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Biomedical subjects

M Krausz

Publications and source records attributed to M Krausz.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Quality of life. Construct validation and the development of a modular system].

The construct Quality of Life (QoL) is investigated by metaanalysis of eight (inter)nationally validated questionnaires in a multicenter study. Data have been collected in a mentally healthy (n = 479), a depressed (n = 171) and a schizophrenic (n = 139) sample. Conventional psychometric criteria and a facet analytical methodology have been applied. The resulting questionnaire "Modular System for Quality of Life" (MSQoL) consists of a core module with 47 items (one "G-factor" and six subdimensions), which is sufficiently valid for all three samples. Additionally, there are four specific modules (demography, family, partnership, profession). No specific modules can be identified for the psychopathological subgroups. The validated radex structure for subjective QoL offers the opportunity for a cumulative research design and for adaptations to the actual setting.

Adolescent↗
PubMed1999

Neuroleptic-induced extrapyramidal symptoms are accompanied by cognitive dysfunction in schizophrenia.

Cognitive impairments in schizophrenics have been found to precede tardive dyskinesia and to co-exist with other motor deficits. However, little is yet known about the prevalence of cognitive disturbances in patients with neuroleptic-induced parkinsonism. From the literature on idiopathic parkinson, it was inferred that extrapyramidal symptoms (EPS) are accompanied by cognitive dysfunction. 85 schizophrenic in-patients were divided into EPS high and low scorers according to an established criterion (Simpson Angus Scale, cut-off score: 0.4). Cognitive impairments were assessed using a self-rating instrument measuring disturbances of information processing. Patients with high EPS exhibited significantly elevated scores in six of ten cognitive and perceptual subscales (t = 2.1-3.1) as compared to low EPS patients. It is concluded that high EPS patients suffer from cognitive disturbances which are assumed to possess high relevance for both psycho-social and medical treatment. Cognitive problems may, when not considered, disturb compliance, insight of illness and transfer of learnt skills into everyday life.

Adult↗
PubMed1999

Increased automatic spreading activation in healthy subjects with elevated scores in a scale assessing schizophrenic language disturbances.

BACKGROUND: Previous studies on semantic priming have suggested that schizophrenic patients with language disturbances demonstrate enhanced semantic and indirect semantic priming effects relative to controls. However, the interpretation of semantic priming studies in schizophrenic patients is obscured by methological problems and several artefacts (such as length of illness). We, therefore, used a psychometric high-risk approach to test whether healthy subjects reporting language disturbances resembling those of schizophrenics (as measured by the Frankfurt Complaint Questionnaire subscale 'language') display increased priming effects. In addition, the Schizotypal Personality Questionnaire was used to cover symptoms of schizotypal personality. Enhanced priming was expected to occur under conditions favouring automatic processes. METHODS: One hundred and sixty healthy subjects performed a lexical decision semantic priming task containing two different stimulus onset asynchronicities (200 ms and 700 ms) with two experimental conditions (semantic priming and indirect semantic priming) each. RESULTS: Analyses of variance revealed that the Frankfurt Complaint Questionnaire-' language' high scorers significantly differed from low scorers in three of the four priming conditions indicating increased automatic spreading activation. No significant results were obtained for the Schizotypal Personality Questionnaire total and subscales scores. CONCLUSIONS: In line with Maher and Spitzer it is suggested that increased automatic spreading activation underlies schizophrenia-typical language disturbances which in our study cannot be attributed to confounding variables such as different reaction time baselines, medication or length of illness. Finally, results confirm that the psychometric high-risk approach is an important tool for investigating issues relevant to schizophrenia.

Adult↗
PubMed1999

Postoperative suction drainage of the axilla: for how long? Prospective randomised trial.

