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W Häfner-Ranabauer

Publications and source records attributed to W Häfner-Ranabauer.

10 recordsLinked to original sources
PubMed2001

[Schizophrenia and delusions in middle aged and elderly patients. Epidemiology and etiological hypothesis].

Knowledge of the similarities and differences between early- and late-onset schizophrenia and between late-onset schizophrenia and paranoid disorder of old age and very old age is fragmentary. We compared diagnosis, subtypes, syndromes and symptoms between first-episode schizophrenia (ICD-9: 295) and paranoid disorder (ICD-9: 297, 298.3/4.) over the life cycle in a population-based (N = 232) and a clinical first-admission sample (N = 1109). Apart from different age patterns of the sexes only two symptom groups were significantly different between early- and late-onset illness: paranoid and systematic delusions showed a linear increase, symptoms of disorganisation a linear decrease over the life cycle. Clearly different between early- and late-onset illness were the neurobiological and psychological risk factors, suggesting that both neurodevelopmental and neurodegenerative disorder causes psychopathology typical of schizophrenia. Late- (40 to 60) and very-late-onset (over 60) cases of both groups of illness showed the same symptom profiles, merely the number of symptoms being higher in the group diagnosed with schizophrenia. Age was the only factor significantly contributing to a clinico-diagnostic differentiation of schizophrenia from paranoid disorder beyond age 40.

Adolescent↗
PubMed2000

Need and demand in psychiatric emergency service utilization: explaining topographic differences of a utilization sample in Mannheim.

Up to now all investigations about the topographic distribution of psychiatric utilization rates ignore whether or not the patients really require care (need for care) respectively express that need by themselves (demand for care). To analyze utilization rates of the psychiatric emergency service of the Central Institute of Mental Health in Mannheim (CIMH), variables differentiating between need and demand for emergency care were included. The investigation is based on contacts in the psychiatric emergency service between 1982 and 1993 and comprises 6463 patients with 14,628 contacts. To operationalize the concepts of need and demand the items "instance of consultation", "reasons for consultation", "inpatient admission" and "rated urgency" from the standardized record system of the psychiatric emergency service were used. The association between need, demand and ecological, socio-demographic and distance-related factors were analyzed. The results show that demand for psychiatric emergency care is an important factor for explaining topographic differences in service utilization. Demand correlates with ecological, socio-demographic and distance related factors; need only correlates with age. The amount of demand also varies with specific mental disorders.

Emergency Services, Psychiatric↗
PubMed1998

Utilization of the psychiatric emergency service in Mannheim: ecological and distance-related aspects.

Ecologically oriented research of psychiatric service utilization has almost exclusively dealt with regular in- and out-patient services. There are hardly any results on the ecological distribution of utilization rates of psychiatric emergency services. This study aims at investigating the topographic distribution of utilization rates of the psychiatric emergency service out of office hours at the Central Institute of Mental Health (CIMH, Mannheim) from 1982 to 1993. Within this period of time 6463 patients with a total of 14,628 contacts were registered at the CIMH. In order to explain topographic differences in the utilization rates, ecological variables, the distance between patients' residence and service location, and diagnosis were taken into account. The study shows that ecological, distance-related and diagnostic factors all influence the utilization of the psychiatric emergency service in Mannheim. First contact and contact rates decrease from the city centre toward the outskirts. There was a strong general effect of ecological variables: the utilization rates were higher for districts with worse ecological conditions and specific for some diagnostic groups. The greatest difference in utilization rates between the city centre and the outskirts was found for schizophrenia and psychoactive substance use disorders, whereas there was no difference with regard to organic and symptomatic mental disorders. With increasing spatial and time-related distance between residence and service location, the utilization rate decreases. No relation was found between diagnosis and distance. The study also shows an interaction between time-related distance and the ecological variables. The influence of the ecological factors on service utilization is amplified with decreasing distance.

Ambulatory Care↗
PubMed1996

[2 class psychiatry].

Community care and sectorisation, specialisation and differentiation, integration of psychiatric and other medical services, crises intervention and emergency psychiatry--and patient's choice--are basic issues of the organisation of psychiatric services. They are discussed and evaluated in respect of the Region of Mannheim and the Mannheim Zentralinstitut für Seelische Gesundheit.

Community Mental Health Services↗
PubMed1996

[Quality assurance in clinical social work: specific interventions for specific problem areas in different psychiatric patient groups?].

