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M Döpfner

Publications and source records attributed to M Döpfner.

At least 19 recordsLinked to original sources
PubMed2006

[The effectiveness of atomoxetine in children, adolescents, and adults with ADHD. A systematic overview].

This paper gives an overview of the pharmacology, efficacy, duration, tolerance, and side effects of atomoxetine for children, adolescents, and adults. A systematic analysis of the published clinical studies and poster abstracts was conducted. Atomoxetine is the first selective inhibitor of the noradrenaline transporter that was approved by the FDA in the US as a nonstimulant for the treatment of ADHD in children, adolescents, and adults. In clinical studies, its efficacy was studied in 4,000 patients. Compared with placebo, atomoxetine proved to be superior with respect to reducing impulsiveness, hyperactivity, and inattention. There are indications that its efficacy is comparable to that of methylphenidate. In general, atomoxetine was well tolerated. The most frequently reported adverse events were decrease of appetite, abdominal problems, tiredness, and vertigo. These were classified as mild and found mostly at the beginning of treatment. The existing results indicate that atomoxetine is promising for the treatment of ADHD in children, adolescents, and adults.

Adolescent↗
PubMed2005

[The psychopathy-concept and its psychometric evaluation in childhood, adolescence and adulthood].

The psychopathy concept in accordance with Robert Hare was operationalized in 1985 when the revised form of the Psychopathy Checklist (PCL-R) was published. Since then, the PCL-R has been used internationally in prognosis and therapy research. In North America, personality traits of psychopathy have also been studied in children and juveniles for several years by now. On the basis of the PCL-R, a checklist for adolescents (PCL-YV) was developed that takes the special conditions of adolescents into account. In juveniles with a high score research with the PCL-YV demonstrated a lack of empathy, impulsivity and social adjustment disorder. Furthermore, researchers found associations between the number and severity of violent offences, early drug abuse and earlier recidivism, i. e. repeated criminality. The biological determinants of these dimensions are discussed as well as associated questions about recent specific therapy concepts and diagnostic aspects of psychopathy in juveniles.

Adolescent↗
PubMed2003

[Disorder attribution in psychiatric problems of adolescents. A pilot study of inventory validation of disorder attribution of psychiatric problems in adolescents].

OBJECTIVES: The first Questionnaire on Disorder Concepts for Mental Problems in Adolescents (SPPJ) was developed on the basis of the attributional theory (health locus of control) and validated in a population of 54 adolescents with mental disorder hospitalized primarily as in-patients. METHODS: Analysis of consistency, correlation with the test for locus of control in health and illness (KKG-Test), scale intercorrelation, correlation with the Frankfurt Self-Concept Scales, therapy cooperation and prognosis. RESULTS: The SPPJ distinguishes between causal attributions and locus of control and proves to be a reliable measuring instrument that delivers satisfactory correlations to the statement of general measuring instruments (KKG-Test). Contrary to our expectations there is no significant positive correlation between internal locus of control and cooperation and prognosis. An external, powerful-others causal attribution has a negative effect upon cooperation, while an external powerful-others locus of control has a positive effect upon it. CONCLUSIONS: Adolescent self-assessment of mental problems is a defined research subject different from illness or health concept variables in adults or concerning bodily illness. Adolescents who are less inclined to blame others for their problem and who value professional competence are probably more accepting of interventions and more compliant. Further research in this area is necessary. On the basis of the attributional theory more attention must be paid to the substantial difference between locus of (treatment) control and causal attributions.

Adolescent↗
PubMed2002

[Child is inattentive, cannot sit still, disturbs the classroom. Is it really a hyperkinetic disorder?].

