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Biomedical subjects

W Barnett

Publications and source records attributed to W Barnett.

At least 19 recordsLinked to original sources

[Disguised Tourette's syndrome. A contribution to the differential diagnosis on phobia and fear].

Patients with Tourette's syndrome often develop multiple psychopathological symptoms beyond the basic symptoms (motor and vocal tics). We describe a female patient who had been treated over years with cognitive-behavioural methods under the diagnosis of anxiety disorder without success. Her obsessive-compulsive and tic symptoms had been ignored because they had not been reported by the patient, who was accustomed to them. Our case underlines the necessity of specific exploration and taking of a case history, especially when symptoms are atypical and do not improve under treatment. This gives cause for some critical remarks on the principle of comorbidity.

Adult↗

Neurophysiologic tests during antidepressive treatment - an exploratory study.

This is a non-randomized exploratory study showing the sensitivity of neurophysiological parameters for autonomic side-effects during the application of antidepressant drugs. Inpatients on tricyclic antidepressants (TCA: amitriptyline or doxepine), inpatients on serotonine-reuptake inhibitors (SSRI: fluvoxamine or paroxetin) and a control group of healthy volunteers underwent neurophysiological examination. The treatment group was investigated after at least 7 days of continuous treatment with the final dose. Adjustment of the autonomic nervous system was studied, first, by measuring latency and amplitude of the sympathetic skin response (SSR), elicited by electric stimuli and by deep inspiration, and second, by analysis of the heart rate variation (HRV) during rest and inspiration. Relevant affections of the peripheral parts of the reflex arc under discussion were excluded by taking the nerve conduction velocity (NCV) and F-wave referring to cervical segment C7. In total, 48 individuals were examined. The TCA group showed delayed latencies and smaller amplitudes of the SSR in comparison with the controls. In the SSRI group, these parameters did not differ significantly from those of the controls. Analysis of HRV put further emphasis on the impaired adjustment of the autonomic nervous system in the TCA group. To sum up, our test battery indicated a specific vegetative alteration due to TCA.

Adult↗

Repeated arson: data from criminal records.

The criminal careers of all arsonists convicted in former West-Germany between 1983 and 1985 who were found not to be responsible due to diminished responsibility for psychiatric reasons and a random sample (every third) of all criminally liable arsonists during the same period of time were followed up until 1994 by means of their trial records. Reappearance before the court for arson did not differ between the groups. When subjects are grouped by the additional occurrence of crimes other than arson, however, arsonists with diminished responsibility are the most problematic group: In comparison with all other subgroups, the arsonists who were partly responsible who did not commit any crimes other than arson showed the highest number of fire-setting incidents. Among the arsonists who committed other crimes as well, arsonists with diminished responsibility had the highest number of additional offences.

Adult↗

[Psychodynamics and therapy of trichotillomania].

After a short review of the literature, some aspects of the psychodynamics and therapy of trichotillomania with an adolescent patient are presented that up to now have not been described in great detail. Against the backdrop of previous fears of being abandoned, the patient feels threatened that while coping with the developmental tasks of sexuality and aggressiveness she will be dropped once again. This psychodynamically oriented therapy makes it possible for the patient to accept and verbalize the corresponding feelings in a relationship that gives a feeling of security. Therefore, the symptoms that previously served the purpose of regulating diffuse inner tensions and fears may be abandoned.

Acculturation↗

Recidivism and concomitant criminality in pathological firesetters.

The purpose of this study was to explore dangerousness and fire setting recidivism of mentally disordered firesetters in comparison with mentally healthy arsonists. In Germany, all trials are registered centrally by the Federal Central Register. The records of this Register for the three year period from 1983 until 1985 were used in this follow-up study of arsonists to identify three samples of subjects: (1) All persons convicted of arson who have been found not guilty by reasons of insanity (n = 186), (2) all person convicted of arson who have been found guilty of diminished responsibility (n = 97), and (3) a random selection from all persons convicted of arson who have had no psychiatric examination in their trial (n = 187). The follow-up ended in 1994, providing a period of, on average, ten years. Mentally disordered arsonists differed from non-mentally disordered arsonists in the following ways: They were more likely, first, to have a history of arson before 1983, and secondly, to be convicted of arson again (11% relapse compared to 4%). Mentally disordered arsonists had fewer registrations of common offenses, such as theft as well as traffic violations and alcohol-related offenses. Based on the present sample, mentally disordered firesetters have a higher rate of recurrence of firesetting than non-mentally disordered firesetters and commit fewer common offenses other than firesetting.

Adolescent↗

Forecasting recidivism in delinquency by intelligence and related constructs.

