Search PubMed⌕ Search

Biomedical subjects

W Hiller

Publications and source records attributed to W Hiller.

53 records · Page 3Linked to original sources
PubMed1989

Alcohol dependence in ICD-9 and DSM-III-R: a comparative polydiagnostic study.

Diagnoses of alcohol dependence, using the classification systems ICD-9 and DSM-III-R, were compared in a sample of 215 psychiatric outpatients. A lower diagnostic threshold was obtained for DSM-III-R. This category tended to be more inclusive for relatively mild forms of inadequate alcohol use. Of those patients with ICD-9 alcohol dependence, 79% also met criteria for the corresponding DSM-III-R category, whereas 61% of subjects diagnosed as dependent according to DSM-III-R received the equivalent diagnosis in ICD-9. These results were obtained assuming equal base rates (sample frequencies) for dependence and abuse. Diagnoses were further compared with independently derived scores of the Munich Alcoholism Test (MALT), and the validity of DSM-III-R was found to be superior. Checklist-guided interviews had a positive impact upon accuracy and validity of diagnoses.

Adolescent↗
PubMed1989

Anxiety disorders: a comparison of the ICD-9 and DSM-III-R classification systems.

Corresponding categories for anxiety disorders, as defined by the classification systems of the ICD-9 and the DSM-III-R, were compared in a selected sample of 114 outpatients. An unequivocal category-to-category correspondence could not be demonstrated for any diagnosis. Anxiety states in ICD-9 were closely related to generalized anxiety and panic disorder in DSM-III-R, and most patients diagnosed as phobic according to ICD-9 received one of the specific phobia diagnoses of DSM-III-R. To some degree, diagnostic discrepancies were caused by coexisting symptoms of phobia, panic attacks and/or generalized anxiety within patients. A new technique is introduced to adjust corresponding proportions according to base rate differences.

Adult↗
PubMed1988

Divergence and convergence of diagnoses for depression between ICD-9 and DSM-III-R.

Contrasting the classification systems ICD-9 and DSM-III-R, a comparison of diagnoses for unipolar depressive disorders is presented from a sample of 168 psychiatric outpatients. A relatively clear correspondence existed between ICD-9 endogenous depression and DSM-III-R major depression. Neurotic depression (ICD-9) divided into either dysthymia or major depression in DSM-III-R. A generally greater variety of corresponding ICD-9 diagnoses was observed for DSM-III-R categories, since patients with eating disorders, alcohol or drug dependence, or with neuroses other than depressive type often received an additional specific DSM-III-R diagnosis for depression. For ICD-9 diagnostics, a decreased threshold was found for diagnosing depressive reaction, as compared with the equivalent DSM-III-R diagnosis of adjustment disorder with depressed mood. A new technique is introduced in order to adjust corresponding proportions according to base rate differences.

Adjustment Disorders↗
PubMed1988

A five-coordinate copper complex with superoxide dismutase mimetic activity from Streptomyces antibioticus.

A Cu(II) complex of desferrithiocin from Streptomyces antibioticus was prepared and characterized. The first shell atoms, including one nitrogen and four oxygens, were arranged around the copper in a square-planar pyramide. Due to the axially Jahn-Teller-distorted Cu-O distance at 224.7 pm, a distinct Cu2Zn2superoxide dismutase mimetic activity was measured. The Cu-complex survived 600 microM bovine serum albumin and the thermodynamic stability (pK = 17.4) was not very different from that of Cu-EDTA. The electronic absorption properties, circular dichroism and electron paramagnetism were in accordance with those of the type-II copper species.

Circular Dichroism↗
PubMedDate not supplied

Synthesis and properties of the first all-aza analogue of a biologically active peptide.

The synthesis of the first all-aza-amino acid analogue (2) of a peptidic renin inhibitor is described. The X-ray structural analysis and molecular modelling investigations of this novel compound reveal interesting conformational features which have a significant impact on its biological activity. In addition, insight into conformational features of azapeptides in general in comparison with the corresponding purely peptidic compounds is given.

