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1.
Acta Psychiatr Scand ; 138(5): 409-419, 2018 11.
Article in English | MEDLINE | ID: mdl-30146733

ABSTRACT

OBJECTIVE: Longitudinal and cross-sectional studies suggest that affective instability is inversely related to greater age in borderline personality disorder (BPD). However, existing studies relied on retrospective self-reports of perceived instability. We examined affective instability in everyday life in patients with BPD and healthy controls (HCs) by age in a cross-sectional e-diary study. METHODS: Two hundred and sixty female participants between 14 and 53 years of age (130 patients with BPD and 130 HCs) carried an e-diary over 4 days. The e-diaries emitted a prompting signal in approximately hourly intervals asking participants to rate their current affective state, that is valence (ranging from pleasant to unpleasant) and tense arousal (ranging from calm/relaxed to restless/under tension). RESULTS: Multilevel analyses revealed a significant interaction of age and group predicting affective instability (valence: F(1,255.6)  = 7.59; P < 0.01; tense arousal: F(1,252)  = 6.08; P < 0.01), suggesting that affective instability significantly declines with greater age in patients with BPD. Controlling for the number of comorbid disorders and BPD severity did not change the results, illustrating an inverse relationship between age and affective instability in BPD (significant interaction of age*group for valence: F(1,238.7)  = 5.74; P < 0.02 and tense arousal: F(1,235.2)  = 5.28; P < 0.02). CONCLUSION: Affective instability during daily life declines with greater age in BPD. This decline is irrespective of comorbidity and BPD severity.


Subject(s)
Affective Symptoms/physiopathology , Borderline Personality Disorder/physiopathology , Ecological Momentary Assessment , Adolescent , Adult , Affective Symptoms/etiology , Age Factors , Borderline Personality Disorder/complications , Cross-Sectional Studies , Female , Humans , Middle Aged , Monitoring, Ambulatory , Young Adult
2.
Eur Psychiatry ; 30(2): 214-20, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25561292

ABSTRACT

BACKGROUND: We investigated if alterations in higher-order association areas related to schizophrenia, namely the heteromodal association cortex (HASC), are also observable in subjects with autism spectrum disorder (ASD). METHODS: A group of 18 children with ASD and 18 healthy controls (HC) underwent magnetic resonance imaging (MRI). The examination comprised an analysis of group differences in gray matter (GM) volume, surface area (SA) and hemispheric lateralization. RESULTS: Differences in GM volumes in children with ASD and HC were detected in frontal and parietal areas related to the HASC. No HASC structure that showed changes in GM volume exhibited differences in SA. Alterations in hemispheric lateralization between ASD and HC are seen in a frontal area of the HASC. CONCLUSIONS: Our results indicate that changes in HASC areas are not restricted to schizophrenia, but extend to other psychiatric disorders, namely ASD. The lacking group differences in SA indicate that changes in GM volume are possibly evoked by other variables than SA in children with ASD.


Subject(s)
Autism Spectrum Disorder/pathology , Cerebral Cortex/pathology , Gray Matter/pathology , Temporal Lobe/pathology , Adolescent , Brain/pathology , Child , Female , Functional Laterality , Humans , Magnetic Resonance Imaging/methods , Male
3.
Child Psychiatry Hum Dev ; 46(2): 300-7, 2015 Apr.
Article in English | MEDLINE | ID: mdl-24838299

ABSTRACT

Adolescent patients with inflammatory bowel disease (IBD) show an increased risk for behavioral and emotional dysfunction. Health-related quality of life (HRQoL) is influenced by medical illnesses, as well as by psychiatric disorders, but for adolescents with IBD, the extent to which HRQoL is influenced by these two factors is unclear. For 47 adolescent IBD patients, we analyzed disease activity, HRQoL and whether or not a psychiatric disorder was present. Disease activity was estimated using pediatric Ulcerative Colitis Activity Index and pediatric Crohn's Disease Activity Index. The IMPACT-III and the EQ-5D were used to measure HRQoL and QoL, respectively. In addition, patient and parent diagnostic interviews were performed. 55.3 % patients fulfilled DSM-IV criteria for one or more psychiatric disorders. In all patients, psychiatric comorbidity together with disease activity contributed to a reduction in quality of life. Adolescents with IBD are at a high risk for clinically relevant emotional or behavioral problems resulting in significantly lower HRQoL. We conclude that accessible, optimally structured psychotherapeutic and/or psychiatric help is needed in adolescent patients with IBD.


