PubMed Health⌕ Search

Biomedical subjects

H Schanda

Publications and source records attributed to H Schanda.

At least 37 records · Page 2Linked to original sources
PubMed1984

Course and outcome of delusional psychoses.

The authors reinvestigated 84 out of a sample of 90 patients with delusional psychoses after an interval of 6-9 years. The results of the follow-up showed a pattern of episodic versus chronic course which compares to follow-up studies on classically diagnosed schizophrenias. The authors found evidence for their hypothesis concerning the nosological heterogeneity of this group of psychoses and propose a syndromatological classification apart from the delusional symptomatology itself. What they call background symptomatology was divided into axial syndromes. The authors feel that this results in subgroups that are more homogeneous for course and outcome than the usual classification systems.

Adolescent↗
PubMed1984

Heterogeneity of delusional syndromes: diagnostic criteria and course prognosis.

In addition to genetic findings and treatment response, the course prognosis is also meant to be a possible validating criterion for diagnosis and diagnostic systems. In our study we used the polydiagnostic approach (i.e. the simultaneous application of various criteria for diagnosing a given disorder to one and the same population) to test the ability of several diagnostic systems to create homogeneous groups regarding the course (episodic/chronic). We applied Schneider's FRS, ICD-9, DSM-III, Spitzer's RDC and the Vienna Research Criteria to 90 patients with the diagnosis of delusional syndrome (aside from any nosological classification), who underwent 6-9 years of follow-up. At the index examination, schizophrenia was most frequently diagnosed with Schneider's FRS, which apparently encompasses a very heterogeneous group of patients regarding psychopathology and course. Diagnostic systems which allowed the diagnosis of affective disorders despite the presence of mood-incongruent delusional symptomatology (DSM-III, RDC, Vienna Criteria) or offered the diagnosis of schizoaffective disorder (DSM-III, RDC) succeeded in separating subgroups with an episodic course on a statistically significant level. In ICD-9 this significance appeared only after exclusion of the schizoaffective cases from the group of schizophrenias. Our data thus uphold the old rule of thumb that affective symptomatology apparently has a very high prognostic value regarding the course of the illness and is in this respect superior to productive symptomatology (such as delusions and hallucinations), still taken to be pathognomonic for schizophrenia by some of the diagnostic criteria under study. This aspect warrants further investigation and should be taken into account in the development and improvement of diagnostic manuals (e.g. ICD-10, DSM-IV).

Adolescent↗
PubMed1983

[Clonidine for the treatment of heroin withdrawal syndrome].

In an open study of 50 patients with heroin addiction, clonidine was efficacious by mouth in the treatment of acute heroin-withdrawal syndrome. Mean administration of clonidine (on an "as-needed" basis) was 5 days (maximum 7 days), whilst the mean daily dosage ranged from 0.112 mg to 0.468 mg, the maximum requirement occurring on day 2 of withdrawal and sinking thereafter. Since insomnia was not influenced by clonidine, we offered 100 mg doxepine and/or 10 mg nitrazepam (the latter only until day 4 of treatment). Under this medication a sudden, dramatic decrease in blood pressure was not seen, mean blood pressure and pulse rate were not markedly altered; this may, perhaps, be a consequence of the blocking effect of doxepine on the peripheral hypotensive actions of clonidine. Of the 9 drop-outs from treatment, five (10% of the total 50) were certainly directly attributable to the lack of response to clonidine, representing a failure of therapy in 10% cases at least.

2-Hydroxyphenethylamine↗
PubMed1983

The genetics of delusional psychoses.

