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Biomedical subjects

H Rittmannsberger

Publications and source records attributed to H Rittmannsberger.

At least 19 recordsLinked to original sources
PubMed2006

[Patient knowledge regarding tardive dyskinesia].

BACKGROUND: Patients can provide appropriate and legally valid consent to treatment with antipsychotics only if they received adequate information on the risk of tardive dyskinesia (TD) and have the capacity to give informed consent. METHODS: Eighty-seven patients in a psychiatric practice undergoing treatment with antipsychotics were interviewed for their level of information regarding TD and were subsequently provided with additional information on TD as needed. Three months after provision of this information, the interview was repeated. RESULTS: Though 82% of the patients had read the patient information leaflet and 44% had already received previous information, only 17% were found to be informed. The proportion of informed patients increased to 72% at the second interview. Among patients remaining uninformed despite previous information, a statistically significant higher proportion of elderly patients and patients with marked psychopathological impairments was found. CONCLUSIONS: Schizophrenic patients' knowledge on TD is low. With appropriate oral information being provided patients' knowledge can be considerably improved in the short run.

Adult↗
PubMed2004

Spontaneous remission of SSRI-induced orgasm delay.

BACKGROUND: Orgasm delay is a common side effect of SSRIs,causing negative influence on patients' compliance and quality of life. A possible strategy for the management of SSRI-induced orgasm delay is waiting for tolerance to develop. The authors studied the natural course of SSRI-induced orgasm delay over a period of 6 months. METHODS: One hundred eight patients having been started on SSRIs were included in an open, naturalistic study. Sexual dysfunction was assessed at monthly intervals using a structured interview. RESULTS: Twenty-six patients developed clinically relevant SSRI-induced orgasm delay. Eight patients (30.8%) reported complete remission of sexual dysfunction, while four patients (15.4%) noted a marked improvement. Four patients (15.4%) continued to describe severe orgasm delay at the end of the observation period. High severity of orgasm delay significantly correlated with lack of remission. CONCLUSIONS: A significant proportion of patients, especially those with mild to moderate orgasm delay, develop tolerance within 6 months.

Adult↗
PubMed2002

The use of drug monotherapy in psychiatric inpatient treatment.

OBJECTIVE: Monotherapy has always been the goal in psychiatric drug treatment, but it does not seem to be very common in everyday practice. METHOD: The available literature on the frequency of monotherapy or polytherapy with psychotropic agents in psychiatric inpatient treatment is reviewed. FINDINGS: Taken all together (28 studies on 42 treatment facilities), the mean number of psychotropics prescribed was 2.47, the rate of monotherapy was 36.2% and 37.9% of inpatients received > or = 3 different drugs. Comparing the last three decades, a significant decline of the rate of monotherapy was found, topping at 47.8% in the 70s and falling to 19.6% in the 90s. The mean number of psychotropic drugs prescribed rose from 2.2 to 2.9 and the number of patients receiving > or = 3 psychotropics rose from 27.5 to 49.7%. CONCLUSION: Though it is still mandatory to avoid unsound polypharmacy, we must assume that the occasions for polypharmacy are increasing. New psychotropic drugs, increasing comorbidity and augmentation strategies may be incentives for polydrug use. Since in most countries the number of psychiatric beds declines, inpatient treatment has to deal with the most severe, often treatment-resistant patients requiring special therapies.

Drug Therapy, Combination↗
PubMed2001

Zotepine in the treatment of acute hospitalized schizophrenic episodes.

The atypical antipsychotic zotepine was studied in an open, multicentre uncontrolled, post-marketing surveillance study in 108 schizophrenic patients hospitalized in 12 trial centres in Austria. Within the dosage range of 50-450 mg (mean at the end of the study, 207 +/- 125 mg/day), a significant reduction of positive as well as negative symptoms was noted. There was no increase in extrapyramidal side-effects during the study and a significant decrease in akathisia scores. The medication was well tolerated during the 42-day observation period. Zotepine improved both positive and negative symptoms and was not accompanied by extrapyramidal side-effects, justifying its classification as an atypical antipsychotic.

Acute Disease↗
PubMed2000

Alcohol consumption during methadone maintenance treatment.

