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G Scheibe

Publications and source records attributed to G Scheibe.

At least 19 recordsLinked to original sources
PubMed1999

[The Dusseldorf short-term dynamic psychotherapy project (DKZP)].

Time-limited psychodynamic therapies in the outpatient setting are offered for a broad spectrum of psychogenic disorders. Meta-analyses prove their effectiveness mainly for neurotic disorders. We are interested in the suitability of the here applied CMP/SASB model (Tress et al. 1996) of psychodynamic short-term therapy for patients with psychosomatic and severe personality disorders. We extensively present the concept of Cyclic Mal-adaptive Pattern (CMP) in its clinically relevant parts as the core of psychogenic pathological developments. Particularly the introject, as the patient's attitude towards him- or herself, is of great importance for therapeutic change and its follow-up development. Within the DKZP (Duesseldorf Short-Term Psychotherapy Project), 36 male and female therapists, mostly interns at the local university clinic, treated 82 patients (m: 23/f: 59) with personality disorders (n = 26) and psychosomatic disorders (n = 31) as research groups and, in comparison, neurotic patients (n = 25) in a naturalistic design. 68 treatments have been completed so far, 11 patients have dropped out, the remaining 3 are still in therapy. Relevant research instruments are the Beeinträchtigungsschwere Score (BSS, an impairment score), Global Assessment of Functioning Scale (GAF), Cyclic Maladaptive Pattern (CMP), Symptom Check List (SCL-90-R), and Structural Analysis of Social Behavior (SASB) including process and content ratings, as well as the Intrex questionnaire. The treatments last 25 sessions. We carried out follow-up examinations after 6 months, 1 year, 2, and 5 years. Effect sizes for the whole sample by BSS and GAF are remarkably high, with further increase at follow-up interviews. Psychosomatic patients came off best, but personality disorders in comparison to neurotic patients profited surprisingly well. Effect sizes in self-rating (SCL and Intrex) were less high. However, in self-rating the changes of social functions are not sufficiently addressed. As a result, our form of focal therapy is well suited not only for neuroses, but also for psychosomatic disorders and personality disorders. An enlargement of the indication spectrum for this form of psychodynamic therapy to include these disorders is well founded and promising.

Adult↗
PubMed1997

Physiological, biochemical and subjective parameters in anxiety patients with panic disorder during stress exposure as compared with healthy controls.

Physiological (heart rate, blood pressure, electrodermal activity), biochemical (epinephrine, norepinephrine, cortisol) and subjective parameters (self-rating score) of 33 patients with panic disorder (diagnoses according to DSM-III-R) before, during and after stress exposure were compared with those of healthy controls. As stressors a video containing frightening scenes (FS), mental arithmetic (MA), a video documenting a patient suffering from a panic attack (PA) and an improvised speech (IS) were applied. We found significantly higher baseline levels of electrodermal activity (EDA) and norepinephrine (NE) secretion and a subsequent further increase during stress exposure in panic disorder patients as compared with normal controls. The most potent stressors during the trial proved to be mental arithmetics and improvised speech, which was evident in both groups. The situation panic attack video appeared to be a "panic disorder patient-specific" stressor; here we noticed the most pronounced reactions in the patient group. Panic disorder patients had significantly higher self-rating scores of the parameters panicky feelings, anxiety and nervousness at the beginning and throughout the investigation. We conclude that panic disorder patients have a higher degree of activation compared with normal controls, which is evident regarding levels of electrodermal activity and norepinephrine secretion. Furthermore, the panic attack video appears to be a panic disorder patient-specific stressor.

Adult↗
PubMed1997

Predictors and outcome in panic disorder: a 2-year prospective follow-up study.

53 patients presenting at an outpatient unit for anxiety disorders were included in the present prospective 2-year follow-up study. Sociodemographic, illness history, index rating, and 2-year follow-up data were evaluated. A multiple stepwise regression analysis was carried out in order to find predictors of the 2-year outcome. Results indicate that panic patients without episode at follow-up show less symptoms and a better psychosocial functioning than patients with episode at follow-up. Comorbid generalized anxiety disorder, duration of illness, and phobic avoidance behavior were found to be the best predictors of outcome. Conclusively, the present study confirms the most important predictors in patients with panic disorder.

Adult↗
PubMed1996

Predictors of outcome in panic disorder: a 5-year prospective follow-up study.

A prospective 5-year follow-up study in patients with panic disorder was carried out in order to determine predictors of outcome. 50 patients presenting at an outpatient clinic for anxiety disorders were enrolled initially in a controlled treatment study using either imipramine or doxepin in addition to supportive psychotherapy and were then followed under naturalistic treatment conditions. By means of multiple stepwise regression analyses comorbidity with current depression, severity of illness and agoraphobic avoidance turned out to be the strongest predictors. These data confirm the findings of shorter-term prospective follow-up studies and of retrospective studies. In contrast to several reports, illness-related social impairment at baseline was not found to affect outcome.

