[Diagnosis of schizophrenia. Puberty-related crisis or psychosis?].
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Adolescent↗
Biomedical subjects
H Braun-Scharm
Publications and source records attributed to H Braun-Scharm.
[Coping of schizophrenic adolescents].
The present study examines for the first time specific forms of coping in adolescents with schizophrenia during the initial phase of their illness. It was found that schizophrenic adolescents develop considerably less active coping compared to adolescents with other disorders. Active coping is least prominent for positive symptoms (delusions, hallucinations, thought disorders); the youngest first-manifestation adolescents are also impaired in other domains (irritability, psychosocial stability). The results have exploratory character as they are based on a small and thus not representative number of cases, but should prompt further investigations.
Adaptation, Psychological↗
[Misdiagnosis of first onset schizophrenia in adolescents].
The intensity of the symptomatology of schizophrenia in adolescents is essentially the same as in adults. As a rule schizophrenic psychoses in adolescence are first manifestations, and other psychiatric disorders have to be ruled out. The classical differential diagnoses include: exogenous psychoses, in particular drug-induced; affective psychoses; pubertal crises; personality disorders. Special early-onset features arise because drastic behaviour of another nature is occasionally misinterpreted or--more commonly the case--early schizophrenia in adolescents is not recognised and treated in time because of the uncharacteristic initial symptoms.
Adolescent↗
[Personality disorders in adolescence. A pilot study on classification and early course].
72 case histories of former adolescent psychiatric inpatients diagnosed on discharge as suffering from a personality disorder were evaluated. It was possible to re-examine 33 (46%) of them. The discharge diagnosis was made according to ICD 9, the follow-up diagnosis according to ICD 10 and DSM-III-R. Depending on the instrument and criterion, 40% to 87.9% of the discharge diagnoses made could be confirmed after an average follow-up period of 3.4 years. Only in 12.1% of the cases there was no personality disorder established. There was no indication of any change of diagnosis to other psychiatric disorders. The re-diagnosis rates obtained are thus similar to those for adults. The classifications of ICD 10 and DSM-III-R corresponded much better than those of ICD 9 to clinical reality. The classification systems and assessment instruments that have normally been verified only for adults thus also seem suitable for use among adolescents. In both adolescents and adults the avoidant personality disorder is a particularly frequent subtype. However, the current study was unable to resolve the question of what the decisive criteria should be in the case of competing definitions such as puberty crisis, personality development disorder, personality disorder and emotional or affective disorder. This issue requires further investigation.
Adolescent↗
[Aqueductal stenosis and hydrocephalus in a psychotic adolescent].
Examination of a 14-year-old male who was admitted to an inpatient unit with an acute paranoid syndrome yielded serious organic findings: macroencephaly, head tilted to one side, strabismus, neurological deficits, hydroencephaly and an expressive speech disorder. The personal and family history revealed a disturbance of motor development since infancy and psychiatric illness in the immediate family. The medication and the surgical procedure selected--endoscopic third ventriculostomy--are described and the difficult differential diagnosis is discussed.
Adolescent↗
Suicidality and personality disorders in adolescence.
The prevalence of personality disorders is higher among suicidal adolescent inpatients (15.3% out of 163) than among nonsuicidal adolescent inpatients (8.6% out of 374). Among the personality disorders, the borderline syndromes or emotionally unstable personality disorders were more frequent in the suicidal adolescents. Limited emotional control, intolerance of frustration, and impulsiveness are important characteristics of suicidal adolescents.
Adolescent↗
[Anorectic reactions in low intelligence].
Six female in-patients suffering from anorectic reaction are described. Difficulties in diagnosis and differences between these patients and anorectic patients of normal intelligence are discussed. The main finding is that in all six cases there was an extremely close and symbiotic mother-child relationship and a weak or absent father. Relevant life events in the nuclear family (new partner for the mother, illness in the father) then triggered the eating disorder.
Adolescent↗
[Inpatient management of adolescent psychiatric patients. A single day study].
