[What is Machiavellian intelligence? Views on a little appreciated side of the psyche]. / Was ist machiavellische Intelligenz? Betrachtungen über eine wenig beachtete Seite unserer Psyche.

Ethological and evolutionary psychological research has produced evidence that intelligence is not a monolithic functional entity but includes a number of specialized mental abilities to cope with life which even stem from diverse evolutionary origins. One of these subforms of intelligence is called "Machiavellian intelligence," named after the 15/16th century Italian politician and author, Niccolo Machiavelli. It provides individuals or groups with a means of social manipulation in order to attain particular goals. Thus, it builds the psychological basis for the display of power in social groups. Machiavellian intelligence can be observed and evaluated in bands of primates as well as in humans, and there are even tools for measurement in the latter.

[Mild traumatic brain injury and its psychiatric assessment]. / Das leichte Schädel-Hirn-Trauma und seine psychiatrische Begutachtung.

Mild traumatic brain injuries without circumscripted necrotic areas in brain tissue were called concussion in classic terminology. It was generally assumed, that such lesions were to heal without any residues. This notion can not be upheld completely any longer, since according to today's state of knowledge on the pathogenesis of brain trauma, chronic troubles and impairments may occur even after mild traumatic brain injuries. Besides, a number of psychosocial stress factors making it more difficult to cope with the posttraumatic disturbances and the new challenging life situation, play a marked role as to the outcome. In mild brain injuries, these environmental factors as well as a general lack of internal resources may be even more crucial than the trauma's severity by itself.

[Pedophilia and its treatment]. / Die Pädophilie und ihre Behandlung.

Pedophilia is a frequent cause of infringement of children's sexual integrity. It's a widely spread deviant pattern of sexual arousal and behavior, which seems to be deeply rooted in human nature, as shown by impressive ethological and cultural historical evidence. Aetiology and pathogenesis of pedophilia are still not clarified, but there is a number of interesting findings suggesting multifactorial developmental disorder as the basis of pedophilia. Regarding the treatment of pedophiles, there is usually drawn a distinction between somatic and non-somatic methods. The latter aim at relapse-prevention by augmentation of self-control. The former mean drive-reduction on a hormonal basis. Antiandrogens, progestogens and LHRH-agonists have proven themselves as having significant effects on sexual drive, whereas their side effects are quite tolerable on the whole.

Prevention of bone loss and fracture after lung transplantation: a pilot study.

BACKGROUND: Osteoporotic fracture is a significant source of morbidity after lung transplantation. Therapies to prevent posttransplant fracture are largely untested among lung transplant recipients. METHODS: In this prospective uncontrolled study, lung transplant referrals were assessed for bone health with metabolic, radiographic, and bone mineral density measurements. Transplant recipients were treated with an antiresorptive regimen that included a bisphosphonate starting before or after transplantation. One year after transplantation, the fracture rate and bone density of patients in each group were reassessed and compared to historical controls. Between January 1996 and August 1999, 45/50 (90%) lung transplant referrals underwent bone health assessment. Transplant candidates received calcium, vitamin D, and hormone replacement therapy as indicated for hypogonadism. After July 1998, bisphosphonate therapy was added for candidates with osteopenia or osteoporosis (T score <1). After transplantation, all patients received 90 mg of pamidronate i.v. every 12 weeks, regardless of pretransplant bone density. Radiologic evaluation was performed for clinical suspicion of fracture. Bone density was remeasured 1 year after transplantation. RESULTS: Most transplant referrals suffered from osteopenia or osteoporosis, and 29% of transplant referrals had prevalent vertebral compression fractures. Hypogonadism was untreated in 50% of men and 20% of women, and 15% of patients had hypovitaminosis D. Of the 21 patients assessed 1 year after transplantation, new fractures occurred in 4% of these patients. Lateral lumbar spine and hip bone density remained stable or improved in 65% and 86% of patients, respectively. Most of those who lost bone density had started bisphosphonate therapy after transplantation. CONCLUSIONS: Antiresorptive therapy with a bisphosphonate decreases the fracture rate and preserves bone mass 1 year after lung transplantation. In end-stage lung disease patients with osteopenia or osteoporosis, bisphosphonate therapy should be initiated before transplant surgery is contemplated.

[Pica as a harbinger of schizophrenia]. / Pica im Vorfeld einer schizophrenen Psychose.