Based on the standardized data of 2643 treatment episodes documented over 11 years in a psychiatric hospital, this study investigates the issues, activities, and outcome of social work with 2038 psychiatric inpatients from the perspective of quality assurance. A primary objective was to study how the social workers' interventions relate to the patients' problems also with regard to sociodemographic characteristics and type of disorder of the patient. The social workers' estimation of the outcome was also studied in relation to these variables. Interventions were found to correspond significantly with problems, and were mostly depending on age, sex, and diagnosis. Impaired social functioning, predominantly present in chronic disorders, was the major concern of social work interventions.

Activities of Daily Living↗
PubMed1996

[Quality assurance in clinical social work: how do social workers judge the success of their interventions?].

Therapy outcome is an important criterium for quality assurance. In this study, clinical social workers themselves estimated the outcome of their interventions in 2643 admissions of 2038 patients to a psychiatric hospital. These inpatients had been referred by a psychiatrist to the social worker and comprised 27 % of all patients admitted to the hospital within 11 years. The study purpose was to investigate how the outcome estimates relate to clinical and sociodemographic variables of the patients, to their specific problems, and to the applied interventions. The fewer areas of problems were perceived and the more interventions were performed, the more positive these interventions were evaluated. Administrative interventions were seen as more successful than counseling. Outcome estimates were particularly positive in long and intensive therapies.

Adult↗
PubMed1996

[Social work in inpatient psychiatric management. An empirical study of indications and success].

The participation of social work in inpatient psychiatric care is generally considered necessary, but there is a lack of empirical studies in this field. The analyses presented of a systematic documentation of social work interventions in 2038 cases during an 11-year period demonstrate that social workers are mostly involved in the treatment of chronic and previously treated patients. Interventions in younger patients, most of whom are suffering from psychoses, aim at rehabilitation through activity; in elderly patients with organic or depressive disorders, the major concern is to improve posthospital care; patients with neurotic or personality disorders comprise another group with a chronic course and a relatively poor outcome. As far as their goals are comparable, social workers and doctors agree on their objectives. Social workers usually see their own interventions as successful, but patient groups who benefit greatly can be differentiated from groups with poor outcome.

Adult↗
PubMed1994

[Formulating a diagnosis in psychiatry].

Referring to some critical comments on operational diagnostics in view of the adoption of the 10th Revision of the International Classification of Diseases, the relevance of symptomatology for diagnosis using ICD-8 and ICD-9 was investigated in a retrospective study. Inpatients with neurotic depression, endogenous depression, schizoaffective psychosis, manic psychosis and paranoid schizophrenia were included in the study. Data came from routine documentation of every episode of treatment, symptoms being assessed according to the AMP system. Discriminant analyses revealed psychopathology at admission to be the most important information for diagnosis both at admission and at discharge. Psychopathology at discharge seemed to be of no importance for diagnosis, whereas inclusion of the reasons for referral improved discrimination between categories of depressive disorder. When in addition sex, age, and chronicity were included in computation of the discriminant function, a further improvement in the prediction of psychiatric diagnosis at discharge resulted. These findings are compared to others reported in the literature.

Adult↗
PubMed1984

[Development and function of the psychiatric crisis and emergency service in Mannheim].

The setting up of a psychiatric emergency and crisis service during the years 1974 to 1980 in Mannheim forms part of the evolvement of a central psychiatric overall care programme with emphasis on patients residing in the same region, that is to say, close to the psychiatric facilities; within this framework, the role played by the emergency service is preferably of an auxiliary and additional nature, over and above the already existing regular care facilities. Since the emergency and crisis service forms a part of a regular psychiatric care network, its principal functions are: 1. First diagnosis and, in connection therewith, the decision whether 2. acute intervention in an existing crisis should be effected within the emergency service, or 3. whether further treatment must be instituted with a psychiatric or internistic or social partner of the emergency service. The emergency service has to look after an increasing proportion of patients with severe mental disturbances who are seen by the emergency service in moments of extreme crisis (high rate of attempted suicides) or in acute severe relapses, and who are normally also looked after by the regular psychiatric services. Over and above, the emergency service has to look after a special small group of patients not covered by any other psychiatric service on account of their social disorganisation , frequently also because they are addicts. As should be expected, there is an almost continuous drop in the referral to the psychiatric service, the farther away the patients live from the seat of the emergency service. This, however, applies in a very similar manner to the regular outpatient services and also to the entire psychiatric care available to the residents of Mannheim.

Alcoholism↗