Biomedical subjects

G Schüssler

Publications and source records attributed to G Schüssler.

At least 19 recordsLinked to original sources

PubMed1996

Results of the ICD-10 research criteria study in German-speaking countries in the field of psychosomatics and psychotherapy.

Selected results from the section psychotherapy/psychosomatics of the ICD-10 research criteria study are discussed. One hundred thirty diagnosticians from 11 psychosomatics centers took part in this section, assessing 16 video-documented patients in case conferences. The results of the study, which were based on 633 diagnostical assessments, demonstrated sufficient chance-corrected interrater reliability coefficients for the majority of the disorders (kappa ranged from 0.22 to 0.99). System-related problems of the ICD-10 approach were identified concerning depressive and psychosomatic disorders. The results are discussed, following some problematical aspects of the concept of comorbidity and multiaxial approaches. Special reference is given to the work group "Operational Psychodynamic Diagnoses' which has produced a multiaxial system covering important psychodynamic variables.

Adult↗

PubMed1996

[Psychological stress and neuronal plasticity. An expanded model of the stress reaction process as the basis for understand central nervous system adaptation processes].

A short survey on results and theories in psychosomatic and neurobiologic stress research is presented. Based on a comprehensive definition of the stress-reaction process, the biological and psychological consequences are described which are elicited by either controllable or uncontrollable stress. We conclude that controllable stress triggers the stabilization and facilitation of neuronal networks involved in the generation of appropriate patterns of appraisal and coping, whereas uncontrollable stress favours the extinction of inappropriate patterns and the reorganisation of neuronal connections underlying certain inappropriate behaviors. Both, controllable an uncontrollable stress-reaction-processes are therefore essential prerequisites of, and inherent challenges to, the development and adaptation of an individual in an ever changing external world but may also lead to psychodevelopmental failures and psychosomatic diseases.

Adaptation, Psychological↗

PubMed1995

Instruments in the assessment of psychosomatic and neurotic disorders.

The introduction of DSM-III/DSM-III-R and ICD-10 implies fundamental innovations to the diagnostic process. The changes relate both to formal aspects (e.g. symptom and time-related criteria) and to content (e.g. the abandonment of the concept of neurosis). Additionally, specific assessment instruments are introduced. However, other aspects important for the description and treatment of patients easily become neglected when concentrating on a system of diagnoses which aim at the classification of patients by groups of disorders. The present article will present instruments which make it possible to do justice to both points of view.

Humans↗

PubMed1995

Obsessive-compulsive disorder among patients with anorexia nervosa and bulimia nervosa.

OBJECTIVE: The present study sought to determine the prevalence of obsessive-compulsive disorder among patients with eating disorders. METHOD: Ninety-three women who met DSM-III-R criteria for anorexia nervosa or bulimia nervosa were investigated by using a semistructured diagnostic interview, the Yale-Brown Obsessive Compulsive Scale, and the Eating Disorder Inventory. RESULTS: Thirty-four patients (37%) met the DSM-III-R criteria for obsessive-compulsive disorder and also had a clinically significant score of 16 or higher on the Yale-Brown scale. These patients also had significantly higher, and hence pathological, mean scores on five of eight Eating Disorder Inventory scales than patients with eating disorders without concomitant obsessive-compulsive disorder. CONCLUSIONS: These results suggest that there is a high prevalence of obsessive-compulsive disorder among patients with anorexia and bulimia nervosa and that this prevalence may be correlated with the severity of the eating disorder.

Adolescent↗

PubMed1995

[Obsessive-compulsive symptoms in structural ego defects--a study exemplified by anorexia and bulimia nervosa].

The present study reports findings concerning the hypothesis whether patients with narcissistic self-system disturbances show more obsessive-compulsive (OC) symptoms as compared to patients without such disturbances. Ninety-one patients meeting DSM-III-R criteria for anorexia nervosa (AN) or bulimia nervosa (BN) were investigated using the Narzissmusinventar (NI), the Hamburger-Zwangsinventar (HZI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Eating Disorder Inventory (EDI). The NI-data demonstrated a great variance of self-system disturbances in AN and BN; a cluster analysis identified two different clinical features. In comparison to eating disorder patients without concomitant disturbances of the self-system (n = 34) the patient group with such narcissistic deficits (n = 57) showed significantly higher Y-BOCS and HZI-scores indicating more and severer OC symptoms. These patients also had significantly higher and hence pathologic means on seven of eight EDI scales. The results suggest that OC behaviour may be an unconscious attempt to stabilize the self-system equilibrium, i.e. counteracting narcisstic desintegration. Regulatory processes of the self-system and OC symptoms may present additional prognostic factors and lead to new approaches in psychotherapy research.