The author reports the case of a youth who first became salient by self-neglect and finally was hospitalized for heavy drug abuse. In the closed ward, he suddenly displayed pica behavior but, in the further course, developed a typical schizophrenic syndrome. The diagnostic criteria are presented as well as all subtypes of pica. The author goes into the question of the aetiology of this enigmatic disorder. Finally, he points out the typical complications of pica and the therapeutical possibilities which are determined most of all by the underlying disease.

[Neurobiology of excess self-defense use. Case report with summary of neuroscientific principles]. / Zur Neurobiologie des Notwehr-Exzesses. Fallbesprechung mit Zusammenfassung der neurowissenschaftlichen Grundlagen.

"Excess of self-defence", from the forensic-psychiatric point of view, is a hybrid between a crime of passion and a spontaneous retaliation. The Criminal Code puts under threat of penalty exceeding actions of self-defence, but it grants exemption from punishment to a person exceeding the limits in an excusable state of excitement. Going out from a case report, the author elucidates the problem of determining the degree of diminished responsibility. In order to do so, he points out the alternative pathways of affect-driven information-processing in the human central nervous system according to today's neuroscientific state of knowledge.

[Pica--a qualitative appetite disorder]. / Pica--eine qualitative Appetitstörung.

Pica is the collective term for any form of qualitative disorder of eating behaviour. If a patient's deviant appetite is fixated on one special object, there are quite a number of corresponding terms available (e.g. geophagia for eating dirt). Pica, although a ubiquitous phenomenon, shows heightened prevalence in certain high-risk populations, i.e. infants, pregnant women, the mentally retarded, special ethnic groups and psychiatric patients. The author briefly summarizes the medical history of the pica concept and the present state of knowledge concerning aetiology and pathogenesis. The numerous possible complications and various therapeutic approaches are pointed out.

[Tattooing and dyssocial behavior]. / Tätowierungen und Dissozialität.

After a brief culturo-historical introduction into the subject of tattooing, the author makes a comparison between two groups of offenders with antisocial traits, of which only one group consists of tattooed individuals. 48 characteristics concerning family history, personal biography, social situation, drug consumption habits and clinical aspects are taken into consideration. In general view, it shows, that there are very few significant differences between the two groups except for the fact, that the tattooed individuals are less characterized by a positive family history for delinquency, broken home situations and lack of a steady partner. Moreover, there is a tendency for higher education and better professional accomplishments in this group. So the question remains, whether tattoos could also be considered under the aspect of subcultural status symbols.

[Significance of a single tattoo in dyssocial probands. Statistical comparison of socially maladjustment, male delinquents with and without tattoos]. / Der Stellenwert einer Einzeltätowierung bei Dissozialen. Statistische Vergleiche an sozial auffälligen, männlichen Delinquenten mit und ohne Tätowierung.

Although tattooing is not confined to the circle of sociopaths and delinquents, it is widely known, that criminal offenders always had heightened tendencies towards this kind of body ornamentation. The author makes an attempt to clarify the significance of a single tattoo in a sample of male delinquents by comparing the tattooed and the non-tattooed individuals. In spite of the popular prejudice, the results of this trial show, that delinquents with one tattoo stem from comparatively more favourable familiar backgrounds, are less loaded with mental disorders and delinquency among blood relatives, show better scholastic and professional accomplishments. However, tendencies toward addictive and delinquent behavior were comparable in the two groups.

[Gilles de la Tourette's disease. Symptoms, etiopathogenesis and therapeutic approaches]. / Die Gilles-de-la-Tourette'sche Krankheit. Symptomatik, Atiopathogenese und therapeutische Ansätze.

The Gilles de la Tourette syndrome is a usually chronic neuropsychiatric disorder with an early childhood onset featuring mainly motor and vocal tics. It seems that strong genetic factors make a major contribution to the etiology of this disorder, but there are also clues that epigenetic factors are involved in the pathogenesis of Tourette's syndrome, such as maternal stress during pregnancy, birth complications and hormonal influences. First in line for adequate treatment are neuroleptic compounds of high potency, besides, several other psychoactive drugs have shown some therapeutic effects. Less evident is the efficacy of neurosurgical and psychotherapeutic interventions.

[Joy riding and dyssocial behavior. A comparative study based on 84 members of a delinquent group]. / Joy Riding und Dissozialität. Eine Vergleichsstudie anhand einer 84köpfigen Straffälligengruppe.

