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Biomedical subjects

M Hollweg

Publications and source records attributed to M Hollweg.

14 recordsLinked to original sources
PubMed2006

[Evaluation of risk assessment instruments for sex offenders].

In order to evaluate risk assessment instruments for sex offenders in Germany, we compared the predictive validity of the Static-99, HCR-20, SVR-20, and PCL-R scales for 134 sex offenders. The mean follow-up time was 9 years (range 1-340 months), using the first entry into the National Register of Criminal Convictions as endpoint variable. For the estimate of predictive power, the area under the curve (AUC) of receiver operating characteristic (ROC) analysis was calculated. The AUC plots accurately identified violent or sexual recidivists and "false positives" at all scale levels. Comparing the predictive validity of these four instruments, the results favored Static-99. As for the limited sample size, differences between the assessment instruments were, however, not statistically significant. The ROC analysis for Static-99 showed that including treatment dropouts does not improve predictive accuracy (including dropouts: AUC 0.710; excluding dropouts: AUC 0.721). Kaplan-Meier survival analyses yielded highly a significant correlation to recidivism time point for two Static-99 and SVR-20 risk categories. Higher-risk categories were related to earlier recidivism. However, relying on the Static-99 and SVR-20 alone showed false positive results: for up to two out of three sex offenders, they predicted recidivism which did not occur.

Forensic Psychiatry↗
PubMed2001

[Quantitative detection of dyssocial and psychopathic personalities in criminal expert assessment. Retrospective study of the value of the German version of the Hare Psychopathy Checklist].

In 1980, the Hare Psychopathy Checklist (PCL), an operationalised rating scale for the quantitative assessment of "psychopathy" as seen in the Anglo-American literature, was developed by R.D. Hare in Canada. It proved to be the most valid prognostic instrument for assessing relapse of criminals in English-speaking countries. This study was aimed at verifying the applicability of a German version of the revised PCL (PCL-R) on carefully selected subjects from the Forensic Psychiatric Department of the Psychiatric University Hospital in Munich. Two groups with an equal number of different forensic-psychiatric reports were evaluated retrospectively using the PCL-R. The results confirm the applicability of the PCL-R for the assessment of psychopathy in our sample population. One can expect that the positive experiences with the PCL-R abroad can be transferred to German conditions. The results are encouraging as to the practicability of the PCL-R as a prognostic instrument in routine forensic assessment.

Adult↗
PubMed2000

[Schizophrenic psychoses and suicide in the clinic. Risk factors, psychopharmacologic treatment].

For all 5,352 patients treated for schizophrenia at the Psychiatric Hospital of the University of Munich in 1981 and 1992, detailed routine and data processing-assisted documentations were made of the psychopharmacological therapies. Nineteen of the patients committed suicide while undergoing inpatient treatment; the control group consisted of all other patients (n = 5,333). More than 77 sociodemographic and anamnestic variables as well as 195 items from the admission summaries were taken into account while comparing the groups. Furthermore, the pharmacological data were classified according to drug groups and comparison was based on the mean frequency of prescription of each group. We analyzed the mean number of prescriptions for neuroleptics, tranquilizers, and antidepressants, which were further differentiated into sedating and nonsedating types. For frequently administered drugs, mean daily doses were also compared. Bivariate analysis of the data suggests that the suicide cases presented depressive signs, symptoms, and tendencies already present on admission more frequently than with controls; the same applies to previously attempted suicides. Discriminating analysis showed that the variables "feeling of loss of feelings," thought insertion," "visible depression," "free-floating anxiety," "suicidal tendencies," and "previously attempted suicide" have the greatest predictive value with respect to suicide, in descending order. No differences in psychopharmacological treatment between suicides and controls were found, apart from a significantly higher percentage of antidepressive treatments and a higher mean number of antidepressant prescriptions for the suicides.

Adult↗
PubMed2000

Pisa syndrome (pleurothotonus): report of a multicenter drug safety surveillance project.

BACKGROUND: Pisa syndrome is usually regarded as a rare adverse event of neuroleptic medication. However, its frequency and predisposing factors have yet to be defined. Here, we investigated risk factors of Pisa syndrome occurring in a large population of psychiatric patients surveyed during a multicenter drug safety project. METHOD: Twenty episodes of Pisa syndrome were documented in 17 patients within a population of 45,000 psychiatric patients monitored by a multicenter drug safety surveillance project (Projekt zur Uberwachung der Arzneimittelsicherheit in der Psychiatrie) between 1990 and 1997. All results were related to the epidemiologic data provided for this population and systematically analyzed regarding history of medication, current medication, comedication, and clinical course. RESULTS: A constellation of putative risk factors was found in the majority of patients: previous treatment with classical neuroleptics, combined pharmacologic treatment, female gender, old age, and the presence of an organic brain disorder. Given these risk factors, Pisa syndrome was also documented with atypical neuroleptic drugs such as clozapine, olanzapine, and sertindole. CONCLUSION: We conclude that Pisa syndrome is a very rare adverse event occurring with neuroleptic treatment. In patients exhibiting the reported constellation of risk factors, neuroleptic drugs should be administered with particular caution.

Adult↗
PubMed1998

Risk factors for suicides of inpatients with depressive psychoses.

