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PubMed1986

The participative mental health administrator.

This article analyzes the role of the participative mental health administrator. Participative administrators are distinctive because they are experts in human behavior at work, in techniques of professional decision making, and in interviewing methods. They also adopt some Japanese management approaches. The article concludes with a description of characteristics of participative mental health administrators, including the fostering of an open organizational environment, giving high standing to individuality, encouraging personal development, and favoring decentralized management.

Administrative Personnel↗
PubMed1997

Premorbid personality in patients with uni- and bipolar affective disorders and controls: assessment by the Biographical Personality Interview (BPI).

The relationship between premorbid personality and subtypes of affective disorder was investigated by means of the Biographical Personality Interview (BPI) and by a self-rating scale. Interviewer and rater (BPI) were blind to diagnosis. A total of 52 patients with unipolar depression or bipolar II disorder (D/Dm), 32 bipolar-I patients (DM) and 39 control subjects (C) were examined. Expert rating of "typus melancholicus" features (BPI) were found to be more pronounced in D/Dm than in DM and C. "Typus manicus" features were also distinguished between both clinical groups, whereas anxious-insecure features were not significantly different between the groups of patients. In contrast to the expert-rated personality variants, self-rating of personality features did not reveal any significant differences between the two clinical groups. Potential sources of the discrepancies between the questionnaire data and the interview data are discussed. It is concluded that premorbid features of "typus manicus" and "typus melancholicus" predicted, respectively, a predominant manic and a predominant depressive course of an affective disorder.

Adult↗
PubMed1992

Naproxen premedication reduces postoperative tubal ligation pain.

This study evaluated the effectiveness of naproxen sodium oral premedication in reducing postoperative pain, analgesic requirements and day surgery length of stay in patients undergoing outpatient laparoscopic tubal ligations. We undertook a randomized, double-blind clinical trial on ASA I and ASA II patients undergoing outpatient laparoscopic tubal ligations. The treatment group received two capsules containing naproxen sodium, 275 mg each, and the control group received two identical capsules containing placebo. Postoperative visual analogue pain scores, analgesic requirements, side-effects and length of day surgery stay were studied. Forty-four patients completed the study with 21 patients in the naproxen group and 23 in the placebo group. There was a statistically significant difference between groups in terms of pain score (naproxen group 0.9 +/- 0.2 vs placebo group 3.5 +/- 0.6); patients requiring postoperative opioids (naproxen group 0% vs placebo group 34.8%); and time spent in the day surgery unit (naproxen group 168 +/- 13 min vs placebo group 188 +/- 15 min). There was no difference in the incidence of nausea and vomiting. Only one person developed a side-effect from the naproxen sodium which was minor gastric discomfort. This study shows that naproxen decreased the postoperative tubal ligation pain with less subsequent postoperative analgesic requirements, less time to street fitness and no increase in analgesic side-effects. We recommend the use of this premedication in outpatient laparoscopic tubal ligations.

Administration, Oral↗
PubMed2003

Geriatric medicine in the European Union: unification of diversity.

The numbers of older people in the European Union are increasing and, with their associated health needs, there is a requirement for the specialty of Geriatric Medicine to be available throughout Europe. At present, specialists in Geriatric Medicine are not recognised in some of the European Union member countries. It is imperative that training in Geriatric Medicine should take place throughout Europe, starting at undergraduate level and progressing through postgraduate training. There must be a programme of continuing medical education and personal development. This paper highlights some of these challenges and suggests a possible way forward.

Accreditation↗
PubMed1995

[Are mothers of children with neurodermatitis psychologically conspicuous? Critique and replication of a study of the "psychosomatic aspects of the parent-child relationship in pediatric atopic eczema"].

A study concerning some "psychosomatic aspects of the parent-child relationship and atopic eczema in childhood" was published in this journal in 1986 [8]. The authors concluded that mothers of children suffering from atopic eczema "were shown to be less 'spontaneous', more 'under control' and less 'emotional' than the normal population." They showed "characteristic features indicating difficulties in emotional relationships with their children." These conclusions were based on the answers of 14 mothers to a popular German personality questionnaire (Freiburger Persönlichkeitsinventar, FPI). We analyzed the investigation cited, judged it to be unsatisfactory and attempted to duplicate the study. Two parallel samples of mothers with healthy and ill children (n = 50 and n = 47) were tested with the same questionnaire. The previous results could not be verified. Therefore, we reject the interpretation that mothers of children suffering from atopic eczema have unique psychological characteristics.

