The Sumbolic and Literal in Schizophrenic Language

topic . Differences between the symbolic, or poetic, and the literal in schizophrenic language
purpose . To enhance the nurse's therapeutic effectiveness with these clients
source . Review of the literature
conclusion . What often is perceived as literal language in schizophrenic communication is, in many cases, full of symbolic meaning.     

精神分裂症患者细胞因子的研究

目的探讨细胞因子在精神分裂症病理生理机制中的作用。方法采用酶联免疫吸附法（ＥＬＩＳＡ）检测６０例精神分裂症和１８例健康对照的血清ＩＬ－６、ＴＮＦα和ＳＩＬ－２Ｒ水平。结果精神分裂症患者血清ＩＬ－６（Ｐ＜００１）和ＴＮＦα（Ｐ＜００５）水平显著高于健康对照,且血清ＩＬ－６水平男性患者显著高于女性患者（Ｐ＜００５）,阳性家族史患者显著高于阴性家族史患者（Ｐ＜００５）,但精神分裂症患者血清ＳＩＬ－２Ｒ水平与健康对照差异不显著（Ｐ＞００５）。结论精神分裂症存在ＩＬ－６和ＴＮＦα介导的免疫功能异常,血清ＩＬ－６水平可能是其亚型的标志之一。     

Healthy Functioning in Families with a Schizophrenic Parent

This is a study using Family Adaptability and Cohesion Evaluation Scales (FACES IV) that surveyed married couples with children where one person was schizophrenic. A surprising finding was that both the patient and their partner rated their family in the healthy range. Using the Circumplex Model where balanced scores are healthy, most of the patients (78%) and spouses (87%) described their family as balanced. Both groups saw their family as “flexible to very flexible” and “connected to very connected.” In terms of the unbalanced aspects of their family (disengaged, enmeshed, rigid, and chaotic), the vast majority of patients and spouses rated these traits as low or very low. Both the patients and spouses described the family communication as more negative than positive. In terms of family satisfaction, it was low for over half of the patients and partners. In summary, these families with a schizophrenic parents generally were functioning well in spite of this major disorder in one parent.     

Water Intoxication in a Schizophrenic Patient with Rhabdomyolysis

Abstract: We report a case of water intoxication in a 54-year-old female schizophrenic patient with rhabdomyolysis. She had been admitted to a mental hospital, and treated with spiperone 6 mg daily. On August 3, 1992, the coma following a convulsion occurred. Laboratory data initially showed marked hyponatremia and hypochloremia with decreased serum potassium, and a gradual increase in serum creatine phosphokinase (CPK). The elevation in serum CPK with marked hyponatremia observed in the present patient was probably caused by excessive drinking of water. In this patient, the CPK elevation revealed the rhabdomyolysis.     

The Clinical Applicability of the Self-Appraisal of Illness Questionnaire (SAIQ) to Chronic Schizophrenic Patients in Taiwan

Over the last decade, several self-report instruments to assess insight of illness from schizophrenic patients’ perspectives have been administered. The main purpose of this study was to ascertain the reliability and validity of the Taiwanese version of the Self-Appraisal of Illness Questionnaire (SAIQ) in a chronic schizophrenic sample in Taiwan. This scale is a self-administered instrument designed to evaluate attitudes toward mental illness among patients receiving treatment. In the current cross-sectional study, 104 patients who met DSM-IV criteria for schizophrenic disorders were recruited and independently interviewed. The psychometric properties of the translated SAIQ were determined, including internal consistency, test–retest reliability, and construct validity. In addition, we analyzed psychosocial and clinical characteristics as correlates of the Taiwanese version of the SAIQ. Overall, the Taiwanese version of the SAIQ was found to be internally consistent and reliable over time. This translated scale comprised a three-factor solution with factors corresponding to worry, the need for treatment, and presence/outcome subscales. The results also indicated that the three subscales and its total score were significantly associated with both the research-rated insight scale and psychopathology and mood state. This culture-specific study shows that the Taiwanese version of the SAIQ is a simple and reliable scale for use.     

