Nervenkr., B 219,Heft 2, (1974).
3. v. Milev, D. Mihov. and P. Simeonova, Opiti za
samoubijstvo C.J;"ez otravjane.
4. w. Beier, "Biophysic," VEB Georg Thieme,
Leipzig (1960).
5. G. F. Plehanov, "0 vosprijatii celovekom
neosusaem'ih Signalov," Avtoreferat na Kand.
disertacija, TGMI, Tomsk (1967).
6. N. I. Muzalevskaja, 0 biologiceskoj aktivnosti
vozmusennogo geomagnitnogo polja. Sb.
Vlijanie solnecnoj aktivnosti na atmosferu
Zemli, Nauka, Moskva (1971).
HEALTa ORG~I~ATION AND EPILEPSY
A SOCI~-PSYCHIATRIC APPROACH?
H. Smits
439
440 H. SMITS
I'-' I
I~ I
ambulant specialistic 1 i
1 care
I"Q. I a
2 rd
line
clinical care IW I
b
institutionalized care L-.J
c
1 - - - -''somatic'' health- - --+-•mental health.-..l
total population
Sickness-fund act ± 70%
Private insurance company ± 30%
(:::::::::::::::::::::::::::::::::::::::::::1 ~----------,
~------ _____I
100'1, 20.5 100%
Medical dimension
Social dimension MSO approach
Occupational dimension
17500
D Numberofvisits
• Number of patients
15000
12500
10000
7500
5000
2500
'69 '70 '71 '72 '73 '74 '75 '76 '77 '78 '79 '80
c;:::t• ••
...... .. . 1
(
··--- .,
.;,
.-·
·.,
, .....·
e Epilepsy centre+polsoc
• Polsoc
1936
Advisory bureau for general practitioners. specialists and patients
Early attending patients carreer
Conduct1ng in cooperation with general practitioners
After care of discharged patients
1980 nd
Consultation 1st and 2 lines
Referral to other systems and special centres
Prevention and educat1on
Research
(task fields)
Medical group:
Administrative group:
30 8 77
M s 0
5 5 5
1 Owninitiative (50%)
11 Referral general practitioner (31 %)
111 Referrall.v.E (10%)
IV Referral specialist ( 9%)
Own iitiative
1a Fam/acquaintances (74%)
lb Publicity (14%)
lc Media ( 2%)
ld Various (10%)
Area 41'60 sq Km
F\:Jpliation ca l4 million
estimated rumbef of patients
with epilepsy ca 90 <XlO
SUMMARY
Luis Oller-Daurella
Escuelas Pias, 89
Barcelona
Spain
I. INTRODUCTION
453
454 L. OLLER-DAURELLA
Within the psychic disorders we shall include oligo-
phrenia and mental deterioration on the one hand and the
different types of dysthymia and behavior disorders on
the other.
~
Table 1. ~
0
Percentage in Percentage in z
1. Partial Seizures 1562 Epileptics 1062 Epileptics ~I
with Elementary Percentage in with Partial with Elementary H
3000 Epileptics Seizures Partial Seizures (')
Symptomatology Patients
IJ1
""
IJ1
456 L. OLLER-DAURELLA
From all these data the importance of psychic crises
of short duration within the group of epileptics as a
whole can be seen.
Percentage
in 677
Percentage Epileptics
in 3,000 with Status
Patients Epileptics Epilepticus
1. Confusional Status
with Spike and Wave
{Absence State) 176 5.86 26
With Ictal E.E.G. 49 1.63
2. Partial Complex
Status 73 2.43 10.78
With Ictal E.E.G. 4 0.12
Patients Percentage
~
t"i
~
tJ
z
0
Table 4. zI
H
()
3000 8
Epileptics 656 P.G.E. 571 S.G.E. 234 U.E. 1179 P.E. 360 N.C.E ~
't:l
l. Oligophrenia 468 (15. 6%) 61 (9.29%) 205 (35.90%) 66 (28.20%) Cfl
81 (6.87%) 55 (15.27%) ...::
2. Deterioration 372 (12.4'ro) 40 (6.09%) 211 (36.95%) 23 (9.82%) 88 (7 .46%) 10 (2. 77%) ()
3. Oligophrenia Plus
::r:
H
Deterioration 68 (2. 26%) 3 (0.45%) 47 (8.23%) 11 (4. 70%) 6 (0.50%) 1 (0.27%) :t:'
8
4. Dysthymia 155 (5.16%) 21 (3.20%) 13 ( 2. 27%) 16 (6.83%) 93 (7.88%) 12 (3.33%) ~
H
5. Behavior Troubles 148 (4.86%) 46 (7 .01%) 22 (3.85%) 0 63 (5.34%) 17 (4.72%) ()
~
U1
1.0
460 L. OLLER-DAURELLA
CONCLUSIONS
Table 6.
1976
Epileptics 562 P.G.E. 330 S.G.E. 127 U.E. 801 P.E. 165 N.C.E.
1. Normal School
or Work 1433 (72.52%) 456 (82.46%) 82 (24.85%) 79 (62. 50%) 667 (83.27%) 149 (90, 30'ro)
2. Special School 219 (11.08'ro) 25 ( 4.52%) 127 (38.48%) 38 (29.92%) 26 ( 3.25%) 3 ( 1. 82%)
3. Work in Special
Conditions 126 ( 6.38%) 44 ( 7.87%) 24 ( 7.27%) 2 ( 1.57%) 48 ( 6. 61%) 8 ( 4.85%)
4. No Work or
School 198 (10.02%) 28 ( 5.06%) 97 (29.36%) 8 ( 6.30%) 60 ( 7.49%) 5 ( 3.03%)
Zarko Martinovic
465
466 Z. MARTINOVIC
Methods
Number of Number of
Diagnosis patients patients
without with
epilepsy epilepsy
Psychoneurosis 12 4
Depressive reaction 10 4
Adolescent crisis 4 3
Character disorder 1 2
Behaviour disorder 2 1
Learning difficulty 3 3
Delinquency 1 0
Psychosis 1 0
468 Z. MARTINOVIC
Discussion
SUMMARY
REFERENCES
Vilmos Szilagyi
Private practitioner
1034 Budapest, Kerek u. 2.
Hungary
SUMMARY
The author differentiates between individual and
relational (marital and family) consequences of sex
disorders. He demonstrates that depending on certain
outer and inner conditions the scale of consequences
can extend from the slight increase of personal and
relational tension to severe neurotization or psychoti-
zation, to divorce and loneliness. He stresses that
traditional medical treatment is not adequate in the
case of sex disorders, but they could be effectively
treated by the methods of modern sex therapy.
REFERENCES
1. w. H. Masters and v. Johnson, "Human sexual
response," Little, Brown and Co., Boston
(1966).
2. w. H. Masters and v. Johnson, "Human sexual
inadequacy," Little, Brown and Co. Boston
(1970).
482 V. SZILAGYI
Mladen Seidl
483
484 M. SEIDL
SUM!-1ARY
The contemporary busy family physic1an 1s considered
by many the essential and most responsible sex counselor.