In a longitudinal survey of 122 healthy criminal offenders aged 18 to 37 years, the relationship between intelligence measured by the Wechsler Adult Intelligence Scale (WAIS), neuropsychological scales and delinquency was investigated. The Benton Test correlates well with the WAIS and moderately with offence data, but not with recidivism in delinquency. The 122 men had normal intelligence test scores (average IQ = 102), but bad school and working records. The 34 per cent and 60 per cent respectively of offenders, who relapsed within the time span of 1.5 and 3 years respectively, showed significantly worse results in the Verbal Scale and in the Block Design of the Wechsler Intelligence Scale. Poor performance in the Information and the Block Design sub-tests of the WAIS, a low level of formal education and the belief in external control by circumstances and powerful others are predictors of a high risk of recidivism.

Adolescent↗

[Primary and secondary negative symptoms: a useful differentiation? An empirical study].

The concept of schizophrenic negative symptomatology consisting of primary, treatment-resistant negative symptoms associated with cognitive dysfunction and treatable secondary composite negative symptoms was tested by comparing a group with non-chronic schizophrenia and a neurotic group with negative symptoms before and 8 weeks after the start of treatment. Contrary to our hypothesis, we found no association between schizophrenic negative symptoms and cognitive dysfunction as measured by CPT and K-V-T either at the first or at the second assessment point, but did find a strong relation between depressive and negative symptomatology at both assessment points in both groups. Thus, we conclude that a chronic course, rather than primary negative symptomatology, may be associated with cognitive dysfunction. The concept of primary negative symptoms based on cognitive dysfunction versus secondary negative composite symptoms encompassing motivation and reactive attitudes is not supported by these results.

Adult↗

[Psychotherapy in psychiatry--an assessment of current status. Report on the DGPPN Status Colloquium "Psychotherapy in Psychiatry" 22-24 February 1996 in Heidelberg].

The German psychiatrists have agreed to new training regulations which now include psychotherapy. On this occasion the German Psychiatric Association organized a symposium "psychotherapy within psychiatry". Psychotherapy researchers of all psychiatric departments in German speaking countries were invited. As a result, a cross-sectional picture of current psychotherapy research within psychiatry showed a great variety of methods and ways of thinking about research on psychotherapeutic process, outcome, and applications. Even non behavioural approaches showed a trend towards operationalized and quantifying, but also standardized qualitative research. All participants agreed on the necessity of better and in comparison with psychopharmacological research more fair financing of psychotherapy research.

Curriculum↗

The core of negative symptoms in schizophrenia: affect or cognitive deficiency?

The association of negative symptoms on one hand and cognitive failures and language and thought disturbances on the other hand was examined in 25 schizophrenics and 22 neurotics over a 2-month period of intensive therapy. Psychopathological negative symptoms were more pronounced in schizophrenics than in neurotics at the first assessment before intensive therapy. However, cognitive and language performance showed no difference between the groups in both cross-sectional comparisons before and after treatment. Thus, our hypothesis that cognitive deficiencies are the core of negative symptoms could not be confirmed. It is discussed that young schizophrenics at an early stage of the illness may imply more affective components in the psychopathology of their negative syndrome than chronic schizophrenics with more pronounced cognitive deficits.

Adolescent↗

Pathological fire-setting 1951-1991: a review.

The purpose of this article is to review the whole literature on pathological fire-setting and related fields since 1951 in order to present a state of the art picture of our contemporary knowledge about this phenomenon. Papers were initially selected by using a Medline search. From the articles obtained in this way the references had to be pursued, because many relevant papers and books in this research field of different scientific and practical disciplines are not listed in conventional literature services. Finally, only those contributions were selected which provided new information when published, by original research, theoretical interpretation or practical implications. The last forty years have brought a growing body of data and understanding--especially concerning pathological fire-setting by children--etiology, and therapy, which often proves successful. The situation remains unclear for arson by psychologically disturbed adults and we still have a poor understanding of arson without apparent motive. There is a conflict of opinion as to whether adult fire-setters are suitable for therapy and therapeutic efforts dealing with psychologically disturbed adults are rare. With increasing knowledge about child fire-setting and its successful treatment, etiological and therapeutic models for adult fire-setting behaviour may be developed. Research into the latter area should focus on both biographical and social conditions of development from childhood on as well as biological measures. Both will be reviewed here.

Adolescent↗

[Stiff-man syndrome. Report of 4 cases].

Four patients are presented who exhibited progressive muscular rigidity in both legs, the thoracolumbar, paraspinal and the abdominal muscles. In only one patient, there was an initial involvement of the shoulder girdle muscles. Electromyography in all four patients at rest recorded continuous electric activity resembling an interference pattern. Following sudden exteroceptive stimuli the activity increased in amplitude and density this corresponded clinically to painful spasms. All patients had oligoclonal banding in CSF. In the serum and CSF of three patients IgG subtype autoantibodies were detected. These have been found to be directed against GABAergic nerve terminals in the rat and human cerebellum and, more specifically, to glutamic acid decarboxylase. All patients improved on clonazepam. Trials of intermittent high-dose methylprednisolone administration gave relief from rigidity in one patient and permitted reduction of clonazepam in another. Intravenous immunoglobulins however had no effect in one patient.

