Fortschritte der Neurologie · Psychiatrie最新文献

{"title":"[Whiplash and Werther effect: the potential of google insights for search for medical research and public health].","authors":"M Noll-Hussong,&nbsp;C Lahmann","doi":"10.1055/s-0031-1273293","DOIUrl":"https://doi.org/10.1055/s-0031-1273293","url":null,"abstract":"<p><p>Illness behaviour involves cultural, situational and personal predispositions. World Wide Web search statistics provided by internet applications like Google Insights for Search have the potential to facilitate our research on the distribution of mental disorders, our understanding of both sociocultural imprintings and trends in psychophenomenology and could make a remarkable contribution to medical research and public health.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"340-4"},"PeriodicalIF":0.6,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0031-1273293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40097214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Placement of stimulus electrodes and heart rate during electroconvulsive therapy].","authors":"J Nagler","doi":"10.1055/s-0029-1245600","DOIUrl":"https://doi.org/10.1055/s-0029-1245600","url":null,"abstract":"<p><strong>Objective: </strong>Bifrontal stimulation in electroconvulsive therapy (ECT) has been increasingly administered and evaluated over the past years. However, no attention has been paid to cardiac side effects of this novel form of treatment during the application of the electrical stimuli.</p><p><strong>Method: </strong>Cardiac responses to different electrode positions were compared intraindividually, using synchronised electrocardiograms and waveforms of pulse oximetry.</p><p><strong>Results: </strong>Unilateral ECT gave rise to a marked cardiac response during stimulation. Intervals between two consecutive heartbeats increased from 0.6 ± 0.0 sec to 4.1 ± 3.4 sec (mean ± standard deviation). In contrast, stable heart actions were documented in the same patients during bifrontal stimulation.</p><p><strong>Conclusion: </strong>The placement of the stimulus electrodes for ECT determines the incidence of asystole events during stimulation. Bifrontal electrode positioning results in less activation of the vagus nerve than unilateral treatment. The longer distance from the electrode site to the nerve in bifrontal treatment could account for these findings.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"599-604"},"PeriodicalIF":0.6,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1245600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40069425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Asperger syndrome].","authors":"M Dose","doi":"10.1055/s-0028-1109588","DOIUrl":"https://doi.org/10.1055/s-0028-1109588","url":null,"abstract":"Der aus Klekotow (Galizien, damals ÖsterreichUngarn) gebürtige, 1919 in Berlin promovierte und 1924 in die USA ausgewanderte Psychiater Leo Kanner veröffentlichte 1943 die erste Beschreibung der heute als „frühkindlicher Autismus/Kanner-Autismus“ (ICD-10 F84.0) klassifizierten „tiefgreifenden Entwicklungsstörung“ [1]. Ohne expliziten Bezug auf Bleuler (s.u.) sprach Kanner von einer „extremen autistischen Einsamkeit“ (extreme autistic aloneness), die das Bild der von ihm als „Childhood psychosis“ bezeichneten Entwicklungsstörung prägte. Damit sollte ausgedrückt werden, dass es bei der klinisch auffälligen „Andersartigkeit“ der beschriebenen Kinder nicht um Unsicherheit, Schüchternheit oder Zurückgezogenheit, sondern um selbstbezogene Isolation und psychisches Alleinsein ging [2]. Kanner folgerte aus seinen Beobachtungen, dass „... diese Kinder mit der angeborenen Unfähigkeit zur Welt gekommen sind, den normalerweise biologisch angelegten, affektiven Kontakt zu Menschen herzustellen ...“ [1]. Im November 1944 erschien die als Habilitationsschrift vom Leiter der „Heilpädagogischen Abteilung“ der Wiener Universitätskinderklinik Hans Asperger eingereichte Arbeit über „Die „autistischen Psychopathen“ des Kindesalters“ [3]. Es handelte sich um die Beschreibung eines Störungsbilds von 4 Knaben, die Asperger als „kleine Professoren“ bezeichnete, was heute als „Asperger Syndrom“ oder „Asperger Autismus“ (ICD-10 F84.5; DSM – IV299.80) klassifiziert wird. Asperger nahm – im Gegensatz zu Kanner – bei der Erklärung des Begriffs „autistisch“ ganz explizit Bezug auf den Psychiater Eugen Bleuler, über den er schrieb: Der Name leitet sich von dem Begriff des Autismus