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Biomedical subjects

P Petersen

Publications and source records attributed to P Petersen.

At least 19 recordsLinked to original sources
PubMed1992

[Psychiatric diseases among the homeless in Funen County].

The purpose of the study was to investigate whether deinstitutionalization of psychiatric patients had produced a clientele of homeless mentally ill people which is not treated. During week 47, 1990, 94 of the 129 residents 73%) in the institutions for homeless people in the County of Funen (population 459,000) were examined for mental illness by a psychiatrist. Diagnoses were made using the ICD-8 classification. Social data were recorded. Eighty-nine per cent were men, 59% were aged 30-49 years, 93% were single, and source of incomes for 80% were public assistance or disability pensions. More than half had been sentenced for crime at least once. The majority suffered from severe psychosocial strain. In 91% a psychiatric diagnosis was established, the most frequent being alcoholism (73%) and personality or character disorder (70%). Psychoses were found in 10 cases or 11%. About 29% required psychiatric treatment. The conclusion was that deinstitutionalization in the County of Funen had not resulted in influx of psychotic persons to institutions for the homeless people.

Adult↗
PubMed1992

[The circumstances of life and need for social measures of patients with prolonged psychiatric illness].

The circumstances of life and the need for social support were investigated in 142 patients with prolonged psychiatric illness who sought help consecutively in the psychiatric casualty department or who were referred to the psychiatric department of Odense Hospital during the period 11 Sep. 1989-31 Dec. 1989. 80% of these were psychotic and 20% were borderline psychotic. Approximately 90% were young adults (20-49 years). Schizophrenic men predominated. More than 40% of all the patients had some form of addiction as a contributory diagnosis and 71% of the patients with borderline psychoses were addicts. Approximately 3/4 of the patients lived alone in flats. The level of occupational training was low as compared with the remainder of the population. The majority received early pensions. The majority lived in social isolation from the remainder of the community. Only a single patient had no fixed abode but suitable forms of residence where social support could be given were insufficient. Similarly, the requirements for possible employment and leisure activities were great.

Adult↗
PubMed1992

[The dialogic principle in medical treatment].

Almost all kinds of medical therapy are based on a therapeutical dialogue. Some aspects of the dialogue principle in medical therapy are shown in this article. In addition the dialogue can open ways of communication to art-therapy (e.g. music therapy) and even to the arts itself.

Communication↗
PubMed1991

[Violent patients in a psychiatric outpatient department].

During the period 23.11.1987-22.11.1989, a total of 7,906 patients attended the psychiatric outpatient department and observation section on 12,469 occasions. Sixty patients (0.8%) behaved violently on 85 occasions. None of these episodes of violence resulted in injuries to persons requiring medical attention. 90% of the violent patients were men and 70% were in the age group 20-39 years. Approximately 1/5 were psychotic and, of these, approximately half suffered from schizophrenia. Comparison with the non-violent patient revealed that the probability of violence was greater if the patient was a man under the influence of alcohol and who had the diagnoses of narcomania, drug abuse or personality disorders. Significantly fewer violent patients were admitted than non-violent patients. Over 80% of the violent patients had previously been admitted to psychiatric departments. Approximately 60% had behaved violently on previous consultations with the psychiatric outpatient department.

Adolescent↗
PubMed1991

[Atrial fibrillation--thromboembolism and prevention].

Chronic non-rheumatic atrial fibrillation is associated with a risk of thromboembolic complications of about 5% per year. Previous myocardial infarction seems to be a significant risk factor for development of thromboembolic complications in chronic atrial fibrillation, whereas paroxysmal atrial fibrillation and isolated atrial fibrillation in younger patients may be associated with a lower risk of emboli. Silent cerebral infarction occurs more often in chronic atrial fibrillation than among controls in sinus rhythm. Three prospective trials of patients with atrial fibrillation found effect of warfarin on the occurrence of thromboembolic complications. In one study aspirin 325 mg daily was effective in patients below 75 years of age, but not in patients above this age. The other trials revealed no effect of aspirin.

Aged↗
PubMed1991

[Attempted suicide and depression].

The frequency of depressive illness was investigated in 195 patients who had been referred consecutively after attempted suicide during the period 15. February 1989-15, October 1989. A total of 130 of these patients were admitted to hospital while the remainder were treated in the psychiatric emergency room or admission department. Registration of depressive symptoms on admission revealed that 85% had depressed mood and other depressive symptoms. According to the criteria established by Feighner et al. 51% suffered from definite depressive disease on admission. According to Zung's Depression Scale, 60% were depressed. On the basis of observations during hospitalization, 25% suffered from depressive disease according to the criteria established by Feighner et al. 19% of these patients suffered from endogenic depression according to the Newcastle I scale which corresponds to 5% of all the hospitalized patients with attempted suicide. Approximately 10% were treated with antidepressives. Only 8% were discharged with the diagnoses of endogenic or reactive psychoses (ICD-8). It is concluded that depressive symptoms occur in the majority of patients with attempted suicide but that slight non-endogenic depressive states are most commonly concerned and that many of these improve rapidly during hospitalization without medicinal treatment. Restraint should be observed in prescription of antidepressive medicine to patients with attempted suicide until the diagnosis of depressive disease is verified.

