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V Arolt

Publications and source records attributed to V Arolt.

83 records · Page 5Linked to original sources
PubMed1994

Confounding diagnostic systems: a major risk in the use of criteria-based manuals.

In psychiatry, the new classification of diseases, the ICD-10/chapter V(F), will be introduced worldwide in the near future. As in the USA in the case of the DSM-III, psychiatrists will have to change their diagnostic procedures from traditional typology to criteria orientation. 83 West German psychiatrists in practice, who were unfamiliar with the use of criteria-oriented diagnostic systems, documented not only the ICD-9 diagnoses of 10,902 depressive patients but also their DSM-III diagnoses. A comparison between the results of the diagnostic distribution of this sample and a smaller sample diagnosed by well-trained interviewers reveals that, to a great extent, systematic mistakes were made, especially by confounding typological and criteria-oriented diagnostic entities. In a vulnerable period of changing diagnostic procedures, such as during the introduction of ICD-10, facilities for training and discussion should be supplied.

Adult↗
PubMed1994

[Psychotherapy of depression in general practice of established psychiatrists: results of an empirical study].

A severe deficit in studies providing a valid assessment of indication of psychotherapy in different population samples and care settings must be stated for the FRG. Actual decisions in health care politics are not supported by sufficient empirical data. The objective of this study was to gain an overview on the psychotherapy of depressive syndromes, treated by psychiatrists in practice. The psychotherapeutic treatment methods of 55 psychiatrist's in practice, applicated to a sample of 9956 depressive patients, are documented. Supportive psychotherapy was common whereas the use of structured psychodynamic or behavioral therapy was highly selective.

Adult↗
PubMed1993

[Disorders of eye movements in schizophrenia--a critical review and future perspectives].

Disorders of smooth pursuit eye movements and saccadic eye movements have been reported frequently in schizophrenics. Probably 50% of the schizophrenic probands and of their unaffected relatives perform abnormal smooth pursuit movements. These deficiencies have been regarded as a possible genetic trait marker for schizophrenic vulnerability. Saccadic eye movements have been investigated less intesively. The most prominent pathological feature is a lack of precision of reflexive saccades in case of schizophrenic probands. Although a large body of research has been conducted, the multitude of the results of eye movement disorders in schizophrenics and also technical and methodological problems impair the significance of these findings. In this review, the most important results are critically elaborated and research perspectives are pointed out. A valid identification of eye movement abnormalities is necessary.

Humans↗
PubMed1993

[Indications for psychiatric consultation: a case-specific parallel survey of psychiatrists and treating physicians].

In a prospective study about the consultation triad (doctor-doctor-patient) 334 of 388 consecutive psychiatric consultations at two large hospitals of Lübeck within 5 months have been analyzed. The psychiatric consultant and the doctor on duty answered questions with regard to diagnosis, treatment indication and after care. 162 physicians (22 psychiatric consultants and 140 physicians working in 14 different departments) took part in the study. On one hand it turned out that there were specific indications for different diagnosis groups. On the other hand the two samples of physicians presented surprising differences with regard to their (case related) treatment indications and after care options. Psychiatrists found it less important to carry out reconsultations and the somatic orientated doctors emphasized more often psychodynamical orientated interventions for patients in contrast to the psychiatrists. Psychiatrists in contrast have been more sensitive for atmospheric tensions at the ward. These differences even grew following the amount of practice. Gerontopsychiatric patients turned out to be a special problem group. Doctors of both groups rarely share their opinion with regard to after care options.

Adult↗
PubMed1993

[Diagnosis and treatment of depressive syndromes in general practice of established neurologists. Results of an empirical study].

Data on 9956 patients concerning the diagnosis (ICD-9) and treatment of depressive syndromes were collected in psychiatric office practice. About 50% of the patients were over 50 years of age. Among all depressive disorders, neurotic and endogenous depression were found to have the highest prevalence. Amitriptyline and Doxepin were preferred in psychopharmacological treatment. Supportive Psychotherapy was practised extensively while highly structured psychoanalytical or behavioural forms of psychotherapy were relatively rare. The discussion emphasizes a methodological and epidemiological research perspective.

Adult↗
PubMedDate not supplied

The influence of familial loading on the course of schizophrenic symptoms and the success of psychoeducational therapy.

This prospective study examines the influence of familial loading on the course of schizophrenic illness and the extent to which this is modifiable by psychoeducational training as a form of psychotherapy. 182 schizophrenic patients enrolled in the study were allocated at random into four different treatment groups and one control group. 40% of the patients had mentally ill relatives, 20% with some form of schizophrenia. Patients attending the treatment group and those in the control group were examined before and immediately after psychoeducational training and at 2-year and 5-year follow-ups. Control group patients with mentally ill relatives displayed a significant increase in psychopathological symptoms and rehospitalization rate compared to those without. The psychoeducational training arrested or even improved the increase in psychopathological symptoms in patients with mentally ill relatives. Familial loading contributes substantially to a high rehospitalization rate and a poor outcome in schizophrenic patients. Psychoeducational interventions are an appropriate means of arresting this unfavorable development.

Adult↗
PubMedDate not supplied

Care complexity in the general hospital: results from a European study.

There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between complexity indicators, highlighting differences between length of stay (LOS), objective complexity (such as medications or consultations), complexity ratings by the nurse, and complexity ratings by the doctor. Their findings illustrate limitations in the use of LOS as a sole indicator for care complexity. The authors show how objective and subjective complexity indicators can be used for early and valid detection of patients needing interdisciplinary care.

Diagnosis-Related Groups↗
PubMedDate not supplied

Risk factors for complex care needs in general medical inpatients: results from a European study.

The authors linked admission risk factors to a series of indicators for complex care delivery to enable detection of patients in need of care coordination at the moment of admission to the general hospital. The authors found 13 risk factors to be predictive of more than one indicator of care complexity. An admission risk screening procedure to detect patients in need of care coordination should focus on these risk factors and should include predictions made by doctors and nurses at admission and information collected from the patient and the medical chart.

Diagnosis-Related Groups↗
PubMedDate not supplied

COMPRI--an instrument to detect patients with complex care needs: results from a European study.

The authors developed a screening instrument to detect patients in need of complex care coordination at admission to a general hospital. On the basis of a series of risk factors for care complexity, the authors constructed a short, care complexity prediction instrument (COMPRI) and assessed its qualities. The COMPRI is an easily administered screening instrument that detects patients at risk for complex care needs for whom care coordination is indicated. COMPRI's predictive power exceeds all currently available case-mix instruments.

Diagnosis-Related Groups↗