OBJECTIVE: To define the correct time to remove the drain after axillary dissection for carcinoma of the breast. DESIGN: Prospective randomised trial. SETTING: Two public hospitals, Israel. SUBJECTS: 90 women who required axillary dissection for carcinoma of the breast. INTERVENTIONS: 42 were randomised to have the drain removed on postoperative day 3, and 48 to keep the drain in until discharge had decreased to less than 35 ml/24 hours. MAIN OUTCOME MEASURES: Formation of seromas or wound infections, need to reinsert the drain, and duration of hospital stay. RESULTS: Early removal of the axillary drain was associated with a significantly higher incidence of seromas (9/42 compared with 2/48, p = 0.02) unless the total amount of fluid drained during the first three postoperative days was less than 250 ml. CONCLUSION: Drains should be removed after axillary dissection only when the daily amount of fluid discharged is low, unless the drainage during the first three days is less than 250 ml.

Axilla↗
PubMed1999

Psychiatric comorbidity in opiate addicts.

The present study investigates whether a correlation exists between mental symptoms and opiate dependency. During a 5-year follow-up study in Hamburg, of 350 opiate addicts who were in contact with the help system at the time of the initial investigation, 219 (63%) could be interviewed three times at 1-year intervals. The investigation instruments were standardized questionnaires such as EuropASI, CIDI, SCL-90-R and BDI. The general life situation of the investigated persons had, on the whole, improved in the course of the last 2-3 years. Drug consumption had markedly decreased. One third of the opiate addicts were in a comparatively good mental condition on all three survey interviews, for 17% there was a worsening of the condition, and for another 17% the negative mental condition was reinforced. A correlation can be established between mental disorders/symptoms and drug addiction or drug-related problems. The more unfavorable the course of the mental symptoms, the greater the problems of the client's current life situation. There is also an overall relationship between increased drug consumption and mental symptoms like depressivity and anxiety, and the psychosocial functioning level. However, the expected correlations between mental disorders and the extent of drug consumption are not very marked. This indicates that specific constellations of drug consumption and mental disorders are not isolated but are related, as elements of a complex behavioral pattern, to the development of other life areas of the client.

Adolescent↗
PubMed1999

[Admission status of alcohol and drug-dependent patients in "high threshold" access to withdrawal treatment].

OBJECTIVE AND METHODS: 106 patients (64.2% male and 35.8% female) who applied for a withdrawal treatment by phone call, were interviewed concerning the admission context with the aim to find out whether the admission regulations prevent patients from undergoing treatment. RESULTS: 72.6% of all patients were admitted as inpatients. The average waiting period was 8 days. 15.1% were known to have previously suffered from conclusions and 4.7% from delirium tremens; for these patients, the waiting period was significantly shorter. CONCLUSIONS: High-threshold admission is not an insurmountable difficulty. Waiting periods and soberness at admission are accepted. Setting up admission conditions is, on the one hand, justified, whereas on the other hand chronic patients are often not reached. Telephone contacts with patients willing to undergo treatment should be replaced by contacts in an outpatient setting.

Alcoholism↗
PubMed1998

[Prevalence of psychiatric disorders in opiate dependent patients in contact with the drug treatment system].

In the course of a 5-year follow-up study concerning comorbidity in opiate addicts, 350 patients were investigated initially in various addiction centres in Hamburg. More than two thirds of the participants of the study are male, with an average age of 29 years at the time of the investigation. Most of them are receiving methadone maintenance treatment (42%), about one fourth is in residential rehabilitation and another 17% in inpatient detoxification treatment. The patients have been consuming heroin for an average of 9 years. For 55% of the opiate addicts (at least) one more psychic disorder in accordance with ICD-10 has been diagnosed (lifetime prevalence). F6 personality disorders have not been taken into consideration. The 6-month prevalence is 37%, 2-week prevalence 23%. For 43% of the opiate addicts, the predominant disorders belong to the group of neurotic, endurance, and somatoform disorders (F4), and for 32% of the patients to the group of affective disorders (F3). Schizophrenic, schizotypic and delusional disorders (F2) are less frequent (5%). Another 5% of the opiate addicts suffer from eating disorders (F5). These are partly multiple diagnoses cases; there is an average of 1.3 diagnoses per patient. Women are clearly more often affected by comorbidity than men. Most disorders first occur between the age of 18 and 21 years. Therefore, (lifetime) prevalence rates are twice to three times as high as that of the average German population, according to the present state of knowledge. This underlines the great importance of specific diagnostic and explorative methods for the treatment of addiction. Psychic disorders or disturbances that might adversely affect the course of treatment should be given more consideration.

