[Comparative psychiatric diagnosis in dialysis patients and kidney transplant recipients]. / Vergleichende Psychodiagnostik bei Dialyse-Patienten und Nierentransplantat-Empfängern.

UNLABELLED: 12 male and 8 female patients treated by hemodialysis (mean age: 38.5 years, s = 11.1) and 10 male and 10 female renal transplant recipients (mean age: 35.4 years, s = 9.7) were given 8 psychological tests. The results of both groups were compared with each other and with the respective standardizations. RESULTS: In comparison with the respect standardizations the transplant recipients obtained average results in 5 to 6 achievement tests, whereas the dialysis patients showed deficiencies in higher perceptive processes, namely attentiveness, power of concentration, speed of performance, reductive thinking, and short-time memory. Confronted with problems which must be solved by making use of formerly acquired knowledge, experiences, and skills (crystallized intelligence), the average results of both groups coincided with the average of the respective standardizations. As for their way of acting in frustrating situations, the persons of both groups tried to avoid any aggressive reaction against fellow-men. They tended to self-reproaches, though generally referring to inevitable circumstances. If possible they evaded any question of guilt by minimizing the problems. All in all, renal transplantation can effect a substantial improvement in mental ability, especially of fluid intelligence.

[Computer-assisted analysis of the electroencephalogram with a theta ground rhythm variant]. / Rechnergestützte Analysen bei Elektroenzephalogrammen mit einer Theta-Grundrhythmusvariante.

UNLABELLED: From 8 men and 12 women with a slow posterior rhythm on the one hand and from 7 male and 5 female healthy volunteers with a regular alpha-EEG on the other closed-eye-EEGs were registered at 8:00 a.m., 12:00 noon, 4:00 p.m., and 8:00 p.m. and recorded on tape for computer processing. Simultaneously each time the body temperature was measured. RESULTS: In 11 of the 20 patients the slow posterior rhythm shows a right-sided accentuation, in 6 a left-sided. Besides the activity of all frequency-bands favours occipital and occipital-central the right hemisphere. The control group shows only an insignificant right-sided accentuation of alpha-power and alpha-peak-power. The alpha-peak-frequency of the 20 patients is slower than in the controls, the body temperature on the contrary is higher. The physiological circadian shift of the alpha-peak-frequency and of the body temperature does not come up to a similar extent as in the controls. Striking slight is the circadian shift of the frequency of the slow posterior rhythm. Furthermore the day-time related shifts of the alpha-power and of the beta-power take other courses than in the controls. And the maxima of the alpha-power and of the alpha-peak-power are mostly located parietal instead of occipital. All in all the slow posterior rhythm seems to be connected with far-reaching peculiarities of the cerebral function.

[Diagnostic inquiries in patients with a theta ground rhythm variant in the EEG]. / Erhebungen bei Patienten mit einer Theta-Grundrhythmusvariante des EEG.

UNLABELLED: Basing on the examination of 82.767 EEGs, 118 patients with theta rhythm variant (GRV) were found out. From their case-histories all particulars taken to be important were gathered by means of a questionnaire. In addition to this 70 of these patients were interviewed, mostly in the course of a visit at home, in order to supplement the data by catamnestic informations. Moreover, attending family doctors were asked for informations, and from 14 patients elsewhere recorded EEGs were evaluated. RESULTS: With regard to its cycles per second, the GRV proved to be stable even for long periods, but as to its coming to the fore a slight changeability revealed. Concerning physical complaints, the patients primarily suffered from headache, giddiness, and liability to fainting fits, secondary they frequently were affected with vegetative disorders and stomach complaints. In view of the psychic aspect striking often came to light unrest, lack of vitality, disturbed social contacts, sexual problems, anxiety fits, depressive reactions, and suicidal thoughts. High sensitiveness and insufficient self-sureness in many cases were conspicuous attributes. In particular men often failed in establishing or maintaining intimate human relations, so that many of them remained single, made at best only few friends, and easily became outsiders. Inability to enforce own desires against opposition, liability of mood, ill-humor, discontent, or even jealousy frequently made their appearance. As to gainful employment and professional status several of them were less successful than their siblings and their parents.