her, jener bei Schizophrenen in extremer Weise ausgeprägten Grundstörung. Der Ausdruck – unseres Erachtens nach eine der großartigsten sprachlichen und begrifflichen Schöpfungen auf dem Gebiet der medizinischen Namensgebung – stammt bekanntlich von Bleuler. Während der Mensch normaler Weise in ununterbrochener Wechselbeziehung mit der Umwelt lebt, und ständig auf sie reagiert, sind bei dem „Autistischen“ diese Beziehungen schwer gestört und eingeengt. Der Autistische ist nur „er selbst“ (daher das Wort autoj*), nicht ein lebendiger Teil eines größeren Organismus, von diesem ständig beeinflußt und ständig auf diesen wirkend. (Im folgenden gebrauchen wir Formulierungen Bleulers über den schizophrenen Autismus:) „Die Schizophrenen verlieren den Kontakt mit der Wirklichkeit“ in verschieden hohem Grade, „kümmern sich nicht mehr um die Außenwelt“. Es besteht ein „Mangel an Initiative, Fehlen eines bestimmten Zieles, Außerachtlassen vieler Faktoren der Wirklichkeit, Zerfahrenheit, plötzliche Einfälle und Sonderbarkeiten“. „Viele einzelne Handlungen wie die ganze Einstellung zum Leben sind von außen ungenügend motiviert“, „Intensität wie Extensität der Aufmerksamkeit sind gestört“. „Dem Willen mangelt oft die Nachhaltigkeit, unter Umständen können aber bestimmte Ziele mit großer Energie festgehalten werden“, ","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"233-41; quiz 242-4"},"PeriodicalIF":0.6,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0028-1109588","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40002997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Usage of drugs with potential adverse effects on cognition in a memory-clinic].","authors":"M Weih,&nbsp;S Scholz,&nbsp;K Reiss,&nbsp;P Alexopoulos,&nbsp;U Degirmenci,&nbsp;T Richter-Schmidinger,&nbsp;J Kornhuber","doi":"10.1055/s-0028-1109625","DOIUrl":"https://doi.org/10.1055/s-0028-1109625","url":null,"abstract":"<p><p>Cognitive decline is a frequent clinical symptom in elderly patients. In particular, memory disturbances are an early sign and a risk factor for subsequent development of neurodegenerative dementia. At the same time, elderly patients often receive multiple medications due to an increasing number of acquired diseases. Certain drugs have adverse side effects on cognition due to interference with the cholinergic or GABA-ergic system. This could lead to underestimation of the actual cognitive status at initial clinical presentation. In the present study we included 221 patients (mean age 68,5 years) who presented for the first time in a specialized memory-clinic and who had or developed dementia during follow up. Most patients had mixed vascular-degenerative dementia (57 %). On average, patients took 2.1 drugs. 19.9 % of the patients had medications with potential adverse effects on cognition. Patients with medication affecting cognition had a worse cognitive performance than patients with a medication not influencing cognitive functioning (Mini-Mental vs. 18.8. 22.01, p = 0.01) in univariate analysis. Psychotropic drugs were used less frequently (38 %) than primary non-CNS medication. The results remained unchanged even after performing a case-control study with the mixed dementia population with age and gender matched patients. However, in multivariate analysis, only the absolute number of medication taken remained as an independent factor. Our data highlight the clinical importance of medication history in the diagnostic work-up of cognitive impairment. The absolute number of medication taken seems to be more important than medication with possible adverse side effects on cognition.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"523-7"},"PeriodicalIF":0.6,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0028-1109625","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40002996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Addiction in DSM V and ICD-11 state of the art].","authors":"O-M Lesch","doi":"10.1055/s-0028-1109590","DOIUrl":"https://doi.org/10.1055/s-0028-1109590","url":null,"abstract":"<p><p>Diagnoses are made for identifying rather homogeneous groups of patients being thereby relevant for research and for therapy. Therefore diagnostic manuals, like the DSM-IV and the ICD-10 are subjected to changing knowledge derived from research on one hand and to changes of clinical necessities. The diagnosis of substance related disorders, published for DSM-IV in 1994 and for the ICD-10 in 