Psychiatrie, Neurologie, und medizinische Psychologie最新文献

Clinical psychopathology has a diagnostic and therapeutic purpose. On the level of phenomenology one has to deal with four paradoxes. 1. The paradox of gradual transition from normality towards pathology versus the occurrence of symptoms of a new quality, 2. the paradox of nosological nonspecificity of various symptoms versus typical constellations of special symptoms for certain diseases, 3. the paradox of pure and typical symptoms and diseases versus symptoms and diseases which are mixed and non typical. 4. The paradox of the prevalence of psychopathological phenomena versus prevalence of somatic phenomena in one and the same disease. On the level of etiology one must face the fact that there are not only typical endogenous, exogenous (organic) and psychogenic syndromes. Neurotic symptoms may have an endogenous cause. Therefore neuroses may be treated effectively with antidepressants.

The slight therapeutic breadth involved means that manic depressive lithium prophylaxis may call for life-long routine management. The lithium/serum-level checks required hitherto are here compared with a non-invasive method, that of determining the lithium level from a mixture of the patient's saliva, a method involving no danger that will eventually assume considerable importance.

Despite the obviously more important degeneratively conditioned dementias, particularly of the Alzheimer-type, dementias due to vascular disorders are still of considerable relevance. They are even predominant among autopsies in a neurological-psychiatrical hospital, showing, however, a decreasing tendency. Though this cannot reflect the real incidence of a disease, because many cases of dementia die in geriatric or nursing homes, mostly not autopsied, exact epidemiological examinations of autopsy-cases seem to be advisable, limited temporarily and locally for economic reasons. Topographical specialities and modern methods of investigation in living persons increasingly enable a differentiation of vascular and degenerative dementias and thus frequently an effective treatment.

Among 28 autopsy-cases with EMC had been none diagnosed clinically before. Typically we found an interstitial myocarditis and perivenous encephalitis with a preferred participation of the brain stem, eventually resulting in a central failure. There were only 5 cases with meningitis. Myelitis was not found. Former cardiac, less often cerebral lesions are likely risks for the lethal event.

The terms Notfall and Krise, and the semantic problems arising, are elucidated; and an analysis of one years work in provision for emergency psychiatry and stress intervention is presented. Psychoreactive syndromes were found to be most common, followed in second place by psychotic conditions. In third place come disorders in connection with alcohol, which display a rising tendency. 40% of the clinic's beds are occupied by acute emergency cases, chiefly of short duration. Emergency provision is thus shown to be a major feature in the work of psychiatric clinics.

The investigation involved 30 hysterical women, who were interviewed and who completed four questionnaires relating to: psychosexual development; attitude towards sexuality; sexual activity; and reactivity. Dysharmonic sexual development, and low levels of activity and reactivity in their sexual life was revealed. Contrasted with other groupings of female psychiatric patients, from a sexual point of view the female hysterical personality presents a special psychological case.

20 patients with schizophrenic disorders, displaying a depressive syndrome, were given bright-light therapy, and compared with 11 patients treated by means of partial deprivation of sleep. Against a figure of 27% in the case of sleep-deprivation, syndrome remittance was 55% in the case of bright-light therapy. Psychometric data were obtained by use of three external-assessment schemes (HAMD, BPRS, and NOSIE) and two self-assessment procedures (TSD, POMS). As depressive syndromes improve under bright-light therapy, schizophrenic symptoms also recede, which suggests close syndromatologic links in the sense of a universal genesis of psychoses.

From a starting point of therapeutic and prophylactic components identifiable in the dance, the authors regard the dance as deserving of greater attention than was hitherto the case in programs of physiotherapy, psychotherapy, and sociotherapy. From the existing essays at a therapy basing on body and motion, they infer basic common points, and to promote discussion, they state their attitudes in respect of the potential and rank of the dance in the concept of complex multimodal psychotherapy.

From the starting point of cases reported in literature, five of the authors' own cases are reported in which multiple sclerosis had its origins not later than in the fourteenth year of the patient's life. There is no basic difference from adult cases in respect of neurological symptoms, course, and cerebrospinal-fluid condition, but unmistakably, well remitting episodic courses were in the foreground, multilocular failures preponderated, and cerebral symptoms predominated over spinal symptoms. As in adult cases, females were more commonly affected. There were inflammatory changes in the cerebrospinal fluid.