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Biomedical subjects

B Krumm

Publications and source records attributed to B Krumm.

At least 37 records · Page 2Linked to original sources
PubMed2001

Functional independence measure (FIM) assessing outcome in medical rehabilitation of neurologically ill adolescents.

With the Functional Independence measure, which is a reliable and valid instrument, data can be collected for large groups of persons with different disabilities. For the first time the FIM has been used for outcome assessment in medical rehabilitation of a cohort of neurologically ill adolescents. The instrument is appropriate for this purpose. The severity of disability, which changes during rehabilitation of adolescents, is adequately estimated with FIM. The motor FIM and the cognitive FIM can be summed up separately for evaluation. In our investigation the construct validity of the cognitive FIM was demonstrated: the cognitive FIM showed a high correlation with the degree of neuropsychological impairment following brain damage. Psychiatric disorder does not correlate with the motor FIM and the severity of disability.

Activities of Daily Living↗
PubMed1999

Demand for psychosocial counselling of young wheelchair users.

Young persons tied to wheelchairs increasingly report fears and inhibitions in romantic attachments, irrespective of whether they are paraplegic or not. More frequently they complain about being gaped at and being pitied by healthy persons more than they would like. Being tied to the wheelchair had a significant relation to these results, but not gender, age and illness variables. A high demand for psychosocial counselling during rehabilitation is deduced from these results, in particular also for young people without paraplegia.

Adaptation, Psychological↗
PubMed1998

The combined dexamethasone/corticotropin-releasing hormone stimulation test is more closely associated with features of diurnal activity of the hypothalamo-pituitary-adrenocortical system than the dexamethasone suppression test.

BACKGROUND: The dexamethasone suppression test (DST) is a widely used endocrine test in psychiatry, but was reported to not allow reliable inferences with regard to the basal activity of the hypothalamo-pituitary-adrenocortical (HPA) system. We compared the association of the standard DST and the combined dexamethasone/corticotropin-releasing hormone (DEX/CRH) challenge with parameters of diurnal cortisol profiles. METHODS: We performed a DEX/CRH challenge and 24-hour cortisol profiles in 25 depressed patients (mean age: 47.4 +/- 16.0 years) and 33 age-matched healthy controls (mean age: 51.4 +/- 19.3 years). RESULTS: A path analysis showed cortisol area under the curve (AUC) after CRH (= DEX/CRH status) to be dependent upon minimal 24-hour cortisol and evening frequency of pulsatile cortisol release. In contrast, postdexamethasone cortisol (= DST status) was related to 24-hour mean cortisol. Simple linear regressions supported an association of cortisol AUC with several parameters of the diurnal cortisol profiles, which was not true for the standard DST. CONCLUSIONS: We conclude that the combined DEX/CRH challenge test is more closely associated with the activity of the HPA system than the standard DST in healthy and depressed subjects.

Adrenocorticotropic Hormone↗
PubMed1995

[Empirical results of adjustment to disability by adolescents with spina bifida and traumatic paraplegia].

Between June 1991 and June 1992, a total of 39 rehabilitees aged 16 to 25 years were examined, i.e., 21 patients suffering from spina bifida and 18 patients suffering from traumatic paraplegia. Diagnostic instruments used were the Freiburg questionnaire on coping with illness (FKV 102), Goldberg et al's questionnaire for the evaluation of subjective wellbeing regarding health, and a self-constructed questionnaire for evaluating satisfaction with rehabilitation. Medical interviews on the present state of health and the present situation were held with each patient. The level of paralysis was taken as an indicator of the motor handicap present. The patients examined showed distinctly less confidence in doctors than adults do. From a subjective point of view, however, the confidence in doctors was good: among the coping strategies chosen, the compliance strategies ranked first and second, respectively, in the two groups. The coping strategy of "cognitive avoidance and dissimilation" is distinctly less common among spina bifida patients than among patients with traumatic paraplegia. They are less inclined to hope for a miracle, and take their handicap much more seriously than adolescents suffering from traumatic paraplegia. The higher the level of paraplegia, the more use is made of the coping strategy of "emotional control and social withdrawal". Regressive tendencies and depressive modes of coping were equally present in both groups. When investigating satisfaction with rehabilitation and with the own person, both groups showed very high satisfaction with the physical independence achieved and the possibilities of acting independently.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1995

[The Mannheim long-term study of schizophrenia. Initial results of follow-up of the illness over 14 years after initial inpatient treatment].

