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Biomedical subjects

R Mass

Publications and source records attributed to R Mass.

At least 19 recordsLinked to original sources
PubMed1998

Impact of ethnicity on the prevalence of psychiatric disorders among migrants in Germany.

OBJECTIVES: Studies on psychiatric disorders among migrants have described higher rates, especially of schizophrenia. Some evidence points to the possibility of misdiagnosis for this higher rate; other studies point to the underrepresentation of migrants in psychiatric services, leading to artefactual epidemiological data. METHODS: All admission records of migrants to a psychiatric clinic from 1993 to 1995 were assessed for diagnosis, symptomatology and treatment. RESULTS: Admissions of 408 migrants, 8.1% of total admission, were assessed. Of these, 38.7% received a diagnosis of a schizophrenic disorder, significantly more than the other clinic patients. The mean age at admission was 34.0 years, at onset of illness 28.6 years and at time of migration 20.4 years. Only 8.3% were mentally ill at the time of migration. Language problems correlated with the diagnosis of a schizophrenic disorder. CONCLUSION: An underrepresentation of migrants shows differences in the use of psychiatric services. Some evidence from the mental status and reported language problems may explain the higher rate of schizophrenia due to misdiagnosis.

Adult↗
PubMed1998

Schizophrenia-specific basic symptoms. A successful replication.

Several investigations showed that the Frankfurt Complaint Questionnaire (FCQ) has no diagnostic specificity. However, in a preceding study two new FCQ subscales were developed: FCQ-S, sensitive to schizophrenia, and FCQ-A, sensitive to alcoholism. The aim of the present study was to replicate the diagnostic sensitivity of those subscales. Four groups were considered: schizophrenics with marked negative symptoms (n = 25); schizophrenics with no or mild negative symptoms (n = 25); alcoholics (n = 25); patients with obsessive-compulsive disorder (n = 15). FCQ original subscales and total score did not differ between groups. As expected, in FCQ-S both schizophrenic groups had significantly higher scores than the other groups; FCQ-A failed to show group differences but was significantly related to alcoholism markers.

Adult↗
PubMed1997

[Validity of assessment of schizophrenic basic symptoms].

A study on the concept and measurement of the basic disorders of schizophrenia is presented. A total of 151 male adult psychiatric inpatients (51 with a dual diagnosis of schizophrenia and alcoholism, 50 schizophrenics and 50 alcoholics) were included. The aims of this study were: (1) the replication of the previous finding that the Frankfurt Complaint Questionnaire (FBF) contains items that discriminate between schizophrenia and alcoholism; (2) an empirical comparison between FBF and the Bonn Scale for the Assessment of Basic Symptoms (BSABS); (3) testing the relationship between basic and negative versus positive symptoms, as measured by the Positive and Negative Syndrome Scale (PANSS). Regarding (1), the former result was replicated. Regarding (2), FBF subscales and BSABS categories were shown to be significantly but weakly related, even if identical symptoms were included in the inquiry. Regarding (3), FBF and BSABS were found to be more closely related to negative than to positive PANSS items. Theoretical implications and consequences for further research are discussed.

Adult↗
PubMed1997

[Dimensional structure of the German version of the Brief Psychiatric Rating Scale (BPRS)].

Since the early 1960s the Brief Psychiatric Rating Scale (BPRS) has been one of the most frequently used standardized methods in international psychiatric research. The BPRS is used mainly for the rating of psychopathological symptoms of schizophrenic subjects. According to the results of factorial analyses, the original version of the BPRS is divided into five subscales, which have been preserved in the German translation. The validity of this original scale structure for the German BPRS version has not been investigated, however. A principal-components analysis of the 18 BPRS items carried out on the data of 301 schizophrenics yielded four factors that are comparable with four of the original subscales: Thought disturbance, Hostility/suspiciousness, Anxiety/depression, and Anergia. These results are compared with earlier findings and similarities and differences are discussed.

Adolescent↗
PubMed1997

Reduced cognitive inhibition in schizotypy.

