[Change in the self-concept of drug-dependent patients in inpatient care]. / Die Veränderung des Selbstwertes von Drogenabhängigen während einer stationären Behandlung.

As a rule, drug addicted people show a distinctly diminished estimate of the value of their selves. It is investigated whether this estimate changes during a inpatient stay on a drug rehabilitation ward and whether the selected methods of investigation form an adequate means of evaluating the therapeutic program. It can be shown that under certain conditions (duration of stay, compliance, problem-solving ability) this is indeed the case. However, it remains an open question, whether the observed amelioration has to be viewed as a non-specific effect of the change of milieu or whether it depends on the therapeutic program offered on the ward.

Effect of 15(R)-15-methyl prostaglandin E2 (arbaprostil) on the healing of duodenal ulcer: a double-blind multicenter study.

A multicenter study was conducted on 173 patients with active, endoscopically proven duodenal ulcers (158 men, 15 women). They were randomly assigned, in a double-blind manner, to two groups: those receiving placebo capsules (91 patients) and those receiving capsules containing 100 microgram of 15(R)-15-methyl prostaglandin E2 (arbaprostil) (82 patients). Each drug was ingested four times a day (1 h before meals and at bedtime) for 28 days. Endoscopy was performed on days 0, 14, and 28 after the trial began. At each examination, the ulcer size was measured and whether the ulcer had healed was recorded. Arbaprostil increased the incidence of ulcer healing to approximately the same degree as reported in most extensive studies with cimetidine. At 14 days, three times as many patients were totally healed in the arbaprostil-treated as in the placebo-treated group (37% vs. 12%, p less than 0.001). At 28 days, 67% of patients receiving arbaprostil were healed compared with 39% in the group receiving placebo (p less than 0.001). Similarly, the ulcer size, measured endoscopically, was much smaller after arbaprostil administration than in the group receiving placebo after both 14 and 28 days (p less than 0.001). Side effects attributable to treatment consisted primarily of loose stools and diarrhea (34%). Smoking retarded healing in the placebo-treated group (p less than 0.05), but did not significantly retard healing in patients treated with arbaprostil. We conclude that arbaprostil markedly accelerates the healing rate of active duodenal ulcers. This effect may be due to inhibition of acid secretion as well as gastric cytoprotection.

[Confrontation with aggression - psychopathological patterns of behavior]. / Konfrontation mit der Aggression - Psychopathologische Verhaltensmuster.

Man in our society is less and less able to manage his own aggression or aggression of others. Psychopathologic patterns of reaction appearing thereby are demonstrated on the example of the soldier, and relations to stress theories are discussed. Conditions of formation and consequences of suppression of aggression are shown on the example of the recruit with fear of shooting or failure in basic training; similar manifestations in non-military life are referred to. The necessity of an education to adequate management of aggression is stressed.

[Faculty placement - a problem in psychiatric care]. / Fehlplazierung - ein Problem der psychiatrischen Versorgung.

The article reports on different components of misplacement as an important problem in the psychiatric care. Basing on a census of all in-patients of the Psychiatrische Universitätsklinik Bern (n = 551) different methods of evaluating misplacement are discussed. Some results of the census: - two thirds of the patients suffer from psychoses, another 13% from oligophrenia: - 46% of the patients are older than 60 years; - 72% have been in hospital for more than one year, 30% even for more than 20 years; - a quarter of the patients need special care. Psychiatrists and nursing staff agree that 198 (= 36%) of the 551 patients do not need any psychiatric treatment or nursing. From this point of view these patients have to be regarded as misplaced in the Psychiatrische Universitätsklinik Bern.