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Biomedical subjects

A Marneros

Publications and source records attributed to A Marneros.

At least 55 records · Page 3Linked to original sources
PubMed1993

[The quality of life after the implantation of a cardioverter/defibrillator in malignant arrhythmias].

Quality of life after implantation of an automatic implantable cardioverter/defibrillator (ICD) was assessed by questionnaire in 43 patients (38 males, 5 females; mean age 57 +/- 16 years) with treatment-resistant symptomatic ventricular arrhythmias. 37 of the 43 patients felt better after ICD implantation. 23 were always conscious of having an ICD, but 18 had got used to it in less than 2 months. 15 patients reported being afraid of an ICD shock, while eight noted physical discomfort caused by the ICD. Limitations concerning their professional, recreational and social activities were reported by six patients. 41 of the 43 patients confirmed that the ICD had been helpful, enabling 23 to return to an active life. 42 would recommend implantation to others if indicated. These data demonstrate that there is a remarkably high degree of acceptance of the ICD. Survival rate after implantation is thus not the only criterion of success. All aspects of the quality of life should be taken into consideration before implantation is decided upon.

Adult↗
PubMed1993

Subtypes in schizophrenic disorders: frequencies in long-term course and premorbid features.

The subclassification of schizophrenic disorders according to four diagnostic systems (DSM-III-R, ICD-10, the positive vs. negative dichotomy and Schneider's first rank symptoms) was compared over the long-term course of the disease in 148 narrowly defined schizophrenic patients. A total of 595 episodes were classified over a mean observation period of 23 years (range 10-50 years). Initially, paranoid/positive subtypes predominated, while later in the course episodes fulfilling the symptomatological criteria of residual/negative subtypes became more frequent. Disorganised/hebephrenic and catatonic subtypes were found to be rare. Some premorbid features were investigated as non-symptomatological validators for subclassification. Significant differences were found with regard to age at onset. Patients whose first episode was paranoid or positive had the highest age at onset. Patients with initial disorganised/hebephrenic or "residual" episodes had the most unfavourable premorbid social adjustment, even when the influence of age at onset was discounted. The diagnostic systems investigated showed similarities and differences as a result of the underlying concepts. Methodological implications are discussed.

Adult↗
PubMed1993

Long-term stability of subtypes in schizophrenic disorders: a comparison of four diagnostic systems.

The long-term stability of subtypes of schizophrenic disorders in 148 narrowly defined schizophrenic patients according to four diagnostic systems was compared. The patients were investigated longitudinally for 23 years on average (range 10-50 years). Patients who experienced only one episode and those who were permanently hospitalised were excluded on methodological grounds. Of the remaining 100 patients, a total of 461 episodes were classified into various subtypes according to the criteria of DSM-III-R, ICD-10, the positive/negative dichotomy, and Schneider's first-rank symptoms. It was found that long-term stability of subtype in schizophrenic disorder was not the rule but the exception. The frequency of stable course was found to be depend on the type of the initial episode. In most cases a subtype change occurred within the first few years of the illness with no clear direction. In later stages of the illness the relative frequency of episodes predominated by negative symptomatology increased. The findings were similar for DSM-III-R, ICD-10 and positive/negative dichotomy. Only in patients beginning without first-rank symptoms were more stable than non-stable courses found. The results of this study do not support the assumption that stable subtypes are nosological or etiopathogenetic subentities of schizophrenic disorders.

Adolescent↗
PubMed1993

Treatment of catatonic stupor with oral lorazepam in 14-year-old psychotic boy.

The case history of a 14-year-old psychotic boy with catatonic stupor who responded dramatically to 2 mg lorazepam is presented. He had been psychotic for over four weeks and had developed mutism, rigidity, negativism, and posturing (but without fever and without changes in blood and serum parameters) despite neuroleptic therapy, but recovered dramatically from stupor within 40 min. after oral administration of lorazepam.

Adolescent↗
PubMed1993

[Psychoses in puerperium: symptoms, course and long-term prognosis].