Adolescent↗
PubMed1998

Maintenance treatment of opiate addicts in Germany with medications containing codeine--results of a follow-up study.

AIMS: Outpatient maintenance treatment of opiate addicts with codeine/dihydrocodeine is a common approach in the treatment of drug addicts in Germany. This study was carried out to assess possible benefits of codeine maintenance in terms of patients' health stabilization, social rehabilitation and drug consumption. DESIGN: Three-year follow-up study. SETTING: Three practices of substituting physicians in large-city areas in Germany. PARTICIPANTS: Of a random sample of 297 people attending for opiate outpatient treatment in 1993, 199 were successfully followed up 3 years later. MEASUREMENTS: Measures of health, living conditions, employment, criminal activities and drug use were collected at baseline and follow-up. The data were based on standardized interviews and medical examinations by the attending doctors as well as on questionnaires from the patients. FINDINGS: Based on a 67%-follow-up rate, after 3 years of codeine maintenance there was improvement in general health and mental problems. The living and working situation remained more or less unchanged and stabilized at a satisfactory level. The same applies to the consumption of drugs. CONCLUSION: The patients' progress shown in this study was comparable to that achieved by methadone maintenance in similar geographical regions. Codeine has a weaker pharmacological effects and our results suggest that codeine maintenance treatment deserves more attention and controlled trials to assess the benefits compared with methadone (or other opioids).

Adult↗
PubMed1998

[The impact of the central serotonin system on alcoholism and therapeutic consequences].

Several studies support the assumption that the development and/or maintenance of alcoholism is due to a deficit of the central serotonergic system. But it still remains open whether the imbalance in the serotonergic functioning is due to genetic factors or whether it is a result of alcoholism. It has been hypothesised that both mechanisms interact with each other creating a vicious circle. The efficacy of serotonin reuptake inhibitors (SSRIs) in treating alcoholism supports the pathophysiological assumptions. Citalopram (40 mg) and Fluoxetine (60-80 mg) significantly reduce ethanol intake. However, treatment effects disappear after a treatment period of more than 4 weeks in most of the studies. Chronic and heavy alcoholics benefit less from treatment. Better treatment results were obtain in alcoholics with primary depression, especially with a prolonged treatment period. The promising treatment outcome in primary depressed alcoholics suggests an efficacy of SSRIs in alcoholism with primary anxiety disorders, although no data are available. The results of the studies in this field support the following therapeutic consequences: 1. Alcoholics with primary depression should be treated with SSRIs. 2. A short-term treatment with SSRIs in primary alcoholism without comorbid psychiatric diseases can be considered, e.g. to prevent treatment drop-outs or for relapse prevention. 3. So far, treatment in alcoholics with primary anxiety disorders is not supported simply due to a complete lack of data. Studies on this problem are imperative.

Alcoholism↗
PubMed1998

Impact of ethnicity on the prevalence of psychiatric disorders among migrants in Germany.

OBJECTIVES: Studies on psychiatric disorders among migrants have described higher rates, especially of schizophrenia. Some evidence points to the possibility of misdiagnosis for this higher rate; other studies point to the underrepresentation of migrants in psychiatric services, leading to artefactual epidemiological data. METHODS: All admission records of migrants to a psychiatric clinic from 1993 to 1995 were assessed for diagnosis, symptomatology and treatment. RESULTS: Admissions of 408 migrants, 8.1% of total admission, were assessed. Of these, 38.7% received a diagnosis of a schizophrenic disorder, significantly more than the other clinic patients. The mean age at admission was 34.0 years, at onset of illness 28.6 years and at time of migration 20.4 years. Only 8.3% were mentally ill at the time of migration. Language problems correlated with the diagnosis of a schizophrenic disorder. CONCLUSION: An underrepresentation of migrants shows differences in the use of psychiatric services. Some evidence from the mental status and reported language problems may explain the higher rate of schizophrenia due to misdiagnosis.

Adult↗
PubMed1997

[Opiate dependent patients in inpatient detoxification. Prevalence of somatic diseases in hospital admissions].