1992, has proven of value for epidemiological research and economic validation. In spite of these advantages the concept has prove to be too broad and rather unspecific for research, specific therapeutic strategies and for defining an illness course. During the last 20 years research has yielded many criteria of interest, which never entered DSM IV or ICD-10, remaining therefore on the level of single items, which are nowadays additionally assigned to all patients (like e. g. early versus late onset) or on the level of typologies (like e. g. Lesch's typology) demanding different treatments. To give an example: acamprosate has lasting relapse preventing effects in Lesch types I and II, while naltrexone is effective in types III and IV. For rendering an expertise in Germany, the referring literature recommends to utilize Lesch's typology additionally to the ICD-10 diagnosis, especially when prognosis or therapeutic strategies are demanded. Since 1999 different expert groups strive for including new criteria into DSM IV and ICD-10. The revised manuals should include easily assignable items for severity of different arrays (time illness onset, co-morbidity, withdrawal symptoms, bridge symptoms and neurological sequela). Different therapy stages (e. g. withdrawal or relapse prevention) need a different weighting of individual symptoms (e. g. degree of intoxication, severity of withdrawal is needed for acute treatment, while an assignment of co-morbidity and personality factors is necessary for relapse prevention). This quantifier is rendered by Lesch's typology, which is available in the form of a computer programme, based on a decision tree (see also www.ausam.at - Typology according to Lesch). Non substance related disorders should enter other diagnostic categories, like e. g. impulse control disorders. A revised diagnostic classification suggests presently offered therapeutic strategies to follow up with necessary modifications. A tailor made therapy according to subgroups can result in better long term performance of therapies offered to persons suffering form substance related disorders.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"507-12"},"PeriodicalIF":0.6,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0028-1109590","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40002995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Folie à deux - mental infection or individual psychosis].","authors":"B Jabs,&nbsp;K Jabs,&nbsp;A Reif,&nbsp;B Pfuhlmann","doi":"10.1055/s-2007-980123","DOIUrl":"https://doi.org/10.1055/s-2007-980123","url":null,"abstract":"<p><p>The phenomenon of folie à deux has been a topical issue in psychiatry for more than a century. Mainly, genetic and psychodynamic factors are discussed controversially in terms of their relevance to the etiology of folie à deux. In this paper, effort is taken to reconceive the topic applying the criteria of a differentiated psychopathological classification. Based on the literature and on two own cases, we try to elaborate characteristical psychopathological features of folie à deux patients. We hypothesize that at least a substantial fraction could be classified as \"folie simultanée\" when Leonhard's criteria of the affect-laden paraphrenia are considered.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"149-54"},"PeriodicalIF":0.6,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2007-980123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40998170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Off-label use in psychiatry].","authors":"M Weih,&nbsp;N Thürauf,&nbsp;S Bleich,&nbsp;J Kornhuber","doi":"10.1055/s-2007-980126","DOIUrl":"https://doi.org/10.1055/s-2007-980126","url":null,"abstract":"<p><p>In psychiatry, there is an increasing use of drugs Off-Label. Especially antidepressants and antipsychotic drugs are prescribed more often outside approved indications. Main problems with Off-Label Use are drug safety, lack of reimbursement by health care providers and insufficient coordination between clinics and primary care psychiatrists. Many, especially older psychotropic drugs are approved for psychopathologic phenomena rather than on ICD-10 categories. According to current judication of the German supreme court for social issues, specific criteria for Off-Label Use have been defined. Now, in social legislation, under particular circumstances Off-Label Use is feasible. Recommendations of expert groups for psychiatry are currently lacking, but are expected in next future for Methylphenidate in treatment of adult attention-deficit-hyperactive disorder (ADHS). Especially important for all psychiatrists is to receive informed consent of the patient before initiation of a drug therapy Off-Label.