Biomedical subjects

A Rohde

Publications and source records attributed to A Rohde.

At least 55 records · Page 3Linked to original sources

PubMed1989

Long-term outcome of schizoaffective and schizophrenic disorders: a comparative study. II. Causal-analytical investigations.

The influence of symptomatological and non-symptomatological factors on the long-term outcome of schizoaffective and schizophrenic disorders was investigated using the Analysis of Linear Structural Relationships (LISREL). The outcome was assessed employing the GAS, WHO/DAS, PIRS and the Bonn Criteria of Outcome. The analysis produced some interesting results in both groups, separately and in comparison with each other. The most striking difference between the two disorders concerns the finding that only symptomatological parameters directly influence the long-term outcome of schizoaffective disorders - melancholic episodes are correlated with favourable outcome, symptoms typical of schizophrenia with a relatively unfavourable outcome. Both symptomatological parameters (such as schizophrenic first-rank symptoms during course) and non-symptomatological parameters (such as life events or acuteness of onset) have a direct impact on the outcome. It was also found that "simple" depressive symptomatology (the presence of depressive symptoms not fulfilling the criteria of melancholic episodes according to DSM-III-R) has no influence on the long-term outcome of schizophrenia.

Adult↗

PubMed1989

Long-term outcome of schizoaffective and schizophrenic disorders: a comparative study. III. Social consequences.

A significantly higher proportion of schizophrenic than schizoaffective patients were found to experience negative social consequences of their illness. Schizophrenic males are more likely to have an unfavourable social prognosis than are schizophrenic females or schizoaffective patients of either gender. Schizophrenic males are, however, equally disadvantaged in regard to social consequences independently of other premorbid and sociodemographic factors. Unfavourable social consequences in male schizophrenics and favourable ones in female schizoaffectives can be predicted with high probability. Some social consequences can be predicted with relatively high probability for male schizoaffectives, while no prognosis can be made for female schizophrenics.

Achievement↗

PubMed1989

Unipolar and bipolar schizoaffective disorders: a comparative study. I. Premorbid and sociodemographic features.

Seventy-two schizoaffective patients were investigated longitudinally (mean follow-up period 25.6 years). Unipolar (n = 37) and bipolar (n = 35) schizoaffectives were compared. Relevant differences in sociodemographic variables were found between the two groups, especially in: (a) sex distribution (more females among unipolar schizoaffectives), (b) social class, (c) occupational and educational level (higher in bipolars), and (d) premorbid personality (obsessoid and low-self-confidence personality types were more frequent in unipolars). Surprisingly there was no difference in age of onset, but some factors were identified that elevated the age of onset in bipolar and reduced it in unipolar schizoaffectives, which may explain this finding. Among bipolars there were more frequent relapses, but there was more suicidal symptomatology in unipolars. No differences were found with regard to long-term outcome, i.e. disability (Disability Assessment Schedule), level of functioning (Global Assessment Scale) or psychopathology at follow up.

Adult↗

PubMed1989

Unipolar and bipolar schizoaffective disorders: a comparative study. II. Long-term course.

Seventy-two schizoaffective patients were investigated longitudinally (mean follow-up period 25.6 years). Of these, 37 were classified as unipolar and 35 as bipolar schizoaffectives. Their long-term courses were compared. Bipolar schizoaffectives were found to have shorter cycles, i.e. more frequent relapses and more episodes. Bipolars displayed much more variation in symptomatology. Unipolar schizo-affectives had longer periods of remission (that is the last relapse-free period if longer than 3 years) and more frequently showed suicidal symptomatology than did bipolar schizoaffectives. Altogether bipolar schizoaffective disorders had a more unfavourable course than unipolar disorders.

Adaptation, Psychological↗

PubMed1989

Unipolar and bipolar schizoaffective disorders: a comparative study. III. Long-term outcome.

