Biomedical subjects
Publications and source records attributed to W Böker.
The authors report a case of unexpected sudden death in a woman receiving relatively high dose of haloperidol. They postulate that drug-induced laryngeal spasm leading to cardiac arrest via vagal reflexes may represent the mechanism of neuroleptic sudden death in some cases.
The public opinion frequently attributes a dangerous behavior to the severe mentally disturbed. Is there really an overrepresentation of the mentally sick among violent delinquents? In a retrospective epidemiological study performed in the Federal Republic of Germany the personality features, mental status and criminal acts of 533 mentally disturbed violent delinquents were investigated and compared with the same data obtained in healthy violent delinquents, in mentally disturbed non-delinquents of the same diagnosis and in the general population of a responsible age. The most important results of this study are reported. The proportion of the mentally ill in the group of all violent delinquents of the decade examined (1955-1964) does not exceed the proportion of the mentally ill in the entire population so that the question asked above can clearly be answered with no. Factors increasing the risk of aggressive behavior in various groups of mental disturbances are discernible; the recognition of these factors should be followed by appropriate therapeutic measures.
The article reports on different components of misplacement as an important problem in the psychiatric care. Basing on a census of all in-patients of the Psychiatrische Universitätsklinik Bern (n = 551) different methods of evaluating misplacement are discussed. Some results of the census: - two thirds of the patients suffer from psychoses, another 13% from oligophrenia: - 46% of the patients are older than 60 years; - 72% have been in hospital for more than one year, 30% even for more than 20 years; - a quarter of the patients need special care. Psychiatrists and nursing staff agree that 198 (= 36%) of the 551 patients do not need any psychiatric treatment or nursing. From this point of view these patients have to be regarded as misplaced in the Psychiatrische Universitätsklinik Bern.
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Contemporary psychiatry is frequently characterized as "dynamic". This adjective has been used, not only to denote a psychodynamic, psychotherapeutic orientation, but also to accentuate a sharp contrast with the older "classical" psychiatry. Often the orthodox schools of psychiatry are jointly condemned as being adynamic, static, descriptive-classificatory and inimical to psychotherapy. The author traces the development of the concepts "classical" and "dynamic" in the psychiatry of the past 200 years, and attempts to show that they represent a false antithesis.
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