Adult↗
PubMed2001

Parental 'affectionless control' in adolescent depressive disorder.

BACKGROUND: Adults with depressive disorder report high rates of sub-optimal maternal care in childhood. Despite the greater salience of relationships with parents earlier in life, associations with parenting style have not yet been systematically studied in adolescent onset disorder. METHODS: A six-wave, 3-year study of adolescent health in 2032 Australian secondary school students provided an opportunity to undertake a two-phase study of early onset depression. Between waves 2 to 6, a self-administered computerised form of the revised Clinical Interview Schedule (CIS-R) was used to generate a first phase diagnosis of ICD-10 depressive episode. Each subject with a CIS-R-defined depressive episode was selected for second phase assessment together with two subjects from the CIS-R non-cases in each school. Second phase assessment included a second diagnostic assessment using the depression and hypomania modules of the Composite International Diagnostic Interview (CIDI) and assessment of paternal and maternal style using the Parental Bonding Instrument. RESULTS: A total of 1947 out of 2032 subjects in the sampling frame (95.8%) participated in the cohort study (phase 1) at least once; 406 (94%) of the 435 selected subjects completed second phase assessment. One hundred and nineteen subjects fulfilled criteria for depressive episode on the CIS-R at one or more waves. Over the 30-month study period, 69 subjects (10 male, 59 female) fulfilled both CIS-R and CIDI definitions of depression at the same wave and were classified as 'definite depressive disorder'. Low maternal and paternal care held independent associations with both definitions of depression, with the effects clearest in those in the lowest quartile of reported care. After adjusting for low parental care, the associations between high parental control and depression were small. CONCLUSIONS: Sub-optimal parenting is associated with depressive disorder in adolescents. Low maternal and paternal care are each associated with a two- to three-fold higher rate of depressive disorder. These findings are consistent with an effect of sub-optimal parenting on the onset rather than course of disorder. Whether sub-optimal parenting is associated with a risk for the onset of depression outside the adolescent years has yet to be clarified.

Adolescent↗
PubMed1999

Lower limb amputations during 3 years in Hungary.

We reviewed nationwide hospital data of amputations during 3 years to provide a comparison with similar data gathered about 20 years ago. Data were provided by the National Medical Records Centre and processed by our personally developed programmes. The cause of amputation was most often vascular disease, amputees were usually elderly, and the large majority of amputation surgery was carried out on the lower limb. The rate of transtibial amputation has increased favourably in the last 2 decades, but there are large regional differences within the country. Mortality parameters remarkably exceed those of foreign countries. Although the data accuracy is compromised, there are still ways of exploiting the data in favour of quality improvement of care, e.g. improve transtibial amputation rate, reduce mortality. The publication of data can be of benchmarking importance for hospitals by enabling them to compare their own results with those of other hospitals, as well as to develop and improve performance.

Adult↗
PubMed2000

Executive functions and the frontal lobes: a conceptual view.

Several problems in understanding executive functions and their relationships to the frontal lobes are discussed. Data are then presented from several of our studies to support the following statements: (1) the examination of patients with focal frontal lobe lesions is a necessary first step in defining the relation of executive functions to the frontal lobes; (2) there is no unitary executive function. Rather, distinct processes related to the frontal lobes can be differentiated which converge on a general concept of control functions; (3) a simple control-automatic distinction is inadequate to explain the complexity of control-automatic processes; (4) the distinction between complex and simple tasks cannot explain the differences in functions between the frontal lobes and other brain regions; and (5) the most important role of the frontal lobes may be for affective responsiveness, social and personality development, and self-awareness and unconsciousness.

Attention↗
PubMed2004

Foreword -- ADHD in the scientific and political context.

