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Biomedical subjects

M H Friedrich

Publications and source records attributed to M H Friedrich.

At least 19 recordsLinked to original sources
PubMed2002

[Subjective family image in anorexia nervosa and bulimia nervosa in adolescence: a controlled study].

OBJECTIVES: The family environments of patients with eating disorders have been studied extensively in recent decades. The "Subjective Family Image Test" is an instrument developed especially to measure differential perceptions by family members. Assessments of subjective family image in families of adolescents by means of this test have been carried out in only a few samples. METHODS: We aimed first to investigate subjective perceptions by adolescents of their family relations in a larger clinical sample of female adolescents (n = 118) suffering from anorexia nervosa of either subtype or from bulimia nervosa and to compare these perceptions with those of healthy controls (n = 96). Second we investigated intra-familial differences in perception. RESULTS: The main findings were that bulimia nervosa patients perceived lower individual autonomy and lower emotional connectedness than all other groups, the adolescents with bulimia perceived significantly lower autonomy and emotional connectedness within the family than their fathers, and the restrictive anorexia nervosa patients perceived higher connectedness than their fathers. The relevance of these findings for understanding family dynamics are discussed.

Adolescent↗
PubMed2001

Characteristics of self-regulation in adolescent patients with anorexia nervosa.

The purpose of the study was to investigate the different modes of self-regulation in adolescent anorexia nervosa (AN). A self-system questionnaire, the Narcissism Inventory, was given to 61 adolescent females with AN and 61 controls. Patients with AN reported higher overall disturbances in self-regulation than controls. In particular, a highly unstable self-system, a tendency to use idealization as modus of regulation, and high narcissistic gain from their illness was found in the patient group; however, the patients did not report a 'classic narcissistic self'. Furthermore, we were able to differentiate between two clusters of patients, one with high (n = 34) and one with low (n = 27) disturbance in self-regulation; the latter reported a shorter duration of illness and lower oral control but did not differ on any other clinical variables. Stronger relationships were found between the dimension 'endangered self' and the overall scores of the Eating Attitudes Test (EAT) and the Eating Disorder Inventory (EDI) as well as two subscales of the EAT and five of the EDI. Our study in anorexic adolescents demonstrated that the self-system is experienced as highly unstable, that idealization is used as mode of regulation, and that the dimension of the 'classic narcissistic self' is less important in this patient group. It is important to evaluate the system of self-regulation for planning treatment in the individual patient according to their needs.

Adolescent↗
PubMed2000

Premorbid performance IQ deficit in schizophrenia.

OBJECTIVE: Performance IQ (PIQ) is often lower than verbal IQ (VIQ) in schizophrenic patients. Whether PIQ < VIQ precedes psychotic symptoms in schizophrenia remains uncertain. METHOD: We investigated premorbid IQ scores in 63 subjects assessed at a child and adolescent psychiatric unit (mean age 13.1 years, SD 3.2), who at follow-up in adulthood (mean age 30.9 years, SD 3.9) received a lifetime RDC diagnosis of schizophrenia-related psychosis, affective disorder, or no psychiatric disorder. RESULTS: Premorbid PIQ < VIQ significantly differentiated the groups with schizophrenia-related psychosis and no psychiatric disorder. Subjects with schizophrenia-related psychosis had a significantly lower mean value for premorbid PIQ, but not VIQ, compared to subjects who developed affective disorder or subjects without psychiatric disorder. CONCLUSION: Our results emphasize premorbid intellectual deficits in schizophrenia. Those deficits might largely be in consequence of an impairment on the PIQ scale.

Adolescent↗
PubMed1999

Application of correlation dimension and pointwise dimension for non-linear topographical analysis of focal onset seizures.

