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Biomedical subjects

W Berner

Publications and source records attributed to W Berner.

At least 19 recordsLinked to original sources
PubMed1996

Outpatient treatment of mentally disordered offenders in Austria.

The mental health system is faced with a growing number of MDOs with treatment orders. For more than 90% of our sample of 157 discharged irresponsible MDOs a mandatory outpatient treatment was ordered. Considering the fact that half of these patients are transferred after discharge to institutions like psychiatric hospitals or nursing homes (Leygraf, 1988), institutional as well as outpatient treatment options are needed (Silver & Tellefsen, 1991). Within the Austrian mental health system here is an enormous lack of post-discharge treatment facilities for forensic patients (Meise, Rossler, & Hinterhuber, 1994). Furthermore, the existing structures obviously do not meet the special needs of forensic patients. Although this point of view is shared by the psychiatric hospitals and their contentment with the settings for forensic outpatient treatment was low, only one hospital intended conceptional change and modifications. Facing the reality that the same psychiatric hospital authorities complained that they could not release MDOs from an inpatient status because of inappropriate outpatient facilities, the responsibility for forensic patients seems to be projected from the medical to the legal system. This can be seen as a symptom of the tendency to a step wise and long-standing exile of forensic patients from the mental health system. Actually, forensic patients were for various reasons refused by mental health professionals and could not get psychotherapy, medication or adequate psychosocial care. A possible answer to these problems is to establish institutionalized outpatient facilities in the "hybrid" gap between the legal and mental health system (Lamb, Weinberger, & Gross, 1988). The new outpatient clinic in Vienna deals with rejected treatment-order patients, most of them with additional treatment problems such as impulsivity, substance abuse, and mental impairment (Cote & Hodgins, 1990). The special structure of the institution (i.e., a multiprofessional team that offers a wide and easily accessible spectrum of interventions, the realization of individual treatment programs with psychotherapeutic and psychosocial as well as biological aspects, and the long-term personal continuity of care by staff members with forensic psychiatric skills) promoted the experience that after some time half of the patients came on a voluntary basis (Fenell, 1992; Winick, 1994). Some pressure by the court was an efficient way to guarantee regular treatment for patients with personality disorders and perversions. The model of a special, structured, multiprofessional outpatient clinic is successful, but the role of such complementary pilot institutions is ambiguous. Simultaneously, the deficit of adequate outpatient care for MDOs has to be opposed by stopping the unacceptable withdrawal of general psychiatry from the forensic sector.

Aftercare↗
PubMed1995

Diagnostic value of ultrasonography and conventional radiography for the assessment of sternal fractures.

This study compares the sonographic and conventional radiographic examination of sternal fractures. Forty-five patients with a suspected sternal fracture were examined radiographically and sonographically. Sixteen had a sternal fracture which could be identified sonographically. In 15 of the 16 cases an equivalent diagnosis could be made radiologically. In one case no definite statement could be made radiologically but the sonographic finding together with the clinical aspect of the patient proved the diagnosis of a fracture. In four sternal fractures displaced by more than one anteroposterior thickness, the fracture itself was shown by sonography whereas the extent of the injury could not be displayed. Ultrasonic investigation of the sternum is a useful way to demonstrate fractures that provides a similar sensitivity to conventional radiography. In contrast sonography is not suited for portraying the grade of displacement. In case of doubt after radiological examination the ultrasonic examination serves as a valuable tool but conventional plain radiography remains the standard means of documenting a sternal fracture.

Adult↗
PubMed1994

[Dimensions of psychological disorders in children and adolescents with psychiatric disorders based on clinical observations].

Up to now dimensional classification systems for psychiatric disorders in children and adolescents have been developed exclusively on the basis of parent, teacher and self-report questionnaires. In the present study a dimensional classification system for psychiatric disorders was developed that is based on clinical ratings and involves factor, reliability and correlational analyses. The ratings are made with a special documentation system for psychopathology in children and adolescents. Four primary symptom scales (aggressive symptoms, antisocial symptoms, hyperkinetic symptoms and social-emotional impulsivity) are combined into the secondary scale external symptoms. Two symptom scales (social and achievement anxiety, depressive symptoms) make up the scale internal symptoms. Two other symptom scales cover language and eating disturbances. Reliability coefficients are given and correlational structures discussed.

Adolescent↗
PubMed1994

[Reliability and factorial validity of the Child Behavior Checklist--an analysis of a clinical and field sample].

The purpose of this study was to assess the reliability (internal consistency), the correlations of the scale scores and the factorial validity of the German version of the Child Behavior Checklist (CBCL). The analyses were performed in a sample of patients at two child and adolescent psychiatric facilities (N = 1653) and in a community sample (N = 1622). The analyses were based on the 1991 American version of the CBCL. The internal consistency of most of the scales was good to excellent (rtt > .80). The reliability of the scales "Withdrawn", "Somatic complaints" and "Social Problems" was not completely satisfactory (rtt > .70). The reliability of the syndrome scales "Thought Problems" and "Sex Problems" and the Competence Scales was unsatisfactory (rtt < .70). The internal consistency of the syndrome scales in the German and American samples was very similar. The correlations between the scales were predominantly in the lower range, with some in a medium range (rtt > .50). Factor analyses in the clinical sample confirmed that the syndrome scales had been well-designed. With the exception of the scales "Social Problems" and "Withdrawn", where the items have loadings on a common factor, the scales proved to be factorially valid.

