AN OTHER CASE OF
ATTENTION AND CONCENTRATION TROUBLE IN A MAN DURING A POST-GRADUATE COURSE.
Renato Cocchi, a neurologist and a medical
psychologist.
(Other six texts on this topic)
Summary.
This is the report of the clinical and
therapeutical history of a man of 32 years, who is attending a postgraduate
course. At first consultation he referred intrusive thinking, lack of
concentration, easiness to the stress answers, and an evident depression, but
underestimated. After six months and a half, following an antistress and
antidepressant drug therapy he reduced the intrusive thinking, and improved his
concentration ability. Now, he is not anymore depressed, he is more sociable
and he improved some traits of his personality.
Key words: Intrusive thinking,
concentration, depression, stress, personality, man, drug therapy, results.
Attention and concentration troubles, and stop studying
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Among the new cases of trouble of attention
and concentration treated by me, a different one occurred, because not more
delayed or with examinations stopped of the university course. It deals with a
graduate who is attending a doctorate. The contact with me happened through
Internet, and I thought to have to report it, with even the email
correspondence.
The case history.
October 2004, by email. Since yesterday,
I could first give the name to a problem that bothers me from rime. My name is
N. I am 32, and I am attending a postgraduate course in the university of C..
Since several years I have great problems
in paying attention for more than fewer minutes, linked to many other problems
derived from extremely fluctuating thinking. All that has created me an
unbelievable delay in my studies.
By chance, I read an article on a not
scientific magazine, I did a short research on Internet and I met your name and
some of your investigations.
I would like to understand if in my
discomfort it is possible to track down the terms of an illness, then curable,
or it is only a disturbed trait of my personality, made by idleness and several
incapability, then a thing I have to hold dearly.
My question is: Here in C. Can I find a
colleague of yours who uses your same approach to these discomforts? If yes,
could you address me? N.
My answer by email: The information I get
from you is too fewer, but I should say that you have a trouble of attention
and concentration. For what I know, in Italy I am still the only one who deals
with this problem, which has always some personalized features. No physician
ever asked me information, less that ever from your city.
My articles on this matter on Internet
are five, and the last one concerns a student of your region. RC
October 2004, another answer by email . . .
1. With persons who live under Rome,
all becomes more difficult, for which I usually discourage them.
As an average, however ( see my last
article, where the man is of your region, but a university student in north
Italy) at least three consultations should be necessary, the second of which
within 1-2 months from the first visit.
I Do not have magic abilities. I do a
working hypothesis for the person seen at the first visit, I correct it, if in
need, or I integrate it, to the first checkup, and I verify it after 4-5 months
since the first visit. 2. A recent EEG may be useful, but not essential . . .
RC
Beginning December 2004, the first
consultation. Male, 32 years old, a researcher to the university of C. He has a
trouble of attention and concentration. He refers that this trouble started, or
it became evident, when he was attending the third year of university, after
the death of his father, about 10 years ago, by showing difficulties to give
examinations. Then he spent four years to prepare the final thesis.
Depressive symptoms: He has moments where he feels disheartened. To the
test: Which is the opposite of the colour Red? he answers Black. In the
afternoon he is doing better. He remembers that he was always a child with
fewer social contacts.
Problems of half-brain dominance: He has intrusive thinking, and so a trouble of
attention and concentration. Often He does bad dreams. In some moments he
doesn't succeed to take decisions. There is not an emergency of evil thoughts
referred to beloved persons.
Stress symptoms: He does not bear the heat. He has a greediness for
sweet foods and mainly for the chocolate but normal liking for the meat or cube
broth, while he eats much meat. He doesn't appreciate milk and dairy, while, in
past, he consumed much milk. No fat hair occurs.
He sleeps normally, has drooling during the
sleep, does not suffer from nighttime muscular cramps, awakes tired. Rarely he
has breakfast. Colic and diarrhoea rarely occur. He doesn't have disbandment
feelings, but, perhaps, fainting feelings.
Mediastinal oppression comes out, with also
the lump in the throat. Often he has sudden asthenias, for no reason. Dyslalias
are rare, but he seems, sometimes, to hardly find the right word. When under
emotions, he has hands oversweating. He does not need to often urinate. In certain
periods he needs drinking much water. Some days he is pale with eye sockets.
Other: He reports about a normal delivery, but in his first year of life he
cried for no reason, and he did not take illnesses from cooling. At school, he
did better in Italian.