OBJECTIVES: The relationship between negative priming and the positive symptoms of schizotypy was investigated. It was hypothesized that high schizotypes would display less negative priming than low schizotypes. A further important aim of the study was to disentangle the modalities involved in negative priming performance, since a reduction in negative priming, as revealed by schizophrenics and schizotypes, might reflect a failure to actively inhibit irrelevant information (cognitive inhibition) as well as dyslexia or a general slowness in information processing. DESIGN: A paper test based on the German version of the Stroop test was used to measure negative priming. A baseline condition of the test, colour word reading, that has proven to be a valid indicator of dyslexia was used to measure the influence of reading disturbances on negative priming. Additionally, a priming condition, termed inverted priming, in which the target of a stimulus is identical with the distractor in the subsequent stimulus, was employed. METHODS: Fifty healthy adults were drawn from the general population. After neuropsychological assessment participants completed a battery of schizotypal questionnaires. Correlational analyses and mean comparisons were used to investigate the relationship between neuropsychological data and schizotypy. RESULTS: Results suggest that reduced negative priming is related to positive schizotypy. Reduced negative priming in high schizotypes was unrelated to dyslexia, and found unlikely to be affected by deficits in early processing. The inverted priming condition produced comparatively fewer errors in high schizotypes. CONCLUSIONS: Results support the hypothesis that reduced cognitive inhibition may underlie positive schizotypal symptomatology.

Adolescent↗
PubMed1997

[Consumption patterns and motivation for use of addictive drugs in schizophrenic patients].

In particular studies conducted in the U.S. display a tendency for schizophrenics to combine hallucinogens and amphetamines, whereas other studies report on a combination of psychotropic substances with a similar range of action. Influencing negative symptoms is reported to be the motivation for consumption. A total of 222 patients with a schizophrenic disorder (F2) and addiction (F1) were examined. The main substance was alcohol (F10.1 or F10.2; 52.2%), followed by cannabis (F12; 25%), opiates (F11; 4.1%), sedatives or hypnotics (F13; 2.7%) and cocaine (F16; 0.5%). A multiple drug use (F19) is reported by 14% of them. The most frequent combination was alcohol and cannabis, whereas hallucinogens and amphetamines were only rarely combined. Actual multiple consumption was reported by 55% of the patients, while lifetime multiple consumption applied to 72%. The motivation seems to be an unspecified sedation of unpleasant affective symptoms of schizophrenia. The most frequently seen combinations do not correlate with the reports published in the literature. The great variations in motivation seem to mainly reflect the importance of the availability of the substance.

Adult↗
PubMed1996

Interoception of respiratory resistance in asthmatic patients.

The interoception of respiratory obstruction was investigated in three different experimental or quasi-experimental studies. In two experiments of the first study, the psychophysics of the perception of externally added flow resistive loads were examined by using a signal detection approach. Asthmatic patients displayed a decreased sensitivity in the discrimination of such loads. The second study assessed the individual consistency of dyspnea ratings at different levels of bronchoconstriction provoked by allergic agents. A great variation in subjects' ability to discriminate consistently between various levels of airway resistance was observed. This ability was found to be relevant for coping with asthma. In the third study the visceral perception hypothesis of J. Brener was examined. This theory states that biofeedback training of voluntary control of respiratory resistance is accompanied by an improvement in perception of airway obstruction. No specific effect on load perception resulted from this training. The results of these three studies are of specific relevance to symptom perception in asthmatic patients. Further experimental studies should be directed towards the interoception of real bronchoconstriction instead of the perception of added loads which only partially models the clinical situation.

Adult↗
PubMed1996

Biofeedback-induced voluntary reduction of respiratory resistance in severe bronchial asthma.

Attempts to reduce asthmatic symptoms with respiratory resistance (Ros) biofeedback yielded heterogeneous results. The nature of treatment effects remained unclear (e.g. unspecific relaxation, visceral learning); little is known about clinical long-term effects. The present study investigated the suitability of a statistical single-case approach for an adequate evaluation. A female asthmatic underwent 12 Ros biofeedback sessions. Several breathing parameters were recorded during all sessions and pre/post investigations. The clinical course was observed with symptom diaries for 100 days. The subject achieved considerable voluntary control over her Ros, this control was based upon the expiratory flow. In general, the effects on the clinical course were weak; however, asthmatic attacks decreased in the follow-up period. Careful analyses of physiological, psychophysiological, and course variables allowed the identification of the main processes underlying the biofeedback effects. Further studies should investigate the worth of the expiratory flow as feedback variable.

Aged↗
PubMed1996

Psychopathology in patients with schizophrenia and substance abuse: a comparative clinical study.

