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Biomedical subjects

P Brieger

Publications and source records attributed to P Brieger.

32 records · Page 2Linked to original sources
PubMed1997

[What is cyclothymia?].

The term "cyclothymia" is being used with different meanings. DSM-IV and ICD-10 define "cyclothymia" or "cyclothymic disorder" as a long lasting, subeffective disorder with frequent shifts between hypomanic and (sub)depressive states. In the tradition of Kurt Schneider cyclothymia was understood as a synonym for manic-depressive illness exclusively, while different personality typologies speak of a "cyclothymic" typus. Historically, the term was first used by the German psychiatrist Ewald Hecker in 1877. The definitions of DSM-IV and ICD-10 seem to be satisfactory in respect to reliability, but the nosological position of "cyclothymic disorder" is unclear. We review results concerning clinical symptomatology, comorbidity, biological parameters, personality (including the question of creativity), psycho- and pharmacotherapy as well as clinical course, which leave many questions open. Nevertheless, results in family studies support the idea that at least a fraction of "cyclothymia" is a mild or subclinical form of bipolar disorders. Until further research, which is urgently needed, we suggest that the term "cyclothymia" should be only used according to the guidelines of DSM-IV and ICD-10.

Bipolar Disorder↗
PubMed1997

Dysthymia and cyclothymia: historical origins and contemporary development.

The aim of this article is to review and put in their historical context today's data, methodologies and concepts concerning subaffective disorders. The historic roots of dysthymic and cyclothymic disorders--part of the subaffective spectrum--are essentially Greek, but the first use of the word 'dysthymia' in psychiatry was by C.F. Flemming in 1844. E. Hecker introduced the term 'cyclothymia' in 1877. K.L. Kahlbaum (1882) further developed the concepts of hyperthymia, cyclothymia and dysthymia--with possible subthreshold symptomatology--in 1882. After Kraepelin's rubric of 'manic-depressive insanity', the term 'dysthymia' was widely forgotten, and 'cyclothymia' became ill defined. Nowadays the latter term is used in three, partially contradictory, senses: (1) a synonym for bipolar disorder (K. Schneider), (2) a temperament (E. Kretschmer) and (3) a subaffective disorder (DSM-IV, ICD-10). A renaissance of subaffective disorders began with the development of DSM-III. Therapeutically important research has focused on dysthymic disorder and its relationship to major depressive disorder, while cyclothymic disorder is relatively neglected; nonetheless, operationalized as a subaffective dimension or temperament, cyclothymia appears to be a likely precursor or ingredient of the construct of bipolar II disorder.

Cyclothymic Disorder↗
PubMed1997

[Conrad Ferdinand Meyer reflected in the paradigm change in German psychiatry].

German-speaking psychiatrists had a great interest in the Swiss poet and writer Conrad Ferdinand Meyer (1825-1898)-even after his death. Meyer was hospitalised twice for major depression with psychotic features. For many years of his life he showed a chronic depressive disorder. We would diagnose a dysthymic disorder with comorbid recurrent major depressive disorder with psychotic features according to DSM-IV or ICD-10. After Meyer had lived isolated for many years and had hardly left his house, he reached public recognition and found his "profession" only at the age of 40. Different pathographic publications (amongst others Möbius, Hellpach, Sadger, Lang, Jung) on Meyer in the early 20th century reflect the debate over both Kraepelin's theories and psychoanalysis. In these publications the scientific argument was often more important than Meyer's biography. Two topics play an important role in these discussions: the differences between idiographic and nomothetic method, and the question, where the border between "personality variation" and "illness" lies.

Adult↗
PubMed1997

[Compulsive disorder with homicidal impulses and paranoid symptoms in vascular encephalopathy].

We report on the case of a 45-year old man with OCD who had the obsessive impulse to kill his 3-year old son. The patient showed signs of vascular encephalopathy after perinatal brain damage; besides that, he had developed a mild "explanatory" delusional system. Under treatment with SSRI and clozapin he improved remarkably. Presenting this case, we discuss the connection between organic disorders and OCD, and especially its relationship to perinatal brain damage.

Brain↗
PubMed1996

[Delusion of mercury poisoning in multiple sclerosis].

We confirmed the diagnosis of multiple sclerosis in a 54-year-old man. The patient rejected this diagnosis and was completely convinced that all his symptoms resulted from a chronic mercury intoxication. We found evidence that this delusional disorder was an independent illness, and not a "symptomatic psychosis in multiple sclerosis." So far, little notice has been taken in psychiatry of delusions of environmental poisoning, which cause difficulties in applying common criteria of delusion.

Delusions↗
PubMed1995

[The dysthymia concept: current and historical aspects--an overview].

The article reviews the historical development of the understanding of dysthymia from C. F. Flemming (1844) to DSM-IV and to Akiskal's concepts. Recent results on epidemiology, comorbidity, neurobiology, familial patterns, clinical course, psychological characteristics, psycho- and pharmacotherapy of dysthymia are discussed. Although present concepts of dysthymia have led to results of high scientific and clinical relevance, the classification of chronic depression and their relation to both personality disorders and affective psychoses need further clarification. The development of dysthymia reflects the differences between Anglo-American operational psychiatric systems and the rich tradition of psychopathology in German-speaking psychiatry.

Adolescent↗
PubMed1994

[Social support by professional personnel during inpatient treatment of cancer patients. "Chronic disease and coping with illness" research project].

We examined 63 in-patients in a medical hospital with a semi-structured and video-taped interview about the professional social support they had received. Patients were quite satisfied with physicians' and nurses' support, still more than one third of them had missed appraisal support from physicians. We found evidence that older, more ill and female patients perceived more professional social support was given. With the help of a hierarchical cluster analysis it was shown that the importance of professional social support depended remarkably on individual factors as identity or partner relation.

Adaptation, Psychological↗
PubMedDate not supplied

[Inpatient treated, mono-symptomatic childhood enuresis--results of follow-up in adulthood].

32 formerly monosyndromatic enuretic patients who had been treated for this condition between 1980 and 1992 were compared with a matched control group from the general population in respect of sociobiography, psychopathological and dimensional factors (depressiveness, satisfaction with life, global functioning). Most of the former patients did not fulfil diagnostic criteria for an ICD-10 diagnosis at follow-up, although there was a 37% vs. 9% difference between former patients and controls in this respect--without a clear diagnostic pattern of such disorders. Furthermore, former patients had slightly higher depression scores and slightly lower global functioning than controls at follow-up. These results confirm that childhood enuresis has a low negative predictive value concerning the development of psychiatric disorders, although it may constitute a vulnerability factor.

Adolescent↗