However, a number ot two-way communication d1tficulties
in dealing with patients' sexual concerns have been
recogn1zed. The paper reviews the issue and offers prac-
tical strategies for prevention and removal of patient -
doctor - pat1ent communication barrier.
REFERENCES
1. D. w.
Burnap and J. s. Golden, Sexual problems
in medical practice, J. Med. Educ., 42:673
(1967). - _..._ ------
2. w. H. Masters and v. E. Johnson, "Human sexual
inadequacy", Little, Brown & Co., Boston
(1970).
3. M. Seidl, How to feel comfortable with sexual
complaints. Presented at the St. Joseph's
Health Centre Holistic Medicine Seminar,
Toronto, May (1980).
4. Canadian Family Physician, May (1971).
5. M. Cohen, Uncovering sexual problems, Can. Faro.
Physician, 23:933 (1977). ---
6. J. A. Lamont, The role of the family physician
in human sexuality, Med. Aspects Human
Sexual., March (1974r:-
7. R. H. Klerner, "Counselling in Marital and
Sexual Problems: A Physician's Handbook",
The Williams & Wilkins Co, Baltimore (1965).
8. J. s. Annon, "Behavioral Treatment of Sexual
HOW TO REDUCE COMMUNICATION DIFFICULTIES 489
REFERENCES
IT BE PREVENTED?
Yukio Ishizuka
495
496 Y. ISHIZUKA
2. DIVORCE 73
3. MARITAL SEPARATION 65
4. JAIL TERM 63
5. DEATH IN FAMILY 63
6. ILLNESS OR INJURY 53
7. MARRIAGE 50
8. FIRED AT WORK 47
9. MARITAL RECONCILIATION 45
10. RETIREMENT 45
(SELF)
1. IN TOUCH
2. AT PEACE
3. IN CONTROL
(INTIMACY)
-------------
(ONE TO ONE RELATIONSHIP)
1. IN TOUCH:
2. AT PEACE:
3. IN CONTROL:
(INTIMACY) (ACHIEVEMENT)
4. MANAGE RESOURCES
INTIMACY
1. CONCERN
2. AFFECTIO N
3. LOVE
2. SENSUAL
2. Emotion al Dimensi on
"HAPPINESS ZONE"
1/)
1/)
w
z
w
1/)
0 1. ANXIETY
..J
CJ 2. ANGER
3. PHYSICAL SYMPTOMS
4. DEPRESSION
5. PSYCHOSIS
TIME .....
3. Sexual-Physical Dimension
PROGNOSTICATION
HIERARCHY OF DEFENSE
5. PSYCHOSIS
,','! 4. DEPRESSION
,, ''
/f 3./PHYSICAL SYMPTOMS
,, ': :
'
1./ ANfiE~Y
,: --~~~~~------------------
,F.
, ,, :'
'
, '
,, '
THERAPEUTIC BREAKTHROUGH
I ( 1)
WITHDRAWAL
I
I DEFENSIVE REACTIONS
I 1. ANXIETY
(3) I 2. ANGER
I 3. PHYSICAL SYMPTOMS
+
,, I 4. DEPRESSION
,
,,
5. PSYCHOSIS
, ,,
, ,, (4)
SUICIDE
"HAPPY ZONE"
"'"'zw
w
0"'
...J
u
TIME -
"HAPPY ZONE"
Ill
RESISTANT POINT
(DEFENSIVE REACTIONS)
BREAKTHROUGH
~
t
Ill
w
z
w
Ill
....- ..,-----.--t>
0 : ', CHRONIC
~
: ', STATE
u
v:
I '
WITHDRAWAL
(SETBACK)
~
WITHDRAWAL
(DIVORCE)
SUICIDE
TIME -
I
I
I
~---------
1 ------
1
1
---
----.c-.
I \;7'·---
1 ---
--- ---
..@ __ _
I ---
!. ------------------- I
I
I
1 I
I
---
---------$.
I --- I
·-- I
I
FULCRUM
(LEVEL OF CLOSENESS)
"Seesaw phenomenon"
"SEESAW PHENOMENON"
SEQUENTIAL BREAKTHROUGHS
I
/
"HAPPY ZONE" ///
----------------------------------- ----1-------------
,-
1/ -~--------• FAILURE
,/
\ (CHRONIC
\,MALADJUSTMENT)
1/)
1/) \
w FAILURE
z
w (SEPARATION)
1/)
(DIVORCE)
_,
0
(.)
TIME _.
THERAPY FAILURE
SUCCESSFUL DIVORCE?
REFERENCES
Dorothy E. Gibson
San Francisco State University, u. s. A.
Secretary & Board Member, Family Survival
Project;Fellow, American Association for Social
Psychiatry
519
520 D. E. GIBSON
SUMMARY
REFERENCES
Morton L. Podolsky
Beverly Hills
California
USA
INTRODUCTION
531
532 M. L. PODOLSKY
PERSONAL OBSERVATIONS
the child was brought into the parental bed. This con-
trasts with the pre-shortage times when children either
were never picked up or cried for much longer periods,
and seldom if ever found their way to the parental bed.
Night wakers tended to have mothers with rapid response
times to crying. Conversely; mothers who allowed children
to cry longer, or had longer response times to crying,
had more night sleepers.
CONCLUSIONS
REFERENCES
SUGGESTED READING
537
538 B. KONSTANTINOVICH AND C. A. PHILLIPS
SUMMARY
REFERENCES
1. D. Sanua, Immigration, Migration and Mental
Illness: A review of literature with special
emphasis on schizophrenia. in: "Behavior in
New Environments: Adaptation-of Immigrant
Populations" 1 E. B. Brody, ed. ,Sage Publi-
cations, California (1970).
2. B. Malzberg and E. s. Lee, "Migration and
Mental Disease, 1939-41", Social Science
Research Council, New York (1956).
3. B. Malzberg, Migration and mental disease among
the white population of New York State,
1949-1951, Human Biology, 34:89-98 (1962).
4. E. s. Lee, Soc1oeconomic and migration differ-
entials in mental disease, New York State,
1949-1951, Milbank Memorial Fund Quarterly,
41:244-268 (1963). -
5. H. B. M. Murphy, Migration and the major mental
diseases, in: "Mobility and Mental Health",
M. B. Kantor, ed. ,Charles c. Thomas,
Springfield, Ill.(l965).
