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Biomedical subjects

F Resch

Publications and source records attributed to F Resch.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Brief report of working group OPD-CA (children and adolescents) Axis IV: structural standard].

Apart from the structural differentiation of the body and its functions, the enlargement of the child's repertoire of possibilities to make experiences and to act is a manifestation of the development of the child's psychic structure which, advancing in years, may be considered as a treasure of all the experiences one has made with oneself, with the world and with the others. Structure will develop along with the interactional experiences with the world around us and becomes manifest in one's behaviour which may be witnessed and observed. The description of the psychic structure comprises three dimensions (perception of the self and of the objects, control, communication and bonding) which will be described by certain capabilities and will be assessed with the help of an anchoring example typical for each age which serves the purpose of clinical illustration. The adaptational achievement may then be assessed on the basis of a structural standard independent of age and may be ranged on a structural level. It appears that the exemplary description of different scopes of tasks typically to be performed at certain ages which serves as a basis for the assessment of the adaptational competence during childhood and adolescence seems to be a good policy. The purpose of our studies is the development of a valid instrument which is easy to handle in practice and which has a high interrater-reliability.

Adolescent↗
PubMed1998

[Effects and significance of specific spelling problems in young adults--empirical studies in an epidemiologic patient sample].

OBJECTIVE: With reference to an epidemiological sample of adolescents and young adults the impact of different models on the number of children classified as having specific spelling problems is investigated. METHOD: Using the same set of data, the effect of alternative definitions and methodological procedures on the prevalence of specific spelling retardation is shown. The virtual consequences of various norm-orientated definitions of cases is discussed with reference to external empirical criteria. RESULTS: Particularly, obsolete norms lead to a large overestimation of cases. In the present study case definitions of specific spelling retardation based on substantial criteria result in prevalence rates between 6 and 9 percent. Academic achievement is considerably affected by persisting specific spelling problems and the attendance of secondary schools is rare, in spite of sufficient nonverbal intelligence. CONCLUSIONS: Because of the high impact of spelling ability for educational success, dyslexic children need help by early intervention. Furthermore scholastic promotion is necessary to enable a school carer appropriate to the intellectual possibilities of the child.

Achievement↗
PubMed1998

[Psychotherapy aspects of inpatient treatment of adolescents with acute psychiatric illnesses].

In the inpatient treatment of acute psychiatric episodes in children and adolescents, the psychiatrist must set up an initial treatment plan incorporating one or more psychotherapeutic modalities and adapt this plan to the patient's clinical course. This article summarises the clinical experience of a model unit at the University of Heidelberg, the result of a collaboration between the Department of General Psychiatry and the Department of Child and Adolescent Psychiatry at the Clinic of Psychiatry. A series of 116 adolescent admissions was reviewed for clinical diagnosis, the nature and frequency of psychotherapeutic modalities, and the role of family involvement in patient care. Differential and adaptative approaches to the selection of treatment modalities in the context of an acute care setting are emphasised.

Acute Disease↗
PubMed1997

Premorbid adjustment and remission of positive symptoms in first-episode psychosis.

The impact of premorbid social and intellectual functioning in childhood and early adolescence on the developmental course of schizophrenia is not sufficiently understood. In a retrospective case study (93 consecutive in-patients, 43 males and 50 females) of first-episode psychosis occurring in adolescence, the relationship between premorbid adjustment and short-term therapeutic outcome under treatment conditions was examined. All of the patients had a DSM-III-R diagnosis of schizophrenia (n = 56) or schizo-affective disorder (n = 37). The mean age of the patients at the time of the study was 15.8 (SD = 1.0). Premorbid functioning during childhood and early adolescence was assessed by using the Cannon-Spoor et al. Premorbid Adjustment Scale (PAS) and studied with respect to its prognostic relevance for short-term therapeutic outcome (eight weeks) under neuroleptic treatment (350-700 mg Chlorpromazin dose equivalent). Criteria for clinical outcome were obtained from the study by Pearlson et al. (1989) which defines three grades (complete remission, partial remission and no response), according to the degree of positive symptomatology. Statistical analysis was based on nonparametric variance analysis. Patients with complete remission of positive symptoms after eight weeks of therapy had experienced far better premorbid adjustment in early adolescence and in childhood. Diagnosis and gender did not bias this result. Our data suggest that premorbid social functioning is a crucial variable with regard to therapeutic outcome in first-episode psychosis. Previous studies have reported a relation between poor premorbid functioning and negative symptoms. We found premorbid adjustment related to the course of positive symptoms.

Adolescent↗
PubMed1997

Testing the hypothesis of the relationships between laterality and ability according to Annett's right-shift theory: findings in an epidemiological sample of young adults.

