C. Kraiuhin

Augmentation of auditory evoked potentials in somatization disorder

Sensory input regulation was examined in terms of augmenting/reducing of auditory evoked potentials in 10 patients with somatization disorder (8 males and 2 females) and 10 age- and sex-matched normal controls. The slope of P1-N1 amplitude change as a function of stimulus intensity was greater in patients compared with controls, suggesting an enhanced central nervous system response to sensory input. Taken together with previous findings of a failure to habituate to incoming stimuli in a similar group of patients, and evidence obtained in somatizers of both over-responding to background stimuli in a simple tone-discrimination task and enhanced parietal activation during selective attention, this finding suggests disturbances in the processes of attention and in the regulation of afferent stimuli in somatization disorder, and may help explain the multiple and chronic complaints characteristic of patients with the disorder.

Evoked Response Potentials and Regional Cerebral Blood Flow in Somatization Disorder

Somatization disorder (SMD) is a chronic condition characterized by multiple complaints which are not due to any apparent organic illness but frequently involve pain. This study employs computer-aided imaging technologies to examine brain function in thousandths of a second (event-related brain potentials) and over a number of minutes (regional cerebral blood flow). Fourteen patients with SMD and 14 normal controls were investigated. Results from both studies suggest that patients with SMD have a dysfunction in the processes of attention, compared to normal controls.

The development of hysteria as a psychiatric concept

Abstract The long and colorful history of hysteria has spanned some four millenia of recorded medicine. It is evident that social and cultural factors have influenced the development of both theoretical concepts and clinical symptomatology of this disorder. In this paper we present a synthesis of this history. Much of the early confusion relating to hysteria has endured to the present time. Against this background we present a rationale for the delineation of acute from chronic hysteria. This distinction is evident both on a clinical and neurophysiological level.

An investigation of patients presenting with multiple physical complaints using the illness behaviour questionnaire.

The Illness Behaviour Questionnaire was used to determine whether three groups of patients who had presented with multiple symptoms in different treatment settings (Briquets syndrome, post-viral fatigue syndrome, and a heterogeneous general practice group) could be differentiated from one another and from a mixed group of psychiatric patients on the basis of their abnormal illness behaviour. All groups completed a version of the Perley and Guze diagnostic criteria for Briquets syndrome. The three groups presenting with multiple symptoms were more similar to each other than to the psychiatric patients. The results suggest that patients presenting with multiple symptoms include similar populations of patients who are poorly distinguished using current schemes of classification.

A modified selective attention auditory event-related potential paradigm suitable for the clinical setting.

Auditory event-related potentials (ERPs) were recorded without practice sessions using a selective attention ERP paradigm modified from Hillyard et al. (1973) in 20 normal individuals who varied across wide ranges of age and educational background. The results concur with previous findings concerning the effects of selective attention on both the earlier and later phases of the ERP waveform. Attended stimuli elicited a larger N1 deflection compared with unattended stimuli. Processing negativity was also elicited by attended stimuli, but not by unattended stimuli. Mismatch negativity (N2) was evident in waveforms to signals as compared with standards, and a late positivity (P3) followed N2 only in waveforms to attended signals. This paradigm may be appropriate for evaluating suspected attentional dysfunctions in clinical populations.

Images of the Brain in Psychiatry

In psychiatry, the use of computer-based techniques for constructing images of the brain is relatively recent. Nevertheless, findings that have resulted from their use thus far might provide us with a new perspective in the understanding of mental illness. They raise the possibility that many of the disorders, previously understood primarily in terms of psychosocial factors, are associated with specific abnormalities of brain structure and/or function. Although terms such as NMR, BEAM, RCBF, SPECT and PET are increasingly found in medical and psychiatric journals, few people understand in simple terms the principles on which these techniques are based. In this article the techniques used for constructing images of brain structure and function are explained, and an overview of the findings in psychiatric disorders is presented.