Secrets, lies, and disguise: The case of andy warhol.

The life and works of the great American artist Andy Warhol (1928-1987) are examined in the context of Warhol's compulsive and often gratuitous lying. Elements of early trauma-contracting St. Vitus Dance at age of 7, his father's death at age of 13, and the abject poverty in which he grew up as the son of immigrants-are viewed as central antecedents of his deceptiveness. The relevance of these dynamics to the clinical situation is examined.

Letters from a suicide: Van Gogh and his sister.

An analysis of trends over a 3-yr. period in the letters of Vincent Van Gogh to his sister as the time of his suicide approached identified 8 trends, including an increase in words concerned with anxiety and words concerned with the past.

Anxiety: its role in the history of psychiatric epidemiology.

BACKGROUND: The role played by anxiety in the history of psychiatric epidemiology has not been well recognized. Such lack of understanding retarded the incremental growth of psychiatric research in general populations. It seems useful to look back on this history while deliberations are being carried out about how anxiety will be presented in DSM-V. METHOD: Drawing on the literature and our own research, we examined work that was carried out during and after the Second World War by a Research Branch of the United States War Department, by the Stirling County Study, and by the Midtown Manhattan Study. The differential influences of Meyerian psychobiology and Freudian psychoanalysis are noted. RESULTS: The instruments developed in the early epidemiologic endeavors used questions about nervousness, palpitations, sweating, trembling, shortness of breath, upset stomach, etc. These symptoms are important features of what the clinical literature called 'manifest', 'free-floating' or 'chronic anxiety'. A useful descriptive name is 'autonomic anxiety'. CONCLUSIONS: Although not focusing on specific circumstances as in Panic and Phobic disorders, a non-specific form of autonomic anxiety is a common, disabling and usually chronic disorder that received empirical verification in studies of several community populations. It is suggested that two types of general anxiety may need to be recognized, one dominated by excessive worry and feelings of stress, as in the current DSM-IV definition of Generalized Anxiety Disorder (GAD), and another emphasizing frequent unexplainable autonomic fearfulness, as in the early epidemiologic studies.

Fifty years with the Hamilton scales for anxiety and depression. A tribute to Max Hamilton.

From the moment Max Hamilton started his psychiatric education, he considered psychometrics to be a scientific discipline on a par with biochemistry or pharmacology in clinical research. His clinimetric skills were in operation in the 1950s when randomised clinical trials were established as the method for the evaluation of the clinical effects of psychotropic drugs. Inspired by Eysenck, Hamilton took the long route around factor analysis in order to qualify his scales for anxiety (HAM-A) and depression (HAM-D) as scientific tools. From the moment when, 50 years ago, Hamilton published his first placebo-controlled trial with an experimental anti-anxiety drug, he realized the dialectic problem in using the total score on HAM-A as a sufficient statistic for the measurement of outcome. This dialectic problem has been investigated for more than 50 years with different types of factor analyses without success. Using modern psychometric methods, the solution to this problem is a simple matter of reallocating the Hamilton scale items according to the scientific hypothesis under examination. Hamilton's original intention, to measure the global burden of the symptoms experienced by the patients with affective disorders, is in agreement with the DSM-IV and ICD-10 classification systems. Scale reliability and obtainment of valid information from patients and their relatives were the most important clinimetric innovations to be developed by Hamilton. Max Hamilton therefore belongs to the very exclusive family of eminent physicians celebrated by this journal with a tribute.

Psychological treatment of anxiety: the evolution of behavior therapy and cognitive behavior therapy.

The development of evidence-based treatments for anxiety disorders is a major achievement of clinical psychology, and cognitive behavior therapy is the best-established and most widely used method. The first form of this therapy, behavior therapy, was a combination of Pavlovian and Behavioristic ideas and methods and was particularly successful in reducing fears. The infusion of cognitive ideas in the late 1970s generated the wider and more flexible cognitive behavior therapy that independent agencies in the United States and United Kingdom now recommend as the treatment of choice for most of the anxiety disorders. Remaining theoretical problems and clinical limitations need to be tackled.

Hysteria and neurasthenia in pre-1914 British medical discourse and in histories of shell-shock.

Histories of shell-shock have argued that the diagnosis was subdivided into the categories hysteria and neurasthenia, and that the differential distribution and treatment of these diagnoses was shaped by class and gender expectations. These arguments depend on the presentation of hysteria and neurasthenia as opposed constructs in British medical discourse before 1914. An analysis of the framing of these diagnoses in British medical discourse c. 1910-1914 demonstrates that hysteria and neurasthenia, although undergoing redefinition in these years, were closely connected through the designation of both as functional diseases, and the role attributed to heredity in each. Before the war these diagnoses were perceived as indicators of national decline. Continuity, as well as change, is evident in medical responses to shell-shock.

[Masked depression--history and present days]. / Depresja maskowana--historia i wspólczesnosc.

Masked depression is a special form of an atypical depression. In the 70's and 80's years it was often identified at patients who complained on somatic diseases, without any distinguishable organic disorder. Depression symptoms were of secondary importance, with lesser intensification, some of them didn't appear at all. The psychiatrists of the time created a lot of terms to describe them, i.e.: a depression equivalent, a vegetative equivalent, a depression without a depression, a hidden depression. Current classifications: ICD-10 (International Classification of Diseases, 10th Revision) and DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, published by the American Psychiatric Association) do not contain the term masked depression. It doesn't mean that have disappeared the problem of atypical depression syndrome with a picture significantly different from the commonly known. The american scientists claim that such group contains 6-7% of depression disorders. The lack of proper diagnosis and disease entity qualification leads to serious somatic and psychological consequences for patients. Improper diagnosis and treatment of a patient limits his or her social and professional life, forms suicide rate and makes high costs of diagnosis and treatment.

