Psychiatrie, Neurologie, und medizinische Psychologie最新文献

A comparison was carried out between 237 hospitalised patients with emotional disorders during the years 1972-1975, and 316 patients between 1982 and 1985. The number of admissions as a percentage of all psychiatric admissions rose from 18.21% to 26.49%. There was a significant rise in the number of readmissions, notably from the third admission upwards, but a considerable reduction in the length of stay in hospital. During the period the number of admissions to general hospitals within the catchment area was reduced by about one half, with the result that there was no appreciable overall increase in the number of admissions for in-patient treatment of emotional disorders in the ten-year period.

Under the acute influence of alcohol with blood alcohol concentrations (BAK) ranging between 0.62 to 2.04%, the IPL prolongations of our subjects were within standard deviations compared with normal data. Depending on the BAK, these minor IPL alterations hint at a special vulnerability in the pontomesodiencephal area. The increase in BAK significantly correlates with the reduction of body temperature. The BAEP proves to be suitable for defining undear states of coma different origin.

The question if there are "symptomatic schizophrenias" has been discussed since the 20s. Schizophrenic psychoses caused be definable and well known brain diseases are presented. All schizophrenic symptoms and syndromes, the first rank symptoms (K. Schneider) too, occur in somatically founded psychoses. The group of paroxysmal transition syndromes in the sense of aura prolongata (continua) and the episodic schizophrenic psychoses in psychomotor epilepsy may be a model for the schizophrenia research. Vital threatening, so-called pernicious catatonic schizophrenias are found on the basis of infectious brain diseases, sometimes only diagnosed in autopsy. Beside acute and reversible symptomatic schizophrenic psychoses there are, even if rarely, recurrent and chronic courses of symptomatic schizophrenias. That certain conditions for the developing of symptomatic schizophrenias are rarely realised, could be an explanation for their rarity. Some findings indicate that the limbic system is significant for symptomatic (and idiopathic) schizophrenic psychoses and the pre- and postpsychotic basic stages determined by dynamic and cognitive basic symptoms, which are phenomenologically very similar to aura symptoms released by stereoelectroencephalographic depth recordings (Wieser). The characteristic features of marked fluctuation, discontinuity and insteadiness of the cognitive thought, perception, psychomotor and cenesthetic phenomena do not speak against an organic brain disorder provided that the traditional process hypothesis is abandoned in favor of a neurobiochemic disorder, fluctuating on its part depending on endogenous as well as psychic-reactive factors.

Nietzsche's autobiography gestates neither conflicts, nor life problems, nor matter suppressed from his subconscious, nor are the speech distortions of the schizophrenic patient to be found. In all, analysis allows with certainty the conclusion that is was written by a sick person suffering from a psycho-organic disorder of the kind Bonhoeffer referred to by the general term "symptomatic psychosis".

Karl Bonhoeffer set great value on the precise description of psychopathological findings, and was the first to stress the very close relationship between Wernicke's encephalopathy and Korsakoff's psychosis. Proof of mnestic deficiency is still today very important in the exact analysis of chronic symptomatic psychoses. Knowledge acquired in neuropsychology must be incorporated into psychopathometry to enable a more exact analysis of chronic cerebral psychosyndromes. The paper presents a new test to measure mnestic deficiency, suitable for the examination of patients with pseudoneurasthenic syndromes, organic change of personality, or mild early forms of dementia.

Against the background of the lifetime of Karl Bonhoeffer, March 31, 1868 to December 4, 1948, and the eighty-year-old concept of symptomatic psychoses, a sketch of the latter is set out and its present significance in symptomatology and research followed up.

It is the opinion of the present writer that endogenous and symptomatic schizophrenia are two completely different matters. By classical symptomatology it is impossible to establish the distinction in every individual case. Nevertheless, in not one of the published cases known to us did Bonhoeffer err in his diagnosis of the one or the other. Evidently he made use of additional characteristica gathered in practice, about which he himself may not always have been quite clear.

It is reported on a mental retarded female, observed from 3-33 years of age, which demonstrated even in adulthood with long lasting shrill crying the clinical leading symptom of Lejeune syndrome and further typical symptoms with inhibition of physical maturation, important delayed motoric and mental development, microcephaly resp. characteristic craniofacial dysmorphia, anomalies of extremities, muscular hypotonia and susceptibility to infection. Psychically there were a striking affective instability and irritability, neuropathologically pachygyria and multiple cortical heterotopias.