Biomedical subjects

J Bauer

Publications and source records attributed to J Bauer.

At least 37 records · Page 2Linked to original sources

PubMed2006

[Paraneoplastic encephalitis].

Paraneoplastic neurodegenerative diseases are defined as damage to central and peripheral nervous tissue related to a malignancy, in the absence of metastases. If they represent first disease manifestation, the diagnosis can pose a real problem. A case of 59-year-old woman is described, who suffered during her last nine months of life from meningoencephalitis, with cranial nerves pareses and progressive quadruparalysis. The CSF exhibited a temporary inflammatory response with slow improvement, whereas the clinical status progressed continually toward terminal bronchopneumonia. An extensive infectious agent search was negative. Though the result of the autoantibody panel available (anti Yo, Hu, Ri) was negative, the paraneoplastic degeneration remained a part of the differential diagnosis. Post-mortem examination revealed residual brain stem meningoencephalitis and advanced cerebellar loss of Purkinje cells, in the presence of a neuroendocrine small cell lung carcinoma in the right lower lobe. The carcinoma only manifested intravitally, with paratracheal lymphadenomegaly on imaging. Rapid progress in the diagnostics of autoimmune neurodegeneration with the increasing spectrum of autoantibody detection tools has recently increased the possibilities of revealing clinically silent, primary manifesting neurodegeneration. In the future, it may also represent a target for therapeutic intervention.

Carcinoma, Small Cell↗

PubMed2005

Changes in enteric neurone phenotype and intestinal functions in a transgenic mouse model of enteric glia disruption.

AIMS: The influence of enteric glia on the regulation of intestinal functions is unknown. Our aim was to determine the phenotype of enteric neurones in a model of glia alterations and the putative changes in intestinal motility and permeability. METHODS: Transgenic mice expressing haemagglutinin (HA) in glia were used. Glia disruption was induced by injection of activated HA specific CD8+ T cells. Control mice consisted of non-transgenic littermates injected with activated HA specific CD8+ T cells. Immunohistochemical staining for choline acetyltransferase (ChAT), substance P (SP), vasoactive intestinal peptide (VIP), and nitric oxide synthase (NOS) was performed on jejunal submucosal plexus (SMP) and myenteric plexus (MP). Neurally induced jejunal muscle activity was characterised in vitro. Gastrointestinal transit and paracellular permeability were measured using fluorescein isothiocyanate-dextran markers. RESULTS: CD3 positive T cells infiltrates were observed in the MP of transgenic mice. In the SMP, the proportions of VIP and SP positive neurones decreased in transgenic mice compared with control mice. ChAT remained unchanged. In the MP, the proportions of ChAT and NOS positive neurones increased and decreased, respectively, in transgenic mice. In contrast, VIP and SP remained unchanged. Neurally mediated jejunal relaxation was lower in transgenic mice than in controls. This relaxation was reduced by NG-nitro-L-arginine methyl ester in control mice but not in transgenic mice. Gastrointestinal transit was delayed and intestinal permeability increased in transgenic mice compared with control mice. CONCLUSION: Glia disruption induces changes in the neurochemical coding of enteric neurones, which may partly be responsible for dysfunctions in intestinal motility and permeability.

Adoptive Transfer↗

PubMed2005

Oxaliplatin combined with irinotecan and 5-fluorouracil/leucovorin (OCFL) in metastatic colorectal cancer: a phase I-II study.

BACKGROUND: A phase I-II multicenter trial was conducted to define the maximal tolerated dose and describe the activity of an OCFL combination using oxaliplatin (OHP), irinotecan (CPT-11) and 5-fluorouracil (FU)/leucovorin (LV) in metastatic colorectal cancer (CRC). PATIENTS AND METHODS: CRC patients not pretreated with palliative chemotherapy, with performance status < or =1 and adequate haematological, kidney and liver function, were eligible. Treatment consisted in weekly 24-h infusion 5-FU (2300 mg/m(2))/LV (30 mg) and alternating OHP (70-85 mg/m(2), days 1 and 15) and CPT-11 (80-140 mg/m(2), days 8 and 22) repeated every 5 weeks. OHP and CPT-11 were escalated in cohorts of three to six patients. RESULTS: Thirty patients received a median of five cycles. Dose-limiting toxicity occurred at dose level 3, and the recommended dose was OHP 70 mg/m(2), CPT-11 100 mg/m(2), LV 30 mg and 5-FU 2300 mg/m(2)/24 h. Grade > or =3 toxicities were diarrhea 23%, neutropenia 20%, fatigue 7%, and neurologic 7%. Two febrile neutropenia episodes (one fatal) were recorded. Among 28 patients with measurable disease (90%), we observed two complete and 20 partial responses; overall RR was 78% (95% CI, 59% to 92%). Median time to progression and overall survival were 9.5 and 25.4 months, respectively. Seven patients underwent liver metastases resection. CONCLUSION: OCFL is an overall well tolerated regimen with very high efficacy, which makes it most suitable for tumour control before surgery of metastatic disease.

