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Biomedical subjects

L Ciompi

Publications and source records attributed to L Ciompi.

At least 37 records · Page 2Linked to original sources
PubMed1985

Aging and schizophrenic psychosis.

The author discusses the question of the interference of schizophrenia and aging, and specially of the impact of biologic and organic versus social and situational factors. The presentation is based on long-term follow-up studies by the author himself and others, showing favorable outcomes in about half of the cases. Contrary to general beliefs, old age has quite often a favorable influence, eg. by dampening acute productive symptoms and drives, and by improving interpersonal relations. Psycho-organic deterioration is hardly more frequent, in schizophrenics, than in the general population. In conclusion, in old age, too, schizophrenia does no longer appear as a fatally progressive organic disease, but as a multiconditional open life process in vulnerable individuals with persisting potential for improvement even in old age.

Adolescent↗
PubMed1984

[Model concepts of the interaction of biological and psychosocial factors in schizophrenia].

On the basis of the current research, his own contributions and complementary theoretical considerations, the author develops four possible models on the causal relations between biological and psychosocial factors in schizophrenia, namely 1. a biological-psychosocial model, 2. a psychosocial-biological model, 3. a parallelist- or multilevel-model and 4. a circular model. According to the latter as currently most probable model, variable interactions between biological and psychosocial factors lead to a premorbid vulnerability with lowered information processing capacities and increased tendencies to psychotic functioning under stress. Equally, variable interactions between different biological and psychosocial factors furnish the best explanation for the enormous multiformity and nearly unforeseeable variability of the long-term evolutions. The circular model is also particularly fruitful for therapeutic purposes.

Brain Damage, Chronic↗
PubMed1984

Is there really a schizophrenia? The long-term course of psychotic phenomena.

The author fundamentally questions the traditional concept of the disease-entity (or several disease entities) of 'schizophrenia' and discusses an alternative concept, based on vulnerability and information-processing. According to this, schizophrenia-like psychotic phenomena develop in three phases. In the first, premorbid phase, combined biological (genetic and possibly other organic) and psycho-social influences lead to a premorbid 'vulnerability', characterised by a low tolerance of cognitive and emotional stress, corresponding to an insufficient capacity for the adequate processing of complex information. In the second phase, stressful life-events can lead to unique or repeated acute productive psychotic episodes. The third phase, that of long-term evolution, depends more on psycho-social influences than on biological factors. Under unfavourable conditions, it may lead to predominantly unproductive residual states of various degrees, which can largely be understood as regulatory mechanisms to restrict stressful over-stimulation. There is no clearly delimitable disease entity of schizophrenia with constant causes, psychopathological picture, or course, but rather a multi-conditioned life-process, occurring in people with a particular vulnerability, interacting with complex life-events and circumstances. This new concept has important consequences for therapy and prevention.

Adult↗
PubMed1984

[Effect of social factors on the long-term course of schizophrenia].

On the basis of the literature and of his own research concerning the long-term-evolution and the vocational rehabilitation of schizophrenics, the author shows that social factors play an important role in the long-term-evolution of schizophrenia. Of particular importance is the influence of the therapeutic setting, of overtaxing "life-events", of the family atmosphere, of the institutional infrastructure, of the expectations of the social environment, and of several socio-economic and cultural factors. Biological and psychosocial influences can be combined into a multiconditional model of schizophrenia in three phases, in which the vulnerability- und information-processing-hypothesis are central. This model leads to interesting consequences for the prevention and the therapy of schizophrenia.

Antipsychotic Agents↗
PubMed1984

[Inpatient social psychiatric crisis intervention exemplified by the crisis intervention center of the Social Psychiatric University Clinic of Bern].

With a case-history of a puerperic psychosis we describe the crisis-interventions-technique in six steps used in our 16-bed, socio-psychiatric ward in the city of Berne at a general hospital. Out of more than 5 years of work we illustrate one year with client-data, working-methods and statistical results. With such a ward in the community, embedded in a complete net of socio-psychiatric institutions, we can treat quite serious psychosocial crisis adequately and in relatively short time.

Adolescent↗
PubMed1980

[Is chronic schizophrenia an artefact?--Arguments and counter-arguments (author's transl)].

The working hypothesis is investigated that chronic schizophrenia could differ from acute schizophrenia not only phenomenologically, but also in its causes. The following arguments in favour of the hypothesis that chronic schizophrenia could mainly be a psychosocial "artefact", caused by the psycho-social consequences of acute attacks of illness, are presented 1. institutionalisme and understimulation; 2. non-specifity of many phenomenons attributed to "chronic schizophrenia"; 3. great variability of long-term courses; 4. lack of influence of genetic factors on long-term course; 5. importance of social factors for long-term course; proposition of a "general principle of psychosocial inertia"; 6. family influences; 7. lack of sufficient proofs for a clearcut illness-concept. --On the other hand the following arguments against the artefact-hypothesis are discussed: 1. the question of "irreversible residual states"; 2. organic and biochemical arguments; 3. genetic arguments; 4. the problematic distinction between acute and chronic schizophrenia; 5. the ubiquity of chronic schizophrenia. --On the whole, the arguments in favour of the artefact-hypothesis seem more pertinent, but more research is needed for a definite decision.

Acute Disease↗
PubMed1980

Catamnestic long-term study on the course of life and aging of schizophrenics.

The author summarizes a monograph study on the course of schizophrenia into old age, which he co-authored with C. Müller, and which includes mortality and cause-of-death statistics on 1,642 original cases and an average of 37 years of catamnestic observation of the 289 patients who survived until the final followup examination. The separate investigations of the development of schizophrenia, the psycho-organic symptomatology, and the social adaptability show that the long-term course was favorable in at least half of the cases. From a statistical viewpoint, outcome depended primarily on premorbid personality factors, on certain psychopathological factors, and on the influence of advanced age. These findings supported and supplemented important findings by other authors (in particular those of Bleuler and Huber), on the long-range development of schizophrenia.

Adult↗
PubMed1977

[Crisis and crisis intervention in modern psychiatry].

After discussion of the definition, concept and theory of psychic crisis, the modern techniques of crisis intervention are presented in the light of the literature and the author's personal experience, illustrated by case histories. Finally, the organizational place of crisis intervention in a modern psychiatric care system is discussed, with emphasis on the advantage of using socio-psychiatric half-way institutions for rehabilitation between hospital and ambulatory services for crisis intervention as well.

Adolescent↗
PubMed1977

[Reflections on the therapeutic possibilities of a technic of provoked crisis].

The author demonstrates the therapeutic possibilities of a technique of 'provoked crisis' on the ground of theoretical models and practical examples. Such a technique seems mainly indicated in situations of chronified and stagnant equilibrium in individual patients, families or groups, which cannot be changed by stepwise proceedings.

Adult↗