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Biomedical subjects

M Amering

Publications and source records attributed to M Amering.

At least 19 recordsLinked to original sources
PubMed2005

Pharmacophilia and pharmacophobia: determinants of patients' attitudes towards antipsychotic medication.

OBJECTIVE: To identify factors that influence attitudes towards psychopharmacological treatment in patients suffering from schizophrenia and schizoaffective psychoses. METHODS: Ninety-two participants in an outpatient psychoeducational program, classed as "pharmacophobic" or "pharmacophilic" according to the Drug Attitude Inventory scale, were compared with regard to sociodemographic variables, clinical characteristics, subjective deficit syndrome, illness concepts, knowledge, locus of control, and quality of life. RESULTS: The 59 pharmacophilic and the 33 pharmacophobic patients did not differ significantly with regard to most sociodemographic variables, symptoms, or classic personality traits such as locus of control, self-concept, and quality of life. The only differences concerned hospitalization history ( P < 0.05) and statements on the actual, subjective experience of desired and undesired effects of medication ( P < 0.01). CONCLUSIONS: The impact of subjective experiences with drug treatment on attitudes towards medication and compliance needs to be a main focus of interventions targeting attitudes towards pharmacological treatment.

Adult↗
PubMed2003

The long-term course of panic disorder--an 11 year follow-up.

BACKGROUND: The purpose of this study was to assess the naturalistic long-term course of panic disorder over a period of 11 years. METHOD: Thirty DSM-III-R panic disorder patients, who had suffered from panic disorder for 6 years on average and who had taken part in an 8-week multicenter drug trial, were included in the intent-to-follow-up group to be reinterviewed 11 years after the end of the trial. At baseline and at follow-up the same instruments were used to assess frequency of panic attacks, level of phobic avoidance, and disabilities. Treatments received during the follow-up period and attempted suicides were assessed with a structured interview. Periods of well-being during the follow-up period were elicited retrospectively with a specifically designed longitudinal chart. RESULTS: Twenty-four patients could actually be reinterviewed after 11.3 years. While at baseline all patients had suffered from panic attacks and had been severely disabled on a number of measures, 66.7% had no panic attack during the year before follow-up. During the month before follow-up 87.5% had no panic attack, and 54% showed no or only mild phobic avoidance. In the areas of work and family life 90% showed no or only mild disabilities, whereas in the area of social life this percentage was lower (67%). Thirty-three percent of the patients were completely remitted according to a composite remission criterion. CONCLUSIONS: Panic disorder is not a uniformly chronic and progressing disorder. Over a period of 11 years there is a good chance of recovery from panic attacks and disabilities, and full remission is also possible.

Activities of Daily Living↗
PubMed2001

["I am a Misunderstood Being on Earth" - Concept of illness of patients suffering from schizophrenic psychosis before and after psychoeducational treatment].

OBJECTIVE: To determine the effects of a psychoeducational intervention on the individual concepts of illness of patients suffering from schizophrenia. METHOD: 27 patients with a diagnosis of schizophrenia according to ICD-10 were interviewed with open ended questions about their concept of illness at admission to a day hospital and after 10 weeks of attending a psychoeducational program. Questions concerned terminology, diagnosis, prognosis, interventions and aetiology. A qualitative analysis of these data is presented. RESULTS: The terms used to describe the illness were mostly colloquial. Highly individualized and heterogeneous concepts of illness, aetiology and helpful interventions and a positive view regarding prognosis prevailed. Changes over time were limited and arbitrary. CONCLUSIONS: The concepts offered by professionals were adopted in a very limited way, which can be understood in the context of highly individualized ways of coping with diagnosis and illness.

Adolescent↗
PubMed1999

Psychiatric wills of mental health professionals: a survey of opinions regarding advance directives in psychiatry.