Aza Compounds↗
PubMedDate not supplied

"The" pheochromocytoma: a benign, intra-adrenal, hypertensive, sporadic unilateral tumor. Does it exist?

This study aims to examine the frequency of the pheochromocytoma (pheo), defined as a "benign, intra-adrenal, hypertensive, sporadic, unilateral tumor." Three large series amounting to 310 subphrenic chromaffin tumors operated over periods of 17, 23, and 41 years, respectively, have been reviewed. Among those combined 310 pheos, 48 (15.5%) were malignant (i.e., metastatic) and 262 (84.5%) were benign; 42 (13.5%) were ectopic (35% of malignant tumors versus 9.5% of benign tumors); 230 (74.2%) were hypertensive (74% of benign tumors versus 73% of malignant tumors); 29 (9.4%) were bilateral, including 23 patients with a family history; 41 (13.2%) of patients had MEN II type A or B syndrome; and 20 (6.5%) occurred in a phacomatosis setting. Some of the patients had a non-MEN family history of pheo (n = 5), seemingly sporadic hyperparathyroidism (n = 4), or other associated neuroendocrine tumor (n = 9). Sometimes several of these features were combined. Finally 125 (40.3%) cases fitted the classic description of the tumor, 47.0% at the time of initial presentation and 40.3% at the end of follow-up. Late occurrence of metastases or metachronous diagnosis of familial disease make lifelong follow-up mandatory. Genetic studies may be indicated in pheochromocytoma patients.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

A systematic evaluation of the DSM-III-R criteria for alcohol dependence.

The diagnostic efficiency of the nine DSM-III-R criteria (signs and symptoms) for alcohol dependence was systematically investigated in a sample of 215 psychiatric outpatients. Specificity was generally greater than 0.90, but two groups of criteria were distinguished according to high v moderate sensitivity rates. The diagnostic relevance of all DSM-III-R criteria was strongly supported by a comparison with additional characteristics of alcoholism. Features referring to impaired control over alcohol use and to physical dependence (tolerance and withdrawal) were found to be most clearly discriminating between subjects with and without alcohol dependence. There is strong evidence that two positive criteria are sufficient to reliably diagnose alcohol dependence. A computer-simulated analysis was performed to demonstrate predictive power of single symptoms under different base rate conditions, and results were promising for the most common settings in clinical research.

Adolescent↗
PubMedDate not supplied

The overlap between depression and anxiety on different levels of psychopathology.

Symptoms, syndromes, and diagnoses (DSM-III-R) for depression and anxiety were assessed and evaluated in 150 psychiatric outpatients. It was hypothesized that the coexistence of depression and anxiety within subjects strongly depends on the psychopathological level determined. The results confirmed this assumption. Overlap proportions for symptoms were almost twice as high as for diagnoses (52% vs. 29%). Intermediary rates were obtained for syndromes. Implications of these results for research on anxious depression, often considered to be qualitatively distinct from pure depression or anxiety disorders, are discussed.

Adult↗
PubMedDate not supplied

ICD-10 checklists--a tool for clinicians' use of the ICD-10 classification of mental and behavioral disorders.

The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) checklists are a set of semistructured instruments designed for clinician assessment of mental and behavioral disorders according to ICD-10 criteria. The checklists have been produced as a package consisting of the ICD-10 Symptom Checklist and Glossary and the International Diagnostic Checklists (IDCL) for ICD-10 and Manual. This report describes the main features of the newly released World Health Organization (WHO) instruments and specifies areas of possible application by clinicians.

Humans↗
PubMedDate not supplied

Effect of comorbid anxiety, depressive, and personality disorders on treatment outcome of somatoform disorders.

