Karin Fabisch

Pharmacotherapy of alcohol dependence

The current pharmacotherapeutic approaches to alcohol dependence, together with the results of a number of clinical trials, are reviewed in this article. Despite the somewhat disappointing clinical results, pharmacotherapeutic interventions did lead to some small, but significant, improvements in alcohol abstinence rates.

Obsessive-compulsive symptoms in schizophrenia

phrenic patients had pathologic serum immune findings and why others had not. The psychopathology (quantified via PANSS) was dichotomized: 15 male patients with high scores in delusions and schizophrenic autism were compared with 15 male patients with low scores in these items. All of them met DSM-IV criteria for schizophrenia. Serum immune screening was done with a program searchingfor autoantibodies, immune complexes, immunoglobulins and markers of cell activation. Patients with low scores for delusions and autism had significantly more pathologic immune findings. The conclusion is drawn from these data that for some subgroups of schizophrenia somatic vulnerability factors could playa more dominant role than for other subgroups.

Basic Symptoms and Their Contribution to the Differential Typology of Acute Schizophrenic and Schizoaffective Disorders

One hundred and fifty male inpatients – 128 patients with DSM-IV schizophrenia and 22 patients with DSM-IV schizoaffective disorder – were investigated, over the course of their acute psychosis, on whether there were differences in the extent of basic symptoms (measured by the Bonn Scale for the Assessment of Basic Symptoms) according to their diagnostic subtype. Another aim was to find out if the diagnostic subtypes could be discriminated by means of basic symptoms and if clusters gained from basic symptoms were in accordance with the diagnostic subtypes. Differences in basic symptoms were found between the subtypes, but a clear discrimination of diagnostic subtypes by means of basic symptoms could not be achieved. There was indication that patients with prominent delusions or auditory hallucinations reported more basic symptoms than patients with exclusively prominent disorganization.

A Case of Comorbidity between Panic Disorder and Photosensitive Epilepsy

Panic disorder and epilepsy usually are distinct entities which require different and specific therapeutic stategies. While anticonvulsant medication is the treatment of choice for seizure disorders, behavioral methods have proven to be effective in panic disorder. We here report a case of comorbidity between panic disorder and photosensitive epilepsy. Special attention is given to the different symptomatic presentations of the disorders, because a thorough knowledge of both disorders may save unnecessary diagnostic procedures. Therefore, the necessity of taking a careful patient’s history is underlined. Furthermore the different possible relationship between panic disorder and epilepsy are discussed.

Characteristics and motivations of volunteers providing one-to-one support for people with mental illness: a survey in Austria

PurposeLarge numbers of volunteers provide one-to-one support for people with mental illness, sometimes referred to as befriending. However, there has been very little research on their characteristics and motivations. This study aimed to assess the personal characteristics and motivations of such volunteers across different regions in Austria.MethodsQuestionnaires assessing characteristics and motivations were distributed to 663 volunteers providing befriending for people with mental illness within volunteering programmes organised in four Austrian regions.ResultsQuestionnaires were completed and returned by 360 out of 663 approached volunteers (response rate 54%). Whilst most socio-demographic characteristics were widely distributed, 78% were female; 42% reported to have a family member and 56% a friend with a mental illness. Most volunteers cited motivations to do something both for others (e.g. “feel a responsibility to help others”) and for themselves (e.g. “enhance my awareness of mental health issues”). When the total group was divided into four subgroups in a cluster analysis based on their socio-demographic characteristics, a subgroup of female, single and younger volunteers in full-time employment expressed motivations to achieve something for themselves significantly more often than other subgroups.ConclusionsThe study provides the largest sample of volunteers in befriending programmes for people with mental illness in the research literature to date. The findings suggest that people with different characteristics can be recruited to volunteer for befriending programmes. Recruitment strategies and supervision arrangements should consider motivations both to help others and to achieve something for themselves, and may be varied for specific volunteer subgroups.

Attitudes towards severe mental illness and social distance: A survey of volunteer befrienders in Austria

Background: Research suggests there is a propensity for people in the general population to distance themselves from people with severe mental illness (SMI), which reportedly decreases with increased contact with individuals with SMI. Volunteer befrienders in the mental health sector have ongoing contact with this population, yet little data exist to reflect their attitudes towards people with SMI. Method: A questionnaire was distributed to all volunteer befrienders for people with SMI within volunteering programmes organised in five Austrian regions. A vignette described an individual with SMI and was followed by questions assessing willingness to interact with this person in personal or professional contexts. Social distance scores, calculated based on responses to attitude items, were used as the dependent variable in regression analyses. Independent variables included participant characteristics, experience of family/friends with mental illness, time spent befriending and satisfaction with the relationship. Results: Questionnaires were completed and returned by 360 volunteers (54.0%). A minority would allow someone with SMI to look after their children (6.2%), while most volunteers positively endorsed other personal interactions such as having the individual marry into their family (67.8%) or become a neighbour (99.7%). Social distance (M = 2.5, standard deviation [SD] = 1.16) was not associated with any independent variables. Conclusions: Volunteers had a lower desire for social distance from individuals with SMI as compared to findings from the general population. Future research may establish whether lower social distance is part of the motivation to volunteer as a befriender to people with severe mental illness or develops over time in that role or both.

Ein Wandel des Phänotyps

Von der bipolaren Störung zum Organischen Psychosyndrom mit schizophreniformer Symptomatik. Die Fallvignette zeigt, wie wichtig – auch bei chronischen psychiatrischen Krankheitsverläufen – eine begleitende somatische Kontrolle ist.

Immunological alterations in three types of schizophrenia

Immunological blood serology has been showing a manifold picture of pathological changes in patients suffering from schizophrenic disorders (DeLisi, 1986). The focus of scientific investigation has been set on zytokines and their receptors (Ganguli and Rabin, 1989; Goldstein etal., 1980; Muller etal., 1990; Villemain etal., 1989). The examination of immunoglobulins, especially antibodies against neuronal tissue (Henneberg etal., 1994), is an important part of the question, in how far immunological changes may have a causal relationship to the development of schizophrenic disorders. Another important issue concerns the search for the significance of antinuclear factors (Noy et al., 1994; O’Donnel et al., 1988; Villemain et al., 1989). Altogether the findings are rather heterogenous and there are many schizophrenic patients showing normal serological parameters.