In a 3-month epidemiologic survey at the Psychiatric Clinic of the University Hospital Hamburg-Eppendorf, a total of 372 patients between 18 and 60 years of age were screened with a variety of clinical psychiatric tests. Of the entire group, a subgroup of 180 patients was placed into one of four index groups: schizophrenics with first-rank symptoms and with (n=47) or without (n=52) concomitant past or acute use of psychotropic substances; alcoholics (n=63), and patients with alcoholic psychosis (n=18). In almost all areas examined, the group of schizophrenics with substance abuse was revealed to be a severely disturbed subgroup of schizophrenics with a long history of disease. Particularly with respect to psychopathology, there was an increase in depressive and suicidal tendencies.

Adolescent↗
PubMed1995

[Basic symptoms in schizophrenia and alcoholism. A methodological comparative study].

The results of a study on the subjective basic symptoms associated with schizophrenia and drug abuse (especially alcoholism) are presented. A total of 242 psychiatric inpatients (74 with a dual diagnosis of schizophrenia and drug consumption, 81 schizophrenics, and 87 alcoholics) were included. The three groups did not differ with regard to the general score of subjective basic symptoms measured by the Frankfurt Complaint Questionnaire (Frankfurter Beschwerde-Fragebogen, FBF). Further analyses showed that the FBF statements are only partly typical for schizophrenia; another part is connected with alcoholism. Two new scales ("FBF-S" and "FBF-A") were created from the schizophrenia-typical items and the alcoholism-typical items, respectively. In "FBF-S" schizophrenics (with and without alcoholism) had higher scores than patients suffering from alcoholism alone; in "FBF-A" alcoholics (with and without schizophrenia) reached higher scores than schizophrenic patients. Consistent correlations with independent parameters of psychosis and alcoholism confirm the validity of "FBF-S" and "FBF-A". It is concluded that the FBF's capacity to discriminate different diagnoses can be improved and that the model of basic disturbances must be re-evaluated.

Adolescent↗
PubMed1995

The iatrogenic interview in the effective management of the fearful dental patient.

This article discusses how dentists can effectively deal with the dental fears and anxieties of patients. It will provide an understanding of the cause of dental fear and the importance it plays in successful patient management. A simplified approach is described that provides a practical method of implementing these techniques in our daily routines.

Behavior Therapy↗
PubMed1993

Clinical evaluation of a respiratory resistance biofeedback training.

This study evaluated the effectiveness of a respiratory resistance biofeedback training. Fifteen adult asthmatic subjects participated in a feedback training program including twelve feedback sessions (three sessions weekly). Respiratory resistance (Ros) was measured using the forced oscillation method; to prevent subjects from lung hyperinflation, feedback was interrupted when functional residual capacity increased. One-second forced expiratory volume (FEV1), usage of self-administered medication, degree of asthmatic dyspnoea, and general activity were daily recorded in symptom diaries for at least three months, starting four weeks before the first feedback session. Seven subjects showed significant average Ros decreases within the sessions, while mean Ros in two subjects was increased. However, these direct feedback effects were not related to transfer effects outside the laboratory: e.g., not one of the seven successful subjects showed FEV1 improvements, and only in one of them were within-session Ros reductions accompanied by a decreased frequency of self-administered medication during the training period. These results lead to the conclusion that Ros feedback may not be an effective technique for the treatment of bronchial asthma in adults.

Adult↗
PubMed1993

Statistical methods for analyses of incomplete clinical service records: concurrent use of longitudinal and cross-sectional data.

Statistical procedures that have become routine in other social sciences were used to analyze data from clinical service records. Despite the absence of control groups, nonrandom assignment of clients to treatment conditions, and incomplete records, effective analyses of psychotherapeutic processes were possible. Multivariate regression models, with variables that were transformed to significantly improve skewness and regression linearity, were controlled for heteroskedasticity and for end-point censoring of dependent variables. They were also used to measure the effects of a categorical variable (gender) and a scalable variable (intake distress) on a reactive outcome measure (of acute distress) and on an unreactive one (of long-term life satisfaction). Graphical methods for summarizing large data sets helped identify intake variables that could control for attrition-related sampling biases. These longitudinal covariates and corrections to adjust degrees of freedom for cases with repeated measures were then used to construct statistical models that were equivalents of pure cross-sectional designs.

Adolescent↗
PubMed1993

Parenteral sedation education.

