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Biomedical subjects

H G Nehen

Publications and source records attributed to H G Nehen.

10 recordsLinked to original sources
PubMed2004

[Changes of a sample of aged > or = 60 years of age in-patients after five years: results from the ELDERMEN-Study].

METHOD: The ELDERMEN Study, which was funded by the German Research Association, comprises baseline assessment during 1994-1997 and a second assessment during 2000-2002. A total of 261 in-patients participated in an extensive examination at baseline assessment and were contacted again five years later. RESULTS: Five years after baseline assessment, 135 former participants had deceased, 29 newly fulfilled exclusion criteria. Of the 97 individuals who matched the study's inclusion criteria at the second assessment, 74 participated in the second evaluation. Baseline assessment revealed no significant differences between participants at second assessment and those persons who refused the second participation. However, participants in the extensive examination and longitudinal design were a positive selection when compared to the whole baseline sample. DISCUSSION: Because of increasing morbidity and mortality, longitudinal gerontological studies have to deal with the problem of selective diminishment of the sample, which can endanger the validity and generalizability of results. The problem has to be dealt with by careful documentation and evaluation of selectivity effects. We focus on the problems of longitudinal studies in gerontologic research and examine the longitudinal development of a sample of geriatric in-patients aged > or = 60 years.

Aged↗
PubMed1999

[The degree of Objective Health Burden (OHB) - an expert assessment of the impairment caused by somatic illnesses in geriatric medicine].

The degree of Objective Health Burden (OHB) is an expert assessment of the impairment caused by somatic illnesses. It allows an overall clinical rating of the severity of a patient's somatic condition, considering all available information, not only the content or number of diagnoses. The rating on a five point scale is demonstrated with clinical examples. Interrater-reliability is satisfactory, being at least 0.74. External criteria indicate the OHB's validity. As the OHB is easy to comprehend and to employ, it is suitable for broad clinical application in geriatric basic assessment as well as for scientific purposes.

Adaptation, Psychological↗
PubMed1999

[Psychogenic impairment and current feelings in the elderly. Which options are offered by the biographical perspective?].

In the Eldermen study funded by the German Research Association (DFG), a consecutive sample of patients, aged > or = 60 (n = 120) and being treated for a variety of internal medical complaints in an acute geriatric hospital were examined with the help of comprehensive somatic diagnostics, standardised questionnaires, and a semi-structured biographical interview. The study investigates the relationship between burdensome and supportive biographical experiences and the extent of psychogenic impairment as well as aspects of feeling tone and self-concept in later life. For the degree of psychogenic impairment (Impairment Score. IS; Schepank 1995), subjectively experienced burdens and support were found to be more relevant than "objective" burdens. As expected, subjective burdens consistently experienced over several life phases, particularly in association with limited experienced support, were found to be associated with greater psychogenic impairment and a higher "case risk" in later life. However, the patients with the highest values for current life satisfaction as well as a more positive self-concept were not those patients who never experienced more burdens than support in their biographies, but rather those who experienced more burden than support in one life phase. The results are presented in relation to models of learning theory and object relation theory and discussed for their clinical relevance.

Aged↗
PubMed1997

[Early and differential diagnosis of 1,000 patients examined in a memory clinic].

The results from 1000 patients included in a consecutive sample of older persons showing signs of "age-related memory deficits" clearly demonstrate the necessity for a wide spectrum of differential diagnostic competence. The patients included in the study were diagnosed in succession by an interdisciplinary team of psychiatrists, neurologists, geriatric medical specialists, psychologists and gerontologists. The diagnostic process for clarification of DSM-III-R and ICD-10 criteria are discussed in detail. In all, 49.6% of the patients were diagnosed as suffering from dementia of the Alzheimer type, 31% from vascular dementia and 10% from a mixed form. In all, 12.5% of the patients were somatically ill and 31.4% displayed other psychiatric conditions, 50% of which were evaluated as being treatable with psychotherapy. The results are primarily discussed for their relevance to the reality of current treatment.

