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Biomedical subjects

P J Scheer

Publications and source records attributed to P J Scheer.

14 recordsLinked to original sources
PubMed2006

Tube weaning according to the Graz model in two children with Alagille syndrome.

Two children were weaned from long-term tube feeding after liver transplant because of Alagille syndrome. The children were successfully weaned, one in seven days and the other in 13 days, using our standard and highly specialized intensive treatment protocol. Normal feeding behavior and stabilization of body weight were established. Children fed by long-term enteral tubes can be weaned from enteral feeding even after a long period of treatment. The return to age-appropriate self-feeding should be introduced as early as possible. Our weaning program time is brief and effective and can be recommended generally to improve quality of life and withhold unintended side-effects of enteral nutrition.

Alagille Syndrome↗
PubMed1996

Changes in psychopathology of parents of NOFT (non-organic failure to thrive) infants during treatment.

This clinical case-study of 50 infants suffering from NOFT (non-organic failure to thrive) and their parents supports the idea that the feeding problem is intimately related to parental disorders. We find a high rate (70%) of parental psychopathology (axis I diagnosis applying DSM-III-R) at the time of referral and a significant reduction (to 37%) during treatment of the infants and their parents. After a year only 12% of the parents were diagnosed with psychiatric disorders. In contrast personality disorders (axis II diagnosis applying DSM-III-R) show more stability and can be regarded as a trait variable, whereas the psychiatric disorders are of a more reactive nature. These conclusions may be influenced somewhat by the strictly hospital based design of our pilot study (infants and parents contacted only after clinical referral) and by inclusion only of firstborn infants. Nevertheless, they point to the psychopathology of parents as a main cause for non-organic failure to thrive. Psychopathological traits such as severe attachment behavior problems and primary bonding difficulties may have been latent and only became manifest due to the task of nurturing an infant for the first time.

Analysis of Variance↗
PubMed1991

[Non-epileptic sleep disorders (somnambulism) in epilepsy. Diagnostic and therapeutic possibilities].

The case history of a 15 1/2-year-old boy is presented who suffers from screaming fits during the night and epilepsia. The problem has existed since he was eight. He lives alone with his mother in a "partner-like" relationship. The previous diagnosis, namely epilepsy, has masked any possible psychodynamic element. Our diagnostic instruments were: 1. Standardized diagnostics with DSM III-R; 2. psychoanalytically oriented psychodiagnostics; 3. long term EEG-video-monitoring, which eventually succeeded in differentiating his multiple symptoms. Using these methods we were able to differentiate a sleep disorder (somnambulism) from his grandmal epilepsy. We changed his anticonvulsive pharmacological therapy and introduced an individual psychotherapy ("Katathymes Bilderleben"). This kind of psychotherapy is applied for the first time as a therapy for somnambulism. By using this therapeutic concept we cured our patient from his symptoms.

Adolescent↗
PubMed1991

Depression in children with cancer.

The results of a standardized evaluation of the occurrence of depression in a group of 34 children suffering from cancer are presented. The children (13 male, 21 female) were admitted to the oncological unit of the Department of Pediatrics at the University of Graz, Austria, during a 14 months-course (January 1987-March 1988). We rated each child 4 times in 4 weekly intervals after admission and start of induction chemotherapy. To access the occurrence and severity of depression and to monitor progress during treatment we performed a psychiatric interview and also applied the psychiatric rating scale CDRS (Children's Depression Rating Scale) by Poznanski et al 1979 and SCMDD (Self-Report Symptom Checklist for Major Depressive Disorders) by Kashani et al 1985 derived from DSM III. 340 diagnostic ratings were performed by 3 raters; two of them were psychotherapeutically trained pediatricians (M. D., P. J. S.) and one psychologist (L. W.). A "clearcut" depression was found in 25 of the 340 ratings i.e. in 6 of the 34 children, demonstrating that the occurrence of depression in pediatric cancer patients was lower than primarily assumed.

Adaptation, Psychological↗
PubMed1991

[Psychosomatic diseases of adolescents].