Adolescent↗

PubMed1995

[Compulsive symptoms in anorexia and bulimia nervosa].

The present study reports findings concerning the prevalence of obsessive-compulsive symptoms in eating disorders. Ninety-three women meeting DSM-III-R criteria for anorexia nervosa (AN) or bulimia nervosa (BN) were investigated using the Hamburg Obsession Compulsion Inventory HZI-K (Klepsch et al. 1993). Forty-six patients (49.5%) met the criteria for obsessive-compulsive disorder (OCD). This subgroup showed significant pathologically elevated scores on several scales of the Eating Disorder Inventory (Garner et al. 1983), and two different personality questionnaires (Freiburger Persönlichkeitsinventar, Fahrenberg et al. 1984; Giessen-Tests, Beckmann et al. 1983). The results demonstrate a high rate of OCD in AN and BN. The relationship between eating disorders and OCD and the question of clinical relevance is discussed.

Adolescent↗

PubMed1995

[Psychosomatic aspects of sarcoidosis].

Sarcoidosis is a multisystemic granulomatous disorder of unknown etiology. Several times pneumonologists described a remarkable personality of patients suffering from sarcoidosis. 44 patients with sarcoidosis were examined physically and psychosomatically. There are subgroups of patients, an important risk group shows long-lasting depressive features.

Activities of Daily Living↗

PubMed1994

[The psychosomatic aspects and results of rheumatoid arthritis and fibromyalgia].

The results of an empirical study on psychosomatic aspects of rheumatoid arthritis (RA) and fibromyalgia syndrome (FMS) are presented and discussed in the setting of previous concepts about rheumatoid arthritis. The patients investigated in the two disease groups represent an unselected population with regard to psychological abnormalities (from two internistic rheumatism outpatient clinics); the results can thus be considered to be representative and permit the following conclusions to be drawn: RA is not a psychosomatic disease in the strict sense; however, psychological factors must be adjudged to have a disease-modifying influence. FMS may be classified within the group of psychosomatic diseases, although it should be regarded as the final stage of a wide variety of different processes within the biological, psychological and social sphere.

Activities of Daily Living↗

PubMed1994

[Prognostic criteria of behavioral pain treatment in groups of patients with rheumatoid arthritis].

The effectiveness of behavior therapy programs for the treatment of pain of various origin can be regarded as proven. However, there is a general lack of information about prognostic and indication criteria. These questions were investigated by means of a controlled, cognitive-behavioral orientated clinical study on 79 patients with the certified diagnosis of rheumatoid arthritis. While our study was also able to prove short-term effectiveness for all patients, some exhibited regressive effects during the six-month follow-up period. A lack of regular practice and the presence of neurotic disorders were responsible for this instability. Patients who already have neurotic disorders prior to arthritis should accordingly be given more intensive psychotherapy. In this exceeding a standard-program psychotherapy can be dealt with the disease-related and other psychosocial problems and conflicts on an integrative basis.

Adaptation, Psychological↗

PubMed1993

Coping with myasthenia gravis and implications for psychotherapy.

The aim of this study was to investigate psychosocial influences and mechanisms of coping to establish indications for psychotherapy in patients with myasthenia gravis. We investigated clinical symptoms, personality, psychopathology, and coping in 44 patients with myasthenia gravis. The patients' personalities were not characteristically altered, and in 29.5% (13/44) of them, preexistent, long-term psychiatric disturbances (according to International Classification of Diseases criteria) were present, which corresponds to the prevalence in the average population. In general, coping was characterized by an attitude of calmness and acceptance, which is attributable to effective medical treatment and could be considered an unspecific mode of coping with chronic diseases of moderate severity. Four women had undergone psychotherapy because of neurotic symptoms that were unrelated to myasthenia gravis. At the end of psychotherapy, their myasthenic symptoms had greatly improved or disappeared. Psychotherapeutic techniques may be helpful in patients with neurotic or reactive psychiatric symptoms, but there is no general implication for psychotherapy in myasthenic patients, especially if there is adequate "somatic" therapy.

Adaptation, Psychological↗

PubMed1993

[Coping with illness in myasthenia gravis].