The foreword focuses on the three main critical questions within the political debate: (1) Is ADHD a psychiatric disorder? (2) Is there over-diagnosis and overtreatment of ADHD? (3) Are psychostimulants dangerous drugs? After discussing the problems within the context of general scientific and merely European political context, the authors conclude with a positive outlook comprising (1) step-up of research in ADHD, (2) exercised control over diagnosis and treatment, (3) the need for training and continuous personal development for doctors, and (4) Improvement of information to teachers and parents. The presented supplement on "ADHD -- beyond core symptoms. Not only a European perspective" underlines this perspective and reflects a broad spectrum of ADHD-related activities currently underway in Europe while having the worldwide development of the field in mind.

Attention Deficit Disorder with Hyperactivity↗
PubMed2001

Long-term outcome and prognosis of obsessive-compulsive disorder with onset in childhood or adolescence.

The aim of the catch-up follow-up study is to describe the long-term outcome of obsessive-compulsive disorder (OCD) with onset in childhood and adolescence. The psychiatric morbidity in adulthood including personality disorders was assessed and predictors in childhood for the course of obsessive-compulsive symptoms were examined. The total study group consisted of the entire patient population treated for OCD at our departments for child and adolescent psychiatry between 1980 and 1991. We reassessed 55 patients personally by way of structured interviews. The mean age of onset of OCD was 12.5 years and the mean follow-up time was 11.2 years. At the follow-up investigation 71% of the patients met the criteria for some form of psychiatric disorder, while 36% were still suffering from OCD. Of the patients with a present diagnosis of OCD 70% had at least one further clinical disorder (especially anxiety and affective disorders). The most frequent personality disorders diagnosed were obsessive-compulsive (25.5%), avoidant (21.8%), and paranoid (12.7%) personality disorders. In-patient treatment, terminating treatment against advice and tics in childhood or adolescence significantly correlated with more severe OC symptoms in adulthood.

Adolescent↗
PubMed2006

The family environment and developmental psychopathology: the unique and interactive effects of depression, attention, and conduct problems.

Prior studies have found remarkable similarity in the family characteristics across a wide range of child psychopathologies. This study investigated the unique relationships between symptoms of depression, conduct problems/aggression, and inattention/hyperactivity and characteristics of the family environment. Parents and teachers completed multiple behavioral, emotional, and family measures to describe the characteristics of a community sample of 362 children. Results indicated that depression and conduct problems/aggression symptoms were uniquely associated with specific family environments. Both symptom clusters predicted family environments marked by less cohesiveness and intellectual/cultural pursuits and greater conflict. Depression alone was related to less expressiveness, independence, and activity, and to higher levels of control. Inattention/hyperactivity was not uniquely related to any aspect of family environment when controlling for depression and conduct/aggression problems, nor were combinations of symptoms. Findings are discussed with regard to implications for understanding clinical presentations, comorbidity, and treatment.

Attention Deficit Disorder with Hyperactivity↗
PubMed2006

Impaired face processing in autism: fact or artifact?

Within the last 10 years, there has been an upsurge of interest in face processing abilities in autism which has generated a proliferation of new empirical demonstrations employing a variety of measuring techniques. Observably atypical social behaviors early in the development of children with autism have led to the contention that autism is a condition where the processing of social information, particularly faces, is impaired. While several empirical sources of evidence lend support to this hypothesis, others suggest that there are conditions under which autistic individuals do not differ from typically developing persons. The present paper reviews this bulk of empirical evidence, and concludes that the versatility and abilities of face processing in persons with autism have been underestimated.

Autistic Disorder↗
PubMed2025

Transcriptomic landscape of NK cell-related genes in hepatocellular carcinoma: associations with prognosis and therapeutic response.

Hepatocellular carcinoma (HCC) is a highly aggressive and heterogeneous malignancy, in which natural killer (NK) cells play a crucial role in tumor progression and immune surveillance. This study aimed to characterize the transcriptomic landscape of NK cell-associated genes (NAGs) and explore their associations with clinical outcomes and therapeutic responses in HCC. Using transcriptomic data from The Cancer Genome Atlas (TCGA), we identified key NAGs through comprehensive statistical analyses. Patients were stratified into distinct risk groups based on NAG expression profiles. Low-risk patients demonstrated better survival, higher immune infiltration, and greater predicted sensitivity to immunotherapy, whereas high-risk patients were associated with reduced chemotherapy responsiveness. These findings contribute to a deeper understanding of the immunogenomic features of HCC and provide a basis for developing personalized therapeutic approaches centered on NK cell-related mechanisms.