Comorbid mental disorders of DSM-IV axis I and axis II have repeatedly been found to be a negative predictor for the treatment of axis I disorders, although recent contrary findings exist. Little is known about the effect of comorbidity on the therapy outcome of somatoform disorders. We compared three types of comorbidity, (1) personality disorders (PDs), (2) major depression (MDD) and anxiety (ANX) disorders, and (3) PDS and MDD and ANX, with regard to their relevance for the treatment outcome of somatoform disorders. One hundred twenty-six inpatients were assessed at least 4 weeks before admission to treatment, upon admission, and again at discharge. Somatoform, hypochondriacal, and depressive symptomatology, dysfunctional cognitions about body and health, dysfunctional social relationships, and other clinical characteristics were measured. Diagnostic assessments were based on the DSM-IV. Our findings suggest that none of the three types of comorbidity influence the therapy outcome of somatoform disorders or have a modifying effect on the level of psychopathology.

Analysis of Variance↗
PubMedDate not supplied

A two-year follow-up study of patients with somatoform disorders.

Thirty inpatients with multiple somatoform symptoms admitted to a psychosomatic hospital were diagnosed using the Structured Clinical Interview for DSM-III-R and questionnaires. Two years later, a reexamination by interview and a follow-up questionnaire took place. The authors found high comorbidity rates not only for affective disorders (lifetime 86%), but also for anxiety disorders (lifetime 43%). Comorbidity is of high prognostic relevance: whereas patients with only somatoform disorders at first assessment may remit until second assessment, in those patients with comorbidity with other psychiatric disorders, some somatoform symptoms still remain. The rate of misdiagnosed organic disorders is estimated at lower than 10%.

Adult↗
PubMedDate not supplied

Further evidence for a broader concept of somatization disorder using the somatic symptom index.

Somatization syndromes were defined in a sample of 102 psychosomatic inpatients according to the restrictive criteria of DSM-III-R somatization disorder and the broader diagnostic concept of the Somatic Symptom Index (SSI). Both groups showed a qualitatively similar pattern of psychopathological comorbidity and had elevated scores on measures of depression, hypochondriasis, and anxiety. A good discrimination between mild and severe forms of somatization was found by using the SSI criterion. SSI use accounted for a substantial amount of comorbidity variance, with rates of 15%-20% for depression, 16% for hypochondriasis, and 13% for anxiety. The results provide further evidence for the validity of the SSI concept, which reflects the clinical relevance of somatization in addition to the narrow definition of somatization disorder.

Adult↗
PubMedDate not supplied

Searching for a gastrointestinal subgroup within the somatoform disorders.

The authors examined whether patients suffering from functional gastrointestinal symptoms constitute a separate group within the broader concept of the somatoform disorders. The authors compared 103 patients with a severe gastrointestinal syndrome, 220 patients with a somatization syndrome according to DSM-IV, and 250 clinical control subjects with nonsomatoform mental disorders. The gastrointestinal group showed more catastrophizing thinking, complained more about autonomic sensations, felt bodily weaker, was less tolerant towards bodily discomfort, had developed more hypochondriacal fears and behaviors, was more depressed, and was more severely disabled in different areas of psychosocial functioning than the other groups. These differences, however, disappeared when general somatization was controlled for by analysis of covariance. Only a small effect related to dysfunctional cognitions remained specific to the gastrointestinal syndrome. Because these results do not confirm the idea of an independent gastrointestinal syndrome, general mechanisms of somatization seem to play the dominant role.

Adolescent↗
PubMedDate not supplied

[Description and validity of Enedam test-retest. A structured interview for the diagnosis of Alzheimer's, multi-infarction dementias and dementias of other etiologies based on the CIE-10 and DSM-III-R].

The SIDAM, a new clinical structured interview for the diagnosis and measure of dementia according to DSM-III-R and ICD-10, is described. This instrument comprises a clinical overview, several cognitive tests, including the Mini-Mental State, and a section for clinical judgement and information coming from others. Every item relies on DSM-11-R and ICD-10 algorithms. The SIDAM has a hight test-retest reliability on the clinical diagnosis and the different diagnostic criteria. It is a brief (28 minutes), practical screening instrument. Good congruence is found between SIDEM, DSM-III-R and ICD-10, and the corresponding ICD-9 expert diagnosis. Furthermore the SIDAM Total Score (SISCO), allows a good measurement of low level of cognitive impairments and provides quantification of severity of cognitive disorders. The SIDAM has been translated and adapted into Spanish.

Aged↗