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Biomedical subjects

M H Schmidt

Publications and source records attributed to M H Schmidt.

At least 163 records · Page 9Linked to original sources
PubMed1990

Conduct disorders (CD): the reliability and validity of the new ICD-10-categories.

The conduct disorders (CD) were re-grouped in the 10th revision of the International Classification of Diseases (ICD-10), that comes into force in 1990. The new categories and the empirical findings based upon them are presented. The interrater reliability for the CD was satisfactory at 48.5%, but was clearly lower for the CD with emotional disorders with a correspondence of 33.3%. In a longitudinally examined field random test the total amount of CD increased clearly between 8 and 13 years, whilst it remained more or less constant between 13 and 18 years. The symptom load as parameter for the degree of severity of a disorder was significantly different to the disadvantage of the unsocialized in the 13 year olds between the CD without and with socialization, but was not so in the children and young adults. In the long-term, as far as the symptom load is concerned, there were no important group differences.

Adolescent↗
PubMed1990

[Evaluation of a transitional group home for psychiatric patients during and after adolescence].

A report is given on a 6-year follow-up study of a project involving outpatient treatment of adolescents and young adults (16-21 years of age) coupled with group living following inpatient treatment for psychiatric disorders. During the period studied 45 of the 53 participants completed treatment. The mean duration of treatment was 46 weeks for both the group with and without psychotic symptoms.

Adolescent↗
PubMed1990

[Reliability of child and adolescent psychiatry diagnoses in ICD-10].

In the following, the findings from a field study on the reliability of ICD-10 for classifying psychiatric disorders in children and adolescents are presented. In the main study there were 33 raters from 9 different facilities; each rater assessed 29 case studies independently. The evaluations of the 29 case studies independently. The evaluations of the 29 case histories yielded 957 ratings. When 4-digit ICD-10 codes were used, the most common main diagnosis was coded by an average of 50.3% (ICD-9: 47.3%). When 3-digit ICD-10 codes were used, the figure was 60.6% (ICD-9: 66.5%), that is, as expected, agreement was clearly better. When alternative diagnoses were considered, agreement was substantially better; the same was true for intensive schooling of the raters (additional study). Some diagnoses were rather difficult to differentiate from each other. Among these were the mixed disorders of conduct and emotions (F92). The main problem was differentiating between this disorder and the categories conduct disorder (F91), emotional disorder (F93), affective disorders (F30-F39), and neurotic disorders (F40-F49). There were also problems classifying age-related depressive disorders which in ICD-9 could be coded under 313.1, probably in part because this category does no longer exist in ICD-10. These disorders have now to be coded as depressive disorders (F31.1, F33.1 or F34.1). The diagnostic descriptions of these categories are based mainly on the symptoms typical in adults. No facility-related tendencies to code in a particular way are evident.

Adolescent↗
PubMed1989

[The Mannheim Rating Scale for the Assessment of Mother-Child Interaction in Infancy].

Within a prospective longitudinal study of the first eight years of life, which aimed determination of pathogenesis of neuropsychiatric disorders a qualitative rating system of mother-infant face-to-face-interaction was evaluated. The rating system consists of 8 scales for mother and 5 scales for infant behavior. The rating intervals had a length of 60 sec, whereas the whole video-taped interaction took 10 minutes. Analysing 48 dyads sufficient coefficients of interraterreliability and validity could be demonstrated for the rating system. It proved to be an appropriate measurement for mother-child interaction in early infancy. Behavior of the mother described by the rating system predicts behavior disturbances of the child better than the total of organic and psychosocial risk factors.

Child↗
PubMed1989

Anxiety syndromes in childhood and adolescence.

Anxieties are very widespread in children and adolescents, they only rarely to lead to the need for medical care. Physiological anxieties as phenomena dependent on maturity are differentiated from anxiety syndromes typical to age according to the degree of severity or the persistence of the signs and symptoms. Typical forms of age-typical syndromes are fear of separation, childish phobias, anxiety syndromes with shyness, going into one's shell, avoidance behaviour as well as school phobias. These confront the generalized anxiety disorders and the phobias as anxiety syndromes, which occur in children, adolescents and adults. The various anxiety syndromes were discussed in this order, information concerning anxiety symptomatology in the framework of depressive syndromes and other psychiatric illnesses in children and young people are to follow. Besides descriptions of the signs and symptoms, in particular concerning differential diagnosis and ..reflections are described.

