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Biomedical subjects

C Mundt

Publications and source records attributed to C Mundt.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Psychotherapy of delusions].

Psychotherapy of delusion is usually considered far from promising. However, patients with delusional problems require some of psychotherapy if they fail to respond to pharmacological treatment, particularly if their behaviour and wellbeing are severely disturbed. Case reports indicate that at least delusional social behaviour, but also general cognitive styles, can be influenced outside of delusional perception and the delusional work of systematization. Diagnostic assessment for psychotherapy of deluded patients should clarify: the affective charge of the delusion; the degree of fixation; and its compensatory function for impeding disorganization. The expressive function of the delusion may help the therapist to pay attention to the patient's most important and unresolved life themes, even if they cannot be addressed at the beginning of the therapy. In the acute phase this knowledge can help to disactualize the theme; in the post-acute phase it can help to reflect on the further destiny of the blocked development expressed in the theme, be it by grief or by promoting it to more adequate striving. Based on those theories of delusion which have a practical impact and illustrated by case vignettes, proposals are made on how to deal psychotherapeutically with the pre-predicative statement of delusional belief, how to support disactualization of the delusional theme, how to help the patient with self-presentation, and how to support more flexible decentered cognitive styles.

Cognitive Behavioral Therapy↗
PubMed1996

[Primary and secondary negative symptoms: a useful differentiation? An empirical study].

The concept of schizophrenic negative symptomatology consisting of primary, treatment-resistant negative symptoms associated with cognitive dysfunction and treatable secondary composite negative symptoms was tested by comparing a group with non-chronic schizophrenia and a neurotic group with negative symptoms before and 8 weeks after the start of treatment. Contrary to our hypothesis, we found no association between schizophrenic negative symptoms and cognitive dysfunction as measured by CPT and K-V-T either at the first or at the second assessment point, but did find a strong relation between depressive and negative symptomatology at both assessment points in both groups. Thus, we conclude that a chronic course, rather than primary negative symptomatology, may be associated with cognitive dysfunction. The concept of primary negative symptoms based on cognitive dysfunction versus secondary negative composite symptoms encompassing motivation and reactive attitudes is not supported by these results.

Adult↗
PubMed1996

[Psychotherapy in psychiatry--an assessment of current status. Report on the DGPPN Status Colloquium "Psychotherapy in Psychiatry" 22-24 February 1996 in Heidelberg].

The German psychiatrists have agreed to new training regulations which now include psychotherapy. On this occasion the German Psychiatric Association organized a symposium "psychotherapy within psychiatry". Psychotherapy researchers of all psychiatric departments in German speaking countries were invited. As a result, a cross-sectional picture of current psychotherapy research within psychiatry showed a great variety of methods and ways of thinking about research on psychotherapeutic process, outcome, and applications. Even non behavioural approaches showed a trend towards operationalized and quantifying, but also standardized qualitative research. All participants agreed on the necessity of better and in comparison with psychopharmacological research more fair financing of psychotherapy research.

Curriculum↗
PubMed1995

Dignified death: a German perspective.

After discussing some defining questions concerning dignified death, active and passive euthanasia, assisted suicide and the criteria for free will and informed consent, the juridical situation in Germany is reported. Passive euthanasia according to the patients' free will is accepted, assisted suicide, active euthanasia, and passive euthanasia without informed consent are not accepted. The ethical discussion on these topics in Germany reveals a spectrum of opinions. There is somewhat more emphasis on the cons than on the pros. Humanistic and economic arguments merge in the debate. The philosophy of consequentialistic utilitarianism is heavily criticized by many authors who warn that respect even for the unproductive life must not fade. After some remarks on empirical studies on attitudes towards death and the history of attitudes towards euthanasia the conclusion lists the arguments, pros and cons, and gives a personal view.

Ethics, Medical↗
PubMed1995

The core of negative symptoms in schizophrenia: affect or cognitive deficiency?

The association of negative symptoms on one hand and cognitive failures and language and thought disturbances on the other hand was examined in 25 schizophrenics and 22 neurotics over a 2-month period of intensive therapy. Psychopathological negative symptoms were more pronounced in schizophrenics than in neurotics at the first assessment before intensive therapy. However, cognitive and language performance showed no difference between the groups in both cross-sectional comparisons before and after treatment. Thus, our hypothesis that cognitive deficiencies are the core of negative symptoms could not be confirmed. It is discussed that young schizophrenics at an early stage of the illness may imply more affective components in the psychopathology of their negative syndrome than chronic schizophrenics with more pronounced cognitive deficits.

Adolescent↗
PubMed1993

3H-spiperone binding capacity in mononuclear cells: a family study.

