["Responsiveness" in psychiatric outpatient care and in hostel management]. / "Responsiveness" in der psychiatrischen ambulanten Versorgung und in der Heimversorgung.

OBJECTIVE: Responsiveness is a concept developed by the World Health Organisation (WHO) to evaluate health system performance. It measures how well a health system meets its users' legitimate expectations in non-medical related service aspects. Responsiveness consists of the categories "patient orientation" and "respect for persons". It is operationalised by nine (8+1) domains. This project aims to explore the responsiveness concept as a possibility to evaluate the performance of mental health care. METHOD: Face to face interviews with users of outpatient and hostel mental health services by means of a standardised instrument, developed by WHO were carried out. RESULTS: Overall responsiveness in outpatient care was rated by a lower proportion of users negative than responsiveness in hostel care (15 vs. 20%). Socio-demographic characteristics were related only to responsiveness ratings in hostel care when legal guardianship was considered. Domains indicated as most important (attention, participation) in out-patient care did not perform well there. In hostel care the domains attention and respect were rated as most important. These domains performed well. DISCUSSION AND CONCLUSIONS: The results are in line with the literature and adequately reflect the realities in mental health care. The responsiveness concept offers a systematic approach for considering the categories "patient orientation" and "respect for persons" as quality criteria in mental health care. Evaluating mental health service provision using the concept of responsiveness, indicates where to launch reforms in health care.

Clonazepam for the treatment of lancinating phantom limb pain.

OBJECTIVE: To propose clonazepam for use in the empiric treatment of shooting/shocking phantom limb pain. SETTING: Outpatient pain clinic associated with a university hospital. PATIENTS: Two patients with phantom limb pain after total hip disarticulation. INTERVENTIONS: Treatment with clonazepam. RESULTS AND CONCLUSIONS: Clonazepam provided effective relief for > 6 months in two patients with shooting/shocking phantom limb pain. Although clonazepam therapy is not new, it appears to have been omitted from current pain texts and journals as a treatment option for phantom limb pain.

[Event-related potentials and memory capacity: 1. A comparison of intentional and incidental learning modes]. / Ereigniskorrelierte Potentiale und Gedächtnisleistung: 1. Vergleich von intentionalem und inzidentellem Lernmodus.

Event-related brain potentials were recorded from healthy young adults during two paradigms calling for recall and recognition of previously presented words. In the first part of the study incidental learning was employed, i.e. the subject was unaware that he participated in a memory test and engaged in a semantic task instead. ERPs from the encoding phase were averaged according to whether a word was 1. subsequently recalled, 2. recognized or 3. neither recalled nor recognized. The intentional paradigm was identical in all respects except for the instructions to remember as many words as possible for subsequent memory testing. No semantic task was employed during intentional encoding. Both paradigms yielded significantly higher positivities for words which were later recalled.

[Event-related potentials and memory capacity: 2. Recognition of words]. / Ereigniskorrelierte Potentiale und Gedächtnisleistung: 2. Wiedererkennen von Wörtern.

The second part of this study deals with the behavioral und event-related potential (ERP) findings from the recognition phase of incidental and intentional learning paradigms. Correctly recognized old items were characterized by a significantly more positive ERP in the 400 to 800 ms range when compared to correctly identified new items. Furthermore old words, which had previously been remembered in a free recall test were associated with a more positive ERP when compared to both, correctly recognized and nonrecognized old words. This effect also had an earlier onset latency. The findings are considered in the context of recent results from continuous recognition memory and repetition priming studies. It is concluded that in the present paradigm ERP differences due to recognition can be attributed to unspecific phenomena.

Event-related potentials and visual spatial attention: influence of a cholinergic drug.

The effects of two dosages (200 mg, 600 mg, placebo) of a cholinergic nootropic (WEB 1881 FU) were investigated in a visual spatial attention task. Event-related brain potentials (ERPs) were used as a physiological measure of attention as they have previously been shown to be sensitive to allocation of attention to points in space. The typical enhancement of several peaks of the visual ERP due to attention was found in the present experiment. No systematic effect of the medication was revealed, suggesting that the effects of WEB 1881 FU do not extend to early perceptual processes.