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Biomedical subjects

K Heinrich

Publications and source records attributed to K Heinrich.

At least 19 recordsLinked to original sources
PubMed1992

Low dose neuroleptanxiolysis in anxiety states.

1. In order to prove that neuroleptanxiolysis represents a therapeutical alternative in the treatment of patients suffering from anxiety we conducted four investigations. 2. In the first study it was experimentally proved with 45 outpatients suffering from anxiety that fluspirilene (1.5 mg per week) is superior to bromazepam (6 mg/day), especially in patients with a high degree of somatic anxiety. 3. In the second study the tolerance of fluspirilene (1.5 mg per week) was investigated in 1261 patients with anxiety states and psychoreactive disorders under controlled and open conditions for a period of six weeks. Side effects were found in 11.5% of the patients. All side effects had in common that they occurred already within the first few weeks of treatment. 4. In the third study investigating the dose-effect relationship 106 patients received either 0.5, 1.0, or 1.5 mg fluspirilene per week for a period of 6 weeks. The main result of this study was the verification of a clear dose-effect relationship. 5. The fourth study compared 155 patients who had received long-term treatment with fluspirilene (max 1.5 mg/week) and 121 patients with long-term benzodiazepine treatment. No differences were found with regard to the frequency and intensity of extra-pyramidal disturbances. 6. The therapeutical relevance of the findings was emphasized in the general discussion.

Adult↗
PubMed1992

[Cumulative trauma caused by continued sadistic child abuse in a patient with chronic artefact disease].

A 37-year old female with borderline personality disorder, who had experienced the cumulative trauma of a history of sadistic child abuse by her mother, developed the symptomatology of chronic factitious illness after an operation necessitated by an accident injury. Relationships between chronic factitious disease and obsession, addiction, perversion and suicidal behaviour are discussed against the background of a literature review.

Adult↗
PubMed1992

[Endangerment and dangerousness of psychiatry].

Psychiatry is more influenced by the "Zeitgeist" than other medical disciplines. One important reason is the lack of biological data despite large efforts. In this situation ideological factors may become more relevant than they deserve. Temptations of a "pure" doctrine are dangerous. New developments (methadone substitution, active euthanasia) add to the possible dangerousness of psychiatry. Psychiatrists will have to be careful to avoid this dangerousness and the endangering of their discipline.

Dangerous Behavior↗
PubMed1991

[Old age and illness--destroying the intolerable?].

The spectacular criminal case of a nurse who because of killing seven old patients in an intensive care ward had been sentenced to jail for 11 years is shown as example of radical thinking in the face of intolerability of serious illness and age. The deficit model of age is on the one hand justly criticized and called invalid, on the other hand negative aspects of age may not be concealed in the face of hedonistic principles of the present epoch. There is no doubt about the monstrosity of the case of the guilty nurse but it may be exemplary for a frequent defensive behaviour against the phenomena of age. If this is right this singular case may be characteristic of common thinking on the unbearable presumption of age. Self defense turning into aggressivity because of foreseeing the own fate of hopeless illness in moribund aged would then have to be seen as a socially significant attitude.

Adult↗
PubMed1990

Double-blind study of the therapeutic efficacy and tolerability of amitriptylinoxide in comparison with amitriptyline.

In a double-blind trial, 32 patients with endogenous or neurotic depression requiring drug treatment in hospital were randomly allocated to a four-week treatment with amitriptylinoxide or amitriptyline. The initial dosage was, in most cases, 60 mg b.i.d. for both drugs. During the first week of treatment, the dose was increased to a maximum of 300 mg/day with amitriptylinoxide and to 240 mg/day with amitriptyline, depending on tolerability and clinical impression. This dose was then maintained, if possible, throughout the following three weeks. During this period the mean dose of amitriptylinoxide was 167 +/- 8 mg/day, that of amitriptyline 166 +/- 8 mg/day. Seven of the 32 patients (three in the amitriptylinoxide and four in the amitriptyline group) discontinued the trial. Therapeutic efficacy was assessed by means of the AMDP system (scale 4), HAMD total scale, 4 HAMD subscales, and DSI and Bf-S scales. Tolerability was assessed using the AMDP system (scale 5) and a list of side-effects often associated with antidepressive drug treatment. With regard to therapeutic efficacy, no differences were noted between the two drugs except on the DSI scale. In contrast, there was a significant difference in tolerability--both in terms of the vegetative syndrome (AMDP) and the sum of side-effects--in favour of amitriptylinoxide.

Adult↗
PubMed1990

Safety of long-term neuroleptanxiolysis with fluspirilene 1.5 mg per week.