[EEG studies in Alzheimer dementia and multi-infarct dementia at various times of the day]. / EEG-Untersuchungen bei Demenz vom Alzheimer-Typ und Multiinfarktdemenz zu verschiedenen Tageszeiten.

From three men and seven women (mean age 70 years) with dementia of the Alzheimer-type (DAT), and from four men and six women (mean age 77 years) with multi-infarct dementia (MID) closed-eye EEGs were registered at 0800, 1200, 1600, and 2000 hours and recorded on tape for computer processing. The data of both groups were compared statistically and also compared with data of former investigations conducted with 10 healthy elderly volunteers and 10 patients who suffered from cerebral arteriosclerosis with serious disorder of sleep-walking rhythm (HA). Most pathological EEG deviations are found in the MID-patients, but there is no significant distinction compared to the DAT-patients, although three of the latter showed normal EEGs. Compared to the HA the EEGs of the MID-patients differed more from those of the healthy volunteers; however, the physiological circadian variations were not leveled as in the HA. Even in consideration of daytime dependent fluctuations of frequency-parameters, a clear-cut discrimination between DAT and MID by means of the EEG seems impossible.

[Clinical findings in Alzheimer dementia and multi-infarct dementia]. / Klinische Befunde bei Demenz vom Alzheimer-Typ und bei Multiinfarktdemenz.

From 1969 to 1989, 63 patients with dementia of the Alzheimer-type (DAT), 84 patients with multi-infarct dementia (MID), and 52 mixed type patients were treated. Two-thirds of the patients were women. Among the 66 men, 23% belonged to the DAT-group, and 56% to the MID-group. While the DAT-group, with regard to the age at on-set of dementia, showed a bimodal distribution with peaks at 51-55 years and at 71-75 years, in the MID-patients and in the MB-patients an age-related increase up to the age of 80 years was evident. Compared to the MID-patients, in the DAT-patients pathological EEG findings were less serious, even if a considerable brain atrophy was already evident. Psychic unbalance and states of temporary mental confusion, however, were more frequent in the MID-patients.

[Long-term benzodiazepine medication]. / Untersuchungen zum Problem der langfristigen Benzodiazepinmedikation.

UNLABELLED: Benzodiazepine (BD) misuse and dependence in 80 patients, 1974-1983 undergoing withdrawal treatment, were investigated by means of case histories and catamnestic inquiries. RESULTS: Three fourth of the patients were women. Many of the patients suffered from disturbed matrimonial relations, and 36 lived unmarried, divorced, or widowed. Besides, among the men frequently vocational difficulties were found, which increased in the course of BD-taking. In particular after removal of Lorazepam or Bromazepam in 58 cases withdrawal symptoms appeared, among them seven times delirium and six times epileptic seizures (grand mal). Catamnestic inquiries were practicable in 51 patients. 20 of them had required no further treatment, while 18 took again BD. But only 3 still proved to be as well psychical as physical dependent, in contrast to 14 before withdrawal treatment. Among the 15 only psychical dependent patients 8 merely showed a low dose dependence. Hence BD-dependence proves to be remediable, and subsequently shows only little tendency to relapse.

[Sleep disorders in dialysis patients]. / Schlafstörungen bei Dialysepatienten.

By means of standardized interviews and a self-rating scale, information was obtained from 51 dialysis patients concerning their duration of sleep, fitness, working capacity, interests, quality of life, etc. 34 of the subjects reported sleep disorders: 2 had difficulties falling asleep, 21 in sleeping through, and 11 experienced both. Severity of the sleeping problems increases with prolonged hemodialysis therapy; the same seems to apply to lack of an active lifestyle. 9 patients, apart from repeated nocturnal urination, no longer complained about sleeping problems following kidney transplantation.

[EEG studies before and following hemofiltration]. / EEG-Untersuchungen vor und nach Hämofiltration.