Subject(s)
Inflammatory Bowel Diseases/psychology , Mental Disorders/psychology , Quality of Life/psychology , Adolescent , Child , Comorbidity , Cross-Sectional Studies , Female , Humans , Inflammatory Bowel Diseases/epidemiology , Male , Mental Disorders/epidemiology
4.
Fortschr Neurol Psychiatr ; 81(6): 324-30, 2013 Jun.
Article in German | MEDLINE | ID: mdl-23775165

ABSTRACT

This investigation aimed to evaluate the German version of the BPQ as a screening instrument for borderline personality disorder (BPD) in a clinical sample. Furthermore, an association between self-esteem and BPD was examined. In a consecutive modus, 27 patients with BPD and 54 clinical controls (age range: 14 - 25 years) completed a self-report questionnaire and took part in a semi-structured interview. The German version of the BPQ revealed a high internal consistency (α = 0.95) and test-retest-reliability (r = 0.94). The criterion validity (r = 0.60) and the cut-off value (49) must be interpreted with caution due to the small sample size. BPD as well as 8 out of 9 subscales of the BPQ were significantly associated with lower self-esteem. A pre-screening using the BPQ within the clinical setting may facilitate early detection of BPD. In addition, building up self-esteem seems to be very important in the treatment of patients with BPD.


Subject(s)
Borderline Personality Disorder/diagnosis , Borderline Personality Disorder/psychology , Personality Tests , Self Concept , Adolescent , Confidence Intervals , Data Interpretation, Statistical , Female , Humans , Language , Male , Psychometrics , ROC Curve , Regression Analysis , Reproducibility of Results , Surveys and Questionnaires , Young Adult
5.
Psychol Med ; 38(8): 1195-201, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18366816

ABSTRACT

BACKGROUND: A potential association between schizophrenia and osteoporosis or osteopenia has recently been reported. Various factors affect bone mineral density (BMD) such as polydipsia, nicotine, alcohol abuse, lack of physical activity, an unbalanced diet, a lack of ultraviolet exposure and/or vitamin D. In addition, decreased BMD in women with schizophrenia has been attributed to drug-induced hyperprolactinaemia and/or secondary hypogonadism. This study was undertaken because empirical evidence from larger patient cohorts is limited and the data are still controversial. METHOD: Seventy-two premenopausal, regularly menstruating women suffering from schizophrenia and 71 age- and sex-matched healthy controls were included in the study. Biochemical markers of bone turnover (serum osteocalcin, urinary pyridinium crosslinks), parathyroid hormone and 25-hydroxyvitamin D were measured. BMD at the femoral neck and lumbar spine was determined by dual-energy X-ray absorptiometry in a subgroup of 59 patients. In addition, 17beta-oestradiol, prolactin, testosterone, gonadotrophins and dehydroepiandrosterone sulfate were measured. RESULTS: Compared with healthy controls, both markers of formation and resorption were increased in women with schizophrenia. However, in the subgroup of 59 patients, BMD was within the normal range. In women suffering from schizophrenia, testosterone levels were higher than in controls, and serum oestradiol levels were lower compared with the normal range. CONCLUSION: Despite significantly increased bone turnover, we conclude that premenopausal and regularly menstruating women suffering from schizophrenia have normal spine and hip BMD. This may be due to the opposite effects of the various parameters influencing bone metabolism, especially of the gonadal hormones, and due to an intact coupling mechanism.


Subject(s)
Bone Density/physiology , Osteoporosis/epidemiology , Osteoporosis/physiopathology , Schizophrenia/epidemiology , Absorptiometry, Photon , Adult , Diagnostic and Statistical Manual of Mental Disorders , Estradiol/blood , Female , Humans , Light , Male , Middle Aged , Osteocalcin/blood , Osteoporosis/etiology , Parathyroid Hormone/blood , Schizophrenia/blood , Testosterone/blood , Vitamin D/blood
6.
Psychopathology ; 40(6): 446-52, 2007.
Article in English | MEDLINE | ID: mdl-17709975

