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Biomedical subjects

L Schlebusch

Publications and source records attributed to L Schlebusch.

14 recordsLinked to original sources
PubMed1992

Illness behaviour in live-related and cadaver renal transplant recipients.

Illness behaviour was compared in 10 biologically live-related and 30 cadaver renal donor recipients in respect of their long-term psychological adjustment. The results indicated few long-term statistically significant differences postoperatively in illness behaviour between the two groups of patients, but a factor analysis revealed 8 items that were significantly related to illness behaviour associated with post-transplant psychological adjustment for all 40 transplantees studied. These were feelings of inadequacy; the renal graft being 'alien'; an inability to cope with the transplant; the disease resulting in the transplant being an external imposition beyond their control; responsibility for and acceptance of the transplant as a 'gain'; culpability for what has happened to them; anxious preoccupation with long-term prognosis; and dependence on others. Further analysis of these findings and their relevance for optimal patient management are discussed. Appropriate psychological support for these patients is important and, although long-term illness behaviour of biologically live-related and cadaver-related renal transplant recipients was found to be relatively similar, the various issues related to post-transplant illness behaviour in both groups of patients should be addressed in the provision of a psychonephrology service to a renal unit.

Adult↗
PubMed1991

Neuropsychological deficits associated with uraemic encephalopathy. A report of 5 patients.

Although uraemic patients with end-stage renal disease (ESRD) often present with impaired cognitive functions, little information exists concerning the identification of some of the neuropsychological processes underlying overt behaviour that affect adjustment to ESRD. The results of a neuropsychological investigation of a sample of adult patients with ESRD, before being accepted for dialysis, is documented in order to determine their altered neuropsychological status, since this may have a bearing on patient management and compliance. The patients were assessed by a single-case study methodology and the Luria-Nebraska Neuropsychological Battery in which parts requiring verbal patient response were taped for later detailed analysis. Neuropsychological complications occurred in conjunction with high urea levels in all patients, indicating varying degrees of impaired performance in motor tactile, receptive language, arithmetic, and intellectual functions. A common underlying pattern of performance decrement revolved around disturbed spatial synthesis and orientation in relation to visual perception, activity, logical-grammatical and arithmetical operations, and in intellectual tasks requiring identification of visual signs and spatial organisation. Further research is necessary to establish a possible correlation between physiological, biochemical and neuropsychological indices, and to compare neuropsychological differences between patients on different forms of treatment for ESRD.

Adult↗
PubMed1989

Depression and self-report disclosure after live related donor and cadaver renal transplants.

Important psychological reactions are associated with renal transplantation in general. Differences in psychological adjustment between recipients of kidneys from cadavers (CRs) and recipients of kidneys from live related donors (LRRs), however, have been poorly researched. In this study 10 LRRs (mean age 35,7 years; mean number of years after transplant 4,5) were compared with 30 CRs (mean age 38,6 years; mean number of years after transplant 5,3). The prevalence of depression and self-disclosed stress-inducing factors which might have affected long-term psychological adjustment after the transplant were investigated. The psychological status of each patient was assessed by means of a clinical interview, a mental status examination, the Beck Depression Inventory and a self-report questionnaire. There were found to be no long-term statistically significant differences between the LRR and CR groups in terms of the prevalence of depression, although 20% of the patients overall were depressed to varying degrees. The CR group was more concerned about the psychological and personal characteristics of the donors and their families than the LRR group, who expressed concern about the future well-being of the donors. Many members of both groups expressed having experienced both fear of graft rejection, before and immediately after the transplant, and anxiety, which decreased with time. The therapeutic value of a positive psychological climate in the renal unit and of supportive family relationships was confirmed for both groups. In comparison with their existence while on dialysis, most of the patients, irrespective of donor type, ultimately enjoyed an enhanced quality of life.

Adult↗
PubMed1989

Negative bodily experience and prevalence of depression in patients who request augmentation mammoplasty.

Increasing numbers of women seek to improve their physical appearance through augmentation mammoplasty (AM), often as a result of underlying psychological problems. Because of methodological problems in many studies, the reported prevalence of psychopathology in these patients varies widely. This study was designed to ascertain the presence of negative bodily experience and depression in patients requesting AM. The study cohort of 30 patients (mean age 30,4 years) was matched and compared with a hospital control group (mean age 30,8 years) who had never requested AM and had been admitted for minor surgery. The two groups were sociodemographically equivalent, the typical patient being a relatively well-educated white housewife. Each patient underwent individual psychological assessment, which included a semistructured interview, mental status examination and administration of the Beck Depression Inventory. Apart from several psychological problems related to a negative bodily experience, results indicated that varying degrees of depression were present to a significant extent in most patients seeking AM, emphasising the need for careful pre-operative psychological assessment and treatment of those patients who may require it.

Adult↗
PubMed1988

Hopelessness and low-intent in parasuicide.

Parasuicide is usually associated with low suicidal intent and research data show that rising rates remain a challenging clinical and research problem. Hopelessness, a core characteristic of depression, appears to be the link between depression and suicidal behavior in high-risk patients. Previous research in this regard focused largely on hopelessness as a correlate of suicide, attempted suicide, serious suicidal intent, and as a predictor of eventual suicide among serious suicidal ideators in the absence of a recent suicide attempt. The present study was designed to investigate the relationship between hopelessness and low suicidal intent in a cohort of 337 hospitalized adult parasuicide patients referred to a general hospital psychiatric unit. Within 24-48 hours after admission, all patients, once alert, underwent an individual detailed clinical interview and one of three assessments, viz., they were rated on the Beck Hopelessness Scale, The Zung Self-Rating Depression Scale or, DSM III criteria for depression. Results support the positive relationship between hopelessness and suicidal behavior in low-intent patients, previously demonstrated in high-intent patients. The need to also address hopelessness in low-intent patients as part of an effective therapeutic intervention strategy is discussed.