Adolescent↗
PubMed1993

[Documentation of psychopathologic findings: a procedure for the evaluation of psychological disorders in children and adolescents].

A standardized documentation system for psychopathological findings allowing an assessment of psychiatric disorders in children and adolescents after clinical evaluation of the patient and his or her caregivers is presented. The symptomatology during the previous few months and the symptoms seen during the examination are rated separately. Altogether 113 items in 16 areas are assessed. In addition, motivation to participate in treatment is judged and a global assessment is made of symptom severity. A number of facilities are already employing this documentation system in their routine clinical work. In a first study 597 patients from a routine clinical population seen consecutively were assessed at the start of treatment. As expected, the most commonly recorded symptoms were those of expansive behavior. Such symptoms were seen much more rarely during the evaluation than outside this situation. The documentation system for psychopathological findings complements diagnosis by category according to ICD with a phenomenological description of psychiatric disturbances on the level of single symptoms. It enables simple and economical documentation of clinical findings after evaluation of the patient and his or her caregivers.

Adolescent↗
PubMed1989

[Effects of partial inpatient treatment of preschool children with behavior disorders and developmental delay].

In a sample of 55 preschool children, four to seven years of age, treated by a therapeutic day-treatment programme up to 3;4 years, developmental delays and behavioral disorders, rated by parents and preschool teachers, were assessed every five months until discharge. Developmental delays and behavioral disorders were reduced clinically and statistically significant between onset of treatment and discharge. This result could also be verified preponderantly by analysing several measurement points in parts of the sample with different treatment durations. Comparing changes during a waiting period of one year at most with changes during a waiting period of one year at most with changes during day-treatment of equal duration, treatment effects could be verified at least as a tendency for changes in behavior problems but not for developmental abilities due to methodological problems.

Affective Symptoms↗
PubMed1988

Failure load and displacement of the human sacroiliac joint under in vitro loading.

The stability of the sacroiliac joint was studied using an in vitro loading system. Forty-nine sacroiliac joints taken from fresh cadavers were examined. The ligamentous structures of the joint disrupted at 3368 +/- 923 N under transverse loading. Higher disruption forces were observed under ventrocranial (4933 +/- 1038 N) and dorsocranial (5150 +/- 947 N) loading. At joint failure the displacement in loading direction ranged from 5.5 +/- 2.3 mm in the transverse to 6.6 +/- 2.3 mm in the dorsocranial direction. In some experiments the interlocking effect between the articular surfaces of the sacrum and ilium were examined. The best interlocking capacity was observed under dorsocranial loading. This capacity is much higher than the friction in other human joints. The study shows that correct anatomical reconstruction without displacement increases the stability of the disrupted sacroiliac joint.

Adult↗
PubMed1987

Human immunodeficiency virus infections among civilian applicants for United States military service, October 1985 to March 1986. Demographic factors associated with seropositivity.

During the six months from October 1985 through March 1986, blood samples from 306,061 civilian applicants for military service from the United States were tested for antibody to the human immunodeficiency virus (HIV). Four hundred sixty subjects were positive for the antibody as determined by Western (immune) blot reactivity. The mean prevalence of HIV infection in this population of teenagers and young adults was thus 1.50 per 1000. According to multivariate analysis, the following demographic factors were found to be significant independent predictors of a positive HIV-antibody test: age (adjusted odds ratio = 1.10 per year), black race (adjusted odds ratio = 2.04), male sex (adjusted odds ratio = 1.84), residence in a densely populated county (adjusted odds ratio = 1.05 per 1000 per square mile), and residence in a metropolitan area with a high incidence of the acquired immunodeficiency syndrome (adjusted odds ratio = 1.53). Antibody-positive applicants were identified in 43 of the 50 states. Counties with high prevalence rates for HIV (greater than 5 per 1000) were located in New York State (four counties), New Jersey (three counties), California (two counties), Maryland (two counties), and Texas, Colorado, and Washington, D.C.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[DSM III personality diagnosis in a group of chronic offenders].

A group of chronic offenders (n = 44) was investigated and their personality disorders coded according to two different methods, namely the ICD 9 (International Classification of Diseases 9) and the American DSM III (Diagnostic and Statistical Manual III). The total number of personality disorders diagnosed by DSM III was less than by ICD 9. This cannot be attributed only to the fact that according to DSM III cyclothymic disorders do not have a direct correlate in axis II-personality disorders, but are, instead, assigned to the group of affective disorders. The majority of persons in whom the diagnosis of cyclothymic personality disorders was made on ICD 9 were rated as having one of the "extroverted personality disorders" in DSM III. If the personality disorders are combined to form three groups - (a) eccentric (close to psychoses), (b) extroverted and (c) introverted - then the overall correlation between ICD 9 and DSM III is considerable. The DSM III system promises a higher reliability due to the existence of criteria for inclusion and exclusion. The diagnosis "borderline personality disorder" was compared with the DIB Gunderson interview (kappa 0.89). In the international classification DSM III borderline personality disorder was equivalent to a diagnosis of cyclothymic, irritable, hysteric or sociopathic personality disorder.

Borderline Personality Disorder↗
PubMed1983

The cyproteronacetat treatment of sexual offenders.

Anti-hormonal treatment of sexual offenders with Cyproteronacetat is discussed. The authors report on their own findings, and review the literature. They believe that Cyproteronacetat in combination with supportive psychotherapy is a promising modality. They further comment on the Austrian legal situation.

Adult↗