PubMed Health⌕ Search

Biomedical subjects

K Schonauer

Publications and source records attributed to K Schonauer.

16 recordsLinked to original sources
PubMed2001

Attention training in the cognitive rehabilitation of schizophrenic patients: a review of efficacy studies.

OBJECTIVE: To review the literature on effects of attention and cognitive training on attentional functioning in schizophrenic patients. METHOD: Relevant efficacy studies were identified by literature searches (in Medline, Current Contents, Psyclit, and Psyndex databases) and through the reference lists of key papers. RESULTS: Re-examination of findings from nine methodologically adequate studies using computer-based or non-computer-based training procedures provided inconsistent results. On 16 of 35 outcome measures significant performance improvements were observed from pre-treatment to post-treatment but on the majority of the applied measures no performance improvement could be determined. In general, treatment effect sizes but also power of tests were low. For nearly all the outcome measures for which differential training effects were reported there also exist contradictory outcome results. CONCLUSION: There is inconclusive evidence that attention training is effective in schizophrenia. Longitudinal efficacy studies are needed in which different aspects of attention are systematically exercised and assessed.

Attention↗
PubMed2001

[The course of infantile autism through adulthood. An overview of long-term follow-up data].

The symptoms of infantile autism were first described almost 60 years ago. In contrast to its course in puberty and adolescence, follow-up-data on the late course in adulthood are decidedly sparse. As the outcome of research in the literature, we found 21 methodologically heterogeneous follow-up-studies. The arithmetic mean age of all subjects investigated was 24.0 years. The results are supplemented by various case reports and sporadic biographical reports by affected persons. On the basis of the available data, the discontinuous and dynamic changes of course verified in puberty and adolescence are not applicable to the third and fourth decades to the same extent. Gains in competence and autonomy appear to develop in the vocational rather than in the domestic sphere. The significantly more favorable courses of the form described by Asperger are continued in adulthood. The disorder-associated lack of empathy and social interaction is by no means experienced in terms of self-satisfaction by those concerned but rather as a loss. Interpersonal sexual needs are expressed by a substantial proportion of autistic adults. The cumulative mortality rates of the follow-up-studies suggest that the mortality rate among autistic patients is higher than among their non-autistic peers.

Adult↗
PubMed2000

Long-term psychiatric patients in vocational rehabilitation programmes: a naturalistic follow-up study over 3 years.

OBJECTIVE: This paper aims at assessing the vocational integration attained after a 3-year period by psychiatric patients who participated in different vocational rehabilitation programmes. METHOD: In the north-western German region of Westphalia-Lippe a naturalistic follow-up study was carried out on 471 patients from three different types of vocational rehabilitation programmes. The sample comprised chronically ill patients with a history of repeated and long-term hospitalization. RESULTS: After 3 years 11% of the patients were in competitive employment, 67% (still) in sheltered employment, 7% in out-patient work therapy programmes and 15% were unemployed. It is important to notice that 74% achieved their subjective rehabilitation goals expressed at baseline. CONCLUSION: Vocational rehabilitation programmes are an essential part in the treatment of people with chronic mental illness. Integration into work varies markedly while patients' satisfaction is comparably good. Competitive employment represents a realistic objective only for patients with high motivation and favourable preconditions.

Adult↗
PubMed1999

[Psychoeducational-psychotherapeutic treatment of schizophrenic patients and their caregivers. II. Supplementary findings at a 2-year follow-up].

In this study we investigated whether, in conjunction with neuroleptics, a psychoeducational and cognitively oriented treatment for schizophrenic outpatients and their key-persons can improve the course of schizophrenic illness within a 2-year follow-up. This prospective randomized study covered a total of 191 schizophrenic patients (according to DSM-III-R) and comprised a psychoeducational training and cognitive psychotherapy for patients and counseling for their key persons in various combinations. Patients were examined before, immediately after and 2 years after the end of the intervention. Patients in the treatment groups reduced their overall psychopathology and their attention deficit. For patients receiving all three treatment conditions, there was a relevant preventive effect with regard to the rehospitalization rate appearing during the second year of the follow-up. We conclude that in the mid-term, a combination of psychoeducational and cognitively oriented therapy for patients and their keypersons can improve the course of schizophrenic illness.

Adult↗
PubMed1999

Comorbidity of schizophrenia and prelingual deafness: its impact on social network structures.

