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Biomedical subjects

J Willi

Publications and source records attributed to J Willi.

At least 37 records · Page 2Linked to original sources
PubMed1988

[A 10-year follow-up of cases with anorexia first hospitalized in the Canton of Zürich].

Out of all 38 anorexia nervosa patients hospitalized for the first time in a private or state hospital for pediatrics, internal medicine or psychiatry in the Canton of Zurich during the period 1973-1975, 28 cases could be assessed 10 years later using a semistructured interview. Catamnestic data were categorized according to Morgan and Russel (1975) in a general outcome score and an average outcome score. Regarding somatic and psychosocial dimensions, 11% of the patients examined can be considered symptom-free, 71% improved and 14% unchanged. One patient (4%) had died from the sequelae of anorexia. 64% increased in weight, nevertheless more than half of the patients had disturbed eating behavior at the time of this catamnestic study. An equally frequent finding was considerable impairment of psychologic well-being chiefly reflected in anxiety and depression. The time necessary to attain the normal weight range had varied between a few months and 11 years. Of 8 variables often claimed to be prognostic in the literature on the course of anorexia nervosa, only a short duration of illness before hospitalization was shown to be relevant. The patients with good or medium outcome most often consider psychotherapy or a partner relationship a decisive factor in the favorable course of their eating problem.

Adult↗
PubMed1987

Some principles of an ecological model of the person as a consequence of the therapeutic experience with systems.

How do systems therapists' ideas of an individual differ from those of individually oriented therapists? Systems therapists are less interested in stable personality structures than in the contextual variability of a person's behavior. They think that although partnership may restrict, it also triggers the personality's development and shapes and models self-realization. The coevolution of partners can neutralize neurotic dispositions and can have a healing effect. On the other hand, it is the individual who largely decides in what systems he or she will participate, and to what extent and in which manner. In modern, Western society, personal regulations through social systems are becoming increasingly weaker, and the possibility for individuals to realize themselves in interactions is more and more restricted. According to an ecological model of the person, self-realization has to rely on relations to other persons in order to make it more real.

Attitude of Health Personnel↗
PubMed1986

[Crises in interpersonal relations--stimulation or blocking of mutual growth?].

Time and again, couples have to cope with changes and challenges (e.g. choice of partner, marriage, childbirth and upbringing, retirement, infirmity, etc.) which cause stress and crises to their relationship. They may try to forestall such pressing changes by entering a collusion and clinging to well-established solutions. In the therapy of chronic relational crises, it has to be taken into consideration that in case of a divorce, the partners often have no real possibilities to make a new start, and that it is often more useful to support the actual coping strategies of the couple. In urgent crises, it is recommended that the therapist structures even cuts off the partners' interactions through separation or the intervention of third parties. Only when calm has been obtained should the actual conflict be treated.

Adaptation, Psychological↗
PubMed1984

The concept of collusion: a combined systemic-psychodynamic approach to marital therapy.

The author presents some new theoretical aspects and therapeutic implications of the concept of Couples in Collusion, (22), first published in 1975. According to this concept, the emotional attraction in the selection of a mate is based on a fascinating, mutual, and alarming theme, shared by both partners in order to be mastered together. The partners unavowedly start colluding to compensate for former frustrations and to repress fears of intimacy. After some time of living together and in defense of repressed feelings, they may enter into an escalation of the dysfunctional interactional pattern. Experience shows that severely neurotic personalities don't necessarily start colluding, provided that their partners don't gratify regressive needs or reinforce their defenses but help to cope with the frustrations of these unfulfilled regressive wishes. Therapies based on the concept of collusion aim at the improvement of intradyadic and extradyadic boundaries and the depolarization of extreme progressive-regressive behavior. These goals can be reached by both systemic and psychodynamic techniques. The concept of collusion may serve as a guide for this therapeutic process.

Adaptation, Psychological↗
PubMed1984

[Male and female].

Explore the source record for details and available documents.

Cultural Characteristics↗
PubMed1983

Epidemiology of anorexia nervosa in a defined region of Switzerland.

The authors conducted a retrospective study of the incidence of anorexia nervosa in the industrialized canton of Zurich, Switzerland, during three randomly selected sampling periods from 1956 to 1975. The data were derived from case histories from nearly all medical, pediatric, and psychiatric clinics in this region. The incidence of anorexia nervosa increased significantly, from .38/100,000 for 1956-1958 to .55/100,000 for 1963-1965 to 1.12/100,000 for 1973-1975. This increase was not due to the fact that nowadays anorectic patients are hospitalized earlier or that they are hospitalized for less severe illness.

Adolescent↗
PubMed1979

[Physicians: how might patients see you and how do we see ourselves? A questionnaire concerning the physician-patient relationship].

Patients and doctors in specialized surgical, medical and gynecological clinics in the Zurich area replied to the Giessen test and a questionnaire on their attitude towards work. The results suggest that the traditional idea of the doctor-patient relationship as propagated by medical sociology (e.g. PARSONS) seems rather to correspond to patients' stereotyped (projective) ideals, but positively not to the realistic self-assessment of doctors. Doctors do not depict themselves as being as socially esteemed, self-satisfied and self-assured about their skills as patients would like them to do.

Attitude of Health Personnel↗
PubMed1976

[Long-term course of anorexia nervosa].

A follow-up study has been recently conducted in 20 female patients with severe anorexia nervosa who had undergone stationary psychotherapeutic treatment at our clinic 8-16 years ago. Whilst according to our findings the prognosis for anorexia nervosa still remains poor, it does not seem quite so hopeless as is frequently presumed. Out of the 20 patients followed up, 5 now have chronic anorexia nervosa and in 2 cases transition to an endogenous psychosis has occurred (schizophrenia simplex with chronified anorexia in one, and endogenous depression after improvement of anorexia in the other case). 1 patient died in the interval between observations as a result of her anorexia. The general results of our investigation roughly confirm the rule-of-thumb predictions for many psychotherapeutic treatments of neurotic diseases, i.e. 1/3 unimproved, 1/3 improved, 1/3 cured. Although free from illness, the majority of the patients must be described as conspicuous within the norm. The typical personal characteristics of the anorectic are maintained, their weight remains below normal level, and they suffer from eating problems. According to our investigation a positive prognosis correlates with onset of the illness before the age of 18, absence of laxative abuse, and subsequent marriage, whereas premature interruption of the treatment with return to the parental home proves to have a negative effect. In apparent contradiction to the persistence of the characteristic anorectic features is the evidence that out of the 20 patients in question 12 married and 8 had children. On the other hand, the fact that during the interval between observations 4 patients relapsed into severe anorexia in connexion with engagement or pregnancy indicates that acceptance of a mature female or maternal role often remains a problem. Of gynecologic interest is the fact that long-lasting secondary amenorrhea (up to 10 years, with an average of 5 years) has not led to fertility problems for any of the married patients who wanted children.

Adult↗