In a genetic study of the first-degree relatives of 77 patients with delusional (paranoid) psychoses, the morbidity risks for schizophrenia, affective disorders, and atypical psychoses were evaluated using ICD-9 criteria. The prevalence of schizophrenia was 3.10 percent (4.12 percent with age correction to 40 years and 4.94 percent with age correction to age 60), which is higher than in investigations of paranoid psychoses, but lower than in studies of paranoid schizophrenia. The prevalence figure for affective disorders (age-corrected 3.04 percent for unipolar plus bipolar patients) is also intermediate to those for relatives of paranoid schizophrenics and paranoid psychotics. When the 77 index delusional patients were subdivided into axial syndromes (endogenomorphic-schizophrenic, endogenomorphic-cyclothymic, and organomorphic axial syndromes), two very homogeneous subgroups emerged. The endogenomorphic-schizophrenic subgroup showed high rates of schizophrenic secondary cases, whereas the endogenomorphic-cyclothymic subgroup showed high rates of affectively disordered secondary cases. The third organomorphic subgroup showed a high prevalence of atypical psychoses among first-degree relatives. Thirty-seven of the 77 index patients could not be assigned to any axial syndrome; their first-degree relatives had an increased prevalence of schizophrenia, but affective disorders were no more frequent than in the normal population. These data suggest that the heterogeneous group of paranoid psychoses can be meaningfully subdivided by use of axial syndromes which are viewed as representing "basic" disturbances underlying delusional symptomatology.

Adolescent↗
PubMed1983

[Inpatient withdrawal treatment of heroin dependence with neuroleptics--an approach to addicts].

The authors present a setting for abrupt withdrawal treatment with the following targets: 1. To facilitate the addicts the voluntary use of medical and psychiatric service. 2. To develop methods for withdrawal treatment, as riskless and easy to handle as possible. 3. To use the time of inpatient treatment for building up confidence in psychiatric services to motivate the patients for a following therapy. Drugs and dosage of peroral and intravenous neuroleptic treatment and possible complications are discussed. Peroral treatment has the advantage of lower doses, easier handling and lower complication rates. The setting and the used drugs seem to be attractive enough for many addicts to contact the clinic on their own account.

Administration, Oral↗
PubMed1983

[Family picture studies in patients with paranoid psychoses].

Among the first-degree relatives of 77 patients with delusional functional psychoses the authors found 13 schizophrenics (3.10%), 8 manic-depressives (1.91%) and 14 cases with atypical psychoses (3.34%), following ICD-9 criteria. These figures were compared with the figures in the literature on the genetics of paranoid schizophrenics and nonschizophrenic paranoids, regarding the different composition of the samples. Subdivision of the original 77 patients, using the concept of the axial syndromes, was able to form two homogeneous subgroups of first-degree relatives: one with a schizophrenia prevalence of 6.52% (uncorrected) and without any manic-depressive secondary cases (endogenomorphic-schizophrenic axial syndrome) and another with a manic-depressive illness (MDI) prevalence of 6.58% (uncorrected) without any secondary cases with schizophrenia or atypical psychosis. The first-degree relatives of the patients with an 'organomorphic' axial syndrome (usually excluded in other studies) had an increased rate of manic-depressive secondary cases (3.57%, uncorrected) and the highest rate of atypical psychosis (7.14%) without any schizophrenics, according to the etiopathogenetic heterogeneity of this group. 37 of the 77 patients were not assignable to any of the axial syndromes. In the first-degree relatives of these patients--best comparable to Kendler's criteria for 'delusional disorder'--an increased rate of schizophrenics and atypical psychoses was found (3.59 and 3.08%, uncorrected); the figures for MDI were within normal limits. Our results suggest that the axial syndromes are a useful diagnostic instrument in identifying--from the genetic standpoint--in part very homogeneous subgroups. This allows the conclusion that they are indicators for hypothetical basic disturbances.

Adolescent↗
PubMed1982

[In-patient withdrawal treatment of heroin addicts with neuroleptics (author's transl)].

The results are reported of 144 abrupt withdrawal treatment in heroin addicts (102 in males, 42 in females). Neuroleptics were given intravenously (partly via subclavia catheter) or orally and the results compared with one another. Parenteral treatment needed much more specialist supervision and control and had a much higher complication rate. It should be used only on the individual special case. The initial withdrawal lasts about 4 days with an oral dosage of 270 mg levopromazine in males and 240 mg in females or 540 mg chlorprothixene in males and 520 mg in females per 24 hours. The only side effects encountered were tachycardia and the occasional occurrence of extrapyramidal signs. The liver function tests did not show any significant changes during the treatment.

