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Biomedical subjects

R D Stieglitz

Publications and source records attributed to R D Stieglitz.

At least 55 records · Page 3Linked to original sources
PubMed1990

Schizophrenia, schizotypal and delusional disorders (section F2): results of the ICD-10 field trial.

To determine whether the use of ICD-10 provides greater diagnostic reliability than ICD-9, a field trial of the ICD-10 draft (WHO, 1987) was carried out. A total of 1,778 diagnoses made on the basis of ICD-10, ICD-9 and, in part, DSM-III were established by 134 clinicians in 10 centres using case reports and interviews. The corrected reliability coefficients of schizophrenic disorders obtained with ICD-10, with kappa-coefficients of reliability of 0.69 for the 2-character category and 0.67 for the 3-character category are higher than those reported for the diagnosis of schizophrenia made without specified criteria, but lower than those reported for DSM-III. Despite the operationally defined diagnostic guidelines, diagnostic discrepancies still persist when organic disturbances, substance abuse or psychogenic features are additionally present. The diagnoses of each rater remain stable on change over from ICD-9 to ICD-10. Our data suggest that ICD-10 is suitable for worldwide use in diagnosing schizophrenia.

Adult↗
PubMed1990

Mood (affective) and schizoaffective disorders (section F3): results of the ICD-10 field trial.

Section F3 (affective disorders) of ICD-10 has preserved a high degree of continuity with respect to ICD-9, and a strong convergence towards DSM-III-R affective disorders is evident. Despite this tendency, some categories, like F31, F33 and F36, need further specification. In general, section F3 was adequately accepted by clinicians, easy to use and proved to be user-friendly for a wide variety of psychiatrists with different orientation.

Affect↗
PubMed1990

Neurotic, stress-related and somatoform disorders (section F4) and physiological dysfunction associated with mental or behavioural factors (section F5): results of the ICD-10 field trial.

The results of the ICD-10 field trial in German-speaking countries relevant to sections F4 (neurotic, stress-related and somatoform disorders) and F5 (physiological dysfunction associated with mental or behavioural factors) show a comparatively low level of acceptance. Interrater-reliability in various diagnostic categories is not always adequate. In particular the allocation of some of the "old" diagnostic entities of ICD-9 to various sections of ICD-10, and in part unsatisfactory classificatory distinctions gave rise to certain problems.

Behavior↗
PubMed1990

Feasibility, suitability, and interrater reliability of ICD-10 during different stages of the ICD-10 field trial.

A total of 134 clinicians in 10 centres participated in the WHO-initiated field trial in German-speaking countries prior to the introduction of ICD-10 (chapter V; categories F00-F99. Mental, Behavioural, and Developmental Disorders), and provided 1,778 diagnostic assessments of 90 cases. Since these assessments were made in different phases of the field trial, the present study investigated how the "feasibility" and "suitability" of the so-called "Clinical Descriptions and Diagnostic Guidelines" was assessed within the individual phases. In addition, the interrater reliability of diagnostic assessments for the respective phases was investigated. The results show that ICD-10 was accepted both at the beginning of the study, and after several months of use. With respect to interrater reliability, improvements in some of the categories are necessary.

Humans↗
PubMed1990

ICD-10 field trial in German-speaking countries--summary of the quantitative empirical results.

The summary of the quantitative results of the ICD-10 field trial in German-speaking countries shows a adequate acceptance of ICD-10. The figures for interrater reliability for the diagnostic categories are adequate for most categories considering the comparatively low level of familiarity with the new system. The high degree of overlap between the diagnostic categories in ICD-9 and ICD-10 is an indication of the validity of ICD-10. The major source of disagreement is the relocation of several diagnostic categories to different sections.

Austria↗
PubMed1990

ICD-10 field trial in German-speaking countries--summary, judgement and perspectives.

On the basis of the results of the field trial, the most important classificatory innovations of ICD-10, together with their advantages and disadvantages are described. The initial good acceptance of the new system could be further improved by structural modifications, such as a uniform and systematic description of the individual diagnostic categories. Criticism of content was focused on affective and neurotic disorders and adult personality disorders. When it is introduced, the psychiatric chapter of ICD-10 will surpass most of the hitherto existing psychiatric classification systems in size, differentiation and international testing.

Adolescent↗
PubMed1990

External attributions and outcome in depressive in-patients.

Thirty-four voluntarily admitted depressive in-patients were asked by their clinicians in the first interview why they came into hospital and what they expected there. Some patients expressed external attributions referring to other persons who were viewed as being responsible for the admission or for improvement under treatment. External attributions of this kind were found to have some negative predictive value for the outcome of treatment.

Adjustment Disorders↗
PubMed1990

[Trials with ICD-10: results of a multicenter field study in German speaking countries].

134 clinicians in 10 centres participated in the WHO-initiated field trial in German-speaking countries of the provisional form of ICD-10, chapter V, clinical descriptions and diagnostic guidelines. 1778 diagnostic assessments were given for 90 cases. In general, the results show a comparatively high degree of acceptance of the new classification. Interrater-reliability coefficients are satisfactory. A high concordance of diagnostic categories between ICD-9, ICD-10 and DSM-III was found.

Adolescent↗
PubMed1990

[Percentile distribution of depression scales of the AMDP system].

The severity of the depressive and apathy syndrome, which are factoranalytically derived from the AMDP-system is reported for 428 patients with a monopolar depression. The data are compared with the results from 79 patients with a bipolar depression, 192 with a neurotic depression and 89 with a depressive reaction. The percentile scores can be used for the evaluation of the severity of a depressive and apathy syndrome in comparison to a reference sample.

Adjustment Disorders↗
PubMed1989

Impaired performance in a saccadic tracking task in schizophrenic patients.

