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R Neugebauer

Publications and source records attributed to R Neugebauer.

At least 37 records · Page 2Linked to original sources
PubMed1996

Schizophrenia after prenatal famine. Further evidence.

BACKGROUND: Suggestive findings of an earlier study that prenatal nutritional deficiency was a determinant of schizophrenia prompted us to undertake a second test of the hypothesis using more precise data on both exposure and outcome. METHODS: Among persons born in the cities of western Netherlands during 1944 through 1946, we compared the risk for schizophrenia in those exposed and unexposed during early gestation to the Dutch Hunger Winter of 1944/1945. The frequency of hospitalized patients with schizophrenia at age 24 to 48 years in the exposed and unexposed birth cohorts was ascertained from a national psychiatric registry. RESULTS: The most exposed birth cohort, conceived at the height of the famine, showed a twofold and statistically significant increase in the risk for schizophrenia (relative risk [RR] = 2.0; 95% confidence interval [CI] = 1.2 to 3.4; P < .01) in both men (RR = 1.9; 95% CI = 1.0 to 3.7; P = .05) and women (RR = 2.2; 95% CI = 1.0 to 4.7; P = .04). Among all birth cohorts of 1944 through 1946, the risk for schizophrenia clearly peaked in this exposed cohort. CONCLUSION: Prenatal nutritional deficiency may play a role in the origin of some cases of schizophrenia.

Adult↗
PubMed1995

Increased risk of affective disorders in males after second trimester prenatal exposure to the Dutch hunger winter of 1944-45.

BACKGROUND: Prenatal and perinatal factors have been linked to affective disorders. We therefore undertook an exploratory study to determine whether prenatal exposure to severe famine was associated with an increased risk of affective disorders. METHOD: Monthly birth cohorts that were exposed and unexposed to the Dutch Hunger Winter of 1944-45 were identified. The cumulative incidences of affective psychoses and neurotic depression (ICD-9 criteria) were compared between exposed and unexposed cohorts during each trimester of gestation. RESULTS: The relative risk (RR) of affective psychosis (broad and restricted definitions) among persons exposed to famine during the second trimester was significantly increased (broad: RR (95% confidence interval) = 1.62 (1.19, 2.20); restricted: 1.59 (1.14, 2.21)). Separate analysis by gender showed a significant association among males (broad: 2.26 (1.43, 3.57); restricted: 2.40 (1.49, 3.89), but not females (broad: 1.28 (0.84, 1.94); restricted: 1.17 (0.73, 1.76)). The risk of neurotic depression was not increased after prenatal famine exposure. CONCLUSIONS: These results suggest a possible relationship between prenatal famine during the second trimester and affective psychosis, lending plausibility to reports that have associated affective psychoses with prenatal exposures. Further studies of this relationship are warranted.

Adult↗
PubMed1995

[Loss of the replanted thumb by drug-induced ergotism].

Vasospastic reactions are known to be a complication of thromboembolic prophylaxis with Heparin-dihydroergotamine. We describe a rare case after successful replantation of an amputated thumb. On the third day after surgery, Heparin-dihydroergotamine was administered once. Within three hours, the thumb turned pale and cold. At revision, a spasm of the artery proved to be the cause of ischemia. Therapeutic efforts were unsuccessful, even intraarterial injection of Prostaglandin E1 and the interposition of a vein graft. Amputation became necessary. Because of the possible complication with ergotism and the consequence of a failed replantation, we suggest not to use Heparin-dihydroergotamine for thromboembolic prophylaxis in microsurgery.

Adult↗
PubMed1994

[Early functional after-care of surgically treated fresh ruptures of the Achilles tendon].

