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Biomedical subjects

H Katschnig

Publications and source records attributed to H Katschnig.

At least 37 records · Page 2Linked to original sources
PubMed1996

The World Health Organization Short Disability Assessment Schedule (WHO DAS-S): a tool for the assessment of difficulties in selected areas of functioning of patients with mental disorders.

The World Health Organization Short Disability Assessment Schedule (WHO DAS-S) is an instrument for clinicians' assessment and rating of difficulties in maintaining personal care, in performing occupational tasks and in functioning in relation to the family and the broader social context due to mental disorders. The WHO DAS-S was developed and underwent preliminarily testing in the context of two international field trials of the multiaxial presentation of ICD-10 for use in adult psychiatry. The instrument was found to be useful, user-friendly and reasonably reliable for use by clinicians belonging to different schools of psychiatry and psychiatric traditions. Further work on the WHO DAS-S should include development of national adaptations of the instrument, studies of concurrent validity of the instrument and modification of the instrument to accommodate changes in the next edition of the International Classification of Impairments, Disabilities and Handicaps (ICIDH).

Disability Evaluation↗
PubMed1996

The boundaries of social phobia and its subtypes: workshop report 1.

The separation of social phobia from normal social anxiety (shyness) and from other psychiatric disorders (e.g. agoraphobia, atypical depression with rejection sensitivity) is as important for research and for treatment decisions as is the definition of subtypes. While empirical evidence supports the distinction of a generalized and a specific subtype of social phobia, the other boundary issues, the separation of social phobia from shyness and its distinction from the comorbidity with other psychiatric disorders, still require research.

Comorbidity↗
PubMed1996

Contextual aspects of mental disorders: a proposal for axis III of the ICD-10 multiaxial system.

After several years of development and testing, the World Health Organization (WHO) has recently completed work on the multiaxial presentation of ICD-10 for use in adult psychiatry. Axis III of the ICD-10 multiaxial system is intended for clinicians' reporting of contextual factors which may influence the diagnosis, treatment or prognosis of mental disorders that are recorded on Axis I. It was tested in two WHO-co-ordinated international field trials and found to be user-friendly, reasonably reliable and useful in routine clinical work, in the training of mental health professionals and in research on mental disorders.

Adult↗
PubMed1996

[Evaluation of psychiatric treatment teams by relatives].

262 members of the Austrian relatives' self-help organisation HPE evaluated their experience with 12 types of psychiatric professionals and judged their satisfaction with the behaviour of these professionals on a 5-point scale corresponding to the Austrian school mark system (1 = the best mark, 5 = the worst mark). Overall the core group of psychiatric professionals-psychiatrists, psychologists and nurses-had the worst rating, while non-core professionals like occupational therapists, social workers and ambulance aids received the highest satisfaction ratings. One possible explanation for the dissatisfaction with the core psychiatric professionals is the unmet needs of the relatives for information, which 93% complained of. It is suggested to teach professionals systematically how to evaluate the needs of relatives and how to communicate with them in a more satisfying way.

Adult↗
PubMed1996

Predictors of quality of life in a long-term followup study in panic disorder patients after a clinical drug trial.

In a prospective 4 year followup study, 423 panic disorder patients participated in one of two international multicenter drug trials. They were to be reinterviewed 4 years after leaving the trials; 367 (86.8%) interviews were completed. At followup, 3 of 5 patients still suffered from at least occasional panic attacks, and 2 of 5 were still agoraphobic, but only about 20 percent of the patients were still disabled. The only baseline variables that predicted disabilities at followup were the disability measures at baseline themselves. Neither panic attack frequency nor phobic avoidance at baseline predicted disability at followup. Because of the lack of association between the presence of symptoms and of social disabilities, future clinical trials and other clinical and epidemiological studies should use independent symptom measures and quality-of-life measures simultaneously.

Alprazolam↗
PubMed1995

Is there a pathophysiological and therapeutic link between panic disorder and epilepsy?

Relations between panic disorder (PD) and epilepsy (E) have repeatedly been discussed. Three patients with juvenile E who had been free of seizures under anticonvulsant medication for many years and developed PD are presented. Increasing anticonvulsant medication resulted in complete and stable remission of PD. It is hypothesized that, in a subgroup of patients with PD, there is a pathophysiological relation to E. Further research into the usefulness of anticonvulsants in the treatment of PD, especially in therapy-refractory cases, is suggested.