BACKGROUND: Prelingually deaf persons usually gain only a rudimentary command of speech and prefer sign language to communicate within the deaf community without the handicap they experience in the hearing world. Maintaining social contact within this rather scattered community, however, requires higher degrees of social initiative and mobility. The aim of the present paper was to study the quantity and quality of social integration among a group of prelingually deaf schizophrenic patients (n = 49) and two control groups comprising prelingually deaf psychiatric but non-psychotic patients (n = 38) and hearing schizophrenic patients (n = 30), with account being taken of the special socialisation conditions of deaf persons and of their cultural standards and values. METHOD: Data were collected with the help of semi-structured interviews; with the deaf patients these were conducted in German sign language. Using rating procedures we assessed seven social support components, selected items from a history schedule for schizophrenia, and the probands' visual and verbal language skills. RESULTS: The social networks of the two deaf groups were found to have larger gaps than those of the hearing schizophrenic patients, with significant differences being registered most clearly in the comparison between deaf schizophrenic and hearing schizophrenic patients. Comparison of the verbal and visual language skills of the two deaf groups revealed a substantial deficit among the deaf schizophrenics. Visual language skills were found to correlate more strongly than verbal language skills with the social support components. CONCLUSION: Prelingual deafness has a strong impact on the course of schizophrenia. In the long run, many of these patients belong to a "minority within a minority".

Adult↗
PubMed1998

[Schizophrenic prelingual deaf and hearing patients. A comparison of premorbid and current data after several years of progression].

Prelingually deaf persons belonging to a linguistic and cultural minority have to cope with a particular sociocultural situation. The present study endeavours to analyse possible effects of this situation in the course and outcome of schizophrenia. Two samples, one comprising 27 prelingually deaf and one 27 hearing patients, all with schizophrenic psychoses, were parallelised on the basis of gender, age, duration of illness and number of previous hospitalisations. Data were then collected on the premorbid and current social situation and on the psychopathometric outcome after an (on the average) ten-year course. The prelingually deaf patients were much more profoundly impaired with regard to the rating of their residual symptoms and their social situation than those of the hearing control group. Only with respect to vocational rehabilitation did the prelingually deaf patients record a slightly more favourable situation than the hearing patients, as a greater proportion of them had regular employment, in most cases in workshops for the disabled.

Adult↗
PubMed1998

Collaboration with drug treatment by schizophrenic patients with and without psychoeducational training: results of a 1-year follow-up.

Within a controlled prospective intervention study, schizophrenic outpatients randomly assigned to four treatment groups and one control group were assessed with regard to collaboration with drug treatment. In total, 39.3% of 84 regular attenders of the psychoeducational training programme and 26.6% of 64 control patients reported having persuaded their psychiatrists to modify their medication prescriptions. A total of 8.3% and 7.8%, respectively, modified their medication on their own initiative, although with subsequent approval by the psychiatrist, and 20.2% and 15.6%, respectively, modified their medication after consulting their psychiatrist. With regard to medication management, the groups did not differ either at post-treatment or at follow-up. At follow-up, regular attenders showed a reduced fear of side-effects, increased confidence in their medication and stable confidence in their physician. Among the control subjects, confidence in the medication and in their physician declined, and fear of side-effects increased. Psychoeducational training therefore led to an optimization of patients' attitudes toward treatment, but not to changes in medication management.

Adult↗
PubMed1998

Hallucinatory modalities in prelingually deaf schizophrenic patients: a retrospective analysis of 67 cases.

In order to examine the effect of congenital or early acquired deafness on hallucinatory modalities in schizophrenia, we interviewed 67 prelingually deaf schizophrenic patients (using sign language) about their hallucinatory experiences over the entire course of their illness. We also analysed the clinical records of our subjects' previous hospitalizations. In our deaf sample, visual and tactile hallucinations were plainly over-represented as hallucinatory modalities in comparison with hearing schizophrenic samples. Although some patients reported visual hallucinatory perceptions of sign language messages, the hallucinatory reception of meaningful information in deaf patients seems also to remain affiliated to the 'auditory' modality. It was concluded that the different representation of hallucinatory modalities reflects in particular the influence of 'the deaf way' of sensory experience on imagery processes.

Adolescent↗
PubMed1998

[Medication-related attitudes of chronic schizophrenic patients. A follow-up study after psycho-educational intervention].

OBJECTIVE: To evaluate the effect of a psychoeducational training, compliance, medication management, and illness-related attitudes were assessed among schizophrenic outpatients. METHODS: Study patients who attended at least 70% of 10 psychoeducational sessions (n = 74) and the 57 patients of the control group were reexamined 2 years after the end of intervention. RESULTS: Attenders had better compliance, were more confident in medication codetermination and more satisfied with their knowledge about medication. Confidence in medication and physician increased whereas in the control both decreased. CONCLUSIONS: Although there were no statistically significant differences the results show impressive longterm effects of psychoeducational training.

Adult↗
PubMed1998

[Occupational rehabilitation of chronic psychiatric patients. Results of a prospective study over 3 years].