6. L. Snole, T. s. Langer, s. T. Michael, H. K.
548 B. KONSTANTINOVICH AND C. A. PHILLIPS
Michael Madianos
Introduction
549
550 M. MADIANOS
G.I.A.S. Scale
Table 2. Mean and Standard Deviation and t Values between
Males and Females, and the Four Groups of Immi-
grants (n=225)
MIN. 65 52 51 39 39 47 39
Results
1,60
l,OO
1 , ~6
1 ,10
7
A B
~ C D TOTAL
!,·._.::.,'·:. ·.·J M ~F
106.0
• • •
• •• •• •
~
mo •• • •••
..:1
~ • • • • • • ••• •
u
Ul 9160 • • •• • •• • •• • ••
••
z •• • • • • • •
0 • ••
H
E-<
11.90 • • ••• • ••
••• • •
~
::J 79.10 •
• •••• •• •
••
E-<
•• •
..:1
::J
u 71.50
• ••• •
u
• • •••• ••• •
~
•• •
E-<
65.10
• • • •• • • •• • • • •• •
~ ••
59.10 •• • •• •• • ••
••
• • • • •• • • •••
C)
H • • ••
~ SHO • • •
H • • •
~
~ IS 70 ••
~
C)
39.00 •
3300 36.10 39.10 11.30 15.10 II. SO 51.60 51..70 SHO 60.90 61.0 0
P1arson Corr. r: -0.103L1. r1: 0.01069 p ( .060
Langner Scale
Discussion
VARIABLES 1 2 3 4 6 7
5 8 9
1. Age -
2. Sex .06
3. Place of Birth .01 .15
4. Stay in u.s. -.07 .22* -.67*
5. Education in Greece -.05 .21*~ .13 .03
6. Education in u.s. .08 .67* .34 .42 .62*
7. Occupation .11 .57* .16 .36 -.16 -.68*
8. Income .10 .25* .25* .04 -.05 -.16 .33*
9. G.I.A.S. .09 -.40* -.42* ***
.17 .05 .29* .39* -.43*
1 o. 22 Items .04 .24* .06 .03 .02 -.05 .10 .19 .10*/
(T.Langner Scale)
* P (.oo1
** p (.005
*** p (.01
·: p (.06
SUMMARY
REFERENCES
A. Dosen
Observation Centre
for Children with Developmental
Disorders, "de Hondsberg"
Oisrerwijk, Holland
559
560 A. DOSEN
patients motivated a preliminary examination of a group
of 150 factory workers. Forty-six women and men were
interrogated through mail-poll, and the questions mainly
concerned these people's social life and their bodily and
mental heal thl, 2. ··
Most of the examinees were dissatisfied with their
social life in The Netherlands. Most of them have not
mastered the language of the country and have little
contact with the Netherlanders. A great number of the
examinees mention having bodily difficulties for which
they had been medically examined. The cause of these
difficulties had not been discovered by this examination
in the majority of cases, so many of them were dissatis-
fied with Netherlandish doctors and developed a distrust
toward them. A certain number of these people mention
visiting Yugoslavia at their own expense to obtain "a
proper medical check-up".
For the examination of the mental condition of the
members of this group, Zung's scale was applied to
evaluate the depressive condition3. Forty one percent of
the examinees reached a number of points which, by the
scale, indicated the presence of depressive symptoms and
the development of depression.
POPULATION AND METHOD
Alarmed by the above-mentioned data, we started a
wider and statistically more accurate examination.
In the territory of a province where there are 406
Yugoslav men and women (165 men and 241 women) living
and working in The Netherlands, 100 subjects were chosen
by random selection (43 men and 57 women). Most of these
people come from Croatia (Dalmatia and Slavonia) and from
Serbia (from the surroundings of Leskovac, Valjevo and
sabac). The majority of men are employed in the metal
industry and are mostly qualified workers. They are,
partly, workers in the detached Yugoslav firms in The
Netherlands. Women work in Dutch firms, in the food,
textile and metal industry and are usually unqualified
workers.
The examination was carried out in the manner of a
linked interview and it concerned somatic complaints, the
difficulties of a depressive nature and the symptoms of
paranoic disposition. The list which was used to examine
somatic complaints mentioned the somatic difficulties
which most frequently occurred among the polyclinical
FREQUENCY OF DEVELOPMENT OF DEPRESSIVE CONDITION 561
RESULTS
N % N % N % N %
F. 57 48 84 29 51 29 51 35 61
M. 43 25 58 7 16 16 37 16 37
To-
tal 100 73 73 36 36 45 45 51 51
DISCUSSION
N % N % N % N %
Subjects
with sympt.
of Depression
N = 36 1 3 31 86 23 64 20 56
Subjects
without sympt.
of Depression
N = 64 19 30 42 66 22 34 15 23
564 A. DOSEN
CONCLUSION
SUMMARY
REFERENCES
9. B. s.
Dohrenwend, Social status and stressful
life events, J. Pers. 22£• Psychol.
28:225-235 (1973r:--
10. G. J. Warheit, Life events, coping, stress
and depressive symptomatology, Am. J.
Psychiat., 136:4b.(l979). --
11. G. Caplan, Mastery of stress, Psychosocial
aspects, ~· .:r.Psychiat., 138:413-420
(1981).
THE NEED FOR SEX COUNSELLING IN AN
Mladen Seidl
Private Practice
Toronto, Canada
Incidence
Categories
No. %
DISCUSSION
SUMMARY
REFERENCES
Dorothy E. Gibson
Introduction
573
574 D. E. GIBSON
planned, with others, the best for me. The only cost in
Greece was the ambulance - about $14. from hospital to
private home and the same to the airport and from National
side in Athens to International side. For the entire trip
there were 6 ambulance transfers. The others being Kennedy
Airport, San Francisco Airport to hospital and from
hospital to home. These all cost about $500. Air/ambulance
(four seats first class required) was $6000., hospital
for 10 days in US was $3500. Subsequent doctor costs,
x-rays, gadgets and services about $1000. Since I bought
an "Excursion" ticket for the trip to Greece the rebate
was about 1/10th of the original cost - so I lost the
balance of that. The total basic cost of trip travel
(devoid of vacation expenses within Greece) and all the
accidental accoutrements was about $13,000 (including cost
of escort to come from US).
Milena Stojcevic-Polovina
Introduction
581
582 M. STOJCEVIC-POLOVINA
No % No % No %
Up to 20 2 3 0 0 2 1
21 to 30 48 60 34 43 82 52
31 to 40 25 31 36 46 61 39
41 to 50 4 6 9 11 13 8
Total 79 100 79 100 158 100
::r:
~
Table 2. 0
H
Eduac ationa l Level (Qual ificat ion and Emplo yment of
the Paren ts)
1.11
00
w
584 M. STOJCEVIC-POLOVINA
children carne after a delay or very late. 1 In these
children the deviation from normal development was first
noted by the doctor in 48% of all the cases and in 53%
the parents themselves were the first to notice the
symptoms and their suspicions were confirmed by the doctor.