The clarification of attention-deficit/hyperactivity disorder (ADHD) requires an unequivocal categorization of the diagnostic criteria and a differentiation of the condition from normal variations and other disorder patterns. The ICD-10 criteria comprise the main symptoms inattention, hyperactivity and impulsivity. In kindergarten and preschool children, hyperactivity predominates, while in schoolchildren poor attention and cognitive impulsivity tend to be to the fore. In adolescence, aggressiveness and dissocial behavior coupled with drug abuse become central. In adulthood, ADHD is associated in particular with a tendency towards a lower social status and more frequent delinquency. Establishment of the diagnosis of ADHD requires information from the person to whom the individual relates. In this connection, exploration schemas, check lists and questionnaires are often very helpful. With regard to the differential diagnosis, mental disturbances due to physical causes (e.g. hearing disorders, epilepsy, etc.) must be excluded. Consideration must also be given in particular to comorbidities--found in up to two-thirds of cases--in which disordered social behavior, affective disorders and anxiety disturbances dominate.

Adolescent↗
PubMed2002

[Multimodal therapy concept in hyperkinetic disorder. Drugs alone are not enough].

For the treatment of attention deficit/hyperactivity disorder, both medical and behavioral therapeutic concepts have been shown to be effective. Somewhat problematical, however, is the fact that a large percentage of these children retain residual symptoms that need treating over a longer period of time. The value of a multimodal therapeutic approach (combination of medication and behavioral treatment including counseling of parents, teachers and the patient) remains controversial. Over the long-term, and account being taken of a number of indicators extending beyond the core symptoms, however, the multimodal treatment concept would appear superior to treatment solely with psychostimulants. For effective treatment accurate titration and the recording of the changes occurring under medication are important.

Attention Deficit Disorder with Hyperactivity↗
PubMed2001

Discriminant validity of the child behaviour checklist CBCL-4/18 in German samples.

This study examined the discriminant validity of the German version of CBCL in two large samples of referred and non-referred children and adolescents which were matched for age, sex and socio-economic status. The combined sample that was used for statistical analysis consists of 2,058 referred and 2,058 non-referred boys and girls between 4 and 18 years of age (mean age: referred boys= 10.9 years, non-referred boys = 10.9 years, referred girls=11.3 years, non-referred girls=11.1 years). Referral status was used as validity criterion. Statistical procedures included Odds Ratios, Total Predictive Values, ROC analyses and discriminant analyses. Results indicated that the discriminant validity of the German version of CBCL is comparable to the original English version. With the use of CBCL Total Problem Score as predictor (cut-off T > or = 60) 83.8% of children and adolescents could correctly be classified (sensitivity 83.6%, specificity 83.9%). Symptoms of the "Attention Problems Scale" show the highest discriminative power to distinguish between disturbed and undisturbed children and adolescents.

Adolescent↗
PubMed1999

[Drug therapy of hyperkinetic diseases in adults].

Attention deficit hyperactivity disorder (ADHD) is often diagnosed in children. Some major studies proved that symptoms can persist until the patients are grown up and that the prevalence of adult ADHD is underestimated. The classification systems ICD-10 and DSM-IV allow a diagnosis for adults, they differ, however, from childhood regarding symptoms. The diagnostic procedure requires extensive exploration and information from parents and school. Diagnostic interview procedures and questionnaires for self and expert rating are available to date only for English speaking countries. Apart from counselling and psychotherapeutic intervention pharmacotherapy is a third option. Especially stimulants proved to be an efficient treatment. Alternatively tricyclic antidepressants can be considered, other agents play only a minor role. Clinical trials trying to evaluate the efficacy of different pharmacotherapeutic agents are lacking.

Adult↗
PubMed1999

[Abbreviated Psychopathological Scale in basic documentation in child and adolescent psychiatry--results of a multicenter study].

The short form of the Clinical Assessment Scale of Child and Adolescent Psychopathology (CASCAP) assesses psychopathological features only on the level of symptom domains and not on the level of single symptoms. The instrument is part of the basic documentation of child and adolescent psychiatry. Based on the multicenter study sample of CASCAP the ratings of the symptom domains in the different centers were analysed. Inpatients receive higher ratings than outpatients on nearly all symptom domains. Only minor differences could be found between the centres. Advantages and disadvantages of this short version are discussed.

