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B Küfferle

Publications and source records attributed to B Küfferle.

At least 37 records · Page 2Linked to original sources
PubMed1991

Predicting course and outcome in delusional psychoses.

Eighty-four of 90 patients with delusional syndromes of different nosological attribution underwent a 7-year follow-up. From 179 items covering the whole spectrum of psychiatric description of index examination, 20 were found to be statistically significant in predicting different aspects of course and outcome by stepwise discriminant analysis. Course and outcome were defined by 6 criteria (course of illness, course of delusion, development of deficiency, length of inpatient care, adequate activity and social adjustment) encompassing separate (but only partly independent) aspects of a disorder. In contrast to the literature, clinical and psychopathological variables have major prognostic weight for different psychopathological as well as psychosocial aspects of outcome. Ten of the 20 significant items cover psychopathology, 4 pre-index course, 3 precipating events, 2 data from childhood, and 1 premorbid personality. Our results stress the importance of sensitive data collection and a clear separation of different outcome variables.

Adolescent↗
PubMed1990

EEG-brain mapping in schizophrenics with predominantly positive and negative symptoms. Comparative studies with remoxipride/haloperidol.

EEG brain maps obtained in 48 drug-free hospitalized schizophrenics diagnosed according to DSMIII demonstrated significant differences as compared with normal controls characterized by a decrease of alpha-1 activity, increase of beta activity and acceleration of the centroid. These findings suggest a state of sustained hyperarousal in schizophrenia. While the patients with negative schizophrenia showed a bi-temporal and frontal augmentation of delta/theta activity, patients with florid symptomatology exhibited just the opposite findings. Alpha-1 activity was attenuated, beta activity augmented in both groups with the findings more pronounced in the positive schizophrenia group. The increase of slow activity suggests an organic factor in the pathogenesis of the negative syndrome, which was supported by correlation maps between EEG measures and the apathy syndrome as measured by the AMDP system. Treatment of schizophrenics with predominantly positive symptoms with 2 different neuroleptics such as remoxipride and haloperidol resulted also in differential effects on brain activity: while haloperidol augmented delta/theta and alpha activity and decreased beta activity, remoxipride produced a decrease of slow and increase of beta activity as well as an acceleration of the centroid suggesting vigilance-promoting properties of the drug. These differential effects on the neurophysiological level were also reflected at the behavioural one evaluated by psychometry, while global clinical evaluation showed, as expected, similar improvement with both drugs (apart from extrapyramidal side effects being significantly more pronounced after haloperidol than remoxipride). Our findings suggest that brain electrical signal topography is a promising method in regard to a better understanding of pathogenesis and treatment in schizophrenia.

Adult↗
PubMed1990

A double-blind multicentre study comparing remoxipride, controlled release formulation, with haloperidol in schizophrenia.

A double-blind multicentre study was undertaken to compare the efficacy and safety of remoxipride in a controlled release (CR) formulation given once daily with haloperidol twice daily in patients with schizophrenic illness. In total, 114 patients were included. All were diagnosed as schizophrenic or schizophreniform according to DSM-III. Their mean daily dose of remoxipride CR during the last week of treatment was 385 mg. In the haloperidol group the corresponding dose was 17 mg per day. The intended study period was 4 weeks with at least a one-day washout. No significant differences were found between treatments regarding efficacy variables. The median total Brief Psychiatric Rating Scale (BPRS) score was 40 in the remoxipride CR group at start of treatment and 21 at last valid rating. For the haloperidol group the corresponding figures were 40 and 22. Treatment-emergent extrapyramidal symptoms (Simpson and Angus rating) occurred statistically significantly more frequently and were more severe during haloperidol than during remoxipride CR treatment despite a statistically significantly higher concurrent use of anticholinergic drugs in the haloperidol group.

Acute Disease↗
PubMed1990

Smooth pursuit eye movements in schizophrenia: influences of neuroleptic treatment and the question of specificity.

The authors investigated smooth pursuit eye movements (SPEMs) in 66 schizophrenic and 40 major affective patients and 39 healthy controls. The results showed significant differences of both patient groups as compared to the controls. Schizophrenics with neuroleptic treatment in the preceding 2 years were significantly more disturbed than the controls, the affective patients and the untreated schizophrenics. Acute neuroleptic medication and neuroleptic treatment of a duration of 4-6 weeks appear not to significantly influence the quality of SPEMs.

Adolescent↗
PubMed1988

Group dynamics as an emotional turmoil precipitating psychotic manifestations.

Data on 23 patients developing a psychosis precipitated by group sessions (mainly nontherapeutic groups in a strict sense) are presented. Nearly 70% (16 patients) fulfilled the DSM-III criteria for major affective disorder, while only 4 patients met the criteria for schizophrenia. Possible factors for the development of psychotic symptomatology during group activities and the role of group dynamics acting as stress factors precipitating functional psychoses, especially bipolar manifestations, are discussed.

