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H-P Kapfhammer

Publications and source records attributed to H-P Kapfhammer.

8 recordsLinked to original sources

[Depressive disorders. A diagnostic and therapeutic challenge also for primary care].

Diagnosis and treatment of depressive disorders play a major role in primary care. Due to their high prevalence in the general population with a pronounced psychiatric and somatic morbidity and a significant subsequent psychosocial disability, such disorders constitute a serious disease entity. This review provides basic knowledge on epidemiology, diagnosis, pharmacotherapy and psychotherapy to enable successful primary care of this important group of patients.

Antidepressive Agents↗

[The effects of stalking on psychiatrists, psychotherapists and psychologists. Prevalence of stalking and its emotional impact].

Stalking in the psychiatric context describes a pathological behaviour which is characterized by repeated persecution, harassment, or menacing of or assault on a person. Because of the association between stalking and mental disorders, psychiatrists, psychologists and psychotherapists belong to particularly exposed professions. If they fall victim to stalking during their career, disruptive impacts up to posttraumatic stress disorder (PTSD) can be the consequence. A total of 117 psychiatrists, psychologists or psychotherapists in Graz participated in an anonymous interview. To register possible experiences with stalking defined behaviour, a modified version of the questionnaire of Kamleiter was used. The prevalence and severity of posttraumatic stress symptoms were determined using the Impact of Event Scale of Horowitz. The study showed an incidence of stalking of 38.5%. The rate of female stalkers (60%) was extraordinary high. Most victims (68.9%) experienced non-violent threats. Most of the offenders (41.9%) were diagnosed as suffering from schizophrenia, schizotype and delusional disorders (F2) followed by disorders of adult personality and behaviour (F6) (30.2%). Some 44.4% of the victims developed symptoms of PTSD, which were usually only slight. The analyses suggest that stalking, in the psychiatric field of activity, is a common and serious phenomenon, and that strategies for the prevention and protection of potentially affected professions have to be developed.

Adult↗

Basal ganglia volumetric studies in affective disorder: what did we learn in the last 15 years?

Until today, morphometric neuroimaging studies on affective disorders concentrate on the limbic system, especially the hippocampus, amygdala, and anterior cingulate. In most of the studies and reviews available today, the basal ganglia are of secondary interest. It seems that the basal ganglia are interest of neurologist, whereas the limbic system is reserved for psychiatric neuroimaging studies. We follow a different approach in this review, studying all available papers on MRI research of the basal ganglia in unipolar depression and bipolar disorder. We found a possibly larger neostriatum in bipolar and possibly smaller one in unipolar patients. None of the unipolar studies found any larger basal ganglion, and only one out of 12 bipolar studies found smaller basal ganglia. Both findings seemed to depend on age (tendency toward smaller volumes in unipolar and bipolar with older age), sex (men tending to pathology in both disorders) and bipolar patients show a possible influence of medication, which is not assessed so far in unipolar depression. We conclude that several methodological shortcomings in volumetric MRI research on the basal ganglia in affective disorders make it necessary to imply more research in this area. We suggest (a) better MRI methods (we do not have a single volumetric 3 Tesla study in this patient group); (b) studies of medication-naïve patients (thus ruling out the medication effect); (c) Studies that directly compare unipolar depressed and bipolar patients are needed to determine whether these apparent differences in morphometric abnormalities, as observed through the mediating comparison with healthy subjects, are real.

Basal Ganglia↗

Sexuality in multiple sclerosis.

Sexuality and partnership have an important influence on the quality of life of every person and also on people with chronic disorders such as multiple sclerosis. The findings in literature show high evidence that people with multiple sclerosis experience high levels of sexual dysfunction, most of them with hypoactive sexual behaviour often associated with dissatisfaction in relationship, and also the partners seem to show lower sexual and partnership satisfaction. The most common problems in women are lack of sexual interest and decreased libido, often with problems in orgasmic capacity, while men report erectile dysfunction and also lack of sexual interest. The impact of the level of disability and duration of the illness remains unclear. Positive familial support can often help the patient in coping with the illness, nonetheless problems with changing roles and multiple-sclerosis-minimizing can improve the need of contacts to outstanding persons.

Humans↗

[PTSD in somatic disease].

This review describes the incidence of posttraumatic stress disorder (PTSD) in physically ill patients. At the beginning, research in the field of PTSD was primarily focused on war veterans and victims of bodily assault or rape. Starting in the early 90 s, PTSD after civilian traumas such as motor vehicle accidents was diagnosed increasingly more often. Recent publications showed that PTSD can also follow serious somatic diseases. Hence, awareness during anaesthesia, prolonged ICU treatment (ARDS, septic shock), burns, successful resuscitation after cardiac arrest, coronary artery bypass surgery, organ transplantation and cancer were all linked to the development of PTSD. Prevalence of PTSD in these medical conditions lies around 5 - 10 %, and it is therefore considered an important comorbidity. Unfortunately, the diagnosis and treatment of PTSD are not well enough established yet and thus do receive too little attention in the treatment regime of somatic illness. Generally, PTSD can occur with every life-threatening disease, but possibly also with less severe diseases if the patient experiences intense fear. PTSD symptoms, especially intrusive recollections, avoidance and hyper-arousal can impair the patients' quality of life more than the primary disease. This seems to be also true for sub-syndromal PTSD. To adequately diagnose and treat patients at risk of developing PTSD, close collaboration between physicians of all subspecialties and psychiatrists will be necessary.

Accidents, Traffic↗

[Late adolescence and young adulthood -- their etiopathogenetic significance for schizophrenia].

The significant upsurge of schizophrenic illness manifestations during adolescence and young adulthood is a core finding of epidemiological research in schizophrenia. The reasons are probably manifold, so far, however, not well understood. From the perspective of neurobiological maturation, processes of neuronal reorganisation in cortical and subcortical structures are hot topics. Aberrant forms of pruning, sprouting and myelinization may play a major role in the pathogenesis of a schizophrenic breakdown. The consequences for the pathophysiology of schizophrenia have to be considered. Models of neuroplasticity during adolescence can be connected with models of a neurodevelopmental vulnerability and models of neurotoxicity within an integrated aproach in order to better understand premorbid adjustment, onset, and course of schizophrenic illness. From the perspective of psychosocial development, prominent developmental tasks have to be considered, which form a major challenge to all adolescents, bearing, however, special risks for some adolescents. Patterns of psychosocial adaptation found during this developmental period must be considered in their long-term consequences. Neurobiological reorganisation and psychosocial transformation are both sides of one developmental process during adolescence and young adulthood.

Adolescent↗

[Depression in the medically ill: diagnosis and treatment considerations in C-L psychiatry settings].

Depression in general hospital patients is one of the main psychiatric problems in the medically ill. It often complicates the treatment and prognosis of patients with active medical conditions. However, depression in the medically ill is frequently under-recognized and under-treated. This article reviews the historical concept of secondary depression, and gives an overview of medical conditions and medications associated with depression. Phenomenological issues in the diagnosis of depression in medically ill populations and treatment considerations in C-L psychiatry settings will be discussed. The authors have used the examples of Parkinson's disease and epilepsy commonly associated with depression to illustrate how these considerations affect the C-L psychiatrist's choice of an antidepressant in the medically ill.

Antidepressive Agents↗