Search PubMed⌕ Search

Biomedical subjects

W Pöldinger

Publications and source records attributed to W Pöldinger.

At least 19 recordsLinked to original sources
PubMed1992

[Ethics in psychiatry].

In psychiatry there are two major problem areas where ethical questions are of greatest importance. On one hand these are problems arising from commitment to an institution, e.g. forced hospitalisation and forced treatment. Swiss civil law requires in articles 397a to f that such patients may appeal to a judicial court. When this court is a commission comprised of an attorney and of psychiatric and psychotherapeutic specialists, it is of greatest importance that the patient himself be heard by the attorney and not just by a member of the commission and that this attorney also takes into account statements of relatives, as an incompetent patient may say things that are inconsistent with actual facts. As existing or planned hospitalization laws apply mainly to acutely ill patients who are dangerous to themselves or to others, the treatment of chronically ill psychiatric patients cannot be guaranteed. Thus conflicts of conscience arise, since physicians are required to provide medical aid; therefore if such aid is not given or if it is refused, a physician can be sued for inflicting heavy injury. Hence there is an urgent need for judicial measures that guarantee also the treatment of the chronically ill who, like all patients, have a right to be treated. A second problem area is represented by the ethical commissions that decide which scientific investigations may be performed on psychiatric patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Commitment of Persons with Psychiatric Disorders↗
PubMed1991

[The face of depression].

While describing mimic and pantomimic aspects in depressive patients, the author points out how these features can often be found clearly reproduced in the paintings of artists. Then paintings of a depressive and suicidal female patient are discussed and compared with paintings of a talented student-nurse from our institution expressing her experiences with depressive patients. Also some examples of literary depiction of experienced depression are discussed. Finally the question is posed whether suicidal individuals can be freed from their ideas and impulses by pictures expressing suicidal ideas.

Depression↗
PubMed1991

Diurnal variation of symptoms in seasonal affective disorder.

The classic melancholic pattern of depressive symptoms being worse in the morning was present in 3/4 of a sample of 47 seasonal affective disorder patients (SAD), as assessed by global ratings and self-ratings of diurnal variation (DV). The type of DV did not predict response to light, but it did predict relapse within a week: Only those SAD patients with symptoms worse in the evening or no DV did so.

Adult↗
PubMed1991

A functional-dimensional approach to depression: serotonin deficiency as a target syndrome in a comparison of 5-hydroxytryptophan and fluvoxamine.

H.M. van Praag has been suggesting a reappraisal of syndromes in psychiatry for over 20 years. He has tried to define syndromes originating from the same biochemical disorder. He has denoted this concept as 'functional psychopathology'. As an example of such a functional syndrome, he has cited the serotonin-shortage syndrome which unifies various psychiatric symptoms under a new point of view. The treatment of the serotonin-shortage syndrome is best served by psychopharmaca which raise the metabolism of serotonin in the synaptic cleft, e.g. the selective serotonin re-uptake inhibitors. Borrowing F. Freyhan's concept of 'target symptoms', one can now speak of 'functional target syndromes', within the frame of functional psychopathology.

5-Hydroxytryptophan↗
PubMed1990

[The importance of psychotropic drugs for gerontology].

Psychopharmacotherapy in the aged with psychiatric problems must always be considered within the framework of an overall therapeutic concept. In the elderly, psychotropic drugs are prescribed for the same sort of symptoms as those observed in young adults. The multimorbidity often observed in old age can lead to a polypragmatic approach with associated possible interactions between the various drugs, and possible potentiation of known side effects. The side effects are frequently misunderstood and additional drugs prescribed, or doses increased, sometimes with development of confusion that might lead to unnecessary hospitalization. An accurate diagnosis, selection of the smallest possible dosage, and prescription only when the indication has been clearly established, should be our guidelines when prescribing such drugs in the elderly.

Aged↗
PubMed1990

Morning or night-time melatonin is ineffective in seasonal affective disorder.

Melatonin, at the same doses used to treat circadian-rhythm related sleep disturbances, had no effect on the depressive symptoms in seasonal affective disorder (SAD) patients, whether given early (7 a.m.) or late (11 p.m.) for a week. Slight improvements in sleep were seen with nighttime administration. The circadian rhythmicity of urinary 6-sulphatoxymelatonin was not modified in any way. Melatonin at this dosage (5 mg/day) or at these two times is therefore not a potential alternative treatment for SAD; light remains the therapy of choice.

Adult↗
PubMed1990

[Recent aspects of biological treatment of depression].

The problem of the so-called 'therapy-resistant depressions' or, as we prefer to say, 'depressions that are difficult to treat', is discussed. After paying particular attention to the infusion therapy, we deal with nonpharmacological treatments like sleep deprivation and light-therapy. Functional psychopathology and functional target syndromes, illustrated with the serotonin deficiency syndrome, are further topics. The use of low-dose high-potency neuroleptics in the treatment of affective disorders is covered. Finally, we point to the concept of 'neurasthenia' which seems to gain popularity anew.

