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H Lauter

Publications and source records attributed to H Lauter.

At least 19 recordsLinked to original sources
PubMed1992

[The new euthanasia-discussion from the psychiatric viewpoint].

The practice to kill terminally ill patients on their own demand has resulted in the Netherlands in a decriminalisation of active euthanasia which thus has fundamentally changed the way to deal with dying patients. Sooner or later this development will extend to other European countries as well as to the USA. Involuntary euthanasia of severely handicapped newborn children or of demented persons is propagated by the practical ethics of P. Singer and other representatives of utilitarianistic philosophy. According to the standpoint of utilitarianism a human being should only have the right to live as long as he or she is a person, i. e. has rationality and self-consciousness. The next step toward the elimination of elderly people can easily be predicted. For economical reasons these persons may be withheld from life-saving medical treatment or may be supposed to commit suicide. A moral pressure is created to make a decision for suicide as soon as severe invalidity occurs. The consideration of such ideas shows that in today's debate on euthanasia the issue is no longer the right of a few severely and terminally ill human beings to their "own death". Instead, the right to live of a large group of handicapped and "socially useless" or "unproductive" persons is at stake. This is the danger of today's discussion of euthanasia.

Persons with Disabilities↗
PubMed1991

Depressive disorders and dementia: the clinical view.

The relationship between depression and dementia is complex. Transient emotional disturbances and long-lasting depressive disorders may occur as psychological reactions to the loss of mental abilities or as behavioural manifestations of brain injury. On the other hand, major depressive disorder of late onset or of a recurrent type may be superimposed on dementing illness. Depression, particularly in elderly individuals, can manifest itself as a reversible syndrome of dementia that responds favourably to antidepressant treatment. It is not known whether the dementia syndrome of depression represents a quantitative intensification of minor cognitive impairments that can be observed in a large proportion of depressed patients. It also remains doubtful whether dementia in depressed patients has to be considered as an epiphenomenon of pervasive melancholic illness. An alternative explanation would look at such conditions as manifestations of a specific brain dysfunction. Major depression associated with cognitive impairment in stroke patients might be regarded as an example of a reversible dementia dysfunction.

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PubMed1991

[Information-centered family groups for improving compliance in schizophrenic patients].

We tried to improve the compliance in the long-term treatment of schizophrenic patients by psychoeducational groups for relatives of 48 patients over the course of six months. More than 90% of the relatives requested mainly informations concerning the illness and its treatment both at the beginning and at the end of the group sessions. At the beginning only 33% of the relatives thought they could benefit from sharing their experiences with others, afterwards this rate rose to 67%. At first, 49% believed to understand the nature of schizophrenia, at the end this rate was 86%. The importance of medication implying certain side effects was accepted by about 85% before and afterwards. This good quota at the beginning of the group sessions can be explained of this high acceptance rate appears to be a direct result of the group meetings.

Adaptation, Psychological↗
PubMed1991

[Visual evoked potentials in Alzheimer's and Parkinson disease].

Harding et al. suggested at first that an increase of P2 latency in flash VEP without an increase of P2 latency in pattern reversal VEP may be a diagnostic marker of Alzheimer's disease. Up to now there is no convincing evidence for this hypothesis. The purpose of the present study was to examine this hypotheses in an extended group of patients with Alzheimer's disease (n = 36). In addition, a group of patients with Parkinson's disease (n = 8) without dementia syndrome and a group of healthy elderly controls (n = 46) was investigated in order to determine the sensitivity and specificity of these VEP parameters. The results confirmed significant group differences between patients with Alzheimer's disease and healthy controls concerning the increase of Flash P2 latency and unchanged latency of P2 in the pattern reversal VEP. No significant correlations were found between duration of illness and mental test scores. The group differences of P2 latency in the flash VEP for patients with Parkinson's disease and healthy controls were also significant. Therefore, the increase of flash P2 latency in VEP does not seem to be specific for Alzheimer's disease nor for dementia syndrome. The pathological mechanism causing the flash P2 latency increase in a remarkable number of neuropsychiatric patients should be elucidated in further experimental investigations.