No % No % No % No % No % No % No % No % No %
I
61 18 79 35 44 79 74 5 79
~
t"i
78 22 100 44 56 100 94 6 100 1-<:
I
U1
00
U1
U1
CXl
CTI
Table 4. Realiza tion of the Child's Handica p and Its Influen ce upon the Life
of the Family
56 7 17 79 66 8 5 79 63 13 3 79
70 9 21 100 83,6 10' 1 100
6' 3 80 16 4 100
.::;;:
(/)
8
0
y
n
trJ
<:
H
n
I
1-cJ
0
t-<
0
<:
H
z
::r:-
~
l::tj
:I::
s;
t:l
H
Table 5. Childre n's Reactio n to the Applied Therape utic Program me Q
(Parent s' Observa tions) 1-0
1-0
l::tj
t:l
()
The child according to the parents' observatio ns :I::
H
t"'
t:l
In carrying out the therapeuti c
Accepts the therapeuti c programme programme the child reacts s;
t:l
The therapeuti c
Equally H
programme is carried 1-3
IHth (well,with Better Total
Well Poorly Total (/)
out difficulty difficulty ,
poorl ) 1-:!:j
No % No % No % No % No %
% No %
No
~H
t"'
61 18 79
...::
Therapeut ist 65 9 5 79
(in the out-patien ts) ll ,4 6,3 100 77 23 100
82,3
64 8 7 79 71 8 79
Parents (at home) 100 90 10 100
81 10 9
U1
CXl
-..J
588 M. STOJCEVIC-POLOVINA
Discussion
Conclusion
Summary
REFERENCES
Hyman R. Soboloff
INTRODUCTION
595
596 H. R. SOBOLOFF
1. Marriage
2. Children
3. Father's career
4. Mother's career
5. Children's schooling
6. Children's separation from family
7. Death of parent or parents
1. Marriage
2. Children
3. Father's career
4. Mother's career
a. Altered by need of care of handicapped child
5. Children's schooling
a. Handicapped child is delayed or in special
classes.
6. Children's separation from family
a. Restricted or maybe never
7. Death of parent or parents
PRESENT STUDY
Early No early
Family reaction intervention intervention
(N=50) (N=50)
No. No.
Acceptance 29 21
Over-protection 8 6
Rejection 5 14
Ignored 3 2
Total 45* 43*
Table 2. Mainstreaming
Early No early
Mainstreaming intervention intervention
(N=50) (N=50)
No. No.
Yes 39 38
No 11 12
598 H. R. SOBOLOFF
Mainstreaming refers to the handicapped person being
enabled to function as indePendently as possible in a
normal social setting. The intention is to maximize
their capabilities in the normal educational finding,
but a reason might be that those who had received early
intervention had not yet reached the stage of maturity
(20 years or older) of the non-intervention group.
DISCUSSION
CONCLUSIONS
REFERENCES
*Department of Pediatrics
University Hospital Rebro
**Department of Pediatrics
University Hospital "Dr·
Mladen Stojanovic"
601
602 B. STAMPAR-PLASAJ ET AL.
Discussion
SUMMARY
REFERENCES
I NEUROLOGICAL BASIS
605
606 C. AVALLE AND V. VOJTA
abnormal postural and motor patterns in a case of
disturbed central coordination. These patterns are never
seen in normal motor development. Such patterns are
similar to the fixed, pathological movement patterns of
fully developed Cerebral Palsy, e.g. rigid extension or
rigid flexion of the arms with retraction of shoulders
and clenched fists; opisthotonus or extreme hypotonicity
of the trunk; rigid extension combined with adduction of
the legs and extreme dorsal extension of the feet.
III RESULTS
V CONCLUSION
REFERENCES
INTRODUCTION
611
612 T. MATASOVIC ET AL.
later, between the 2nd and the 5th year of life, depending
on the psychophysical development of the child.
Our Patients
Discussion
Summary
REFERENCES
Visnja Fabecic-Sabadi
Method
617
618 V. FABECIC-SABADI
Discussion
Conclusio n
Summary
REFERENCES
Marianne Berel
United Cerebral Palsy
of New York City, Inc.
New York, u.s.A.
627
628 M. BEREL
REFERENCES
Nevenka Novakovic
631
632 N. NOVAKOVIC
for our society on the basis of self-management agreements
and compacts and firstly on the basis of the delegate
system.
1. INTRODUCTION
639
640 H. LECHNER AND R. DANZINGER
INDEPENDENT LIVING
premorbid
!i~~~~r~1
episodes
FOLLOW-UP CARE
EMERGENCY job counseling
THERAPY ~ group therapy
recreational programs
help with finding housing
plenary group
9-915 g y mn a s t i c s
915_10 mo r n i n g g r o u p s e s s i o n
10-12 0 c c u p a t i o n a 1 t h e r a p y
12-13 1 u n c h
N 5213 interventions
EXPERIENCES WITH A COMMUNITY MENTAL HEALTH CENTER 643
wide variety of possibilities for help - an effort which
is facilitated by the varied professional background of
the staff.
Within the spectrum of services offered by the center
practical organizational help .j:>reddtnina,tes over purely
psychotherapeutic or drug treatments. In this ,context it
must be considered, however, thatin the process of
working out a solution to a pr~ctical problem conjointly
with a member of the staff the patient frequently acquires
new skills, thus enlarging his potential for self-help.
schizophrenia 17%
alcoholism 10%
geriatric psychiatry 8%
attempted suicide 4%
drug addiction 2%
mania 1%
100%
644 H. LECHNER AND R. DANZINGER
readmission 13%
100%
EXPERIENCES WITH A COMMUNITY MENTAL HEALTH CENTER 645
prevalence per
1000 sector with control sector
CMHC without CMHC
<X'>
opening of
the center
3
J
2
5 1 5,2
5
SUMMARY
REFERENCES
G. Ross
649
650 G. ROSS
DISTURBED ADOLESCENTS
Stanley Schneider
Summit Institute
Jerusalem
Israel
I Introduction
One of the most difficult aspects in working with
emotionally disturbed adolescents and young adults is
their educational/vocational rehabilitation. Psy-
chiatrically, they have been treated by mental health
professionals who have helped them over their crisis and
have stabilized their condition. They may even be on
psychotropic medication, and be involved in treatment
on an ambulatory basis. Now these adolescents and young
adults are ready to integrate back into the community.
This may be after: a hospitalization, treatment in a
residential treatment center, treatment in a half-way
house, or after having been treated in an out-patient
capacity. Their one commonality is that they were unable
to continue in the regular mainstream of society: home,
school, job, friends etc.
659
660 S. SCHNEIDER
III Summary
REFERENCES
667
668 N. MANOS ET AL.
Mean Score
B P R S 1st 2nd df t Significance
eval. eval.
Factor I (Anxiety-
Depression) 6.07 10.87 54 13.034 P<0.001
Factor II (Anergia) 7.35 15.40 54 14.875 p<O.OOl
Factor III (Thought
(Disturbance) 6.80 14.51 54 14.168 p<O.OOl
Factor IV (Activi-
tat ion) 4.44 9.33 54 11. 607 p<O.OOl
Factor v (Hostile-
Suspicious) 4.05 11.22 54 16.746 p<O.OOl
Total Score 28.71 61.33 54 20.225 p<O.OOl
RESULTS
*SD
670 N. MANOS ET AL.
Table 2~ NOSIE-30 factor, total asset and total raw
score comparison between the two evaluations
of the 55 patients.
Mean Score
N 0 S I E - 30 1st 2nd df t Significance
eval. eval.