The distribution of disorders in a one-day sample of 1806 adolescents receiving inpatient psychiatric care and classified with the diagnostic system ICD-9 is described. Of the inpatient psychiatric facilities for adolescents in the Federal Republic of Germany and West Berlin, 85% responded to our questionnaire. The main findings were: 1) More of the inpatients were male than female (1:0.8); 2) 80% of the patients were being treated at non-university facilities; 3) differences in diagnose between university and other hospitals were small and concerned only psychosis, eating disorders and oligophrenia; 4) the most frequent diagnoses were psychosis and neurosis (20% each), followed by special symptoms/syndromes and conduct disorders (between 10% and 15% each) and emotional disorders (10%); 5) other disorders were less common (under 10% each); 6) a comparison of the different Länder in the Federal Republic indicated that some regions do not have enough inpatient facilities.
Adolescent↗
[EEG changes and seizures with clozapine medication in schizophrenic adolescents].
Clozapine is an effective antipsychotic agent with atypical neuroleptic and side effects. The risk of pathological changes in the EEG and of seizures is correlated to the dosage administered. With dosages of 300 mg/day or higher the EEG should be monitored regularly. The neurophysiological effects of this drug, known only in adults up till now, were also found in adolescents suffering from schizophrenia.
Adolescent↗
Conversion disorder (DSM-III 300.11): symptomatology and course in childhood and adolescence.
The incidence, age and sex distribution, symptomatology, psychosocial stress factors and course of conversion symptoms in a child and adolescent psychiatric patient sample were studied. Under the age of 10 conversion symptoms are comparatively rare and consequently require careful diagnosis, particularly regarding visual and hearing defects. Predominant conversion symptoms are seizures, gait problems and paralysis.
Adolescent↗
The incestoid family.
Following a short overall view on family therapeutic models of close family systems and on incest family models, the concept "incestoid family" is conceived. In this way, families should be exemplified in which it is true that no manifest incest occurs, but by going from one generation to another, relationships between parents and children, resembling a relationship between partners and the constellation of subliminal enticement and seduction situations promote pseudosexual behaviour patterns; the most conspicuous symptom of such a family is hyper- as well as hyposexualised behaviour in children and young people. Definitive and conceptual demarcations to oedipal and incestuous structures were undertaken. Four case descriptions should illustrate the clinic of incestoid families.
Adolescent↗
[Psychogenic vision disorders in children and adolescents].
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Adolescent↗
[Hysterical neuroses in childhood and adolescence].
A sample of 148 child and adolescent psychiatric patients with hysterical neurosis is described as to the variables features and extent of symptomatology, age and sex distribution, psychosocial adversity and prognostic factors. Out of the "classical" symptoms seizures, walking disturbances, twilight attacks and paralyses were seen most frequently whereas vision and hearing disturbances were rather rare. Only one fifth of the patients presented a monosymptomatological pattern of disturbance. Mean age at falling ill was 13.4 years, just three children were younger than 6 years. Our clinical results buttressed by other reports of the child and adolescent psychiatric literature indicate that the traditional concept of hysteria postulating a close link between somatical symptom development and a specific intrapsychic conflict is hardly tenable at least for childhood and adolescence. Classification should be rather grounded upon an essential phenomenological approach as designed by ICD 10.
Adolescent↗
[XYY syndrome (diplo-Y syndrome)].
A case is reported of a 12-year-old boy with the XYY syndrome and unusual clinical symptoms. In addition, past research on the XYY syndrome and the current state of knowledge is reviewed, with special emphasis on psychopathology, psychiatry and genetic counseling.
Child↗
[Obsessive phenomena in schizophrenic adolescents].
Adolescent schizophrenics show obsessive-compulsive symptoms as often as adult patients. Obsessive-compulsive symptoms occur generally both in premorbid and post-acute states, whereas they are rarely observed in acute states. A particular preference of any schizophrenic subgroup doesn't seem to exist. Obsessive-compulsive phenomena are not the same as coping-techniques or (pseudo)-neurotic defense mechanisms, and don't allow a prediction of a distinct outcome. The relationship between schizophrenia and obsessive-compulsive symptoms is variable, and doesn't follow a set pattern.
Adolescent↗