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Biomedical subjects

M Brüne

Publications and source records attributed to M Brüne.

16 recordsLinked to original sources
PubMed2007

[Neuropsychological aspects of delusional disorders. Characteristic attributional style or cognitive deficit?].

BACKGROUND: "Pure" delusional disorders are clinically rare, and the neuropsychology of such disorders is poorly understood. Whereas "deficit" models suggest a cognitive impairment accounting for the incorrigible fixation of false beliefs, cognitive models propose the existence of a characteristic attributional style in patients to stabilise a fragile self. PATIENTS AND METHODS: The cognitive flexibility and attributional style of 21 patients diagnosed with delusional disorder according to ICD-10 were compared with a group of healthy controls paralleled for age, sex, education, and intelligence. RESULTS: Patients with delusional disorders made more errors and more perseverative errors in the Wisconsin Card Sorting Test compared with controls. However, these differences were only significant in patients with a comorbid depression. In contrast to earlier studies, patients with delusional disorders did not attribute negative events to external or personal causes more often than healthy controls, but partly tended to show a depressive attributional style. CONCLUSION: Our results do not support either a cognitive deficit in patients with delusional disorders or a characteristic attributional style. In terms of treatment recommendations, a thorough diagnosis of comorbid depressive disorders in patients with delusional disorders is warranted.

Adult↗
PubMed2001

[A case of primary zopiclone dependence].

MEDICAL HISTORY: A 59-year-old female patient reported an increasing intake of up to 20 pills of zopiclone per day (150 mg) during the past 3 years. The dose increase was associated with euphoria and subjectively improved fitness. The patient suffered from anxiety and inner restlessness when trying to discontinue the medication, as well as from fatigue and forgetfulness when on medication. The medical history was free of psychiatric disorders and abuse of psychoactive substances. CLINICAL FINDINGS: Apart from mild attention and concentration deficits with a mildly depressed mood the psychiatric findings were normal. COURSE AND TREATMENT: Consistent with the preliminary diagnosis of a primary non-benzodiazepine dependence (zopiclone), after withdrawal of zopiclone the patient suffered from inner restlessness and psychomotor agitation, vague abdominal pain, and hypertension. The symptoms subsided after administration and subsequent gradual discontinuation of diazepam. CONCLUSION: Zopiclone dependence has repeatedly been reported in patients with pre-existing substance-related addictions, and in patients with other psychiatric disorders. Primary zopiclone dependence may be regarded as rare. Despite the low dependence potential of non-benzodiazepine hypnotics, the indication of prescription should be thoroughly considered.

Anti-Anxiety Agents↗
PubMed2001

[A case of delusional jealousy in Parkinson disease ].

Delusional jealousy has been reported in organic and "functional" psychotic disorders. In organic psychoses, delusional jealousy is usually associated with impaired orientation or other cognitive disturbances. Delusional jealousy in Parkinson's disease has rarely been reported in the scientific literature. A case of a 49-year-old man suffering from this pathology in the course of Parkinson's disease is presented as to clinical picture, therapy, course, and outcome.

Antiparkinson Agents↗
PubMed2001

[Neuropsychological follow-up of attention deficit/hyperactive disorder in adulthood before and after treatment with methylphenidate].

Attention-deficit/hyperactivity disorder (ADHD) in adulthood is frequently overlooked. Motor restlessness, impulsivity, low frustration tolerance, and conduct disorders are diagnostically ambiguous, but are predominantly ascribed to affective disorders, anxiety disorders, and personality disorders. Furthermore, substance-induced addiction may develop consecutively to untreated ADHD. We report on a case of primary diagnosis of ADHD in adulthood with secondary cocaine dependency, who was neuropsychologically assessed before and following treatment with methylphenidate. Frequency of errors and reaction time in performance on attention tests, concentration tasks, and multiple stimuli-/reaction tasks improved under treatment with methylphenidate. ADHD may be treated efficiently even after primary diagnosis in adulthood. Differential diagnosis of ADHD should be considered in disorders associated with motor hyperactivity, impulsivity, stress intolerance and conduct disorders.

Adult↗
PubMed2001

Evolutionary fallacies of Nazi psychiatry. Implications for current research.

Evolutionary theory has had a major impact on psychiatry since the middle of the 19th century. During the Nazi regime psychiatry supported compulsory sterilization and euthanasia of physically and mentally ill and subsequently the killing of "inferior" races by borrowing scientifically invalid conclusions from evolutionary biology. The present paper deals with some of the flaws and shortcomings of the scientific paradigms of evolutionary theory adopted by psychiatry during the Nazi regime and discusses possible implications for modern research in evolutionary psychology and psychiatry.