Adult↗

PubMed2005

Morphological findings in lymphatic tissues of sheep following oral application of the immunosuppressive mycotoxin mycophenolic acid.

Mycophenolic acid (MPA) is applied in immunosuppressive therapy after organ transplantation. As a common contaminant in silage, this substance is also frequently fed to sheep unintentionally. In this study, the effect of MPA on the immune system of sheep was examined. Four groups of 9 sheep each were fed 0, 0.5, 1.2, or 5 mg of MPA per kg body weight per day for 6 weeks. Then, the animals were slaughtered and various organs were examined macroscopically, histologically, and immunohistochemically. No effect of MPA on general health was detected. With increasing dose of MPA, germinal centres in the retropharyngeal lymph nodes displayed an activated morphology with numerous centroblasts. In the highest dose group, the sheep showed shrinkage of thymic lobules. The numbers of IgG or IgM positive plasma cells decreased in the ileum with increasing MPA-doses. These results suggest, that MPA in a high concentration may affect the morphology of immune organs of sheep.

Administration, Oral↗

PubMed2005

Interdisciplinary resources optimize Evidence-Based Dental Practice.

Evidence-Based Dental Practice (EBDP) is the most appropriate and best patient-centered care because it uses the evidence derived from interdisciplinary resources. These resources include the integration of the clinical and basic science researcher, clinician, and patient in the clinical decision-making process. Best evidence has different meanings to each of the interdisciplinary decision makers and, thus, defines their individual roles accordingly. Implementing EBDP requires an organizational structure and process that involve evidence-based dentistry databases in centralized repositories that are shared nationally and internationally. Facilitating the inclusive and reciprocal transfer of information from all resources requires use of information technology and computerized decision-making support programs. However, the potential lack of financial resources and incentives will diminish the universal adoption of EBDP.

Journal Article↗

PubMed2005

Poor nutritional status prior to peripheral blood stem cell transplantation is associated with increased length of hospital stay.

The nutritional status of patients prior to peripheral blood stem cell transplantation (PBSCT) and its impact on length of hospital stay is not well described in the literature. The nutritional status of 66 consecutive patients (46 m:20 f); and the mean age 58.7+/-12.0 years was determined a maximum of 2 weeks pre-transplantation using the scored Patient-Generated-Subjective Global Assessment (PG-SGA). According to the global assessment, 73% patients were well nourished, 23% moderately malnourished and 4% severely malnourished. There was a significant difference in post transplant length of stay (mean difference+/-s.e.m. -7.0+/-2.1 days) between well-nourished and malnourished patients and a trend towards higher mortality in the malnourished group (2 vs 20%). Although 89% of patients described no problems eating, two or more nutrition impact symptoms were reported in 30% of patients. From stepwise multiple regression analysis, nutritional status as determined by PG-SGA score was significantly associated with length of stay, accounting for 12% of the variance. In conclusion, malnutrition prior to PBSCT is associated with increased length of stay. Routine nutrition assessment of patients prior to PBSCT should be undertaken.

Aged↗

PubMed2005

Clinical accuracy of the MedGem indirect calorimeter for measuring resting energy expenditure in cancer patients.