</p>","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"7-13"},"PeriodicalIF":0.6,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2007-980126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40998169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Neurosyphilis--diagnosis and treatment approaches in clinical psychiatry].","authors":"H-B Rothenhäusler","doi":"10.1055/s-2007-959189","DOIUrl":"https://doi.org/10.1055/s-2007-959189","url":null,"abstract":"Bei der Syphilis handelt es sich um eine Infekti− onskrankheit, die durch den bakteriellen Erreger Treponema pallidum, subsp. pallidum aus der Gattung der Spirochäten verursacht wird. Die Übertragung des Syphiliserregers geschieht mehrheitlich durch Sexualkontakte. Syphilis heißt daher in der klinischen Medizin auch Lues venerea (1Lustseuche“). Der direkte oder indirek− te Nachweis von Treponema pallidum unterliegt somit in Deutschland einer nichtnamentlichen Meldepflicht an das Robert Koch−Institut gemäß §7 Abs. 3 des zum 1.1.2001 in Kraft getretenen In− fektionsschutzgesetzes (IfSG) [1].","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"737-44; quiz 745"},"PeriodicalIF":0.6,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2007-959189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41053604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[New diagnostic concepts and tools for the dementias--so what?].","authors":"C-W Wallesch","doi":"10.1055/s-2007-980152","DOIUrl":"https://doi.org/10.1055/s-2007-980152","url":null,"abstract":"Korrespondenzadresse Prof. Dr. med. Claus-Werner Wallesch Otto-von-Guericke-Universität Magdeburg, Universitätsklinik für Neurologie Leipziger Str. 44 39120 Magdeburg neuro.wallesch@ medizin.uni-magdeburg.de Prof. Dr. med. Claus-Werner Wallesch Die Versorgung von Menschen mit Demenz stellt ein rasch zunehmendes epidemiologisches, medizinisches, ethisches und çkonomisches Problem dar. „The decade of the brain“ war motiviert von der gesellschaftlichen Herausforderung durch die rasch steigende Zahl Demenzkranker in den USA. In Deutschland wurde das Kompetenznetz Demenzen initiiert und die Bundesregierung plant nun eine nationale, zentral koordinierte Initiative zur Demenzforschung. Demenzforschung heute reicht von Grundlagenforschung zu Pathomechanismen bis hin zur Versorgungsforschung, von der Definition und diagnostischen Abgrenzung weiterer degenerativer Demenzerkrankungen über verbesserte diagnostische Verfahren und Algorithmen bis hin zu innovativen therapeutischen Ansätzen – mit bislang meist wenig versorgungsrelevanten Ergebnissen bei den degenerativen Demenzerkrankungen. Dennoch erscheint dieser Weg richtig, wie die Entwicklung bei den vaskulären Demenzen zeigt. Intensivierte Diagnostik und „Gefäßhygiene“ haben die vaskuläre Demenz zu einer verhinderbaren und – bei Früherkennung – behandelbaren Erkrankung gemacht. Inwieweit „Gefäßhygiene“ auch degenerative Erkrankungen v.a. vom Typ Alzheimer zu verhindern oder zumindest zu verzçgern vermag, bleibt offen [1– 3]. Denkbar ist z. B., dass die vaskulär bedingte Noxe den Manifestationszeitpunkt einer degenerativen Demenzerkrankung zeitlich um Jahre vorverlegt, wie es für schwerere Schädel-Hirntraumen zumindest epidemiologisch nahegelegt wurde [4]. Wegen der großen wissenschaftlichen und Versorgungsrelevanz haben die Fortschritte das Thema der Demenzen in den letzten Jahren immer wieder aufgegriffen, so z.B.","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"691-3"},"PeriodicalIF":0.6,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2007-980152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41053603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[\"Depression arrived in health politics\"].","authors":"M Wolfersdorf","doi":"10.1055/s-2007-993027","DOIUrl":"https://doi.org/10.1055/s-2007-993027","url":null,"abstract":"","PeriodicalId":509563,"journal":{"name":"Fortschritte der Neurologie · Psychiatrie","volume":" ","pages":"633-4"},"PeriodicalIF":0.6,"publicationDate":"2007-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2007-993027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41006077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}