Biomedical subjects

A Deister

Publications and source records attributed to A Deister.

47 records · Page 3Linked to original sources

PubMed1989

Quality of affective symptomatology and its importance for the definition of schizoaffective disorders.

169 patients with schizophrenic symptomatology at least once and a mean follow-up period of 20 years were divided in three groups regarding the presence and type of accompanying affective symptomatology. The groups were compared regarding sociodemographic and other premorbid features and long-term outcome. The results show that not every depressive or euphoric symptom but only melancholic or manic symptomatology qualifies the schizophrenic syndrome as schizoaffective.

Adolescent↗

PubMed1988

Long-term course of schizoaffective disorders. Part I: Definitions, methods, frequency of episodes and cycles.

The present study (Cologne study) investigated the long-term course (means = 25.6 years, minimum 10, maximum 59 years) of 72 schizoaffective patients. The diagnosis was based on the longitudinal approach. All patients were interviewed personally, using the Present State Examination and a pool of questions based on some instruments of the WHO (DAS, PIRS, etc.). The course was found to be usually polyphasic (more than 3 episodes) and only exceptionally monophasic (1 episode). For the purposes of statistical analysis an episode was considered in terms of time between the beginning and ending of inpatient or inpatient-like treatment. The number of episodes and cycles were found to be independent from premorbid and sociodemographic variables. But a significant relation was found between number of episodes (and cycles) and (a) polarity of the affective symptomatology, (b) presence of psychotic productive symptoms, (c) polymorphous course, (d) age at onset, and (e) duration of activity of the illness. It can be said that schizoaffective disorders are recurrent whereby the frequency of relapses is higher in bipolar than in unipolar types.

Adult↗

PubMed1988

Long-term course of schizoaffective disorders. Part II: Length of cycles, episodes, and intervals.

Length of cycles, intervals, and episodes of 72 schizoaffective patients were investigated (duration of the follow-up means = 25.6 years, minimum 10, maximum 59 years). The average cycle length (time between beginning of an episode and next relapse) was found to be 37.5 months (median). Patients with a schizodepressive initial episode, unipolar course, and without precipitating factors relapsed much later than patients with schizomanic onset, bipolar course, and precipitating factors. The older the patient at onset the shorter the first cycle. The length of cycle decreased with increasing cycle number. Patients with schizodepressive onset, asthenic personality, and monomorphous course stayed in hospital longer or needed longer inpatient-like treatment than others. Length of cycles and intervals were characterized by an extraordinary intraindividual and interindividual variation.

Adult↗

PubMed1988

Long-term course of schizoaffective disorders. Part III: Onset, type of episodes and syndrome shift, precipitating factors, suicidality, seasonality, inactivity of illness, and outcome.

In addition to the findings presented previously, one-half of the 72 investigated schizoaffective patients had an acute onset. Onset of manic symptomatology was found to be usually acute. Although precipitating factors were found in 76% of the patients, this was found for only one-third of the 397 episodes. In spite of the fact that the majority of patients (61%) had a polymorphous course (with more than one type of episode), the pure schizophrenic or pure affective syndromes only seldomly dominated the course, as schizoaffectivity score and syndrome-presence index showed. Some 81% of the patients had delusions or hallucinations but only 37% of the individual episodes; 65% of the patients had suicidal symptomatology (24% of the episodes, mainly the schizodepressive ones). No seasonality was found, and 50% of the patients had a favorable outcome, only 6% ended in severe residuum. In old age the illness usually became inactive.

Adult↗

PubMed1988

Syndrome shift in the long-term course of schizoaffective disorders.

Seventy-two patients diagnosed as having schizoaffective disorders (Cologne study) were investigated with regard to syndrome shift. During long-term follow-up (mean 25.6 years) they had 400 episodes (the duration of an episode being defined as the time between the beginning and end of inpatient or inpatient-like treatment). A total of 61% of the patients had a polymorphous course, i.e. displayed more than one type of episode. The first syndrome shift was found in the early stages of the course (in 61% of the cases as early as the second episode, in 84% at latest by the third episode). Using diagnostic criteria considering the longitudinal approach, 88% of schizoaffective disorders could be definitively diagnosed as such at the latest by the second episode. The only difference in the course between polymorphous and monomorphous (with only one type of episode) schizoaffective disorders was that the former relapsed more frequently. On the basis of the findings of the present study we suggest a longitudinally based dichotomy of schizoaffective disorders into bipolar and unipolar.

