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H E Klein

Publications and source records attributed to H E Klein.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Expectations and satisfaction of social-psychiatric services regarding their collaboraton with the psychiatric hospital] .

OBJECTIVE: Collaboration with the psychiatric hospital should be investigated from the viewpoint of social-psychiatric services (SpDi). METHODS: Based upon a content analysis of interviews with staff members of all social-psychiatric services working in the catchment area of a psychiatric hospital, a questionnaire was developed which consists 32 Items assessing expectations and satisfaction in 6-step Likert-type scales. RESULTS: Response rate was 80% (n = 40). SpDi's staff express high expectations to psychiatric hospital. They assess good inpatient treatment, patient's information about treatment, SpDi's involvement in discharge planning, patient's attendance at SpDi's consulting in the hospital, and networking of psychiatric institutions to be very important. Differences between expectation and satisfaction especially refer to information of SpDi about client's admission, SpDi's involvement in discharge planning, and knowledge of hospital staff about social-psychiatric services. CONCLUSIONS: Evaluation of expectations and satisfaction of SpDi as an important partner of the psychiatric hospital allows conclusions for quality assurance of psychiatric care and offers concrete clues for a better collaboration at the interface of out-patient and in-patient care being advantageous for patients.

Hospitals, Psychiatric↗
PubMed1999

hSKCa3: no association of the polymorphic CAG repeat with bipolar affective disorder and schizophrenia.

hSKCa3 is a neuronal small conductance calcium-activated potassium channel, which contains a polyglutamine tract, encoded by a polymorphic CAG repeat in the gene. Since an association between longer alleles of this CAG repeat and bipolar disorder or schizophrenia has been reported, we genotyped the polymorphic CAG repeat in 91 German family trios of patients with bipolar disorder I and used the transmission disequilibrium test (TDT) to test for association. Applying a dichotomized model (< or = 19 or > 19 CAG triplets), we found no evidence for an association of longer alleles with bipolar disorder (TDT = 0.75, P = 0.386). Regarding the whole range of alleles, there was no preference in transmitting the larger of the two observed alleles from parents to the affected offspring. In parallel we performed an independent case-control study on German patients with bipolar disorder and schizophrenia. Again we did not detect an overrepresentation of longer CAG repeats in patients. Thus, our data do not support the hypothesis that longer CAG repeats in the hSkCa3 gene contribute to the susceptibility for bipolar disorder and schizophrenia.

Adult↗
PubMed1998

Peripheral-type benzodiazepine receptors in diagnostic subtypes of schizophrenic patients.

The peripheral-type benzodiazepine receptor (pBZD-R; also called the omega-3 receptor or the mitochondrial benzodiazepine receptor) seems to play a critical role in the production of neurosteroids, which are able to alter the electrical properties of neuronal membranes and thus the firing patterns of neurons. Putative endogenous ligands are the diazepam-binding inhibitor and its processing products, as well as porphyrins, some of them, in the case of porphyria, are well known to give rise to certain aspects of neuropsychiatric disorders, such as schizophrenic-like symptoms. Previous findings of altered benzodiazepine binding sites in post-mortem brain samples and platelets from small samples of schizophrenic patients have been inconclusive. Therefore we investigated characteristic binding parameters (Bmax, Kd) of the granulocytic pBZD-R by using the selective ligand PK11.195 in 53 subjects, fulfilling ICD-10 and DSM-IV criteria of schizophrenia. The binding parameters in our total group of 53 schizophrenic patients did not differ from those in healthy subjects. However, Bmax values were significantly reduced in schizophrenic patients with predominantly negative symptoms (residual type) compared to schizophrenic patients with predominantly positive symptoms, i.e. paranoid (-50%) and catatonic subtype (-38%). Moreover, only residual type schizophrenics exhibited a significantly reduced binding capacity compared to healthy subjects (-38%). More studies are warranted to clarify the functional significance of this binding site in the pathogenesis of negative symptoms.

Adult↗
PubMed1998

Detection of polymorphic triplet repeats in the genomes of patients suffering from bipolar affective disorder.