Positive Factors
Factor I (Social 6.95 11.38 54 9.682 p<O.OOl
Competence)
Factor II (Social 13.35 7.38 54 12.671 p<O.OOl
Interest)
Factor III (Personal 10.36 8.95 54 6.200 p<O.OOl
Neatness)
Negative Factors
Factor IV
(Irritability) 10.36 13.73 54 6.569 p<O.OOl
Factor V
(Manifest Psychosis) 5.98 9.02 54 9.587 p<O.OOl
Factor VI
(Retardation) 6.98 9.91 54 7.506 p<O.OOl
Factor VII
(Depression) 3.60 4.27 54 3.318 p<O.Ol
Total Asset 123.74 ll0.78 54 13.948 p<O.OOl
Total Raw Score 57.42 64.64 5.554 P<0.001
DISCUSSION
SUMMARY
REFERENCES
OF SCHIZOPHRENIC PATIENTS
Danica Koretic
677
678 D. KORETIC
Table 1.
CLASSIFICATION ACCORDING TO THE WORK STATUS
NUMBER OF
PATIENTS
GROUP II students 14
a) retired 10
GROUP Ill
b)more than two years on the sick leave 11
Patients receiving social help, supported by the family
GROUP IV
or waiting for a job 10
I TOTAL 97
® ILSHORT-TERM
PATIENTS REGULARILY EMPLOYED
SICK LEAVES DURING
WITH
CRISES
I 41 patient
111 patients
I T0 TAL : I 52 PATIENTS I
Psychiatric disturbances are treated by a complex
treatment program. Pharmacologic therapy, individual
psychotherapy, group psychotherapy and family treatment
are combined. If necessary, home visits are practiced
as well as therapeutic interventions in the patient's
working surrounding. Some patients continue their
treatment in the day hospital of an average duration of
one month.
Table 3.
G R 0 U P Ill ( age, marital status, clinical
®\\ RETIRED
l10 patients
IT 0 TAL :I 21 PATIENT I
In this work a group of patients is studied who were
treated for schizophrenic psychosis at our Department
from 1978 to 1981. The patients treated as in-patients
and who were later on included in the organized post-
hospital treatment and follow-up were chosen from the
register. Ninety seven patients were thus chosen.
Table 4.
II STUDENTS
114 patients
G R 0 UP IV
II PATIENTS RECEIVING SOCIAL HELP, SUPPORTED
II BY THE FAMILY OR WAITING FOR A JOB
l10 patients
SUMMARY
REFERENCES
Istvan Kappeter
683
684 I. KAPPETER
Both sexes
F. M. together
No. %
Independent persons in
peculiar conditions
in a second job after
retirement 17 10 27 9
doing auxiliary work at home
for factories 3 1 4
living as a housewife 13 13 5
occupied in a day-hospital 8 7 15 5
living alone on pension 14 22 36 11
living an outlaw life ' 10 8 18 6
Total 65 (37%) 48(36%) 113 36
Depending on an institution
in hosp. dept. of psychiatry 4 3 7
in inst. for occupational ther. 2 2 4
in inst. for criminals 1 3 4
in a home for chronic psycho-
tics 5 4 9
Total 12(7%) 12(9%) 24 8
Unknown 6 2 3
LIFE OF PEOPLE WITH SCHIZOPHRENIA 685
never F. 1 1 1 48 51
38
married M. 61 61
used F. 8 18 11 4 19 60
to be 29
married M. 1 3 4 2 14 24
F. 27 6 5 4 13 55
married 33
M. 13 3 8 13 37
F. 36 25 16 9 80 166
Total 14
M. 6 12 2 88 122
SUMMARY
A. 0. A. Wilson
INTRODUCTION
687
688 A. 0. A. WILSON
METHOD
Table 1.
Informal 26 9
Section 24 6 1
C.P.A. 376 3
NEW LONG-STAY PSYCHIATRIC PATIENTS 689
Table 2.
21-30 4
31-40 7 3
41-50 11 3
51-60 10 3
61-65 3 1
RESULTS
General Characteristics
Table 3.
Single 17 3
Married 5 1
Divorced 10 3
Widowed 3 2
Separated 1
Table 4.
Schizophrenia 19 1
Organic Brain Syndromes -
Korsakoff's Psychosis 4 1
Huntington's Chorea 2 1
Others 4 4
Affective Disorders 3 2
Epilepsy (T.L.E.) 1 1
Chronic Alcoholism 1
Atypical Psychosis 1
Mental Defect (Uncomplicated)
NEW LONG-STAY PSYCHIATRIC PATIENTS 691
long-stay patients under 65 years in 1979 at this hos-
pital, schizophrenics numbered 66% and organic disorders
15% of the total.
Table 5.
1975 3
1976 4
1977 12
1978 10
1979 16
Total 45
692 A. 0. A. WILSON
Rehabilitation Medium 20
Long Stay Medium 12
Long Stay High 6
Closed (Disturbed) High 3
Hospital Group Home Low 4
NEW LONG-STAY PSYCHIATRIC PATIENTS 693
Table 7.
In-patient 25 4
Home 2
Staffed Hostel 6 3
Group Home 3
Sheltered Lodgings
Special Accommodation (Home
for Spastics, Epilepsy) 2
REFERENCES
Ilse v. Colett
University of California Medical School
San Francisco, Ca.
INTRODUCTION
CONTRASTING IMAGES
cannot deal with. The therapist who senses that his older
patient has a lot of this existential fear, takes uncon-
scious steps to signal that patient not to bring out these
fears. We may be the cause of our patient~s apparent emo-
tional impoverishment. If we are to think of our patients
as troubled, rather than "old", we might somehow be more
receptive to both a difficult, but productive relationship
and the ventilation of feelings.
SUMMARY
REFERENCES
Vladimir Hudolin
707
708 VL. HUDOLIN
have been chanqing extremely rapidly, just as technology
has been changing faster and faster over the past 100
years. Technological progress and rapid changes in
technology demand that we adapt to the new ways of life
with incredible speed. The customs associated with drink-
ing alcohol cannot change so quickly and therefore a
number of problems have arisen in contemporary society.
Summary
THEORY
Nebojsa Lazic
Introduction
713
714 N. LAZIC
When considering the role played by a particular
model in the existence of human behavior systems, we
must not stop at trying to just explain some process;
rather, we must realize that the model in question was,
in a particular time and space continuum, a necessity
which determines life, i.e. growth, differentiation and
reproduction of the system.
Conclusions
REFERENCES
Table 1.
41 - 45 11 7%
46 - 50 49 30%
51 - 55 61 37%
56 - 60 44 26%
723
724 L. PAVICEVIC AND M. MIMICA
Table 2.
less than 10 3 2%
10 - 14 15 9%
15 - 19 68 41%
20 or more 79 48%
Table 3.
Not observed 6 4%
Observed before
20 - 24 years 39 24%
25 - 29 years 47 28%
Table 5.
No. of
Qualification Percent
subjects
Treatment No. of
subjects Percent
none 88 53%
SUMMARY
REFERENCES
729
730 R. BUTTOLO ET AL.
The main work consisted of lessons for large groups,
Therapeutic Community, little discussion groups, formul-
ation and development of theses, exams and awarding of
diplomas.
