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Biomedical subjects

B Dahme

Publications and source records attributed to B Dahme.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Do asthmatic patients have deficits in symptom perception? Quasi-experimental and experimental findings on introception of airway obstruction].

Symptom perception of asthmatic patients was investigated in a quasi-experimental and in two experimental studies. Simultaneous ratings and measurements of airways obstruction assessed during an inhalative provocation test were correlated in the first study, in the two latter studies psychophysical parameters of the perception of external flow-resistive loads were determined for asthmatic patients and normal controls. These are the main results: 1. Most of the asthmatic patients are rather poor in discriminating provoked airways obstructions which results in a negative coping with the illness. 2. Asthmatic patients are slightly poorer in discriminating flow-resistive loads than healthy controls. 3. A distinct tendency of asthmatic patients to dissimulation found in the first study could not be confirmed in the two experiments.

Adult↗
PubMed1990

[Central nervous system risk factors in heart surgery].

Serious complications involving the central nervous system in the course of cardiac surgical procedures have become rare. Nevertheless, CNS dysfunctions still are observed in a considerable number of patients, exceeding by far the number of those at risk from preoperative neurological hazards. The influence of extracorporeal circulation performance and hypothermia on the physiology of cerebral autoregulation, as well as microembolization events seem to be crucial factors in this context. The resulting regional or global posthypoxic changes in brain metabolism may lead to the manifestation of various neurologic and psychiatric disorders in the postoperative course. These often minor disturbances of CNS function can only be detected regularly and diagnosed correctly in a prospective way by consulting specialists in neurology, psychiatry and psychology, as performed at the Department of Thoracic- and Cardiovascular Surgery of the University Hospital in Hamburg since 1974, and currently in use an international multicenter study. We found postoperative neurological abnormalities in more than 50% of our patients. While irreversible brain damage occurred in only 0.5% of cases, about twothird exhibited transient symptoms that were no longer apparent after 8-10 days postoperatively. Obvious psychopathological symptoms were noted in 10% of cases after surgery, and minor, likewise transient, psychiatric disturbances were seen in up to 50% of patients; 20% suffered from long-lasting psychic problems. The subjective complaints in these cases exceeded the results of objective assessments to a remarkable amount. The discussion focuses on a critical valuation of clinical and supplementary examination techniques and on the potential pathophysiologic mechanisms induced by extracorporal circulation.

Brain Damage, Chronic↗
PubMed1990

[Psychophysiologic microperspective in the psychotherapy process--a sequential approach of investigation].

To Investigate the interpersonal psychophysiology in the psychotherapeutic process a sequential approach using single case analysis is presented. During 18 psychoanalytic-psychosomatic initial interviews simultaneous recordings of heart periods (IBI) and arrhythmia scores (from ecg) and the psychotherapeutic dialogue were made from 10 patients with cardiac neurosis and their interviewers. The general finding is that therapists were able to forecast those segments better, in which their own physiological activity was involved than the segments of their patients. Consideration is given to the consequences which should be drawn from these results for psychophysiological psychotherapy research.

Adult↗
PubMed1990

[Diagnosis and prevalence of latent hepatic encephalopathy].

To compare the efficacy of various psychometric and neurophysiological tests in the detection of latent hepatic encephalopathy (LHE) cerebral functions were studied in 146 patients with liver cirrhosis but without overt encephalopathy and in 146 matched controls. Patients with liver cirrhosis scored significantly worse than controls in 8 out of 11 tests. Best discrimination between patients with cirrhosis and controls was obtained by testing for reaction time to white and colored light with a reaction time apparatus (DTG), and with the digit symbol (UT1) and block design test (UT4), i.e. with two Wechsler adult intelligence scale performance tests. Thirtyseven out of 146 (25%) patients with cirrhosis reveiled an abnormal result with the DTG alone. A combination of the DTG, UT1 and UT4 yielded the diagnosis in 44 (30%) patients. LHE correlated with the severity of the disease (Child-Pugh classification) but not with its etiology or with portasystemic shunting. In the Federal Republic of Germany about 300,000 subjects suffer from liver cirrhosis. Based on our results 100,000 of them may have LHE.

Adult↗
PubMed1985

[The Hamburg Rating Scale for psychiatric disorders following heart operations (HRPD)].