Adult↗
PubMed1987

Medical psychology--its growth and development in South African medical schools.

New training models and programmes in the teaching of clinical psychology associated with medically applied psychology at medical schools are developing in South Africa. However, a recent survey showed that a minimum number of full-time clinical psychologists is employed by medical schools in South Africa. How the few who are so employed fare away from their 'home base' is also explored as well as what their contributions are in such settings and in providing medical psychological services in general hospitals. These findings are discussed with reference to a developing country such as South Africa. Methods are proposed to further enhance the development of medical psychology and the effective contribution of clinical psychology to medical and related education, and its functioning as a bridge across the body-mind dichotomy within promotive and preventive healing systems.

Psychology, Clinical↗
PubMed1986

Short-term precipitants of parasuicide in adolescents.

Despite extensive research, our knowledge about adolescent parasuicide, why its incidence is currently so high and how to predict it remains incomplete. In the past research often focused on aetiological factors and long-range prediction. In this article short-term aetiological variables relating to both immediate precipitants and psychiatric diagnoses in a sample of 159 adolescents who attempted suicide are explored. The findings should contribute to a clearer understanding of the build-up to the parasuicidal crisis, the consequent level of disturbance and its treatment.

Achievement↗
PubMed1985

Self-destructive behaviour in adolescents.

Parasuicides continue to be an important public health responsibility. The consensus of opinion of most research workers is that the previously observed high rates are increasing on an international scale. Generally tabulated figures are minimal, representing an underestimation of actual rates, and exclude an unknown proportion of events classed incorrectly, although such studies nevertheless give some comprehension of the nature and severity of the problem. A 1978 study of parasuicides in young patients seen in the Department of Psychiatry, Addington Hospital, Durban, is updated for the period 1 January - 31 December 1983. The overall patient attendance figure for this period was 10 984, while a total of 3 200 requests for consultations were received. Of these 567 were for patients referred because of parasuicides--17,7% of all consultations referred. Nearly one-third (29%) of the parasuicides were in young patients, i.e. of 19 years old and younger, which represents a notable increase for the next 5 years when compared with the 1978 study in which 25% of parasuicides were in patients in this age range. There were more girls than boys. Peak months were October and November. A number of patients had a history of earlier parasuicides, suicidal thoughts and psychological treatment or came from a family with a history of mental disorder or previous parasuicides. Ten per cent of patients had a history of alcohol or drug abuse. Self-poisoning with analgesics, benzodiazepines and antidepressants was the most common method used. Results are discussed within the context of a service in medical psychology in a general hospital.

Adolescent↗
PubMed1985

Characteristics and post-hospital perceptions of patients refusing inpatient treatment in a South African general hospital psychiatric unit.

This paper explores characteristics and post-hospital perceptions of patients who refused general hospital psychiatric inpatient treatment in a relatively young unit. It was found that after an initial significant increase of up to 9.6% per year in these patients, the average for the 6-year period studied was 6.2% of all admissions. Most of the patients were single or divorced, not gainfully employed, refused hospital inpatient treatment within the first day after admission and were significantly younger than the controls. Substance use, adjustment and personality disorders predominated, and most of the patients were dissatisfied with some aspect of their treatment. Less than half the patients had a positive attitude towards at least one staff member. Results are discussed within the context of understanding the decision of such patients, in an attempt to deal with the problem and with reference to a consultation-liaison approach.

Adjustment Disorders↗
PubMed1985

Mianserin is better tolerated and more effective in depression than a nomifensine-clobazam combination: a double-blind study.

Patients suffering from depression (mostly depressive neurosis) were admitted to a double-blind study which compared the efficacy of a combination of nomifensine and clobazam with mianserin. Therapeutic efficacy was evaluated on the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Clinical Global Impression Scale, physician's assessments, Global Improvement and Treatment Emergent Symptom Scale for side-effects. Assessments were made before admission to the trial and on days 3, 7, 14 and 21. Forty patients were randomly allocated to two treatment groups. A case is made against polypharmacy and in particular against the use of benzodiazepine combinations in depression. Nineteen patients on nomifensine-clobazam and 14 on mianserin completed the three-week trial. At 7, 14 and 21 days, the Hamilton Depression Rating Scale (HDRS) total scores were significantly improved for mianserin when compared with nomifensine-clobazam. Similarly, at 7 and 14 days the Hamilton Anxiety Rating Scale (HARS) total scores were significantly better for mianserin than for the nomifensine-clobazam combination. There were also significant improvements for mianserin on the HDRS sub-scales of anxiety somatization, cognitive disturbance and sleep disturbance. There were no significant differences for HDRS somatic symptoms between treatment groups. Drowsiness was the most common side-effect in both groups. The incidence of total side-effects was 74% for nomifensine-clobazam and 71% for the mianserin group.

Adolescent↗
PubMed1979

The diagnosis and treatment of conduct disorders in young people.

Conduct disorders are among the most prevalent psychiatric disorders currently encountered in young people. The condition 'conduct disorder' is, however, an 'umbrella concept' which affects divergent personality subtypes. Treatment in the past, based on such an 'umbrella concept', has often proved itself prognostically dubious. This article stresses the need for the direction of management towards differential diagnosis and treatment of the various conduct disorder subtypes.

Adolescent↗
PubMedDate not supplied

Burns.

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Burns↗