[Syndrome of painful muscle fasciculations. Case report and differential diagnostic review]. / Das Syndrom der schmerzhaften Muskelfaszikulationen. Kasuistik und differentialdiagnostische Ubersicht.

The case of a patient with spontaneous painful muscular activity is described. We diagnosed the muscular pain fasciculation syndrome. Biopsy of the sural nerve and electrophysiological examination provided evidence of the neurogenic nature of the disturbance showing a remarkable axonal degeneration. In addition, when immunohistochemical studies were performed, the detection of immunoglobulins and complement components suggested an immunological process in the etiology of the disease. The patient made a good response to carbamazepine therapy. This effect is found in various syndromes of abnormal continuous muscle activity. Clinical, neurophysiological and morphological features of this case are discussed in relation of pathogenesis, possible drug effects and related diseases.

[Decisions of the physician in a psychoanalytic interview. Patient characteristics in the initial psychodiagnostic interview]. / Die Entscheidung des Arztes zum psychoanalytischen Interview. Patientenmerkmale im psychodiagnostischen Erstgespräch.

The focus of our investigation is the question which criteria of the first psychodiagnostic dialogue are associated with the decision of a physician to make a psychoanalytic interview. 51 patients have been investigated who had contacted the out-patient department of the Psychosomatic Hospital at the Central Institute of Mental Health in Mannheim. Patients who have been provided with a psychoanalytic interview by the therapist have been estimated as having a greater motivation for psychotherapy and they seemed more likely to consider their complaints as being psychologically caused. Younger patients have been regarded as having a greater motivation for psychotherapy than older ones and they could more likely attribute their complaints to psychologic causes, especially if they are females and belong to the middle social stratum. Furthermore, those patients who had been decided by the therapist to undergo a psychoanalytic interview more than the other group of patients showed a pattern of values which was similar to that of the therapists.

[The Mannheim Cohort Project--prevalence of psychogenic diseases in cities]. / Das Mannheimer Kohortenprojekt--Die Prävalenz psychogener Erkrankungen in der Stadt.

For the purpose of our research project the term 'psychogenetic disorders' covers psychoneuroses , character neuroses in a broader sense, and functional-vegetative as well as psychosomatic affections. So far information concerning basic descriptive-epidemiological data, especially the frequency of occurrence and the dependence upon demographic variables of the above mentioned disorders, is insufficient and controversial. Even less satisfactory is our information on the progress of these disorders. The specific difficulty with the diagnostic apperception of these disorders in particular requires field research within the entire population. Only by means of such a very expensive procedure can valid information on the true prevalence or incidence of the above mentioned disorders be obtained. Moreover, for a follow-up design each test subject must be examined several times by highly qualified experts, each examination requiring his personal presence. The "Mannheimer Kohortenprojekt" involves six hundred test subjects, two hundred each born in 1935, 1945, and 1955, selected at random from the 'normal' general population. They were examined with the aid of a structured interview schedule oriented on psychoanalytic principles and with other instruments (lists of complaints, inventories of life events, FPI-tests, etc.). Results from the first three-year investigation period include: Out of the total of six hundred test subjects twenty-five per cent are "cases". Women are significantly in the majority. Apparent is an obvious connection between different types of complaints and the social class of the test subject. Identified disorders show correlations with life events on the one hand and with early childhood disturbances on the other.