Test therapy (daily doses, by the oral via):
Glutamine 250mg; Pyridoxine 75mg; Carbamazepine 200mg; Amitriptyline 10mg +
perphenazine 2mg, Oxazepam 15mg, then substituted with bromazepam 0.5mg.
December 2004, by email. Two weeks run
since our meeting and from the beginning of the therapy, as said, I replaced
the oxazepam (which I cannot find here) with the bromazepam. The therapy is
going well, but the first week when I warned some drowsiness, then no bother
else. I start to see some changes: A need of order that first, too having it, I
did succeed absolutely to put to a conclusion; Usually I pay greater attention,
and not I do not forget things.
For what concerns the matter of studying
and reading, I succeed to have an autonomy of about one hour, one hour and
half. This is the period where I can perfectly concentrate, except the normal
distractions, and during which I have not more thinking impaired. This time
overcome, I am again going badly. So I can take a true comparison between my
state of discomfort and my natural condition. Even the need of eating sweet
things decidedly reduced, with little attack late in the evening and nothing
more. N.
December 2004, my answer by email. Well!
More or less, the times to begin warning some changes is this, even if then
every body does what it may do. When we can check all the symptoms, we should
understand if there is still some producer of internal stress not yet treated.
RC
December, 2005, by email. I scheduled my visit
according to your secretary at the January end!
The therapy is doing well, even if last
days some things had little regression: The distraction, certain obsession for
the sweets, but, in general, the things go well! An evident thing is my new
sense of the order. I succeed to do order around me, when first it was not
possible. Of the rest, I will speak during the visit. N.
End January 2005, the first checkup after 56
days of drug therapy. Attention and concentration improved. He is much more
orderly.
As for his health also, he improved. Not
more lump in the throat occurs, fewer sudden asthenias, perhaps less emotional
oversweating of his hands. He reduced moments of indecision. He feels less
depressed, but now it is a little so in a reactive way, for the many skipped
works. Perhaps he is drinking less water. Surely he has fewer days of pallor
with eye sockets.
In social relationships he seems less rigid,
he speaks more. Nobody said him to have found him different.
Therapeutic variation (daily doses, by the
oral via): Glutamine 125mg; Glycerophosforil-etanol-amine 250mg: Carbamazepine
300mg; Bromazepam 7.5mg.
February 2005, by email. This time I need
writing shortly in advance because I noticed little problems.
1) I have strange lacks of memory, that
is, it happened to have the feeling that a particular word is entirely missing
from my mind. For some seconds, there is a kind of darkness. That happens with
simple words, of common use, like "a bolt" and similar. It clogs my
memory and I do not succeed to remember this word. The problem is that it
happens often.
2) My mood is very bad, really black, a
kind of heavy soul. The awakening is slow, I do not like to go out of the bed,
and I am already in a bad mood since the morning, with a following by unpleasant
thoughts. The other things do well (:-)). I reduced my desire of sweet foods,
etc., etc. N.
May 2005, by email. Because of an
appointment (I am moving and I am going to live alone) I am forced to postpone
my arrival to B. . . . I think I shall come there on first days of June.
As you said to me, I write shortly as the
therapy worked in these months. It is the same that you prescribed me last
January. In the first week I observed that strange case of words' impairment,
like a kind of hole in the memory . . . then I slowly overcame it. Sometimes it
returns, but much more rarely, and usually in the day when I take the new drug
that I alternate to the glutamine [glycerophosforiletanolamine].
As for the remaining, all did well, with
less confusion, a greater degree of concentration, even if in the last times I
started again sweets greediness attacks, and of increased distraction.
[When I am studying], the impelling
demand of standing up and doing other, reappears. There is then a strange thing
that happened during this long period, and it is a kind of habituation to the
therapy. I went on in an automatic way without being careful to the therapy and
its effects on of me. I paid again attention only in the last weeks.
The problem of the early-morning
awakening did not change. . . . Being just awake in the morning I feel me as if
went up again from a sink ditch. So, I do labour to recover contact with the
reality . . . clearly in first minutes after I awake. The afternoon remains
always the better moment for my activity. N.
Half June 2005, the second checkup after
over six months of drug therapy.
He had little spring regression, for which
the concentration reduced to half an hour. Then he has to stand up and to move.
