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W Gaebel

Publications and source records attributed to W Gaebel.

113 records · Page 7Linked to original sources
PubMed1983

Prediction of "natural" course, relapse and prophylactic response in schizophrenic patients.

Three problems in the prediction of the long-term outcome of schizophrenia are illustrated by the results of three separate studies: The limitations of the possibility of generalizing results, the limits being due to the given historical and sociocultural settings. This determines the results of research. The relationships between different types of predictors and targets. The disease-related specificity of predictors. A prospective 1-year follow-up study comparing 100 schizophrenic patients in a rural region with 200 schizophrenic patients in an urban region shows regional differences in outcome criteria, such as rate of hospitalization. The prognostic significance of the various predictors is also different in the two regions. A follow-up study of 70 schizophrenic patients, who were continuously treated with neuroleptic drugs in our outpatient clinic after hospital discharge for an average of 14 years, shows a relatively good outcome. Several outcome dimensions (rehospitalization rate, symptoms, social and work adjustment, self-ratings) are partly mutually independent. The various outcome dimensions are predicted by different predictor patterns. A prospective follow-up study of 86 schizophrenic patients compared with 75 patients with other psychiatric diagnoses confirms the finding of the partly low intercorrelations of the different outcome criteria. The study additionally shows that the predictors of some outcome dimensions, such as work adjustment, are non-specific in respect of diagnosis.

Adult↗
PubMed1981

[On the prognostic value of the 1-h level in the glucose tolerance test. (Five year follow-up with long-term hospitalised psychiatric patients) (author's transl)].

In 922 long-term hospitalised psychiatric patients the glucose tolerance war examined by 1-h level after oral glucose during a five year follow-up study on cardio-vascular risk factors. We were unable to determine the future development of metabolism with reference to normal findings of the test, borderlines levels ans positively impaired glucose tolerance. But it was to be seen than depending on increasing basic levels the tendency towards a decrease in glucose tolerance increased too. As far as prognosis is concerned, a turning-point for the further development either towards a return to normal or a manifest diabetes seems to be at 180 mg% after 1 h. Above this level, the probability to develop manifest diabetes respectively a higher degree of impaired tolerance has become within a few years, just as great as the probability of a remission. The tendency towards a decreasing glucose tolerance or the manifestation of diabetes was furthered by initial existence or development of a higher overweight (more than 30%).

Adult↗
PubMed1981

[Predictors of the course of schizophrenic diseases under neuroleptic long-term medication (author's transl)].

70 schizophrenic outpatients have been treated continuously after index hospital discharge with neuroleptic drugs for an average of 14.3 years. In predicting their outcome in several dimensions (rehospitalization rate, symptoms, social and work adjustment, self ratings) differential predictor patterns could be confirmed, at most accounting for 65% of the outcome variance. In part work adjustment at follow-up cold be predicted by premorbid social and sexual adjustment as well as by working capability at index discharge. The most powerful predictor for the number of social relations was the former frequency of social contacts. Rehospitalization was related to higher neuroleptic equivalence dose at index discharge among other predictors, whereas presence of symptoms could be predicted e.g. by formerly longer hospital stays. Although at the beginning of the treatment our sample was classified as "process schizophrenic" on "classic" prognostic scales, 40-60% of our cases had a relative good outcome. This results and the considerable decrease of the rehospitalization rate from 0.57 before treatment to 0.11 during treatment stand for a clear treatment related improvement of the spontaneous prognosis. The partly mutually independence of the outcome criteria and predictor patterns underlines the importance of multiaxial diagnosis.

Adult↗
PubMedDate not supplied

Prodromal states in schizophrenia.

The vulnerability-stress-coping (VSC) model is the most influential heuristic concept in understanding the course of schizophrenia, whose prodromal status still offers unsolved conceptual and methodological issues. Improved knowledge about the prodromal phase would provide a better understanding of the developing psychopathology and psychophysiology of schizophrenia and could also be of predictive value to attune therapeutic actions to the course of the illness more precisely. To shed more light on the characteristics of prodromal states, data from a German multicenter study on intermittent versus maintenance neuroleptic long-term treatment in schizophrenia (ANI study) were reanalyzed with respect to the prevalence and profile, nature, time course, and predictive value of prodromal symptoms in impending relapse. The results demonstrate that prodromes are a category of symptoms on their own, but they share variance with other symptom domains. Treatment side effects, psychotic symptoms, dysphoric mood, and social dysfunction are all associated with prodromal states--the direction of this association, however, is still to be clarified. Prodromal symptoms are also related to the neuroleptic treatment strategy and its relapse-preventive efficacy--findings that underscore neuroleptic maintenance medication in preventing both overt and subthreshold psychotic morbidity in schizophrenia.

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