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Biomedical subjects

H Remschmidt

Publications and source records attributed to H Remschmidt.

At least 199 records · Page 11Linked to original sources
PubMed1991

[The significance of familial relationship dynamics for the success of inpatient treatment in child and adolescent psychiatry].

A sample of 131 consecutively hospitalized psychiatric inpatients (adolescents of 12 years and older) was investigated with regard to the question of whether family relationship variables influence therapy outcome. Before the beginning of treatment, the familial relationship structure, specifically bonding behavior and rejecting/detachment behavior in the interactions among father, mother and adolescent, was investigated. The clinical rating scales used yielded values representing directed relationship characteristics of the family triad. These relationship values were used as prognostic variables for prediction of therapy outcome, which was assessed independently of the family diagnostic ratings. The results show that the relationship dynamics in the family have a high prognostic value with regard to changes in symptoms during therapy. Several different prognostically relevant characteristics of the relationship structure could be identified.

Adolescent↗
PubMed1990

[Psychological symptoms in school children. An epidemiologic study].

After a study of almost complete patient populations at selected child and adolescent psychiatric facilities as part of the federal government's "Modellprogramm Psychiatrie", two groups of children were investigated with the Child Behavior Checklist: a representative sample of 1969 school children between 6 and 17 years of age and 404 patients from child and adolescent psychiatric services. The presence of psychiatric problems was based on symptoms reported by the parents that experts rated as requiring treatment (at least two critical items). Of the 1969 school children, 253 (12.7%) required counseling or treatment, but only 64 (3.3%) were being treated for psychiatric problems or a developmental delay, half of them at non-psychiatric medical facilities. Symptoms prevalence correlated with age, social class, type of school and nationality.

Adolescent↗
PubMed1990

[The prognostic value of the dexamethasone suppression test for the course of anorexia nervosa--comparison with depressive diseases].

In the light of studies in affective disorders the predictive potential of the Dexamethasone Suppression Test was investigated in 31 patients with anorexia nervosa. According to the Morgan and Russell general outcome score the follow-up was conducted one year after each patient's discharge from hospital. There was a highly significant association between the post-dexamethasone-cortisol-plasma-value in weight-corrected patients at discharge and the one year follow-up. Patients who did not normalize their DST responses were at higher risk for a poor outcome. In contrast to patients with pure malnutrition a number of weight-restored anorexic patients continue to show or return to nonsuppression. It appears that reversion to a positive DST result might reflect a stress response in patients who failed to recover completely though weight stabilisation during inpatient treatment. Stress may lead to hypersecretion of CRH, which is known to be a potent anorexic agent. The present study does not point to a common etiology of anorexia nervosa and affective disorders as nonsuppression in the DST might be an unspecific response to stress-related factors.

Adolescent↗
PubMed1990

[Concept and services provided by a mobile pediatric and adolescent psychiatric service in a rural area].

A mobile child and youth psychiatric service is presented that concerned with the mental health care of a county with a population of 239,000 inhabitants. This kind of service was conceived especially to meet the demands of rural regions which are high, as empirical investigations about administrative and real prevalence have shown. The hypothesis that child and youth psychiatric or other specialized institutions create demands not normally existing, could be refuted. The service proved to be an efficient model for mental health care in rural regions so that it can be looked upon--especially in areas which are not sufficiently provided with child psychiatric institutions--as a fully valid alternative to other kinds of mental health services. Still, there is the problem of financing, which is not yet completely solved. A standardized regulation for the whole Federal Republic is suggested with the participation of the health insurance funds.

Adolescent↗
PubMed1989

[Are pediatric and adolescent psychiatric diseases preliminary stages of psychiatric diseases of adulthood?].

There are many factors that influence the manifestation and course of child psychiatric disorders. Such influences are: genetic factors and temperament, natural course of the disorder, developmental factors, age and sex, socio-familiar influences, systematic influences and accidental influences, risk factors and protective factors. With regard to the course of child psychiatric disorders, three types can be distinguished: disorders which continue into adulthood (continuity type), disorder with strong dependence on developmental factors, diminishing from childhood to adulthood, and newly manifested disorders starting during adolescence and following the same rules as psychiatric disorders in adulthood. In this regard the continuity hypothesis applies only to some child psychiatric disorders and not to others. Besides the three types concerning the course of child psychiatric disorders, it should be mentioned that some disorders change their symptomatology on the way to adulthood. For example, hyperkinetic children frequently develop antisocial behaviour, delinquency and alcoholism during adult age.

Adolescent↗
PubMed1989

[Anorexia nervosa and depression. On the relation of body weight and depressive symptoms].

To investigate the relationship between weight deficit and depressive symptoms, 48 adolescent patients (41 females, 7 males) fulfilling DSM III R criteria for anorexia nervosa were also assessed for DSM III diagnosis of major depressive disorder (MDD). Patients who met diagnostic criteria for MDD had a significantly lower body weight than those without a current episode of MDD. In turn patients with high weight loss had higher mean depression scores (HAMD, SDS) than patients with less weight deficit. With increase of body weight we found a highly significant decrease of depressive symptoms. The authors hypothesize that the DSM III criteria for MDD may not specifically distinguish between starvation-related psychopathology in anorexia nervosa and primary affective disorder.

Adolescent↗
PubMed1988

[Minimal brain dysfunction--on the revision of a clinical concept. Clinical data of a total pediatric and adolescent psychiatric patient population].

After a discussion of the changes of the MCD concept over the years, the authors describe their own investigation of a total sample of 3280 children, attending outpatient and inpatient facilities of three counties with a total population of 574,000 inhabitants. The aim of the study was to investigate the frequency, sex distribution, and social class dependency of the MCD-diagnosis and its relationship to clinical-psychiatric syndromes. The following results were obtained: There is a strong correlation of MCD-diagnosis with age, sex, and social class. MCD was most frequently diagnosed in the age groups of 3-6, 6-9 and 9-12 years, being twice as frequent in boys than in girls and dominating among the lower social classes. The frequency of MCD in the total sample was 11%, taking into consideration all age-classes. MCD was significantly associated only with two psychiatric syndromes: conduct disorders and hyperkinetic syndrome. There was no correlation with emotional disorders or neurosis, however, a very strong one with specific delays in development, defined according to the multiaxial classification system. 72% of the children diagnosed as MCD-children revealed specific delays in development. But this high correlation was caused only by two conditions: developmental speech/language disorders and specific motor retardation. There was no correlation between MCD and specific reading retardation nor with other specific learning difficulties or mixed developmental disorders. Future research in this field should look upon the so-called MCD more in terms of general developmental delays than in terms of brain pathology.

Achievement↗
PubMed1988

[Therapy evaluation in child and adolescent psychiatry: inpatient treatment, day care treatment and home treatment in comparison].

The aim of the present study was to compare inpatient, day hospital and home treatment of 10 child psychiatric disorders as defined in the Multi-axial Classification Scheme. The subjects were 109 patients from two child psychiatric hospitals who fulfilled clearly defined criteria. They comprised about 10 to 15% of the total clinical population of the two hospitals. The patient were assigned at random to the three treatment modalities. Treatment effectiveness was evaluated blind by experienced child psychiatrists not involved in the study. There were no significant differences between the treatment modalities in duration of treatment. Neither were there any significant differences between the treatment modalities with respect to treatment effectiveness, although there were some overall differences between different diagnostic categories. For a small group of carefully selected children day hospital and home treatment can therefore be looked upon as alternatives to inpatient treatment.

Child↗