The Return to Reality as a Critical Phase in the Treatment of Schizophrenic Patients

Abstract

Understanding the dynamics of caregiving is essential to providing effective support to individuals and families living with serious mental illnesses. Yet, research in this area has typically explored caregiving without consulting mentally ill people. This paper adds this overlooked viewpoint by exploring the experience of care relationships by people diagnosed with schizophrenia. A secondary analysis of interview data from 21 individuals reveals that relevant dimensions of care relationships include: providers of care; types of care received; self—care; contested practices in care; negotiating practices; recipients of care; and types of care provided to other people. Addressing care within this broader conceptualization can contribute to developing interventions for individuals and families that more fully recognize the potential for people with mental illnesses to be active participants in care relationships.     

Ward Atmosphere, Client Satisfaction, and Client Motivation in a Psychiatric Work Rehabilitation Unit

This study investigated the ward atmosphere of a psychiatric work rehabilitation unit and its relationships to clients' satisfaction with the unit and client motivation, operationalised as proneness to set personal goals for their rehabilitation. The Community-oriented Programs Environment Scale was used and 52 clients participated. Their report of the ward atmosphere was in accordance with recommended levels on 5 sub-scales out of 10. A regression analysis revealed that optimal levels of order-and-organization and support were of importance for satisfaction with the unit. An optimal level of support was associated with a high rating of personal goals. This study added two therapeutically interesting factors—satisfaction and motivation—to the flora of factors that have been related to perceptions of the ward atmosphere.     

Severe Episodic Memory Impairment in a Patient With Clinical Features Compatible With Corticobasal Degeneration

Corticobasal degeneration (CBD) is a progressive neurodegenerative disorder characterized by asymmetric parkinsonism associated with apraxia, cortical sensory loss, and alien-limb phenomenon. Neuropsychological testing in patients with CBD typically shows deficits in executive functions, praxis, language, and visuospatial functioning, but not in memory. We report a CBD patient with severely impaired memory function but relatively mild motor symptoms. Detailed neuropsychological assessment showed significant verbal and visual memory deficits accompanied by frontal executive dysfunctions. Our observations indicate that CBD can in rare cases present with severe episodic memory impairment associated with frontal executive dysfunctions in the early stage of illness.     