For a sample of 8 men and 3 women, 47-80 years old, closed-eye-EEGs were registered for the first time in the morning before hemofiltration treatment, again thereafter at 1 p.m., and a third time at 7 p.m. The day after treatment EEG-registrations were conducted at the same times. Apart from traditional visual evaluation every EEG was recorded on tape for computer processing. Simultaneously with every EEG-registration the body temperature was measured. For comparison served corresponding data of 17 hemodialysis patients, and of 10 healthy old and 12 healthy young volunteers. The peak-frequency of the hemofiltration patients turned out significantly slower than that of the healthy persons and of the hemodialysis patients. While in the healthy volunteers the peak-frequency increased corresponding with the body temperature from the morning to the evening, the hemofiltration patients lacked such a correlation, although their temperature ascended in the normal way. As to the circadian variations of the activity in the diverse frequency-bands, the hemofiltration patients, and to a less degree the hemodialysis patients, showed especially in the day after treatment distinct deviations from the healthy volunteers.

[EEG findings in patients with a kidney transplant]. / EEG-Befunde bei Kranken mit einem Nierentransplantat.

UNLABELLED: For a sample of 22 men and 9 women, 24-59 years old, closed-eye-EEGs were registered three times a day: at 7 a.m., at 1 p.m., and at 7 p.m. Simultaneously with every EEG-registration the body temperature was measured. Apart from traditional visual evaluation every EEG was recorded on tape for computer processing. For comparison served corresponding data of 17 hemodialysis treated (HD), and of 11 hemofiltration treated (HF) patients, of 12 healthy young volunteers (J), and of 10 healthy old volunteers (A). RESULTS: As the illustration shows, the occipital peak-frequency (F) of the renal transplant recipients (NT) resembles that of the J and exceeds negligibly that of the A, whereas considerable differences are revealed compared with the peak-frequencies of the HD- and of the HF-patients. Statistically the peak-frequency of the NT-patients occipital and parietal turns out significantly higher than that of the HD- and HF-patients. According to these findings intraindividually in 5 of the former HD-patients after transplantation a remarkable increase of the peak-frequency is visible. In addition to this the figure demonstrates, that only in the healthy volunteers the peak-frequency (F) ascends corresponding with the body temperature (T) from the morning to the evening, while in the NT-patients similar increases scarcely are recognizable. In contrast to this in the HD- and HF-patients the body temperature rises in the normal way, but there is no corresponding variation of the peak-frequency. In the NT-patients pathological patterns are less frequent than in the HD- and HF-patients, but nevertheless more frequent than in healthy persons.(ABSTRACT TRUNCATED AT 250 WORDS)

[Circadian rhythm-related EEG changes in endogenous depressions and manias]. / Tageszeitabhängige EEG-Veränderungen bei endogenen Depressionen und Manien.

UNLABELLED: From 10 endogenous depressive and 10 manic alert but relaxed patients closed-eye-EEG's were registered at 8.00 a.m., 12.00 noon, 4.00 p.m., and 8.00 p.m., and recorded on tape for computer processing. Simultaneously each time the body temperature was measured. The findings were compared with corresponding former data of 12 healthy young people and 10 healthy aged volunteers. RESULTS: The peak-frequency of the manic patients proved to be significantly higher than that of the depressive ones, and besides slightly exceeded that of the healthy persons. While in the latter temperature and occipital peak-frequency ascend step by step from the morning to the evening, the depressive patients show a resembling increase only in outlines in the peak-frequency, whereas the temperature already decreases from 4.00 p.m. to 8.00 p.m. In the manic patients peak-frequency and temperature and delta-Power reach their acme at 4.00 p.m., but as well the peak-power as the power of alpha- and beta-frequency-bands show a trough just at 4.00 p.m. In the depressive patients, on the other hand, alpha-, theta, and delta-frequency-bands mainly have their summits at 12.00 noon. Finely the manic patients stand out by most significant band-power-variations between the distinct daytimes, while uninterrupted gradual increasing is extreme rare. In the depressive persons both these events scarcely are found. The healthy volunteers have intermediate positions. All in all the results show, that in endogenous depression circadian variations of EEG-parameters appear disorganized, while in mania a modified organization prevails.

