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Biomedical subjects

C Cording

Publications and source records attributed to C Cording.

16 recordsLinked to original sources
PubMed2000

[What do general practitioners expect from a psychiatric clinic? Wish for closer cooperation].

OBJECTIVE: In the present study the views of family doctors on what constitutes "ideal" cooperation with a psychiatric hospital were investigated. METHOD: The views expressed by 24 family doctors and recorded in interviews were analyzed qualitatively with the aim of assessing their importance. RESULTS: Regular exchange of information between family doctor and psychiatrist, prompt receipt of the discharge report, a named contact person on admission and during hospitalization, competent psychiatric inpatient care, and the possibility of being able to directly refer patients were felt to be the most important points. Almost a half of all the views expressed related to intercommunication. CONCLUSION: Psychiatric hospitals should give more consideration to the views and wishes of family doctors as a means to resolving possible problems of interaction and to improving the care afforded mentally sick patients.

Family Practice↗
PubMed2000

[Collaboration of the general practitioner and the psychiatrist with the psychiatric hospital. A literature review].

Co-operation of physicians in private practice with psychiatric hospitals was investigated in Germany scarcely until now, although evaluation of consumer satisfaction is of great importance to quality assurance in psychiatry. In this paper, findings from previous studies are presented together with data from interviews with general practitioners and psychiatrists, evaluating their expectations regarding psychiatric hospitals. Substantial problem area in collaboration is referral to the psychiatric hospital. Apart from sociodemographic and disease-related variables, referral practice depends on referring physician's attitudes and competence in psychiatry, and provider influences like delay of admission, communication with referring physician, and competence of the hospital. As conclusion, constructive collaboration must be developed at the interface of outpatient and inpatient care. On account of increasing diversification of psychiatric services, functional network should be an ongoing goal to improve treatment continuity of patients with mental disorders.

Germany↗
PubMed1999

["Ideal" inpatient psychiatric treatment from the viewpoint of the patients].

PURPOSE: In this study "ideal" psychiatric inpatient care from the patient's point of view was examined. METHODS: Based upon a content analysis of 38 interviews a questionnaire containing 39 items was developed to evaluate attributes of ideal psychiatric inpatient care from the patient's viewpoint. 58 of 116 patients completed the questionnaire; the analysis group was representative for acute psychiatric inpatients. RESULTS: The patients ranked highly: successful treatment, upholding of human rights, privacy, empathic doctors, competent doctors, free exit, friendly staff. Factor analysis identified four factors that may be called Psychiatric Treatment, Patient Autonomy. Staff Competence, Appointment. The ratings were not associated with sociodemographic or disease-related variables. Therapists' ratings were mostly in agreement with those of the patients', but therapists underestimated the importance of the items free exit, patients' co-influence in treatment planning, respect among the patients. The aspect of patient autonomy was also rarely found in other professionals' questionnaires. CONCLUSIONS: Findings reflecting patients' expectations regarding "ideal" psychiatric inpatient care vary. Validity of former questionnaires is reduced if important aspects of patient satisfaction are disregarded.

Germany↗
PubMed1999

[Quality assurance regarding cooperation between general practitioners and psychiatric services].

Although evaluation of client satisfaction is of great importance in quality assurance of psychiatric care, general practitioners' cooperation with psychiatric services was rarely investigated until now. The referral to a psychiatric hospital is a substantial problem area. Apart from length of waiting lists, competence of hospital and quality of cooperation, particularly general practitioner's role perception regarding mental illness determines referral policy. The need of general practitioners should be taken into consideration in planning psychiatric care to improve the treatment of patients with mental disorders.

Family Practice↗
PubMed1998

[Conceptual aspects in development and implementation of basic psychiatric documentation].

The main conceptual prerequisites for the development and introduction of a standardised documentation system in psychiatry (in this case: psychosocial rehabilitation) are discussed. These will help to improve the acceptance of the system and optimise the quality of the data. Since the positive motivation of the staff is decisive, it is essential to meet their needs and demands.

Confidentiality↗
PubMed1998

[Aggression in the psychiatric hospital. A psychiatric basic documentation based 6-year study of 17,943 inpatient admissions].

Based upon the psychiatric basic documentation, the incidence of aggressive behaviour before admission and during hospitalisation in a psychiatric hospital was investigated for a six-year period from 1989 through 1994. Aggressive behaviour was found in 8.3% of the patients before admission and in 2.7% during hospitalisation. Injuries to other persons were relatively more frequent in patients with social disorders, mental retardation, dementia and schizophrenic psychoses. The relative risk was increased especially in patients who had injured other persons prior to admission. Considering only the included variables, prediction of aggressive behaviour is not possible with sufficient certainty.