Seventy-two schizoaffective patients were investigated longitudinally (mean follow-up period 25.6 years). Long-term outcome of unipolar (N = 37) and bipolar (N = 35) schizoaffectives was compared. Different aspects of outcome were investigated separately using standardized instruments of evaluation. No differences were found between unipolar and bipolar schizoaffective patients with regard to global functioning (GAS), disability (WHO/DAS) or psychopathological symptomatology at follow-up. There were also no differences in social consequences of the illness, i.e. downward occupational and downward social drift, premature retirement and achievement of the expected social development.

Adult↗

PubMed1989

[Premorbid and social markers of patients with schizoaffective psychoses].

The present study reports on findings in international literature regarding premorbid and social factors of schizoaffective patients and also own findings of the Cologne study (72 schizoaffective patients with a mean follow-up period of 25.6 years). Altogether it can be said that more women suffer from schizoaffective disorders than men. The mean age at first manifestation is higher than that of schizophrenic patients and lower than that of affective disorders, although schizoaffective disorders can occur at any age. Premorbid social adjustment and ability to form a stable heterosexual partnership before onset are good in schizoaffective patients. There seems to be no special premorbid personality of schizoaffective patients. Education and level of vocational training are generally good. Only a few schizoaffective patients belong to the lower social classes. Most schizoaffective patients do not come from a "broken home". Although "life events" are frequent in a schizoaffective population, the relevance of this finding has to be limited: If we evaluate "life events" in regard to single episodes, we find that most episodes, especially episodes occurring during the later course, do not have precipitating factors. In conclusion, it can be said that - besides the already known better prognosis of schizoaffective disorders - several differences exist regarding premorbid and social factors, between schizoaffective disorders and schizophrenia.

Adolescent↗

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↗

PubMed1988

[HMPAO-SPECT in cerebral seizures].

In nine patients with suspected psychogenic seizures and in three patients with proven epileptic seizures HMPAO-SPECT was performed prior to and during seizure. In the patients with later on-proven psychogenic seizures no, or only slight, changes of regional cerebral blood flow were found. Patients with proven epilepsy revealed partly normal findings interictally but during seizure a markedly increased circumscript blood flow was found in all patients. Even though PET is superior to SPECT with respect to spatial resolution, in the diagnosis of seizures HMPAO-SPECT has the advantage of enabling injection of the tracer during the seizure and the performance of the SPECT study subsequently.

Epilepsy↗

PubMed1987

[Infection-caused mental disorders. Are they still topical in the antibiotic era?].

Of 104 patients treated in a psychiatric hospital because of mental disturbances caused by an infection, almost one-half had been referred directly to the psychiatric hospital on account of their psychically abnormal behaviour. The infectious disease causing these disturbances was diagnosed only after their admission. In most of the cases the psychic abnormalities did not seem to be due to a physical cause, so that the somatic examination was frequently delayed. Pneumonic infections were most frequently seen, but there were also numerous other infections from all other disciplines of medicine. Clouding of consciousness developed rapidly in 84% of the patients during the course of inpatient treatment with an incidence that was almost fivefold that of the initial stage. Visual hallucinations (37%) were the most frequent productive-psychotic phenomenon. 45% of the patients presented with a delirious pattern and 4% with a psychosis resembling schizophrenia. In 35% of the patients treatment with psychotropic drugs proved necessary, whereas with the remaining 65% therapy remained antibiotic or generally somatic only. 18% of the patients died.

Anti-Bacterial Agents↗

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↗

PubMed1987

Psychopathology of organic mental disorders due to infections in the antibiotics era. Stability of syndromes and classification.

104 patients diagnosed as having an organic mental disorder due to infection were classified according to DSM III criteria. The vast majority of patients (76%) fulfilled the criteria of delirium, 6% that of organic hallucinosis, while others had to be classified as affective, personality or delusional syndrome. We found a great instability of syndromes causing classification problems. A classification rule is suggested, which we called 'compromise of clinical reality'.

Adult↗