PubMed Health⌕ Search

Biomedical subjects

E M Steinmeyer

Publications and source records attributed to E M Steinmeyer.

At least 37 records · Page 2Linked to original sources
PubMed1996

Phenomenology of simple partial seizures.

Based on a sample of 325 inpatients we present the subjective experiences during simple partial seizures. In a majority of cases, auras comprised composed forms of different symptomatic qualities. We describe rules which seem to govern sequences of aura phenomena. Autonomous and vestibular sensations were shown to have preceding positions related to others, olfactory and gustatory sensations preferred a following position. The tentative explanation of the findings favours the idea of heterogeneity rather than the concept of a focal discharge in a simple partial seizures.

Autonomic Nervous System Diseases↗
PubMed1995

Positive or negative symptoms--which are more appropriate as diagnostic criteria for schizophrenia?

For over a decade there has been a consensus that the diagnosis of schizophrenia should rest upon the presence of positive symptoms. Recently it has been suggested to give negative symptoms, which have played a prominent role in research, more diagnostic importance again. This study investigated the usefulness of that suggestion. In a sample of 489 inpatients covering the whole range of psychiatric diagnoses, the frequencies and prevalences of positive and negative symptoms were determined. Analyses of variance were calculated to assess the diagnostic validity of the different classes of symptoms. The study demonstrates that positive symptoms are of much higher diagnostic value than negative symptoms. A change of diagnostic procedures giving more importance to negative symptoms is discouraged.

Delusions↗
PubMed1994

"Patterns of comorbidity" among DSM-III-R and ICD-10 personality disorders as observed with a new inventory for the assessment of personality disorders.

Although DSM-III-R and ICD-10 suggest the assignment of multiple personality diagnoses, a high degree of overlap may be an indicator of insufficiently distinct and too inclusive types of personality. We studied this problem with a new inventory in an unselected clinical sample. The Aachen List of Items for the Registration of Personality Disorders (AMPS) integrates the different types of disordered personality according to DSM-III-R, ICD-10, and four subaffective categories, which largely follow the typologies of Kraepelin, K. Schneider, and Kretschmer. The prevalence rate of each personality disorder was calculated in a consecutive group of 231 patients. Patterns of comorbidity were computed using odds ratios. More than one personality disorder was found in 41% according to DSM-III-R. ICD-10 showed a significantly higher degree of overlap. Interesting comorbidity patterns are discussed in comparison with several North American studies. Results indicate that clear-cut categorical personality diagnoses are not likely to be set up.

Adult↗
PubMed1994

Are serotonergic reuptake inhibitors more potent in reducing suicidality? An empirical study on paroxetine.

There is some empirical evidence that selective serotonin reuptake inhibitors reduce suicidal ideas faster than other antidepressants. These findings are well in line with the theory of a serotonergic hypofunction in suicidal patients. To test this hypothesis the data of a 6-week double-blind control-group study comparing paroxetine versus amitriptyline were analyzed with respect to suicidality. The global antidepressive efficacy was comparable under dosages of 30 mg paroxetine or 150 mg amitriptyline per day. A differentiated analysis failed to confirm the hypothesis of a faster reduction of suicidal cognitions by paroxetine.

Adult↗
PubMed1994

[Positive or negative symptoms. Which are more reliable in the diagnosis of schizophrenia?].

Due to the anticipated revisions concerning diagnostic criteria for schizophrenia in DSM-IV, recent Anglo-American research has been particularly concerned with the controversial problem whether positive or negative symptoms are more suited for the determination of these criteria. We addressed this problem in an empirical study. A total of 489 consecutive admissions to the Department of Psychiatry at the RWTH University, Aachen were assessed for the distribution of positive, negative and basic symptoms according to six ICD-10 double-digit diagnostic categories. Positive symptoms were shown to be more useful for diagnosis than the negative or basic symptoms. Basic symptoms, however, had a pattern of distribution which supports the notion that they may also be useful for the early diagnosis of schizophrenia.

Affective Symptoms↗
PubMed1993

Double-blind multicenter study of paroxetine and amitriptyline in depressed inpatients.

Paroxetine is a new compound in the group of the selective serotonin-reuptake inhibitors. The results of several open and double-blind control-group studies demonstrate clear antidepressive efficacy of paroxetine. However, most data were collected in samples of outpatients. To overcome this restriction, a six-week double-blind control-group study, comparing 30 mg paroxetine with 150 mg amitriptyline per day, was performed in a sample of inpatients suffering from major depression. Generally speaking, the efficacy analysis of 160 patients was not able to demonstrate statistically significant differences in the antidepressive activity of paroxetine or amitriptyline, either with respect to the total score on the Hamilton Depression Scale (HAMD) and the Clinical Global Impressions or with respect to the subscores of the HAMD. One exception was the retardation subscore, in which amitriptyline showed a greater degree of reduction. Both drugs had a characteristic side-effect profile. Paroxetine was characterized by a lack of anticholinergic side-effects and a higher rate of nausea.

