Archiv Fur Psychiatrie Und Nervenkrankheiten最新文献

The admission data of the psychiatric unit of the Hannover Medical School for the period 1973 to 1981 were studied by time-series analysis (Box and Jenkins 1970). The total number of admissions as well as subgroups formed according to diagnosis, sex and age did not show any seasonal variations.

The psychopathological and somatic symptoms documented by the AMDP-system on the admission of 1654 patients to the Psychiatric Clinics of the Universities in München und 659 patients in Berlin were factor analyzed. Eight factors could be extracted which describe the psychopathology on eight syndrome-scales. These factors could be cross-validated by factor analyses on random samples. In correspondence with the factors of the AMP-system the following syndromes were found: paranoid-hallucinatory, depressive, psycho-organic, manic, hostility, autonomic, apathy, obsessive-compulsive. For each of the 70 items which were associated with a factor we computed the percentage occurrence and item-scale-intercorrelations, for each of the eight syndrome-scales reliability-coefficients, intercorrelations and T-transformations. For further data-reduction second-order-factors were also computed.

There is some evidence for a relation between critical life-events and the excessive drinking of alcoholics; the present study fits well into the approach of life-event-research assuming an aggregation of life-events and difficulties to elicit or cause excessive drinking. In all 25 men who were in danger of becoming excessive drinkers and 29 who were not--all between 18 and 24 years of age--were asked for their life-events and difficulties within the past 5 years. The LES by G. Brown was used for assessment. The results showed clear evidence for the basic hypothesis of life-event-research; to account for this a 'model of an addictive threshold' is proposed. A qualitative analysis of the experienced difficulties and the way of coping throw some light on the nonspecificity of critical life-events within the stress model.

Eighteen adult patients with typical history and signs of normocalcemic tetany (hyperventilation syndrome) and 18 age- and sex-matched controls were submitted to a provocation test for tetany. This consisted of 10-min ischemia of the right arm produced by suprasystolic cuff compression at the upper arm (Trousseau test) and a postischemic electromyographic recording from the right interosseous I muscle. Postischemic repetitive discharges were found in all patients and predominantly consisted of multiples of 5 times and more. These discharges lasted 8 min on the average. Of the normal controls, as many as 16 subjects (88.8%) also exhibited tetanic discharges. However, these preferred a lower number of repetitions, such as doublets or triplets. Both number of repetition and duration of postischemic tetanic activity were significant parameters discriminating between patients and controls (2P less than 0.001), as was the cumulative total number of spontaneous potentials, amounting, on the average, to 10,266 in the group of patients and to only 320 in the controls (2P less than 0.001). The investigation has shown that the occurrence of postischemic tetanic spontaneous activity per se does not help to discriminate between cases of latent tetany and healthy controls. However, a normocalcemic tetanic condition may be assumed if multiples occur with a complexity of quadruplets or more, if these multiples last at least 2 min, and if they appear in a rhythmic order and in groups.

A female patient with subacute neurological deficits secondary to an hereditary vitamin B12 deficiency was repeatedly examined clinically and neurophysiologically. It is concluded that neurological normalization after treatment with vitamin B12 also occurs within the CNS. Such normalization takes place soon after initiating treatment and probably reflects other neuronal mechanisms that remyelination, i.e. recovery from conduction block in fast somatosensory pathways and/or improvement of synaptic transmission.

Looking through the items of the FPI the hypothesis was proposed that the FPI determines aspects of the alcohol-withdrawal-syndrome. Greater deviations from standard norms found on admission and greater changes during inpatient treatment can be attributed to the occurrence of withdrawal symptoms and their improvement. Alcoholics without withdrawal symptoms seem to describe themselves quite normally on personality dimensions.

For an investigation on the question of whether fertility rates of schizophrenics have been increasing in recent times, two cohorts of patients were defined on an epidemiological basis. The patients were first admissions during either 1949-50 (n = 183) or 1965-67 (n = 228). The conditions of case definition as well as their demographic and psychiatric characteristics are described. These data are necessary for the evaluation of reproductive rates observed in the patient sample. Furthermore, the two cohorts of patients may be of general interest, because they comprise patients first admitted to a hospital who were completely ascertained in a certain region and time period. They reflect certain changes in hospitalization practice in Germany.

Eye movements in five patients with chronic bilateral labyrinthine loss were tested with sinusoidal movements during cervico-ocular stimulation and active head movements (0.05, 0.1 and 0.2s-1; 20, 40, and 60 degrees) and were compared with healthy subjects. Consideration was given to saccadic activity and slow phase velocity of nystagmus and overall gaze shift. The cervico-ocular response was not altered in the patients. During active pendular head movements the saccadic activity and slow phase velocity of nystagmus were more reduced than the eye shifts. The phase relation of eye shifts was not changed. In our patients neck to eye responses did not compensate for the abolished vestibulo-ocular reflex.

Cervical and cortical somatosensory evoked potentials (SEP) to median nerve stimulation were recorded in 65 normal subjects. Absolute peak latencies and amplitudes of cervical components N9, P10, N11, N13, P17, and cortical components P16, N20, P25, and N35 were measured. By means of partial correlations the interdependency of SEP-features could be verified in addition to the well-known dependence on arm length and age. In certain respects our results replicate other studies finding significant correlations between age and latency of early SEP-components as well as inverse relations between age and cervical amplitudes. Further analysis disclosed high inter-correlations between the latencies and between the amplitudes of the cervical and cortical components also revealing a certain exceptional position of the positive wave P17. In contrast to an inverse relation of amplitude and latency of the cervical components there were positive correlations between the respective features in the cortical evoked response. The findings are discussed with regard to the current knowledge about the origins of the SEP-components.

In a companion paper we described the disposition of a 75 mg single dose of amitriptyline in normal volunteers who were phenotyped as extensive or poor metabolizers of debrisoquine and bufuralol, and had a four-fold range in the oral clearance of the antidepressant, 50 mg of amitriptyline was also administered to the same volunteers. This paper compares the results after both doses and suggests that the disposition of amitriptyline is linear even in subjects with a low oral clearance. There was no relation between the pharmacokinetic data and the intensity of sedation or of psychomotor impairment.