In a large epidemiological sample of young adults, predictions of the right-shift (RS) theory of Annett that cognitive abilities will vary with right-left hand skill were tested. Presenting a theory of a genetic balanced polymorphism with heterozygote advantage for laterality and ability, Annett & Manning (1989, 1990a) and Annett (1993c) claimed that probands at the right end of the R-L hand skill continuum would show lower general intelligence in IQ testing and that specific verbal abilities and educational success would be lower at both extremes of the R-L distribution, taking the form of an inverted U. Most of these predictions could not be confirmed by our study. In particular, our data contrast with the important and specific prediction of the RS theory that strong dextrals will be the most disfavoured group. In our sample, probands at the left end of the R-L continuum had significantly lower scores in spelling and educational success and showed a tendency to have lower non-verbal IQ scores, while strong dextrals tended to have average or even marginally higher ability scores. The effects, however, are small and decrease when controlling for other variables. Implications of these empirical findings for the right-shift theory are discussed.

Achievement↗
PubMed1997

[Disappearance of shame and puberty in girls].

The sense of shame seems to vanish for more than a decade now, manifested e.g. by an increasing tolerance toward the naked female body. However, it is supposed that shame has still its significance especially during female puberty. Psychological considerations referring to shame and to the puberty of girls are reported and the significance of feeling ashamed in this salient segment of female development is delineated. Finally a concept is proposed within which the feeling of shame is understood as a possibility to create accordance between the positive aspects of being ashamed and the tendency of going beyond the borders of shame usually guaranteed by social rules.

Adolescent↗
PubMed1996

Correlation between vasopressin baseline and TSH-blunting in depressives.

A blunted thyrotropin (TSH) response is a predictor of a good response to antidepressant drug treatment in depressives and neuroleptic treatment in paraphrenic patients (Larger et al 1986). The aim of the following study was to elucidate possible relationships between different endocrine systems and to shed light on the pathogenetic hypotheses of TSH-blunting. In order to evaluate especially hypothalamic activity in severe depression we were interested in the vasopressin system as another hormonal system underlying hypothalamic control. Thirty-four patients who met the criteria for major depression according to DSM-III-R were subjected to the thyrotropin-releasing hormone (TRH) test. We also took baseline readings of the cortisol, neurophysinI (hNpI, reflecting vasopressin plasma levels), and neurophysinII (hNpII, reflecting oxytocin plasma levels) levels. Likelihood ratio tests were done with logistic regression models to analyze the phenomenon of TSH-blunting. We observed that the likelihood of a blunted TSH response increases with higher levels of hNpI and low levels of cortisol, but is unrelated to hNpII levels.

Adult↗
PubMed1996

Self-mutilation in adolescence as addictive behaviour.

Self-mutilation as addictive behaviour has been mentioned in a few studies in recent years. We present the case of a girl with narcissistic borderline personality disorder (DSM III-R: 301.83, 301.81), who undertook multiple, repetitive self-mutilating acts. Self-mutilation is discussed as addictive behaviour in this case. We emphasize the evaluation of repetitive self-mutilating acts by applying criteria for addictive and dependence disorders, in order to achieve additional adequate strategies for treating patients showing this behaviour.

Adolescent↗
PubMed1996

[Handedness and cognitive abilities: findings in a representative sample of adolescents and young adults].

Handedness and cognitive abilities in a representative sample of adolescents and young adults. The relationship between laterality and cognitive ability was examined in a representative sample of adolescents and young adults between 16 and 30 years of age. The study was designed as a possible replication of Annett's data supporting her right-shift theory (rst), but included other measures of laterality as well. We found, as Annett did, that strong right-handedness was associated with a weak left hand rather than a strong right hand. However, we could not confirm two other predictions of the rst with our data: The nonverbal IQ was significantly lower in both extreme groups of handedness than in the two middle groups. Because of the sample size this rather small effect, explaining only 1.9% of the variance, is significant, but it disappears with other kinds of grouping for handedness. We could not find the linear decline in nonverbal IQ from the left to the right extreme of handedness as predicted by the rst. In spelling, too, there was a rather small, but significant effect of handedness, explaining 2.4% of the variance. Spelling in the first (left most) quartile of handedness was worse than in quartiles two and four. The predicted poorer spelling in the extreme groups than in the middle groups (inverted U) was not found in our sample. In multivariate analysis with variables explaining larger proportions of the variance in spelling (education, nonverbal IQ and sex) the small effect of handedness on spelling completely disappeared. A weak relationship between left-handedness and dyslexia was evident only with the strictest definition of dyslexia, regardless of how handedness was defined. The implications of these data for the rst are discussed.

Adolescent↗
PubMed1995

Dilation of the internal mammary artery by external and intraluminal papaverine application.