Adolescent↗
PubMed1989

[Effects of partial inpatient treatment of preschool children with behavior disorders and developmental delay].

In a sample of 55 preschool children, four to seven years of age, treated by a therapeutic day-treatment programme up to 3;4 years, developmental delays and behavioral disorders, rated by parents and preschool teachers, were assessed every five months until discharge. Developmental delays and behavioral disorders were reduced clinically and statistically significant between onset of treatment and discharge. This result could also be verified preponderantly by analysing several measurement points in parts of the sample with different treatment durations. Comparing changes during a waiting period of one year at most with changes during a waiting period of one year at most with changes during day-treatment of equal duration, treatment effects could be verified at least as a tendency for changes in behavior problems but not for developmental abilities due to methodological problems.

Affective Symptoms↗
PubMed1988

[Catatonic psychoses in adolescence--a case report of clinical aspects and therapy].

Because catatonic psychosis in childhood and adolescence is rare we have only scanty knowledge about the clinical picture, treatment and prognosis. Based on a single case study these aspects are discussed with respect to treatment course and outcome. A multidimensional treatment concept integrating neuroleptic treatment, individual and family therapy, and physical and occupational therapy seems to be the best approach to the severe affective and cognitive deficits.

Adolescent↗
PubMed1988

[Therapy evaluation in child and adolescent psychiatry: inpatient treatment, day care treatment and home treatment in comparison].

The aim of the present study was to compare inpatient, day hospital and home treatment of 10 child psychiatric disorders as defined in the Multi-axial Classification Scheme. The subjects were 109 patients from two child psychiatric hospitals who fulfilled clearly defined criteria. They comprised about 10 to 15% of the total clinical population of the two hospitals. The patient were assigned at random to the three treatment modalities. Treatment effectiveness was evaluated blind by experienced child psychiatrists not involved in the study. There were no significant differences between the treatment modalities in duration of treatment. Neither were there any significant differences between the treatment modalities with respect to treatment effectiveness, although there were some overall differences between different diagnostic categories. For a small group of carefully selected children day hospital and home treatment can therefore be looked upon as alternatives to inpatient treatment.

Child↗
PubMed1988

[A scale for assessing the social adjustment of children and adolescents].

In DSM-III the highest level of social adaptation attained is diagnosed on a special diagnostic axis. Thus, separate statements about general impairment in children and adolescents with psychological disturbances can be made independently of specific diagnoses and severity ratings. The present study reports theoretical considerations and the results of the construction of an operationalized scale that measures social adaptation in the areas of family, school and peer group using information about leisure time activities independent of an individual's psychiatric symptoms. In general, the correlations between the social adaptation level and psychiatric disturbances were rather low, the closest association being in the school domain (grade-point average). The reasons for this are discussed.

Adolescent↗
PubMed1988

[The status of life events in causal analytic considerations in child and adolescent psychiatry: model development trials with LISREL (linear structural relationship analysis)].

An epidemiological longitudinal child psychiatric study with 334 eight- and thirteen-year-olds tried to put life events in an optimal order within a model of causal interrelations. The causal connections were tested by a Linear Structural Relationship Analysis (LISREL), which in addition to life events included child psychiatric disorders, adverse family factors and learning disabilities. By testing different models it could be demonstrated, that adverse family factors do not directly influence the number of life events of 8 to 13-year-old children. Adverse family factors influence life events as well as psychiatric disorders at age 13 predominantly by way of early psychiatric disorders. Psychiatric disorders at age 13 are best predicted by psychiatric disorders at age 8 and to a smaller degree by life events and learning disabilities.

Adolescent↗
PubMed1987

Evaluating the significance of minimal brain dysfunction--results of an epidemiological study.

An epidemiological field investigation of 399 8-yr-old children was unable to support basic assumptions of the clinical MBD concept (existence of a homogeneous syndrome, specific psychopathology, evidence of increased perinatal risks). Using a multi-level case definition procedure and factor-analytic data aggregation, nearly complete independence was found among the diagnostical levels of neurophysiology, neuropsychology and specific skills. Main results were replicated after the application of several alternative models of case definition and were further confirmed by data from a clinical sample. Present findings emphasize the necessity to reconsider the concept of MBD and its practical consequences.

Attention Deficit Disorder with Hyperactivity↗