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H Dilling

Publications and source records attributed to H Dilling.

At least 19 recordsLinked to original sources

[In vivo and in vitro effects of GnRH analogs on ovarian Leydig cell tumor].

A 65-year old patient, suspected to be suffering from an androgen producing ovarian tumour, was treated preoperatively with the GnRH agonist triptorelin (500 micrograms/day s.c.) for 7 days. After an initial rise, gonadotrophin levels were suppressed under this treatment. The elevated serum testosterone concentrations were reduced by approx. 50% by the triptorelin injections. After the extirpation of the tumour (histologically a Leydig cell tumour of the ovary without signs of malignancy), primary cell cultures which secreted testosterone and androstenedione were prepared. Coincubation of the tumour cells with the GnRH agonist triptorelin had no effect on their androgen secretion. Treatment of the tumour cells with high concentrations (10(-5) M) of a GnRH antagonist, however, resulted in a 100% increase of their testosterone and androstenedione secretion. GnRH-binding sites of low affinity (Ka = 0.54 x 10(5) M-1) and high capacity (B max = 1364 x 10(-12) M/mg membrane protein) were identified in the tumour. These findings suggest that GnRH analogues might modify androgen secretion of sex-cord stromal tumours of the ovary via the suppression of endogenous gonadotrophin secretion and possibly also via direct effects on the tumour cells.

Aged

Psychiatric and physical illness, sociodemographic characteristics, and the use of psychotropic drugs in the community: results from the Upper Bavarian Field Study.

In the Upper Bavarian Field Study a total of 1536 persons (15 years and older) were interviewed by research psychiatrists. 8.1% of all respondents took a psychotropic drug during the 7 days prior to the interview. The consumption rate among women was about three times as high as that for men. The use of psychotropic drugs increased with age. No consistent pattern was found with respect to social class. According to psychiatric/physical health status the highest consumption rate (29.4%) was found among those suffering solely from psychiatric disorders. The simultaneous occurrence of both psychiatric and physical disorder did not increase the risk of drug taking (21.4%). Less than 5% of the healthy respondents and of those suffering solely from a physical disorder used psychotropic drugs. A large proportion (63.0%) of those with previous psychiatric in- and outpatient treatment received psychotropic medication, as well as those suffering from schizophrenia (66.7%), affective psychoses (52.6%) and anxiety disorders (50.0%). The higher consumption of psychotropic drugs among women could not be explained by higher psychiatric or physical morbidity or the fact that women consult primary care physicians more frequently than do men. Controlling for co-morbidity and annual consultation of family physicians, significant sex differences in the consumption of psychotropic drugs persist.

Adolescent

Prevalence and treatment of insomnia in the community: results from the Upper Bavarian Field Study.

In the Upper Bavarian Field Study a total of 1,536 persons (15 yr of age and older) were interviewed by research psychiatrists. The prevalence of insomnia (last 7 days) identified with the aid of the Clinical Interview Schedule (CIS) was 28.5% (mild: 15.0%; moderate/severe: 13.5%). For both sexes sleep disorders increased with age. The female preponderance of insomnia was mainly associated with the middle and older age groups. In contrast to other psychiatric disorders, sleep disturbances were not associated with social class. Moderate/severe insomnia was strongly related to psychiatric diagnoses, the use of psychiatric in- and outpatient services and general hospitals. It also constituted a significant burden for the primary-care physicians, whereby the average annual consultation rate among mild (10.61) and moderate/severe insomniacs (12.87) was significantly higher compared to that for those without sleep disorders (5.25). A total of 33.7% of the insomniacs were treated with hypnotic and/or other psychotropic drugs during the week prior to the interview, whereby the drug consumption among moderate/severe insomniacs (48.5%) was significantly higher than that of mild insomniacs (20.4%).

Adolescent

[Memory deficits in alcohol dependent patients in the 1st weeks of abstinence].

The aim of the study is to analyse memory deficits of alcohol dependents after detoxification with regard to the degree of recovery since the beginning of abstinence. Four samples include in the whole 168 alcohol dependent in-patients of same age and sex. Psychological tests of verbal as well as visual memory with retention times of a few seconds to 30 minutes were applicated, among others the Auditory-Verbal-Learning-Test, the digit span as well as the Benton-Visual-Retention-Test. The results show that the performance grows with time of abstinence. This increase, however, is nearly finished after seven days. In the discussion the idea of a dichotomization of the detoxification development concerning the memory performance is encouraged according to which in a first stage of about seven days the most pronounced disturbances become less. In a second stage lasting weeks cognitive deficits of a minor degree remain. This is in accordance with other studies in which however the age was not controlled well.

Adult

Chapter V (F) of ICD-10: mental, behavioural and developmental disorders--introduction and overview.