Adolescent↗
PubMed1996

[Computer-assisted text analysis of psychiatric treatment sessions--comparison with psychoanalytically oriented initial interview, psychoanalytic sessions and visit interviews].

24 interviews in a psychiatric outpatient clinic have been analysed as well by means of the Ulm computer-assisted text data analysis (macro- and micro-structural) as by means of a self-administered adjective checklist and have been compared with psychoanalytic initial interviews, psychoanalytic sessions and visit interviews in an internal and in a psychosomatic ward. The therapists' verbal activity was more in psychiatric interviews than in psychoanalysis and psychoanalytic initial interviews, but less than in visit interviews in an internal, not in a psychosomatic ward, however. Subgrouping the psychiatric interviews according to the patients' initial emotional state, there were significant differences of the sequential analyses- and that regarding verbal activity, frequencies of anxiety topics, common vocabulary, talking about psychopharmacotherapy versus interpersonal relationships and use of personal pronouns. Conclusively, psychiatric interviews can be recorded and evaluated by methods of empirical psychotherapy process research.

Adult↗
PubMed1995

Panic disorder with or without concomitant depression 5 years after treatment: a prospective follow-up.

50 patients with panic disorder (30 without and 20 with concomitant depression) were enrolled in a controlled treatment study using either imipramine or doxepin in addition to supportive psychotherapy and were then studied under naturalistic treatment conditions over a 5-year period. While patients with concomitant depression scored higher in overall measures of illness severity (as measured by HAMA, HAMD and GAS), no differences were detected between the groups with regard to panic disorder symptoms and degree of impairment. Our data suggest that comorbidity of panic disorder and depression is no prerequisite for poorer long-term outcome compared with panic disorder without depression.

Adult↗
PubMed1995

Fluctuation of symptoms and social functioning in panic disorder with or without concomitant depression. A 5-year prospective follow-up.

After controlled treatment with either imipramine or doxepin with additional psychotherapy, 30 patients with pure panic disorder and 20 with concomitant depression were followed under ordinary treatment conditions over a 5-year period. While the overall level of illness severity was mild in both groups (slightly worse in the group with comorbidity), social impairment as well as fluctuation of symptoms were similar in both groups. Therefore, comorbidity of panic disorder and depression does not necessarily imply a poorer outcome in a self-referred patient sample initially treated with psychotropic drugs combined with supportive psychotherapy.

Agoraphobia↗
PubMed1994

Psychophysiological and biochemical changes in patients with panic attacks in a defined situational arousal.

A group of 27 patients with panic disorder with or without agoraphobia were compared with 10 control subjects before stress exposure. No statistically significant differences between patients and controls were found for the cardiovascular parameters. Skin conductance level and skin conductance reaction were significantly higher in the patient group. They also showed higher self-ratings in behavioural symptoms associated with anxiety. There were statistically significant higher venous plasma levels of norepinephrine in patients than in controls, although the epinephrine levels were similar. The number of binding sites of alpha 2-receptors and the affinity of 3H-yohimbine to the alpha 2-receptors on intact thrombocytes was statistically significantly lower in patients compared to controls. Significant differences between the gender groups of patients and controls were found for electrodermal activity and epinephrine levels. These data add further evidence to an overshooting activation of the noradrenergic pathway in patients with panic disorder, possibly based on a dysregulation of alpha 2-receptor.

Adult↗
PubMed1994

Prospective follow-up study lasting 2 years in patients with panic disorder with and without depressive disorders.

A group of 52 patients presenting at an outpatient unit for anxiety disorders were included consecutively in a prospective 2-year follow-up study. Patients were administered to a structured interview for DSM-III-R diagnoses, a follow-up interview (LIFE), and various other ratings. Sociodemographic and illness-history characteristics, levels of anxiety and depressive symptoms, as well as psychosocial impairment, were evaluated at baseline and follow-up and compared between patients with panic disorder only and patients with panic disorder and concomitant depressive disorders at index assessment. Cross-sectional and longitudinal differences between patients with panic disorder only and patients with panic disorder and concomitant depression have been found, indicating that patients with comorbid conditions are more severely ill and have a less favorable outcome. For the total sample, however, the 2-year outcome was better than that reported in many other follow-up studies.

Adolescent↗
PubMed1993

Outcome of panic disorder with or without concomitant depression: A 2-year prospective follow-up study.

In a prospective 2-year follow-up study, 32 patients with panic disorder alone and 20 with panic disorder and concomitant depression were investigated. After controlled treatment with either imipramine or doxepin, patients received naturalistic treatment with antidepressants, benzodiazepines, and supportive psychotherapy. They were evaluated for anxiety, depression, and social disability at least every 3 months during the follow-up period. The data showed fluctuation of symptoms in both groups and a less favorable outcome for the patients with comorbid conditions. However, the overall outcome was better than that reported in other studies and indicates that panic disorder is quite responsive to appropriate treatment.