Since procaine was first synthesized in 1905, local anesthetics have been universally accepted as an effective way to abolish pain. This historical discovery led to advancements in dentistry that continue to this day.

Anesthesia, Dental↗
PubMed1992

[Comparison of two different methods for measuring interoception of obstructions in asthma patients].

For measuring the interoception of airway resistance, bronchial obstructions are often simulated by flow-resistive loads applied externally (i.e. outside the body) into the respiratory flow. However, it is open to doubt whether interoception characteristics obtained in this manner are really related to the clinical pattern of complaints of asthmatic patients. Possibly such externally applied resistance simulates merely an aspect of the physics of apnoea but not a clinical and hence also psychological aspect of the same. To estimate the significance of these aspects for the perception of obstructions, this ability was measured in 25 asthmatic patients first by means of external added loads; this test was then repeated by noting the subjective assessment of bronchial obstructions caused during a routine histamine provocation test. Both interoception parameters correlated only slightly (rxy = 0.31) which is discussed as a pointer to the assumption that, among other parameters, psychological factors may considerably modify the perception of flow resistivity. No correlations were seen between the characteristic interoception value obtained by means of mesh resistivities and the different variables of the clinical pattern of symptoms. On the other hand, the interoception parameter measured on the basis of bronchial obstructions revealed significant connections with several clinical variables: the greatly increased incidence of respiratory distress at night or during certain external conditions, coping medication, physical exercise and style. It is concluded that only such parameters of perception of obstructions are clinically relevant for patients suffering from asthma, which consider not only the somaticophysical but also the psychic component of asthmatic respiratory distress.

Adolescent↗
PubMed1991

A device for functional residual capacity controlled biofeedback of respiratory resistance.

A computer-aided procedure is presented providing subjects with analogous visual feedback of respiratory resistance, which is continuously measured using the forced oscillation method. Simultaneous pneumotachographical control of the breathing volume curve makes it possible to prevent reinforcement for decreases of respiratory resistance which are due to increases of functional residual capacity (FRC). Lung hyperinflation is an unsuitable way to reduce respiratory resistance; if it occurs, feedback is interrupted until the subject decreases his FRC to its initial level. Analysis of the data of 15 adult asthmatic subjects which underwent a 12-sessions feedback training showed that no substantial changes of FRC appeared within feedback trials. Advantages of this new biofeedback technique compared to other procedures are discussed with regard to volume control and feedback signal.

Airway Resistance↗
PubMed1989

The association between high-dose cytarabine neurotoxicity and renal insufficiency.

We reviewed the medical records of 110 consecutive patients at our institution who had acute leukemia and received high-dose cytarabine (Ara-C; HDAC) in order to analyze risk factors associated with HDAC neurotoxicity (NT). There were adequate records on 101 patients who received 147 courses of HDAC. Twenty-six treatment courses (18%) were complicated by NT. The median time of NT onset was 5 days (range, 1 to 10 days), and NT was reversible in 16 of 21 survivors (76%). Patients with severe NT (grades 3 to 4) were less likely to have complete reversal of their neurological deficit than those with mild NT (P less than .1). In our patients, there was no significant association between previously described risk factors (age over 49 years, male gender, CNS disorder, and cumulative HDAC dose greater than 48 g/m2) and incidence of NT. However, treatment courses involving HDAC given during renal insufficiency (serum creatinine greater than or equal to 1.5 mg/dL or an increase in serum creatinine greater than 0.5 mg/dL) were much more likely to be complicated by any degree of NT during administration of HDAC (62%) and severe NT (42%) than those given during normal renal function (8% and 3%, respectively; P less than .001). Of the treatment courses involving patients with estimated creatinine clearances less than 60 mL/min, 76% were complicated by NT compared with 8% of treatment courses involving patients with clearances greater than 60 mL/min (P less than .001). HDAC courses with neurotoxic patients had higher serum creatinines (2.1 +/- 1.4 v 1.1 +/- 0.6 mg/dL), greater increases in serum creatinine (+ 0.5 +/- 0.8 v + 0.07 +/- 0.3 mg/dL), and lower estimated creatinine clearances (61 +/- 35 v 91 +/- 29 mL/min) than those courses with nonneurotoxic patients (P less than .001, all parameters). Patients receiving HDAC during renal insufficiency are at high risk for developing NT. Dose reduction of HDAC should be considered for patients with renal insufficiency.

Acute Kidney Injury↗