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B Blanz

Publications and source records attributed to B Blanz.

52 records · Page 3Linked to original sources
PubMed1991

Familial adversities and child psychiatric disorders.

The well known association between child and adolescent psychiatric disorders and chronic adversities was proved in a field sample. Children (356) were investigated at the ages of 8 and 13 years. The association between child psychiatric disorders and chronic adverse conditions in the familial environment--measured by the FAI--was analysed with respect to the variables: age, sex, psychiatric diagnoses, and course (stability) of disorder. The FAI proved to be predictive of psychiatric disorder, in particular of early onset disorder, of disorders in boys, and of conduct disorders. According to the results, the common assumption that chronic adversities cause child psychiatric disorders must be viewed cautiously.

Adolescent↗
PubMed1990

Psychiatric disorders in children and adolescents: results of the ICD-10 field trial.

Of the numerous changes made in the classification of psychiatric disorders in children and adolescents in ICD-10 the most important are described. In an evaluation of the revised scheme, 7 raters from 2 facilities classified 40 case histories with both ICD-10 and ICD-9 codes. For ICD-10 and 4 character codes the level of agreement was 56% (ICD-9: 60%). As expected, 3-character codes yielded better agreement (ICD-10: 71%; ICD-9: 72%). Within-facility agreement was roughly the same for each. The lowest levels of agreement for a given category were for mixed disorders of conduct and emotions (F92) and depressive disorders (F31, F43). The reasons for this are discussed.

Adolescent↗
PubMed1990

Phenomenal and operationalized classification of psychiatric disorders in children and adolescents with ICD-9 and ICD-10, on the basis of a field study.

In connection with the implementation of ICD-10, a further multicenter field study was conducted with 33 raters from 9 facilities for child and adolescent psychiatry. Each rater evaluated the same 29 case studies, resulting in a total of 957 ratings. When coding was done with 4-character ICD-10 codes interrater agreement on a given diagnosis averaged 50.3% (ICD-9: 47.3%); with 3-character ICD-10 codes the figure was 61.0% (ICD-9: 66.5%). When alternative diagnoses were also considered, agreement improved by about 7% (4-character codes) and 7.4% (3-digit codes), respectively. The highest levels of agreement were found for monosymptomatic disorders (F94, F95 and F98), the lowest for mixed disorders of conduct and emotions (F92) and depressive disorders (F31, F43). These results indicate that, on the whole, psychiatric disorders in children and adolescents can be classified reliably with the ICD-10, even when the raters have had no experience with the scheme.

Adolescent↗
PubMed1990

ICD-10 field trial in German-speaking countries--summary, judgement and perspectives.

On the basis of the results of the field trial, the most important classificatory innovations of ICD-10, together with their advantages and disadvantages are described. The initial good acceptance of the new system could be further improved by structural modifications, such as a uniform and systematic description of the individual diagnostic categories. Criticism of content was focused on affective and neurotic disorders and adult personality disorders. When it is introduced, the psychiatric chapter of ICD-10 will surpass most of the hitherto existing psychiatric classification systems in size, differentiation and international testing.

Adolescent↗
PubMed1990

Conduct disorders (CD): the reliability and validity of the new ICD-10-categories.

The conduct disorders (CD) were re-grouped in the 10th revision of the International Classification of Diseases (ICD-10), that comes into force in 1990. The new categories and the empirical findings based upon them are presented. The interrater reliability for the CD was satisfactory at 48.5%, but was clearly lower for the CD with emotional disorders with a correspondence of 33.3%. In a longitudinally examined field random test the total amount of CD increased clearly between 8 and 13 years, whilst it remained more or less constant between 13 and 18 years. The symptom load as parameter for the degree of severity of a disorder was significantly different to the disadvantage of the unsocialized in the 13 year olds between the CD without and with socialization, but was not so in the children and young adults. In the long-term, as far as the symptom load is concerned, there were no important group differences.