Adult↗
PubMed1997

[Patient assessment in suspected dementia].

In the near future the number of patients suffering from cognitive impairment and senile dementia will increase because of the change in the structure of population. General practitioners and specialists will be confronted with this problem. The early and differential diagnosis of senile dementia is still a problem. Corresponding with the diagnostic algorithms of ICD 10 and DSM IV the diagnostic procedure is discussed with geriatric, neuro/psychiatric, psychological and psychosocial aspects. The diagnosis also relies on history obtained from family and friends. Although cognitive loss is considered a core symptom of senile dementia, loss of behavioral disinhibition, loss of functional autonomy and mood problems are considered as more important by clinicians and family and are of great diagnostic value. Psychometric tests are important but they are only one out of many different possibilities to find the right diagnosis. If it is possible different specialists should examine the patient. Out of the different methods and views of the specialists a comprehensive image of the patient takes shape and allows a better understanding of dementia.

Aged↗
PubMedDate not supplied

The prevalence and differential diagnosis of subclinical depressive syndromes in inpatients 60 years and older.

BACKGROUND: Depressive syndromes that do not comply with the diagnostic criteria for specific depressive disorders are designated as 'subclinical' or 'subsyndromal' depressive syndromes. Using our own data from a clinical study, this paper outlines the significance of subclinical depressive syndromes and demonstrates the problems of differentiating between depressive and subclinical depression (SD) syndromes and organic mood disorders especially in an elderly population with medical comorbidity. METHODS: Two hundred and sixty-two patients aged 60 years and older in a general hospital were investigated, using a clinical psychiatric interview, expert ratings and self-report scales after extensive internal medical diagnostic evaluation. RESULTS: When, without further differentiation as to their origin, all symptoms required by symptom checklists according to ICD-10 were considered for the diagnosis of major depression (MD), 35.5% of the study participants fulfilled the diagnostic criteria. After differentiating for etiology of symptoms, MD was found in only 14.1%, SD was diagnosed in 17.6% and organic mood disorder in 12.2% of the study participants. In another 41 patients (15.6%), symptoms of depression not fulfilling ICD-10 criteria were classified as being of organic or drug-induced origin. SD patients were in a mean position between nondepressive and depressive patients with regard to social isolation and physical impairment; women were overrepresented in the depressive and subdepressive groups. CONCLUSIONS: SD and organic mood disorder are common and helpful diagnostic categories in the elderly. The results show that in old age there is substantial danger of confounding MD, SD and organic mood disorder, thus leading to erroneously high prevalence rates of MD and underestimations of organic mood disorder if depressive symptoms are recorded only by self-report scales or a symptom checklist. Both internal and psychosomatic-psychotherapeutic competence as well as a liaison service in general hospitals are necessary for the differential diagnosis of MD, SD and organic mood disorder in the elderly with medical comorbidity.

Age Factors↗
PubMedDate not supplied

[The geriatric team in the memory clinic].

The early and differential diagnosis of senile dementia is still a problem. The work of a multiprofessional team in the Memory Clinic Essen is reviewed. the combination of qualifications of the team corresponds with the diagnostic algorithms of DMS-III R and ICD 10. Members of the team are a geriatrician, a psychiatrist, a geragoque, and a psychologist. Every specialist examines the patient using his specialized method. The results are discussed in a diagnostic conference. Out of the different methods and views of the specialists a comprehensive image of the patient takes shape and allows a better understanding of the dementia.

Aged↗
PubMedDate not supplied

[Pain and pain perception in the elderly from the viewpoint of rheumatology].

In rheumatology there is the problem of different terminologies and classification systems; additionally there are only few studies on differential diagnosis and course of diseases in people over 65. The analysis of pain is important for diagnosis; people often have problems in exactly describing their pains. The character of pain changes in the course of disease; therefore a continuous pain analysis is necessary.

Aged↗