Biomedical subjects
Publications and source records attributed to A Finzen.
The frequency of seclusions per admission was not reduced. Patients in seclusion were mainly male schizophrenics, as three years before. The main difference was a drastic reduction of time of seclusion in two thirds of patients.
Assisted suicide has become a topic often and controversally discussed in international literature. Psychiatry and mentally ill, however, have been neglected, probably because the question of competence of judgement and will are a major issue in this matter. Two cases are reported, one of a 60-year old man and a women of 87 years, who have committed suicide a few days after having been dismissed from stationary psychiatric care. The reason of admission had been a psychotic event with manifest AIDS-disease in the first, the public utterance of her wish to die with support of, the swiss "Help to Die" organization "Exit", in the latter. Ethics and means of preentive interventions in such cases are discussed.
Several science history studies have recently focussed on the fate of the first German-speaking lady jurist qualified for lecturing in jurisprudence. Emilie Kempin-Spyri (1853-1901), a niece of the Swiss author Johanna Heusser Spyri who wrote the classical children's story Heidi. In practically all these studies, Emilie Kempin-Spyri's mental disturbance has been instrumentalised for developing historical, sociological of feministic theses. Basing on recourse to hitherto unpublished material excepted from hospital records, the authors of the present article examine the psychiatric perspectives of the interlinking of life and patient history. Taking as an example the manner in which the life and death of Emilie Kempin-Spyri has been visualised in the literature, the authors point out that mental disease is mainly viewed under the aspect of a possible interpretation or significance of the person and his or her life. In this manner, science history and biographical studies exercise an influence also on today's social representations of mental disease.
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Newspapers reports on ECT are extremely biased. A quantitative analysis of four German and Swiss papers demonstrates impressingly the change of meaning of synonymous terms like "Elektroschock" and "Schocktherapie" which refer to torture and brutal reforms of Eastern European communist economies.
Single case reports are common in Anglo-Saxon but not in German medical journal. The "Psychiatrische Praxis" intends to follow foreign tradition. 1996 it published 30 single case reports with a wide clinical spectrum in diagnostics and therapy.
Beyond traditional psychotherapy many new psychotherapeutic schools and methods strive for recognition. Many of them offer psychotherapeutic training by advertisement in Psychologie heute, a popular psychological magazine. These advertisements are analysed. Possible consequences of this flouristing market of methods on social representation of psychotherapy are discussed.
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The term "Social Psychiatry" was first used in English in 1917 by E. E. Southard. Six years before, in 1911 Max Fischer, director of Wiesloch Mental Hospital near Heidelberg employed the terms "Sozialpsychiatrie" and "Soziale Psychiatrie" in German.
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Restrictive measures are widely used in psychiatric hospitals. But they are ill reputed. Little is known about them. This study is about the administration of isolation of mentally ill patients in a psychiatric hospital. 274 isolations of 100 patients within 11 months are recorded. Isolations concern 5% of the treated patients. That means two isolations on 1000 days of hospitalization. Mostly concerned are patients with schizophrenia or manic episodes. The most frequent reasons given were protection or irritation, danger for the patient or others but also molestation or provocation.
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Pharmacotherapy of schizophrenia is a complex matter. Neuroleptics play a dominant role in the acute stage. They have to be complemented however by psycho- and sociotherapeutic measures. In particular when negative symptoms prevail drugs can worsen the course of the disease. In contrast to earlier opinions calling for high-dose treatment, recent studies have demonstrated effectiveness of low- or medium-dose regimens that carry a lower risk of side effects. Six to 18 mg of haloperidol per day constitute an effective neuroleptic dose. Higher doses are in addition sedating. In the course of a treatment the lowest effective dose has to be sought continuously. Complications such as depressive dysphoric states should before all encourage to consider and rule out overdosage. Long term compliance depends crucially on avoidance of undesired or adverse effects of medication, in particular during induction treatment.
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Carbamacepine is an effective drug in the treatment of acute manic states as well as in preventing relapses in the course of manic-depressive illness. Many controlled studies show that carbamacepine is a valuable alternative and an implementation to the existing methods of treatment. Treatment of acute mania can be more rapid, more specific of carbamacepine is used or combined with neuroleptics (or occasionally with lithium). There are less side effects in carbamacepine treatment than in conventional treatment. In relapse prevention carbamacepine is probably as effective as in lithium. The essential progress of using carbamacepine is given, because more patients are eligible for a regime of relapse prevention: Patients that have proven resistant to lithium treatment and patients with contraindications to lithium. Carbamacepine treatment presents an important breakthrough in Rapid Cycling Affective Psychoses. Here it may be superior to all other methods of treatment.
Social Psychiatry mostly is perceived as social epidemiology. But other branches of sociology and social psychology have influenced its history as well, e.g. family sociology and the sociology of institutions. Recently, research in family milieu and social environment has gained some importance. It is demonstrated how research in social psychiatry follows developments in other social sciences.