The need for precise psychiatric diagnoses is indisputable, both for cooperation within the health service systems and for scientific purposes. Over the last few years there has been a revival of interest in psychiatric nosology. Despite new strategies and the results of numerous individual research efforts, no uniform and general satisfactory theory, and thus no classification of mental disorders, has been developed. After the Second World War, the WHO succeeded in introducing an internationally accepted diagnostic system, the ICD-classification. In 1980 the American Psychiatric Association (APA) introduced its DSM-III classification with explicit diagnostic criteria and rules. The ICD-10 has been in preparation since 1982, and will differ considerably from ICD-9: An alpha-numerical system of coding expands the possibilities for diagnoses. For the first time in the history of ICD operational diagnostic criteria and rules are being introduced. The new structure will permit adjustments without the need to completely change the entire classification. The WHO division of mental health is preparing a range of documents and instruments for various purposes; clinical descriptions and diagnostic guidelines for daily clinical use, a short version and the more detailed research criteria; a multiaxial coding is planned as well. The classification of the mental disorders is based on etiological considerations, as far as these are known, in particular in the case of organic disorders, disorders due to the use of psychoactive substances, and stress-related disorders. In other areas, a more non-theoretical and descriptive approach was chosen. As a major change the large "blocks" psychoses and neuroses have been abandoned.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavior

Design of the ICD-10 field trial in German-speaking countries.

The study design of the international multicentric field trial on ICD-10, chapter V (F) "Mental, Behavioural and Developmental Disorders: Clinical Descriptions and Diagnostic Guidelines" (1987 draft) including some modifications for the study in German-speaking countries, is described. The various stages of the field trial, instruments used, and the data base, are presented.

Adult

Summary of the qualitative criticisms made during the ICD-10 field trial and remarks on the German translation of ICD-10.

The 1987 draft of ICD-10 presents many new aspects of the psychiatric diagnostic evaluation. Some were readily accepted by the participants of the field study, including: the purely descriptive approach with the abautonment of many theoretical concepts; the more operationalized descriptions of the diagnoses; similarity in structure and terms to DSM-III-R. Others proved controversial: extension of the term dementia to include even mild and moderately severe organic psychosyndromes; inclusion of all forms of depression in one chapter, and their subdivisioning only by severity; different time criteria for the diagnosis of schizophrenia in DSM-III-R (6 months) and ICD-10 (1 month). Considerable criticism was levelled at the overly long and often tediously formulated text, and the lack of didactic organisation. A number of examples of translation difficulties are given, and the differences between a too literal and a technically correct equivalent translation disu-used.

Adolescent

[Psychiatric diagnosis following the 10th revision of the International Classification of Diseases (ICD-10)].

Following a historical overview the current state of development of psychiatric diagnostics is reported. Instead of intuitive clinical diagnoses an operational classification is aimed at. In the next few years WHO will introduce a new revision of the International Classification of Diseases. Development and structure of the psychiatric chapter V (F) of ICD-10 are described. Different versions of this chapter will appear for use in clinical psychiatry, scientific research and general medicine as well as for the use of the general practitioner. In characterizing the different subchapters some criticism is expressed, which has arisen in the Commission for Diagnoses of the German Society of Psychiatry (DGPN). Finally current studies concerning the practicability, reliability and validity of ICD-10 chapter V (F) are described.

Humans

[Trials with ICD-10: results of a multicenter field study in German speaking countries].

134 clinicians in 10 centres participated in the WHO-initiated field trial in German-speaking countries of the provisional form of ICD-10, chapter V, clinical descriptions and diagnostic guidelines. 1778 diagnostic assessments were given for 90 cases. In general, the results show a comparatively high degree of acceptance of the new classification. Interrater-reliability coefficients are satisfactory. A high concordance of diagnostic categories between ICD-9, ICD-10 and DSM-III was found.

Adolescent

Psychiatric disorders and diabetes--results from a community study.

In the Upper Bavarian Field Study a total of 1536 persons (15 years and older) were interviewed by research psychiatrists. The prevalence of diabetes (ICD 250) identified by the interviewer and/or the primary care physician was 4.0%. Since the number of diabetics among the younger age groups was relatively low (n = 7) and in order to obtain a more homogeneous study group, only those over the age of 55 were considered in further analysis. Diabetics were compared with a control group of persons with another chronic medical condition of similar clinical severity and a control group without a somatic disorder. The sex- and age-adjusted prevalence of psychiatric disorders identified with the aid of the Clinical Interview Schedule was significantly higher among diabetics (43.1%) and persons with other chronic medical conditions (50.7%) in comparison to the healthy control group (26.2%). The difference was mainly due to mild psychiatric disorders and those suffering from depression. No statistically significant association was found between diabetes and moderate to severe mental disorders, the use of psychotropic drugs and previous psychiatric treatment.

Adolescent

Prevalence and treatment of psychiatric disorders in 3 to 14-year-old children: results of a representative field study in the small town rural region of Traunstein, upper Bavaria.

In a representative sample (n = 358) 18.4% of the children aged 3 to 14 were classified as having psychiatric disorders, mostly special symptoms (13.4%) (ICD 307). Using the multiaxial classification of child psychiatric disorders developed by Rutter et al. (1), connections between a psychiatric diagnosis on the one hand and developmental delays, medical conditions and abnormal psychosocial circumstances on the other are pointed out. Finally, the situation regarding help for children with psychiatric disorders is discussed. Only 2.0% of the children were receiving treatment for such conditions.

Adolescent

Prevalence of mental disorders in the small-town--rural region of Traunstein (Upper Bavaria).

The prevalence rate of mental disorders in the population is important to the overall planning of improved psychiatric care services. A prevalence study of 1,536 probands conducted in three communities in the county of Traunstein, Upper Bavaria, revealed that 18.6% of the population were in need of treatment. The results are presented according to sociodemographic characteristics, and ways of improving the care of the mentally disturbed are discussed. Primary emphasis is placed on improving the competence of general practitioners.

Adolescent