Adolescent↗
PubMed1998

[Incidence of psychiatric symptoms and somatic complaints in 4- to 10-year-old children in Germany as judged by parents--a comparison of norm-oriented and criteria-oriented models].

OBJECTIVES: To analyze the frequency of behavioral/emotional problems and somatic complaints of children aged four to ten as rated by their parents. METHOD: The analysis is based on the PAK-KID study on behavioural and emotional problems and psychosocial competencies of children and adolescents in Germany. In a nationally representative sample of N = 1030 children aged four to ten years the parents rated their child using the Child Behavior Checklist. RESULTS: The prevalence rates of the symptoms are presented. Additionally global prevalence rates based on three different models were calculated and compared. They range from 13.1% to 28.3%. The issues of defining cutoffs necessary for the calculation of prevalence rates are discussed.

Affective Symptoms↗
PubMed1998

[Comparison of 2 clinics with reference to axis 5 of the MAS: different patient populations or regional characteristics?].

OBJECTIVE: The university departments of child psychiatry in Cologne and Berlin were compared to assess whether quantitative differences in reported abnormal psychosocial situations (Axis 5 MAS of ICD-10) are due to a difference in patient population or coding practices or to particular regional conditions. METHOD: Data were analyzed for 593 patients seen in Cologne in 1992/93 and for 685 patients seen in Berlin in the same period. The broader social situation was described by sociodemographic data from the respective city. RESULTS: Berlin showed about twice as many psychosocial stressors per patient as Cologne. Consistent relationships between axis 5 stress ratings and other parameters indicated the validity of the data. Only a few points of inconsistency in the data were found. The sociodemographic data for both cities revealed a greater number of single parents as well a a higher rate of suicide in Berlin. CONCLUSIONS: Indicators for the validity of the clinical data analyzed were found. Some special internal clinical and regional conditions were identified as contributing to the quantitative differences between the two university departments.

Adolescent↗
PubMed1998

[Forms of juvenile aggression].

Delinquent behaviour has its roots in early childhood: Hyperactivity and impulsivity are its precursors, especially if rules are not clearly set in kindergarten and school and if aggressive behaviour is tolerated. Conduct disorders are classified into several subgroups with different treatment strategies. Epidemiologically there is no evidence of an increase of aggression and delinquency in childhood and adolescence. As only a small portion of children and adolescents with aggression and conduct problems are considered to be in need of treatment by their parents, early and intensive intervention is necessary.

Adolescent↗
PubMed1997

[From categorial to dimensional diagnosis].

The concepts of categorical and dimensional assessment approaches and their specific advantages--and disadvantages are described. A combination of both concepts within the framework of Multiple Assessment of Psychiatric Disturbances is proposed. This includes the different levels of behavioural and emotional disturbances, different assessment methods, the situational specificity of behavioural and emotional disturbances and individually tailored and treatment related assessment procedures. Thereby two phases are distinguished. In the first phase basic procedures of the Multiple Assessment of Psychiatric Disturbances are accomplished, which cover a broad spectrum of behavioural and emotional problems. In the second phase a differentiated picture of the-specific disturbance is assessed by using symptom-specific instruments of the Multiple Assessment of Psychiatric Disturbances. In a case report the diagnostic procedure is explained.

Adolescent↗
PubMed1997

[Psychopathological evaluation of children and adolescents in 4 child and adolescent psychiatry referral groups--a multicenter study].

Goal of the multicenter study with the Clinical Assessment Scale of Child and Adolescent Psychopathology (CASCAP) in a sample of N = 5027 patients from the inpatient and outpatient clinics of psychiatry and psychotherapy of childhood and adolescence of the universities of Berlin (Virchow Clinic), Frankfurt, Cologne and Zurich is the comparison of the clinical populations of these institutions with respect to single symptoms, to symptom scales and to the supreme level of aggregation, the clinical diagnoses according to ICD 10. On the level of diagnoses similar distributions can be found in the centers, but there are also significant differences between the centers. This differences can be found again also on the level of symptom scales and single symptoms, though the deviations are comparatively low.