[Circadian-dependent changes in the EEG of vital elderly humans]. / Tageszeitabhängige Veränderungen im EEG vitaler alter Menschen.

UNLABELLED: The study was conducted with six women and four men, 70-84 years old, without any psychopathologic signs of organic brain syndrome. Every experiment ran for five days during which closed-eye-EEGs were registered at 8 a.m., at 12 noon, at 4 p.m., and at 8 p.m. of the alert but relaxed patients and recorded on tape for computer processing. Simultaneously with every EEG registration the body temperature was measured. RESULTS: As in younger persons the power of the alpha frequency band occipital exceeds the activity of the other frequency bands. But though the frequency of the dominant alpha rhythm comes with 9.5 Hz occipital on an average clearly under the normal range, there was a slight slowing down in sporadic cases. Probably old age leads to a decrease of alpha frequency, even in a state of unaffected sanity. The increase of peak frequency and body temperature during the day, well known from experiments with younger people, comes to the fore in the healthy aged as well. Of striking intensity, especially in the evening, is the beta power at the parietal and the central parts of the scalp, caused possibly by a transitory decline of vigilance. Circadian variations of the different band powers, ascertained in younger persons, are absent in the present collective.

[Effect of the time of day on the EEG in cerebral arteriosclerosis]. / Einfluss der Tageszeit auf das EEG bei zerebraler Arteriosklerose.

UNLABELLED: The study was conducted with three men and seven women, 72-84 years old, characterized by psychopathological and clinical signs of cerebral arteriosclerosis (A). All patients suffered from disorder of sleep-waking rhythm. With one exception every experiment ran for five days during which closed-eye-EEGs were registered at 8 a.m., 12 noon, 4 p.m., and 8 p.m. of the alert but relaxed patients and recorded on tape for computer processing. Simultaneously with every EEG registration the body temperature was measured. The findings were compared statistically with corresponding data of a former study conducted with ten healthy aged volunteers (G). RESULTS: The dominant peak-frequency of the patients turned out significantly slower than that of the volunteers.--While in healthy persons the peak frequency increased corresponding with the body temperature from the morning to the late afternoon or the early evening respectively, the patients lacked such a correlation, although their temperatures rose gradually in the normal way. In most of the patients the peak-frequency had a remarkable small variety from day to day as well as from scalp-position, and its circadian shift was poor. Psychopathologically these subjects manifested primarily memory loss, general intellectual decline, and in four cases disorientation. On the other hand the EEGs of three women showed substantial greater variety of the peak-frequency from day to day and from scalp-position to scalp-position. Besides the alterations during the day were rather excessive, but lacking any appreciable correspondence with the undisturbed circadian variations of the body temperature. In these three cases psychopathologically personality changes preponderated.

[Psychodiagnostic studies in dialysis patients of a center and a limited care facility]. / Psychodiagnostische Untersuchungen bei Dialysepatienten eines Zentrums und einer Limited-Care-Einrichtung.

In order to find out how far center hemodialysis (ZD) and limited-care hemodialysis (LCD) influence adjustment and being of the afflicted persons, 21 ZD-patients and 19 LCD-patients were examined psychodiagnostically with the following tests: Rosenzweig Picture-Frustration Study, Taylor's Manifest Anxiety Scale (adapted to German conditions), and Freiburger Persönlichkeits-Inventar. By means of statistical analysis it could be shown that the hemodialysis patients do not present themselves to their fellow-men in accordance with their real thinking and feeling. This behaviour brings on the peril of deviating attitudes which can affect their vigour. The LDC-patients gave much more indications of autonomous self-responsibility than the ZD-patients did. Psychotherapeutic efforts primarily should counteract regressive tendencies.

[EEG studies before and after hemodialysis]. / EEG-Untersuchungen vor und nach Hämodialyse.