Adult↗
PubMed1997

[Quality assurance by interviews with patients].

Subjective criteria like patient satisfaction are of increasing interest in evaluation of psychiatric care. Although many improvements have been made in patient satisfaction research, methodological problems limit the interpretation of the findings. Further research is needed to develop reliable and valid instruments for measuring patient satisfaction within quality assurance. Own studies and findings are presented.

Germany↗
PubMed1979

Action of d-propranolol in manic psychoses.

Six manic patients were treated with high doses of d-propranolol or d- and dl-propranolol in a double-blind, placebo controlled study. The following variables were measured: propranolol dosage, propranolol serum concentration, pulse frequency, blood pressure, and psychotic behavior. In all cases an improvement was noticed. High dosages were necessary to obtain sufficient effect. The antimanic property of d-propranolol was approximately 50% smaller than the antimanic property of dl-propranolol. We conclude that at least some part of the antimanic action of beta-blockers is independent from the beta-blocking property.

Adult↗
PubMed1979

Action of propranolol in mania: comparison of effects of the d- and the l-stereoisomer.

The antimanic action of high doses of the beta-receptor blocking agent propranolol was investigated by the use of a double-blind placebo controlled ABA design. For comparison, the d-stereoisomer (which is practically devoid of beta-blocking activity) was used. 6 trials were performed with d-propranolol, 6 trials with the racemic mixture. From dose-effect relations one can conclude that the d-stereoisomer is about half as effective against manic syndromes as the racemic mixture. From this finding it can be concluded that the antimanic action of propranolol is at least partially due to a mechanism independent of its beta-blocking action.

Adult↗
PubMed1979

Bimodal distribution of REM sleep latencies in depression.

The REM sleep latency of endogenously depressed patients was investigated by analyzing 90 polysomnograms of six patients during depression and 58 polysomnograms of four of these patients after remission. During depression the REM sleep latencies are distributed bimodally with peaks at sleep onset (sleep onset REM phases, SOREMPs) and 60 min later. During the follow-up examinations some time after remission, the occurrence of SOREMPs is very rare. A model is proposed according to which the occurrence of SOREMPs in the sleep of these patients is caused by a reduced amplitude of the circadian rhythm of the arousal system.

Adult↗
PubMed1978

The measurement of change in endogenous affective disorders.

Psychopathological syndromes, as originally revealed by clinical observation, can also be detected by multivariate statistical analyses of symptom ratings. Changes in the course of psychiatric syndromes may be rated simply by improvement scales or by consecutive quantifications of symptoms and their comparison in chronological order. For the latter approach, which is less liable to bias, clinical ratings of psychopathology by staff members, self-ratings by the patients, analyses of patients' overt behavior (including video and speech records), or objective measurements of psychological and/or physiological variables can be used. Advantages and limitations of these different methods are discussed and illustrated by examples from ongoing clinical research in affective disorders. Generally, the combined use of different rating procedures is recommended. Self-ratings are economical, but they may represent aspects of psychopathology other than clinical ratings. In endogenous depression, mood scales are valid (supplementary) tools for the quantification of long-term as well as short-term changes, including diurnal variations. In severe conditions of mania, however, clinical rating has been--until now--the only valid basis for quantifying the degree of psychopathology and its changes with time. Precise evaluation of changes in psychopathology is essential in longitudinal investigations of endogenous affective disorders, since psychopathology up to now seems to have been the most sensitive and the most specific indicator of the hypothetical underlying abnormalities of cerebral functioning.

Affect↗
PubMed1977

Indication of an antipsychotic action of the opiate antagonist naloxone.

In 20 psychotic patients with frequent hallucinations and/or actual delusional experience a possible antipsychotic action of the opiate antagonist naloxone (N-allyl-noroxymorphone) was investigated, using a double-blind placebo-controlled cross-over design. 18 of these patients were not treated with neuroleptic drugs; 13 suffered from an acute episode of schizophrenia. Psychopathological changes were assessed by the use of the IMPS-scale and of a symptom-specific rating scale (VBS). Intravenous injection of naloxone (in most cases 4.0 mg) induced a reduction of psychotic symptomatology (especially hallucinations) in the majority of patients. Compared with placebo this effect reached statistical significance within 2-7 hours after injection. From this result a possible involvement of endogenous ligands of opiate receptors in the pathogenesis of schizophrenia may be concluded.

Adult↗