OBJECTIVE: To compare, in patients with cancer and in healthy subjects, measured resting energy expenditure (REE) from traditional indirect calorimetry to a new portable device (MedGem) and predicted REE. DESIGN: Cross-sectional clinical validation study. SETTING: Private radiation oncology centre, Brisbane, Australia. SUBJECTS: Cancer patients (n = 18) and healthy subjects (n = 17) aged 37-86 y, with body mass indices ranging from 18 to 42 kg/m(2). INTERVENTIONS: Oxygen consumption (VO(2)) and REE were measured by VMax229 (VM) and MedGem (MG) indirect calorimeters in random order after a 12-h fast and 30-min rest. REE was also calculated from the MG without adjustment for nitrogen excretion (MGN) and estimated from Harris-Benedict prediction equations. Data were analysed using the Bland and Altman approach, based on a clinically acceptable difference between methods of 5%. RESULTS: The mean bias (MGN-VM) was 10% and limits of agreement were -42 to 21% for cancer patients; mean bias -5% with limits of -45 to 35% for healthy subjects. Less than half of the cancer patients (n = 7, 46.7%) and only a third (n = 5, 33.3%) of healthy subjects had measured REE by MGN within clinically acceptable limits of VM. Predicted REE showed a mean bias (HB-VM) of -5% for cancer patients and 4% for healthy subjects, with limits of agreement of -30 to 20% and -27 to 34%, respectively. CONCLUSIONS: Limits of agreement for the MG and Harris Benedict equations compared to traditional indirect calorimetry were similar but wide, indicating poor clinical accuracy for determining the REE of individual cancer patients and healthy subjects.

Adult↗

PubMed2005

Perioperative management in pediatric heart transplantation.

Peri- and early postoperative mortality significantly influences the probability of survival following heart transplantation in children. Main causes of death early after transplantation are rejection, non specific graft failure and RV failure due to pulmonary hypertension. Optimal therapy of pulmonary hypertension and aggressive use of assist devices as a bridge to recovery will substantially improve survival in the early period after transplantation. Furthermore, the use of marginal donor organs will be more acceptable because transient myocardial insufficiency may recover during extracorporeal life support.

Child↗

PubMed2005

Surveillance of patients at high risk for cutaneous malignant melanoma using digital dermoscopy.

BACKGROUND: Dermoscopy has improved the sensitivity and specificity of clinical diagnosis of melanoma from 60% to over 90%. However, in order not to miss melanoma a certain percentage of suspicious but benign lesions has to be excised. OBJECTIVES: To evaluate the dermoscopic changes and the rates of excision in benign melanocytic naevi and cutaneous malignant melanoma in long-term follow-up of high-risk patients using digital dermoscopy. METHODS: Digital dermoscopic images of 2015 atypical melanocytic naevi in 196 high-risk patients were analysed retrospectively. Among others, the following data were collected for each naevus: changes in surface area, overall architecture, dermoscopic patterns and distribution of pigmentation. All tumours suspicious for melanoma or showing asymmetrical changes were excised. RESULTS: During a median follow-up time of 25 months 128 (6.4%) of all naevi showed changes in size or architecture. Eighty-six per cent of all changes in patients who attended more than one visit were observed at the first follow-up visit. Thirty-three lesions showing changes were excised and two melanomas in situ and 31 melanocytic naevi were diagnosed. CONCLUSIONS: Follow-up examinations using digital dermoscopy revealed unchanged morphology in the large majority of melanocytic naevi. Excisions were only performed in cases of asymmetrical growth, asymmetrical changes of pigmentation, or development of dermoscopic features indicative of melanoma. The ratio of 33 lesions excised in order to identify two melanomas in situ seems reasonable and may be further reduced in future.

Adolescent↗

PubMed2005

Estimation of total body water from foot-to-foot bioelectrical impedance analysis in patients with cancer cachexia - agreement between three prediction methods and deuterium oxide dilution.

INTRODUCTION: Bioelectrical impedance analysis (BIA) is a useful bedside measure to estimate total body water (TBW). The aim of this study was to determine the agreement between three equations for the prediction of TBW using BIA against the criterion method, deuterium oxide dilution, in patients with cancer cachexia. METHODS: Eighteen measurements of TBW using foot-to-foot BIA in seven outpatients with cancer cachexia (five male and two female, age 56.4 +/- 6.7 years) at an Australian hospital. Three prediction formulae were used to estimate TBW - TBW(ca-radiotherapy) developed in patients with cancer undergoing radiotherapy, TBW(ca-underweight) and TBW(ca-normal weight) developed in underweight and normal weight patients with cachexia. TBW was measured using the deuterium oxide dilution technique as the gold standard. RESULTS: Mean measured TBW was 39.5 +/- 6.0 L. There was no significant difference in measured TBW and estimates from prediction equations TBW(ca-underweight) and TBW(ca-radiotherapy). There was a significant difference in measured TBW and TBW(ca-normal weight). All prediction equations overestimated TBW in comparison with measured TBW. The smallest bias was observed with TBW(ca-underweight) (0.38 L). The limits of agreement are wide (>7.4 L) for each of the prediction equations compared with measured TBW. CONCLUSIONS: At a group level, TBW(ca-underweight) is the best predictor of measured TBW in patients with cancer cachexia. For an individual however, the limits of agreement are wide for all prediction equations and are unsuitable for use. Practitioners need to be aware of the limitations of using TBW prediction equations for individuals.