Alcohol consumption during methadone maintenance treatment (MMT) often becomes a problem. We investigated a group of 68 patients undergoing MMT in our care. Mean duration of MMT was 50 months. A set of risk factors for problematic alcohol use ('alcohol indicators') was set up consisting of patients' account and laboratory parameters. 52% of patients were positive for these 'alcohol indicators' and 32% of patients fulfilled more severe criteria for alcohol abuse. There was exactly the same proportion of patients with 'alcohol indicators' at the start of MMT as at follow-up examination. In 79% of these patients 'alcohol indicators' were found on both occasions, testifying that alcohol problems were a stable trait. While patients without 'alcohol indicators' showed an improvement of liver parameters over time, those with 'alcohol indicators' suffered a considerable deterioration, indicating that the amount of alcohol consumption had increased.

Adult↗
PubMed1999

Polypharmacy in psychiatric treatment. Patterns of psychotropic drug use in Austrian psychiatric clinics.

There are great variations in the way psychotropic drugs are prescribed. Most experts are in favour of psychopharmacological monotherapy, but little is known about the extent to which it is actually practised. A survey of the psychopharmacological medication of all patients under treatment was carried out in three Austrian psychiatric clinics of various types on two separate days. A psychiatric university clinic, the psychiatric department of a general hospital and a regional mental hospital were selected for the survey. It was established that only 8% to 22% of the patients underwent psycho-pharmacological monotherapy and that the patients received 2.2 to 3.3 psychotropics on average. Five to 22% of the patients received five or more psychotropic agents. The results are presented in more detail in relation to the diagnoses of schizophrenia and depression. The rare occurence of monotherapy might be due to unsound treatment regimens in some instances, but much more to a general trend in psychiatry fostering polydrug use.

Adult↗
PubMed1998

[Neuroleptic treatment by the established psychiatrist. A report of experiences].

PURPOSE: Contrary to in-patient psychiatric care, quality assurance in the area of psychiatrists in outpatient practice is hardly in use. METHODS: Neuroleptic therapy regarding the following quality criteria was examined for 6 months in an outpatient psychiatric practice: choice of neuroleptics, dosage and combination of additional psychopharmacological medications. RESULTS: 13 different neuroleptics were prescribed to 147 schizophrenic patients, most frequently haloperidol and clozapin. 31% of these patients (n = 147) fell below the dosage recommendations for maintenance therapy. The most frequent psychopharmacological combinations were the combination of two neuroleptics (30%), the combination with lithium or carbamazepin (28%) and the combination with antidepressants (23%). CONCLUSION: Standardised treatment suggestions as guidelines are valuable for psychiatrists in an outpatients setting. In some cases it is necessary to develop individual treatment strategies that vary from the usual treatment standards.

Adult↗
PubMed1996

[Somatic illnesses in psychiatric patients. 9 case reports].

We report nine case histories of patients admitted to a psychiatric hospital for severe somatic disorders. The somatic disease was either the cause of the psychiatric symptomatology, or it occurred in addition to a well-known psychiatric disorder. For general practitioners and psychiatrists it can be difficult to differentiate between symptoms due to psychiatric disorders and symptoms that indicate somatic disorders. If patients refuse the necessary diagnostic or therapeutic procedures and show behaviour that is not related to good health, there is increased risk for complications and increased morbidity.

Adult↗
PubMed1996

Asterixis induced by psychotropic drug treatment.

Asterixis (flapping tremor) can be induced by treatment with psychopharmacologic agents. We observed 10 cases of asterixis in psychiatric inpatients, most with affective spectrum disorders being treated with combination therapy. The drugs most often used were clozapine (eight cases), lithium (seven cases), and carbamazepine (seven cases). There were neither metabolic disorders nor structural brain lesions that might explain the occurrence of asterixis. Because dosage in general was moderate and serum levels were within therapeutic boundaries in most cases, the symptom seemed to have been caused by an interaction of drugs rather than by a single agent. Therefore clozapine, carbamazepine, and lithium should be combined with each other only with great care.

Adult↗
PubMed1996

[Vocational rehabilitation of psychiatric patients].