Hepatocellular carcinoma↗
PubMedDate not supplied

Molecular epidemiology of tuberculosis among HIV-infected persons in Switzerland: a countrywide 9-year cohort study. Swiss HIV Cohort Study.

We investigated tuberculosis transmission during a nine-year period (1988-1996) in a countrywide community-based cohort of HIV-infected persons in Switzerland (the Swiss HIV Cohort Study [SHCS]). We estimated the proportion of tuberculosis cases due to reinfection and relapse, and assessed factors which may increase the risk of tuberculosis transmission. HIV-infected persons were followed prospectively and molecular fingerprinting with insertion sequence (IS) 6110, 36-bp direct repeat, and IS6110-PCR was used to determine M. tuberculosis case clustering. Out of 7999 SHCS participants, 267 persons developed tuberculosis. 158 M. tuberculosis isolates from 138 patients were available for study. Molecular analysis identified 33 (24%) episodes of tuberculosis associated with 12 clusters including 2 to 8 patients. Two patients experienced reinfection, and nine had a relapse. Detailed contact investigation identified definite or possible epidemiological links between 21 of 33 cluster patients (64%). Multivariate logistic regression analysis did not identify any risk marker significantly associated with clustering. During a nine-year period, one fourth of tuberculosis cases were grouped in clusters within a selection of 138 HIV-infected patients. This may represent the lowest estimation of recently acquired tuberculosis infection. There were no large institutional or community outbreaks among HIV-infected participants of the Swiss HIV Cohort Study.

AIDS-Related Opportunistic Infections↗
PubMed1990

The fear behind the fear: a case study of apparent simple injection phobia.

The interrelations of multiple phobias are illustrated in the case of a female student whose presenting complaint of injection phobia did not at first appear to be related to her other fears. The rapid amelioration of her presenting complaint (sustained at three-month and eight-month follow-up) followed the discovery of functional relationships between these fears. The implications of the case with respect to Lang's (Anxiety and the Anxiety Disorders, 1985) work on the cognitive psychophysiology of emotion, and the investigations of McNeil and Berryman (Behavior Research Therapy 27, 233-236, 1989) and Rachman and Lopatka (Behavior Research Therapy 24, 653-660, 1986; Behavior Research Therapy 24, 661-664, 1986) are discussed.

Adult↗
PubMed1993

Self-reports of panic attacks and manifest anxiety in adolescents.

A recent paper by Nelles and Barlow (1988; Clinical Psychology Review, 8, 359-372) provided the rationale for an investigation of panic attacks in adolescents. A panic attack questionnaire and the Revised Children's Manifest Anxiety Scale were administered to an unselected sample of Australian adolescents. Of 534 adolescents, 42.9% reported having at least one panic attack. Other data are reported on the characteristics of panic attacks, life interference and avoidance behaviour. Panickers reported significantly higher anxiety levels than nonpanickers. Differences between the findings of Australian and American samples were noted and directions for future research were identified. Several methodological issues were also discussed including the reliability and validity of self-report data on panic attacks.

Adolescent↗
PubMed1993

Comparing high school and college students' leisure interests and stress ratings.

We compared a large high school area sample with normative data from prior research with college students on the Leisure Interests Checklist (LIC) factor scales, and on the BAROMAS. Whether combined or separated by sex, the college sample displayed far more interest in the LIC activities than the high school students (all P << 0.001). On the BAROMAS, differences were more complex. The teenagers expressed more confidence about dismissing time pressures, sleeping soundly and finding time to do sports, but college students were more confident about falling asleep and sticking to set priorities. The high school data replicated the previous pattern of LIC x BAROMAS relationships, with most scales significantly inter-correlated within inventories, but mainly the sports scales covarying across the two inventories. Numerous differences between the sexes emerged from the high school student sample.

Adaptation, Psychological↗