Psychiatric wills are advance directives for an eventual involuntary treatment in psychiatry. We attempted to determine psychiatric professionals' knowledge and opinion about this legal option and obtain their formulations of advance directives for themselves. A total of 101 psychiatric nurses and psychiatrists at the Department of Psychiatry of the University of Vienna responded to a questionnaire about psychiatric wills and anonymously drafted advance directives for themselves concerning psychiatric treatment in case of an acute psychosis. Fifty-four percent knew about this legal option, 55% considered it an appropriate legal possibility, and 29% considered it inappropriate. The study also found that 75% of respondents reject certain methods of therapy, e.g. 30% want to exclude the use of neuroleptic medications, and 46% reject ECT. We conclude that although there is little experience so far with advance directives for psychiatric patients, there is an interest and predominance of positive attitudes towards this legal option among mental health professionals. Concerning their preferences, professionals felt inclined to make very specific statements as to which available treatment strategies they would reject and which they would request for their treatment. This bodes well for the widespread use of advance directives in mental health settings.

Adult↗
PubMed1998

The long-term course of panic disorder and its predictors.

Whereas lifetime prevalence rates of panic disorder--as established in epidemiologic surveys--range between 1.6 and 3.5%, 1-month rates usually amount to much less than one half of the lifetime rates. This finding indicates that a substantial proportion of patients who had panic disorder at some stage in their life must have remitted. In contrast to these results, clinicians tend to regard panic disorder as a chronic condition because, as a rule, they see panic patients only several years after onset of the disorder. A number of small, prospective, long-term studies of such clinical populations indicate that after several years, between 17 and 70% of patients still have panic attacks, and between 36 and 82% have phobic avoidance. In the largest and longest follow-up study published to date, 45% of all patients showed an unremitting--although in a certain proportion waxing and waning--course, 24% followed a pattern of remissions and relapses, whereas 31% went back into a stable remission. The evidence of factors predicting the course of panic disorder in clinical populations suggests that long duration and agoraphobia at baseline--not the severity and frequency of panic attacks--are predictors of an unfavorable course. Additional studies are needed to determine whether personality factors, depression, and other variables are also of predictive relevance. Also, factors working during follow-up, such as positive and negative life events, coping behaviors, and treatment, should be considered in future studies.

Chronic Disease↗
PubMed1998

["Because it concerns me"--patient-directed discharge letters].

PURPOSE: Evaluation of practicability and acceptance of discharge summaries addressed directly to patients after psychiatric hospitalisation. METHODS: Over a period of 3 months 65 patients got discharge summaries addressed directly to them. Doctors and patients--4 months after discharge--were asked to evaluate this procedure. RESULTS: Both doctors' and patients' acceptance and evaluation was very positive. Argumentations for this view were the need to give and get information and the impression that this procedure can enhance confidence and trust.

Adult↗
PubMed1997

[Sitting or supine stereotaxic core biopsy of the breast? A comparison based on a randomized, prospective study].

UNLABELLED: OBJECTIVE/MATERIAL AND METHODS: In a prospective randomized study, the techniques of stereotactic breast biopsies in prone and sitting position were compared. Part of the data has already been published. A total of 103 women underwent stereotactic breast biopsies, either prone (n = 51; using TRC-Mammotest, Sweden) or in the sitting position (n = 52; using Stereotix 2, General Electric Medical Systems, Milwaukee, Wisconsin, USA). With the help of pre- and post-biopsy questionnaires, anxiety, pain, and subjective experience were recorded in all patients. Vasovagal reactions were scored from 0 to 2 according to their severity. All biopsy results were verified by surgery. The specificities and sensitivities for the two positions were calculated and statistically compared. RESULTS: With regard to overall tolerance no statistically significant difference between biopsies performed in the sitting or the prone position was noted. Significantly more patients (p = 0.04) in the prone position stated they would prefer premedication prior to a repeat biopsy. Three patients (prone; n = 1; sitting; n = 2) fainted during the procedure. There was no statistically significant difference between the two biopsy positions regarding sensitivity (95%) and specificity (100%). CONCLUSIONS: More attention should be paid to patient care and, especially, preintervention information. Biopsies in the prone or sitting position are equally well tolerated. Somatic reactions are not a major problem during breast biopsy. Success and validity are independent of the biopsy position.