The history of generalized anxiety disorder as a diagnostic category.

From the 19th century into the 20th century, the terms used to diagnose generalized anxiety included "pantophobia" and "anxiety neurosis." Such terms designated paroxysmal manifestations (panic attacks) as well as interparoxysmal phenomenology (the apprehensive mental state). Also, generalized anxiety was considered one of numerous symptoms of neurasthenia, a vaguely defined illness. Generalized anxiety disorder (GAD) appeared as a diagnostic category in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980, when anxiety neurosis was split into GAD and panic disorder. The distinct responses these two disorders had to imipramine therapy was one reason to distinguish between the two. Since the revised DSM-III (DSM-III-R), worry about a number of life circumstances has been gradually emphasized as the distinctive symptom of GAD. Thus, a cognitive aspect of anxiety has become the core criterion of GAD. The validity of GAD as an independent category has been questioned from DSM-III up to preparation of DSM-5. Areas of concern have included the difficulty to establish clear boundaries between GAD and (i) personality dimensions, (ii) other anxiety-spectrum disorders, and (iii) nonbipolar depression. The National Institute of Mental Health has recently proposed the Research Domain Criteria (RDoC), a framework destined to facilitate biological research into the etiology of mental symptoms. Within the RDoC framework, generalized anxiety might be studied as a dimension denominated "anxious apprehension" that would typically fit into the research domain called "negative valence systems" and the more specific construct termed "potential threat."

Desde el sigh XIX y hasta el siglo XX, los términos empleados para diagnosticar la ansiedad generalizada incluyeron la "pantofobia" y la "neurosis de ansiedad". Tales términos designaron manifestaciones paroxísticas (ataques de pánico) como también fenomenología interparoxística (el estado mental de aprensión). También la ansiedad generalizada fue considerada uno de Ios numerosos síntomas de la neurastenia, una enfermedad definida vagamente. El trastorno de ansiedad generalizada (TAG) apareció como una categoría diagnóstica en la tercera edición del Manual Diagnóstico y Estadístico de Ios Trastornos Mentales (DSM-III) en 1980, cuando la neurosis de ansiedad fue dividida entre el TAG y el trastorno de pánico. Una de las razones para distínguir estos dos trastornos fue la respuesta diferente que tuvieron a la terapia con imipramina. A partir de la edición revisada del DSM-III (DSM-III-R), la preocupación People Like Us - situaciones de vida se ha enfatizado gradualmente como el síntoma distintivo del TAG. En consecuencia, un aspecto cognitivo de la ansiedad ha llegado a ser el criterio central del TAG. La validez del TAG como una categoría independiente ha sido cuestionada desde el DSM-III hasta la preparación del DSM-5. Algunos aspectos tornados en cuenta han incluido la dificultad para establecer límites claros entre el TAG y 1) dimensiones de la personalidad, 2) otros trastornos del espectro ansioso y 3) la depresión no bipolar. Recientemente, el Instituto National de Salud Mental de EE.UU. propuso Ios Research Domain Criteria (RDoC), un sistema destinado a facilitar la investigación biológica acerca de la etiología de Ios síntomas mentales. Dentro del sistema RDoC, la ansiedad generalizada podría ser estudiada como una dimensión denominada "aprensión ansiosa", la cual podría ajustar típicamente con el dominio de investigación llamado "sistemas de valencía negativa" y más específicamente con el constructo llamado "amenaza potencial".

Entre le XIXe et le XXe siècle, plusieurs termes ont été utilisés pour dénommer l'anxiété généralisée, notamment la «pantophobie¼ et la «névrose d'angoisse¼. Ces termes désignaient à la fois des manifestations paroxystiques (les attaques de panique) ainsi que les symptômes intercritiques (l'état mental d'appréhension). D'autre part, l'anxiété généralisée était aussi considérée comme l'un des nombreux symptômes de neurasthénie, une maladie de définition imprécise. Le trouble anxieux généralisé (TAG) est apparu pour la première fois en tant que diagnostic dans la 3e édition du manuel statistique et diagnostique des troubles mentaux (DSM-III) en 1980 quand la névrose d'angoisse a été divisée en TAG et trouble panique. Ces deux troubles ont été distingués sur la base d'une réponse différente au traitement par imipramine. À partir de la révision du DSM-III (DSM-III-R), l'inquiétude face à un certain nombre de situations de la vie courante a été conceptualisée petit à petit comme le symptôme cardinal du TAG. Ainsi, un aspect cognitif de l'anxiété est devenu le critère primordial du TAG. La validité du TAG en tant que catégorie diagnostique indépendante a été mise en doute depuis le DSM-III jusqu'à la préparation du DSM-5. Les questionnements reposaient sur la difficulté à établir des frontières claires entre le TAG et (1) les dimensions de personnalité, (2) les autres troubles du spectre de l'anxiété et (3) la dépression non-bipolaire. L'institut national de la santé mentale aux États-Unis a récemment mis en place le Research Domain Criteria [RDoC], un cadre destiné à faciliter les recherches biologiques dans le domaine de l'étiologie des troubles mentaux. Dans le cadre du RDoC, l'anxiété généralisée pourrait être étudiée comme une dimension appelée «appréhension anxieuse¼, qui appartiendrait typiquement au domaine de recherche dénommé «systèmes de valences négatives¼ et plus spécifiquement au concept dit de «menace potentielle¼.