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Biomedical subjects

A Warnke

Publications and source records attributed to A Warnke.

At least 55 records · Page 3Linked to original sources
PubMed1999

[Current developments in the treatment of obsessive-compulsive disorders in children and adolescents].

For the treatment of obsessive-compulsive disorders during childhood and adolescence, multidimensional therapeutical approaches have proven useful in clinical practice. First controlled studies have demonstrated the efficacy of both psychotherapeutical and pharmacological strategies. Exposure and response prevention are considered the most efficient psychotherapeutical methods. On the basis of the available data, the question of the pharmacological dose can not be answered definitely. For Clomipramin, the dose most probably is between 75 mg and 150 mg, where as for Fluoxetine and Fluvoxamine 20 mg-60 mg and 100 mg-250 mg respectively. However, it has to be kept in mind that sometimes improvement of symptoms is not seen after 8-10 weeks of treatment. Basically it can be stated that to date there is an urgent need for therapeutical studies of obsessive-compulsive disorders in the childhood and adolescence. Most relevant would be studies evaluating pharmacological treatment versus a placebo control groups and carefully designed controlled psychotherapeutical treatment studies as well studies comparing pharmacological and psychotherapeutical approaches.

Adolescent↗
PubMed1999

The influence of different diagnostic approaches on familial aggregation of spelling disability.

The influence of different diagnostic approaches on familial aggregation of spelling disability was investigated in three studies. In the first study, in a sample of 32 dyslexic children and their families, we found significantly increased rates of spelling-disabled sibs and parents by applying the IQ-discrepancy criterion. There was no evidence for the assumption that IQ-discrepancy and low achievement criteria define different subgroups of spelling disorder regarding familial aggregation. In the second study, in a sample of 79 adults, it could be demonstrated that questionnaire data can be used as an appropriate method to classify adult probands as spelling disabled with a correct classification rate above 87%. In the third study, a subgroup of dyslexic boys could be characterized by a lack of the N1-component in visual evoked potentials which was most prominent in those boys whose spelling scores were more than 1.5 standard deviations below their intelligence level. This subgroup could be interesting also for genetic research.

Achievement↗
PubMed1998

Comparison of total and regional body composition in adolescent patients with anorexia nervosa and pair-matched controls.

Body composition in 31 adolescent girls suffering from anorexia nervosa (AN) was measured at the time of hospitalization in order to assess the muscle/bone relationship as a potential source of the development of osteopenia. Differences in lean tissue, fat and bone mass in total body, weight bearing and non weight bearing limbs were estimated in AN and pair-matched controls aged 14.2 +/- 1.8 years (range: 9-17 years). Further, it was investigated if bone mineral density (BMD) better reflects the muscle/bone relationship than bone mineral content (BMC). At the distal radius parameters measured by peripheral quantitative computed tomography (pQCT) were used to estimate the association of volumetric bone density to bone strength and lean body mass. The correspondence to the same and different body regions was assessed. Total lean mass in the controls was closely related to total body bone mineral content (TBBMC), as was lean tissue and bone mass of the limb subregions (r = 0.82 to 0.93). In contrast, the correlation was significantly lower in AN (r = 0.33 to 0.77). In the controls, the pQCT-derived bone strength was correlated with muscle mass of the forearm (r = 0.78, p < 0.001), but only moderately in AN (r = 0.47, n.s.). Regional lean tissue was 11-20% and fat mass was 56-66% lower in AN (p < 0.01). After adjustment for height, TBBMC was different at p = 0.01. Within the limbs subregions, BMC (but not BMD) was different in both groups only in the upper arm and the thigh. BMC reflected the bone/muscle relationship better than BMD. Intra- and between group regressions gave no significant differences between weight bearing and non weight bearing limbs. In conclusion, the assessment of musculoskeletal factors may be a useful tool to develop individual preventive measures for therapy after recovery of our patients.

Adolescent↗
PubMed1997

Leptin levels in patients with anorexia nervosa are reduced in the acute stage and elevated upon short-term weight restoration.

Circulating leptin concentrations are known to be low in acute anorexia nervosa (AN), which is characterized by low weight, amenorrhea and specific psychopathological features. In this study plasma leptin concentrations were determined during inpatient treatment of 23 adolescent females with AN using a sensitive radioimmunoassay (RIA) and set into relationship to leptin levels of females matched for age, body mass index (BMI; kg m-2) and/or percent body fat. At referral patients had leptin concentrations well below the female controls. Weight gains led to steep increases of leptin levels which peaked at values well in excess of those observed in controls matched for BMI. In patients who reached the final treatment stage and who were followed-up after discharge, levels subsequently fluctuated and finally dropped into or below the control range. The low leptin levels at referral are likely to be involved in the pathogenesis of amenorrhea and the reduced metabolic state of acutely ill patients. Peak leptin levels reached after weight gain are possibly the cause of increased energy expenditure during this stage of the disorder.