A 14-year follow-up was accomplished on 56 out of a total of 70 patients first admitted to hospital with Schneiderian first-rank symptoms. Data collected during 5 years after index admission were also at our disposal. Three quarters of the probands are living alone, and barely one third are in regular employment. At the time of the 14-year follow-up about one third showed delusions or hallucinations. Almost the same number had psychological impairments and 64% were socially disabled. Comparison with the data collected at 1 year and 5 years reveals no difference in the rates of impairments and symptomatology, but a significant increase of social disability.

Adult↗
PubMed1992

Neurological disorders in 166 patients with basal ganglia calcification: a statistical evaluation.

Patients investigated at our institute during the last decade included 166 (1.2%) who showed uni- or bilateral basal ganglia calcification on computed tomography. We tested the significance of this neuroradiological observation by statistical comparison of these patients' clinical disorders with the findings in a random sample of 622 patients without basal ganglia calcification. The odds for the most common neurological disturbances were similar in patients with and without basal ganglia calcification. After adjustment for differences in age and brain atrophy there was no evidence of a significantly increased risk of dementia (odds ratio 1.1), cerebral infarction (1.4), epilepsy (0.9), vertigo (1.6), headache (1.8), or alcoholism (0.9), which represented the most common diagnoses. We conclude that basal ganglia calcification cannot be considered as a clinically relevant neuroradiological finding in the majority of cases and that it should not be used as an explanation for frequently observed neurological disturbances.

Basal Ganglia Diseases↗
PubMed1991

What is the psychiatric significance of bilateral basal ganglia mineralization?

One percent (143) of patients who underwent cranial computed tomography at the Central Institute of Mental Health during the last 10 years had bilateral basal ganglia mineralization (BGM). The relationship of this finding to the psychiatric disorders in the group was evaluated by statistical comparison with a group of patients without BGM (control group). The odds ratios for affective disorders and for organic brain syndromes with affective or paranoid symptoms showed a mild, but statistically significant, increase in patients with BGM. There was no evidence of an increased proportion of dementia, schizophrenia, or alcoholism in those with BGM. Those with BGM had a higher mean age and significantly more cortical atrophy and ventricular enlargement than did patients without. These confounding variables contributed to clinical differences between the BGM and the control groups.

Adult↗
PubMed1991

The course of schizophrenia: some remarks on a yet unsolved problem of retrospective data collection.

The retrospective assessment of symptoms and syndromes is a basic measure in research of the longitudinal course of schizophrenia. In spite of its importance there have been few studies evaluating the standard of quality of instruments for retrospective data collection. Combining retrospectively and cross-sectionally collected data on schizophrenic symptomatology in a cohort study over a period of 5 years revealed a significant underestimation of symptoms when assessed in retrospect. The need for studies on the validity of instruments for the retrospective assessment of symptoms is stressed.

Delusions↗
PubMed1986

Prediction of outcome and utilization of medical services in a prospective study of first onset schizophrenics. Results of a prospective 5-year follow-up study.

After an introduction on design and definition of constructs, followed by an overview on case-finding, description of cohort and epidemiological considerations, this paper presents results on (social) disability (course of disability, prediction of disability), reported symptoms (course of symptomatology, prediction of symptomatology), observed (psychological) impairments (course of impairments, prediction of impairments, and value of impairment scores as predictors) and the utilization of medical services (scale of predominant utilization levels, longitudinal pattern of care, proportions of time in and out of hospital, prediction of length of hospitalization and cumulative time in rehabilitation institutions) in an epidemiological cohort of first onset schizophrenics prospectively over 5 years.

Female↗
PubMed1985

Does outpatient treatment reduce hospital stay in schizophrenics?

The implementation of community mental health care for psychiatric patients in Mannheim, an industrial city of approximately 300,000 inhabitants, poses questions concerning the impact of outpatient treatment on the probability of rehospitalization. For this purpose the use of extramural facilities by a group of 148 patients with a diagnosis of schizophrenia was studied over a period of 18 months. Based on a model of utilization that allows for the removal of confounding effects the statistical analysis reveals that outpatient contacts with psychiatrists in practice or with an outpatient clinic indeed reduces time in hospital and also improves the psychopathological status of the patients.

Ambulatory Care↗
PubMed1985

[Does sex modify referral for inpatient psychiatric treatment? A model supported analysis based on utilization data].

Since 1968, a comprehensive community mental health care system was implemented step by step in Mannheim. This concept includes arrangements with respect to the accessibility to inpatient care. We analyzed data of a cohort of 126 schizophrenic patients using a multivariate model of utilization. The uneven distribution of sexes in two inpatient facilities can be accounted for by duration of illness and modalities of admission.

Commitment of Persons with Psychiatric Disorders↗