Evidence for the operation of expanded trinucleotide repeats in the pathogenesis of bipolar affected disorder has recently been found at the molecular genetic level. For the screening of these repeat motifs in genomes of patients with bipolar affective disorder, we established a modified PCR-based fingerprinting technique, called triplet repeat enhanced arbitrarily primed PCR (TREAP-PCR). Using this approach, 40 patients suffering from bipolar affective disorder (ICD10: F31) and 15 healthy controls were investigated. Interindividual polymorphisms generated by TREAP-PCR seemed to depend on the type of triplet. Using CCG triplet primers, polymorphisms could be observed more often in the genomes of patients compared with controls, whereas no significant differences could be found using primers of the CAG or AAT type. These data might indicate the existence of subgroups of manic-depressive patients based on molecular genetic differences.

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↗
PubMed1994

[Hypothermia caused by neuroleptics. 2 case reports and review of the literature].

The present paper discusses appearance and course of neuroleptic induced hypothermia of a 36 years old woman suffering from periodic catatonia and a 38 years old seriously mentally handicapped man. Analysis of clinical studies and pharmacological tests with animals about body temperature changes caused by neuroleptics yields that these may lead to hypothermia as well as hyperthermia, depending on individual disposition and dose, which is mainly a result of their effect through dopaminergic neurons of the hypothalamus, which controls thermoregulation, and of their influence on vasomotoric mechanisms of vessels of the skin. Though hyperthermic changes are more hazardous and occur more frequently hypothermia by neuroleptic agents is clinically relevant as shown by the summarizing presentation of previously released case reports: hypothermia is found at neuroleptic medicated healthy volunteers and at psychiatric patients with or without physical illness, at which hypothyreosis and impair of the brain seem to represent special risks.

Administration, Oral↗
PubMed1993

[Stress in nursing students and graduate nurses in inpatient psychiatry].

This article deals with differences in work satisfaction, general state of well being, somatic complaints and work load of psychiatric student nurses and graduated nurses. Data were collected from a sample of 53 psychiatric student nurses and 145 graduated nurses. The graduated nurses reported an unexpectedly high job satisfaction of 70% compared to other working groups in hospitals. The student nurses were more content with their work and reported less somatic complaints. Furthermore the student nurses found in 20 cases certain duties less strenuous. In addition, the student nurses reported a more negative general state of well being.

Adult↗
PubMed1989

Endocrinological studies in alcoholics during withdrawal and after abstinence.

Several endocrine parameters were assessed in 35 alcoholic inpatients after admission to hospital, and 17 of the 35 were retested after several weeks of sobriety. No difference was found in clonidine-stimulated growth hormone (GH) secretion between male alcoholics and male healthy controls, but significant positive correlations of GH secretion and alcohol content in expired breath on admission and gamma-GT values after abstinence were observed. Nonsuppression in the dexamethasone suppression test was found in 17% of the patients on admission, which seemed to be due to alcohol withdrawal. Postdexamethasone cortisol levels were significantly positively correlated with the "apathic syndrome" (r = 0.40; p less than or equal to 0.05). About one-third of the patients showed a blunted response in the TRH-test both on admission and after abstinence. No significant influence of alcohol intake, withdrawal or familial disposition on prolactin values could be detected. The results of the TRH test and the DST point to similar endocrinological patterns in alcoholics as in depressive patients and thus support the hypothesis of a link between alcoholism and depression.

Adrenocorticotropic Hormone↗
PubMed1989

Sex differences in schizophrenia.

Demographic and clinical characteristics of 275 schizophrenics consecutively admitted to seven hospitals were examined. Males were younger than females when first hospitalized, diagnosed and treated. Psychiatrists rated on two rating scales by using a structured interview to compare the symptomatology. Female schizophrenics were more agitated, inappropriate, silly, irrelevant, over-talkative, and exhibiting more flight of ideas, while male schizophrenics were more slowed, hypoactive, grandiose, withdrawn, and showing more blocking, auditory hallucinations and poor communications. Katz Adjustment Scales were rated by the patients and their relatives. Female schizophrenics were perceived by relatives to be more helpless and withdrawn-depressed than male schizophrenics.

Adult↗
PubMed1986

Symptom differences between urban and rural schizophrenics in Turkey.

