Search PubMed⌕ Search

Biomedical subjects

R Battegay

Publications and source records attributed to R Battegay.

At least 19 recordsLinked to original sources
PubMed1992

[Decreased narcissism in the aged and in suicide].

The elderly have less narcissism (= self-representation, narcissistic information, attention or libido) at their disposal to invest their own ego as well as the environment narcissistically. It therefore becomes more difficult to enlarge one's own self on encountering new persons, new environments and new customs. Some elderly may therefore feel more and more isolated and commit suicide. The rate of suicide attempts in the Canton (state) Basel-city shows a statistically significant decrease with higher age (p < 0.001) up to the age group of 60-69. Men of the age group > 80, however, manifest a significant increase in the rate of suicide attempts. The rate of fatal suicides for Swiss women increases with growing age, though not reaching statistical significance. In Basel-city, the suicide rate for women shows a rising tendency only up to the age group of 50-59 years. For Swiss men from 30-69 there is a steady, but not significant increase, which is still more pronounced from 60-69 to 70-79 (p < 0.05) and from 70-79 to > 80 (p < 0.01). For men of Basel-city the suicide rate shows, however, a clear peak in the age group 30-29 and, after a downwards trend until 40-49, an increase to a peak in the age group 60-69. From there the suicide rate stays level with a slightly decreasing trend. These statistical data seem generally to confirm, at least as a tendency, that suicide rates increase with growing age, i.e. with diminishing narcissism at one's disposal. The exception, the peak of suicides in young adults, is probably due to drug dependents who have taken their own lives. When working with elderly people, it is important to consider this reduction in narcissism and to work with them on an individual psychotherapeutic and eventually psychopharmacological but parallel also on a group basis. The individual psychotherapy should be directed toward supporting their self-confidence. In the supervision of two groups of elderlies, one of which was composed of older people who suffered from paranoid ideas, it was striking that during 75 sessions of working with this group the delusions receded and the patients became more and more communicative and no longer thought of committing suicide. In prevention it is important that the elderly be encouraged to seek participation in some group and/or family activities, though even then the individual freedom of each one not to participate in such events should be respected.

Adult↗
PubMed1992

[Tactile-symbiotic relationship as the earliest step of child development].

Whereas Sigmund Freud considered the orality to be the beginning of the child development, in the last two decades the tactile-symbiotic mother-child-relationship came into the center of scientific attention. The symbiotic-narcissistic basal relationship of early childhood is reactivated in each later object relation. On this basis all active ego performances are built up, as e.g. the projective identification (archaic form), the identification, the transference (in psychotherapy), the regression etc. as well as the delimination from the object. The next level of the object relation is that of the free decision for or against an object. People with narcissistic personality disorders (narcissistic neuroses), having a constituent ego, and borderline personality disorders which occur in individuals with a fragmentation-prone ego, have suffered in their early childhood under deficiency experiences or the experiences of overprotection or of an attention under conditions. The more the individuals were disturbed also in their ego functions, the more an incapacity of the infant has to be supposed to experience or to admit the attention really presented to it. In major depressions the narcissistic emptiness or depletion seems to be at least partially the consequence of a genetic predisposition.

Adult↗
PubMed1991

[Confusional states following administration of short-acting benzodiazepines (midazolam/triazolam)].

The authors report about six patients, who after the intake of Midazolam or Triazolam suffered from an oneiroid-confusional state in which they carried out complex acts and for which an anterograde amnesia existed. In addition to these drugs, one female patient was under the influence of alcohol and one male patient of Bromazepam. Two of the patients suffered of emotional conflicts. The possibility of disinhibition of suicide and other impulses is named. The authors recommend caution in prescribing these benzodiazepines of ultrashort action.

Adult↗
PubMed1991

[Crisis intervention in suicidal subjects].