Within the past few years, the introduction of immunosuppressants in the treatment of myasthenia gravis, has turned this severe, chronic and life-threatening disease into a moderate illness with good chances of control or even remission. Of 44 patients whose coping behavior and course of disease we investigated, only seven experienced a significant change in severity of the disease within nine months. This consistency in the course of the disease was also reflected in the forms of coping with the disease: in contrast to the situation two decades ago, today's myasthenia gravis patients are no longer caught up in the dilemma between passive dependency and active resistance, most of them adopting an attitude of calm acceptance. According to the Berne Forms of Coping (BEFO) which we applied, this attitude is expressed as a pattern of passive cooperation, acceptance, distraction and relativization. This coping pattern remained largely intact even in relation to the severity of the disease and the retrospectively assessed course of the disease. We present two cases to illustrate the influence of coping behavior on the course of the disease. Comparison with two other patient groups (rheumatoid arthritis and hip osteo-arthrosis) showed that there is no disease specificity of coping behavior. It can be assumed that there is a basic pattern in coping with chronic diseases, the manifestation of which is dependent on the severity and prognosis of the disease. If depressive reactions to the disease are excluded, the prevalence of longer-term pre-existent psychiatric disorders among MG patients corresponds to the average for the general population, although there is a relatively high incidence of anxiety disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

PubMed1992

Coping strategies and individual meanings of illness.

Every person has a subjective understanding of their own illness. The personal attitude towards disease and the corresponding coping mechanisms go beyond biomedical factors to influence the course of the disease. Lipowski described eight different disease concepts which were supplemented by the theory of control conviction (external-internal control). Several hypotheses about disease concepts, coping strategies and psychopathology were globally confirmed in a study of 205 chronic patients: Ability to control and acceptance lead to a more active and problem-related coping, whereas emotional coping modi occur more often in persons who do not accept their illness or do not consider it to be controllable. Results confirm the necessity of a differentiated analysis.

Adaptation, Psychological↗

PubMed1992

[Coping with depressive disorders].

Coping behavior was assessed in 40 depressed patients during their hospitalization and 2 months later. Patients completed an antidepressive activity questionnaire and were interviewed. External assessment and patient self-assessment showed significant differences between patients with monopolar or bipolar depressive disorders and those with neurotic/reactive disorders. Patients treated with antidepressants reported more frequent and effective coping behaviors. There is a fundamental difficulty in distinguishing differentiate between symptoms of depression and certain coping behaviors (eg withdrawal). Only a longitudinal analysis of individual cases could help us to differentiate.

Activities of Daily Living↗

PubMed1992

[New approaches to the revision of psychoanalytic developmental theory. The D. N. Stern concept].

Facing the empirical infant research the traditional psychoanalytic theory of development for the first two years of life needs revision. D. N. Stern and J. D. Lichtenberg described new models. In the first part the concept of four phases of self-development according to Stern is described. Past II compares this model with the theory of J. D. Lichtenberg. Furthermore principles of a new theory are discussed.

Ego↗

PubMed1992

[Psychosomatic factors in idiopathic sudden deafness].

A clinical and psychological history of 27 patients suffering from sudden deafness was taken shortly after the onset of symptoms and 4 months later. Psychosocial factors seem to be important in the beginning of sudden deafness, but there was no specific conflict or personality pattern. Predictors of a good outcome are stable personal relations, emotionally balanced personality factors and a reduction of stress factors after the onset of symptoms. A tendency to addictive behaviour was of unfavourable prognostic significance.

Adaptation, Psychological↗

PubMed1992

[New approaches to revision of the psychoanalytic theory of development. II. The J. D. Lichtenberg concept and principles of a new psychoanalytic theory of development].

Both D.N. Stern and J.D. Lichtenberg have outlined new models of a psychoanalytic theory of development taking into account the results of empirical infant research. The theory of Lichtenberg is described, whereas part I centered about the model of Stern. Both theories are discussed and central principles of development are specified: activity, social adaption, the influence of genetic factors, the importance of affect and a transactional model of development.

Adaptation, Psychological↗

PubMed1990

[Multi-axial diagnosis in psychosomatic medicine and psychotherapy--a report of experiences].

A certain number of attempts to establish a multi-axial classification system in psychiatry go back to before the introduction of the DSM-III. Such diagnostic and classificatory attempts are almost totally lacking, however, in the fields of psychotherapy and psychosomatic medicine. This discussion presents and evaluates a multi-axial diagnostic and documentary system that has been under development and testing in the Department of Psychotherapy and Psychosomatic Medicine at the University of Göttingen since 1986 as well as first empirical results from the year 1987. Results show that multi-axial diagnostics represent a useful and promising approach, particularly for psychosomatic medicine and psychotherapy.

Adult↗

PubMed1989

[Microbial contamination of drinking water by a polyamide feedpipe].

An incident is described with high colony counts in the drinking water from a well. The well was disinfected with sodium hypochlorite for several times, but without permanent success. After that the search for the reason of the high colony counts started. It turned out that the polyamide rising-pipe produced the microbial growth. Besides the colony increase in the water there was a microbial growth upon the surface of the polyamide pipe as well. When a high grade steel pipe was installed instead of the polyamide pipe there was no colony increase in the water any more.

Germany, West↗