Adult↗

Untreated neuroborreliosis: Bannwarth's syndrome evolving into acute schizophrenia-like psychosis. A case report.

In general, meningopolyradiculitis (Bannwarth's syndrome, stage 2 of neuroborreliosis) follows a predictable monophasic self-limiting course. In contrast, we report the case of a patient with an untreated meningopolyradiculitis which evolved into acute schizophrenia-like psychosis due to persistent infection with Borrelia burgdorferi. The psychosis resolved within 1 week of treatment with ceftriaxone. This case shows that the usually benign monophasic meningopolyradiculitis may progress to severe CNS complications, which may have implications on current pathophysiological beliefs.

Acute Disease↗

Partnership after induced abortion: a prospective controlled study.

To study the social and psychological consequences of induced abortion on the relationship between the pregnant woman and her partner, 92 patients seeking a socially indicated abortion, who had a stable partner at the time of abortion, were interviewed. Standardized psychological measures were used to assess their partnerships before abortion and on follow-up 1 year later. A control group of 92 patients (matched for age, marital status, duration of partnership, number of children, and educational background), drawn from a larger sample of women using safe contraceptive methods, completed the same psychological measures. Prior to abortion, partnerships in the study group showed considerably more conflicts and were less harmonious than in the control group. One year after the abortion, the number of separations in the study group was not significantly higher than in the control group, nor were there any remaining qualitative differences in the partnerships of either group. When separations occurred, they had been more frequently initiated by women in the study group than in the control group.

Abortion, Induced↗

[Psychology and psychopathology of firesetting behavior 1955 to 1991--a review].

After a historical introduction and some short remarks on criminal arson, this review of the literature since 1955 mainly focuses on pathological firesetting. It deals with all important aspects of the psychiatry of firesetting: arson by persons referred to psychiatric examination, by the mentally ill, and by psychiatric inpatients, the relationship between arson and sexuality, psychoanalytical contributions, arson by children and juveniles, therapy and prevention of firesetting behaviour. Female arsonists, recidivism, and suicide by burning are considered separately.

Adolescent↗

Distribution of vasoactive intestinal polypeptide (VIP) binding in circular muscle and characterization of VIP binding in canine small intestinal mucosa.

The present study examined the localization and characterization of [125I]vasoactive intestinal polypeptide (VIP) binding to synaptosomes and enterocyte membranes using preparations made from homogenized canine intestinal mucosa and compared it to [3H]saxitoxin binding and VIP-immunoreactive content (markers for synaptosomes). The highest [125I]VIP binding was located in the P2 fraction and was correlated with the locations of maximal [3H]saxitoxin binding and VIP-immunoreactive content. This correlation indicates that VIP receptors are present on synaptosomes of canine small intestinal mucosa. A fraction enriched in synaptosomes contained a high density of saturable VIP receptors (352 +/- 26.40 fmol/mg) having high affinity (Kd, 0.23 nM) for [125I]VIP. Studies of association and dissociation of [125I]VIP to this site revealed that binding was fully reversible and yielded a Kd value similar to that from equilibrium binding. Competition binding experiments suggested the presence of two binding sites, a high and a low affinity binding site. The order of competition potency was VIP greater than peptide histidine isoleucine greater than secretin greater than peptide histidine methionine greater than or equal to [D-Ala4]VIP greater than or equal to [Phe1]VIP greater than VIP10-28 greater than [4-Cl-D-Phe6-Leu17]VIP. All these competitors displaced all specifically bound VIP. VIP, peptide histidine isoleucine and secretin interacted differentially with each of the two binding sites. Peptide histidine methionine, [D-Ala4]VIP, [Phe1]VIP, VIP10-28 and [4-Cl-D-Phe6-Leu17]VIP interacted with a single low affinity at all binding sites. Other VIP binding sites were sought in circular muscle and submucosa.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Endogenous paranoid-hallucinatory syndrome caused by Borrelia encephalitis].

We describe a case with no neurological signs but marked psychiatric symptoms induced by borrelia burgdorferi, whose clinical picture was indistinguishable from an endogenous schizophrenia. The symptoms within one week under antibiotic treatment with ceftriaxon, but afterwards the patient showed a mild organic brain syndrome. The case demonstrated the aetiologic nonspecificity of paranoid symptoms and hallucinations and emphasizes that in psychotic patients without psychiatric history additional diagnostic measures should be performed.

Brain Damage, Chronic↗

Further notes on Munchausen's syndrome: a case report of a change from acute abdominal to neurological type.

A rare case of Munchausen's syndrome beginning in early childhood is described. The diagnosis of Munchausen's syndrome was made at the age of 29 years, after the symptoms had changed from acute abdominal to neurological complaints, with feigned loss of consciousness, first ascribed to an encephalitis. Insight into the psychopathology of this patient is given by his biography, by assessment of a psychotherapist, who had treated him some years before, and by his observed profile in some psychological tests.

Abdomen, Acute↗