For a sample of 10 men and 11 women EEGs were recorded, the first being made immediately before hemodialysis, the second immediately after, and the remainder at fixed subsequent periods. Apart from traditional visual evaluation every EEG was recorded on tape, to permit computer analysis of frequencies.--The visual evaluation showed in nearly all cases an increase of dysrhythmic waves after hemodialysis. More than half the patients had additional pathological patterns, especially during hyperventilation.--Special frequency analysis of the basic rhythm in 14 cases proved that the slight acceleration, which normally lasts from the morning to the evening, was disarranged. This disturbance extended at a weaker rate to the following day. In 9 of the 14 cases the frequency of the basic rhythm was slower in the morning after treatment than at the matutinal EEG-recording immediately preceding treatment.

[Human freedom between self realization and self destruction]. / Menschliche Freiheit zwischen Selbstverwirklichung und Selbstzerstörung.

Men consider only those motives valuable, which originate from inborn patterns of behaviour, and that means in the first place most of the different activities in the course of living together. In primitive communities, when holding together and wrestling with a combined effort against natural adversities or rival tribes, each individual acquires a homogeneous basis of habits in doing and thinking which become irrefutable matters of course.--In case of economical surplus consolidation of bigger social units gets under way.--That leads step by step--starting always from pioneering élites--in the course of many generations to increasing awareness in the conduct of life and at the same time to dwindling of the emotionally fixed matters of course. In the final stage of evolution, therefore, everyone should consequently acquire for himself a framework of habits and attitudes, representing a compromise between selfish and altruistic tendencies and granting his thoughts and actions steadiness, assurance, and self-confidence.--If, however, owing to affluence, adverse living conditions do not force joint exertions and concord, individualistic expansion, competition, and rivalry arise and undermine the human relations. As a result increasingly self-realization is claimed to the debit of the fellow-men. But in view of the fact that the individual as a gregarious being cannot exist without trustworthy social ties and esteem, a rising number of men comes into a conflict between individualistic desire for expansion and yearning for the security of a community. Exposed to such a situation a lot of people are unable to adjust to a harmonious living together.

[The role of aggression and sense in the regulation of interpersonal relations]. / Zum Stellenwert von Aggression und Vernunft beim Regeln der zwischenmenschlichen Beziehungen.

Five qualities have given man his ability to realize his full human potential: 1) an innate predisposition to gregarious life, 2) an aggressive instinct, 3) an aptitude for insight, 4) a capacity for gaining extensive knowledge and skills which are at his disposal independent of instinctual drives, and 5) an urge to acquire speech, enabling him to establish a second signal system as the basis of the unique human form of consciousness. The combination of the qualities 3, 4, and 5 are, as it were, man's accessories in his struggle for existence, and can be used to serve his aggressive needs. - Every cultural development leads in the course of generations to an increase of intellectual awareness, because an increasing share of indispensable knowledge must be passed on verbally. At the same time the importance of direct, practical first-hand experience and imitative learning declines. Especially for those men whose occupations primarily involve theoretical activities a discordance arises between the world of their imaginations and consciously-controlled ways of thought and behaviour on the one hand, and their endothymic impulses, moods and feelings (which mostly originate from the innate predisposition for gregarious life) on the other. If rationalistic processes predominate in shaping forms of social interaction, man will have to manipulate the behaviour of his fellow-men as well as his own mental capacities for emotional distancing, disregarding or even violating the incalculable "endothymic" part of his being. That may have disastrous effects.

[Detachment of man from life]. / Abkehr des Menschen vom Leben.

As an instrument and a weapon in the struggle for existence man has at his disposal the intellect which enables him, by means of language, to make use of conceptional thinking. But if he uses the intellect in order to manage the interactions with his equals, he unaffectedly has to observe and to manipulate the behaviour of his fellow-men as well as his own psychic processes like functions of intricate technical apparatuses, disregarding or violating the incalculable 'endothymic' part (strivings and feelings) of human being. Innate dispositions of behaviour, urges, moods, and emotions, however, constitute real life. Suppression of vital powers by the laws of rationality makes civilized people suffer.