Antidepressive Agents↗
PubMed1990

Suicidal tendencies: detection and evaluation.

Initially we differentiate a simple psychosocial crisis from a psychiatric crisis; the former is usually a non-pathological phenomenon, which may result in a pathological development. As one critical assumption, we consider suicidal potential. After discussing the phenomena of suicide and attempted suicide, the problem of suicide and family is emphasized in regard to biological-genetic and psychosocial aspects. Finally, we refer to prophylactic-therapeutic interventions for psychosocial crisis and manifest suicidal tendency.

Humans↗
PubMed1989

[Clinical aspects of sleep disorders].

An attempt is made at categorizing the sleep disorders according to various features. According to syndromes we distinguish hyposomnias, hypersomnias, dyssomnias, parasomnias, and the mixed hypo- and dyssomnias. With respect to phenomena the hyposomnias are subdivided into the disorders of falling asleep, sleeping through the night, early morning waking-up and sleep reversal. Thereafter an attempt is made at describing the sleep disorders according to their etiology: hyposomnias are subdivided into primary, essential or ideopathic type, secondary type in the context of organic and psychiatric disorders, reactive hyposomnias, and finally pharmacologically induced or iatrogenic sleep disorders. Among the hypersomnias the hypersomnia-sleep-apea-syndrome is given special attention while shedding light as far as necessary also on therapeutic approaches.

Diagnosis, Differential↗
PubMed1989

[The treatment of severe, therapy-resistant depression using infusions of antidepressants].

Infusion-therapy with antidepressants has been of value in severe as well as therapy resistant depressive states. In addition to doses lower than those used for oral treatment, a more rapid onset of therapeutic effect and a better tolerance, the beneficial effect seems also to depend on the setting in which the treatment takes place. Infusion-therapy is a combined pharmacopsychotherapeutic procedure. Next to infusion-treatment a pretreatment with neuroleptics is advised either via the oral or parenteral route. In extremely refractory depression the infusion-therapy can be applied twice a day; in some cases we resort to continuous infusion for a few days. Infusion-therapy is not applicable in patients prone to epileptic seizures or with serious cerebral dysfunction with a risk of delirium. In case of doubt an EEG is mandatory. Tricyclic antidepressants may not be used in cardiac diseases especially those with troubles of the conduction propagation or repolarization.

Antidepressive Agents↗
PubMed1985

[Biologico-pharmacologically oriented methods of treating depression with special reference to the state of medical practice].

Following a discussion of the diagnostic preconditions that are essential to any treatment of depression, this paper deals with the biologically-based therapies that recommend themselves in psychotherapy. Of chief interest here are the pharmacotherapeutic possibilities and above all the indications of the various antidepressants - many of them new - which are listed together with their German, Austrian and Swiss brand names in Table 8. Some new drugs that are not first and foremost antidepressants are also discussed here, as well as adjunctive medication and treatment of therapy-resistant depression. The main types of chronobiological therapy discussed are sleep deprivation and the use of light in the treatment of depression. Finally, there is a brief outline of shock therapy; for non-medical reasons, this no longer plays an important role today, but is nevertheless an extremely effective method of treating depression.

Antidepressive Agents↗
PubMed1979

The long-term treatment of periodical and cyclic depressions with flupenthixol decanoate.

In a 2- to 3-year open study 30 patients were treated with flupenthixol decanoate (depot form). These periodic and cyclic depressive patients had side effects during treatment with lithium salts. In comparison with the depressive and manic phases before the treatment, the prophylactic effect of flupenthixol decanoate on periodic and cyclic forms of depression was similar to the effect of lithium salts.

Adult↗
PubMed1979

[Problems with hypnotic drug abuse and its therapy (author's transl)].

Barbiturate dependence leads to serious withdrawel symptoms requiring first hospitalisation and later intensive outpatient treatment. This treatment can be supported with neuroleptic and anti depressant drug therapy. Adequate supportive aftercare is essential for a successful treatment of drugdependence.

Ambulatory Care↗
PubMed1979

[Position of behavior therapy among the psychiatric therapies].

In the fourth table, we have classified the most important measures of behaviour therapy: desensitivization, operating conditioning, aversive therapy and negative learning. These courses of action can play an important role in psychiatry and can enrich the therapeutic repertory through their rational use, placed in a general plan of treatment. Moreover, these methods are usually excluded from the tought theories and they do not see in the neurotic troubles a consequence of unconscious conflicts; these conflicts must become conscious again, but they must appear, then, as the result of the learning of bad behaviour.

Aversive Therapy↗