J. Kenneth Lawton
International Christian Federation
for the Prevention of Alcoholism
and Drug Addiction
London, England
Introduction
Modern Medicine
733
734 J. K. LAWTON
A New Lifestyle
REFERENCES
741
742 B. LANG ET AL.
CONCLUSION
REFERENCES
ALCOHOLISM
Sergije Padelin
Total 52 22 10 84
747
748 S. PADELIN
Table 2. The Alcoholic History
Total 35 30 15 4 84
viz. that women start the abuse of alcohol later than men.
However, women's alcoholism has a course that is more
malignant: pathology develops more swiftly; the with-
drawal syndrome appears earlier, and the general and
social degradation of personality advances more rapidly.
F (N=15) M (N=32)
4,67 2,55
Total 32 52 84
750 s. PADELIN
Total 20 30 34 84
Total 45 23 16 84
SPECIFIC FEATURES OF WOMEN'S ALCOHOLISM 751
Negative +- Total
Total 40 17 14 71
Total 6 33 45 84
752 S. PADELIN
Total 38 46 84
SUMMARY
Total 13 17 54 84
SPECIFIC FEATURES OF WOMEN'S ALCOHOLISM 753
REFERENCES
1. L. v.
Stereva and v. M. Nezemcev, "Klinika i
lecenie alkogolizma", Medicina, Leningrad
(1980).
2. J. Lopes Verde and J. Foles, Cited in: A. D.
Portnov and L. v. Pjatnickaja, "Klinika
alkogolizma", p.p. 235, Medicina, Leningrad
(1973).
3. J. P. Lengrand, Contribution a l'etude de
Lralcoholisme feminin dans le Nord-Traval
du service du Docteur Claud Nachin, Paris
(1964).
4. s. Stojiljkovic, c. Smid-Vesel and J. Vesel,
Alkoholizam kod zena, Anali Bolnice ".£!:• M.
Stojanovic", 3:210 (1964).
ALCOHOL RELATED PSYCHIATRIC EMERGENCIES:
Athens University
Department of Psychiatry, Eginition Hospital
Athens, Greece
Introduction
755
...,J
Ul
0'1
2 t<:l
0
X 37.77 D.F. 16 p (. 005
t'i
....::
()
0
c:::
~
til
t<:l
t-3
.~
ALCOHOL RELATED PSYCHIATRIC EMERGENCIES 757
Material and Method
All alcohol related psychiatric emergencies referred
to Eginition Hospital during the operation of a 24-hour
Psychiatric Emergency Service between June 10, 1978 and
June 10, 1980, were evaluated. A total number of 507 al-
cohol related emergencies out of 4516 psychiatric emergen-
cies (group A) were compared to 42 psychiatric cases
treated for alcohol related disabilities in the Out-
patient Department (group B), for the same time period.
The statistical analysis focussed on the distribution
of the two groups under evaluation by sex, age and marital
status, the second somatic or psychiatric illness
accompanying alcoholism, the time of the onset of alco-
holism, reason for referral and the modes of intervention.
The criteria for the diagnosis of alcoholism or
alcohol related disability used were those of the
International Classification of Diseases by W.H.O. (9th
revision).
Results
The mean age was 46.05~11.76(16-77) for males and
92 100.0
758 E. LYCOURAS ET AL.
20 -t 107 21 .1 0
Unknown 39 9.69
N % N %
Unknown 35 6. 91
Discussion
Summary
REFERENCES
763
764 P. VIDINOVSKI ET AL.
Table 1. Sex
Group A Group B
N % N %
Male 48 96 49 98
Female 2 4 1 2
Table 2. Age
Group A Group B
N % N %
to 20
21-30 13 26
31-40 8 16 14 28
41-50 29 58 18 36
51-60 12 24 4 8
up to 60 1 2 1 2
CHARACTERISTICS OF DELIRIUM TREMENS 765
Table 3. Duration of drinking
{years)
Group A Group B
N % N %
to 3 4 8
4-10 5 10 15 30
11-15 16 32 13 26
16-20 9 18 8 16
above 20 20 40 10 20
Group A Group B
N % N %
Unemployed 4 8 5 10
Employed 35 70 39 78
Retired 7 14 5 10
Farmers 4 8 1 2
766 P. VIDINOVSKI ET AL.
Pathoanatomically, delirium tremens is a type of dif-
fuse toxic encephalopathy4.
Group A Group B
N % N %
Single 2 4 4 8
Married 42 84 41 82
Divorced 4 8 5 10
Widowers 2 4
CHARACTERISTICS OF DELIRIUM TREMENS 767
Table 6. Admission to the
Hospital
Group A Group B
N % N %
First 36 72 27 54
Second 8 16 9 18
Third and
more 6 12 14 28
Results
N %
First 45 90
Second 5 10
Group A Group B
N % N %
Beer 1 2
Wine 2 4 2 4
Home-made
plum brandy 20 40 10 20
Industrial 11 22 17 34
Mixed 17 34 20 40
CHARACTERISTICS OF DELIRIUM TREMENS 769
N %
Abuse 31 62
Abrupt cessation
of alcohol intake 11 22
Trauma 4 8
Fever 4 8
770 P. VIDINOVSKI ET AL.
SUMMARY
REFERENCES
Males: N = 62
Females: N = 33
Age range: 20-71 yrs (Mean = 49.4)
16 between 40-60 yrs of age
Nationality: English 24
Scottish 2
Irish 3
Welsh 1
Others 3
ALCOhOL
PER
DAY
.y
.:3::
()
.
::r:
0
. V?" t-<
10 20
lj91 }oL /,///ij/; J t:J
30 40 <;1\ h()"
l:7j
"" ,~.
z
l:7j
ADHITTED TO UNIT 8
Fig. l.
.~
z
0
zz 0
(')
~ PUBLICAN (')
"'I u
z"" BARMAN
..; [j
'-' ""I ENGINEER :::> H eJ"' ~
,...l
"" z H
..... H
-~~ ~
~
0
..... " z
""z ~
u "" ~ ~
~I I 0 &'"i ~
~
C»IE TO U.K.
til
0
J (')
500. H
500 ~
4oo . 1 ~
350 0
GMli/
300. 1
"tt
ALCUI!OL 1:"1
250.
PER 200.
ffi
150
DAY
lUO.
~
(')
75. 0
50
40 ~
30
20
j
til
10
AGE
L 10
ADMITTED TO UNIT
-..J
Fig. 2. -..J
-..J
I
...<11>.
.....
<!>•'"' -....)
:;l
...." .. -....)
..."' OJ
5" ARMY
(-- _.,~-:-
... ,g 3 ~ I Tea/Kub-
her ~·~rPUBLICANl ~
1~
0 0
~~ s::: ....
~ ~ ·~ ....... • ... Q.l
781
782 D. KRAPAC ET AL.
so • REGULAR SMOKERS
60
40
20
Results
cf N =54 ~ N: 28 -~ N = 82
5 -7 12 (22.2%) 1 ( 3.6 "!. ) 13 ( 15.9.,.)