Adult↗
PubMed1997

Embarrassment about the first panic attack predicts agoraphobia in panic disorder patients.

In order to find out whether contextual variables of the first panic attack and the person's reaction to it predict the development of agoraphobia in panic disorder patients, 60 patients with a DSM-III-R diagnosis of panic disorder with agoraphobia and 30 patients suffering from panic disorder without agoraphobia were interviewed about their first panic attack. Single comparisons between groups of agoraphobic and non-agoraphobic patients were carried out and a logistic regression model was applied. Occurrence of the first panic attack in public and the feeling of embarrassment were found to be significantly associated with the development of agoraphobia. It is concluded that eliciting this specific form of social concern at an early stage might help to identify patients at risk for later agoraphobia, which could, in turn, help to further specify early therapeutic interventions and concentrate therapeutic efforts on a high-risk group of panic disorder patients.

Adaptation, Psychological↗
PubMed1997

A study of the effects of patient anxiety, perceptions and equipment on motion artifacts in magnetic resonance imaging.

We investigated to see if motion artifacts (MA) occurring in magnetic resonance imaging (MRI) are related to prescan anxiety measures and test the feasibility of identifying patients at risk for the development of MA before scanning. Furthermore, to determine a possible influence of constructional differences between a 1.5 and a 0.5 tesla scanner on the frequency of MA. Two hundred and ninety-seven first time MRI patients were surveyed before and after imaging with anxiety and attitude questionnaires. Frequency and impact on diagnostic quality of MA were documented. 12.8% of all scans showed MA not related to normal body pulsations. In 6.4% the diagnostic quality was impaired. Constructional differences did not influence the frequency of MA. Also, anxiety as determined with the most common anxiety measuring instrument was not related to the development of MA. Concern about the technical apparatus identified 70.6% of all individuals developing MA. Patients at risk for the development of MA can be identified prior to scanning. It seems necessary to further develop reliable methods to detect them and to evaluate strategies to prevent MA.

Adult↗
PubMed1997

[The first panic attack: a missed chance for prevention of panic disorder and its complications].

OBJECTIVE: Assessment and analysis of first medical consultations and their significance in panic disorder patients. METHODS: 90 panic disorder patients were interviewed concerning their experiences with the medical system at the time of their first panic attack. RESULTS: Panic disorder patients contacted mostly non-psychiatric medical services at the time of their first panic attack. The correct diagnosis was established in only 4 cases (5.6%). CONCLUSIONS: An important chance for secondary prevention of the development of panic disorder is missed, probably due to the poor education of physicians on panic attacks.

Adolescent↗
PubMed1996

High frequency of EEG and MRI brain abnormalities in panic disorder.

The frequency and quality of brain abnormalities in panic disorder (PD) were assessed with magnetic resonance imaging (MRI). The use of electroencephalography (EEG) to detect PD patients with a high probability of morphologic brain abnormalities was also explored. Consecutive PD patients (n = 120) were screened with routine EEG examinations and were divided into the following subgroups on the basis of their EEG findings: patients with non-epileptic EEG abnormalities (EEG-A group, n = 28), matched patients with normal EEG results (EEG-N group, n = 28) and matched healthy controls (n = 28). PD patients showed a higher than expected rate of non-epileptic EEG abnormalities (29.2%; 35 of 120). EEG screening was effective in identifying patients with a high probability of morphologic brain abnormalities. MRI abnormalities were found in 60.7% of the EEG-A patients, 17.9% of the EEG-N patients, and only 3.6% of the controls. A high frequency of septo-hippocampal abnormalities was found. Further research should focus on attempts to subtype PD on the basis of neuroanatomic and functional brain abnormalities.

Adult↗
PubMed1996

Predictors of quality of life in a long-term followup study in panic disorder patients after a clinical drug trial.

