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Biomedical subjects

J Modestin

Publications and source records attributed to J Modestin.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Relation between criminal and suicidal behavior].

Results of many psychological, clinical, and epidemiological studies indicate a possible relationship between criminal and suicidal behavior. However, most data supply indirect evidence only and they are by no means conclusive regarding such a relationship. The results of a few well controlled studies, devoted specifically to this issue reveal that there is no real inner relatedness between criminality and completed suicide, even though both behaviours can sometimes occur together, e.g. in connection with alcoholism. It is still not clear whether there is a relationship between criminal and parasuicidal behavior.

Aggression↗
PubMed1986

Degree of suffering--a neglected variable.

Treating physicians estimated in 437 acute psychiatric inpatients whether the individual patients subjectively suffered severely from their condition or not. The judgement of the degree of suffering of the patient proved to be not only strongly influenced by the psychopathology of the patient and its relatedness to normal psychological phenomena, but also by the subjective factors of the rater including his interpersonal difficulties and/or prejudices.

Acute Disease↗
PubMed1985

Antidepressive therapy in depressed clinical suicides.

A total of 61 clinical suicides, all of them fulfilling the Research Diagnostic Criteria for a depressive disorder, were examined with regard to the psychopharmacological treatment they received at the time of their suicide. Scarcely half were treated with antidepressants, and only a small minority were optimally treated. One of the reasons for this therapeutic inadequacy lies in a discrepancy between the clinical and RDC diagnoses. An improvement in diagnostic practice, in the sense of paying more attention to the presence of a depressive syndrome, along with an improvement in psychopharmacological treatment, could contribute to a reduction in the clinical suicide rate, which has recently been observed to be increasing.

Adult↗
PubMed1985

Homicide in a psychiatric institution.

A unique case of a homicide committed by a young male psychotic inpatient on a fellow-patient is reported and discussed with regard to the special victim-offender relationship, the relationship between suicide and homicide, the phenomenon of aggression and the question of the management of a highly suicidal psychotic patient, including the issue of continuous observation.

Adult↗
PubMed1984

Clinical diagnostic practice reviewed. A comparison of clinical and RDC diagnoses.

A total of 368 clinical diagnoses were given to 298 patients hospitalized in two Swiss psychiatric institutions during the years 1960-1981. Clinical charts of these patients were scrutinized and all patients were diagnosed anew using the Research Diagnostic Criteria. The clinical diagnoses, strongly influenced by Bleuler and expressed in ICD-9 nomenclature, as well as the diagnoses obtained with the help of RDC, were compared with each other. Considerable differences were found regarding the diagnostic agreement in different diagnostic categories investigated. The most important finding of the study is a tendency to overdiagnose schizophrenic disorders clinically to the disadvantage of affective - mainly depressive - disorders and to overvalue the schizophrenic as compared with the affective - first of all depressive - symptomatology, respectively. This finding may have practical therapeutic consequences.

Adolescent↗
PubMed1983

Diagnosing borderline. A contribution to the question of its conceptual validity.

A total of 437 acute psychiatric inpatients were investigated with the help of a questionnaire containing DSM-III diagnostic criteria for schizotypal as well as for borderline personality disorder and criteria of the Flexible System for the diagnosis of schizophrenia. All patients were also independently diagnosed according to the ICD-9. The clinical ICD-9 diagnoses were compared with the diagnoses given on the basis of the three operational criteria sets mentioned. Patients fulfilling the operational criteria for schizotypal personality disorder were clinically diagnosed as mostly schizophrenic, and there was also a considerable overlap between the two groups of patients, those fulfilling the operational criteria for schizotypal personality disorder and those fulfilling the criteria of the Flexible System for the diagnosis of schizophrenia. Schizotypal personality disorder does not seem to be a clinical entity in the sense of a traditional personality disorder. The majority of patients diagnosed as borderline personality disorder received a clinical diagnosis of a personality disorder. The DSM-III criteria of borderline personality disorder discriminated satisfactorily against schizophrenia as diagnosed by the Flexible System and as diagnosed according to ICD-9. On the other hand, there was no relationship between the borderline personality disorder diagnosis and any single of the ICD-9 personality disorder types. The patients fulfilling the criteria of the borderline personality disorder were equally distributed across all ICD-9 personality disorder types. They were also significantly younger than both the non-borderline and the ICD-9 personality disorder patients. The relationship between borderline personality disorder criteria and age might thus be of a greater relevance than the relationship between these criteria and a clinical type.

Adult↗
PubMed1983

Haloperidol in acute schizophrenic inpatients. A double-blind comparison of two dosage regimens.