A brief psychiatric inventory has been developed from the AMP/AMDP system for the assessment and classification of psychic disturbances after open heart surgery in a random sample of 99 patients operated upon. By means of item analysis in accordance with classic test theory, a list of 36 symptoms (items) was selected. Factor analysis of this brief inventory resulted in eight factors: disorientation, impaired concentration and thinking, paranoid-hallucinatory symptoms, anxiety, sullen inadequacy (restraint depression), hostility, loss of control, giving up. By cluster analysis the sample was divided into six subgroups: "unnoticeable", "rather unnoticeable", "slight psycho-organic symptoms with affective-emotional disturbances", "severe psycho-organic symptoms with loss of control", "hostility with paranoid and hallucinatory and psycho-organic symptoms", "delirious symptoms". Some results agree well with the descriptions of syndromes given by other AMP/AMDP reports. Other divergent results probably reflect the particular situation of the patients after open heart surgery.

Adult↗
PubMed1981

[Medical psychological practice (author's transl)].

Based on the qualification regulations for medical practitioners, in most medical specialties and faculties, organizations for training in medical psychology were set up. For some years these organizations also participate increasingly with psychosocial services in the treatment of patients. Just as varied as the duties undertaken the methods applied are most strongly stamped by psychoanalysis and behavior therapy. Some prerequisites for cooperation of doctors and nurses of the "classical" medical disciplines and the medicopsychological and psychosomatic organisations are discussed.

Behavior Therapy↗
PubMed1981

[Phenomenology and psychodynamics of patients with so-called "hard" and "soft" methods of suicide. A comparison].

88 patients with "soft" and "hard" methods of suicide attempts are compared and described. The results show several differences between both groups of patients: (1) In the choice of a "soft" method painlessness played a superior role. Patients who had chosen a "hard" method were far less sensitive to pain, or the experience of pain had extensively faded. (2) Men with "hard" methods seemed to be more needy than men with "soft" methods. (3) Men and women of the "hard" group (preponderantly wrist cutters) showed a stronger and earlier beginning of conflict denial than patients of the "soft" group. Therefore, immediate crisis intervention seems to be especially indicated. (4) Attention should be drawn to the countertransfferance reactions of helpers in contact with patients who had employed different methods of suicide attempts.

Countertransference↗
PubMed1979

Open-heart surgery: somatic predictors of postoperative psychopathology.

This study reports on some relationships between somatic conditions and postoperative psychopathological disturbances in 102 subjects from 20 to 65 years of age, undergoing open heart surgery. The overall incidence of postoperative psychiatric complications was 40%. Only two variables showed a significant correlation with the psychiatric criteria we used, independent of the different diagnoses: body weight and preoperative urea-N levels in serum. Some of the somatic predictors reported in the literature could be found to be specific for mitral or aortic valve disease. Predictors for psychiatric complications in patients with aortic valve replacement were: age, preoperative protein and urea-N levels in serum, and daytime sedation. The predictor in mitral valve replacement was the decrease in venous oxygenation (pulmonary artery) under physical strain.

Adult↗
PubMed1979

Open-heart surgery from the psychological point of view and resulting therapeutic considerations.

A total of 168 patients underwent thorough psychological investigation before and after open-heart surgery. The pre-operative psychological status and the psychosocial situation of the patients were studied by means of questionnaires and semi-standardized interviews. The post-operative psychic status was documented daily on the first four post-operative days and once after discharge from the intensive care unit, by means of a slightly modified version of the AMP rating scale. We found significant correlations between psychosocial problems, the patients' ability to cope with their illness, the surgical stress and the environmental stress of the intense care unit, and post-operative psychic disturbances. The results lead to deliberations on therapeutic consequences.

Cardiac Surgical Procedures↗
PubMed1979

[Problems in the classification of psychopathological disorders following cardiac surgery with extracorporeal circulation].

Classifications of postoperative psychopathological disorders after heart surgery according to the literature are very different as the results are dependent upon the accuracy of the observation. The accuracy and choice of classification are important as the base for identifying causal factors. We studied 214 patients using three alternative methods of classification and discuss problems of classification of the postoperative psychopathological dysfunctions.

Cardiac Surgical Procedures↗
PubMed1979

[Phenomenology and psychodynamics of suicide patients in the awakening phase].

In the following paper is given a first survey of the phenomenology and psychosomatics of the period of awakening of patients having attempted suicide. The findings of the first period were compared to those elicited one or two days later with the same methods but under different somato-psychic circumsatnces. We found that soon after awakening patients gain some distance from events connected with their suicide. From this observation it is concluded that therapeutic intervention with these patients should begin right during the awakening period.

Adolescent↗