Biological Evolution↗
PubMed2000

Animal models of acute drug-induced akathisia - a review.

Akathisia is a complex neurobehavioural side effect of neuroleptics and some other drugs which is characterised by subjective report and objective manifestations of restlessness. Its pathophysiology is poorly understood and there are many limitations to its investigation in humans. This paper reviews the various attempts that have been made in modelling acute akathisia in animals. Homologous as well as isomorphic models have been attempted, but most models are partial as they reproduce either the subjective or the objective features of the syndrome. None of the available models has been fully validated. Neuroleptic-induced defecation in the rat, even though constrained by a lack of symptom similarity and thereby face validity, has been most studied as a model of subjective akathisia. Rat models of restlessness, in particular those involving the use of serotonergic drugs or lesions of the ventral tegmentum or medial prefrontal cortex, are interesting partial models that should be further investigated. Neuroleptic-induced akathisia is observed in primates and has been modelled in dogs, and these should be studied further for their validation. It is also necessary to consider the subtypes of akathisia in the attempts to develop these models.

Akathisia, Drug-Induced↗
PubMed1999

[Stability and variability of catatonic symptoms in the longitudinal course of illness. Videotape documentation in catatonic schizophrenia].

The symptomatology of a female patient with catatonic schizophrenia is presented with respect to its longitudinal course. The stability and variability of catatonic symptoms are investigated using videotape technique. It is demonstrated that catatonic symptoms are stable in the longitudinal course but due to unsteady arousal the severity of the catatonic symptoms varies markedly. There are fluctuating symptom patterns that dominate the clinical picture: a hyperkinetic form with prevailing restlessness or excitement, with abnormal involuntary movements, stereotypies, and parakinetic movements, and a hypokinetic form with various inhibition phenomena, mutism and stupor. The clinical impression of the catatonic syndrome changes according to the dominating symptom patterns at different times, whereas the less severe symptoms recede into the background and thus, may be overlooked. Considering this finding the problem of a 'diagnostic threshold' is discussed. The authors intend to emphasize videotape documentation of catatonic motor disturbances as most useful. This technique may contribute to differentiating illness related from neuroleptic induced movement disorders.

Adult↗
PubMed1999

The incidence of akathisia in bipolar affective disorder treated with neuroleptics--a preliminary report.

BACKGROUND: Akathisia is a common side effect of neuroleptic therapy. Prevalence and incidence studies of akathisia have been predominantly undertaken in patients with schizophrenia and schizoaffective disorder. Investigations of akathisia in neuroleptic treated patients suffering from bipolar disorder are lacking. METHOD: In the present study, 23 patients with bipolar affective disorder who were treated with neuroleptics were assessed for akathisia and parkinsonism, using the Barnes Akathisia Rating Scale and DSM-IV criteria, respectively. RESULTS: 15 patients (65.2%) developed akathisia. Eighteen patients (78.3%) had parkinsonism, including all of the akathisia-group. In six patients (40%) of the akathisia-group the onset of akathisia was after neuroleptic dose reduction or after additional administration of mood stabilizers. CONCLUSIONS: Neuroleptic-induced side effects may occur frequently in patients with bipolar affective disorder and should therefore be monitored thoroughly. Demasking effects due to diminishing parkinsonian symptoms may contribute to akathisia-onset after neuroleptic dose reduction. Early application of alternative treatment regimens, e.g. monotherapy with mood stabilizers in combination with benzodiazepines should be considered. FUTURE DIRECTIONS: The preliminary findings require further investigation regarding dose dependency, incidence of akathisia in untreated patients with bipolar affective disorder, akathisia in patients with depressed episodes on SSRI, and possible differences between various mood stabilizers in their propensity to enhance akathisia, as well as possible sex differences.

Adult↗
PubMed1998

[The relevance of ethology for psychiatry].