Using a double-blind experimental design, two dosage regimens of haloperidol were compared in acutely decompensated, newly admitted schizophrenic patients. Patients in group A (n = 21) received 5 mg haloperidol tablets, patients in group B (n = 20) 15 mg haloperidol tablets. The number of tablets did not exceed six a day but could be varied according to the condition of each patient. On the average patients of group A were prescribed 4.0 tablets, corresponding to 20.0 mg haloperidol a day, and patients of group B 3.9 tablets, corresponding to 58.0 mg haloperidol a day. A significant amelioration of the psychopathology as measured by BPRS were observed in both groups. Between both groups investigated, no differences were found neither with regard to therapeutic efficacy nor to the tolerance of the treatment. Administration of higher oral haloperidol doses cannot be recommended as a standard procedure.

Acute Disease↗
PubMed1980

[Concerning the borderline (author's transl)].

A general survey of the borderline literature is presented. The diagnostic label "borderline" has predominantly been used in North America; nevertheless, many roots of this conception originate in the classical European psychiatry and psychoanalysis. The various diagnostic (mainly descriptive) criteria and characteristics of the borderline are discussed, as well as the most important psychoanalytic hypotheses and conceptions (such as splitting, projective identification, identity diffusion). The therapeutic principles are mentioned as well. The analysis of the surveyed literature reveals on the one hand, that a well defined borderline exists neither as a generally acknowledged clinical entity nor as a circumscribed psychopathological syndrome. On the other hand, there are three various borderline concepts clearly discernible: 1) borderline conceptualized as a form of schizophrenia, 2) borderline conceptualized as synonymous with the general category of psychopathy (personality disorder) and 3) borderline conceptualized as a special form of psychopathy.

Antisocial Personality Disorder↗
PubMed1977

[Psychiatric morbidity of patients hospitalized at the internal medicine ward].

Report on two studies to investigate psychiatric morbidity in patients hospitalized in an internal medicine ward of a distric general hospital. In the first charts of 783 patients hospitalized in 1975 were evaluated retrospectively, while the second study (conducted in 1976) involved clinical assessment by the author of 244 newly admitted patients. A psychiatric diagnosis could be established in some 70% of all patients hospitalized in the internal medicine ward, and the morbidity rate in patients for whom therapy was indicated was 40%. Investigation of the medication utilized on the ward revealed that psychopharmacologic agents (chiefly given as hypnotics) were the most frequently prescribed group of drugs, whereas they were administered to 25% of patients on a regular basis (without indication as hypnotics). These high figures emphasize the need to decentralize psychiatric services and to intergrate psychiatry into internal medicine.

Adolescent↗
PubMed1977

[How blind is a double-blind trial really? Validity of controlled investigations].

During a double blind trial lasting 4 weeks (Diazepam versus Loxapin), two investigators tried to identify the given drug prematurely. Only the more experienced investigator was able to identify the two drugs (p = 0.01). His judgement was based neither on observation of side-effects nor on a clinical improvement but apparently on a summary of particular subtle effects, the cognition of which requires a specific experience. The use of an adequate comparative drug instead of a placebo in a double blind study does not completely prevent a premature decoding but should reduce this risk and therefore increase the validity of the method.

Anxiety↗
PubMed1976

[Beta receptor blocking agents in psychiatry (author's transl)].

The effects of beta receptor blocking agents in various psychiatric indications have been investigated during the last decade. The results are summarised and discussed. A final judgement of the value of beta blocking agents within the complete psychopharmacological treatment is, at present, not yet possible. They appear to have a certain therapeutic effect depending on the peripheral beta receptor blockade, at least on functional psycho- and neurovegetative cardial and circulatory disturbances as well as on anxiety states, neurotic and those caused by stress, both of these presenting primarily somatic symptoms. In other cases the results, as they now stand, present some very interesting features for further investigation.

Adrenergic beta-Antagonists↗
PubMed1976

[Correlation between plasma concentration and clinical effect of neuroleptics and antidepressants].

Results of investigations concerning the correlation between plasma concentrations and clinical effect of neuroleptics and antidepressives are summarised. In the case of neuroleptics there is in general no relationship between clinical parameters of activity and plasma concentration. For antidepressives there is, in most cases, a correlation between side-effects and plasma concentrations. Whether the therapeutic effect is dependent on the plasma concentration or not, is however open to some doubt. The practical value of plasma concentration estimations during therapy with the above mentioned drugs is therefore limited. Inadequate efficacy and/or poor tolerance can occasionally be explained by estimating plasma concentrations which alone, however, scarcely allow one to make prophecies. In determination of the optimal individual dosage must continue to be an empirical process based on clinical observations and experience.

Amitriptyline↗
PubMed1975

[The problem of masked depression].

The term "masked depression" appears to be increasingly used as a diagnostic label, but underlying the label are a multitude of problems. Questions of definition, diagnosis, nosologic classification and differential diagnosis are discussed in detail.

Acting Out↗