Body Composition↗

PubMed2005

Efficiency of Echinacea purpurea on performance and immune status in pigs.

The aim of the present investigation was to examine the inclusion of the dried herb Echinacea purpurea (L.) MOENCH as feed additive in diets of sows, piglets, and grower/finisher pigs on growth performance, blood picture, plasma enzymes including proliferation of lymphocytes, antibody status, and protein and immune globulin content of colostrum. The control groups were supplemented with alfalfa meal. The sows (total 36) received 0%, 1.2%, or 3.6% Echinacea cobs in the diet from day 85 to day 110 of gestation and 0%, 0.5%, or 1.5% Echinacea cobs up to day 28 of lactation. No significant differences were found for growth performance, weight loss, blood picture, plasma enzymes, and colostrum composition. Performance of the sucking piglets was not impaired either during lactation or during a 4 week observation period after weaning. The health status was similar in all treatment groups. In a second experiment, lasting 6 weeks, with 36 piglets (5.8-22.1 kg body weight), 1.8% Echinacea cobs, or 20 mg/kg feed Flavomycin were supplemented. No significant differences were found for the recorded parameters. Feed conversion ratio (kg feed/kg gain) of the Echinacea group was slightly (4%) increased (1.54 vs. 1.60). In a third trial, 48 grower/finisher pigs were used during a 9-week experimental period with two supplementation phases (weeks 1-3 and weeks 7-9). The experimental groups received 0%, 1.5% cobs or 4-6 ml pressed juice (commercial standard) per day respectively. Vaccination with Swine erysipelas was implemented in weeks 1 and 5 to determine the specific immune response. Growth performance and blood picture for all groups were similar, however, feed conversion of both Echinacea supplemented groups was significantly (p < 0.03) better than of the unsupplemented control group (2.44 vs. 2.51). In addition, the Swine erysipelas antibodies showed a marked significance (p < 0.05) in regard of altitude in both supplemented groups. It is concluded, that E. purpurea might be used as a feed additive to achieve immune stimulating efficiency in pig production and increase feed-to-gain-conversion. The efficiency of cobs is comparable to a commercial juice product.

Animal Feed↗

PubMed2004

Capecitabine in hormone-resistant metastatic prostatic carcinoma - a phase II trial.

The objective of the trial is to evaluate the efficacy of capecitabine in patients with metastatic hormone-resistant prostate carcinoma (HRPC), in terms of prostate-specific antigen (PSA) response and clinical benefit (decrease of pain or analgesic score) and its safety profile. In all, 25 patients with HRPC were enrolled on a phase II trial of capecitabine (Xeloda) at a dose of 1250 mg m(-2) orally twice daily on days 1-14 every 21 days. The inclusion criteria were PSA serum levels >3 x upper limit of normal, a WHO performance status 0-2, age <85 years and adequate bone marrow, liver and renal function. In patients with grade 2 or higher haematological toxicity on day 1 of the treatment cycle, therapy was first delayed, and then continued at a lower dose. Trial end points were PSA response and clinical benefit defined by quality of life (QL) data and analgesic consumption. The median age of patients was 70 years (range 54-85 years). A median of three cycles of capecitabine was administered (range 1-8). PSA response was observed in three patients (12%, 95% CI 3-31%), with times to tumour progression of 18, 21 and 35 weeks, respectively. In these patients, the response durations were 12, 17 and 32 weeks, respectively. Minor PSA regression was also seen in two further patients. The median time to tumour progression of all patients was 12 weeks (95% CI 9-15 weeks). Haematological toxicity was minor, with leukopenia grade 3 observed in one patient. There were three deaths during trial treatment, respectively, due to sepsis following mucositis and leukopenia, presumed sepsis with mucositis induced by chemotherapy and concomitant radiotherapy and cerebral dysfunction progressing to coma. Hand-foot syndrome grades 2 and 3 were observed in four patients each. Clinical benefit was observed in five patients (20%, CI 7-41%). Based on toxicity data, we recommend a lower starting dose of 1000 mg x m(-2) orally twice daily. While capecitabine has some activity in HRPC, as suggested by observed PSA responses, we conclude that it is not worthwhile to investigate capecitabine monotherapy in a phase III trial. Combinations of capecitabine with other agents, such as vinorelbine or docetaxel, may prove to be more effective.

