Some problems of genetic counseling in schizophrenic psychoses

The authors sum up the most important basic principles of diagnostics and genetics of the schizophrenic psychoses from the viewpoint of genetic counseling for the practising psychiatrist and medical geneticist. Regarding genetic counselling strategy, in addition to nosological considerations, they stress the importance of socio-cultural and social psychological factors and of the emotional atmosphere in the family, which should all be taken into account together. Because of the special situation of schizophrenic (and in general, psychiatric) patients and their families, they regard it as advisable to set up a separate psychiatric genetic counselling service.     

Hysteria and psychosis

The relationship between endogenous-psychotic and hysterical behavior is presented in this paper on the basis of typical patients' accounts. Various patterns of behavior are revealed: chronic hysterical psychotic syndromes, acute hysterical psychotic syndromes, hysterical exalted psychotic episodes, simulated hysterical psychotic syndromes, hysterical behavior in the attempt to cope with psychosis, and pseudohysterical behavior in endogenous psychoses. The specific aspects of the doctor-patient relationship in the case of these patients are described.     

Results of neurophysiologic studies in ophthalmic migraine

The influence in 8 of our patients with ophthalmic migraine of photic driving with sine-like flashing lights on EEG background activity was checked and the visually evoked potentials following the application of diffused simple light stimuli were analyzed using the recovery cycle technique. The results indicate a slightly increased tonic activity of the structures of the mesencephalic formatio reticularis, such as may be produced by slight functional disturbances. Some vegetative secondary symptoms of migraine attacks and some of the changes in EEG observed in patients with ophthalmic migraine are explicable by such an abnormality.     

Communication-promoting exercise therapy in a closed male psychiatric ward

The use of the communication-promoting gesture therapy in a locked psychiatric men's ward led to the result, that a part of the restlessness and aggression potential of the patients could be commuted into a constructive social behaviour. Simultaneous increased frankness and confidence of patients in physicians and male nurses. A tied group doesn't seem to be a condition for that.     

Chronification of neuroses--on the critical phase of the inpatient-ambulatory care transition

The contribution deals with the critical transition from ward treatment and follow-up care as an outpatient. Patients with primary psychic maldevelopment are compared with those of a secondary psychic development. Changes in symptoms and personality were measured with a battery of tests during a pre-post follow-up study (intervals of eight weeks between tests). Special attention is paid to changes after discharge from hospital and deterioration, which was common among the patients with secondary psychic maldevelopment, is discussed.     

Subjective factor in EEG evaluation exemplified by the nonspecific hyperventilation effect

Subjective differences in EEG evaluation are demonstrated by means of a seven step scale for grading the unspecific hyperventilation effect in 3263 EEG of children. Intermediate steps of this scale allow to minimize such unavoidable differences.     

Treatment of atypical and neurotic depression

Hitherto it has not been usual to talk in the German language about the therapy-oriented concept of two forms of the progress of atypical depression (Type A and Type V). The characteristic symptom of Type A is angst, together with phobias, physical complaints, etc. In Type V there are vegetative symptoms, often towards evening (Hypersomnia, difficulty in getting to sleep, increased appetite, increased weight, increased libido), accompanied by hysterical extrovert personality traits, and of intermittent occurrence. These clinical pictures are amenable to psychopharmalogical therapy. In conformity with the assumption of "somatic accommodation" treatment with antidepressives is recommended in the case neurotic depression, too, at least in the initial stages of treatment.     

Aspects of process diagnosis in the psychotherapy of psychosomatic diseases

15 patients with psychosomatic diseases and the phenomenon of alexithymia, together with neurotic patients are treated psychotherapeutically in half-open groups. Contrary to the neurotics the patients show some special features regarding the process diagnostics. In assessing the wished and really experienced nearness to the group members there is a deficient ability to differentiate. During the therapeutic process the intrapsychic tension (EMI - Inventory of Emotionalities) is subject to great fluctuations or doesn't change. The occurrence of fluctuations in the EMI and of greater differentiations in the N-D-Test (Nearness-Distance-Test) suggest a good prognosis. A therapy of psychosomatic patients together with neurotic patients seems to be more effective than the treatment in homogeneous groups.     

Narcissism and the personal myth

Kris (1956) described the concept of the personal myth as an autobiographical story built around a family romance fantasy seen specifically in obsessive characters and serving a defensive function. In this paper the concept of the personal myth was expanded to include similar defensive constellations originating from within the grandiose self, built around omnipotent and omniscient fantasies and occurring in character formations with pregenital, narcissistic pathology. The case of a known author and poet, Nikos Kazantzakis, was used to illustrate the thesis of the paper. The available biographical material and the work of the author offer evidence to support the claim that the author's personal myth was a protective shield against anxiety originating in early narcissistic traumata.