By the term crisis intervention in connection with suicidal behavior the author understands a therapeutic intervention which should help the concerned individual to cope alone, with the situation which led to the suicidal attempt or to the acute suicidal behavior. With the help of his relatives, of a therapeutic or of a self help group according to the experiences within the psychiatric consultation service at the emergency station at the general hospital in Basel the multidisciplinary approach by a psychiatrist, a psychiatric nurse and, if necessary, a social worker, is indicated. Among the 848 patients who were seen in the years 1985 to 1989 for a psychiatric crisis intervention because of suicidal attempts, the age distribution showed that there is a peak in the age group of 20 to 24 (p less than 0.01). If, however, men and women are taken separately, a much broader age peak is visible in men: 20 to 34 (p less than 0.05). With respect to the diagnosis patients with psychogenic reactions and development included neuroses and borderline personality disorders are overrepresented (p less than 0.01). Also alcohol- and drug-dependents show a significant higher representation (p less than 0.01). The fact that only 17.2 to 24.5% of these patients had to be hospitalized during crises shows that in general the crisis intervention belongs to the ambulatory psychiatric services. A suicidal crisis does not mean that the concerned patients would definitely like to die, but rather to set a signal for the environment that they had not received enough human attention.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Defense and coping in the antinomy between self-maintenance and adaptation.

After definitions of the terms defense and coping, the disturbances of both linked to narcissistic personality disorders, borderline personality disorders, and major depressions are described. All three are characterized by deficient narcissism. In narcissistic personality disorders, defense and coping are hindered mainly because of a lack of narcissistic investment of the ego, in borderline personality disorders preponderantly because of a fragmentation-prone ego with its rigid defenses, and in major depressions primarily because narcissistic emptiness or depletion breaks down interest of the ego to get along with the environment or leads to an extreme overinvestment of the remaining narcissism in the objects. Finally, the three levels of object relations--the narcissistic--fusionary one, the level of active ego performances, and the level of free decisions--and their functioning with respect to coping in the three disorders mentioned are discussed.

Adaptation, Psychological↗
PubMed1991

[Assessment of patients with narcissistic neuroses using the Deneke Narcissism Inventory].

In the following paper Deneke's Narzissmusinventar (1989) was used for examining 32 (17 men, 15 women) patients who, after a first interview were diagnosed having a narcissistic personality disorder respectively neurosis. We compared our results with the results Deneke found in patients with borderline personality disorders, narcissistic personality disorders and healthy persons. Our results correspond with the results Deneke found in patients with narcissistic personality disorders. Deneke's Narzissmusinventar is qualified to confirm the diagnosis of a narcissistic personality disorder respectively neurosis.

Ego↗
PubMed1990

Complementary individual and group analytic training for future psychotherapists.

Whereas individual training analysis offers the candidate the possibility of thoroughly working through unconscious tendencies, desires, and anxieties that come to the foreground, a dyadic setting group analysis permits one to observe and to analyze all the many narcissistic, power, and rivalry problems that are activated in a group setting, and to undergo a social learning process. The author describes the value of training for the (later) activity as individual or especially as group analyst. This training includes participation in an analytic self-experience group (psychodynamic group process), supervision by an experienced group analyst of the work done in an analytic group, and comoderating of an analytic group by two psychotherapists.

Curriculum↗
PubMed1990

Psychosomatic factors in borderline hypertensive subjects and offspring of hypertensive parents.

Psychosomatic factors, sympathoneural and sympathoadrenal as well as cardiovascular mechanisms, were studied in 24 patients 18-24 years of age with borderline hypertension, 50 age-matched normotensive offspring of hypertensive parents, and 49 controls with no family history of hypertension. They were compared by projective and questionnaire-based psychological tests and their circulatory and neurohormonal reactivity to mental (Stroop color-word conflict test and arithmetic test) and physical stressors (orthostasis and bicycle ergometry test) were measured. Borderline hypertensive subjects externalized aggression less (p less than 0.05) but internalized it more (p less than 0.05) and were more submissive (p less than 0.05) when compared with controls. Offspring of hypertensive parents showed a similar but weaker pattern. Both risk groups reported more positive interactions with their parents (genetic risk subjects versus controls, p less than 0.05; borderline hypertensive patients versus controls, p = 0.08) and had higher state-anxiety levels (p less than 0.05). There were more subjective symptoms of beta-adrenergic receptor-mediated functions (e.g., tachycardia, tremor) in borderline hypertensive subjects and offspring of hypertensive parents, elevated heart rates (analysis of repeated measures, p less than 0.001), and enhanced plasma norepinephrine concentrations (p less than 0.05) when compared with controls. These findings in subjects at risk for the development of hypertension suggest that psychosomatic factors and sympathetic overactivity are involved in the early phase of hypertension.