Adolescent↗
PubMed1986

Delusional psychoses: genetic findings as a critical variable for the validation of diagnostic criteria.

77 patients with delusional psychoses, regardless of their nosological attribution (except severe organicity), and their first-degree relatives were diagnosed with the Research Diagnostic Criteria (RDC) and the Vienna Research Criteria (VRC). The diagnostic procedure was performed blindly in the relatives. Both criteria were sufficiently capable of identifying a schizophrenic and affective subgroup of patients characterized by the appearance of homotypical secondary cases. Apart from a small RDC schizoaffective group differing in genetic pattern, there exists another large group of nonschizophrenic, nonaffective delusional disorders lacking a genetic link to the above-mentioned diagnoses. In respect to the development of the diagnostic criteria, the results of this study call for the formulation of a narrow definition of schizophrenia (as in the VRC) which is based on thought disorder and affective blunting with the exception of so-called productive symptomatology (delusions, hallucinations); separate criteria for schizoaffective disorders (as in RDC), and a broad and nonrestrictive definition for nonschizophrenic delusional disorders.

Affective Disorders, Psychotic↗
PubMed1985

Clinical evaluation of language and thought disorders in patients with schizophrenic and affective psychoses.

56 patients with RDC diagnoses of schizophrenia (n = 40) and mania (n = 16) were interviewed with a structured interviewing procedure. The evaluation was performed by 2 raters who were blind for diagnosis. Two instruments were used for evaluation concerning thought and language disorders: the 'Scale for Assessment of Thought, Language and Communication' developed by Andreasen and the 'Endogenomorphic Schizophrenic Axial Syndrome' by Berner with its emphasis on thought disorders. The interrater reliability for both instruments was found to be good to acceptable for the essential items. A comparison of the frequency of thought disorders according to the two different instruments showed an occurrence of derailment and incoherence of the Andreasen scale in both diagnostic groups, while thought disorders of the schizophrenic axial syndrome were represented only in the group of schizophrenics. This is because in contrast to the Andreasen scale, the presence of pressure of speech is considered as an exclusion criterion for the schizophrenic axial syndrome. Thus, thought disorders according to the schizophrenic axial syndrome are seen to possess diagnostic significance.

Bipolar Disorder↗
PubMed1984

Antipsychotic efficacy of fluperlapine. An open multicenter trial.

In an open multicenter trial 46 schizophrenic patients were treated with fluperlapine for 20 days. A mean daily dosage of 300-400 mg appeared to be an effective antipsychotic treatment in most cases. The marked antipsychotic effect was accompanied by a good improvement of depressive symptoms. Extrapyramidal side effects were extremely rare.

Adult↗
PubMed1984

Computer-assisted EEG topography as a tool in the evaluation of actions of psychoactive drugs in patients.

This paper summarizes a tentative application of EEG topography to the evaluation of the efficiency of psychoactive drugs. It shows that the spectral content of the EEG, recorded simultaneously at different locations according to the international 10-20 system, is a sensitive measure for the quantification of drug activity. Furthermore, coherence analysis reveals differences in the functional organization of the neocortex under neuroleptic drug therapy.

Antipsychotic Agents↗
PubMed1984

Course and outcome of delusional psychoses.

The authors reinvestigated 84 out of a sample of 90 patients with delusional psychoses after an interval of 6-9 years. The results of the follow-up showed a pattern of episodic versus chronic course which compares to follow-up studies on classically diagnosed schizophrenias. The authors found evidence for their hypothesis concerning the nosological heterogeneity of this group of psychoses and propose a syndromatological classification apart from the delusional symptomatology itself. What they call background symptomatology was divided into axial syndromes. The authors feel that this results in subgroups that are more homogeneous for course and outcome than the usual classification systems.

Adolescent↗
PubMed1984

Heterogeneity of delusional syndromes: diagnostic criteria and course prognosis.

In addition to genetic findings and treatment response, the course prognosis is also meant to be a possible validating criterion for diagnosis and diagnostic systems. In our study we used the polydiagnostic approach (i.e. the simultaneous application of various criteria for diagnosing a given disorder to one and the same population) to test the ability of several diagnostic systems to create homogeneous groups regarding the course (episodic/chronic). We applied Schneider's FRS, ICD-9, DSM-III, Spitzer's RDC and the Vienna Research Criteria to 90 patients with the diagnosis of delusional syndrome (aside from any nosological classification), who underwent 6-9 years of follow-up. At the index examination, schizophrenia was most frequently diagnosed with Schneider's FRS, which apparently encompasses a very heterogeneous group of patients regarding psychopathology and course. Diagnostic systems which allowed the diagnosis of affective disorders despite the presence of mood-incongruent delusional symptomatology (DSM-III, RDC, Vienna Criteria) or offered the diagnosis of schizoaffective disorder (DSM-III, RDC) succeeded in separating subgroups with an episodic course on a statistically significant level. In ICD-9 this significance appeared only after exclusion of the schizoaffective cases from the group of schizophrenias. Our data thus uphold the old rule of thumb that affective symptomatology apparently has a very high prognostic value regarding the course of the illness and is in this respect superior to productive symptomatology (such as delusions and hallucinations), still taken to be pathognomonic for schizophrenia by some of the diagnostic criteria under study. This aspect warrants further investigation and should be taken into account in the development and improvement of diagnostic manuals (e.g. ICD-10, DSM-IV).

