[Hospital planning--an overview of the '90's. What are the effects on smaller hospitals?].
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Biomedical subjects
Publications and source records attributed to G Koselowski.
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Nosological questions in psychiatry imply core questions of understanding and interpretation in the field of mental illness. The model of unitary psychosis in contrast to the hypothesis of nosological entities has been discussed in controversial terms for a long time. This history of psychiatry in review of a hundred years' development of psychopathology, neurobiological sources and psychosociological conditions points out the multiplicity of adaptive processes in a multifactorial-multiconditional way. Nosological entities such as formulated by Leonhard would have a promising interpretation in the framework of a unitary approach in the philosophy by Rennert and the analysis of various psychodynamic axes.
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The use of computer based diagnostic decision and artificial intelligence are discussed in relation to the problems of validity and reliability of psychiatric diagnoses. The authors suggest a definition of a computer aided classificator as an existent decision system for an automatically analysis of findings.
Discussion of the necessity of unilateral ECT with discontinuous stimulation current and report on an add-on unit to the electroconvulsator "Minicoma" realizing the required stimulation parameters.
With the Structured Psychopathological Evaluation-System (SPES) an instrument existed for employment of objective criteria. This study was designed to present an evaluation system based on new scientific results, that is applying on the strength of a reduced catalogue of symptoms (94 compared with 198 Items at SPES-A) to clinical routine. Additional findings differentiated by this system be able to classify by the help of an operational decision system.
The purpose of this paper is to discuss possibilities for developing operational criteria in psychopathological states and to identify the parameters that differentiate psychotic patients. Statistical analysis was performed in the first step with the aid of factor analysis with extraction of syndromatic characteristics of so-called psychopathological basis syndromes. By cluster analysis in the second step we found out more approaches to a differentiated definition of psychotic states. The classification of individuals into 'natural' and not preestablished groups enabled the construction of descriptive psychopathological algorithms to determine ICD-9 diagnosis within the limitations of descriptive psychiatry.
The medical profession is using computers to an increasing extent, and the graphic epicrises described here, which is intended mainly to augment the conventional epicrisis, is another useful application. It is based on a standardised psychopathological examination and documentation procedure and permits the course of psychopathological syndromes to be demonstrated in an illustrative way.
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