Vocational rehabilitation of mentally ill patients is now focused outside the psychiatric hospital. Three types of programmes play a major role: outpatient work therapy programmes at psychiatric hospitals, jobs in (partly) sheltered employment facilities as in companies specially adapted for employing mentally ill persons, and workshops for the mentally disabled. In the north-western German region of Westphalia-Lippe (population: 9 million) we carried out a three-year prospective study on a regionally representative sample from such rehabilitation institutions to assess the course and outcome of vocational rehabilitation. The sample comprised 295 men and 176 women with a mean age of 36.1 year (+/- 9.6). The majority were chronically ill patients with a history of frequent long-term hospitalisation. 61% of all probands were suffering from schizophrenic disorders. The outcome of vocational rehabilitation differs substantially among the three programme types, primarily due to varying baseline conditions, subjective expectations or goals, and courses of illness. The programmes are not alternatives but should be seen as supplementary components of a care system which has to meet a wide range of patient requirements. Vocational integration into the open labour market is a desirable and realistic objective for only some of those concerned.

Adult↗
PubMed1997

Electroconvulsive therapy vs. paroxetine in treatment-resistant depression -- a randomized study.

Failure to respond to adequate pharmacological treatment for major depression is now the most common indication for the use of electroconvulsive therapy (ECT). The advantages of ECT with respect to both speed and quality of response are clinically important issues, but surprisingly few studies have examined the efficacy of ECT in relation to newer antidepressant agents such as selective serotonin reuptake inhibitors (SSRIs). A total of 39 subjects with major depression and with at least two failed antidepressant trials (mean 4.9 trials) were randomized to either paroxetine treatment (n=18) or right unilateral (RUL) ECT (n=21). Up to the end of the study treatment we found a reduction in the HAMD score of 59% for the ECT group and of 29% for the paroxetine group (P<0.001 paired t-test). In the ECT group, 71% of subjects fulfilled the response criteria (at least a 50% decrease in total HAMD score). The present study found ECT to be superior to paroxetine in medication-resistant major depression, in terms of both degree and speed of response.

Adult↗
PubMed1994

Graphemic jargon: a case report.

We report on a patient with left hemispheric thromboembolic stroke whose writing performance on single word dictation following recovery from an aphasic syndrome remained severely impaired but fluent. Having only very fragmentary command of the target's written spelling she produced neologistic nonwords which were approximately the same length and contained, in addition to perseverative intrusions and unidentifiable errors multiple insertions, deletions, transpositions, and substitutions but only few unpronounceable combinations. The patient was tested 4 and 10 months postonset, before and after having attended a rehabilitation program for dysgraphia. Comparing pre- and post-rehabilitation error corpora we found, besides a slight improvement of her severe dysgraphia, a highly significant predilection of in-class substitutions regarding the consonant/vowel status of misspelled graphemes. The second error corpus revealed some influence of different consonant/vowel patterns among the targets on the emergence of spelling errors. We discuss the hypothesis of an influence of nonlexical "graphotactic" features on the spelling process as has been revealed by other cases of acquired dysgraphia published in recent years.

Agraphia↗
PubMed1994

[Physiology, psychology and pathology of writing and spelling--an overview].

Writing and spelling are conceived as concerted actions comprising cognitive planning, motor action and an expressive content. In literate societies the individual use of alphabetic systems is acquired immediately after speech as a "cultural technique". As such these systems demand specific cognitive and motor skills which have been analysed primarily on the basis of neurological and psychiatric syndromes. We distinguish primary developmental disturbances and secondarily acquired disturbances of writing and spelling, categorizing the latter into four essential disturbance areas: linguistic command, motor execution, automatism control and dynamic tonus regulation. The clinical significance of writing and spelling is not confined to its possible disturbances. In pathologically induced restrictions of cognitive functions or of social skills the fact is rather that the written language frequently contributes to the development of individual coping strategies. From the psychodynamic aspect, written communication is characterized principally by its proximity-regulating function.

Handwriting↗
PubMed1986

[Some linguistic aspects of thought disorder in non-acute schizophrenia].

Seventy texts, which had been produced spontaneously but in standardized contexts by (non-acute) schizophrenic patients and by non-schizophrenic subjects, were analysed linguistically in order to investigate the various strategies that speakers may use to join different sentences together to form a unified structure by semantic and lexicogrammatical ties. For this purpose we used Halliday's and Hasan's classification of so-called "cohesive ties". This theoretical framework makes it possible to describe the inner coherence of linguistic texts in a quantitative way. In the "schizophrenic texts" the sentences contained significantly fewer such cohesive ties than in those texts produced by normal speakers. An additional longitudinal analysis revealed an increase in the number of cohesive ties per sentence, when the same schizophrenic speakers were asked to produce a second text (in a similar context) after participating in a 3-month psychotherapy programme. The central goal of psychotherapy was to improve the patients' cognitive ability to face and cope with social stress situations. The results of several textual and statistical procedures are discussed, mainly under the aspect of cognitive dysfunctions during periods of non-acute schizophrenia.

Adult↗