Aged↗

PubMed2004

Rasmussen encephalitis with active inflammation and delayed seizures onset.

Severe focal epilepsy is regarded as a clinical hallmark of Rasmussen encephalitis (RE). The authors report two children with progressive hemiparesis, contralateral hemispheric atrophy, and pathologic features characteristic for RE. At histologic diagnosis and over several months, neither patient experienced seizures. The report enlarges the clinical spectrum of RE and suggests that seizures are not an obligatory presenting symptom of the disorder.

Age of Onset↗

PubMed2004

Radiation-induced impairment of osseous healing with vascularized bone transfer: experimental model using a pedicled tibia flap in rat.

Aim of this study was to establish an appropriate animal model for investigating the healing of vascularized osseous transplants to irradiated recipient sites applying metabolic, vascular and immunologic experimental studies. In 20 Wistar rats (male, weight 300-500 g), a pedicled osseous tibia flap was raised and transferred to a subcutaneous pocket in the ipsilateral groin. The remaining tibia was stabilized with a monocortical titanium miniplate. To create a pre-irradiated transplant bed, the donor-area including the adjacent bone of the tibia was irradiated with a total dose of 50Gy (5 x 10 Gy) in 10 animals. The interval between irradiation and retransfer of the non-irradiated pedicled tibia flap was 4 weeks. Ten animals received no radiation. Evaluation of osseous healing and the success of the transferred flap were based on a clinical and quantitative histomorphometric assessment. Testing for significant differences was performed using the non-parametric Mann-Whitney U-test. The rate of complete osseous healing in the non-irradiated animals was 90%. In contrast there was no significant bone union observed in the group of the pedicled flaps grafted to the pre-irradiated (50Gy) recipient site (P = 0.001). Similarly bone formation in the transitional zone between bone graft and recipient bone was significantly lower in the preirradiated group (P < 0.001) (16.9 +/- 3%) in contrast to the non-irradiated transplant bed (47.9 +/- 6%).

Animals↗

PubMed2004

Evaluation of foot-to-foot bioelectrical impedance analysis for the prediction of total body water in oncology outpatients receiving radiotherapy.

OBJECTIVE: To investigate the accuracy of total body water (TBW) predicted by foot-to-foot bioelectrical impedance compared with a deuterium oxide dilution technique in oncology outpatients receiving radiotherapy. DESIGN: Cross-sectional design. SETTING: Two private Australian radiation oncology facilities. SUBJECTS: In all, 27 subjects (23 males; four females); mean age 62 (+/-15) y; mean BMI 26.2 kg/m2 (+/- 3.6). INTERVENTION: TBW was measured using a deuterium oxide dilution technique and predicted using foot-to-foot bioelectrical impedance (Tanita Inc., Tokyo, Japan, Models TBF 410 and 300GS). RESULTS: The mean (s.d.) values for predicted and measured TBW was 41.5 (6.7) and 39.7 (8.7) l, respectively, indicating a mean bias to overestimation by the foot-to-foot impedance of 1.8 l. However, a significant negative correlation between the mean of the measurements of TBW and their difference (r=-0.40; P=0.04) indicates a progressive underestimation of TBW by foot-to-foot impedance as the water content of the body increases. The analysis of 95% limits of agreement (+/-2 s.d.) showed that for most individuals the TBW predicted by foot-to-foot impedance can vary as much as 12 l above or 8.6 l below the actual TBW measured by a deuterium oxide dilution technique. CONCLUSION: There is good agreement between foot-to-foot bioelectrical impedance with a gold standard technique at the group level. However, the significant correlation between the difference of predicted and measured TBW, and the wide limits of agreement between the two methods, indicates that the use of foot-to-foot impedance in assessing TBW may lead to unacceptable error in individuals.

Body Water↗

PubMed2004

[Comparison of costs-of-illness in a year before and after inpatient and outpatient rehabilitation in persons with spinal disorders].