Adult↗
PubMed1995

Long-term follow-up after a drug trial for panic disorder.

BACKGROUND: This study investigates the naturalistic course of panic disorder over four years and attempts to identify predictors for outcome. METHOD: 423 DSM-III-R panic disorder patients who had taken part in an international multicentre drug trial were selected for follow-up; we were able to re-interview 367 (87%). For panic attacks, phobic avoidance and disabilities the same rating scales were administered as had been used for the clinical trials. RESULTS: While 61% of all patients experienced at least occasional panic attacks at follow-up, few suffered from serious phobic avoidance (16.7%) or serious disabilities (work 7.9%); family 8.7%; social 13.9%). Panic attack frequency at baseline, original trial medication and continuous use of psychotropic medication during follow-up are not related to outcome, whereas longer duration of illness and more severe phobic avoidance at baseline are unfavourable. CONCLUSION: The course of panic disorder is not uniform. Since long duration of illness and severe phobic avoidance at baseline are predictors for an unfavourable outcome, more rigorous efforts should be undertaken to detect and treat panic disorder at an early stage.

Adolescent↗
PubMed1993

[Prevalence and sociodemographic correlates of benzodiazepine utilization in an urban population].

In conjunction with a population survey of the prevalence of hypertension, conducted in Vienna, the consumption of benzodiazepines was investigated. In cooperation with a public opinion survey institute a quota sample of 1470 Viennese aged over 15 years was visited in their homes by 50 physicians trained in interview techniques. The quota sample comprised 0.959% of the population of 1,531,346 inhabitants and was representative in terms of age, sex, social status and area of residence. 5.3% of the probands took Benzodiazepines often, frequently or at least sometimes. Female sex and higher age correlated significantly with Benzodiazepine use, which was furthermore significantly influenced by the presence of psychopathological symptoms and the responder's subjective feeling of being under stress. Co-medication and physical illness were correlated with a higher benzodiazepine use.

Adult↗
PubMed1992

Center differences and cross-national invariance in help-seeking for panic disorder. A report from the cross-national collaborative panic study.

Help-seeking behaviour for treatment of panic disorder was investigated in the sample of the Cross-National Collaborative Panic Study Second Phase. A total of 1168 patients were entered into this trial in 14 countries. Although there were significant center differences in prior treatment and utilization of health services there were also similarities. Treatment had been provided mainly by general practitioners. Drug treatment consisted mostly of prescription of classical tranquilizers and had a longer duration than treatment by psychotherapy. Patients with agoraphobic avoidance, past major depression and longer duration of illness used medical and psychiatric treatment facilities more intensely. Older and more severely disabled subjects were more frequently treated by medical health care providers and were more likely to receive psychotropic drugs. The results indicate that general practitioners carry an important load in the treatment of panic disorders but may need more information about recent development in pharmacotherapy for this condition.

Adult↗
PubMed1990

[Psychosocial and biological correlates of panic attacks and panic syndrome].

The definition of a separate nosological entity "panic disorder" in the Diagnostic and Statistical Manual of Mental Disorders, 3rd revision (DSM III) of the American Psychiatric Association triggered a flood of empirical research into this disorder. In this article the literature is surveyed to find out to what extent panic attacks and panic disorder bear specific relationships to measurable variables from the psychosocial and biological spheres. The investigated psychosocial variables are: experiences of separation in childhood; separation anxieties in childhood; sociodemographic correlates as they are known from epidemiological studies; personality factors; life events as possible triggering events of periods with panic attacks; and, finally, socalled "cognitive correlates". The results obtained in this field are just as inhomogeneous as they continue to be in the sphere of biological variables. Of these, the following factors are discussed: genetic factors; neurological and psycho-physiological correlates; the problem of mitral valve prolapse; endocrinal correlates and neurotransmitters. Present findings do not supply conclusive evidence either for or against separation of panic attacks from free-floating anxiety. The relationship between panic attacks and depressive disorders is equally unclear if judged on the basis of the results from empirical research which are far from uniform.

Anxiety Disorders↗
PubMed1990

[Panic attacks and panic syndrome--diagnosis and therapy].