Darwin's evolutionary theory was the starting point for ethology, associated with an impact on scientific psychiatry. Psychiatry and ethology have common scientific and methodological prerequisites: inductive and deductive methods and "gestalt theory" as a basis for observing and describing behaviour patterns with subsequent causal analysis. There have been early endeavours to anchor ethological thinking in psychiatry but this tendency did not prevail for the following reasons: on the one hand, the methodology of ethology was immature or not applicable to man, whereas on the other hand the dominating experiential phenomenological school of Karl Jaspers and Kurt Schneider stressed the privileged position of human thinking, perception, and feeling. These fundamental categories of human existence did not appear amenable to any causal ethological analysis. Psychiatry and evolutionary biology were linked in an atrocious manner during the Nazi regime, both being abused for propaganda purposes and genocide. More recently, there is a "reconciliation" of both disciplines. In psychiatric nosology, operational, behaviour-oriented diagnostic systems have been introduced; ethology has opened up for theories of learning; new subsections like human ethology and sociobiology have evolved. The seeming incompatibility of (behavioural) biological psychiatry and experiential phenomenological psychopathology may be overcome on the basis of Konrad Lorenz' evolutionary epistemology. The functional analysis of human feeling and behaviour in psychotic disorders on the basis of Jackson's theory of the evolution and dissolution of the nervous system may serve as an example. The significance of an "ethological psychiatry" for diagnostic and therapeutical processes of psychiatric disorders derive from prognostic possibilities and the analysis of non-verbal communication in therapist-patient-interactions, but have not yet been systematically investigated.

Animals↗
PubMed1998

Ethological remarks on mannerisms. Conceptualisation and proposal for a definition. off.

Mannerisms are symptoms of various psychiatric disorders. The term has not been defined thoroughly and is often confused with stereotypies or the more generally used term 'bizarreness'. From an ethological perspective, mannerisms may be regarded as pathologically altered forms of ritualised behaviour that serve a communicative purpose. Mannerisms are maladaptive behaviours since they lead to withdrawal of and rejection by the socially interacting partner, or even induce aggressive behaviour due to the pathologically exaggerated and overdrawn appearance. The behaviour-physiology interactions of manneristic behaviour are not fully understood. Altered brain metabolism and disturbed perceptivity of social signals may be involved.

Animals↗
PubMed1997

[Akathisia].

The syndrome of akathisia typically consists of a subjective component, e.g. inner restlessness and an urge to move, and observable symptoms such as restless legs and inability to sit still. In most cases akathisia is caused by neuroleptics. There are several subtypes of akathisia according to the time of onset in the course of neuroleptic treatment. In clinical routine extrapyramidal motor disturbances are often underestimated or misinterpreted. As far as akathisia is concerned, differential diagnosis of restlessness or of repetitive movement patterns may be problematic. Non-compliance and impulsive behaviour are regarded as possible complications of akathisia, but systematic investigations are lacking. The pathophysiology of akathisia is not clear, but it probably differs from other pharmacologically induced motor disturbances. If warrantable, the first step in akathisia treatment is dose-reduction of the causing agent. Anticholinergic drugs, benzodiazepines, and beta-receptor blockers may be effective. Clinical assessment and survey of the patient's behaviour, e.g. during occupational therapy and group therapy is important for an early diagnosis of akathisia so that complications may be minimised.

Adrenergic beta-Antagonists↗
PubMed1996

[Delusional "pseudotranssexualism" in schizophrenic psychosis].

The case of a 32-year old man suffering from a 10-year course of schizophrenia is presented. The man's delusions include the conviction of being of the opposite sex and thus, he applied for an operational correction of his gender according to the law of transsexualism. Based on the evident problems arising from this case, the differential diagnosis of genuine transsexualism is discussed.

Adult↗
PubMedDate not supplied

Social cognition and psychopathology in an evolutionary perspective. Current status and proposals for research.

The phylogenetic and ontogenetic developments of social cognition have been a major research focus of evolutionary and developmental psychology. Theory of mind or so-called Machiavellian intelligence, that is the capacity to infer mental states of other individuals and to manipulate them in order to maximise social success, probably emerged due to the need to cope with an increasingly complex social environment. Studies on social reasoning suggest disturbances of mental state attribution in psychiatric disorders. However, apart from autism spectrum disorders, the systematic evaluation of social cognition is still in its infancy, and the present data are ambiguous due to methodological difficulties. Based on the concept of the modular organisation of the mind, a stepwise investigation of social cognition in psychiatric disorders is proposed, including clinical description and available standardised methods. The specific characteristics of psychiatric disorders in respect of social cognition, therefore, may vary according to the hierarchical organisation of the social module. Systematic studies on social reasoning processes in psychiatric disorders may provide new insights also useful for the development of coping strategies in cognitive-behavioural therapy.

Biological Evolution↗