The symptomatology of Turkish urban and rural schizophrenic patients was compared in 94 consecutive hospital admissions. These were rated on two rating scales by psychiatrists, using a structured interview. Urban patients were more frequently anxious, tense, stiff, rigid, perseverating and depersonalized than rural patients; urban patients also exhibited more frequent symptoms of outbursts, blocking, thought pressure, depressed mood and somatic concern than their rural counterparts. Rural patients were more often withdrawn, disoriented, confused/delirious and lacking contact in communication than urban patients; rural patients also showed more frequent symptoms of flight of ideas and consciousness lapses than their urban counterparts.

Adult↗
PubMed1985

Trazodone in endogenous depressed patients: a negative report and a critical evaluation of the pertaining literature.

The antidepressant efficacy of trazodone has been studied during three weeks in 13 endogenously depressed patients, using a fixed dosage of 5/10 mg/kg bodyweight per day. Psychopathological assessments were documented by means of observer rating (HDRS, AMP) and selfratings (Bf-S, EWL-K). Most variables assessed during course of treatment did not reveal amelioration of statistical significance or clinical relevance. If the most frequently applied response criteria of a 50% reduction of the initial HDRS-score was taken, only three patient improved. Those results were surprising in view of the previous and subsequent response to antidepressant therapy of the patient group studied. Plasmalevels of trazodone were monitored once weekly; they showed a nine-fold interindividual variation and did not correlate to the fixed dosage steps. A critical review of the pertaining literature led the authors assume, that the main indication of this drug is within non-endogenous-depression.

Adult↗
PubMed1985

DST in healthy volunteers and after sleep deprivation.

The dexamethasone suppression test (DST) was performed in 46 healthy volunteers and repeated in nine of them following total sleep deprivation (TSD). While only 2 postdexamethasone cortisol values were insufficiently suppressed (greater than 5 micrograms %) in control DSTs, 5 postdexamethasone cortisol values were above 5 micrograms % following TSD. The mean postdexamethasone value was increased from 1.55 +/- 1.06 to 4.47 +/- 5.86 micrograms % following TSD at 8.00 h. The authors conclude that sleep deprivation as a therapeutic approach and prolonged sleeplessness may bias DST results.

Adult↗
PubMed1985

Differences in psychopathology between black and white schizophrenics.

The psychopathology of black and white schizophrenics was compared in 275 consecutive admissions of schizophrenics, who were rated on two rating scales by psychiatrists, using a structured interview. There were significant differences between black and white schizophrenics; blacks exhibited more frequent symptoms of angry outbursts, poor communication, disorientation, asocial behaviour and auditory and visual hallucinations, while whites showed more frequent symptoms of unsystematized delusions. When controlled for sex, additional symptom differences were found for female schizophrenics; blacks were more often excited, ambivalent, rigid and dysphoric. For male schizophrenics, all symptom differences disappeared except one; blacks were more frequently asocial.

Black or African American↗
PubMed1985

Therapeutic results and tissue concentrations of temocillin in surgical patients.

Temocillin, a new beta-lactamase-stable penicillin, was administered in a dosage of 2g twice daily to 25 biliary surgery patients in whom potential septic complications were a concern. Clinical efficacy was assessed as 'very good' in 23 patients. In one patient there was a disorder of wound healing and in another a staphylococcal bronchial pneumonia developed postoperatively. Temocillin was tolerated very well, and no side effects were observed. 12 hours after administration of temocillin 2g intravenously to surgical patients the mean serum concentration was 22.44 (+/- 10.26) mg/L. The median half-life was 3.86 hours (+/- 1.84) hours. Mean concentrations of 12.44 and 38.59 mg/L were measured up to the twelfth hour in the wound secretions and peritoneal secretions, respectively. In skin, fat, fascia, muscle and gallbladder wall, temocillin concentrations greater than the inhibitory concentrations of most Gram-negative bacteria were demonstrated after 1 and 2 hours.

Adult↗
PubMed1985

Psychosocial and environmental variables in outcome of black schizophrenics.

Psychosocial and environmental variables associated with the black schizophrenic patient's discharge from the hospital, community adjustment, and rehospitalization, if any, were examined. Numerous significant variables related to the outcome were identified on the medical, nursing, and social work question-naires through personal interviews with 128 black schizophrenic patients and their families.

Adolescent↗