Adult↗

PubMed1988

Psychopathology of K. Schneider's mania.

An investigation of 107 patients diagnosed as having mania, according to the criteria of K. Schneider, showed that this mania is a syndrome of affective, psychomotor, behavioral and formal thought disturbances, while productive psychotic symptoms are rare. Four psychopathological subgroups were defined: (1) mixed mania, (2) irritable mania, (3) megalomania, and (4) flight-of-ideas mania.

Bipolar Disorder↗

PubMed1988

Nonpsychopathological features of K. Schneider's mania.

The nonpsychopathological features of 107 patients diagnosed as having mania were compared to those of 1,208 patients with the diagnosis of schizophrenia. Both diagnoses were made according to K. Schneider's criteria. Significant differences were found between the two groups in regard to the age of onset, marital status and educational and occupational levels. Manic patients tended to become ill more as age advances than schizophrenics, and exhibited better educational and occupational levels. The premorbid adjustment level of manic patients was found to be higher than that of schizophrenics.

Adult↗

PubMed1988

Delusional parasitosis. A comparative study to late-onset schizophrenia and organic mental disorders due to cerebral arteriosclerosis.

Delusional parasitosis (DP) was found in about 7 of 10,000 psychiatric admissions. The comparison of patients suffering from DP (n = 20) with 170 cases of late-onset schizophrenia (LOS) and 120 patients diagnosed as organic mental disorder due to cerebral arteriosclerosis (CAS) showed more similarities of DP with organic than with schizophrenic disorders. In addition, the phenomenological analysis supports the classification of the majority of DP cases as organic mental disorders. Even careful analysis cannot always answer the question, whether the main symptoms of DP have to be classified as delusions, hallucinations or misidentifications.

Aged↗

PubMed1987

Kurt Schneider's schizophrenia--the picture of schizophrenia in a Schneider-oriented university clinic.

Even in a Schneider-oriented university clinic, the majority of the diagnoses "schizophrenia" are based on non-first-rank symptoms. About one-fifth of the cases diagnosed as having schizophrenia showed nonproductive symptoms such as disturbances of thought, of affect and of behavior. But the nonproductive forms showed a relatively high density of symptoms. Two-thirds of the patients are women, one-third men. Schizophrenia is most frequently diagnosed in the third decade of life. Single people with a low education are more commonly represented. But all this is not valid any longer if we separate schizoaffective psychoses and other atypical psychoses from "pure" schizophrenia.

Adolescent↗

PubMed1984

Schizophrenia suspecta.

We investigated what makes a Schneider-oriented psychiatrist diagnose "suspected schizophrenia" yet nevertheless stop short of a definitive diagnosis of schizophrenia. We compared the case records of 1208 patients hospitalised for schizophrenia for the first time in their life and all patients with discharge diagnosis "suspected schizophrenia" (n = 358). We found that the main factors for making the diagnosis of "suspected schizophrenia" are, as when using Bleuler's concept, intrasymptomatological ones, i.e. type, structure and constellation of symptoms. Hereby the non-committal character of the "expression symptoms in the wider sense" (Schneider), i.e. disorders of thought, of affect and behaviour, is of particular importance. Psychotic productive symptoms in the form of delusions or hallucinations alone are not always sufficient to confirm the diagnosis of schizophrenia. Even first rank symptoms cannot establish the diagnosis schizophrenia if certain factors reducing their pathognomonic value are present.

Delusions↗

PubMed1984

The psychopathology of 'late schizophrenia'.

We investigated the clinical features of schizophrenic syndromes first manifested after the age of 50. By comparison with the schizophrenic syndromes first manifested before the 50th year of life we found: late schizophrenia is characterized by rich psychotic productive syndromes (delusions and hallucinations); disturbances of thought are rare; depression, euphoria and anxiety show no difference between the two groups; females are much more represented than males; social isolation is not more common in late schizophrenia than in non-late schizophrenia.

Age Factors↗