In recent years concern has been frequently expressed that a long-term treatment with fluspirilene 1.5 mg/week might induce tardive dyskinesia, yet there are no empirical data from controlled studies available. In 11 private practices 276 patients under long-term treatment with either fluspirilene or benzodiazepines for reasons of anxiety or psychoneurotic or psychosomatic disorders were investigated by an independent and specially trained physician from our hospital with regard to symptoms to tardive dyskinesia, parkinsonism, and akathisia. Of these patients, 155 had received fluspirilene 1.5 mg/week with a mean duration of treatment of 17.5 months (s = 13.3), and 121 had received benzodiazepines with a mean duration of treatment of 45.7 months (s = 44.6). The mean total scores of the AIMS, the Simpson Angus Scale, and an akathisia scale did not differ significantly between the two groups. In the fluspirilene group a positive correlation of age and psychotropic comedication with the total scores of the AIMS and the akathisia scale could be found, but there was no correlation between duration or continuity of treatment with fluspirilene and symptoms of tardive dyskinesia. In each of the two groups 10 patients (6.9% of the fluspirilene group and 8.3% of the benzodiazepine group) showed abnormal involuntary movements, which corresponds to the incidence of spontaneous dyskinesia. The results of this study do not indicate an increase in tardive dyskinesia for patients with a mean duration of treatment with fluspirilene 1.5 mg/week of 18 months.

Akathisia, Drug-Induced↗
PubMed1990

[Suicide in psychiatric clinic patients].

Psychiatric inpatients who commit suicide differ characteristically from other inpatients. Nearly 60% of them are between 30 and 60 years old and belong to the age group of those who are usually employed. Diagnostically most of them suffer from endogenous psychoses like schizophrenia or major depression. The distribution of the duration of illness shows two peaks: one during the first years and a second after many years of illness. A nearly constant percentage of 40% presents a striking life history, including psychiatric disorders in the family, retardation during childhood, interrupted school education and lack of vocational training. Suicidal attempts in the past are predictive for suicidal behaviour and suicide in the future. The rate of suicides (per 100,000 psychiatric inpatients) is increasing, however there is no evidence for a connection with treatment under open or closed conditions. In case of serious suicidal risk it may be necessary to take antisuicidal measures like temporally limited treatment in a closed ward. On the other hand the liberality which has been established in psychiatric hospitals over the last ten years might be reduced, if restrictive measures are taken in any case of suicidal risk.

Adolescent↗
PubMed1977

[Use of a computer for the preparation of medical history screening in cardiovascular diseases].

Questionable data may be regarded as significant indicators for a screening. It is the aim of our investigations to develop a screening standard anamnesis in form of a questionaire which allows on the scale of larger groups of population to establish the number of endangered persons and patients who probably suffer from cardiovascular diseases but of the quantity of apparantly healthy persons. In order to recognize regularities of the diagnostics coordination of the individual patient by his answers on the questionnaire the data of 400 diagnostically clarified persons (model experiment) underwent a discriminancy analysis. When the data of unknown test persons are given in, on account of the well-known functions of discriminancy a classification in the groups persons with heart and circulatory diseases or with a healthy heart and circulation or a group diagnosis can be performed, respectively. The evaluation of the data of unknown test persons of a pilot study in 96% resulted in a correct classification in patients with heart and circulatory diseases or persons with healthy heart and circulation, the classification in the above mentioned groups of diagnosis was performed on an average to 57%.

Cardiovascular Diseases↗
PubMed1975

Comparison of a new antidepressive, lofepramine, with imipramine in a double-blind multicentre trial.

Lofepramine, an imipramine derivative, shows lower acute toxicity in animals when compared with desipramine and imipramine. Its anticholinergic effect is less pronounced than that of desipramine. In an open clinical trial lofepramine showed a marked antidepressive action. A double-blind multicenter trial of lofepramine v. imipramine, evaluated by means of the AMP system, showed a remarkable degree of concurrence with regards to the effects of those two products.

Adolescent↗
PubMed1975

[Ventricular arrhythmias in reduced glycoside tolerance and digitalis poisoning together with myocardial infarct].

Electrophysiological fundamental principles of the heart muscle cell and the conduction system are discussed in detail. Basic differences are described. Pathophysiology of ventricular arrhythmias is emphasized, especially the ectopic conduction development and conduction defect of the reentry mechanism. Decreased digitalis tolerance of different causes and overdosage of digitalis may lead to ventricular premature heart beats and tachycardias. Myocardial infarction is discussed in detail because lethality within the first hours of infarction is mostly caused by ventricular fibrillation.

Arrhythmias, Cardiac↗