Adolescent↗
PubMed1990

[Reliability of child and adolescent psychiatry diagnoses in ICD-10].

In the following, the findings from a field study on the reliability of ICD-10 for classifying psychiatric disorders in children and adolescents are presented. In the main study there were 33 raters from 9 different facilities; each rater assessed 29 case studies independently. The evaluations of the 29 case studies independently. The evaluations of the 29 case histories yielded 957 ratings. When 4-digit ICD-10 codes were used, the most common main diagnosis was coded by an average of 50.3% (ICD-9: 47.3%). When 3-digit ICD-10 codes were used, the figure was 60.6% (ICD-9: 66.5%), that is, as expected, agreement was clearly better. When alternative diagnoses were considered, agreement was substantially better; the same was true for intensive schooling of the raters (additional study). Some diagnoses were rather difficult to differentiate from each other. Among these were the mixed disorders of conduct and emotions (F92). The main problem was differentiating between this disorder and the categories conduct disorder (F91), emotional disorder (F93), affective disorders (F30-F39), and neurotic disorders (F40-F49). There were also problems classifying age-related depressive disorders which in ICD-9 could be coded under 313.1, probably in part because this category does no longer exist in ICD-10. These disorders have now to be coded as depressive disorders (F31.1, F33.1 or F34.1). The diagnostic descriptions of these categories are based mainly on the symptoms typical in adults. No facility-related tendencies to code in a particular way are evident.

Adolescent↗
PubMed1989

Conversion disorder (DSM-III 300.11): symptomatology and course in childhood and adolescence.

The incidence, age and sex distribution, symptomatology, psychosocial stress factors and course of conversion symptoms in a child and adolescent psychiatric patient sample were studied. Under the age of 10 conversion symptoms are comparatively rare and consequently require careful diagnosis, particularly regarding visual and hearing defects. Predominant conversion symptoms are seizures, gait problems and paralysis.

Adolescent↗
PubMed1989

Somatic findings in children and adolescents with anorexia nervosa.

94 patients (mean age 15,4 years) with anorexia nervosa were investigated. We found cardiovascular parameters in correlation with body weight. ECG-changes had no connection with weight and concentration of potassium. Pulse and systolic blood pressure decreased, concentration of urea and SGOT and SGPT increased with weight decreases. Compared with the results of the adults of Fichter (1985), pulse and blood pressure changed more often, whereas the concentration of potassium often rested unchanged. Therapy with neuroleptics calls for ECG-controls. Interesting was the finding that we found less raised levels of cortisol in the group with extremely low weight on admission.

Adolescent↗
PubMed1989

Anxiety syndromes in childhood and adolescence.

Anxieties are very widespread in children and adolescents, they only rarely to lead to the need for medical care. Physiological anxieties as phenomena dependent on maturity are differentiated from anxiety syndromes typical to age according to the degree of severity or the persistence of the signs and symptoms. Typical forms of age-typical syndromes are fear of separation, childish phobias, anxiety syndromes with shyness, going into one's shell, avoidance behaviour as well as school phobias. These confront the generalized anxiety disorders and the phobias as anxiety syndromes, which occur in children, adolescents and adults. The various anxiety syndromes were discussed in this order, information concerning anxiety symptomatology in the framework of depressive syndromes and other psychiatric illnesses in children and young people are to follow. Besides descriptions of the signs and symptoms, in particular concerning differential diagnosis and ..reflections are described.

Adolescent↗
PubMed1988

[A scale for assessing the social adjustment of children and adolescents].

In DSM-III the highest level of social adaptation attained is diagnosed on a special diagnostic axis. Thus, separate statements about general impairment in children and adolescents with psychological disturbances can be made independently of specific diagnoses and severity ratings. The present study reports theoretical considerations and the results of the construction of an operationalized scale that measures social adaptation in the areas of family, school and peer group using information about leisure time activities independent of an individual's psychiatric symptoms. In general, the correlations between the social adaptation level and psychiatric disturbances were rather low, the closest association being in the school domain (grade-point average). The reasons for this are discussed.