ABSTRACT

BACKGROUND: The significance of behavioral inhibition in the second year of life for the development of social phobia in later childhood was the incentive to explore whether maternal postnatal psychopathology is a predictor for behavioral inhibition in the offspring. METHOD: 101 mother-infant pairs were recruited from local obstetric units and examined for maternal psychopathology by the Symptom Checklist and the Edinburgh Postnatal Depression Scale several times during the first postnatal year. Child behavioral inhibition was assessed at 14 months in a laboratory procedure. RESULTS: Postpartum depression at 4 months measured by the Edinburgh Postnatal Depression Scale was found to be strongly associated with toddlers' fear score/behavioral inhibition at 14 months. Maternal depressive symptoms assessed by the revised 90-item Symptom Checklist at 6 weeks , 4 and 14 months were found to be related to child inhibition as well. CONCLUSIONS: Even maternal depression not reaching the level of clinical diagnosis and treatment has an impact on child behavioral development. These data should give rise to further studies on the origins of this relationship, which might be primarily genetic or interactional.


Subject(s)
Depression, Postpartum/psychology , Inhibition, Psychological , Mother-Child Relations , Phobic Disorders/psychology , Adult , Female , Humans , Infant , Infant Behavior , Infant, Newborn , Longitudinal Studies , Male , Phobic Disorders/etiology
7.
Psychopathology ; 40(5): 321-8, 2007.
Article in English | MEDLINE | ID: mdl-17630500

ABSTRACT

OBJECTIVE: Basic symptoms are early subtle changes in thinking, feeling and perception that are subjectively experienced and precede the onset of a psychotic illness. In adult samples, high basic symptom scores are regarded as specific risk factors for the development of schizophrenia. The aim of this study was to explore the relevance of basic symptoms of psychiatric disorders in adolescent patients with special focus on early detection of psychosis. Furthermore, the association between basic symptoms and personality traits has been investigated. METHOD: From 89 adolescents, who were consecutive inpatients with different psychiatric disorders in 1995 and 1997, 54 were followed up 4.7 years later. Patients were examined with the Bonn Scale for the Assessment of Basic Symptoms at the time of the first presentation and follow-up. Additionally, personality traits were assessed at follow-up using the Junior Temperament and Character Inventory. RESULTS: None of the subjects made the transition to schizophrenia, despite high baseline scores of basic symptoms at the initial assessment. Indirect minus symptoms were found to be the most valid predictor of a persisting psychiatric diagnosis. In addition, this specific category was strongly associated with the personality traits harm avoidance and self-directedness. CONCLUSION: In adolescents, basic symptoms in association with personality traits present as a nonspecific indicator of psychopathology rather than as an indicator of vulnerability to schizophrenia.


Subject(s)
Character , Mental Disorders/diagnosis , Schizophrenia/diagnosis , Schizophrenic Psychology , Schizotypal Personality Disorder/diagnosis , Temperament , Adolescent , Child , Female , Follow-Up Studies , Germany , Harm Reduction , Hospitalization , Humans , Male , Mental Disorders/psychology , Personality Assessment , Psychopathology , Risk Factors , Schizotypal Personality Disorder/psychology
8.
Cephalalgia ; 25(4): 280-9, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15773825

ABSTRACT

Evidence for a disturbed maturation of information processing in migraine came recently from evoked and event-related potential studies during childhood. In adult migraineurs, deficient habituation is proposed as principal interictal abnormality and was found inter alia for Visual Evoked Potentials (VEPs). This study investigated response and habituation to pattern-reversal VEPs and its maturation in 102 children with primary headache (migraine with and without aura, tension-type headache) and 79 healthy controls from 6 to 18 years. A reduction of N180 latency from pre- to postpubertal age reflects maturation and was clearly present in controls but lessened in migraineurs. N180 latency was prolonged in migraineurs without aura from 12 years onwards. Habituation did not differ between groups. In conclusion, diminished N180 latency reduction with age in migraineurs gives further evidence that maturation of visual information processing is altered in migraine. Deficient habituation to pattern-reversal VEPs could not be confirmed during childhood migraine.


