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Biomedical subjects

H Remschmidt

Publications and source records attributed to H Remschmidt.

At least 217 records · Page 12Linked to original sources
PubMed1988

[Anorexia nervosa in adolescence].

Anorexia nervosa is a disease of prepuberty and puberty occurring predominantly in females. There is growing evidence that it is increasing in frequency. The essential features are an intense fear of becoming obese, a disturbance of body image, amenorrhea, and significant weight loss followed by secondary physical changes. The disorder seems to be a product of the reciprocal interplay of biological, familial and sociocultural factors leading to starvation which, in turn, provide feedback perpetuating the anorexia nervosa syndrome. Patients often need therapeutic help to break through the denial. Our management therapy concept includes weight restoration and stabilization, as well as individual and family therapy. At follow-up, 50% of the anorectic patients reveal a good outcome, 25% fall in an intermediate category, and the rest show a poor prognosis.

Adolescent↗
PubMed1988

[Long term prognosis in anorexia nervosa].

Follow-up studies using the same prognostic criteria have shown that about 48% of the patients had recovered at follow-up, while 28% revealed further difficulties with eating, weight and figure, and 24% remained anorectic. Our own study on 103 patients who underwent inpatient treatment, revealed unexpectedly good results: according to the criteria of Morgan and Russell, 72% (n = 58) showed a good prognosis, 11% (n = 9) a fair, and 17% (n = 14) an unfavourable prognosis. 3 patients had died during the follow-up interval. It was possible to predict the long-term outcome from weight recovery during inpatient treatment, more successfully in patients with favourable than unfavourable outcome. The best predictors were: time until weight stabilization, the ratio ideal weight/stabilized weight, and age at onset of the eating disorder.

Adaptation, Psychological↗
PubMed1988

[Somatic disturbances in anorexia nervosa].

This article summarizes a variety of physiological abnormalities found in anorexia nervosa. Metabolic aberrations, endocrine dysfunctions and other physical complications including those of weight-restoring treatments are discussed. Most of them are due to weight loss and the starvation process itself and revert to normal with nutritional rehabilitation.

Anorexia Nervosa↗
PubMed1988

[Bulimia nervosa in adolescence].

Although eating disorders of the bulimic type have been known for a long time, "bulimia nervosa" as a special and specific type of eating disorder was described only during the last decade. Clinical evidence has shown an increase in bulimic disturbances during the last few years. About 30% of the bulimic disturbances begin between the 14th and 18th year of age. About 50% of patients with bulimia nervosa have been anorexic before. A group of 30 patients with anorexia nervosa and a group of 11 patients with bulimia nervosa were compared by means of the dexamethasone suppression test and two depression scales at the beginning of inpatient treatment, after 8-12 weeks of inpatient treatment and at discharge. Patients with anorexia nervosa revealed significantly higher cortisol levels at the beginning of inpatient treatment as compared with the bulimic group. Cortisol levels were normalized with weight gain. Therapeutic measures in bulimia nervosa comprise medical and psychotherapeutic methods.

Adolescent↗
PubMed1988

[Weight-dependent changes in the hematology of anorexia nervosa].

The haematological features of 48 patients with anorexia nervosa were studied in a retrospective fashion, showing a mild hypocellularity with anaemia, thrombocytopenia and granulocytopenia, particularly prominent in male anorectics, but a normal amount of lymphocytes. There was a highly significant association between the degree of weight deficit (in % of ideal body weight) and seriousness of haematological changes, which were all reversible with improvement in nutritional status.

Adolescent↗
PubMed1987

[What are specific performance weaknesses?].

The term "specific developmental disorder" means localized deficits in very different functions contrasting fit in the general otherwise normal performance level of a child. These disorders are mostly looked upon in a developmental context and differentiated from acquired neuropsychological syndromes (e.g. aphasia, apraxia). The most important clinically relevant disorders are: the specific reading disability, the specific dyscalculia, other specific learning disabilities, the specific developmental language disorder, the specific retardation in the motor development, and multiple developmental retardations. In a population of all patients treated in institutions for children and adolescents, 30% show specific developmental disorders with a predominance of boys. There is no correlation between dyslexia and social class but it does exist for specific developmental language disorder and motor retardation. As to the etiology of specific developmental disorders, genetic factors, congenital or acquired cerebral dysfunctions, maturation or developmental retardation and cognitive variables are discussed. The multifactor-approach seems to be the best way of understanding specific developmental disorders, which are difficult to prove.

Child↗
PubMed1987

[Functional hemispheric asymmetry in children with hypersynchronous activity in the EEG. A tachistoscopic study using visuolinguistic stimulus material].