Amitriptyline↗
PubMed1993

Efficacy and safety of moclobemide compared with maprotiline in treatment of major depressive disorder. A double-blind multicenter study with parallel groups.

This report describes the results obtained in a double-blind, six week, prospective, randomized multicenter study. The efficacy, tolerability, and safety of moclobemide (300-600 mg/d) were compared to those of maprotiline (75-150 mg/d) in parallel groups of patients with a Major Depressive Episode (DS-III). In addition, participants were required to have a minimum baseline total score of 17 on the 17-item Hamilton Depression Rating Scale (HAMD) (no run-in), 115 male or female outpatients (aged over 18 years) were randomly allocated to moclobemide t.i.d. (n = 58) or to maprotiline t.i.d. (n = 57). Demographic and illness characteristics were comparable in both treatment groups upon study entry. During the study the patients were not required to avoid tyramine-rich foods but they were advised to take trial medication after meals. Patients were assessed for efficacy and tolerability on days 4, 11, 18, 25, 32, 39, and 46. Efficacy was judged primarily on the HAMD, the investigator's final overall assessment, and on the number of premature terminations associated with insufficient efficacy. No significant difference was observed between both groups. The mean % reduction of the HAMD at the end of treatment was 62.2 in the moclobemide group and 61.2 in the maprotiline group. The percentage of patients in whom efficacy was globally judged as "good" or "very good" was 63.0% in the moclobemide group and 58.5% in the maprotiline group. Seventeen percent moclobemide patients and 21% of maprotiline patients did not complete because of insufficient efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

[Clinical validity of the Beck Depression Inventory. A facet theoretical re-analysis of multicenter clinical observations].

The items of the Beck Depression Inventory are reanalyzed by a non-metric multidimensional scaling procedure (Smallest Space Analysis, SSA-I). The structure of the test items is characterized within the framework of Guttman's facet theory. Two systematic components (facets) are discerned: "centrality" and "aspect". Properties of the facets as well as their relations are assessed and examined empirically by analyzing the interrelations among the items. The spatial configurations obtained by the scaling procedure fit the expectations derived from the facet-theoretic model. The facet "centrality" was found to have a strong overriding influence over the "aspect" facet. The results suggest the introduction of a new combination and selection of items reflecting different facets of depression consistently over time.

Antidepressive Agents↗
PubMed1992

Facet theoretic analysis of the Hamilton-D scale.

The items of the HAM-D(17-item version) were analyzed by a nonmetric (ordinal) multi-dimensional scaling procedure (Smallest Space Analysis, SSA-I) and the structure of the test items characterized within the framework of Guttman's facet theory. Two systematic components (facets) were discerned: 'centrality' and 'aspect'. Properties of the facets as well as their relations were assessed and examined empirically by analyzing the inter-relations among different items. The spatial configurations obtained by the scaling procedure were found only partially to fit the expectations derived from the facet-theory model. The facet 'centrality' was found to have a strong overriding influence over the 'aspect' facet. The results suggest the value of a new combination and selection of items reflecting different facets of depression consistently over time.

Adolescent↗
PubMed1990

[Disability and residual symptoms in schizoaffective psychoses--data, methodologic problems and references for future research].

Schizoaffective disorders take a position between schizophrenia and affective disorders regarding outcome in the sense of psychological residuum and social consequences. What prognosis a schizoaffective illness has depends mainly on intrasymptomatological factors: Melancholic episodes during course seem to predict a good long-term outcome, schizophrenia-typical symptoms in the opposite predestinate to the development of residuum and disability. Non-symptomatological factors do not have any direct influence on the development of a residuum and disability. The comparison of course studies is limited by severe difficulties based on methodological and definitional shortcomings. Such shortcomings are (a) broad definition of schizoaffective but also of schizophrenic psychoses, (b) globalization of the term "outcome", (c) partialization of the term "prognosis", (d) equalization of the terms "course" and "outcome", (e) ignoring of inhomogeneity and polymorphism of schizoaffective disorders, (f) global evaluation of "outcome", (g) short follow-up periods. Some suggestions how to limitate the mentioned methodological shortcomings are discussed.

Disability Evaluation↗
PubMed1990

Mood curves of neurotic-depressive patients undergoing treatment with antidepressants: time-series analyses of experience with HTAKA model.

Statistical time-series analyses of single case data allow a sophisticated person-centered evaluation of therapeutic effects. The possibilities and limitations of a new method of time series analysis are shown by the example of mood curves of neurotic depressive patients. The HTAKA model seems advantageous, because this procedure is less restrictive than other methods as regards the data basis. The cluster-analytical agglomeration of the single-case results indicates a sufficient response to antidepressants in about 40% of the patients who were treated with antidepressants in addition to psychotherapy.