8 -11 27 ( 50.0'/.) 12 (42.9 "!.) 39 ( 47.6 'lo)
12-15 15 ( 27. 8 'lo) 15 ( 53.5 '/,) 30 ( 36.5 "/,)
x2 :7.5968 P<O.OS
the half-day program (T) but the difference was not found
stat1stically significant (Table 3).
Table 3.
T N :42 M tl = 40 L: N =82
5 -7 4 ( 9 5) 9 I22 5 I 13 I 15.9'/. I
B 11 22 (52.41 17 142 5 I 39 I 47.6 '/. I
12 15 16 136.1 I 14 (35 0 I 30 I 36.6 '/. I
x2 = 2.6502 n. s.
T :: TRADITIONAL HALF- DAY SCOOL PROGRAMME
rf N = 12 '¥ N:9 t N = 21
2 - 5 6 I 41.7 l 0 I 0 l 5 123.8 '!.)
5 - 10 6 150.0 ) 7 1778) 13 161.9 '!.)
10- 20 0 I 0 ) 1 111 1 ) 1 I 4.8'1.)
> 20 1 183 ) 1 111.1 ) 2 I 9.5'1.)
PROVING
47 I 46 1 l 37 I 4Hl 84 I 46 7 '!.) t = 0.17 n.s.
MATURITY
LIKING S.
28 127.5) 21 I 26.9 l 49 127.2 '!.) n.s.
SMOKING
FEELING S
5 I 4. 9 l 7 I 9.0 l 12 I 6 7'1. l t = 1.09 n.s.
SECURE
DRAWING
ATTENTION
41 I 40.2 l 40 I 513 l 81 1450 '!.) t o 1.48 n.s.
PARENTS
SMOKING I I 1.0 l 6 I 77 l 7 13 9 '!.) t = 230 P<0.05
TEACHERS
3 I 2.9 l 11 114.1) 14 17 8 '!.) t = 2.78 P<0.01
SMOKING
REASON NOT
7 16.9 ) 5 16.4 ) 12 16.7'1.) n. s.
STATED
ATTITUDE TO SMOKING AMONG PRIMARY SCHOOL PUPILS 785
Conclusion
Summary
REFERENCES
Introduction
787
788 G. TRIKKAS ET AL.
Methodology
Factors
*p.0::0.025
TWO DIFFERENTIALLY SENSITIZED RURAL POPULATIONS 791
Results
Discussion
Factors
A 40.82:!;7.18 42.20:!;5.60 0.96 42.69:!;5.64 41.52:!;6.36 0.96
B 39.95:!;7.02 38.23:!;7.65 1.04 36.81:!;5.56 38.62:!;6.60 l. 46
*p<0.02 ~
f:Ij
1-3
.~
~
Table 3. Means, SDs and t-values of Age and Factors 0
H
A,B,C,D,E Between Males and Females, l'%j
l'%j
Separately for Village K and Village G 1?-:1
~
K G
z
Village 1-3
H
Males (N=41) Females(N=49) t Males(N=39) Females(N=48) t :J::o
t'i
t'i
Age 50.12±11.53 45.87±12.03 1.71 46.69±11.14
...::
44.87±11.73 0.74
(/)
1?-:1
z
(/)
Factors H
1-3
H
A 40.82±7.18 42.69±5.64 1.35 42.20±5.60 41. 52±6. 36 0.53 1:'1
1?-:1
0
B 39.95+7.02 36.81+5.56 2.32** 38.23+7.65 38.62±6.60 0.25 ~
c::
c 31. 97±6. 03 31. 38±4. 95 0.50 32.56±6.10 33.85±6.42 1. 09
~
D 37.65+6.59 37.83+5.45 0.14 38.02±5.72 36.02±7.02 1.46 '"0
0
'"0
E 22.48±5.86 24.95±5.07 2.12* 24.64±5.64 24.64±5.47 o.oo
---~~- - -~--------------
-------------
~1-3
H
*p<. 0.05 **p< 0.02 0
z
(/)
--.1
\.0
w
794 G. TRIKKAS ET AL.
SUMMARY
REFERENCES
Institute of Rehabilitation
at the Academy of Physical Education
Cracow, Poland
Introduction
797
798 M. K. PACHALSKA
11 - 20 yea<.s - 1 1 2 • 9
21 - 30 yea'ls 1 1 2 5' 8
31 - 4 0 yea'ls 2 3 5 14 • 7
1.1 - 50 yea<.s 6 6 12 35. I.
51 - 60 yea'ls 5 3 8 23. 6
61 - 70 yea'ls 4 1 5 11. • 7
71 - 80 ye O'lS 1 - 1 2' 9
phy""~ I ~~~
Oiagn osis
/~
"t.ehabilitation \
-------------
~-~ \
Tha"tapy
--------at homa
T - - - - logothnapy ---in a club
----------in society
H
ve-e bat
E--- psychothnapy====-
----- nonve-rbal
R
_ _ _ _ anvi"tonmenta/ - a c t i v e sociothnapy
p ~gymnastics
~walking
Y---- kiMsithe-rapy
~ tou-rism and -rec'Y.eation
occupa tiona/ the-rapy
800 M. K. PACHALSKA
d~gr:ee I
t
of
distu-rboncas
pudominance of distu-cbances in
I :-.,. spaaking
:1
pr:~dominance of distur:bancfls in
'' under: standing
''
21 ............... -... ....... -·-.
1
Lt-------r--.----r----.-----.---r------d,---~-r:-at_io-l~ of
0
5 10 15 20 25 30
(m month)
thrn:a py
0 (0 - 20 points) no distur:bances
1 (20 - ~0 points) slight d istuzbancfls
2 (~0 - 60 points) - mfldium disturbances
3 (60 - 80 points) dtlr;p dis tur:bances
4 (80 -10o poi nls) total lack of communication
Results
10
9
8
7
-·--·- ·-\ rJxamination I
6
\
examination II
5
4
\
3 \
2 \ ...... ....-·-·-·-·-.
\ ................ ·
0 Q-
3
c L 0
D - exam in afion I
• -examination II
a distu7.bances of speech
u n de'ts fan ding
b - distu7bances of speaking
c - mixed distu-cbances
0 a b c
Final Conclusions
Summary
SOCIO-PSYCHIATRIC ASPECTS
805
806 A. JAREMA AND M. JAREMA
Table 1.
Type of Information
Social
Background
True Incom- Untrue Con- Total
complete cealed
Blue-collar
workers* 34.7 29.7 8.6 27.0 100
White-collar
workers** 32.4 29.6 8.4 29.6 100
Type of Information
Marital
Status
True Incom- Untrue Con- Total
plete cealed
Table 2.
Type of Information
Place of
Residence
- Community True In com- Untrue Con- Total
plete cealed
Large
City 35.9 27.5 10.1 26.5 100
Small
City 28.3 32.2 9.6 30.0 100
Rural
Community 34.3 28.6 7.6 29.5 100
Type of Information
Occupation
"Blue-collar"
- physical 36.4 28.4 9.8 25.4 100
"White-collar"
- intellectual 30.4 31.0 9.4 29.2 100
Non-
employed 30.2 28.6 8.7 32.5 100
RESULTS
Table 3.