Adolescent↗
PubMed1991

[Severe nortriptyline poisoning in poor metabolizers of the sparteine type].

Approximately 7% of the Danish population are so called poor metabolizers (PM) as regards the model compound sparteine. These individuals lack the P450 isozyme which is mainly responsible for elimination of at least 20 different medicaments including nortriptyline. A woman aged 42 years suffering from depression was treated with 100 mg nortriptyline daily and, during the course of treatment, she developed a toxic serum nortriptyline level (approximately 2,100 nM). Treatment was withdrawn temporarily on account of severe side-effects. The depression recurred. During the medicine-free period, a sparteine test was performed and this demonstrated that the patient was a poor metabolizer. Scarcely two months after hospitalization, treatment was recommenced with 25 mg nortriptyline daily after which the patient's depression disappeared completely without any side-effects of note.

Adult↗
PubMed1991

Stroke prevention in nonvalvular atrial fibrillation: a review of prospective randomized trials.

Patients with atrial fibrillation are at risk for cerebral embolism; however, the roles of chronic anticoagulation or antiplatelet therapy for stroke prevention in patients with nonvalvular atrial fibrillation have been controversial. Recently, the results of three large prospective randomized trials that examined the risks and benefits of warfarin or aspirin for stroke prophylaxis in patients with nonvalvular atrial fibrillation were reported. All three studies revealed a reduction in the stroke rate for patients treated with warfarin and a small incidence of major bleeding. One of the studies also reported a reduced stroke rate in aspirin-treated patients. The reduction of thromboembolic events associated with chronic warfarin therapy appears to outweigh the risks of significant bleeding for most patients with nonvalvular atrial fibrillation. Aspirin may offer an alternative for subgroups of patients who are at low risk for stroke or those who are not good candidates for anticoagulation.

Anticoagulants↗
PubMed1991

99mTc-d,l-HMPAO and SPECT of the brain in normal aging.

Single photon emission computed tomography (SPECT) with 99mTc-d,l-hexamethylpropyleneamine oxime (99mTc-d,l-HMPAO) was used to determine global and regional CBF in 53 healthy subjects aged 21-83 years. For the whole group, global CBF normalized to the cerebellum was 86.4% +/- 8.4 (SD). The contribution of age, sex, and atrophy to variations in global CBF was studied using stepwise multiple regression analysis. There was a significant negative correlation of global CBF with subjective ratings of cortical atrophy, but not with ratings of ventricular size, Evans ratio, sex, or age. In a subgroup of 33 subjects, in whom volumetric measurements of atrophy were performed, cortical atrophy was the only significant determinant for global CBF, accounting for 27% of its variance. Mean global CBF as measured with the 133Xe inhalation technique and SPECT was 54 +/- 9 ml/100 g/min and did not correlate significantly with age. There was a preferential decline of CBF in the frontal cortex with advancing age. The side-to-side asymmetry of several regions of interest increased with age. A method was described for estimation of subcortical CBF, which decreased with advancing cortical atrophy. The relative area of the subcortical low-flow region increased with age. These results are useful in distinguishing the effects of age and simple atrophy from disease effects, when the 99mTc-d,l-HMPAO method is used.

Adult↗
PubMed1991

Childhood experiences and repeated suicidal behavior.

The aim of this study was to elucidate the influence of various events in childhood on suicidal behavior in adult age. For this purpose, 99 patients admitted to the Department of Psychiatry of Odense University Hospital after making a suicide attempt were followed for 5 years, to register repeated suicidal behavior. The results showed that three fourths of the patients attempted suicide more than once (62% nonfatal and 14% fatal outcome). The sex distribution was about the same among the first-evers as among the repeaters. Most repeaters were younger people in their twenties and thirties, and the first-evers on average were past the age of 40. Somewhat unexpectedly, significantly more repeaters than first-evers had grown up with both their parents. However, the results also showed that significantly more repeaters than first-evers had had an unhappy childhood. This indicates that the psychological climate of the home may be more important than the rupture of early home life. It is noteworthy that the group of repeaters, as against the first-evers, could be characterized by personality disorders and abuse, especially of alcohol: disorders known to be precipitated by a discordant childhood. It is commonly agreed that the experience in childhood of suicidal behavior among family members or other persons in the close environment is of importance in future suicidal risk. The results of this study indicate that the predictive value of this factor mainly applies to attempts with no fatal outcome: the suicidal act is perceived--and learned--as way to solve problems.

Adult↗