For many patients who are candidates for epilepsy surgery, non-invasive evaluation fails to provide sufficient information to permit surgical treatment. Since there are also definite risks and considerable costs associated with invasive procedures, new (non-invasive) techniques are required. This study provides empirical evidence that a non-linear approach applied to ictal surface electroencephalograms (EEGs) can help to delineate the area of seizure onset and may prove useful in complementing visual analysis of the EEG. Multichannel EEGs, recorded from eight patients with different drug-resistant localisation-related epilepsies, were analysed using the concept of correlation dimension and two extensions based on the pointwise dimension. The latter also provided results in cases where assessment of the correlation dimension was not feasible. Comparative values between 2 and 6 were accepted as the result of the algorithms, mostly 3-4 for the EEG channels strongly reflecting epileptic activity, and 4-6 for the other signals. The proportion of accepted pointwise values was usually 200-800% for strong epileptic EEG activity compared to the other data. The approach permitted the characterisation of the scalp area reflecting epileptic activity. The results obtained were in perfect concordance with those obtained during pre-surgical work-up and confirmed by the post-operative outcome.

Adolescent↗
PubMed1998

Nonlinear dynamics of 3 Hz spike-and-wave discharges recorded during typical absence seizures in children.

One-channel routine recordings of the scalp electroencephalogram (EEG) from unmedicated children strictly classified as unprovoked typical (3 c/s) absence seizures were selected. The dynamics of spike-and-wave discharges (SWD) were then examined by means of autocorrelation, correlation dimension, averaged pointwise dimension and largest Lyapunov exponent. For one EEG signal with pronounced spike-and-wave (SW) patterns, these measures were used complementary to a surrogate data method, a nonlinear (SETAR) modeling approach, and a SW simulation procedure providing five types of SW test signals. The SETAR model exhibited stationary SW dynamics, visually very similar to the EEG target signal, and with clear nonlinear structure. According to the results, the EEG episodes investigated represent low-dimensional dynamics, possibly recorded during nonstationary periods. Arguments that justify the assumption of deterministic chaos in our EEG signals were not obtained with the current methods. From the results one may conclude that two global oscillatory modes are present for the model, and three modes are active during the EEG recording period.

Algorithms↗
PubMed1997

Premorbid adjustment and remission of positive symptoms in first-episode psychosis.

The impact of premorbid social and intellectual functioning in childhood and early adolescence on the developmental course of schizophrenia is not sufficiently understood. In a retrospective case study (93 consecutive in-patients, 43 males and 50 females) of first-episode psychosis occurring in adolescence, the relationship between premorbid adjustment and short-term therapeutic outcome under treatment conditions was examined. All of the patients had a DSM-III-R diagnosis of schizophrenia (n = 56) or schizo-affective disorder (n = 37). The mean age of the patients at the time of the study was 15.8 (SD = 1.0). Premorbid functioning during childhood and early adolescence was assessed by using the Cannon-Spoor et al. Premorbid Adjustment Scale (PAS) and studied with respect to its prognostic relevance for short-term therapeutic outcome (eight weeks) under neuroleptic treatment (350-700 mg Chlorpromazin dose equivalent). Criteria for clinical outcome were obtained from the study by Pearlson et al. (1989) which defines three grades (complete remission, partial remission and no response), according to the degree of positive symptomatology. Statistical analysis was based on nonparametric variance analysis. Patients with complete remission of positive symptoms after eight weeks of therapy had experienced far better premorbid adjustment in early adolescence and in childhood. Diagnosis and gender did not bias this result. Our data suggest that premorbid social functioning is a crucial variable with regard to therapeutic outcome in first-episode psychosis. Previous studies have reported a relation between poor premorbid functioning and negative symptoms. We found premorbid adjustment related to the course of positive symptoms.

Adolescent↗
PubMed1997

Awareness of early-onset anorexia nervosa.