Type of Information
Age
True Incom- Untrue Con- To-
plete cealed tal
Type of Information
Education
True Inc om- Untrue Con- To-
plete cealed tal
Elementary
School 34.0 25.6 9.2 31.2 100
High
School 31.7 33.2 9.6 25.5 100
College
Education 37.5 27.5 10.0 25.0 100
810 A. JAREMA AND M. JAREMA
DISCUSSION
Table 4.
Influence of Information on
Diagnosis Mood Disposition
Given by
Physic-ian
Anxiety Relief No Total
Influence
Other
Illness 92.2 4.2 2.9 100
Lack of
Information 93.4 3.8 2.8 100
Patients' Perception/Judgement
Established about Received Information
Diagnosis
Given by
Physician True Partially Untrue Un- Total
Truthful expressed
opinion
Other
Illness 32.4 31.0 0 36.6 100
Lack of
Information 14.2 14.8 0 71.0 100
SUMMARY
Using an anonymous questionnaire, 561 persons (cancer
patients and controls) were investigated. The aim of the
work was to evaluate the influence of many social factors
on the psychological situation of patients and the problem
of telling them the diagnosis is cancer. One third of the
subjects felt that the patient should always be given
true, complete information. The influence of many social
factors, e.g. social background, marital status, type of
community-res idence, type of occupation, education and age
of subjects is discussed. Also the influence of doctor's
information on patient's well-being as a problem of
interpersonal relationship between the treating physician
and the patient is discussed, as well as the need for
psychological and psychiatric assistance in resolving the
problems of resonance following on the diagnosis of
cancer.
REFERENCES
1. c. Drunkenmolle, Psychologische Untersuchungen
bei Patienten mit Mammakarzinom , Psychiat.
Clin. 8:127 (1975).
2. w. D. Kelly and s. R. Friesen, Do cancer
patients want to be told?, Surgery, 27:822
(1950).
3. w. T. Fills and I. S. Ravdin, What Philadelphia
physicians tell patients with cancer,
J.A.M.A. 153:901 (1953).
4. E. M. Pattison, Experience of dying, Am. J.
Psychiat. 21:32 (1967). ---
s. R. Renneker and M. Cutler, Psychological problems
of adjustment to cancer of the breast,
J .A.M.A. 148:833 (1952).
6. J. Aitken-Swan and E. C. Easson, Reactions of
cancer patients on being told their diagnosis,
Brit. Med. J. 21 ( 3) : 7 7 9 ( 19 59) •
7. D. Parker, Mastectomy rehabilitation programs:
patient's comments, Health Soc. Work,
2(4):164 (1977).
THE INFLUENCE OF SOCIOECONOMIC FACTORS
Introduction
815
816 V. MARKES-MARINIC AND Z. MARINIC
mental patients~ environment tend to result in shorten-
ing the ~eriod of in-patient treatment of this group of
patients •
Results
Conclusion
REFERENCES
Introduction
821
822 U. AVIRAM ET AL.
referred to psychiatric clinics they are commonly diagnosed
as hysterical reaction, immature personality, hypochondri-
asis or psychosomatic9.
Conceptual Framework
Objectives
Method
A. Aspect of B. Types of
resource resources
1. sufficiency } 1. affective
Individual (x) reports about the { 2. utilization of { 2. instrumental
3. Importance 3. cognitive
C. Source of resources
D. Types of
Demands E. Source of demands
1. affective
{ 2. instr~mental
}
demands of the { ~: ~~~:~environment }
3. cogmllve 3. remote environment
{ positive }
negative contribution to psychological equilibrium.
Findings
a) See Table 2
b) Did not fit into the scale
c) No significant difference between groups
00
1\.)
1.0
co
Table 2. Composit e Measures of Psycholo gical Distress w
0
(Guttman scale of symptom items presented in
Table 1)
a "often" or "sometimes"
b differences between groups is siqnificant (o<.001, d.f.=5, Chi2=40.65)
CXl
w
w
834 U. AVIRAM ET AL.
Discussion
SUMMARY
J. Gkiouzepas M. Jen6ne
B Dept of Psychiatry and Esztergom Municipal Hospital
Neurology, Aristotelian Dept of Neuro-psychiatry
University of Thessaloniki Esztergom
Medical School Hungary
Thessaloniki
Greece Jordan Jovev
Bolnica za nervni i dusevni
William Gray zaboluvanja - Bardovci
58 Pine Crest Road 91000 Skopje
Newton Center Yugoslavia
Massachusetts 02159
U.S.A. M. Juric
Psihijatrijska bolnica
Gustav Hofmann Kampor 22
A-4020 Linz 51280 Rab
Wagner Jauregg Weg 15 Yugoslavia
Austria
846 CONTRIBUTORS
A. Martines M. Mimica
Athens University Medical Institut za medicinska
School, Department of istrazivanja JAZU
Psychiatry Mose Pijade 158
Eginition Hospital 41000 Zagreb
74, Vasilissis Sofhias Av. Yugoslavia
Athens
Greece Prem C. Misra
Acron St. Day Hospital
z. Martinovic 23 Acron Str.
Institut za Bridgeton
neuropsihijatriju za djecu Glasgow
i omladinu Scotland
ul.br.Subotica 6a U.K.
11000 Beograd
Yugoslavia Hannu Naukkarinen
Tammiharju Hospital
J. H. Masserman SF-10600 Tammisari
8 South Michigan Ave. Finland
Chicago, Ill. 60605
U.S.A. Nevenka Novakovic
Savezno izvrsno vijece
Tihomil Matasovic Bulevar Lenjina 2
Klinika za ortopediju 11000 Beograd
Medicinskog fakulteta Yugoslavia
KBC
Salata 2 Grace Odiase
41000 Zagreb University of Benin
Yugoslavia Teaching Hospital
P.M.B. 1111
GC. Miglio Benin City
Regional General Hospital Nigeria
of Udine
Long-term Care Dept L. Oller-Daurella
Ward of Alcohology Escuelas Pias, 89
Udine Barcelona
Italy Spain
D. Mihov Sergije Padelin
Psychiatric Clinic Natka Nodila 5/III
Medical Academy 57000 Zadar
Bulevar Lenin 40 klm. Yugoslavia
Sofia
Bulgaria George Papadimitriou
Athens University Medical
Vasil Milev School,Department of
Psychiatric Clinic Psychiatry
Medical Academy Eginition Hospital
Bulevar Lenin 40 klm. 74, Vasilissis Sofhias Ave.
Sofia Athens
Bulgaria Greece
CONTRIBUTORS 849
A.O.A. Wilson
Bangour Village Hospital
West Lothian EH52 6LW
Scotland
U.K.
Jasminka Wolff
University Department for
Neurology, Psychiatry,
Alcohology, and
Other Dependencies of
"Dr.M.Stojanovic"
University Hospital
Vinogradska 29
41000 Zagreb
Yugoslavia
INDEX
853
854 INDEX