[Differential diagnosis and pharmacotherapy of juvenile mania -- a review].

Manic disorders and bipolar psychoses have long been underdiagnosed in child and adolescent psychiatry. Scientific research has been rare as well. In particular in adolescence and young adulthood bipolar disorders are not easy to diagnose.

General practitioners and schizophrenia: results from a Swiss survey.

Background: General practitioners (GPs) have an important role in the care of patients with chronic schizophrenia and of those in the early phases of this disorder.

Aims: To obtain information about the number of patients in the early and chronic stages of schizophrenia seen in general practice; the needs and attitudes of GPs, their diagnostic knowledge concerning early phases of schizophrenia and their knowledge and practice concerning treatment of patients with first-episode and multi-episode schizophrenia.

Method: A postal survey was conducted among randomly selected GPs in Switzerland.

Gender identity disorder and anorexia nervosa in male monozygotic twins.

Objective: Male identical twins with gender identity disorder (GID) in childhood and anorexia nervosa (AN) are presented. Etiologic aspects and the relationship among gender identity, sexual orientation, body dissatisfaction, and AN are discussed.

Method: Case reports and a review of the literature are reported.

[Indications for inpatient child and adolescent treatment].

When the demand for inpatient treatment in acute psychiatric crisis of adolescents rises, it is not always recommended to admit a patient to the hospital. The limited number of hospital beds forces medical professionals to use their resources cautiously. This leads to the need to activate the intrapersonal and intrafamilial resources.

[Misdiagnosis of first onset schizophrenia in adolescents].

The intensity of the symptomatology of schizophrenia in adolescents is essentially the same as in adults. As a rule schizophrenic psychoses in adolescence are first manifestations, and other psychiatric disorders have to be ruled out. The classical differential diagnoses include: exogenous psychoses, in particular drug-induced; affective psychoses; pubertal crises; personality disorders.

[Coping of schizophrenic adolescents].

The present study examines for the first time specific forms of coping in adolescents with schizophrenia during the initial phase of their illness. It was found that schizophrenic adolescents develop considerably less active coping compared to adolescents with other disorders. Active coping is least prominent for positive symptoms (delusions, hallucinations, thought disorders); the youngest first-manifestation adolescents are also impaired in other domains (irritability, psychosocial stability).

[Personality disorders in adolescence. A pilot study on classification and early course].

72 case histories of former adolescent psychiatric inpatients diagnosed on discharge as suffering from a personality disorder were evaluated. It was possible to re-examine 33 (46%) of them. The discharge diagnosis was made according to ICD 9, the follow-up diagnosis according to ICD 10 and DSM-III-R.

[Aqueductal stenosis and hydrocephalus in a psychotic adolescent].

Examination of a 14-year-old male who was admitted to an inpatient unit with an acute paranoid syndrome yielded serious organic findings: macroencephaly, head tilted to one side, strabismus, neurological deficits, hydroencephaly and an expressive speech disorder. The personal and family history revealed a disturbance of motor development since infancy and psychiatric illness in the immediate family. The medication and the surgical procedure selected--endoscopic third ventriculostomy--are described and the difficult differential diagnosis is discussed.

[Anorectic reactions in low intelligence].

Six female in-patients suffering from anorectic reaction are described. Difficulties in diagnosis and differences between these patients and anorectic patients of normal intelligence are discussed. The main finding is that in all six cases there was an extremely close and symbiotic mother-child relationship and a weak or absent father.

[Inpatient management of adolescent psychiatric patients. A single day study].

The distribution of disorders in a one-day sample of 1806 adolescents receiving inpatient psychiatric care and classified with the diagnostic system ICD-9 is described. Of the inpatient psychiatric facilities for adolescents in the Federal Republic of Germany and West Berlin, 85% responded to our questionnaire. The main findings were: 1) More of the inpatients were male than female (1:0.

[Obsessive phenomena in schizophrenic adolescents].

Adolescent schizophrenics show obsessive-compulsive symptoms as often as adult patients. Obsessive-compulsive symptoms occur generally both in premorbid and post-acute states, whereas they are rarely observed in acute states. A particular preference of any schizophrenic subgroup doesn't seem to exist.

[EEG changes and seizures with clozapine medication in schizophrenic adolescents].

Clozapine is an effective antipsychotic agent with atypical neuroleptic and side effects. The risk of pathological changes in the EEG and of seizures is correlated to the dosage administered. With dosages of 300 mg/day or higher the EEG should be monitored regularly.

Conversion disorder (DSM-III 300.11): symptomatology and course in childhood and adolescence.

The incidence, age and sex distribution, symptomatology, psychosocial stress factors and course of conversion symptoms in a child and adolescent psychiatric patient sample were studied. Under the age of 10 conversion symptoms are comparatively rare and consequently require careful diagnosis, particularly regarding visual and hearing defects. Predominant conversion symptoms are seizures, gait problems and paralysis.

The incestoid family.

Following a short overall view on family therapeutic models of close family systems and on incest family models, the concept "incestoid family" is conceived. In this way, families should be exemplified in which it is true that no manifest incest occurs, but by going from one generation to another, relationships between parents and children, resembling a relationship between partners and the constellation of subliminal enticement and seduction situations promote pseudosexual behaviour patterns; the most conspicuous symptom of such a family is hyper- as well as hyposexualised behaviour in children and young people. Definitive and conceptual demarcations to oedipal and incestuous structures were undertaken.

[Hysterical neuroses in childhood and adolescence].

A sample of 148 child and adolescent psychiatric patients with hysterical neurosis is described as to the variables features and extent of symptomatology, age and sex distribution, psychosocial adversity and prognostic factors. Out of the "classical" symptoms seizures, walking disturbances, twilight attacks and paralyses were seen most frequently whereas vision and hearing disturbances were rather rare. Only one fifth of the patients presented a monosymptomatological pattern of disturbance.

[XYY syndrome (diplo-Y syndrome)].

A case is reported of a 12-year-old boy with the XYY syndrome and unusual clinical symptoms. In addition, past research on the XYY syndrome and the current state of knowledge is reviewed, with special emphasis on psychopathology, psychiatry and genetic counseling.