Search PubMed⌕ Search

Biomedical subjects

R Battegay

Publications and source records attributed to R Battegay.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1986

Hyperadrenergic borderline hypertension is characterized by suppressed aggression.

The effect of suppressed aggression on the reactivity of the sympathetic nervous and cardiovascular systems has been investigated in two groups of 24 subjects each with either borderline hypertension or normal blood pressure and no family history of hypertension. Groups were matched for sex and age (18-24 years). Suppressed aggression was defined by the newly standardized Rosenzweig Picture-Frustration test, a projective method assessing the reaction to everyday stress. Responses of blood pressure, heart rate, and venous plasma catecholamines were measured before and during application of mental stressors, using the Stroop color-word conflict test and mental arithmetic. In an analysis of covariance for repeated measures, which eliminates the influence of anxiety, borderline hypertensive subjects with suppressed aggression had significantly higher heart rates and diastolic blood pressures and a greater noradrenaline reactivity than borderline hypertensive subjects without suppressed aggression or normotensive subjects. Suppressed aggression may lead to a hyperadrenergic form of early borderline hypertension and thereby contribute to higher blood pressure.

Adolescent↗
PubMed1986

Psychotherapy of depressives.

People in depressions are submitted to a suffering which always necessitates, in addition to pharmacotherapy, a psychotherapeutic approach. In all the psychotherapies known, a certain attitude of the therapist, which includes an unconditional openness for the patient is necessary. Depressives cannot bear banal optimism, but need the therapist's confidence in their future. This human participation helps to fill up, at least to a certain degree, their lack of narcissism. Special points of psychotherapy of depressives are described: positive emotional attention, empathy, unconditional listening, asking questions (to give the patient's word and attitudes a meaning and to activate cognitive processes), more orientation than interpretation (during depressive phases), giving advice: Whereas in most psychotherapies it is counterindicated to counsel the patient, in major depressions it can be necessary to formulate recommendations, getting conscious about what happened during the therapeutic session in the patient and in the therapist, since otherwise the therapist may get too involved in the depressive's unrealistic expectations or too defensive against him. Psychotherapy with depressives does not only mean individual treatment, but can include--possibly in addition--their social environment: Partner therapy, family therapy, of the use of a social system as a milieu for psychotherapy (group psychotherapy). Whereas psychotherapy in the depressive phases consists mainly in the named procedure, in the intervals, the experiences of the depressive phases and the emotional and cognitive life and behavior patterns should be worked through focally, in an analytically oriented short-term psychotherapy. A long-term analytic treatment is only indicated in depressive neurotics.(ABSTRACT TRUNCATED AT 250 WORDS)

Cognition↗
PubMed1985

Double-blind comparative study of paroxetine and amitriptyline in depressed patients of a university psychiatric outpatient clinic (pilot study).

21 depressed patients of the Basle University Psychiatric Outpatient Clinic were treated in a double-blind study with paroxetine and amitriptyline. 11 of these patients did not continue the trial until the end of the 7th week. There was a significant difference in the number of dropouts between the two groups: 80% of the amitriptyline group did not continue until the end, while in the paroxetine group we found only 30% dropouts. The patients of both groups showed a gradual decrease of the median total scores on the Hamilton and the Montgomery and Asberg Depression Rating Scales. Although the number of patients who stayed in the trial for at least 4 weeks (8 with paroxetine, 6 with amitriptyline) is quite small, we see from the results of the clinical global impression that the members of the paroxetine group improved most of all in the somatic symptoms, while considering their moods we found no differences between the groups. Patients of both groups complained about side effects, most of all about dry mouth and tiredness. From the high rate of dropouts under amitriptyline we found that the side effects under this drug were more severe and therefore led to the dropouts.

Adolescent↗
PubMed1985

The different narcissistic disturbances of personality and their psychotherapeutic approach.

Narcissism is defined as the self-representation which gives to the instances ego, id and superego as well as to the body the narcissistic cathexis which makes the individual feel an entity and continuity. Three kinds of narcissistic disorders are differentiated concerning their psychodynamics: Narcissistic personality disorders (narcissistic neuroses) with an ego basically able to function well, but a lack in the self; borderline conditions with a more or less severe ego pathology and the consecutive difficulty of the concerned individual to build up a consistent self; major depressions with a more or less pronounced emptiness or evacuation in the realm of narcissism. The psychotherapy of these three disorders is explained. The psychotherapy of narcissistic personality disorders (narcissistic neuroses) consists in a slightly modified psychoanalytic approach. The psychotherapy of borderline patients is described as an analytically oriented expressive one. The psychotherapy of major depressions consists in the depressive phases mainly of an empathic approach. In the intervals not only the almighty superego, but also the huge oral and narcissistic expectations as well as the defense mechanisms of the patients against them, as e.g. the lifelong pattern of law and order, should be worked through.

Borderline Personality Disorder↗
PubMed1985

[Ambulatory treatment of sex offenders with cyproterone acetate (Androcur). A catamnestic study].

The authors report about the catamnestic inquiry concerning 13 patients with sexual problems treated with cyproterone acetate (CA) of whom 12 relapsed repeatedly in sexual delinquency. Since 1972 the Basle University Psychiatry Outpatient-Department treated 12 of these patients with CA-tablets and psychotherapy. One patient was treated in the same way by a head physician of the Basle University Psychiatry Hospital. Reason for CA-intake: 6 patients took CA because they were obliged by legal order. 4 patients were "voluntarily" ready to take CA for fear of imprisonment. 2 patients who were not accountable for their crimes were treated with CA and one patient desired CA-medication because he suffered from his masochism severely. The mean age of the patients was 34.5 years, the mean daily dosage 115 mg. Result of CA-therapy and psychotherapy: 11 patients (85%) did not relapse under CA treatment which lasted on the average three years. 3 patients succeeded under CA treatment with full social integration. 3 patients showed an improvement of social integration and 3 patients one of whom received Disulfirame (Antabus) reduced alcohol intake. After having ended or interrupted CA-medication two of 7 patients relapsed. 3 patients who did not relapse after stopping the CA-intake were observed for as long as 3 years. As forensic psychiatric consequence it follows that CA in combination with psychotherapy can be considered--in spite of the side-effects linked with it--as a method of choice in the ambulatory treatment of sexual delinquents who have frequently relapsed and whom psychotherapy alone did not help.

Adult↗