Adolescent↗
PubMed1997

[Follow-up and treatment outcome of early anorexia nervosa].

In a two-center follow-up study on the early-onset form of anorexia nervosa, we reexamined 43 (74%) of 58 former patients who had developed anorexia nervosa at the age of 13 years or younger. In addition to make a standardized assessment of the eating disorder at follow-up we assessed psychiatric comorbidity with a structured interview based on the criteria of DSM-III-R and ICD-10. After an average follow-up period of 6.8 years, 8 (18%) of our former patients had an eating disorder not otherwise specified (EDNOS) and 4 (9%) still suffered from anorexia nervosa. 5 (11%) of the subjects had developed bulimia nervosa. In 3 cases (7%) we found both syndromes. 12 (28%) of our former patients had an additional psychiatric disorder. The results of our study indicate that the quality of outcome in patients with an early-onset form of anorexia nervosa does not differ from that in individuals with a later manifestation of the eating disorder. Factors of prognostic relevance were the existence of an eating disorder during the first year of life and the duration of the follow-up period.

Adolescent↗
PubMed1997

[Open self-injury behavior with special reference to child and adolescent psychiatry. A review of the literature and first study findings].

The present investigation combines a review of the literature on self-mutilation and our own findings. The literature on this topic is extensive, but there are very few reports on self-mutilation in children and adolescents with a psychiatric diagnosis. In our study we explored the symptoms and psychopathological features of 64 children and adolescents with self-mutilative behavior who had been seen at an inpatient psychiatric facility. The topic is presented from a phenomenological and nosological point of view. We identified a subgroup of adolescents with both self-mutilative and suicidal behavior. The implications for the use of longitudinal studies are discussed.

Adolescent↗
PubMed1996

[Hyperkinetic syndrome and behavioral disorders in street traffic: a case control pilot study].

In the present pilot study we addressed the question of whether young people diagnosed with attention deficit hyperactivity disorder (ADHD) as children violate traffic regulations and are involved in traffic accidents more frequently than those in a control group without previous psychiatric disorders. The subjects in the ADHD group tended to be involved in traffic accidents more frequently than those in the control group. Furthermore, they had a significantly higher rate of involvement in traffic accidents before getting their driver's license. The two groups did not differ in the number of traffic violations, alcohol consumption or various attitudes related to driving. Split attention and reactive endurance were assessed with a computer-aided program. The ADHD group partly did significantly worse than the control group. Deficits on such performance measures and a lack of cognitive control in traffic may therefore be mediating factors for being accident-prone in traffic. Regardless of which group subjects were in initially, those reporting severe ADHD symptoms at the time of the study tended to be at an increased risk of causing traffic accidents and of being involved in more than one accident.

Accidents, Traffic↗
PubMed1995

[Credibility and further psychological problems of young children as witnesses in criminal justice procedures: a case study].

A pair of 3 1/2-year-old twins who had possibly witnessed their mother's murder were examined by a child psychiatrist and a child psychologist as part of a judicial inquiry. The procedure developed specially for this purpose, the actual course of the investigation and the evaluation of the findings with regard to psychological aspects of evidence are discussed. The theoretical part of the study deals with the current state of knowledge and the problems relating to evidence given by young children as witnesses. The main emphasis is on general and specific credibility, identification of people associated with the crime, suggestibility and probabilities related to guessing, perceptual and memory performance, and minimization of emotional sequelae in children who are witnesses to violent crimes. The authors conclude that preschool children can be reliable witnesses in preliminary hearings and court proceedings.

Adult↗
PubMed1995

[Self-assessment of prescribing behavior of psychotropic drugs for children and adolescence. Results of a survey of established physicians].

All registered general practitioners, pediatricians, and neuropsychiatrists of lower franconia were asked to fill out a questionnaire regarding the ratio of 0-20 year old patients with psychiatric symptoms and their prescribing methods of psychopharmaca. Neuropsychiatrists treated less children and adolescents with psychiatric symptoms than pediatricians or general practitioners. Approximately 50% of the patients with psychiatric symptoms received psychopharmaca. The most frequently prescribed psychopharmaca were neuroleptics and antidepressants, followed by phytopharmaca with various ingredients, which were most frequently prescribed by general practitioners. The average duration of a psychopharmacotherapy was 9 weeks. A great deal of uncertainty regarding the prescription of psychopharmaca to children and adolescents has become evident. Despite the fact that an enuresis can not be diagnosed before the end of the 5th year, it was one of the most frequently treated symptom of the 2-5 year old children. On the other hand, approximately one third of all physicians principally do not treat children and adolescents with psychopharmaca.

Adolescent↗