Adolescent↗
PubMed1997

[The value of different sources of information in evaluating psychiatric disorders in adolescence--a comparison of parental judgment and self-assessment by adolescents].

Data from the national representative epidemiologic survey (PAK-KID-study) assessed by the German versions of Achenbach'S Child Behavior Checklist and Youth Self-Report of N = 1757 parents and their children aged 11 to 18 years are compared by using the corresponding Cross-Informant-Scales. On all problem scales adolescents report more problems than parents. For some scales the differences between girls and their parents are higher than between boys and their parents (social withdrawal, somatic complaints, anxious/depressed, attention problems, internalizing and total score). Averaged Pearson correlations of the eight subscales are in a moderate rage (r < 0.50). For all problem scales an agreement of 30% in the area of high problems (> PR95) is found. If one informant scores above PR95 the Relative Risk of the other one scoring in this range too is significantly higher than one for nearly all scales.

Adolescent↗
PubMed1997

[Assessment of problem situations in the family].

Goal of the study is the analysis of the German version of Barkle's Home Situations Questionnaire. The analysis is accomplished in a clinical sample of N = 76 children at the age of six to ten years with the diagnosis of a hyperkinetic disorder according to ICD-10 or an Attention deficit-/hyperactivity disorder according to DSM-III-R and in a representative sample of N = 263 children aged seven to ten years. Parents of hyperkinetic children experience many family situations with their child as very problematic which is essentially more often than parents in the representative sample. Analyses of the factorial structure of the questionnaire yielded no clear and well interpretable solutions. The instrument has a good internal consistency. The HSQ-D scores correlate significantly with other parent questionnaires for the assessment of behaviour problems, the highest correlations were found with scales for the assessment of hyperkinetic behaviour problems and social problems. In the clinical practice the instrument has proven helpful within symptom-specific assessment of children with hyperkinetic and oppositional behavior disorders and for the planning of interventions.

Attention Deficit Disorder with Hyperactivity↗
PubMed1997

[Individualized diagnosis in children with hyperkinetic disorders].

Individualized diagnostic procedures assess the individual pattern of emotional and behavioural problems. Different individualized assessment procedures were developed. The advantages of individualized assessment are discussed. The Individual Problemlist is presented as an instrument of the individualized diagnostics. In a sample of N = 76 children with hyperkinetic disorders aged six to ten years together with the parents and the teachers the therapeutic important problems of the child in the family and in the school were developed by using the Individual Problemlist. The frequency of the individual problems are presented. Using a single subject design the employment of this instrument for monitoring is elucidated.

Affective Symptoms↗
PubMed1997

[Mental disturbances in children and adolescents in Germany. Results of a representative study:age,gender and rater effects].

METHOD: A study on behavioral and emotional problems and competence in children and adolescents in Germany (PAK-KID study) is described. It is the first nationwide representative survey of this kind of children and adolescents aged 4 to 18 years in Germany. For children aged 4 to 10 years the parents completed the German version of Achenbach's Child Behavior Checklist (CBCL 4-18) developed by the Arbeitsgruppe Deutsche Child Behavior Checklist. Children and adolescents aged 11 years and older filled out the German version of the Youth Self-Report that is part of Achenbach's CBCL in addition to the parents completing the German version of the CBCL. A total of 2856 parent questionnaires and 1798 self-report questionnaires completed by children and adolescents were analyzed. RESULTS: The sample was representative with respect to the main sociodemographic variables. On all problem scales children and adolescents aged 11 to 18 years reported significantly more problems than their parents did. The frequency of internalizing problems (social withdrawal, somatic complaints, anxiety/depression) and delinquent behavior of children and adolescents reported by parents increased with the children's age, whereas aggressive behavior and attention problems decreased with age. Girls reported significantly more problems than boys on all internalizing scales of the Youth Self-Report. The effect was not totally replicated in the parent reports. In the parent reports, boys had more attention problems and more aggressive and delinquent behavior than girls.

Adolescent↗