Psychiatrie, Neurologie, und medizinische Psychologie最新文献

The files of 322 patients with depressive syndromes in the period 1978-1987, covering 413 in-patient treatments, revealed therapeutic factors whose tendency is to lengthen the period of hospitalisation. There is no indication of therapeutic factors with a tendency to reduce the length of time spent in hospital. Lithium treatment was again shown to increase the hospital stay (chronicity of the overall disorder), others being (treatment with/Netofenazat), electric shock treatment during the initial disorder, and optimum simultaneous treatment with thymoleptics.

The paper gives an account of a man, now 32 years old, who has exhibited the typical characteristics of a "Münchhausen Syndrome", increasing in intensity, since later childhood. The increasingly neurological-neurosurgical range of his predominantly simulated and manipulated complaints covers in the main seizures, attempted suicide, craniocerebral injuries, hemiplegia, and paraplegia. The patient has had four operations for a "Cauda Syndrome". The complex conditioning the complaint, and appropriate medical reaction, are discussed with critical reference to previous literature on the subject.

Localised hyperhidrosis is comparatively rare among the vegetative disorders. A case of pathological gustatory and olfactory sudation is reported, with the sequence of symptoms corresponding to that of the Frey syndrome. Working from the reflex nature of the phenomen, the paper puts forward a model to account for the delayed onset of the manifestation following a peripheral lesion. It is assumed that readjustment of the reflex excitation level takes place according to a modification in peripheral afference, and that a decompensation of the central control mechanisms results in a pathological enhancement of the reflex. The hypothesis of peripheral efferentisl denervation hypersensitivity appears insufficient to account for the delay in manifestation, or even to account for the classic Frey syndrome following an affection of the parotid gland.

The methodological requirements for the use of event-related brain potentials (ERPs) in psychiatry are critically reviewed. In particular the development of psychophysiological models is considered as essential for a functional interpretation of ERP-experiments. In addition problems of signal-analysis and clinical diagnosis relevant to ERP-research in psychiatry are briefly discussed. The logic of ERP-research in psychiatry is illustrated by a series of dichotic listening experiments.

Canalized F-waves and H-reflexes occurring on small hand and foot muscles are to be considered symptoms of central disinhibition. Occurrence of these waves and reflexes in patients with hemispastic syndrome is analyzed and correlated with clinical aspects.

Polyneuropathies by long term alcohol dependent Patients are characterized by "axonal" and "demyelinized" type. By abstinence we found a diminution of symptoms.

Wilson's disease is an autosomal recessive inherited metabolic disorder due to a disturbance of copper metabolism. Although the primary genetic defect is not known a longlife treatment is necessary for establishing a negative copper balance by removing the metal of the abnormal body stores. Experiences in handling with this disease in our country over a period of 20 years are reported. Especially epidemiologic findings, the diagnostic procedures and the strategies in therapeutic regimes are discussed. Future advances in genomic diagnostics are mentioned.

101 mental patients hospitalized according to a court decision stayed on average for 9.7 years. General behaviour, social independence and chances for discharge were not related to illness but to the duration of accommodation. The chances for discharge decrease as the stay in hospital increases. The initial medical reasons for hospitalization are the less important factor in the period of in-patient treatment. The foundations for successful medical and social rehabilitation can only be laid in the early stage of accommodation.