1. A family study was carried out using a putative biological vulnerability trait in families of schizophrenics and schizoaffective indexprobands to investigate, if the clinical phenotype and a biological marker for schizophrenia are cosegregating within families. 2. The binding capacity of the dopamine antagonist spiperone to mononuclear cells was investigated in 21 indexprobands and a total of 147 first and second degree relatives. 3. Increased binding capacity could be found in 17 indexprobands and in their affected relatives, independently from clinical diagnosis and in 22% of their normal relatives. 4. No increased binding capacity was found in 4 indexprobands and in their affected relatives and not n any of the unaffected relatives. These results indicate, that increased spiperone binding may cosegregate with the risk for functional psychoses and that families, loaded with psychiatric disturbances may be distinguished on a biological basis.

Adult↗
PubMed1993

Karl Jaspers.

Explore the source record for details and available documents.

Germany↗
PubMed1993

["Covert criticism"--a new criterion for determining the expressed emotion index in a five-minute speech sample of partners of depressed patients].

The expressed emotion (EE) index is a measure of affective attitudes held by relatives toward a mentally ill family member. In several studies it has been shown to be a predictor of relapse in the course of schizophrenia and depression. Since the Camberwell Family Interview (CFI) as the traditional method for assessing EE is time-consuming, a brief method--the Five-Minute Speech Sample (FMSS)--has been developed as an alternative for research and clinical work. The FMSS is also suitable for repeated application. Reliability and concurrent validity of the FMSS-EE have been demonstrated in cross-cultural samples of families with a schizophrenic member. However, application of the FMSS coding system to relatives of depressed patients in our sample proved to be problematic. Criticism, the most important EE-component, could not be assessed using the existing rating procedure. Therefore a modified version of the rating system has been developed. A new category named "covert criticism" has been defined which also includes indirect criticism. In an ongoing study a high degree of interrater reliability was achieved with the new system. Available data concerning concurrent validity indicate that clinically meaningful results can be derived by using the EE-ratings based on "covert criticism".

Adult↗
PubMed1991

[Differential typology among patients with hard and soft suicide methods].

Two samples of patients admitted during one year after suicide attempts were compared: patients of the University Surgical Department in Heidelberg and a random sample of those who were admitted to the detoxication ward of the University Department for Internal Medicine. The frequency of patients who used "hard" methods was 10% of those using "soft" methods. Patients with hard suicide methods displayed more social desintegration, were more often psychiatrically ill, had a shorter presuicidal phase, a shorter time span from decision to execution of the suicidal attempt, more negative self-esteem and more chronic suicidality. Aggressiveness was low in both groups. Although the number of patients with "hard" suicidal methods is small and does not justify a special service in the Surgical Hospital, these patients need particularly careful supervision because of their psychopathological and psychosocial profile.

Adolescent↗
PubMed1991

[Endogenous paranoid-hallucinatory syndrome caused by Borrelia encephalitis].

We describe a case with no neurological signs but marked psychiatric symptoms induced by borrelia burgdorferi, whose clinical picture was indistinguishable from an endogenous schizophrenia. The symptoms within one week under antibiotic treatment with ceftriaxon, but afterwards the patient showed a mild organic brain syndrome. The case demonstrated the aetiologic nonspecificity of paranoid symptoms and hallucinations and emphasizes that in psychotic patients without psychiatric history additional diagnostic measures should be performed.

Brain Damage, Chronic↗
PubMed1986

[Current status of brain morphologic and related functional diagnosis in schizophrenic patients].

Validity and interpretation of neuroradiological findings in schizophrenics are still discussed controversially. This applies also to some adjacent functional diagnostic techniques, which could possibly give support to neuroradiology, as post-mortem histopathological examination, electrophysiological recording, and positron-emission tomography. One of the causes for the inconclusive findings could be the patient- and control-group sampling, which is despite standardized diagnoses still heterogeneous in factors determining ventricular size. This heterogeneity applies also to the adjacent functional-diagnostic studies. A prevalence of enlarged ventricules of about 10% in schizophrenics is largely assumed, the measurements within the normal range tending to be somewhat higher than in the control-groups as well. Inconsistently a relation is reported between enlarged CSF-spaces on one side and unfavourable premorbid adjustment, chronic course of the illness, and predominance of negative symptoms on the other side. The CT findings in twin- and family studies stress also the etiological impact of brain morphology on schizophrenia. Size and width of ventricles in schizophrenics seem to be determined genetically as well as environmental. Most recently findings of unusual laterality or blurring of physiological lateral organization in the central nervous system gain growing interest. In this area brain-morphological findings are supported and supplemented by electrophysiological and PET-findings. For interpretation most authors at present refer to the hypothesis of 2 subgroups of schizophrenia, with and without dementing factors. The author suggests the view, that there is a common feature in all the heterogeneous and contradictory biological findings: They generally indicate a loss of cerebral organization.(ABSTRACT TRUNCATED AT 250 WORDS)

Arousal↗