Adult↗
PubMed1990

Effects of psychological and physical covariates on plasma catecholamines in borderline hypertensives and offspring of hypertensive parents.

The interpretation of plasma catecholamine measurements may be influenced by psychological and physical factors. Therefore, catecholamine concentrations were adjusted for between-subject differences by the following possible confounding factors, i.e. body-mass index, individual maximal physical work capacity, urinary sodium excretion rates and anxiety score. Subjects were 24 borderline essential hypertensives, aged 18-24 years, 50 age-matched normotensive offspring of hypertensive parents and 49 controls with no family history of hypertension studied at rest and during mental stressors (Stroop colour-word conflict test, mental arithmetic). Borderline hypertensives had consistently higher adjusted venous noradrenaline concentrations than control subjects (p less than 0.05). Adjusted plasma adrenaline concentrations were higher in borderline hypertensive subjects than in offspring of hypertensive parents during supine rest. Despite its limitations, venous plasma noradrenaline concentrations when adjusted for work capacity, body-mass, sodium excretion and anxiety suggest enhanced sympatho-neural activity in young borderline essential hypertensives.

Adolescent↗
PubMed1989

[Holistic medicine--away from the separation of mind and body].

The purpose of liaison-psychiatry is to sensitize the colleagues for the aspect of the patient as a whole. The German expression 'wie er leibt und lebt' (as he exists in and with his body, and lives) is expressing this holistic view and says that the human being is living and experiencing himself in his corporal being and subjectivity. The body simultaneously is a somatic process and experience. If the physician wants to understand the human being, consulting him as an undivided entity, he has to be able to grasp the organ language as posture, as expression of the patient's subjectivity and of his self-esteem. He has to consider that the 'organ choice' shows, besides hereditary, culture and individual factors, the role which an organ plays within a family and an individual. The organ language can also be a significant expression of a basic drive problem. In the encounter with the patient it is further important to notice that he often is only the 'presented symptom' of the family. The vulnerability of a human being, genetically and life-historically caused, is different according to age. The cultural background out of which a human being originates decides on a more somatic or a more verbal mode of expression, whereby in our cultural background prejudices are existing against the emotional expression in the body language. In therapy, unconditional understanding may be expected of the physician.(ABSTRACT TRUNCATED AT 250 WORDS)

Culture↗
PubMed1989

Longitudinal study on the consumption of analgesics, tranquilizers and hypnotics by healthy Swiss men over a 13-year period (1972-1985).

This study describes the course of medical drug consumption (analgesics, tranquilizers, and hypnotics) in 843 identical, healthy men between the ages of 20 and 33 years. In 1972-1973, 4082 randomly selected 20-year-old Swiss military recruits were interviewed with a standardized questionnaire about parental drug consumption and their own consumption of tobacco, alcohol, analgesics, tranquilizers, hypnotics, and illegal drugs. In 1979, 1658 and, in 1985, 1554 men from the original sample were asked identical and similar questions via questionnaires sent by mail. The results presented concern the 843 men who took part in all three phases. The medical drugs these men consumed most often were analgesics. However, there was a significant decrease in the number of men who took these drugs either seldom or repeatedly during the observation period (28.6% vs 21.0%; P less than 0.001). There was also a significant decrease in the proportion of men who used tranquilizers (8.7% vs 4.9%; P less than 0.01); however, the proportions of men taking hypnotics were the same in 1972-1973 and in 1985 (5.4% vs 5.2%). In the study population, repeated consumption of analgesics and/or hypnotics and/or tranquilizers at the age of 20 significantly increased the probability that the subjects would habitually consume analgesics at the age of 33. Repeated parental consumption of hypnotics increased the probability that the sons would significantly increase their consumption of hypnotics and/or tranquilizers between the ages of 20 and 33. The results are discussed against the background of other findings concerning the epidemiology of drug consumption.