AIM: To investigate whether the impression that prevalence rates of diseases in drug addicts undergoing detoxification could be verified empirically. In addition, to make an attempt to identify possible relationships responsible for this development. METHOD: Between 1989 and 1993, within the framework of a detoxification program, 1041 opiate addicts were investigated for the presence of somatic diseases. For this purpose, the overall sample was divided up into 3 groups corresponding to the following time periods: 1989/1990, 1991/1992, 1993. The baseline data comprised the standardised history at the time of admission, the results of the initial clinical examination, and the serological and clinico-chemical findings during the further course. RESULTS AND INTERPRETATION: A deterioration in the general state of health associated with more risky drug consumption patterns and social isolation was established. Apparently, low-threshold treatment programs and prophylactic strategies made available to almost two-thirds of the addicts in Hamburg have proved unable to prevent the deterioration of the situation of a subpopulation of addicts.

Adolescent↗
PubMed1997

Surgery in Israel.

The evolution and development of surgery in Israel reflects the influence of its dramatic historical events. The immigration of surgeons, particularly since the fourth decade of the 20th century, highly contributed to the framework of modern surgery. Medical education occurs at 4 medical schools, in Jerusalem, Tel Aviv, Haifa, and Beer Sheva, and postgraduate surgical training takes place in all public hospitals, most of which are university hospitals or have university-affiliated departments, and is controlled by the Scientific Council of the Israel Medical Association (Tel Aviv). Health care is provided by 4 health insurance funds and has been recently influenced by the National Health Insurance Bill and the Bill of Patient's Rights. Surgical standards are high and similar to the very best of Western countries. The geographical location of Israel in the Middle East, surrounded by hostile Arab countries, has dramatically influenced the development of Israeli surgery. The practice of surgery ranges from full-time service in state and insurance-funded mostly academic hospitals, to private part-time clinics for wealthy and insured patients. Surgical training occurs only in departments accredited by the Scientific Council, which are mostly affiliated with the 4 medical schools. A surgical residency in Israel usually requires 6 years, and its guidelines and regulations are elaborated and recommended by the Israel Surgical Society and controlled by the Scientific Council. Most Israeli surgeons were trained in Israeli hospitals, but a substantial number of surgeons immigrated to the country, especially from eastern Europe.

Curriculum↗
PubMed1997

[Dimensional structure of the German version of the Brief Psychiatric Rating Scale (BPRS)].

Since the early 1960s the Brief Psychiatric Rating Scale (BPRS) has been one of the most frequently used standardized methods in international psychiatric research. The BPRS is used mainly for the rating of psychopathological symptoms of schizophrenic subjects. According to the results of factorial analyses, the original version of the BPRS is divided into five subscales, which have been preserved in the German translation. The validity of this original scale structure for the German BPRS version has not been investigated, however. A principal-components analysis of the 18 BPRS items carried out on the data of 301 schizophrenics yielded four factors that are comparable with four of the original subscales: Thought disturbance, Hostility/suspiciousness, Anxiety/depression, and Anergia. These results are compared with earlier findings and similarities and differences are discussed.

Adolescent↗
PubMed1997

[Consumption patterns and motivation for use of addictive drugs in schizophrenic patients].

In particular studies conducted in the U.S. display a tendency for schizophrenics to combine hallucinogens and amphetamines, whereas other studies report on a combination of psychotropic substances with a similar range of action. Influencing negative symptoms is reported to be the motivation for consumption. A total of 222 patients with a schizophrenic disorder (F2) and addiction (F1) were examined. The main substance was alcohol (F10.1 or F10.2; 52.2%), followed by cannabis (F12; 25%), opiates (F11; 4.1%), sedatives or hypnotics (F13; 2.7%) and cocaine (F16; 0.5%). A multiple drug use (F19) is reported by 14% of them. The most frequent combination was alcohol and cannabis, whereas hallucinogens and amphetamines were only rarely combined. Actual multiple consumption was reported by 55% of the patients, while lifetime multiple consumption applied to 72%. The motivation seems to be an unspecified sedation of unpleasant affective symptoms of schizophrenia. The most frequently seen combinations do not correlate with the reports published in the literature. The great variations in motivation seem to mainly reflect the importance of the availability of the substance.

Adult↗