24 patients of a child psychiatric clinic with focal epileptiform activity located in different brain areas were tested with tachistoscopically presented letter and word stimuli to examine functional hemisphere asymmetry. Children with epilepsy were excluded. No differences were found concerning the lateralisation of the examined functions between the clinical groups and a matched pair nonclinical control group. All children showed an advantage of the left hemisphere in processing the presented visuo-linguistic stimuli. Children with bihemispheric epileptiform discharges showed superior performance on all tasks in contrast to children with left hemispheric discharges and the control group. Results were discussed in the theoretical framework of raised cortical vigilance in these children. Asymmetric hemispheric functions focal epileptiform discharges tachistoscopic study letter/word recognition test.

Arousal↗
PubMed1987

[Functional hemispheric asymmetry in children with hypersynchronous activity in the EEG. A study with the dichotic listening procedure].

24 patients of a child psychiatric clinic with focal epileptiform activity located in different brain areas were tested with a dichotic listening procedure to examine functional hemispheric asymmetry. Children with epilepsy were excluded. No differences were found concerning the lateralisation of the examined functions between the clinical groups and a matched-pair non-clinical control group. Clinical groups as well as the control group showed a right-ear-effect (REE), i.e. a superior functioning of the left hemisphere in processing the presented stimuli. However, children with epileptiform discharges in the left hemisphere showed inferior functioning in the dichotic listening test on both ears in contrast to children with bi-hemispheric discharges and the control group. Results were discussed in the theoretical framework of malfunctions of auditory short time memory.

Adolescent↗
PubMed1987

[Value of the dexamethasone suppression test in anorexia nervosa].

Patients suffering from anorexia nervosa were assessed for variables of weight, dexamethasone-suppression-test and depressive symptomatology at three stages of inpatient treatment. With increase of body weight we found a highly significant decrease of plasma cortisol concentrations and depressive symptoms. During refeeding there also was a significant association between the degree of weight deficit (in % of ideal body weight) and plasma cortisol level, but the dexamethasone-suppression-test-result did not correlate with depression scores. However in 8 patients whose clinical condition deteriorated although their weight remained stable the dexamethasone-suppression-test results became abnormal again. The authors hypothesize that--besides the effect of weight loss--the dexamethasone-suppression-test might reflect the influence of other psychobiological factors which still have to be investigated.

Adolescent↗
PubMed1987

[Inpatient final weight data and long-term prognosis of anorexia nervosa].

In a study of 36 patients with anorexia nervosa (age at onset: 14.5 +/- 1.9 years), an attempt was made to predict longterm outcome (follow-up interval: 7.8 +/- 3.77 years) from weight changes during inpatient treatment (duration of treatment: 156 +/- 76 days). Several statistical methods appropriate for use with longitudinal data were applied. The long-term course could be predicted correctly for 96% of the patients with a good or intermediate outcome (prognostic criteria of Morgan and Russel) and for 89% of those with a poor outcome. The most important factors predictive of a good outcome were relatively long time to stabilization of weight (greater than 47 days), a stabilized weight of at least 64% of ideal weight, low age at onset (less than 13 years) and a high variability in weight during inpatient treatment as compared with patients who had a poor prognosis.

Adult↗
PubMed1986

Comparative studies on recognition of faces, mimic and gestures in adolescent and middle-aged schizophrenic patients.

In adolescent and middle-aged schizophrenic patients and normals 10 different multiple-choice tests of 12 scored movie scenes lasting 10s were applied, measuring the ability to recognize faces, persons and mimic expressions. In all tests errors were significantly higher by a factor of 7 to 14 in patients as compared to normals. The relative impairment of adolescent schizophrenic patients (as compared to adolescent normals) was somewhat stronger than that of adult schizophrenics. This supports the hypothesis that the impairment found in schizophrenic patients is caused by the disease and not by other factors such as duration of illness or hospitalization.

Adolescent↗
PubMed1986

[The mobile child and adolescent psychiatric service: an effective treatment model in rural areas].

A mobile unit for child and adolescent psychiatry is described that serves two counties with a combined population of 400 000. In both counties the unit is the third most frequently used outpatient service, providing 21% of all outpatient care in child and adolescent psychiatry in Marburg-Biedenkopf and 40% in Waldeck-Frankenberg. After the outpatient clinics this unit serves the largest number of patients from the lower social classes, in the case of psychotherapy the majority (54.1%). This unit also makes the largest number of home visits. On the whole, the mobile unit can be considered an effective means of providing mental health services in rural areas.

Adolescent↗