Summary Using a general hospital psychiatric population (CN =158) the following psychometric measures of depression were assessed: Minnesota Multiphasic Personality Inventory, D. Scale; Hamilton Rating Scale for Depression; Beck Inventory for Measuring Depression; Wechsler Depression Rating Scale; and Zung Self-Rating Depression Scale. The patients were grouped according to diagnoses in The Diagnostic and Statistical Manual of Mental Disorders (DSM II): Depressive Neurosis; Severe Depression (Manic-Depressive, Depressed and Psychotic Depressive Reaction); Schizophrenia and Organic Brain Syndrome; Personality Disorder; and Neuroses other than Depressive (mainly anxiety). A group comprising those who attempted suicide was also formed from the above groups. All the measures correlated well with one another. Younger patients tended to score higher on the Zung SDS and the Beck. Females scored higher on the D Scale (MMPI) and males scored higher on the Beck. The group of suicidal patients were predominantly young females. The Hamilton and the D Scale differentiated the groups clinically. These two scales and the Wechsler may be the inventories of choice, expecially since the Hamilton and Wechsler have the advantage of being completed by a psychiatrist.
The case study of a ten year old boy who presented with trichotillomania and symptoms of gender identity confusion is described and formulated in terms of the individual and family factors involved. This approach is presented as more tangible and useful than the traditional method using psychoanalytic theory.
There has been considerable interest in the strength of genetic predisposition to obsessive-compulsive neurosis in spite of the tendency in North America to view this disorder as entirely psychogenic. Both American and British papers have remarked on the rarity of the coincidence of obsessive-compulsive neurosis and the occurrence of MZ twins. An analysis of published reports indicates that, of those cases for which both zygosity and diagnosis can be firmly established, ten are concordant and only four discordant. Errors in previous studies that disqualify them from serious consideration include: failure of the investigators to establish zygosity with some degree of certainty; failure to distinguish between obsessive-compulsive neurosis and a mixed neurosis; and a tendency to confuse obsessive-compulsive neurosis with obsessive-compulsive personality or "obsessive traits". MZ female twins discordant for obsessive-compulsive neurosis are presented and their life histories are discussed. Although the twins were very similar in early childhood, their personality characteristics diverged remarkably, beginning at age 11, with the result that the symptomatic twin became shy, sensitive, cautious, conservative, and religious; whereas her asymptomatic sister became outgoing, confident, and adventuresome. The findings on psychiatric examination and on detailed psychological testing indicate that the obsessive-compulsive neurosis in the affected twin was clearly a phychogenic disorder.
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