Joy riding is the technical term for a specific behavioral pattern consisting of stealing a car without money-making purposes but in order to take it for fast and exciting rides, partially in combination with alcohol or drug consumption. In several cases this behavior can show addiction-like traits. American studies from earlier decades have shown that Joy riding seems to be a typical teenage offense committed by youths stemming from orderly social backgrounds, showing basically prosocial attitudes and seldom ending up in criminal careers. However, the present study provides evidence that Joy riding can also be part of an antisocial lifestyle. The characteristics of the joy riders examined in this trial differed just gradually from the control group of juvenile delinquents. It remains open a question, whether the differences found between our sample and American joy riders are due to sociocultural factors or rather are a consequence of different selection modes.

The humoral hypercalcemia of benignancy. A newly appreciated syndrome.

It has become recently appreciated that the hypercalcemia of malignancy is commonly caused by the increased production of parathyroid hormone-related protein (PTHrP) by the cancer. In fact, the demonstration of increased PTHrP production in a patient with hypercalcemia is regarded as pathognomonic of malignancy. The authors describe a patient with a benign ovarian lesion that produced PTHrP and caused hypercalcemia. They identify other reports of hypercalcemia associated with hypercalcemia and benign tumors, and refer to this syndrome as the humoral hypercalcemia of benignancy. Although apparently rare, a benign PTHrP-producing tumor should be considered in the differential diagnosis of hypercalcemia.

[Modified concept of psychopathy]. / Der neugefasste Psychopathiebegriff.

After a brief recapitulation of the conceptual history of the term 'psychopath', the author presents the modern view of 'psychopathy' coined by US-American researchers. This new concept found its most concise, operationalized form in the 20 diagnostic criteria of Robert D. Hare's 'psychopathy Checklist-Revised' (PCL-R). In sharp contrast to older German concepts, which were not confined to antisocial characters, the American 'psychopathy' diagnosis covers a core group of delinquents showing marked unscrupulousness and elevated proneness to relapse. After having listed a number of empirical findings confirming the validity of the diagnosis 'psychopath' on different levels of investigation, the author demonstrates the close connection between personality traits and behavioral characteristics of this highly problematic group, making use of the so-called functional circle designed by J. v. Uexküll.

[Joy riding: multiple criminal car rides in an intoxicated state in relation to dyssocial personality with addictive tendencies]. / Joy riding: Multiple "Strolchenfahrten" in angetrunkenem Zustand bei einer dissozialen Persönlichkeit mit Suchttendenzen.

Going out from the case report of a young unskilled worker, the author introduces a little known behavioral disorder, named "joy riding". This highly problematic pattern of misbehavior includes the stealing of usually high-powered motorcars in order to take fast and joyful trips without any goal and leaving them anywhere in a more or less damaged state. As our case report shows, this special behavior sometimes develops features of an addiction and thereby similarities to addictive behaviors like pathological gambling, kleptomania, pyromania and others. Rightly, we find in literature several statements denying clearly the nosological independence of all these non-substance-bound addictive behaviors, pointing out the underlying deficiency of impulse control building the common ground to all these addiction-like disorders.

[Jakob-Creutzfeldt disease]. / Jakob-Creutzfeldt-Erkrankung.

Starting out from a case report about a 84-year-old woman changing from absolute inconspicuousness to complete senile dementia within a few months, the authors present a not very well known neuropsychiatric disorder: the Jakob-Creutzfeldt disease. In short, historical, morphological and symptomatological aspects and laboratory findings are discussed, and it is shown that the complex problem of etiology and pathogenesis still is not entirely understood. It is pointed out, that earlier therapeutical attempts have not led to a significant improvement.

[History of psychiatry: Cesare Lombroso and the born criminal]. / Geschichte der Psychiatrie: Cesare Lombroso und der geborene Verbrecher.

In the first part of this paper there is a short abstract of the biography of the famous professor of psychiatry from Torino. The second part consists of a summary of the most fundamental ideas and the most important results of his extensive research, setting the base of his widest-known work, 'l'uomo delinquente'. At last, a number of contemporary and recent comments concerning his theories are quoted, and some criminologically relevant findings of modern genetics are mentioned.

[Biological-psychiatric aspects of delinquency and aggression]. / Biologisch-psychiatrische Aspekte von Delinquenz und Aggression.

After a historical introduction, the author summarizes the findings of biologically oriented psychiatric research on delinquency and aggression. In the field of genetics, twin and adoption studies prove that there must be a strong hereditary factor in the genesis of criminality, although so far only two chromosomal abnormalities have been found which seem to show a comparatively increased tendency to criminal behaviour. In addition, minimal cerebral dysfunction caused by early acquired brain damage, and attention deficit disorder combined with hyperactivity (two types of infantile mental disorder that seem hard to tell apart) are thought to be high risk conditions for criminality.