135 former clients of the "Arbeitstrainingszentrum (ATZ)" in Upper Austria, a facility for vocational rehabilitation, participated in a comprehensive follow-up study 1 to 9 years (mean 3,8 years) after termination of the ATZ. 60% of them finished the ATZ regularly, meaning either that they completed the full training or that they left for another job. Occupational situation of the former clients at follow-up was as follows: 24% were competitively employed, 17% held a sheltered working place, 3% underwent training, 6% did not-economic work, 6% worked in a household. 13% were unemployed and in search for a job, 30% received a disability pension. 41% of all clients had held no job at all since termination of the ATZ.

Adult↗
PubMed1996

[Compulsory commitment to a psychiatric hospital--the status in Austria].

Since 1991 in Austria a new law regulates involuntary admission at psychiatric hospitals and any other restriction of patient's freedom. Within 4 days a judge has to decide about further involuntary treatment. A new profession was established for involuntary patients support--the patients advocat. After a slow decrease of institutionalization rate in 1991 the number of involuntary admissions went up in 1993. The effects of the law upon psychiatric patients and treatment in psychiatric hospitals are discussed. Most psychiatrists (81%) are dissatisfied with the new legal situation because they see negative effects for some patients and have to spend a lot of time for juridical matters.

Attitude of Health Personnel↗
PubMed1996

[Insight into the illness by schizophrenic patients: a psychoanalytic perspective].

People suffering from schizophrenia usually lack insight in their illness leading to considerable problems in clinical treatment. This paper investigates the consequences of lacking insight for the psychoanalytic treatment of schizophrenic patients. Review of the literature reveals that lacking insight forces to substantial modifications of psychoanalytic technique. The therapist has to engage much more in establishing a relation with the schizophrenic patient than in others. The technique applied differs from therapist to therapist and seems to be determined by the therapist's personality primarily. This results in a reversal of Freud's metaphoric description of the therapist as the patent's mirror: on this occasion the patient is a mirror of the therapist's concepts of personality.

Awareness↗
PubMed1995

[Torticollis spasmodicus as a manifestation of tardive dystonia].

Tardive dystonia is a subtype of tardive dyskinesia which is rarely recognised and diagnosed. Tardive dystonia occurs clearly less frequently than oro-bucco-lingual dyskinesia (approx. 1 vs. 20%). We present a case report and give a survey on the characteristics of tardive dystonia, its differential diagnosis and treatment as described in literature.

Anti-Dyskinesia Agents↗
PubMed1995

[Social relations and social support of psychiatric patients--a network study].

24 mentally ill patients were interviewed about social networks and social support systems. The number of network members was 25.7 persons on average, most of them were other mentally ill people themselves (34%) or health professionals (20%). Contacts between mentally ill people were characterised by sympathy for each other, short lasting relationship and little support function. Health professionals have quite different functions for our patients depending on their professional role. Emotional support (which is seen as the most important support function by our patients) is given mainly by psychologists and social workers. Very little support comes from psychiatrists and general practitioners.

Adult↗
PubMed1995

[The need for work--experiences from a day-care center].

The concept of a vocational day-care centre for persons with chronic mental illness is discussed. Work is done with clay, which enables a supply with both very simple and very sophisticated tasks. Clients are able to clearly realize the results of their joint efforts. Analysis of attendance at the centre reveals that especially those who had spent longer periods of time in psychiatric hospital and are already receiving a disability pension came to work most regularly. These findings show that even for those who have definitely withdrawn from gainful employment, individually adapted work opportunities nevertheless remain of considerable importance.

Adult↗
PubMed1994

[Drug-induced asterixis].

A 54-year-old woman with acute schizoaffective psychosis was treated with lithium carbonate (1,350 mg daily) and zuclopenthixol. On admission, clozapine was added (250 mg daily). Because extrapyramidal symptoms (rigor, akinesia) developed, she was additionally given biperiden retard (4 mg daily) from the fourth hospital day onwards. Eleven days after admission she began to complain of "unsteadiness" and "tremors" in her arms and she had asterixis (flapping tremor) on holding up her arms. The electromyogram showed electrical pauses of 60-120 ms, typical for asterixis. There were no significant metabolic or organic cerebral changes that could have accounted for the symptoms which presumably had been induced by the drugs even though their dosage was not unusual. The symptoms in fact regressed completely after the clozapine dose had been reduced, at first to 125 mg then to 50 mg. Previous experience has suggested that the risk of asterixis is particularly high when lithium and clozapine are taken together.

Biperiden↗