Subject(s)
Aging , Evoked Potentials, Visual , Habituation, Psychophysiologic , Migraine Disorders/physiopathology , Pattern Recognition, Visual , Adolescent , Child , Electroencephalography/methods , Female , Humans , Male
9.
Fortschr Neurol Psychiatr ; 73(1): 9-15, 2005 Jan.
Article in German | MEDLINE | ID: mdl-15666219

ABSTRACT

Avoidance and refusal of treatment by patients with anorexia nervosa are eminent features of the disorder. A subgroup of severely ill patients are affected by involuntary hospitalizations. Based on empirical studies, this review analyzes whether patients with involuntary hospitalization differ from patients with voluntary treatment with regard to clinical characteristics and treatment outcomes. Furthermore, reasons for treatment refusal and diminished treatment motivation are outlined based on a selective review of the literature. Patients who where admitted involuntarily had significantly more previous hospitalizations and a longer duration of illness. Other predisposing factors for an involuntary admission were a history of childhood abuse and self-mutilative behavior, whereas a history of comorbid substance abuse or clinical depression was not predictive. Empirical findings suggest that weight restoration was similarly effective for both patient groups. Because catamnestic studies of patient groups with involuntary admissions are insufficient, it is presently difficult to assess the treatment response and the risk of mortality in the long-term. Future research is mandatory to identify risk factors in this special group of patients in order to establish specific interventions.


Subject(s)
Anorexia Nervosa/therapy , Commitment of Mentally Ill , Adult , Anorexia Nervosa/epidemiology , Anorexia Nervosa/mortality , Anorexia Nervosa/psychology , Female , Humans , Male , Middle Aged , Motivation , Prognosis , Substance-Related Disorders/complications , Treatment Outcome , Treatment Refusal
11.
Pharmacopsychiatry ; 37(2): 63-8, 2004 Mar.
Article in English | MEDLINE | ID: mdl-15048613

ABSTRACT

BACKGROUND: Olanzapine, a thienobenzodiazepine, is one of the relatively new atypical antipsychotic drugs. The lowest threshold of effective olanzapine plasma levels in inpatient treatment is assumed to be 9 ng/ml. Very little is known about the plasma concentration in patients at various oral doses of olanzapine or about the clinically relevant interactions with co-medications. METHODS: In 71 schizophrenic patients (age 32.6 +/- 12.1, range 18-63 years; 31 women, 40 men), plasma olanzapine levels were assessed in 377 tests by high-performance liquid chromatography (HPLC) with electrochemical detection. Fifty-six of these plasma levels were assessed while patients were receiving olanzapine as monotherapy; otherwise, the plasma levels were assessed with the patients receiving various co-medications. RESULTS: The mean daily oral dose of olanzapine was 17.5 mg (SD = 7.0, range 5-40 mg), and the mean olanzapine plasma concentration was 54.2 ng/ml (SD 37.8 ng/ml, range 1.2-208 ng/ml). The plasma concentration of olanzapine increased linearly with the daily oral dose (r = 0.64, p < 0.001). A multiple variance analysis considering age and sex as covariables showed a significant difference in the dose-corrected plasma levels of olanzapine among 40 smokers and 31 non-smokers; age and sex did not affect the dose-corrected plasma levels. However, women received a significantly lower daily dose of olanzapine under routine clinical study conditions. No differences could be detected among the dose-corrected plasma concentration of those patients who were taken off olanzapine because they did not respond (n = 14) or because of side effects (n = 5) and those who were discharged while still on olanzapine. Under the co-medication with fluvoxamine, significantly higher dose-corrected olanzapine plasma concentrations were found than with olanzapine monotherapy, whereas significantly lower dose-corrected olanzapine plasma concentrations were detected under lithium and trimipramine co-medication. Under co-medication with amitriptyline, benperidol, carbamazepine, flupentixol, and lorazepam, the dose-corrected olanzapine plasma concentrations were no different than the plasma levels under olanzapine monotherapy. CONCLUSIONS: The relevance of therapeutic drug monitoring is emphasized with respect to the data presented and to the literature. Future studies should examine, in particular, the effects of a wider range of co-medications in a larger patient sample.


