Fortschritte der Neurologie-Psychiatrie
-
Fortschr Neurol Psychiatr · Sep 1998
Review[Schizophrenia and violence: epidemiological, forensic and clinical aspects].
Recent studies confirm a significantly (several times, in fact) increased risk for schizophrenics to commit severely violent acts compared to the general population. Violent acts of minor degree and threats not followed by forensic detention are even much more common. Data on prevalence depend on study conditions, sample selection, and outcome definitions of violence. ⋯ Even imperative hallucinations are not clearly associated with violence: systematic delusions are associated with severe violent acts, but not with the much more frequent violent acts of minor degree. Most probably, the total of psychopathological symptomatology is associated with the proneness to aggressive behaviour. Neuropsychological and biological findings are also inconsistent.
-
Fortschr Neurol Psychiatr · Feb 1998
Review[Neuropsychological and psychopathologic changes following cardiac surgical procedures].
Neuropsychological and neuropsychiatric disorders following open heart surgery are estimated to occur in as many as 80 per cent of all patients. They have been recognised from the very beginning of modern heart surgery. Despite a huge amount of scientific literature, data concerning incidence, the phenomenology and duration of symptoms diverge. ⋯ In the postoperative period, the duration of intubation or ICU stay and related variables (like sleep or sensory deprivation/hyperstimulation) were identified as significant predictors of neuropsychological and psychopathological alterations. Modern research focusses on neurobiochemical markers of brain injury which may serve as early predictors of a postoperative cognitive decrease. These parameters may indicate an early postoperative diagnosis and neuroprotective treatment in patients at risk.
-
Fortschr Neurol Psychiatr · Aug 1996
[Follow-up and prognosis of patients of a neurologic intensive care unit with special reference to age].
To evaluate risk factors effecting course and prognosis of neurological intensive care (ICU) patients with special respect to age, 422 patients (235 male, 187 female, mean age 56.7 years, standard deviation +/- 18.8 years) admitted to the ICU of the Department of Neurology, University Erlangen-Nürnberg, were retrospectively studied. The status at the time of ICU discharge was compared to that assessed 18-30 months later using the Barthel-Index, a five grade scale of independence, and the Glasgow Outcome Scale. At the time of reexamination, 203 of the 422 patients (48.2%) were still alive. ⋯ However, approximately 70% of the patients above the age of 70 years were still alive two years after ICU treatment with the majority of patients describing their life as satisfying. Multivariate analysis demonstrated that age by itself does not determine the course of disease. Age affects the prognosis only in combination with other variables such as preexisting diseases (e.g. stroke, carotid surgery, occlusive arterial disease), secondary complications (e. g. pneumonia), and specific ICU treatment (e.g. mechanical ventilation, nasogastric tube), and the patient's state at the time of ICU discharge (bedriddenness, aphasia, dementia).