Affect↗
PubMed1989

Long-term outcome of schizoaffective and schizophrenic disorders: a comparative study. I. Definitions, methods, psychopathological and social outcome.

The long-term outcome of 72 schizoaffective and 97 schizophrenic patients with a mean duration of illness of 25.6 years and 19.6 years respectively was investigated. The outcome was assessed using the WHO Disability Assessment Schedule (WHO/DAS), the Psychological Impairment Rating Schedule (PIRS) (also developed by the WHO), the Global Assessment Scale (GAS), and the Bonn Psychopathological Criteria of Outcome. The outcome of schizoaffective disorders was found to differ from that of schizophrenia in several ways: (a) schizoaffectives achieve a full remission significantly more frequently than schizophrenics (50% vs 10%); (b) the development of so-called characteristic schizophrenic residua is the exception in schizoaffective disorders, but is frequent in schizophrenia; (c) disability, psychological impairment and disturbances of the level of functioning are not only significantly less frequent in schizoaffective disorders but are also less intense than in the schizophrenic group. The factors influencing the outcome of the two disorders are different (see part II), as are the social consequences (part III).

Adult↗
PubMed1989

Long-term outcome of schizoaffective and schizophrenic disorders: a comparative study. II. Causal-analytical investigations.

The influence of symptomatological and non-symptomatological factors on the long-term outcome of schizoaffective and schizophrenic disorders was investigated using the Analysis of Linear Structural Relationships (LISREL). The outcome was assessed employing the GAS, WHO/DAS, PIRS and the Bonn Criteria of Outcome. The analysis produced some interesting results in both groups, separately and in comparison with each other. The most striking difference between the two disorders concerns the finding that only symptomatological parameters directly influence the long-term outcome of schizoaffective disorders - melancholic episodes are correlated with favourable outcome, symptoms typical of schizophrenia with a relatively unfavourable outcome. Both symptomatological parameters (such as schizophrenic first-rank symptoms during course) and non-symptomatological parameters (such as life events or acuteness of onset) have a direct impact on the outcome. It was also found that "simple" depressive symptomatology (the presence of depressive symptoms not fulfilling the criteria of melancholic episodes according to DSM-III-R) has no influence on the long-term outcome of schizophrenia.

Adult↗
PubMed1989

Long-term outcome of schizoaffective and schizophrenic disorders: a comparative study. III. Social consequences.

A significantly higher proportion of schizophrenic than schizoaffective patients were found to experience negative social consequences of their illness. Schizophrenic males are more likely to have an unfavourable social prognosis than are schizophrenic females or schizoaffective patients of either gender. Schizophrenic males are, however, equally disadvantaged in regard to social consequences independently of other premorbid and sociodemographic factors. Unfavourable social consequences in male schizophrenics and favourable ones in female schizoaffectives can be predicted with high probability. Some social consequences can be predicted with relatively high probability for male schizoaffectives, while no prognosis can be made for female schizophrenics.

Achievement↗
PubMed1989

Single-case evaluation of sleep-deprivation effects by means of nonparametric time-series analysis (according to the HTAKA model)

Modern statistical approaches to the analysis of single cases have so far been rarely employed in psychiatric therapy research. The recently developed Hierarchical Trend-Segment Component Analysis (HTAKA) seems to be an adequate and practicable method for the field of therapy evaluation, not only under sophisticated research conditions, but also under routine treatment conditions, but analysis data of the effects of sleep-deprivation therapy as an example, the results of nonparametric time-series analyses performed according to HTAKA are presented. The statistical agglomeration of the single case results demonstrated that in most cases undergoing repeated sleep deprivation a long-term antidepressive effect related to this therapy could be proven.

Adult↗
PubMed1989

[Premorbid and social markers of patients with schizoaffective psychoses].

The present study reports on findings in international literature regarding premorbid and social factors of schizoaffective patients and also own findings of the Cologne study (72 schizoaffective patients with a mean follow-up period of 25.6 years). Altogether it can be said that more women suffer from schizoaffective disorders than men. The mean age at first manifestation is higher than that of schizophrenic patients and lower than that of affective disorders, although schizoaffective disorders can occur at any age. Premorbid social adjustment and ability to form a stable heterosexual partnership before onset are good in schizoaffective patients. There seems to be no special premorbid personality of schizoaffective patients. Education and level of vocational training are generally good. Only a few schizoaffective patients belong to the lower social classes. Most schizoaffective patients do not come from a "broken home". Although "life events" are frequent in a schizoaffective population, the relevance of this finding has to be limited: If we evaluate "life events" in regard to single episodes, we find that most episodes, especially episodes occurring during the later course, do not have precipitating factors. In conclusion, it can be said that - besides the already known better prognosis of schizoaffective disorders - several differences exist regarding premorbid and social factors, between schizoaffective disorders and schizophrenia.

Adolescent↗