Der Nervenarzt
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Sarcoidosis is an inflammatory multisystemic disease characterised by noncaseating epithelioid granulomas. The lung is affected in over 90% of patients. According to clinical criteria, the nervous system is involved in 5-9%. ⋯ Due to the wide variety of neurologic symptoms, definite diagnosis of sarcoidosis is possible only by histopathological proof of noncaseating epithelioid granulomas. We report a 51-year-old woman who presented with chronic basal meningitis and involvement of the peripheral and central nervous system due to solitary neurosarcoidosis. Diagnostic procedures and differential diagnosis are discussed.
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Pain and depression share similar neurobiological characteristics, and it is a common clinical observation that pain and depression may coincide in the same patient. They also appear to influence each other in the process of chronification. Furthermore, there is a complex coupling of pain and depression by monoaminergic transmitter system. ⋯ The pathological decrease of NE and 5-HIAA in the CSF points to the crucial role of noradrenergic and serotonergic transmitter systems in the generation, modulation, and perpetuation of chronic and episodic pain syndromes. It indicates that antidepressants are effective drugs in these diseases. However, a discriminative neurochemical pattern between pain and depression could not be established. The demonstration of polyvalent correlations between different neurotransmitters is indicative of complex neurobiological coupling between cortical, limbic, and hypothalamic neuronal networks on the one hand and the nociceptive descending system on the other hand in the genesis of pain and depression.
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Counseling of caregivers is an essential component of the management of patients with dementia. According to the empirical research in this field, peer-led self-help groups have the potential to improve subjective outcomes including emotional support, social contact, and control over one's life and thus may facilitate caregiving and reduce psychological burdens. ⋯ Studies in the U. S., Australia, and Finland have demonstrated that multimodal counseling programmes led by professionals significantly reduce the number of nursing home admissions and therefore may have considerable importance for health economics.
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Historical Article
[Psychiatry in the journal "Der Nervenarzt" 1928-2000].
By analysing the complete edition of the German-language psychiatric journal "Der Nervenarzt" from 1928 to 2000 we examined basic trends in the historical and scientific orientation of psychiatry in this journal. All published articles (n=3270) were classified under formal aspects and were assigned to one of 30 categories by content. Inter-rater reliability was determined in 3 years from different eras (1957, 1977, 1997). ⋯ On the other hand, links to related disciplines such as philosophy, sociology and psychology seem to have got lost. The percentage of articles from abroad has been decreasing within the last 2 decades. In comparison, the American Journal of Psychiatry, the Archives of General Psychiatry and the British Journal of Psychiatry have been publishing a higher percentage of original articles, particularly randomised controlled trials.