The present economic analyses of orthopaedic inpatient and outpatient rehabilitation (IPR resp. OPR) focus but on the evaluation of the expenses from the cost carrier's perspective. Lower intervention costs were related to OPR, whereas comparable social and clinical outcome was achieved. Comprehensive assessment of the economic consequences (resource utilization and lost productivity) of low back pain have not been performed up to now. Therefore, as part of a prospective follow-up study (1) a comparison of overall cost-of-illness and cost components 12 months prior and after IPR and OPR, respectively, was carried out in patients with low back pain and (2) the relative changes of these cost components were compared in a full-cost-analysis from a societal perspective. A total of 150 matched pairs (SR and AR) were followed prospectively over 12 months. Disease related costs in the year prior to the intervention were evaluated retrospectively. Prior to IPR and OPR overall costs amounted to 7010 and 7710 Euro, respectively, per person and year in patients with low back pain. As the main cost component of overall costs, sick leave (SL) periods account for 74% (IPR) and 76% (OPR), respectively. Inpatient costs represent the main component of direct costs. In the year after the intervention the costs due to sick leave periods still represent the major cost component (46 and 52%, resp.) of overall costs (3370 and 3600 Euro, resp.). Disease related cessation of work including work disability accounts for about 10% of productivity costs after IPR and OPR. Indirect costs still make up for the major part of overall costs (58 and 62%, resp.). No differences of cost components and their relative changes can be seen between patients participating in IPR and OPR, respectively, within both time frames. The comparison of overall costs in the 12 months before and after IPR and OPR reveals a cost reduction of 52% (IPR) and 53% (OPR), resp. This decrease of costs is mainly related to the reduction of SL periods, though costs due to inpatient treatment decrease as well. Summarizing, the present full-cost-analysis from a societal perspective shows no differences of cost components and cost changes between orthopaedic IPR and OPR in the 12 months prior to and after the intervention. Comprehensive cost-analyses reveal no obstacles for further implementation of OPR in the treatment of low back pain. Future development and diversification of rehabilitation measures should aim at evaluating real resource consumption during the intervention in detail as a basis for further allocational decision making.

Ambulatory Care↗

PubMed2004

Patient satisfaction is rated higher by radiation oncology outpatients receiving nutrition intervention compared with usual care.

BACKGROUND: Satisfaction with services has been considered vital for the provision of quality health care, however, there are few published papers utilizing patient satisfaction with nutrition services as a measurable outcome. METHOD: A randomized, controlled trial investigating the impact of nutrition intervention (NI) vs. usual care (UC) in 54 ambulatory oncology patients receiving radiotherapy to the gastrointestinal or head and neck area demonstrated beneficial impacts in terms of body weight, nutritional status, quality of life and bowel health. This study reports the changes in patient satisfaction that were associated with these improved outcomes for patients receiving NI compared with UC. The patient satisfaction with clinical nutrition services questionnaire was used to measure overall satisfaction and satisfaction with four components of nutrition services 12 weeks after patients commenced radiotherapy. RESULTS: Patients receiving NI rated satisfaction higher for staff interpersonal skills (P < 0.001), perceived health benefits (P = 0.008), staff presentation skills (P = 0.044) and for overall patient satisfaction with nutrition services (P = 0.002). There were no significant differences between those patients receiving NI or UC for the nutrition supplements factor (P = 0.191). CONCLUSIONS: These data suggest that patients receiving NI perceive nutrition as being beneficial and of higher importance to their health than those receiving UC. This may lead to increased compliance with the nutrition prescription and help explain the better outcomes observed in the NI group compared with the UC group. Patient satisfaction with nutrition services should be conducted regularly to act as a quality-control measure and target areas for improvement.

Adult↗

PubMed2004

Multidimensional assessment of personality in patients with psychogenic non-epileptic seizures.

OBJECTIVES: To determine whether patients with psychogenic non-epileptic seizures (PNES) have evidence of maladaptive personality, and whether they have a single or several different typical pathological personality profiles. METHODS: Patients were recruited from the department of epileptology, Bonn, Germany. In all, 85 patients with PNES and 63 with epilepsy completed a postal questionnaire including the dimensional assessment of personality pathology - basic questionnaire (DAPP-BQ). The DAPP-BQ was also completed by 100 healthy volunteers. The groups were compared and the PNES group was subjected to cluster analysis. RESULTS: Patients with PNES had a greater degree of personality abnormality than clinical and non-clinical controls. There were several clusters of personality pathology. The profile of the largest cluster (n = 43) resembled that found in borderline personality disorder, that of the second largest (n = 37) was characterised by an overly controlled personality, that of the third (n = 4) was similar to the profile in avoidant personality disorder. Outcome differed between clusters. CONCLUSIONS: Maladaptive personality is common in patients with PNES. PNES are associated with several distinct profiles of pathological personality. This is relevant because outcome differed between profiles.

Adult↗