Subject(s)
Antipsychotic Agents/blood , Benzodiazepines/blood , Drug Monitoring/methods , Schizophrenia/blood , Adolescent , Adult , Age Factors , Antipsychotic Agents/therapeutic use , Benzodiazepines/therapeutic use , Biometry , Chi-Square Distribution , Chromatography, High Pressure Liquid/methods , Cross-Over Studies , Dose-Response Relationship, Drug , Drug Interactions , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Multivariate Analysis , Olanzapine , Schizophrenia/drug therapy , Sex Factors , Smoking/blood , Spectrophotometry, Ultraviolet/methods
12.
Cephalalgia ; 23(3): 206-13, 2003 Apr.
Article in English | MEDLINE | ID: mdl-12662188

ABSTRACT

Psychiatric co-morbidity is an important risk factor for chronification of primary headache into adulthood. The aim of this study was to investigate the extent and clinical relevance of emotional and behavioural problems in children and adolescents with primary headache. Children and adolescents (n = 128) with primary headache (International Headache Society, codes 1.1, 1.2, 2.1) and 83 matched controls aged 6-18 years were examined by standardized dimensional psychometric tests (Child Behaviour Checklist, Depression Inventory for Children and Adolescents, Anxiety Questionnaire for Pupils). Children and adolescents with primary headache suffer more often from internalizing problems (depression, anxiety, somatization) than healthy controls. The detected emotional and behavioural problems are clinically relevant and require particular therapy in every third child suffering from headache. Two out of three children and adolescents with primary headache do not show clinically relevant psychopathology and may benefit from minimal therapeutic intervention. One of three examined headache patients needs additional psychiatric therapy.


Subject(s)
Adolescent Behavior/psychology , Behavioral Symptoms/psychology , Child Behavior/psychology , Emotions , Headache/psychology , Adolescent , Analysis of Variance , Behavioral Symptoms/complications , Behavioral Symptoms/diagnosis , Chi-Square Distribution , Child , Female , Headache/complications , Headache/diagnosis , Humans , Male
13.
Z Kinder Jugendpsychiatr Psychother ; 30(4): 261-70, 2002 Nov.
Article in German | MEDLINE | ID: mdl-12474317

ABSTRACT

OBJECTIVES: The present study focuses on the possibilities and effects of training dyslexic children in tone and phoneme discrimination tasks. METHODS: A computer program was developed to train dyslexic children to discriminate between tone and speech stimuli. The correlation between auditory discrimination and reading and orthography performance was then tested in a preliminary study of n = 63 children. In a prospective study 44 children were assigned to one of three paralyzed groups: tone training, phoneme training or a control group. Upon completion of the initial diagnostics for all groups, the two training groups received four weeks of discrimination training, after which all three groups were immediately re-tested for the first time. Parallel thereto all children underwent specific training in reading and orthography at their school. Six months later all were re-tested a second time. RESULTS: Both test methods showed a high reliability (rn = .94; .95). Significant correlations between auditory discrimination and reading and orthography performance were confirmed. Auditory discrimination was significantly trainable. Specific training effects, as well as independent developmental effects were found. While the training effects of phoneme discrimination were stable over six months, those of tone discrimination were not. CONCLUSION: The central auditory discrimination between tone and phoneme stimuli can be trained successfully in dyslexic children and might also affect their reading and orthography performance.


Subject(s)
Computer-Assisted Instruction , Dyslexia/therapy , Phonetics , Pitch Discrimination , Speech Perception , Child , Dyslexia/diagnosis , Education, Special , Female , Follow-Up Studies , Humans , Male , Prospective Studies , Reading , Reproducibility of Results , Sound Spectrography , Writing
14.
Psychopathology ; 35(5): 259-66, 2002.
Article in English | MEDLINE | ID: mdl-12457016

ABSTRACT

Based on the results of adult studies that have shown a subgroup of basic symptoms to have a predictive value for later schizophrenic disorder, a cross-sectional study on 36 schizophrenic and 75 nonschizophrenic adolescent psychiatric inpatients was performed to elucidate the specificity of prodromal signs in early age groups. The occurrence of any single basic symptom does not show schizophrenic specificity in adolescents, but the number of basic symptoms in the categories of the Bonn Scale for the Assessment of Basic Symptoms is increased in schizophrenic patients compared with subjects with other diagnoses. The interrelation between minus symptoms and cognitive symptoms exerts a higher amount of cognitive disturbances given a certain level of irritation in schizophrenic adolescents. With the help of odds ratios, the seven most discriminating cognitive items could be elucidated including perception, information processing and action tendency.