Functional treatment regimens in favour of the idea of keeping up regular limited use of the extremities instead of immobilisation have continuously gained influence in orthopedic surgery. The knowledge that inconsistently used biological systems degenerate has now widely become accepted. Immediate Achilles tendon tension reconstruction by means of minimal surgical incision and simple suture in addition with fibrin-glue was performed in 51 patients. Age, sex-distribution, etiology, preexisting pain, rate of degenerative histologic findings and side of rupture were similar to those reported in former studies with large numbers of patients [2, 6, 7, 8, 10, 12, 13]. Non weightbearing functional walking in a side supported "basketball" sports shoe (Adimed) with gradually reduced heel support (initially 3 cm; complete removal regaining neutral position of the ankle joint after 4 weeks) was advised for 6 weeks, after acute postop swelling has resolved. All tendons healed and up to now (follow up period: 14-48 months - average: 26) no rerupture occurred. One insufficiency resulted from non compliance due to alcoholism.

Achilles Tendon↗
PubMed1992

Depressive symptoms in women in the six months after miscarriage.

This study, the first systematic investigation of the psychiatric impact of miscarriage, tests whether miscarriage markedly increases depressive symptoms in the 6 months after loss. We interviewed 382 miscarrying women entering the study at 2 weeks, 6 weeks, or 6 months after loss and, for comparison, 283 pregnant women and 318 community women not recently pregnant. Among women interviewed 2 weeks after miscarriage the proportion highly symptomatic on the Center for Epidemiologic Studies-Depression scale was 3.4 times that of pregnant women (95% confidence limits 2.0 and 5.0) and 4.3 times that of community women (95% confidence limits 3.0 and 5.8). Among women first interviewed 6 weeks and 6 months after miscarriage the proportion highly symptomatic was three times that of the community women. Women reinterviewed at 6 weeks and 6 months did not have elevated symptom levels, a result attributed to the unintended therapeutic and test effects of study interviews. Interviews were fully structured, readily administered by telephone by nonmedical personnel. The possibility that such interviews afford miscarrying women substantial psychologic benefits merits future investigation.

Abortion, Spontaneous↗
PubMed1992

The contribution of maternal depressive symptoms and life events to child behaviour problems.

The effect of maternal depressive symptoms and stressful life events on child behaviour problems has been the focus of clinical and epidemiological research for some years. We interviewed 80 women drawn from the New York City area regarding their life events in the preceding 6 months, current levels of depressive symptoms and behaviour problems in their children. For each woman, one child between the ages of 3 to 8 was selected for study analysis. Maternal depressive symptoms and maternal life events in general, as well as undesirable events in particular, contributed independently to child behaviour problems in multivariable analyses controlling for maternal education. This association did not vary by maternal marital status, or gender or age of the child. Events judged on common sense grounds to be especially disruptive of the child's routine did not contribute to child behaviour problems, independently of maternal depressive symptoms. Future research should devote more attention to specification of the life events under study and of factors that may buffer both the mother and the child from their pathogenic effects.

Adult↗
PubMed1992

Bereavement reactions among homosexual men experiencing multiple losses in the AIDS epidemic.

OBJECTIVE: The authors examined whether deaths of lovers and close friends from AIDS increased the frequency of depressive symptoms and depressive disorder in a group of homosexual men. METHOD: Two hundred seven volunteer male homosexual subjects were interviewed in New York City in 1988 and 1989. Depressive symptoms were measured with the Hamilton Rating Scale for Depression, administered by a clinician, and two self-report symptom checklists. Subjects were evaluated for major depression with the Structured Clinical Interview for DSM-III-R. Each subject also reported the number of lovers and close friends who had died of AIDS 1) since the beginning of the epidemic in 1981 and 2) in the 6 months preceding the interview. RESULTS: Neither the overall level of depressive symptoms, the presence of specific symptom clusters, nor the presence of a diagnosed depressive disorder was related to the number of AIDS deaths a subject reported in either time frame. In contrast, bereavement reactions specific to loss, namely, preoccupation with and searching for the deceased, were more common in subjects with greater numbers of losses. The findings for depressive symptoms and major depression are not readily explained by measurement artifact, overrepresentation of asymptomatic subjects among study volunteers, habituation effects, numbness, or shallowness of attachments in the subjects. CONCLUSIONS: Changes in normative expectations regarding AIDS deaths and mobilization against AIDS within the gay community may account for the lack of association between the number of losses resulting from AIDS and the presence of depressive symptoms and depressive disorder.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Determinants of depressive symptoms in the early weeks after miscarriage.

