Biomedical subjects

H L Van

Publications and source records attributed to H L Van.

6 recordsLinked to original sources

PubMed2002

[Depressive patients who don't recover].

Three patients, two men aged 43 and 53 years, respectively, and one woman aged 40 years, remained depressed despite years of medicinal therapy and counselling, although some improvement was eventually achieved in the woman. Although in general, depression can be treated successfully, in clinical practice many patients experience only limited improvement. It is important to follow through all the steps of the guidelines for treatment of depression and to continue psychiatric management and care in these kind of situations.

Adult↗

PubMed2001

The developmental profile.

We describe the Developmental Profile and the development of the instrument, the theory on which it is based, and the manner in which information is collected, interpreted, and used in clinical practice. We present the results of the psychometric research that has been performed to date. Finally, we examine the extent to which this method is in accordance with recent insights within the field of personality diagnostics.

Freudian Theory↗

PubMed2000

Clinical relevance of gallium-67 scintigraphy in lymphoma before and after therapy.

The clinical impact of gallium-67 scintigraphy before and after therapy for lymphoma remains controversial. The aims of this study were: (1) to compare the staging of lymphoma by 67Ga scintigraphy only with staging by clinical examination and conventional imaging (CI), and (2) to analyse the clinical relevance of both 67Ga imaging and CI after treatment. From March 1995 to November 1998, 86 67Ga scintigraphy studies were performed in 62 patients with Hodgkin's disease (n=52) or non-Hodgkin's lymphoma (n=10). 67Ga scintigraphy was performed at diagnosis (n=44) or after therapy (n=42) using 185-220 MBq 67Ga citrate and planar and single-photon emission tomography (SPET) studies. Treatment comprised radiotherapy, chemotherapy or combined modalities. CI included plain chest radiography, computed tomography (CT) of the chest and abdomen/pelvis, ultrasound of the abdomen, lymphography, bone marrow biopsy and, when necessary, magnetic resonance imaging (MRI) and bone scintigraphy. For individual suspected sites of disease before treatment, complete agreement between clinical examination and CI on the one hand and 67Ga scintigraphy on the other hand was observed in 25/44 patients (57%; 95% confidence interval 41%-72%). Clinical examination and CI showed more sites than did 67Ga scintigraphy in 12/44 patients (27%) and 67Ga imaging demonstrated more sites than CI in 6/44 patients (11%). The clinical stage of the disease as assessed using 67Ga scintigraphy only was in agreement with that using all diagnostic procedures in 34/44 patients (77%; 95% confidence interval 62%-89%). Compared with CI staging, 67Ga scintigraphy downstaged seven patients (16%) and upstaged three (7%). 67Ga scintigraphy downstaged mainly because of the limited value of the technique below the diaphragm and upstaged owing to the good sensitivity in the lung. After therapy, both CI and 67Ga scintigraphy were normal in 11 patients. All but one of these patients were in complete remission after a median follow-up of 31 months. In contrast, radiological residual mass was observed in 31/42 patients. 67Ga imaging was normal in 22/31 (71%); 17 of these 22 patients, including nine with a large residual mass (> or =2 cm), were in complete remission after a median follow-up of 32 months, while four suffered relapses 8-45 months later. The cause of death remained unknown in one patient. 67Ga scintigraphy showed abnormal uptake in 9 of the 31 patients with a large residual mass. Active disease was demonstrated in eight patients and one patient was in complete remission 30 months thereafter. Our data show that 67Ga imaging cannot replace CI in initial staging but can demonstrate additional individual sites of disease in more than 10% of patients and can lead to clinical upstaging with potential prognostic and therapeutic consequences. After therapy, 67Ga scintigraphy has a clinical impact when radiological abnormalities persist because it can either avoid unnecessary complementary treatment or confirm the need to change treatment modalities.

Citric Acid↗

PubMed2000

Measuring overall defensive functioning with the Defense Style Questionnaire: a comparison of different scoring methods.

The evidence for the division of defenses measured with the Defense Style Questionnaire (DSQ) into immature, neurotic, and mature types appears to be lacking. We hypothesized that defenses can be represented unidimensionally. Classical multidimensional scaling was applied to the maturity ratings of items given by 279 experts. It appeared that the items of the DSQ can be represented unidimensionally. In a second study, two three-factor models of the DSQ were tested with confirmatory factor analysis, using scores of 543 psychiatric outpatients. Both three-factor models were implausible. A third study showed that the overall defensive functioning scores derived from the first study discriminated well between samples of 543 psychiatric outpatients, 69 medical students, and 68 graduate students attending a student counselor. We also found that the overall defensive functioning scores correlated positively with the current Global Assessment of Functioning in the psychiatric sample. We concluded that the DSQ is a useful instrument for measuring overall defensive functioning.

Adolescent↗

PubMed2000

The developmental profile: preliminary results on interrater reliability and construct validity.

This study presents the preliminary results of research into the interrater reliability and construct validity of the Developmental Profile (DP). In the DP a number of developmental lines, such as Object-Relations, Self-Images, and Problem-Solving Capacities, are assessed and classified according to the level of functioning. A total of 108 profiles were assessed, drawn from three different categories of patients. The weighted kappa values for interrater reliability were sufficient. On the adaptive level, but also on the maladaptive levels Symbiosis and Resistance, significant differences were found between psychiatric patients, "normal controls" (dental patients) and somatic patients. No differences were recorded between the latter two groups. The conclusion is that the DP is a promising instrument, of which the reliability and validity has to be further investigated in order to contribute to scientific support for psychodynamic theory formation.

Adaptation, Psychological↗

PubMed1999

[Psychiatric consultation and treatment for mentally handicapped persons exhibiting behavioral changes].

In three mentally handicapped people, two women aged 47 and 68 years respectively and a man aged 68, who suffered from behavioural changes that were not understood by the staff of the institution where the people lived, a psychiatric diagnosis was made by a consulting psychiatrist. The first woman had Down syndrome, she suffered from weight loss, loss of enjoyment and severe hallucinations. She was treated for a depressive disorder and recovered. The second woman yelled and threatened to hit the nursing staff. A bipolar condition was diagnosed and after unsuccessful drug treatment she was treated with electroconvulsion therapy upon which she recovered. The man had developed restlessness and verbal aggression with megalomanic episodes. A mood disorder was diagnosed which responded to valproic acid. In people with a mental handicap psychiatric disorders can be easily missed. The disorder can be complicated by an atypical presentation of symptoms, difficulty in obtaining information and limited knowledge and organization of the psychiatric services. Psychiatric consultation in people with mental retardation may lead to diagnosis and treatment of a psychiatric disorder.

Aged↗