Adolescent↗
PubMed1980

Nonschizophrenic paranoid syndromes.

After presenting their model for the description of delusions, the authors report some results of two catamnestic studies in patients with delusional syndromes. There is evidence for the hypothesis that the usual classification of such patients as paranoid schizophrenics is frequently not justified. A reasonable number of the cases might belong to cyclothymia or at least approach it. Disappearance of delusions and complete restitution frequently occur in this group, while chronicity seems connected with persistent psychopathological signs in the accompanying symptomatology supposed to represent--in part--organic brain syndromes or congenital or acquired psychopathic personalities.

Adolescent↗
PubMed1980

Effects of cerebral gangliosides in the alcoholic polyneuropathies.

In chronic alcoholic patients with a slight or moderate polyneuropathy the effect of gangliosides at a daily dosage of 20 mg was investigated. A clinical improvement represented by a reappearance of the Achilles reflex and/or marked reduction of hypoaesthesia was found in the treated group. No significant changes in motor function were observed. No significant variation of the electrophysiological examination was found.

Action Potentials↗
PubMed1979

[Repolarisation disturbances in the ECG under antidepressant drugs. A comparison of two drugs, differing in chemical structure and pharmacological profile (author's transl)].

In connection with clinical drug trials we compared the ECG-recordings during application of two different antidepressants. Tandamine (AY 23946) is a tricyclic drug with main effects on the norepinephrine reuptake, Fluvoxamine (DU 23 000) a nontricyclic antidepressant with a selective effect on the serotonin reuptake. No differences were observed regarding both frequency and patterns of the repolarisation disturbances. Thus, it appears that the chemical structure of the drug is not responsible for the "typical" form of the repolarisation disturbances. We further hypothesize that toxic effects and regulatory mechanisms of the cardiovascular system, caused by changes in norepinephrine and 5-hydroxytryptamine levels may be responsible for the areforementioned ECG aberrations.

Adult↗
PubMed1977

Fluvoxamine-a new serotonin re-uptake inhibitor: first clinical and psychometric experiences in depressed patients.

The clinical efficacy of fluvoxamine (DU 23000)--the first selective serotonin re-uptake inhibitor of the new class of 2-aminoethyloximethers of aralkylketones was investigated in endormorphous depressed patients during 5 weeks treatment with mean daily dosages of approximately 150 mg DU 23000. A marked and statistically significant improvement of the overall and detailed psychopathology was noted by means of the Global Clinical Impression and Hamilton Rating Scale as early as in the first week of drug administration. Bipolar patients tended to improve more than unipolar ones, retarded depressions more than agitated ones. An additional anxiolytic medication was occasionally required. The drug was well tolerated. Psychometric and laboratory findings did not show any significant changes. The findings are discussed in the light of the indolamine hypothesis of depression.

Adult↗
PubMed1977

[Cardiovascular side effects of tricyclic psychopharmaca under special consideration of the ECG (author's transl)].

The cardialvascular side effects of tricyclic psychopharmaca.- alteration of blood pressure and heart rate in connection with hemodynamic effects, the "antiarrhythmic activity" and the abnormal ECG-findings - are reviewed. The ECG-changes are discussed in detail. They can be divided in disturbances of rhythm, conduction and repolarisation. After a survey over the usual interpretation of the ECG-findings a hypothesis for better understanding is presented. There is supposed - in close relation to the dosage - a direct affection of the myocardium (by enzyme suppression, disturbance of the membrane permeability?) connected with reflectory vegetative mechanisms which can be modified by factors like kind and severity of the illness, diurnal changes and many external influences, difficult to quantify and objectivate. So the transitory and alternating ECG-findings could be interpretated as a state-depending summation, subtraction or potentiation of the cited single effects.