Subject(s)
Psychotic Disorders/diagnosis , Adolescent , Adolescent Behavior/psychology , Cognition Disorders/diagnosis , Cognition Disorders/epidemiology , Female , Humans , International Classification of Diseases , Male , Neuropsychological Tests , Prevalence , Psychotic Disorders/epidemiology , Retrospective Studies , Schizophrenia/diagnosis , Schizophrenia/epidemiology , Sensitivity and Specificity , Severity of Illness Index , Surveys and Questionnaires , Time Factors
15.
Fortschr Neurol Psychiatr ; 70(6): 321-30, 2002 Jun.
Article in German | MEDLINE | ID: mdl-12048622

ABSTRACT

The purpose of this review is to analyse nature, degree and consequences of attentional biases in patients with borderline personality disorder based on existing literature. The clinical importance of these phenomena in patients with borderline personality disorder is strengthened and the link between theoretical models, empirical findings and therapeutic interventions is elaborated. This link between selective attention and borderline personality disorder is demonstrated on the basis of studies, which indicate a context between borderline pathology, affective disorders, anxiety disorders, and attention-deficit/hyperactivity disorders and also give evidence to neuropsychological deficits in patients with borderline personality disorder. The present article comparatively describes three theoretical models of borderline personality disorder and their possible links to attentional biases. The dialectical behavior approach postulates a pronounced attentional narrowing to emotional stimuli in connection with deficits regarding affect regulation. The cognitive approach assumes that rigid dysfunctional schemata initiate a cognitive-emotional circuit, which leads to a reinforcement of the symptomatology as a result of a biased perception and memory. Additionally the present article specifies the trauma approach which emphasizes the relation between borderline pathology and childhood trauma with recourse to theories of attentional biases in patients with traumatic experiences. Preliminary empiricial findings suggest that patients with borderline personality disorder demonstrate a general attentional bias for any emotional negative stimuli and not a selective attentional bias to borderline-specific stimuli. Further studies should clarify, whether therapeutical interventions with the aim to influence attentional processes represent a useful complement to established therapies in patients with borderline personality disorder.


Subject(s)
Attention/physiology , Borderline Personality Disorder/psychology , Behavior , Cognition , Humans , Models, Psychological
16.
Cephalalgia ; 22(2): 132-6, 2002 Mar.
Article in English | MEDLINE | ID: mdl-11972581

ABSTRACT

Increased negativity of contingent negative variation (CNV) in adult migraineurs is thought to reflect cortical hyperexcitability. CNV amplitude changes with age in healthy adults. Recently, evidence emerged that this might not be the case for migraineurs. Our study investigates age-dependency of CNV during childhood age. Seventy-six healthy controls and 61 children with migraine without aura (IHS code 1.1) between 6 and 18 years were examined using an acoustic S1-S2-CNV-paradigm with a 3-s inter-stimulus interval. The amplitude of the late component of CNV, as well as total CNV at the vertex (Cz according to the international 10-20 system), were significantly higher in migraineurs without aura than in controls. Healthy controls showed increasing amplitudes of CNV with age, whereas in migraine children without aura amplitudes did not change. Thus group differences were reduced during adolescence. Increased CNV negativity might reflect a biological vulnerability to migraine, rather than being a result of chronification. Migraineurs seem to lack age-dependent development of CNV also during early age, which supports the hypothesis of migraine as a maturation disorder.


Subject(s)
Aging/physiology , Contingent Negative Variation , Migraine Disorders/physiopathology , Adolescent , Child , Female , Humans , Male , Reaction Time , Reference Values
17.
Arch Womens Ment Health ; 5(3): 119-26, 2002 Nov.
Article in English | MEDLINE | ID: mdl-12510215

ABSTRACT

The clinical observation of a possible relation between the phases of the menstrual cycle and psychotic illness dates well back to the beginning of the nineteenth century. This relation is considered to provide further evidence for the protective effect of oestrogens in schizophrenic women and is summarised by the so-called oestrogen hypothesis. In addition, the hypoestrogenism hypothesis postulates a hypofunction of the gonads in women with schizophrenia with subsequent oestrogen deficiency syndrome. The aim of the present clinical study was to answer the question whether there is a perimenstrual increase in hospital admissions of women suffering from an exacerbation of schizophrenia. Two samples of premenopausal women with schizophrenia were investigated (sample 1: n = 115; sample 2: n = 170). In both samples there was a significant increase in admissions in the perimenstrual phase - three days before and three days after the first day of the menses (sample 1: P = 0.002, sample 2: P = 0.028, binomial test). 37.4% of the patients were admitted during the perimenstrual phase of the cycle in sample 1, 31.8% in sample 2. Regarding age, age at onset, and duration of illness, no difference was found between the group admitted to hospital during the perimenstrual phase versus the group admitted during the rest of the menstrual cycle in either of the samples. The results are discussed in relation to the possibly underlying physiological mechanisms.