Altogether he does not go badly. For a certain period he had lost the habit of
the order. His work is going well, and he could reduce his outstanding work. In
family, they find him improved and they considered positively his exit from
home to live as a single. He shows a more strong personality.
Now he feels less tired. He has the doubt
that the Glycerofosforiletanolamine leads to stop the lexical memory. The
emotional oversweating even reduced. He did not have any discouragement moment.
Fewer days of pallor with eye sockets occurred. Now, he drinks less water. His
social relationships improved. Several persons found it as different. There is
no more hair falling.
Therapeutic variation (daily doses, by the
oral via): Glycerofosforiletanolamine stopped; Glutamine 125mg;
S-adenosil-l-methionine 100mg: Carbamazepine 300mg; Bromazepam 7.5mg.
Discussion.
Not having more any need to do examinations,
did non break the relationship between troubles of attention and concentration
and intellectual obligations. Surely the fact was felt in a less dramatic way,
even if the patient clearly discovered it and releted it to the difficulties he
had during the graduation course. Too in the range of a fragility of answers to
the stress, the depressive aspect prevailed ( the answer of Black to the test
"Which is the opposite of the colour?).
Unless the intrusive thinking, the troubles
of the half-brain dominance appeared as modest. Perhaps the indecision, as
symptom of the continuous overthrow of judgment was one of them. Just selected
a thing, the other becomes more useful and so away, with a mechanism that has
to be forced, otherwise becomes a loop without end.
The season change, much felt in this spring
by many patients, did bring to a little regression both of the ability toi
concentrate, whose time reduced, and of on again found tendency to the order.
This last is much curious symptom and it needs further comprehension. In my
textbook on childhood depressions (Cocchi, 1985) I had considered it a signal
of depression. I do not know if it has the same value even in the adult.
As a side-effevt effect of the current
therapy, there was even an improvement of some personality traits, as many
persons observed. Even here I could write many considerations on current idea
of personality, perhaps polluted by psychologistic explanations. It is not the
first case where this happens in patients treated by me with drug therapies
(Cocchi, 2004; Cocchi 2004; Cocchi 2005).
References.
Cocchi R. Le depressioni
infantili. In- Cocchi R. Strutture e dinamiche psicopatologiche in età
evolutiva. Montefeltro, Urbino 1985: 163-183.
<www.stress-cocchi.net/Depres2.htm>
Cocchi R. Problems of
attention and concentration leading to interruption of studying by high school
and University students: A report of 4 cases. It. J. Intellect. Impair. 1994,
7: 29-38. <www.stress-cocchi.net/Droping1.htm>
Cocchi R. Scientific
college dropouts and the risk for psychotic outcome: Four male cases. It. J.
Intellect. Impair. 1995, 8: 37-43. <www.stress-cocchi.net/Droping2.htm>
Cocchi R. The trouble
of the concentration, and stop studying in three university students. Relief
after antistress drug therapy .. July
2003.<www.stress-cocchi.net/Droping3.htm>
Cocchi R. Lack of concentration and academic delay in a female university
student with peculiar neuropsychiatric features. . January
2004.<www.stress-cocchi.net/Droping4.htm>.
Cocchi R. A new case of stop studying by concentration deficit
in a university student. Its resolution with antistress therapy.. July 2004.<www.stress-cocchi.net/Droping5.htm>
* An atypical depression with an altered EEG (epileptic depression?) and
his evident improvement with antiepileptic and antistress drug therapy. (**).
* A third case of recurrent atypical
depression with altered EEG (a probable epileptic depression) in a woman of 22
years at the first consultation. (**)
Cocchi R. An
atypical depression with an altered EEG (epileptic depression?) and his evident
improvement with antiepileptic and antistress drug therapy.. 2004 <www.stress-cocchi.net/Depression6.htm>.
Cocchi R. A second case of
recurrent atypical depression with an altered EEG (epileptic depression?) in a
27-years old man. 2004 <www.stress-cocchi.net/Depression7.htm>.
Cocchi R. A third case of
recurrent atypical depression with altered EEG (a probable epileptic
depression) in a woman of 22 years at the first consultation. . 2005
<www.stress-cocchi.net/Depression8.htm>.
Posted on Internet on July 2005. Copyright
by Renato Cocchi, 2005.
Author's address: dr Renato
COCCHI, via Rabbeno, 3
42100 Reggio Emilia
renatococchi@aliceposta.it
Attention and concentration troubles, and stop studying
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