86 women who suffered from a psychotic disorder for the first time in their life within 6 weeks after parturition, were investigated regarding sociodemographic and gynaecological parameters, time of onset and initial symptomatology, psychopathological symptoms during hospitalisation, treatment and short-term outcome of the illness. The majority of patients became ill after the first (75%), full-term normal (63%) delivery and within the first two postpartum weeks (78%). The most frequent initial symptoms were anxiety, restlessness, depressive mood, sleep disturbances, behaviour disturbances, catatonic excitement, delusions and hallucinations. By the time of follow-up investigation, 16 women had died; 61 women were investigated on average 25.6 years after onset (minimum 12, maximum 41 years), using standardised instruments of evaluation. Nearly two-thirds of the patients had suffered re-manifestation of psychotic disorder during a long-term course (64%). The frequency of re-manifestations of illness after additional pregnancies and deliveries was found to be 1:4, which is also known to be the expected frequency during the course of other psychotic disorders. These results do not justify the global recommendation to avoid additional pregnancies or carry out an interruption of pregnancy, if the patient has a history of postpartum psychosis. The climacteric period also seems to be a vulnerable phase for the re-manifestation of illness. Nearly 3/4 of the investigated women displayed no disturbances in any of the evaluated dimensions (psychopathological, psychological, psychosocial status) at the time of follow-up.

Adult↗
PubMed1993

Patient acceptance of the implantable cardioverter defibrillator in ventricular tachyarrhythmias.

Besides surgical problems, recipients of implantable cardioverter defibrillators (ICDs) are faced with psychological and social adjustments. Successful ICD therapy is influenced by the patients' perceived concerns regarding device, discharge, changes in life style, and complications. In order to assess patients' acceptance of the ICD, the psychological profile of 57 consecutive patients was evaluated using a specifically designed questionnaire and the State Trait Anxiety Inventory (STAI). The results showed that 20 patients stated fear of ICD discharge, 12 patients revealed physical discomfort due to the device, and limited quality-of-life occurred in 8 patients. Fifty-five of 57 patients answered that it was worth having an ICD device implanted, 30 (53%) patients returned to active life, and 56 (98%) would advise another patient to undergo implantation if necessary. Overall, there was only a slight, but insignificant, decrease in the level of anxiety within the total patient population after ICD implantation. However, a comparison of two subgroups indicated that the state of anxiety was significantly higher in patients < 50 years of age as well as in patients having received > 5 shocks versus those > 50 years of age and having experienced < 5 shocks. In general, the acceptance of the ICD as a tool in managing life-threatening ventricular tachyarrhythmias is high. Besides the increased survival rate, quality-of-life and patient acceptance are important criteria for successful ICD therapy.

Activities of Daily Living↗
PubMed1993

Predicting the long-term outcome of affective disorders.

Factors influencing the long-term outcome of affective disorders were investigated in 106 patients with an average length of course of 28 years. Univariate statistical analyses, stepwise multiple discriminance analyses and path analysis were applied. A direct unfavourable influence on the frequency of persisting alteration (evaluated according to the Global Assessment Scale) was found to have the low self-confident premorbid personality and a higher number of episodes during course, whereas only the variable "male" had such an influence on the social consequences of the illness. The variable "manic episode" (bipolarity) and "age at onset" had only an indirect influence, in that bipolar patients had more episodes, and younger patients more frequently had a bipolar course and therefore had more episodes. The unfavourable long-term outcome was due in those cases to the higher number of episodes.

Achievement↗
PubMed1993

Postpartum psychoses: onset and long-term course.

86 cases of narrowly defined postpartum psychosis were investigated with regard to onset and course of symptomatology. The most frequent initial symptoms were restlessness, paranoid symptoms, catatonic excitement, anxiety, sleep disturbances and depressed mood. 16 patients had died at the time of follow-up. Concerning the further course of the disease 64% of the 61 women who were followed up (average 26 years from onset), had recurrences of illness. The most frequent longitudinal diagnosis, in 49% of the 61 cases, was 'schizoaffective disorder'; only 28% of patients were diagnosed as having schizophrenic disorders at follow-up.