Subject(s)
Menstrual Cycle , Schizophrenia/epidemiology , Adult , Analysis of Variance , Estrogens/blood , Female , Germany/epidemiology , Hospitalization/statistics & numerical data , Humans
18.
J Nerv Ment Dis ; 189(9): 602-7, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11580003

ABSTRACT

The purpose of this study was to examine the relationship between dissociative symptomatology and declarative and procedural memory. Subjects were 41 consecutively admitted adolescent psychiatric patients, 13 to 19 years old. Each subject completed the Adolescent Dissociative Experiences Scale (A-DES). Declarative memory was assessed by the California Verbal Learning Test and procedural memory by the Tower of Toronto puzzle. All subjects were controlled for IQ and severity of psychiatric illness. Data analysis was done by multiple regression. Multiple regression analysis revealed a model in which 71% variance of the A-DES scores was explained by psychiatric illness and specific memory variables. This study confirms a strong interrelationship between clinical dissociation and severity of psychiatric illness. Moreover, clinical dissociation seems to be associated with specific memory dysfunctions, indicating that dissociation exerts an impact on basic information processing.


Subject(s)
Dissociative Disorders/diagnosis , Memory Disorders/diagnosis , Mental Disorders/diagnosis , Neuropsychological Tests/statistics & numerical data , Adolescent , Adult , Age Factors , Comorbidity , Dissociative Disorders/epidemiology , Dissociative Disorders/psychology , Female , Humans , Intelligence Tests/statistics & numerical data , Male , Memory Disorders/epidemiology , Mental Disorders/epidemiology , Mental Disorders/psychology , Psychiatric Status Rating Scales/statistics & numerical data , Severity of Illness Index , Verbal Learning
19.
J Nerv Ment Dis ; 188(2): 71-7, 2000 Feb.
Article in English | MEDLINE | ID: mdl-10695834

ABSTRACT

This study describes the relation of different types of childhood trauma to the degree of dissociative experiences. Subjects were 198 consecutively admitted adolescent psychiatric patients, 11 to 19 years old (89 inpatients and 109 outpatients). All patients completed the Adolescent Dissociative Experiences Scale. A Checklist of Traumatic Childhood Events was filled out by clinicians. The results showed an increase in the degree of dissociative experiences in patients with a history of sexual abuse, physical abuse, neglect, and stressful life events. With the exception of life events, a moderate form of traumatic experience had the same effect on dissociative experiences as severe forms. The strongest effect was found for emotional neglect, which seems to be an important pathogenic risk factor. The results suggest that therapists and researchers should be aware that even less severe forms of abuse and neglect may have a significant impact on the development of dissociative psychopathology in adolescents.


Subject(s)
Child Abuse/statistics & numerical data , Dissociative Disorders/diagnosis , Life Change Events , Mental Disorders/diagnosis , Adolescent , Adult , Age of Onset , Ambulatory Care , Child , Child Abuse/psychology , Child Abuse, Sexual/psychology , Child Abuse, Sexual/statistics & numerical data , Dissociative Disorders/etiology , Dissociative Disorders/psychology , Female , Hospitalization , Humans , Male , Mental Disorders/psychology , Psychiatric Status Rating Scales , Psychology, Adolescent , Risk Factors
20.
Stud Health Technol Inform ; 77: 57-61, 2000.
Article in English | MEDLINE | ID: mdl-11187617

ABSTRACT

We would like to introduce several aspects of the analysis and modeling of the treatment process characterizing the cooperation within multi-professional treatment teams. We will determine what is meant by a treatment process in order to then look at five views and four levels of their description. We will introduce possible methods for surveying and describing it. Currently an extensive analysis of the current state of the treatment process and of the weaknesses is underway in the Department of Child and Adolescent Psychiatry of the Heidelberg University Medical Center.


Subject(s)
Computer Simulation , Delivery of Health Care/statistics & numerical data , Efficiency, Organizational/statistics & numerical data , Medical Staff, Hospital/statistics & numerical data , Patient Care Team/statistics & numerical data , Humans , Mathematical Computing , Task Performance and Analysis
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