Adult↗
PubMed1989

Apparent and hidden changes in group members according to the different phases of group psychotherapy.

On a psychological-motivational-vertical axis, the more or less covert experiences of members of a therapeutic group are determining factors, whereas on a sociological-interactional-horizontal axis, the system approach, or the network of preponderantly apparent interactions, is the object of therapeutic interventions. The psychological view is directed toward the individual members, whereas the sociological approach means grasping the group as a whole. In group treatment a shifting resultant is mostly observed, at times stressing the individual-psychological approach and at other times the systemic-interactional approach. Five phases of group psychotherapy are discussed in which childhood conflicts and deficiency experiences are activated, and insight and social learning are furthered; the psychodynamics and interactions between the members go on in the described phases on individually different levels, apparent or hidden.

Group Processes↗
PubMed1989

[The ego--defense mechanisms and coping].

If the aims of defense and coping are considered, it can be concluded that essentially the different kinds of defense should serve to cope with reality. They intend either to inhibit the pressure of the unconscious drives and emotions or to bring them in tracks which are better to overlook. Or they tend unconsciously to reduce the demands of the surroundings and/or to make it possible to use former patterns of coping, as e.g. in regression and transference, or to reduce the cognitive and emotional reception of it, as in autism. Whereas those defense mechanisms, which preponderantly serve to deal with the drives and emotions, may lead to a better coping with the given situation, those defense mechanisms, however, which mostly serve to a reduction of the perception of the environment or to a decrease of expectations of the surroundings, are not increasing the coping capacities with a really given situation. But also when defense is rigid or excessive, which can, if a certain genetic predisposition is given, also be visible in autoimmune-processes, the coping with reality is more difficult. Thereby it is, however, to consider that a rigid defense diminishes the danger of ego-fragmentation and, especially when a psychotherapy is done, leads with the time on this way to a better coping with the outside reality and the inner possibilities. In serious terminal diseases a defense, which permits an active life, seems to have a better prognosis than a resignated acceptation of the illness, which originates in the activity of the superego. Heavy pain-syndromes in diseases which are not life-menacing can apparently be dealt with the better the more the concerned people succeed to turn the anxiety which is little related to objects in object-related fear. With that potencies of the ego are free which otherwise would have to be invested in the defense of anxieties.

Adaptation, Psychological↗
PubMed1988

[Alcohol, tobacco and drug use in Swiss men 20 to 33 years of age].

In a second follow-up in 1985 former military recruits were asked to fill in a standardized questionnaire concerning their consumption of alcohol, tobacco, drugs and medicines. They had been interviewed for the first time on enlistment in 1972/73 and had filled in a second, mailed questionnaire in 1979. The consumption patterns from 1972/73 to 1985 are described in subjects who participated in all three surveys. Out of the original 4082 recruits, 1103 had answered in 1979 and in 1985 the questionnaires of 843 young men could be evaluated for all three inquiries. The average amount of alcohol consumed was 118.7 g per person and week in 1972/73, 102.8 g in 1979 and 117.2 g alcohol 100% in 1985. Accordingly, the numbers of subjects belonging to the extreme consumption classes decreased significantly from 1972/73 to 1979: abstainers from 94 (11.2%) to 44 (5.2%) (p less than 0.001) and heavy drinkers (more than 350 g alcohol 100% per week) from 54 (6.4%) to 27 (3.2%) (p less than 0.001). From 1979 to 1985 the moderate drinkers (up to 150 g alcohol 100% per week) decreased from 638 (75.8%) to 568 (67.5%) (p less than 0.001) and the middle-range drinkers (160 to 350 g) increased from 133 (15.8%) to 193 (22.9%) (p less than 0.001). Concerning consumption of tobacco, the number of nonsmokers rose between 1972/73 and 1985 from 378 (45%) to 464 (55%) (p less than 0.001). The number of heavy smokers did not change significantly over the three surveys. From 1972/73 to 1979 and from 1979 to 1985 fewer (p less than 0.01) subjects increased their cigarette consumption.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking↗
PubMed1988

L-5-hydroxytryptophan alone and in combination with a peripheral decarboxylase inhibitor in the treatment of depression.