The performance of schizophrenic patients in a task which requires a sequence of saccades guided by visuospatial cues is reported. A previous study recording eye movements determined a highly increased number of fixations necessary for this task in acute schizophrenic patients compared with normal controls. The performance of normal control subjects of different age groups and the correlation between the performance in the tracking task and the results of a clinical psychological test battery are described. Schizophrenic patients in a partly remitted state and in a remitted or mildly chronic state performed this task worse than matched control subjects; this was particularly indicated by the time score. The relation to the lifetime dosage of neuroleptic medication is considered.

Adolescent↗
PubMed1989

[Anamnestic and psychopathologic studies of obsessive-compulsive patients].

Twenty-eight patients, that is 0.8% of all 3,225 patients admitted between 1981 and 1986 in the Free University of Berlin, Department of Psychiatry, had a primary diagnosis of obsessive-compulsive disorder (ICD-9: 300.3). These patients were compared with random samples of equal size (N = 28) of schizophrenic psychoses paranoid type (ICD 295.3), manic depressive psychoses depressed type (ICD 296.1) and neurotic depressions (ICD 300.4) using an AMDP-based multiaxial diagnostic description. It turned out, that although obsessive-compulsive patients were best discriminated from the other clinical groups by their typical symptoms, they were characterized likewise by other psychopathological, especially depressive symptoms. In view of the course of obsessive-compulsive disorder, the findings were compatible with those of other reports. Beyond it, a subgroup of patients with relatively unfavourable course could be described by AMPD-items.

Adolescent↗
PubMed1989

[Evaluation of the system of the Study Group of Methodology and Documentation in Psychiatry based on recent literature (1983 to 1987)--a review].

The present paper gives a review of German studies concerning the AMP and AMDP system that have been published since 1983. The test manual to the AMDP-system, published 1983, is complemented herewith. The following topics are discussed: Syndromes/scales on the basis of psychological and somatic outcomes, studies on reliability (especially interrater reliability); capability to differentiate diagnoses; comparison with other assessment instruments, especially biological parameters; results of several diagnoses (schizophrenia, affective disorders, depression etc.); range of application (psychopharmacological studies, diagnostic questions, etc.). The review points out that the AMDP system covers a very wide and elaborate range. Some topics are pointed out that would merit additional study.

Documentation↗
PubMed1988

Prediction of neuroleptic on-drug response in schizophrenic in-patients by EEG.

The subjects were 34 acutely ill in-patients who met the RDC criteria of schizophrenic psychosis, and 4 EEGs were recorded from each patient before, 2 h and 24 h after oral intake of a single dose of 150 mg perazine, and on the 28th day of the neuroleptic treatment period. As a criterion of clinical response a decrease of at least 66% in the schizophrenia-specific sum score of the Brief Psychiatric Rating Scale on day 28 relative to the baseline value was decided upon. The EEGs were assessed using a newly developed procedure which takes into consideration 4 derivations simultaneously. As we tried to search out EEG variables with predictive value the statistical data analysis underlying our findings should largely by regarded as exploratory. Independent of day, responders (R) showed a tendency towards more low voltage desynchronized epochs (non-A stage) than non-responders (NR). Thus, R exhibited a higher degree of dynamic variability or a broader range of control of the spontaneous vigilance fluctuation (dynamic lability) than NR (dynamic rigidity). Furthermore, R and NR differed with respect to their time-dependent changes of non-A epoch frequencies before medication. While R showed a monotonous increase which is typical for normals, NR did not. Because of considerable inter-individual variability these group differences could not be used for individual prediction of the therapy response. By means of a qualitative data analysis R could be distinguished from NR with regard to various test dose-induced changes of the topographical distribution of absolute alpha power. All the group differentiating variables showed a time course of the same kind: R showed a prompt and ample deflection and the same recovery of baseline; NR, in contrast, showed no significant deflections at all. These findings are in line with the results concerning the dynamics of vigilance and certain claims of earlier authors according to which EEG changeability should be decisive for therapeutic outcome.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1988

Effect of nimodipine upon electroencephalographic vigilance in elderly persons with minor impairment of brain functions.

10 volunteers (61-78 years) with minor impairment of brain function were given placebo, 40 mg and 60 mg nimodipine (Nimotop) in single doses with intervals of 3 medication-free days between medications under double-blind conditions. Consecutive 2-s epochs of a 10-min EEG record (resting conditions) of F3/C3-F4/C4-P3/01-P4/02 were subjected to FFT (Fast Fourier Transform). Using the information given by the 4 leads for each minute of recording the number of epochs which correspond to a stage A or non-A were determined. In order to evaluate subtle effects on electroencephalographic vigilance within stage A, also the anterior-posterior and left-right relations of absolute alpha-power were calculated. Since previous findings suggested that a nimodipine effect can only be demonstrated when individual differences in the baseline-EEG are considered, the subjects were subdivided in equal subgroups according to the number of non-A epochs under placebo. The rationale for this is the finding that in geriatric patients two electroencephalographically distinguishable forms of dissolution can be observed. Under both 40 mg and 60 mg nimodipine the subgroup with a prevalence of non-A epochs (poor alpha-activity) showed a decrease of non-A epochs; the subgroup with a prevalence of A-epochs (abundant alpha-activity), an increase. Opposite results for the two subgroups were also obtained for the left-right relations of alpha-power over the anterior regions. Under 40 mg nimodipine the subgroup with poor alpha-activity showed a shift to the left; the subgroup with abundant alpha-activity to the right. Under 60 mg nimodipine both subgroups showed a shift to the left. The results confirm findings that nimodipine stabilizes electroencephalographic vigilance at a medium level. Moreover they suggest a dose dependence of the effect, i.e., at higher doses nimodipine seems to act as a sedative.

Aged↗