Adolescent↗
PubMed1993

Factors influencing the long-term outcome of schizoaffective disorders.

Factors influencing the long-term outcome of schizoaffective disorders were investigated in 101 patients with a mean duration of illness of 25.5 years. Univariate statistical analyses and stepwise multiple discriminance analyses were applied. The most important factors influencing the development of persisting psychosocial alterations proved to be the absence of pure melancholic episodes during course and life events at onset, and the presence of first rank schizophrenic symptoms, schizomanic-depressive mixed episodes, higher number of episodes and higher annual frequency of episodes. The most relevant factors influencing the development of negative social consequences due to the illness were found to be an asthenic/low self-confident premorbid personality and the higher number of episodes and cycles. There are only partial similarities with schizophrenic or affective disorders.

Adult↗
PubMed1993

Chronic palinopsia in schizophrenia.

Palinopsia seems to be a very rare phenomenon in functional psychotic disorders. In this paper, we report on a patient with chronic schizophrenia who displayed chronic persisting palinopsia embedded in a plethora of rare mental phenomena. The possible theoretical relevance of this observation is discussed.

Adult↗
PubMed1993

[Prognosis of puerperal psychoses: follow-up and outcome after an average of 26 years].

61 women, who became ill for the first time in their life within 6 weeks after childbirth were investigated after a mean of 25.6 years (minimum 12, maximum 41 years), using various standardised instruments of evaluation. A total of 39 Patient (63.9%) had had a recurrence of illness, the average number of further episodes being 4.8. 31 of the women had had additional pregnancies and deliveries, and 8 of these (25.8%) had suffered another postpartum psychosis. 23.5% of the patients who had reached or passed the climacteric became ill again in close connection with that time (first time after the postpartum psychosis or first time after a relapse-free interval of more than 12 years). 72.1% of the patients were symptom-free at the time of follow-up, only 17 (27.9%) showed persisting alterations (13.1% "adynamic-deficient syndrome", 9.8% "slight asthenic insufficiency syndrome", 4.9% "chronic subdepressive syndrome"). Considering also the findings according to the Global Assessment Scale (GAS) and Disability Assessment Schedule (WHO/DAS) the long-term outcome was found to be favourable in the majority of cases, with regard to the frequency and intensity of disability and persisting alterations.

Adolescent↗
PubMed1992

Schizoaffective disorders with and without onset in the puerperium.

The premorbid and sociodemographic features, long-term course and long-term outcome (on average 23.8 resp. 26.8 years after onset of illness) were compared in 30 female schizoaffective patients with onset of their illness during the puerperium and 60 female schizoaffective patients with onset at other times. The majority of premorbid and sociodemographic variables as well as course parameters were similar in the two groups. Most of the few differences (in age at first manifestation, marital state at onset, presence of stable heterosexual relationship before onset, acuteness of onset, presence of life events) are closely connected with the inclusion and exclusion criteria applied for the puerperal disorders (exclusion of patients with preexisting illness or psychiatric symptoms during pregnancy, inclusion only if onset was within 6 weeks of parturition). The puerperal schizoaffective disorders began more frequently with a schizomanic episode and less frequently with a schizodepressive episode than did the non-puerperal schizoaffective disorders, a finding which perhaps reflected the "pathoplastic" role of the puerperium on psychotic disorders. Several significant differences were found regarding the long-term outcome (frequency of persistent alterations, level of global functioning and disability, non-achievement of the expected social development, loss of autarky), confirming earlier findings that puerperal disorders generally have a better outcome than other psychotic disorders.

Adolescent↗
PubMed1992

Validity of the negative/positive dichotomy for schizophrenic disorders under long-term conditions.

A total of 148 patients fulfilling the DSM-III symptomatological criteria of schizophrenia were classified according to Andreasen's criteria of positive, negative and mixed symptomatology. After excluding cases of permanent hospitalisation and patients with monoepisodic course the remaining 100 patients had a total of 458 episodes. Of these episodes, 213 were identified as positive, 134 as negative and 111 as mixed. During the course of illness the proportion of negative episodes increased and the proportion of positive episodes decreased. The great majority of the patients (76%) had a bimorphous course, i.e. one showing both types of schizophrenic symptomatology, positive and negative. Only 6% of the patients had only negative episodes, and only 18% had only positive episodes. The shift from one type of episode to another is dependent on the length of illness. Stability was not greater later during the course of illness than at the beginning.