Psychosomatic reactions and disturbancies occur frequently in adolescence. Their dramatic presentation is characteristic for the inner feeling of uniqueness, instability and loneliness of this phase of life. Grownups seem far away and unable to understand what is really going on. The pediatrician being consulted needs special interest and knowledge of the specific dynamics of adolescence and should remember his own youth. He should avoid involving the patient into unnecessary and harmful physical examinations, because they tend to aggravate and fixate the symptom. He must succeed as competent listener without reminding the youngster of the wellment advises of parents and teachers. Often he will feel entangled into a voyage through a jungle of emotions and somatic signals where his function will be to guide and accompany his young patient safely out into the light of adulthood. This paper presents a pediatric and psychodynamic approach to some frequent psychosomatic disorders of adolescence. It discusses Anorexia Nervosa, Bulimia Nervosa, Somatisation Syndrome, Conversion Syndrome, suicidal attempt and physical conditions affected by psychological factors.

Adolescent↗
PubMed1991

[Diagnosis and therapy of early mother-child disorder, the so-called failure to thrive in the infant].

Feeding baby's is mostly a gratifying activity for mothers. But when difficulties arise, they can develop into a serious pediatric issue: The so-called non organic failure to thrive (NOFT). In these cases the feeding difficulties are one aspect of the disturbed relation between the mother and her child. Conventional pediatric therapy often fails to achieve weight gain, the babies seem emotionally disturbed and upset during all feeding procedures. Phenomenologically oriented documentation of the quality and type of the diadic interactions allow a diagnosis of the relationship itself and cleans up with terms like "unreliable" mother or "difficult" babies. We present the first review of theoretical background, diagnostic nomenclature and therapeutic concepts in german and wish to address colleagues with a interest in psychotherapeutic methods.

Adult↗
PubMed1988

[Magnetic resonance tomography confirms the diagnosis of Hallervorden-Spatz disease].

We present the second description of an early diagnosed state of Hallervorden-Spatz disease (HSD) verified clinically and by means of magnet resonance imaging. Since the magnet resonance shows HSD specific transformations brain biopsy can be relinquished. In our case the early confirmation of a neurodegenerative disease (versus the presumption of a severe adjustment disorder as the case was presented) brought much relief in respect of the feelings of guilt to the family, although the long term prognosis is poor. The distinction between neurodegenerative diseases, demyelinisating diseases and HSD was possible considering the clinical signs and using the magnet resonance, which showed various pigments within the globus pallidum.

Adolescent↗
PubMed1988

[Psychosomatic aspects of encopresis].

37 children (aged 4 1/2-15 1/2 years) with encopresis were seen at the psychosomatic outpatient unit of the university children's hospital of Graz in the course of two years, comprising 1.8% of all our outpatients of that time (n = 2037). They had been referred to us by pediatricians general practitioners, welfare institutions and the local children's surgical hospital. Based an our observations and data-analysis of this heterogenic group we would like to suggest a subdivision of the new classification group of "elimination disorders" (307.70/307.60 DSM III-R) into three main subgroups; according to the use of the fifth digit in the DSM III-R (e.g. mood disorders 296.xx) we define: 307.71: primary infantile encopresis (group I); 307.72: primary reactive encopresis (group II a); 307.73: secondary reactive encopresis (group II b); 307.74: late "neurotic" encopresis (group III); 307.70: not otherwise specified NOS. Moreover, we hope to draw attention to the specific psychodynamics of this functional disorder, since we believe this to be a fundamental prerequisite for any successful therapeutic intervention.

Adolescent↗
PubMed1988

[Integration and evaluation of a standardized, multi-axis diagnostic system in pediatric psychosomatic medicine].

We present outcome data of 171 children with psychosomatic and child-psychiatric disorders and discuss the pros and cons of two standardized multiaxial diagnostic systems (DSM III and the Multiaxial System of Rutter 1975). Results and arguments were considered until a clearcut choice fell for the DSM-III. As a major conclusion we introduce the BAT-Index, a factor derived by comparing the psychosocial stressors (Axis 4 DSM III) to the highest level to adaptive functioning past year (Axis 5 DSM III) which can be helpful in estimating the to be expected changes and complications in therapeutic settings and gives us a good prognostic assessment of the patient.

Adolescent↗