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Biomedical subjects

T Steinert

Publications and source records attributed to T Steinert.

11 recordsLinked to original sources
PubMed1996

Considerable improvement in a case of obsessive-compulsive disorder in an emotionally unstable personality disorder, borderline type under treatment with clozapine.

We report on a 27-year-old woman with previously therapy-resistant obsessive-compulsive disorder and emotionally unstable personality disorder, borderline type, which improved considerably on treatment with clozapine. Previous treatment attempts with paroxetine, clomipramine and various classic and atypical neuroleptics, as well as extensive psychotherapeutic treatment, had proved ineffective.

Adult↗
PubMed1996

[Does long-term hospitalization modify cardiovascular morbidity in schizophrenic patients?].

Cardiovascular risk factors, electrocardiographic findings and preexisting diseases of the cardiovascular system were recorded in 90 schizophrenic patients (mean age 62.6 yrs., mean duration of hospitalisation 28.6 yrs.). The obtained data were compared with a group of depressive inpatients matched for age and sex and with corresponding data of the german population. Although among the schizophrenic patients heavy cigarette-smoking was significantly more frequent, hints for a myocardial infarction in history were found in only 3 of these patients and, in contrast, in 7 depressive patients. Systolic and diastolic blood pressure did not differ among depressive and schizophrenic subjects with mean levels in both groups being lower than in the corresponding age of the general population. Total cholesterol levels were lowest in the schizophrenics; in the depressive patients, however, lower than in the general population. There was a continual increase of cholesterol with progressive age in depressive subjects and in the general population. An adverse tendency was found in the long-term-hospitalized schizophrenics of both genders. In male schizophrenics a significant negative correlation between the duration of hospitalisation and both serum cholesterol and diastolic blood pressure could be observed. This may explain cardiovascular mortality rates in these patients which are not elevated in spite of heavy smoking and lack of movement.

Adult↗
PubMed1995

Folate deficiency, anticonvulsant drugs, and psychiatric morbidity.

The folic acid (FOA) level was determined in serum and erythrocytes in 100 epileptic patients and 100 control patients using a luminescence assay. A lowered FOA concentration in serum, erythrocytes, or both was observed in 15% of the epileptic patients and in 2% of the control group. In the epileptic patients, the FOA in the serum and in the erythrocytes was significantly lower than that in the control group. Patients receiving carbamazepine monotherapy had a significantly lower FOA level in the erythrocytes than did patients receiving phenytoin monotherapy. The FOA level showed a negative correlation to the duration of epilepsy. None of the patients with lowered FOA had a normal mental status. The course of the supplementation treatment with 5 mg folinic acid (or FOA) of four patients with FOA deficiency could be monitored psychopathometrically. All four patients showed an improvement in their well-being and the majority of measured variables of the cognitive performance.

Adult↗
PubMed1995

[Violent patients. A problem for the therapist in psychiatric clinics?].

At four psychiatric hospitals, 128 doctors, 50 psychologists and 55 social workers were asked to complete a questionnaire about their experience with aggressive patients. Fifty-five percent reported having been assaulted seriously during their career; physical assaults during the last year had occurred for 29%. Forty-nine percent had experienced a situation judged as fairly or very dangerous. Women were concerned less than men, social workers less than psychologists and doctors.

Aggression↗
PubMed1995

[Differential diagnosis of aggressive behavior in epilepsy].

Aggressive behaviour in epileptics may have many causes which are connected more or less closely with epilepsy. Ictal aggression is very rare. In the case of a patient with complex partial seizures and a schizophrenia-like psychosis different forms of generation of aggressive behaviour are discussed.

Adult↗
PubMed1995

[Borderline disorder and schizophrenia. Still a diagnostic problem].

Two case-reports highlight the problems of co-morbidity of schizophrenia and borderline disorder. On the other hand, borderline disorder in schizophrenia can represent a pre-existent, lasting personality disorder, on the other hand it can be temporary syndrome in the course of illness. The assumption that a borderline syndrome can be a recompensation stage in the course of schizophrenia seems evident by clinical and psychodynamic points of view (concerning a coping strategy). The present categories of DSM III-R and ICD-10, however, do not allow an adequate diagnostic classification of this syndrome.

Adult↗
PubMed1993

[Aggression and autoaggression].

This paper attempts to describe the relationship between violence and suicidality according to phenomenological, biological and psychodynamic aspects. In bringing together these aspects a model of human aggressive behaviour is represented.

Aggression↗
PubMed1992

[Recent trends in pharmacotherapy of aggressive behavior in psychiatric patients].

Patients with recurrent pathologic aggressive behavior constitute a severe problem for psychiatric institutions. Besides of being dangerous towards others, these patients themselves suffer from a variety of negative consequences, such as the danger of long-term hospitalisation etc. Therefore, pharmacologic treatment in addition to psychotherapeutic and social interventions is not only ethically justified but mostly inevitable. This kind of combined treatment as a rather common procedure in psychiatric institutions leads time and again to fairly high doses of neuroleptics but not to satisfactory results. This article gives an overview of studies on the advantages and drawbacks of alternative substances: Benzodiazepines, beta-blockers, lithium salts, amine precursors and antiepileptics. Differential indications are described.

Aggression↗
PubMed1991

[Aggression by psychiatric patients in the clinic. A one-year study of four state hospitals].

This study of aggressive behaviour of patients towards staff was conducted simultaneously for one year at four psychiatric hospitals. Until now there has been very little empirical research carried out in German speaking countries of aggression in psychiatric hospitals; the reasons for that are discussed. The results of the study are compared with findings from the prevalently american literature. Since conflicts between patients and staff precede aggressive incidents in the majority of cases, it is concluded as a practical consequence to train especially the younger staff members, who are primarily concerned, in managing such conflicts. Special importance is attached to knowledge of prior aggressive behaviour and its attending conditions.

Adult↗
PubMed1988

[Aggressive conflicts in physician-patient relations in the course of inpatient treatment--considerations based on case examples].

Physical attacks of patients against the treating therapist during hospitalisation are severe complications in the treatment process, creating a variety of problems for all those involved. Partly due to taboo, literature almost does not deal with physical attacks, although they are likely to be a rather common phenomenon. Contrary to this tendency, it seems fair to say that as a treatment problem these situations deserve special attention. Causes of aggressive escalation will be examined by means of two case studies. The question as to how to prevent physical attacks as well as ways to deal with them will be reconsidered.

Adult↗