Adolescent↗
PubMed1984

Results of a multicenter AMDP study with fluperlapine in schizophrenic patients.

In an open multicenter trial (7 hospitals) 85 schizophrenic patients were treated with 3-fluoro-6-(4-methyl-piperazinyl)- 11H -dibenz[b,e]azepine ( fluperlapine , NB 106-689) during 20 days. Symptomatology was documented with the AMDP system on days 0, 1, 5, 10, 15 and 20. A mean daily dosage of about 400 mg caused a significant antipsychotic effect and pronounced improvement of depressive symptoms. Fluperlapine was well tolerated. Extra-pyramidal side-effects were very rare.

Adolescent↗
PubMed1983

The genetics of delusional psychoses.

In a genetic study of the first-degree relatives of 77 patients with delusional (paranoid) psychoses, the morbidity risks for schizophrenia, affective disorders, and atypical psychoses were evaluated using ICD-9 criteria. The prevalence of schizophrenia was 3.10 percent (4.12 percent with age correction to 40 years and 4.94 percent with age correction to age 60), which is higher than in investigations of paranoid psychoses, but lower than in studies of paranoid schizophrenia. The prevalence figure for affective disorders (age-corrected 3.04 percent for unipolar plus bipolar patients) is also intermediate to those for relatives of paranoid schizophrenics and paranoid psychotics. When the 77 index delusional patients were subdivided into axial syndromes (endogenomorphic-schizophrenic, endogenomorphic-cyclothymic, and organomorphic axial syndromes), two very homogeneous subgroups emerged. The endogenomorphic-schizophrenic subgroup showed high rates of schizophrenic secondary cases, whereas the endogenomorphic-cyclothymic subgroup showed high rates of affectively disordered secondary cases. The third organomorphic subgroup showed a high prevalence of atypical psychoses among first-degree relatives. Thirty-seven of the 77 index patients could not be assigned to any axial syndrome; their first-degree relatives had an increased prevalence of schizophrenia, but affective disorders were no more frequent than in the normal population. These data suggest that the heterogeneous group of paranoid psychoses can be meaningfully subdivided by use of axial syndromes which are viewed as representing "basic" disturbances underlying delusional symptomatology.

Adolescent↗
PubMed1983

Classification and course of schizo-affective psychoses. Follow-up of patients treated with lithium.

68 patients given an ICD (international classification of diseases) diagnosis of schizo-affective disorder during a hospitalization and consecutively treated in a lithium outpatient clinic were investigated. In a 'polydiagnostic approach' the overlaps and differences between different classificatory systems were assessed. A grouping of the patients according to a 'schizophrenic axial syndrome' with an emphasis on specific thought disorders showed significant differences between these groups in regard to the development of residual symptoms. Furthermore, a relationship between the absence of the schizophrenic axial syndrome and a good response to prophylactic lithium treatment was observed.

Adult↗
PubMed1983

[Family picture studies in patients with paranoid psychoses].

Among the first-degree relatives of 77 patients with delusional functional psychoses the authors found 13 schizophrenics (3.10%), 8 manic-depressives (1.91%) and 14 cases with atypical psychoses (3.34%), following ICD-9 criteria. These figures were compared with the figures in the literature on the genetics of paranoid schizophrenics and nonschizophrenic paranoids, regarding the different composition of the samples. Subdivision of the original 77 patients, using the concept of the axial syndromes, was able to form two homogeneous subgroups of first-degree relatives: one with a schizophrenia prevalence of 6.52% (uncorrected) and without any manic-depressive secondary cases (endogenomorphic-schizophrenic axial syndrome) and another with a manic-depressive illness (MDI) prevalence of 6.58% (uncorrected) without any secondary cases with schizophrenia or atypical psychosis. The first-degree relatives of the patients with an 'organomorphic' axial syndrome (usually excluded in other studies) had an increased rate of manic-depressive secondary cases (3.57%, uncorrected) and the highest rate of atypical psychosis (7.14%) without any schizophrenics, according to the etiopathogenetic heterogeneity of this group. 37 of the 77 patients were not assignable to any of the axial syndromes. In the first-degree relatives of these patients--best comparable to Kendler's criteria for 'delusional disorder'--an increased rate of schizophrenics and atypical psychoses was found (3.59 and 3.08%, uncorrected); the figures for MDI were within normal limits. Our results suggest that the axial syndromes are a useful diagnostic instrument in identifying--from the genetic standpoint--in part very homogeneous subgroups. This allows the conclusion that they are indicators for hypothetical basic disturbances.

Adolescent↗