In a prospective 4 year followup study, 423 panic disorder patients participated in one of two international multicenter drug trials. They were to be reinterviewed 4 years after leaving the trials; 367 (86.8%) interviews were completed. At followup, 3 of 5 patients still suffered from at least occasional panic attacks, and 2 of 5 were still agoraphobic, but only about 20 percent of the patients were still disabled. The only baseline variables that predicted disabilities at followup were the disability measures at baseline themselves. Neither panic attack frequency nor phobic avoidance at baseline predicted disability at followup. Because of the lack of association between the presence of symptoms and of social disabilities, future clinical trials and other clinical and epidemiological studies should use independent symptom measures and quality-of-life measures simultaneously.

Alprazolam↗
PubMed1996

Randomized comparison of sitting and prone positions for stereotactic fine-needle aspiration breast biopsy.

In a prospective randomized study, 103 women had stereotactic biopsies performed either in the prone (n = 51) or sitting (n = 52) position. Questionnaires were administered before and after biopsy, to measure anxiety, pain and subjective experience in all patients. Vasovagal reactions were scored from 0 to 2 according to severity. There was no significant difference between biopsies performed in the sitting or the prone position with regard to overall tolerance. Significantly more patients biopsied in the prone position (15 of 51, 29 per cent) than in the sitting position (seven of 52, 13 per cent) would prefer premedication before a repeat biopsy (P = 0.04). Of the total patient group, three women fainted, one in the prone position and two others in the sitting position. Breast biopsies performed in the prone or sitting position are equally well tolerated. Somatic reactions such as fainting are not a major problem during breast biopsy; however, attention should be focused on patient care, including information given before the procedure.

Anxiety↗
PubMed1995

Is there a pathophysiological and therapeutic link between panic disorder and epilepsy?

Relations between panic disorder (PD) and epilepsy (E) have repeatedly been discussed. Three patients with juvenile E who had been free of seizures under anticonvulsant medication for many years and developed PD are presented. Increasing anticonvulsant medication resulted in complete and stable remission of PD. It is hypothesized that, in a subgroup of patients with PD, there is a pathophysiological relation to E. Further research into the usefulness of anticonvulsants in the treatment of PD, especially in therapy-refractory cases, is suggested.

Adult↗
PubMed1995

Long-term follow-up after a drug trial for panic disorder.

BACKGROUND: This study investigates the naturalistic course of panic disorder over four years and attempts to identify predictors for outcome. METHOD: 423 DSM-III-R panic disorder patients who had taken part in an international multicentre drug trial were selected for follow-up; we were able to re-interview 367 (87%). For panic attacks, phobic avoidance and disabilities the same rating scales were administered as had been used for the clinical trials. RESULTS: While 61% of all patients experienced at least occasional panic attacks at follow-up, few suffered from serious phobic avoidance (16.7%) or serious disabilities (work 7.9%); family 8.7%; social 13.9%). Panic attack frequency at baseline, original trial medication and continuous use of psychotropic medication during follow-up are not related to outcome, whereas longer duration of illness and more severe phobic avoidance at baseline are unfavourable. CONCLUSION: The course of panic disorder is not uniform. Since long duration of illness and severe phobic avoidance at baseline are predictors for an unfavourable outcome, more rigorous efforts should be undertaken to detect and treat panic disorder at an early stage.

Adolescent↗
PubMed1992

Center differences and cross-national invariance in help-seeking for panic disorder. A report from the cross-national collaborative panic study.

Help-seeking behaviour for treatment of panic disorder was investigated in the sample of the Cross-National Collaborative Panic Study Second Phase. A total of 1168 patients were entered into this trial in 14 countries. Although there were significant center differences in prior treatment and utilization of health services there were also similarities. Treatment had been provided mainly by general practitioners. Drug treatment consisted mostly of prescription of classical tranquilizers and had a longer duration than treatment by psychotherapy. Patients with agoraphobic avoidance, past major depression and longer duration of illness used medical and psychiatric treatment facilities more intensely. Older and more severely disabled subjects were more frequently treated by medical health care providers and were more likely to receive psychotropic drugs. The results indicate that general practitioners carry an important load in the treatment of panic disorders but may need more information about recent development in pharmacotherapy for this condition.

Adult↗