Research on identifying the relevant risk factors for suicides is faced with a multitude of methodological problems. The present study attempts to improve on some of these problems and to isolate those risk factors that are accessible in the early stages of the treatment of inpatients. A total of 3792 inpatients with monopolar or bipolar depression were treated during the period 1981-1992. Suicides (n=33) and controls (n=3759) were compared with respect to 77 sociodemographic and anamnestic variables and 195 standardised items of the admission summary. In addition to an analysis of contingency tables a discriminant analysis was performed. The suicide rate of patients with depressive psychosis was 2.7 times higher than the average rate of 0.324% for the entire clinic. Suicidal tendencies on admission proved to be the best predictor with a frequency of 91% in the suicide group and 40% in the control group, previous attempted suicide being the second best predictor. We conclude that the rate of inpatient suicide may have been underestimated for methodological reasons in the past decades. Many of the risk factors discussed in the literature may be of little predictive value at least in the initial stages of hospital treatment.

Adult↗
PubMed1997

[Psychopathological syndromes in treatment with gyrase inhibitors].

Psychopathological and neurological adverse drug reactions (ADR) have been repeatedly reported during treatment with gyrase inhibitors (fluorquinolones). Results of earlier studies indicated a high risk for ADR especially in the elderly with high dosage medication, psychiatric history and renal dysfunction. The pathophysiological mechanisms involved in the development of adverse CNS effects are not completely understood. GABA-ergic and monoaminergic mechanisms might play a major part. In a retrospective study conducted by the authors 4189 reports of consultant psychiatric examinations were analyzed. In 29 patients the suspicion of psychopathological ADR during treatment with ofloxacin or ciprofloxacin was documented. Psychopathological findings included delirious states, paranoid, depressive and manic syndromes, agitation, sleep disturbances, sopor and stupor. In elderly patients delirious and paranoid syndromes were predominant, whereas affective disturbances occurred more often in younger patients. In most cases multiple morbidity, liver or kidney diseases, simultaneous treatment with other antibiotics and immunosuppressants, former psychiatric disorders or psychosocial stress factors were present. The results of the study, methodological problems, aspects of risk analysis and implications for medical treatment are discussed.

Adult↗
PubMed1996

[Alcohol dependence and depression. Classification, comorbidity, genetic and neurobiological aspects].

The frequent comorbidity of psychiatric disorders and alcohol dependence has raised increasing interest in the scientific literature over the last few years. Special attention has been given to the coincidence of depressive syndromes and alcohol dependence. Depressive syndromes can both precede and follow the onset of alcohol dependence. Their diagnostic classification can cause considerable problems. In clinical studies, very different prevalence rates of depressive syndromes in alcohol-dependent persons were found. The frequency of primary depressive syndromes appeared to be substantially smaller than the frequency of secondary depressive syndromes. Epidemiological studies did not point at the exceedingly high comorbidity of affective disorders and alcohol dependence. In this review article, scientific results about possible causes of depressive syndromes in alcohol-dependent persons are demonstrated; genetic and neurobiological links between depression, alcohol dependence and the possible importance of changes in serotoninergic transmission are discussed; methodological problems are described, and implications of the comorbidity problem for treatment planning are presented.

Alcoholism↗
PubMed1995

[Forensic psychiatric expert evaluation of so-called drug-induced psychoses].

A considerable number of schizophrenic persons also abuse illegal drugs. This comorbidity raises problems of diagnosis which become particularly important when concerning forensic questions. The hypothesis of a distinct psychopathological syndrome of drug induced psychosis is widely criticized in the literature. A case report is presented to demonstrate the problems of differential diagnoses and the difficulties for psychiatric expertizing arising from these problems.

Adult↗
PubMed1995

[Mefloquine-induced psychoses--problems in etiologic classification based on 2 case reports].

Psychiatric disorders following treatment with Mefloquine were described several times since the introduction of this antimalarial drug in Germany in 1985. On the basis of two case reports problems of the diagnosis and of the correlation of psychiatric disorders with the medication are discussed. Particularly are an analysis of the development of the ADR and a comparison of the psychiatric symptoms with known ADR-cases and with other psychiatric diseases important. This seems to be significant for an optimal treatment as well as for the assessment of the prognosis.

Adolescent↗
PubMed1994

[Arson--a disorder of impulse control?].

Reviewing the literature the current knowledge about the motivational basis of arson is discussed. Fire-setters form a heterogenous group; they seem to commit their crimes for different reasons. Some of them are imbecile, some suicidal, and other showed autoaggressive behaviour in the past; sometimes a connection with sexual excitement can be observed. The criteria for the diagnosis "pyromania" used in the classification manuals DSM-III-R and ICD-10 are strict, in order to facilitate an operationalised diagnosis. Most of the fire-settings cannot be classified under this subcategory of "disorders of impulse control". However, impairments of impulse control are typical characteristics in most cases of arson.

Antisocial Personality Disorder↗
PubMed1991

Remarkable improvement of neuropsychiatric symptoms in HIV-infected patients after AZT therapy.

Treatment of neuropsychiatric symptoms with AZT (Azidothymidine) seems to be effective in many AIDS patients. In earlier studies, 204 of 525 patients treated with AZT showed neuropsychiatric improvement. In this presentation, two patients with affective disorder and dementia are described. Both patients showed remarkable improvement of their severe psychiatric symptoms after AZT. The authors recommend treatment of AIDS-associated dementia and psychoorganic symptoms with AZT.

AIDS Dementia Complex↗