Biomedical subjects

S Bölte

Publications and source records attributed to S Bölte.

9 recordsLinked to original sources

PubMed2006

[Suicidality in depressive children and adolescents during treatment with selective serotonin reuptake inhibitors. Review and meta-analysis of the available randomised, placebo controlled trials].

Due to concerns that selective serotonin reuptake inhibitors (SSRI) might be associated with an increased risk of suicidal ideation and suicide attempts in depressive children and adolescents, treatment with these drugs is controversial. All available data from randomised controlled trials on SSRIs treating depression in these age groups were examined regarding efficacy and suicidality. Results suggest that fluoxetine and, less clearly, sertraline are effective in such treatment. A meta-analysis yielded no statistically significant difference between treatment with SSRI and placebo with regard to the occurrence of suicidal behavior. Following evidence-based criteria, the risk:benefit ratio is favourable for fluoxetine and sertraline. Their use in the pharmacotherapy of depressive children and adolescents is indicated.

Adolescent↗

PubMed2004

[Diagnostic Observation Scale for Autistic Disorders: initial results of reliability and validity].

OBJECTIVE: To examine the psychometric properties of the German version of the Autism Diagnostic Observation Schedule (ADOS). METHODS: Interrater and retest reliability, internal consistency, convergent and diagnostic validity were determined in a total sample of 137 subjects with autism, 23 with atypical autism or pervasive developmental disorder not otherwise specified, 16 with Asperger-syndrome and 13 with other psychiatric disorders. RESULTS: Interrater and retest reliability on the level of diagnosis (kappa w = 1.00 and .62) and raw-scores (ru = .84 and .79) were good. Likewise, the internal consistency of the algorithm scale communication and social interaction of modules 1 to 4 was fair (ru = .78 to .89). The categorical convergence for autism between the ADOS and the Autism Diagnostic Interview-Revised (ADI-R) reached 79% (kappa = .23), with their corresponding subscales correlating moderately (rtc = .31 to .45). The concordance of the ADOS judgment and the clinical consensus diagnosis was 77% (kappa w = .37), with a sensitivity of the ADOS of 90.4% and a specificity of 48.1% regarding the discrimination of autism and other autistic disorders. CONCLUSIONS: The ADOS is a reliable and sufficiently sensitive diagnostic tool in the assessment of autistic disorders. For ICD-10/DSM-IV classification and to ensure a high specificity of diagnosis additional information concerning repetitive, stereotyped behavior and early development (e.g. taken from the ADI-R) has to be collected.

Adolescent↗

PubMed2003

Functional imbalance of visual pathways indicates alternative face processing strategies in autism.

OBJECTIVE: To investigate whether autistic subjects show a different pattern of neural activity than healthy individuals during processing of faces and complex patterns. METHODS: Blood oxygen level-dependent (BOLD) signal changes accompanying visual processing of faces and complex patterns were analyzed in an autistic group (n = 7; 25.3 [6.9] years) and a control group (n = 7; 27.7 [7.8] years). RESULTS: Compared with unaffected subjects, autistic subjects demonstrated lower BOLD signals in the fusiform gyrus, most prominently during face processing, and higher signals in the more object-related medial occipital gyrus. Further signal increases in autistic subjects vs controls were found in regions highly important for visual search: the superior parietal lobule and the medial frontal gyrus, where the frontal eye fields are located. CONCLUSIONS: The cortical activation pattern during face processing indicates deficits in the face-specific regions, with higher activations in regions involved in visual search. These findings reflect different strategies for visual processing, supporting models that propose a predisposition to local rather than global modes of information processing in autism.

Adolescent↗

PubMed2002

[Intervention in autistic disorders: status quo, evidence-based, questionable and doubtful techniques].

OBJECTIVE: We describe and critically discuss intervention methods that have been used to modify autistic behaviors. METHODS: Early intervention methods, training of social skills, pharmacological treatment and alternative approaches are reviewed in the light of the empirical evidence. RESULTS: Autism is a persistent and phenotypically heterogeneous disorder for which no cure has been found to date. However, individually composed care and therapies can lead to remarkable quantitative improvement. CONCLUSIONS: Further research is needed to evaluate the true impact of psychological and biological intervention techniques in autistic disorders. Among other things, the therapy studies carried out up to now often lack an adequate diagnostic assessment.

Autistic Disorder↗

PubMed2001

[Speech development and intelligence in autism. How uniform is Asperger syndrome?].