In an open study 25 depressed patients were treated with L-5-hydroxytryptophan (L-5-HTP) either alone or in combination with a peripheral decarboxylase inhibitor. The therapeutic efficacy of L-5-HTP was considered as equal to that of traditional antidepressants. There was no difference in efficacy between the two treatments. Best results were obtained in patients with an anxious-agitated depressive syndrome and in patients with an endogenous depression if the illness had been acute. The onset of action was rapid (within 3 or 5 days). Gastrointestinal side effects proved to be dose-dependent and occurred more frequently in patients receiving L-5-HTP alone, whereas psychopathological side effects (especially acute anxiety states) have mainly been reported in patients receiving L-5-HTP in combination with a peripheral decarboxylase inhibitor.

5-Hydroxytryptophan↗
PubMed1987

[Narcissistic disorders in the light of modern psychoanalysis].

Whereas psychoanalysis in its beginnings was based preponderantly on drive-theory, later on attention was paid essentially on ego-psychology and in the last years on self-psychology. This development is seen in the context of developments in society, especially of the fact of an increasing outer direction of man in the modern world with the danger linked with it of loss of ego and of self. The designed development may be understood as a reactive one. After an overview on the different concepts of the self it is defined as the narcissism which gives to the instances ego, id and super-ego as well as to the body the feeling and the impression, to be an individual capable for feeling and cognitive processes, forming an entity which is experienced continuously and in its continuity. Two different narcissistic disturbances are described: Narcissistic neuroses (= narcissistic personality disorders in the sense of Kohut) with a consistent ego, but a lack in self-representation because of deficiency experiences in early childhood, Borderline-conditions with a severe ego-pathology and, as a consequence of it, rigid defense-mechanisms, extreme fusion tendencies and projective identification, splitting etc. The development of normal narcissism is discussed. At the end the slightly modified psychoanalytic technique in the treatment of patients with narcissistic neuroses and the analytically oriented expressive psychotherapy of borderline-patients which is directed on reality testing is described.

Borderline Personality Disorder↗
PubMed1987

[Psychoanalytic aspects of depression, including mania].

The narcissistic emptiness respectively depletion in depression with the consecutive deficient narcissistic cathexis of ego, id, superego as well as of the body leads to the fact that the people concerned lose all the pleasureful freshness which healthy persons have, but are also unable to build up or to maintain a communicative object relation. On the one hand depressives have the desire to incorporate and to possess in a compensatory-fusionary way objects and on the other hand, since the objects lose by this their object character, they fear them at the same time. Partners of depressives experience themselves often as being totally in their hands respectively "devoured" by them. How so ever the fusion of the depressives might be, they always suffer from the impression having lost their self as well as the objects. Submitted to their narcissistically uncathected archaic superego, depressives are strictly directed towards law and order. An individual who is not able to accept himself in such a way, has also no possibility for an object love since the basis of each object relation is always the enlargement of the self onto the object and only on this basis an identification can be realized. Due to a narcissistically insufficient cathexis of the body respectively of certain body functions, pains are often experienced, whereby it may happen that the pain experience represents the depression itself. Due to this narcissistic deficiency the depressive considers himself to be outside any social relationships. The depressive suffers therefore not only from the lost self but also from the object from which he feels estranged. In mania however the people concerned succeed to have the enthralling experience of a compensatory grandioe self and of the fusion with the object. Why this defense against the narcissistic emptiness respectively depletion is possible, even when admitting a genetic predisposition, must still be clarified.

Adult↗