Adolescent↗
PubMed1987

[Hysterical neuroses in childhood and adolescence].

A sample of 148 child and adolescent psychiatric patients with hysterical neurosis is described as to the variables features and extent of symptomatology, age and sex distribution, psychosocial adversity and prognostic factors. Out of the "classical" symptoms seizures, walking disturbances, twilight attacks and paralyses were seen most frequently whereas vision and hearing disturbances were rather rare. Only one fifth of the patients presented a monosymptomatological pattern of disturbance. Mean age at falling ill was 13.4 years, just three children were younger than 6 years. Our clinical results buttressed by other reports of the child and adolescent psychiatric literature indicate that the traditional concept of hysteria postulating a close link between somatical symptom development and a specific intrapsychic conflict is hardly tenable at least for childhood and adolescence. Classification should be rather grounded upon an essential phenomenological approach as designed by ICD 10.

Adolescent↗
PubMed1986

[Conversion symptoms in childhood and adolescence].

Departing from a review of definitions of conversion phenomena and hysteria, the necessity to conceptually disentangle these two terms, particularly in childhood and adolescence, becomes evident. Divergent literature reports concerning occurrence rates, gender and age distributions, symptomatology, therapy, and long-term outcome hardly justify the notion of a conversion syndrome representing a clearly distinguishable clinical entity. Thus, it is recommended that diagnosis and treatment of conversion symptoms should not depend on restrictive theoretical considerations. In accordance with the wide range of underlying aetiological factors, the suggested strategy rather emphasizes the advantages of supplementing a basic understanding of the involved psychodynamic aspects by the application of behaviour therapy as well as family therapy techniques.

Adolescent↗
PubMed1986

[Role of the father in the development of school-age children. Results of an epidemiologic study].

As part of an epidemiological follow-up study, data collected from 356 children at ages 8 and 13 and from their parents were analyzed to examine the relationship of parental child-rearing behavior and parents' psychological problems to the intellectual, emotional and social development of the offspring. The results revealed that while children are growing up father and child influence each other in specific ways. The fathers were particularly active in developing their children's cognitive abilities and had a strong influence especially on the development of their sons. At both age 8 and age 13, children whose parents had psychiatric disturbances, regardless of which parent was affected, were much more likely than those with normal parents to have psychiatric disorders themselves. Significant parental gender effects were found, however, when the form of the child's disorder was considered: At age 13, the children were at a higher risk for a conduct disorder if the father had a problem than if the mother did. In further analyses, children who had lost their fathers were compared with those in intact families. Significantly higher rates of psychiatric disorders were found for the fatherless boys, whereas no such effect could be detected for the fatherless girls.

Adolescent↗
PubMed1986

[Child and adolescent psychiatric classification in an unselected sample--a comparison of MAS and DSM-III].

As part of an epidemiological study, the diagnoses of children with psychiatric disorders at age 13 were determined according to the criteria of both the ICD-9-oriented Multi-Axial Classification Scheme (MAS) and the Diagnostic and Statistical Manual, 3rd ed. (DSM-III). A comparison of the diagnosis pairs showed that in most cases (76%) comparable diagnostic categories had been selected. Discrepancies were found mainly in the use of the diagnoses "conduct disorder" (ICD, DSM-III: 312) and "age-specific emotional disorder" (ICD, DSM-III: 313). Severity of disorder had little impact on the extent of agreement between the two classification procedures. In an additional analysis the comparability of the threshold values used in the case definition criteria in the two systems was examined. The DSM-III criteria yielded 11 more cases of psychiatric disorder than the MAS criteria, 10 of these with the diagnosis of "attentional deficit" (ICD, DSM-III: 314).

Adolescent↗