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PubMed1991

[Time perspective in the treatment of elderly depressed patients].

Coping with depressive illness in old age is impeded by particular strains: an increasing incidence of loss events, physical constraints, lack of social support and narrowing prospects for the future may lead to relapse as well as retarded recovery or chronification. Treatment directed toward long-term rehabilitation therefore requires, in addition to medical measures, psychotherapeutic and social interventions which help the patient cope with past loss, solve current problems and open up new perspectives for the future. This integration would overcome a dichotomy, still prevalent in psychotherapy for the elderly, between retrospection and life review on the one hand, activation and extension of competence on the other--or "involution" versus "evolution". A therapeutic approach which thus integrates personal aspects of the past, present and future may also combine various methods such as reminiscence therapy, interpersonal therapy, behavioral and social interventions.

Adaptation, Psychological↗
PubMed1990

The onset of Alzheimer's disease. A longitudinal case study and a trial of new diagnostic criteria.

We had the opportunity to document the onset of presenile Alzheimer's disease in a female patient who presented at a very early stage and was followed for 18 months at close intervals. Disturbances of memory, of intellectual abilities, and of language were the initial symptoms, which caused significant impairment of working performance several months before becoming apparent at home. The clinically evident progression of the disease was confirmed by psychometric tests but was overlooked by cognitive screening batteries and by global severity ratings. In the absence of any signs of brain atrophy, even on repeated X-ray computed tomography, a severe temporoparietal reduction of glucose metabolism was disclosed by positron emission tomography. The typical case demonstrated several imperfections of newly introduced diagnostic criteria in their ability to identify early Alzheimer's disease. Improvements for some of these deficiencies are suggested.

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PubMed1988

[Dementia].

This report briefly reviews the clinical diagnosis of dementia, including the most important problems of differential diagnosis. General guidelines of therapy are presented with special reference to the modification of secondary factor which may contribute to the severity of dementia and to psychosocial approaches in the management of patients.

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PubMed1988

Diagnosis, differential diagnosis and nosologic classification of the dementia syndrome.

Some clinical aspects of the diagnosis, differential diagnosis, and the nosologic classification of the dementia syndrome are presented. In discussing the definition of the dementia syndrome and its differentation from other organic brain syndromes, the criteria of DSM III are taken into account. Considering the nosological classification of the dementia syndrome particular emphasis is placed on the most frequent diseases in the senium, the Multi-Infarct Dementias (MID) and the primary degenerative dementias (PDD, according to DSM III). The clinical problems in differentiating MID from PDD and Morbus Pick from the dementia of the Alzheimer type in the group of are discussed in more detail.

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PubMed1987

Classification of parasuicide by cluster analysis. Types of suicidal behaviour, therapeutic and prognostic implications.

A classification of suicidal behaviour was derived by cluster analysis from descriptive data on parasuicide patients. The grouping was meaningful in terms of clinical interpretation and had both therapeutic and prognostic implications. The sample was broken down into three groups, identified as repeated, serious and non-serious attempts. The repeated attempters had the worst prognosis at 1-year follow-up. When the sample was classified into five groups according to seriousness of the attempts, the repeater and non-serious groups were retained, while the serious attempts were split into three subtypes, which differed on nosological characteristics, treatment disposal and outcome. An excessively high successful suicide rate was found in a small group of elderly attempters.

Behavior↗
PubMed1987

[Family groups in Alzheimer's disease: initial experiences and results].

A regular family support group was established within an outpatient clinic for demented elderly patients. At the outset of the group, the relatives knew little about the disease and about the available resources of help, but some were highly experienced in the management of dementia. The group provided information, exchange of experience, practical problem-solving, support in emotional difficulties, and clarification of interpersonal conflicts in the family. The effect of the group showed in decreased feelings of burden and tension in most participants. The present observations suggest that family support groups should be long-termed and that the experts' primary task is to activate and amplify the self-help potential of the caregivers.

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