Adult↗
PubMed1993

[Group psychotherapy in patients with panic disorder and agoraphobia].

The one-year supportive group-psychotherapy (3 groups with 8-9 patients) was carried out once-weekly by two therapists in 26 patients who met the DSM-III-R criteria for panic disorder and agoraphobia. Patients filled in various ratings at the beginning and at the end of the therapy and a visual analog scale before as well as after each session. Twelve months after the end of the group-therapy the Longitudinal Interval Follow-up Evaluation (LIFE) was carried out. During the group-psychotherapy panic sensations, anxiety, nervousness and fears as well as psychosocial disability decreased. Duration of illness affected the reduction of panic sensations, anxiety, nervousness and fears during the first 6 months of the group-psychotherapy. Phobic fears and avoidance behavior mostly improved in patients with a duration of illness of more than 5 years and an additional depressive disorder. At the one-year follow-up 80% of panic patients without depressive disorder were symptom-free and reported better partner-relationships, more satisfaction, and a better social adjustment compared with panic patients with concomitant depressive disorders.

Adult↗
PubMed1992

Age at onset, precipitating events, sex distribution, and co-occurrence of anxiety disorders.

178 outpatients were administered to a structured interview evaluating diagnostic, illness history, and sociodemographic data of DSM-III-R anxiety disorders. Patients with panic disorder with agoraphobia were a more severely ill subgroup than patients with panic disorder without agoraphobia. Simple and social phobia had the earliest age at onset, panic disorder the latest age at onset. Conjugal stress was the most frequent event preceding the onset of the anxiety disorders. Female patients showed more severe impairment suffering more frequently from concomitant phobic avoidance, generalized anxiety, and depression compared to male patients.

Adolescent↗
PubMed1992

Differentiation of DSM-III-R anxiety disorders by severity of illness and symptom onset sequences.

187 patients were investigated by a structured interview for DSM-III-R and various clinicians' and patients' ratings. A high frequency of comorbidity between different anxiety disorders and between anxiety and depression was found. According to sociodemographic data, various anxiety disorders showed more similarities than differences. Patients with a generalized anxiety disorder showed an earlier age at onset compared to patients with panic disorder as well as a greater severity of illness and comorbidity. Avoidance behavior occurred before, simultaneous with, as well as after the onset of panic disorder.

Adult↗
PubMed1992

Pretreatment anxiety level as differential predictor in outpatients with panic disorder.

The pretreatment anxiety level is supposed to be a very important unspecific treatment factor. Main purpose of this study is to test whether the patients' pretreatment anxiety level is a general or a specific predictor of treatment response and whether mildly, moderately, and severely anxious patients can be differentially characterized by other diagnostic and clinical variables. 103 patients (37 males, 66 females; mean +/- sd age 35.6 +/- 9.5 years), a subsample of the Second Phase of the Cross-National Collaborative Panic Study, were included in the present study. A high positive correlation of initial anxiousness with the number of panic attacks at the end of treatment was found, moreover high positive correlations with most other baseline assessments. Initially severely anxious patients are the severest ill patients with the least treatment response, and that in all treatment groups. The pretreatment anxiety level predicts the number of panic attacks as well as the degree of avoidance behavior in both drug groups, whereas it predicts anticipatory anxiety intensity in the placebo group.

Adult↗
PubMed1990

Pilot study on the therapeutic efficacy, clinical safety, and dosage finding of enciprazine in out-patients with anxious and anxious-depressive syndromes.

The new basic propanolamine derivative enciprazine (D 13 112) was tested in an open single-blind phase-II trial with regard to therapeutic efficacy, clinical safety, and dosage finding. The drug showed a good efficacy in mildly ill patients. Under the highest dosage frequently fatigue was reported. In 78% of the patients the enciprazine trial succeeded in shifting patients from benzodiazepines to non-benzodiazepines or in discontinuation of psychopharmacotherapy after completion of the trial.

Adult↗
PubMed1976

[Hemoperfusion by means of encapsuled charcoal for the treatment of exogenous and endogenous intoxications].

The method developed by Chang for using in collodion and albumin encapsuled charcoal as artificial cells for hemoperfusion has been studied in vitro. The capacity for the absorption of more or less dialysable exogenous substances (barbiturate, Diazepam, Parathion) and an endogenous toxic metabolite (p-hydroxyphenyl acetic acid) has been examined. With the absorption unit one can eliminate 80 to 90 per cent of the initial concentration of barbiturate, Diazepam and p-hydroxyphenyl acetic acid in about 90 min, of Parathion about 50 per cent in the same time, whereas bromide and ammonia are not absorbed. Attempts to avoid regional heparinisation by the incorporation of heparin into the capsule of charcoal granules were not successful. Assuming correct preparation of the hemoperfusion system, observance of steril precoutions and regional heparinisation, the use of the "detoxication shunt" is a promising means in the treatment of severe exogenous and endogenous intoxications which are not accessible by conventional therapeutic means.

Adsorption↗