Paroxysmal states of anxiety that cannot be traced back to somatic causes have been called panic attacks since the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM III) of the American Psychiatric Association. This term has since been accepted as part of psychiatric everyday language in many countries. The present review discusses initially the diagnostic and differential diagnostic aspects against the background of nosological classifications as practised to date, with particular emphasis on the requirements of the practising psychiatrist. The authors of this review hold the opinion that whereas the phenomenon of panic attack is a valid concept, the conceptualisation of a panic disorder is still largely hypothetical. The often observed "natural history"--after panic attacks, anticipatory anxiety, coupling of attacks to certain situations, avoidance of these situations, as well as agoraphobia, depressivity, self-medication with tranquilisers and alcohol, hypochondriacal fears with increased consultation of doctors, and family conflicts may develop--requires early therapeutic intervention. Hence, the second part of this article presents the pharmacological and psychotherapeutical treatment methods for panic attacks and their complications as developed and successfully tried out during the past few years. The efficacy has been proven of drug therapy on the one hand of prophylactic treatment using tricyclic antidepressives, MAO-inhibitors and alprazolam or clonazepam, and on the other hand also of a non-continuous attack-related treatment strategy. Of the more recent psychotherapeutic methods, relaxation methods and the cognitive treatment of panic attacks are discussed. This direct focus on panic attacks seems to be more promising than the conventional treatment methods centered on secondary symptoms such as anticipatory anxiety or agoraphobia.

Anxiety Disorders↗
PubMed1990

[Depression and anxiety--a study for validating subtypes of depression].

Psychopathological analysis of the patterns of symptoms in 176 depressive in-patients disclosed in 73.3% of all patients the presence of anxiety symptoms: of these, 38.6% merely had diffuse anxiety, whereas 34.7% showed either additionally or alone specific anxiety symptoms such as phobias and panic attacks. Similar to the results obtained by dividing the patients into an "endogenous" and "neurotic" group, namely, that there was no difference between the subtypes in respect of triggering the depressive episodes by life events, or in respect of the suicide rate 30 months after discharge and in respect of a chronic course developing during the 2 years following the discharge, there was likewise no difference with regard to these criteria if the patients were subdivided into depressive patients without anxiety and those with anxiety symptoms. However, a subdivision of the depressive patients with anxiety symptoms into a group having only free-floating anxiety and a group with specific anxiety symptoms, resulted in a clear association with these criteria: If a phobia or panic attacks were present, triggering by life events was far more frequent than if there was only free-floating was more often chronic in the first group, but there was no difference in suicidality. The results indicate that it will be necessary to provide for a more differentiated classification of anxiety symptoms before deciding in clinical routine what steps to take wherever depression and anxiety symptoms are present side by side. The same applies to treatment studies.

Adjustment Disorders↗
PubMed1989

The prevalence of psychoactive drug intake in a metropolitan population.

Together with a survey conducted among the population of Vienna on the prevalence of hypertension, the consumption of psychotropic substances was investigated. In cooperation with a polling institute a quota-sample of 1,470 Viennese over 15 were visited in their homes by 50 physicians trained in interview techniques. The quota-sample comprised 1,470 people (0.959(0/00) of the population of 1,531,346 inhabitants) and was representative in terms of age, sex, social status, and area of residence. The overall prevalence of psychoactive drug consumption among the inhibitants of Vienna investigated was found to be 6.8%. The female to male ratio was 3.5 to 1. Furthermore, psychoactive drug use increased with age and was influenced by social status, with the highest consumption rate found among divorced women and widows. Using the Goldberg "General Health Questionnaire", data were collected on the presence of psychopathologic symptoms and the responders' subjective feeling of being under stress was elicited. A significant correlation could be shown between these two factors and the use of psychoactive drugs. The type of drugs most frequently used were tranquilizers (4.96%), followed by antidepressants (0.95%) and hypnotics (0.88%).

Adolescent↗
PubMed1989

Delusional theme, sex and age.

In a retrospective study of 865 delusional syndromes, connections were investigated between delusional themes and the sex of patients, and the ages in which these themes extensively occurred. According to previous reports, the results of this investigation indicated that differences exist between the ages of manifestation regarding the themes of hypochondria, persecution, love and jealously. Furthermore, differences could be observed between males and females in relation to the frequency of choice of particular themes, as well as the age of occurrence. Based on psychological studies concerned with the content's dependence on motives we conclude that the age distribution of delusional themes corresponds to the main existential concerns in different life periods.

Adolescent↗