Three methods for prevention of perioperative spasm of the internal mammary artery were compared in 78 patients undergoing coronary artery bypass grafting. In group 1, internal mammary artery pedicles were divided distally, clamped, and placed under the upper sternum submerged in papaverine solution (1.5 mg/ml). In group 2, as in group 1 but before clamping, 2 ml of heparinized blood with 1.5 mg/ml papaverine added was injected into the vessel lumen. In group 3 treatment was as in group 2, but heparinized blood with papaverine was injected a second time just before extracorporeal bypass was begun. In a univariate analysis free flow from dilated internal mammary arteries was not significantly different among the groups (group 1, 58 ml/min; group 2, 82 ml/min; group 3, 68 ml/min; p < 0.1). When free flow from dilated internal mammary arteries was the dependent variable in a regression analysis, the use of intraluminal papaverine, high blood pressure during flow measurement, and high initial blood flow were predictors of high flow (all p < 0.01). Morphometric measurements on the resected distal portion of the dilated internal mammary arteries disclosed less folding of the internal elastic lamina and a larger luminal area in groups 2 and 3 compared with respective findings in group 1 (1.21 mm2 and 1.42 mm2 versus 0.77 mm2; p < 0.02). Mechanical vessel wall injury occurred in 8 of 52 internal mammary arteries treated with intraluminal papaverine. Intraluminal papaverine solution injected once or twice in addition to external papaverine exposure therefore provides a better blood flow rate and distal dilation than mere submersion in papaverine solution, but at a considerable risk of mechanical wall injury.

Adult↗
PubMed1994

[Psychotherapeutic and sociotherapeutic aspects in schizophrenic psychoses in childhood and adolescence].

A critical review is given of modern psychotherapeutic and sociotherapeutic approaches used with children and adolescents with schizophrenic disorders. Therapeutic strategies are evaluated within the framework of emprical data on biological and psychosocial facets of schizophrenia. Major treatment goals are discussed that go beyond differences in psychotherapeutic methodology, e.g. attainment of biographical continuity, improvement of strategies for social interaction and conflict resolution, stabilization of self-structures, mastery of age-dependent developmental tasks and, finally, coordination of different therapeutic interventions. It is stressed that psychotherapy and sociotherapy are equally important in the treatment of children and adolescents with schizophrenia.

Adolescent↗
PubMed1992

[Side effects of clozapine in therapy of psychotic disorders in adolescents. A retrospective clinical study].

A retrospective study was conducted of 53 consecutive inpatients (through 1990) with psychotic disorders. The patients were between 13 and 18 years of age. In all cases this was the first time they had been treated with clozapine. The adverse effects seen under clozapine are discussed. During the use of clozapine assessments were made of liver enzymes, leukocytes, blood pressure and body temperature. There was an increase in liver enzyme values in 37.7% of the patients, leukopenia under 4000/mm3 in 15.1%, an increase in body temperature in 3.8% and bradycardia together with hypotensive dysregulation in 1.9%.

Adolescent↗
PubMed1990

[Ruptured abdominal aortic aneurysm with aortocaval fistula].

Aortocaval fistula is an uncommon complication of ruptured abdominal aortic aneurysm and is only seen in 4% of all ruptured aneurysms. The symptoms may vary from one patient to another but the characteristic physical findings are high output heart failure, widened pulse pressure with low diastolic blood pressure and venous hypertension. When these signs are combined with an abdominal aortic aneurysm and a continuous abdominal bruit, the diagnosis of aortocaval fistula must be seriously considered. It is important to diagnose the fistula before surgical intervention, so as to prevent intraoperative bleeding and complications. In our surgical department we have operated 103 ruptured abdominal aortic aneurysms but only one with an aortocaval fistula. This case is discussed in the light of the literature on the subject.

Aorta, Abdominal↗
PubMed1990

[Developmental psychological aspects of schizophrenic thinking].

Based on a phenomenological analysis of psychotic interpretation of the world concretism is supposed to represent an important mechanism of schizophrenic thinking: Schizophrenic concretism is the result of an ontological regression of cognitive functioning onto the archaic level of actional representation. Following Jean Piaget's theories about the children's constructions of reality a hypothesis about the structure of psychotic interpretations of the world is being proposed: In psychotic thinking the knowledge about the world is structured in an adualistic way which is characterized by an alloy of significance and notion, inner and outer world, physis and psyche. The structural similarity of psychotic thinking and thinking in early developmental stages is illustrated concretely on the basis of examples. Fundamental differences between childish and schizophrenic ways of interpreting the world will be presented, showing the specificity of cognitive representation in schizophrenic thinking.

Defense Mechanisms↗