OBJECTIVES: We tested whether and under what conditions miscarriage increases depressive symptoms in the early weeks following loss. METHODS: We interviewed 232 women within 4 weeks of miscarriage and 283 pregnant women and 318 community women who had not recently been pregnant. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D) Scale. RESULTS: Among women who had miscarried, the proportion who were highly symptomatic on the CES-D was 3.4 times that of pregnant women and 4.3 times that of community women. Among childless women, the proportion of women who had miscarried who were highly symptomatic was 5.7 times that of pregnant women and 11.0 times that of community women. Women who had miscarried were equally depressed regardless of length of gestation; among pregnant women, depressive symptoms declined with length of gestation. Among women who had miscarried, symptom levels did not vary with attitude toward the pregnancy; among pregnant women, depressive symptoms were elevated in those with unwanted pregnancies. Prior reproductive loss and advanced maternal age (35+ years) were not associated with symptom levels in any cohort. CONCLUSIONS: Depressive symptoms are markedly increased in the early weeks following miscarriage. This effect is substantially modified by number of living children, length of gestation at loss, and attitude toward pregnancy.

Abortion, Spontaneous↗
PubMed1991

[Tissue-preserving ventral compression osteosynthesis of dens axis fractures using endoscopy and special instruments].

Endoscopic operations are tissue-preserving operative methods, which are increasing constantly in importance. Lag screw osteosynthesis is suitable for performance as an endoscopic operation with specially designed instruments. We have developed a set that allows lag screw osteosynthesis into the axis of the dens. Under endoscopic view the soft tissues are divided and a tube is placed through which the screw is inserted with the aid of an image intensifier. Two patients have so far been operated on in this way, both without complications.

Adult↗
PubMed1990

Differential recall as a source of bias in epidemiologic research.

Differential recall between compared groups is discussed most often in the context of case-control studies. Cases, compared to controls, are suspected of providing a more complete report of their true exposure to an hypothesized risk factor, thereby biasing upwards the estimate of its effect. The present paper describes how differential recall can arise with any observational design in epidemiology; with any class of study variable, not only exposures; and may inflate or deflate the true value of the estimate of effect size. We list a variety of study designs and questionnaire tactics that aim to remedy these problems. The scope and magnitude of the bias created by differential recall and the efficacy of proposed remedies require further study.

Bias↗
PubMed1990

Maintenance of hope in HIV-spectrum homosexual men.

The struggle to maintain hope has been described as a central theme faced by clinicians who work with HIV-spectrum people. The authors investigated psychiatric and psychosocial variables thought to be related to level of hope in a community sample of 208 HIV-positive and HIV-negative homosexual men, with the goal of identifying possible risk and protective factors in the progression of HIV infection. Overall, they found high levels of hope and low levels of current syndromal disorder or depressive symptoms. While the sample was a selected group of successful and well-educated homosexual men, it nevertheless remains noteworthy that they were able to preserve a sense of faith in their future despite HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

A doctor's dilemma: the case of William Harvey's mentally retarded nephew.

In June 1637 William Harvey petitioned the Court of Wards and Liveries, a legal incompetency court in early modern England, for a grant of the custody of his mentally disabled nephew, William Fowke. 'Idiocy' and 'lunacy' were the two medico-legal categories for insanity used by the Court and Harvey requested that his nephew be inspected for idiocy. However, the legal and administrative history of the Court indicates that in the 1630s idiocy (but not lunacy) grants were prejudicial to the assets and economic security of retarded persons. Since petitioners' wishes more than clinical status, usually determined the diagnostic label assigned to referred individuals, idiocy grants were not sought by persons of some social standing. Harvey's idiocy referral probably reflects his allegiance to his own clinical observations in the face of opposing social norms and family advantage.

England↗