Since the introduction of a separate diagnosis for Asperger's syndrome in the ICD-10 and DSM-IV classification systems, a controversial debate has continued on whether Asperger's syndrome is a specific, clearly distinguishable disorder within the autistic spectrum or whether it represents a milder phenotypical variation of autism. The effect on the amount of autistic symptoms of the variables language delay and level of intelligence was analyzed within a sample of individuals exhibiting autism diagnosed by standardized methods. Both variables showed a significant effect on the degree of autistic symptoms in that impairments in social interaction were less noticeable. In addition, a subsample of individuals exhibited symptoms assumed to be characteristic for Asperger's syndrome. The findings support the assumption that autism and Asperger's syndrome represent "extreme points" on a scale of severity, which leads to the suggestion that the classification of different subtypes of autism could be abandoned in favor of a dimensional (multiaxial) approach.

Adolescent↗

PubMed2001

[Factor structure of the Autism Diagnostic Interview-Revised (ADI-R): a study of dimensional versus categorical classification of autistic disorders].

OBJECTIVES: This study investigated whether empirically derived dimensions of autistic behavior are consistent with the content-valid construction of the autistic behavior domains according to ICD-10 and DSM-IV (social interaction, communication and repetitive, stereotyped behavior). METHODS: A principal component exploratory factor analysis routine with varimax-rotation and extraction of factors following the Scree criterion was run using data from the Autism Diagnostic Interview-Revised (ADI-R) of N = 262 individuals exhibiting autism or autistic features. RESULTS: A three-factor solution consisting of two socio-communicative and one language dimension and accounting for 46.1% of the total variance was found to best describe the data. These factors yielded only vague correspondence with the idea of behavior domains described in ICD-10 and DSM-IV. In addition, factor loadings of items representing repetitive, stereotyped patterns were generally weak. CONCLUSIONS: The factor-analytic approach to autism indicates a conception of the disorder divergent from that defined in the contemporary psychiatric classification systems, especially regarding the area of repetitive, stereotyped behavior.

Adolescent↗

PubMed2000

[Utilization of psychological tests for diagnosis in German child and adolescent psychiatry: results of a survey].

92 inpatient and outpatient child and adolescent psychiatric institutions all over Germany were surveyed on practice and attitude towards psychological tests. Leading psychologists were contacted by mail and given a 15 item questionnaire. All institutions reported keeping at least a small test-inventory and using psychological tests in diagnostics. Half of the clinics carried out individual tests obligatory in the routine. Additionally, one third applied self-constructed instruments, which in the minority of cases had been psychometrically investigated or published. Computer-aided testing was established in one third of the institutions. Colleagues, test-compendia, scientific journals and the internet are quite often consulted for test-information. Intelligence measures are the most frequently administered test in child and adolescent psychiatry, while structured interviews are applied rarely. Among the highly frequent used individual tests were the Wechsler-Intelligence-Scales for children and adults, the CFT-scales, the projective Sceno-test and the d2-attention endurance test. One forth of the surveyed clinics reported refusal of individual or groups of tests, including projective and cognitive assessments. Thereby, ethic aspects were never mentioned as a reason for rejection. A range of diagnosticians reported to miss adequate measures for diverse constructs, e.g. learning disabilities. Furthermore, new norms and up-dates for regularly used instruments were often demanded. Some single survey-results also give reason for critically reviewing aspects of test-usage in German child and adolescent psychiatry.

Adolescent↗

PubMedDate not supplied

Patterns of parent-reported problems indicative in autism.

Parental report Child Behavior Checklists (CBCL) of 77 male and female subjects aged 4-18 years were analyzed in this study. Individuals had been given diagnoses of autistic disorder using the Autism Diagnostic-Interview-Revised (ADI-R) within a research project on the genetics of autism. A feature of behavior problems independent of sex but influenced by age and IQ level could be identified for the autistic sample with highest relative scores on the scales measuring attention problems, social problems and thought problems and low scores on the scale for somatic complaints.

Adolescent↗

PubMedDate not supplied

Stability and interpersonal agreement of the interview-based diagnosis of autism.

Interpersonal agreement and stability of the Autism Diagnostic Interview-Revised (ADI-R) was examined in this study. Four raters judging 55 subjects agreed moderately to excellently on the items of the diagnostic algorithm, operationalizing the main autistic symptoms according to the classification guidelines of ICD-10 and DSM-IV. When retesting 33 individuals, some items revealed only weak stability. On the level of domains of autistic behavior and diagnosis, the interrater reliability and retest reliability were consistently convincing.

Adolescent↗