The aim of the study was to determine whether physicians consider anorexia nervosa as a possible diagnosis in children and adolescents presenting various somatic symptoms including significant weight loss. Questionnaires were handed out to participants of a national general medical congress in Austria. The questionnaire included two case vignettes of children with anorexia nervosa and questions about diagnosis, differential diagnoses and management. Anorexia nervosa was considered as possible primary diagnosis in both cases by 3.8% of the respondents and 11.4% suspected a psychosomatic or psychiatric disorder as primary diagnosis in both cases. These findings demonstrate a limited awareness of anorexia nervosa and of a psychosomatic or psychiatric origin of somatic symptoms including weight loss in children and adolescents among physicians. Recognizing anorexia nervosa in an early stage and referring the patients for a psychiatric evaluation as soon as possible is a prerequisite for specialized treatment and might improve the long-term outcome of this severe disorder. Increased educational efforts are required to improve the knowledge among primary care physicians about eating disorders.

Adolescent↗
PubMed1992

[Side effects of clozapine in therapy of psychotic disorders in adolescents. A retrospective clinical study].

A retrospective study was conducted of 53 consecutive inpatients (through 1990) with psychotic disorders. The patients were between 13 and 18 years of age. In all cases this was the first time they had been treated with clozapine. The adverse effects seen under clozapine are discussed. During the use of clozapine assessments were made of liver enzymes, leukocytes, blood pressure and body temperature. There was an increase in liver enzyme values in 37.7% of the patients, leukopenia under 4000/mm3 in 15.1%, an increase in body temperature in 3.8% and bradycardia together with hypotensive dysregulation in 1.9%.

Adolescent↗
PubMed1985

[Depression in childhood and adolescence].

Depressive syndromes in childhood and adolescence are distinguished by their varied and diverse symptomatology. They often lack the leading symptoms characteristic of the adult depressive state due to the pathoplasticity which accompanies development. Hence, it appears all the more important to achieve pragmatically-orientated nosological approach, with due consideration to pluralistic modes of therapeutic management. An attempt is made to present such a nosological concept on the basis of experience gained in the study of a collective of out-patient juveniles with depressive states.

Adolescent↗
PubMed1985

[Anorexia-nervosa--psychopathologic findings in relation to body weight and neuroendocrinologic changes].

The present study was conducted to investigate the relationship of psychopathological, behavioral and neuroendocrinological variables to weight profiles in patients with anorexia nervosa. The subjects were 67 patients with anorexia nervosa (61 females, 6 males). Eighteen (27%) were found to have a diffuse organic brain syndrome. Symptoms of hysterical and depressive neurosis predominated among the female subjects and those of obsessive-compulsive neurosis among the male subjects. Obsessive-compulsive and depressive traits were seen more frequently in the subjects with organic brain syndrome (14 of 18) than in the other subjects. One third of the female subjects showed resistance during therapy. Neuroendocrinological investigations (LHRH and TRH tests) were carried out on 27 of the female subjects. The stimulation values for the hormones LH, FSH, TSH and prolactin showed a significant dependence on weight. The symptomatology found in the subjects with organic brain syndrome largely parallels that of the psycho-organic hunger syndrome described by Baeyer. Correlations were found between weight loss and both blood chemistry findings and changes in psychosocial behavior.

Adolescent↗
PubMed1981

[Research in family dynamics with anorexia nervosa (author's transl)].

33 anorectic patients between the ages of 9 and 18 were treated from 1975 and 1980 as in-patients at the University clinic of neuro-psychiatry for children and juveniles. Familial criteria such as personal relationships; role allocation according to the Richter system and family structure were used as parameters. Sequence of siblings, age of parents and social factors were also taken into consideration.

Adolescent↗
PubMed1980

[Psychopathological manifestations in the early diagnosis of cerebral tumours in children (author's transl)].

The psychopathology of cerebral tumours in childhood is divided into syndromes of diminished consciousness, diffuse organic psychosyndromes, regression or retardation and local cerebral psychosyndromes. 15 unselected paediatric patients suspected of having a cerebral tumour owing to psychiatric symptoms were admitted for psychopathological and psychopathometric investigations. It is not possible to detect connections between symptoms and localisation by psychopathological examinations, but skill disorders serve as early unmistakeable pointers to local cerebral lesions. Specific differentiation of psychopathometric investigations give an indication of possible future improvements in tumour localisation.

Adolescent↗