Therapist and Client Trust in The Therapeutic Relationship

This investigation examined the Rogerian assertions that therapists' trust in their clients underlies therapists' experience of empathy, positive regard, unconditional regard, and congruence in the therapeutic relationship, and that therapists' demonstration of these “facilitative attitudes” is associated with clients' trust in their therapists. Seventeen experienced therapists and 48 clients involved in ongoing individual psychotherapy completed self-report questionnaires of these variables. Partial support for the Rogerian assertions was found. Therapist trust in their clients correlated positively with therapist ratings of the facilitative conditions, and client ratings of their therapists' facilitative attitudes correlated with clients' trust in their therapists. However, therapist ratings of trust and the facilitative attitudes did not show the expected correlations with client ratings of the same measures. Examination of correlations between individual facilitative attitudes suggested a more complex model than that predicted by Rogerian theory. The implications and limitations of these findings are discussed.Diese Untersuchung prüfte die Annahme Rogers', dass das Vertrauen von Therapeuten in ihre Klienten die therapeutische Erfahrung der Empathie, der positiven und uneingeschränkten Wertschätzung und Kongruenz in der psychotherapeutischen Beziehung bedingt und dass die offene Demonstration dieser «fördernden Einstellungen» mit dem Vertrauen der Klienten in ihren Therapeuten verbunden ist. 17 erfahrene Therapeuten und 48 Klienten wurden zu Beginn von Einzelpsychotherapien zu diesen Variablen schriflich befragt. Die eingangs genannte Annahme wurde z.T. empirisch gestützt. Das Vertrauen der Therapeuten in ihre Klienten war positiv mit den therapeutischen Beurteilungen der fördernden Bedinguengen korreliert; die Beuteilungen der fördernden Einstellungen durch die Klienten korrelierte mit ihrem Vertrauen in die Therapeuten. Dagegen zeigte sich, dass die Therapeutenbeurteilungen des Vertrauens und der fördernden Einstellungen nicht in erwarteter Richtung mit den Klientenbeurteilungen zusammenhingen. Genauere Analysen der Korrelationen zwischen den Einzelvariablen deuten auf eine höhere Komplexität des Modells im Vergliech zu der ursprünglichen Formulierung. Die Implkationen und Einschränkungen diese Befunde werden abschliessend diskutiert.Nous avons examiné les assertions rogériennes selon lesquelles la confiance du thérapeute on ses patients est à la base de son expérience d'empathie, de considération positive, de considération inconditionnelle et de congruence dans la relation thérapeutique, et que la démonstration de ces «attitudes de facilitation» par le thérapeute est associée à la confiance des patients en leur thérapeute. Dix-sept thérapeutes expérimentés avec 48 patients suivant une thérapie individuelle ont rempli des questionnaires d'auto-évaluation sur ces variables. Une confirmation partielle des assertions rogériennes a été constatée. Il existe une corrélation positive entre la confiance du thérapeute en ses patients et son évaluation des conditions facilantes, et l'évaluation par les patients des attitudes facilitantes de leur thérapeute est corrélée avec la confiance des patients en leur thérapeute. Cependant, les évaluations par le thérapeute de la confiance et des attitudes facilitantes n'ont pas montré les corrélations attendues avec les évaluations par le patient des mêmes mesures. L'examen des corrélations entre les attitudes de facilicitation individuelles a suggéré un modèle plus complexe que celui prédit par la théorie rogérienne. Les implications et les limitations de ces découvertes sont discutées.     

Schizophrenic psychosis in a patient with Gilles de la Tourette syndrome

A 36 year-old female patient with schizophrenia and Tourette syndrome is described. Clinical course, present neurological and psychopathological state, results of psychological testing, computed tomography and MR tomography of the skull, EEG and evoked potentials are reported. Results of neurochemical analysis of CSF and plasma are presented. Possible relationships between Tourette syndrome and schizophrenia are discussed with particular reference to neurochemical findings.     

The Impairment of Reminiscence Phenomenon in the Percept-Motor Learning in Schizophrenic Patients

Sixteen schizophrenics and 16 months were administered the mirror drawing test twice for 5 minutes, with a rest of 10 minutes intervening. 1. In speed, the score on the last pre-rest trial was not significantly different from that on the first post-rest trial within the schizophrenic group, while within the normal group the difference was significant. 2. In accuracy and task performance, within both the schizophrenic and normal groups, the differences between the two scores were significant. 3. In all three scales, the reminiscence scores, as the difference between the first post-rest and the last pre-rest trial, of the schizophrenic group were significantly lower than those of normal groups. These results showed that the schizophrenic was characterized by low reminiscence scores. It was attempted to explain the schizophrenic in both terms of the inhibition theory and the consolidation theory of reminiscence.     

Clinical Supervision for the Treatment of Adults With Severe Mental Illness: Pertinent Issues When Assisting Graduate Nursing Students

PURPOSE. There is little to guide advanced practice nurses to provide supervision for graduate students conducting psychotherapy with persons with serious mental illness. This article provides concrete suggestions for clinical supervision. CONCLUSIONS. Supervision should focus on assisting students to conduct recovery-based psychotherapy in terms of the therapeutic alliance, methods to provide empathy, collaborative goal setting, the management of countertransference, and the development of self-awareness. PRACTICE IMPLICATIONS. In providing clinical supervision, preceptors should assist students to become more aware of their own thoughts and feelings as well as stigmatizing beliefs in order to help clients move toward recovery.