E. Gabriel

Temporal Stability of Diagnostic Criteria for Functional Psychoses

200 first admissions with functional psychoses were interviewed with PSE and rated simultaneously according to different diagnostic criteria (ICD-9, RDC, DSM-III, St. Louis, Taylor, Vienna Research Criteria). At follow-up 7 years later 186 patients could be traced and a course diagnosis was applied to each patient. Temporal stability of diagnostic criteria was calculated for ICD-9, RDC and DSM-III by stability coefficient and kappa values and was used as a criterion for validity. Schizophrenia and affective disorder display considerable stability over time, no matter whether one uses ICD-9, RDC or DSM-III. The data for schizoaffective disorder are less impressive, the stability coefficient is much higher for schizoaffective bipolar than for schizoaffective depressive patients.

Course and outcome of delusional psychoses.

The authors reinvestigated 84 out of a sample of 90 patients with delusional psychoses after an interval of 6-9 years. The results of the follow-up showed a pattern of episodic versus chronic course which compares to follow-up studies on classically diagnosed schizophrenias. The authors found evidence for their hypothesis concerning the nosological heterogeneity of this group of psychoses and propose a syndromatological classification apart from the delusional symptomatology itself. What they call background symptomatology was divided into axial syndromes. The authors feel that this results in subgroups that are more homogeneous for course and outcome than the usual classification systems.

Der langfristige Verlauf schizophrener Späterkrankungen im Vergleich mit Schizophrenien aller Lebensalter

Bleuler’s (5) findings on the long term course of schizophrenias are compared with my own findings on the long term course of so called late onset schizophrenias as defined by Bleuler (4). The comparison is used to establish the characteristics of the entire course and of the tendencies of the later course (1.1–1.4 and 2.1–2.3). Similarities were found in the frequency of episodic courses and in the relative stability of the later course tendencies. Differences were found in the greater number of chronic courses, and in the rarity of recoveries after acute episodes, and also in the large number among our own cases of poor psychosocial adjustment after prolonged illnesses in later age. The significance of psycho-organic deterioration in old age is stressed as a factor in assessing the long term course of late onset schizophrenias as here defined.

Mood-Dependent Learning II.

Influenced by Seligman’s definition of ‘learned helplessness’ we studied the change of expectancy after positive and negative reinforcement before the onset and in the course of trea

Familienbilduntersuchungen an Patienten mit paranoiden Psychosen

Among the first-degree relatives of 77 patients with delusional functional psychoses the authors found 13 schizophrenics (3.10%), 8 manic-depressives (1.91 %) and 14 cases with atypical psychoses (3.34%), following ICD-9 criteria. These figures were compared with the figures in the literature on the genetics of paranoid schizophrenics and nonschizophrenic paranoids, regarding the different composition of the samples. Subdivision of the original 77 patients, using the concept of the axial syndromes, was able to form two homogeneous subgroups of first-degree relatives: one with a schizophrenia prevalence of 6.52% (uncorrected) and without any manic-depressive secondary cases (endogeno-morphic-schizophrenic axial syndrome) and another with a manic-depressive illness (MDI) prevalence of 6.58% (uncorrected) without any secondary cases with schizophrenia or atypical psychosis. The first-degree relatives of the patients with an ‘organomorphic’ axial syndrome (usually excluded in other studies) had an increased rate of manic-depressive secondary cases (3.57%, uncorrected) and the highest rate of atypical psychosis (7.14%) without any schizophrenics, according to the etiopathogenetic heterogeneity of this group. 37 of the 77 patients were not assignable to any of the axial syndromes. In the first-degree relatives of these patients – best comparable to Kendler’s criteria for ‘delusional disorder’ – an increased rate of schizophrenics and atypical psychoses was found (3.59 and 3.08%, uncorrected); the figures for MDI were within normal limits. Our results suggest that the axial syndromes are a useful diagnostic instrument in identifying – from the genetic standpoint – in part very homogeneous subgroups. This allows the conclusion that they are indicators for hypothetical basic disturbances.

Über die individuellen Bedingungen pharmakogener Verwirrtheiten

The literature was surveyed concerning the frequency and conditions for confusional states and deliria following Amitriptyline and Clozapine treatment, and certain discrepancies were noted. As a resul

Das Schicksal katathymer Wahnbildungen im Licht langfristiger Katamnesen

Two groups of patients with delusional illnesses (previous paranoics and previous ‘late schizophrenics’ with delusional syndromes) with similar backgrounds, were followed up after many years and were

Results of Learning Experiments in the Course of Treatment of Endogenomorphic Depression

In this study we attempted to break down short-term effects of electroconvulsive therapy (ECT) on memory into anterograde and retrograde amnesia, and for the latter we again separated short-term store performances from those connected with the long-term store of memory. Our experiments included complicated learning tasks. Although impairment caused by ECT was demonstrable in all three test fields, complicated conditioning experiments stored in the long-term store proved to be most sensitive to the disturbing effect of ECT.

Delusional Psychoses: Genetic Findings as a Critical Variable for the Validation of Diagnostic Criteria

77 patients with delusional psychoses, regardless of their nosological attribution (except severe organicity), and their first-degree relatives were diagnosed with the Research Diagnostic Criteria (RDC) and the Vienna Research Criteria (VRC). The diagnostic procedure was performed blindly in the relatives. Both criteria were sufficiently capable of identifying a schizophrenic and affective subgroup of patients characterized by the appearance of homotypical secondary cases. Apart from a small RDC schizoaffective group differing in genetic pattern, there exists another large group of nonschizophrenic, nonaffective delusional disorders lacking a genetic link to the above-mentioned diagnoses. In respect to the development of the diagnostic criteria, the results of this study call for the formulation of a narrow definition of schizophrenia (as in the VRC) which is based on thought disorder and affective blunting with the exception of so-called productive symptomatology (delusions, hallucinations); separate criteria for schizoaffective disorders (as in RDC), and a broad and nonrestrictive definition for nonschizophrenic delusional disorders.

Statistische Analysen physiologischen Datenmaterials von Patientinnen mit endomorph-depressiven Phasenverläufen

Range-corrected (according to Lykken) physiological data from the parameters of heart rate (HF), respiratory rate (AF), skin potential (skin potential level; SPL; skin potential response, SPR) and skin resistance (skin resistance level, SRL; skin resistance response, SRR) were obtained under an acoustic activation paradigm in the course of a longitudinal investigation on 7 women with endomorph depression treated with thymoleptic medication. These data form the matrix for two- and threefold analyses of variance as well as for concordance analyses according to Kendall. During six measurements (three each taken in the morning and evening) one finds differing levels of activation: relatively low ones at the beginning and at the end, high ones during the ‘labilization phase’ of the treatment. The varying ‘reactivity’ to the diverse examination sequences of an acoustic activation program is little affected by the degree of these changes; patient-specific ‘characteristics’ of the course of the activation are just as recognizable throughout the course of the investigation as are ‘stimulus-specific’ reactions. Each of the parameters is appropriate for the estimation of different physiological variables; SPR seems rather to be a situation-specific variable, HF and AF are probably suitable for establishing the level of activation, while changes in SPL seem to represent patient-specific characteristics.