Adult↗
PubMed1992

[Sex-dependent differences in endogenous psychoses. A comparison between schizophrenic, schizoaffective and affective psychoses].

Sex differences in 355 patients with functional psychoses were investigated longitudinally (mean observation time more than 25 years). Using narrow criteria, 148 patients were diagnosed as having a schizophrenic disorder, 101 as having a schizoaffective and 106 as having an affective disorder. Similarities and differences between male and female patients in these three diagnostic groups were investigated and compared on four levels (premorbid and sociodemographic features, elements of course, symptomatology and the different aspects of outcome) using international standardised instruments of evaluation. A different sex distribution in the three groups was found. Female schizophrenic patients showed a better premorbid social adjustment and a better long-term psychopathological and social outcome than male patients. Differences between male and female schizoaffective patients were found only regarding premorbid personality and polarity, but not regarding symptomatology and outcome. In affective psychoses female patients showed a better social outcome than male patients, but no relevant differences regarding premorbid adjustment were found. Gender differences were found as an important variable for research in functional psychoses, but interactions with other variables have to be considered.

Activities of Daily Living↗
PubMed1992

[Incidence and type of premenstrual symptoms in relation to experienced infertility: a comparative study].

Using the symptomatological criteria of "Late Luteal Dysphoric Disorder" according to DSM-III-R, the frequency and type of premenstrual symptoms were investigated in a group of 405 infertile women (participants in an in-vitro-fertilisation programme at the University of Bonn) and a control group of 101 female medical students. 84% of both groups of women reported premenstrual psychological and/or physical changes. 52% of the infertile patients and 42% of the students fulfilled the symptomatological criteria of late luteal dysphoric disorder. Comparing both groups, it was found, that infertile women reported significantly more often mood lability, anger/irritability, anxiety/tension and loss of interest.

Adult↗
PubMed1992

[Positive and negative symptoms of schizophrenia].

Aim of the present study is to draw conclusions from published research regarding the positive-negative schizophrenia concept, and to try to present the opinion of supporters and critics of the concept in a balanced way. The historical background of the concept, from Reynolds and Jackson during the last century until today, is reviewed. After giving the definitions and presenting various instruments of evaluation, the question is discussed, how stable "negative" und "positive" psychopathological constellations are. Consideration of the results of research on the long-term time course of schizophrenia, as well as in genetics, biology und psychopharmacology, leads one to conclude, on the one hand that the positive-negative concept is relevant for clinical practice and research, but on the other hand that many of the present studies were not able to confirm a clear cut positive-negative dichotomy.

Delusions↗
PubMed1991

Stability of diagnoses in affective, schizoaffective and schizophrenic disorders. Cross-sectional versus longitudinal diagnosis.

The present study investigated the syndrome shift during the course of disease in 355 patients with functional psychoses. The mean observation time was 25.2 years. Every episode was diagnosed cross-sectionally as schizophrenic, melancholic, manic, manic-depressive mixed, schizodepressive, schizomanic or schizomanic-depressive mixed. With regard to the whole course, 148 patients fulfilled the diagnostic criteria of schizophrenic, 106 of affective and 101 of schizoaffective disorders. Patients with a schizophrenic initial episode showed the greatest stability: 90% had no other type of episode. The majority of patients who suffered a melancholic initial episode remained unipolar melancholics or developed manic symptomatology, and only a few suffered schizoaffective or schizophrenic episodes. Patients with a manic symptomatology at the beginning had a very unstable and changeable course. The stability of patients with initial schizodepressive episodes lay between that of patients with melancholic initial episodes and that of those with manic initial episodes. The findings demonstrate the relevance of longitudinal considerations in making the final diagnosis.

Bipolar Disorder↗