Antidepressive Agents, Tricyclic↗
PubMed1977

Tandamine--a new norepinephrine reuptake inhibitor. Clinical, psychometric and quantitative EEG studies in depressed patients.

Tandamine (AY-23,946)- a new norepinephrine reuptake inhibitor with practically no serotonin potentiation, MAO inhibition and anticholinergic activity-was administered in doses from 75 to 200 mg to a group of 20 hospitalized depressed patients. Weekly clinical evaluation including the ECDEU global score. Hamilton score and Zung self-rating score demonstrated a slight improvement which became statistically significant between the 1st and 2nd weeks of therapy. While the 'thymoleptic' properties of the drug were weak, a pronouned 'activating/stimulatory' effect of the drug was noted. Psychometric tests showed an increase in attention, concentration and psychomotor activity as well as an improvement in FPI personality dimensions 'depression' and 'inhibition', while the Taylor anxiety score did not reveal any changes. Digital computer period analysis of the EEG demonstrated, 6 h after oral administration of 50 mg tandamine, a decrease of slow waves, a significant increase of fast activity as well as a significant attenuation of the amplitude variability. Such changes are reminiscent of the pharmaco-EEG profile of psychostimulatory drugs and may represent the neurophysiological correlate for the activating/stimulatory properties of tandamine. Our finding suggest that the well-tolerated drug may be of some benefit for retarded depressions.

Adult↗
PubMed1976

The treatment of endomorphous and psychogenic depressions with a fixed combination of amitriptyline/flupenthixol (Lu 7410).

The clinical efficacy of a fixed combination of 10 mg amitriptyline and 0.5 mg flupenthixol (Lu 7410) was studied in 30 (15 endomorphous and 15 psychogenic) depressive patients over 4 weeks. Stepwise titration of the drug resulted in an optimal daily dosage of 6 tablets (1 table, morning, 1 at noon, and 4 in the evening). Based on the ECDEU Global Score the overall symptomatology improved significantly as early as in the first week and was best in the third week. Evaluation of the detailed psychopathology by means of the AMP-system showed, that aside from thymoleptic properties, Lu 7410 has a stimulatory-activating-effect (improvement of drive) as well as an anxiolytic-sedative component (improvement of suicidal tendencies, agitation and sleep disturbances). While the former is seen predominantly in low doses and in endomorphous depressions, the latter is prominent in higher doses and in psychogenic depressions. There was a lack of extrapyramidal side effects as well as of alterations in blood count, blood chemistry and ECG. Psychological tests supported the clinical observations, inasmuch as a significant increase of extroversion and aggressivity was seen in the FPI of endomorphous depressives, while psychogenic depressives revealed decreases in extroversion and sociability. Moreover, a decrease in the Taylor anxiety score and increase in concentration was noted, based on the AD test. The results will be discussed.

Adult↗
PubMed1976

[Paranoid syndromes in the involution (author's transl)].

Conditions of outbreak and chronification of paranoid syndromes, including the existence of an "axial syndrome" and behaviour theories are hypothetically summarized. The individual characteristics of patients with the first paranoid symptoms during involution appear to depend mainly on three factors: the theme of the delusion seems to be connected with the age at the onset, in more than half of the male patients exogenous psychoorganic symptoms were observed, and in females however predominantly manic-depressive syndroms could be found.

Adult↗
PubMed1975

[An acute psychotic episode following adrenalectomy in cushing's syndrome].

A marked cortisone psychosis with initial depressive symptoms developed following left adrenalectomy in a 41 year-old female patient suffering from Cushing's syndrome due to bilateral adrenal hyperplasia. On deterioration of the clinical picture with the development of delusional ideas, verbal hallucinosis with imperative voices was observed. The administration of neuroleptic drugs favourably influenced the psychosis, which disappeared with a final depressive stage, thereby enabling removal of the second hyperplastic adrenal gland. The physical signs showed a good remission, except for the severe myopathy and osteoporosis; the pathologically-altered serum potassium level and the erythrocyte potassium content returned to normal.

Adrenalectomy↗