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  • Suicide  (3)
  • Attempted suicide  (2)
  • Prophylaxis  (2)
  • 1
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Psychopharmakologie ; Suizid ; Schizophrenie ; Risikofaktoren ; Psychopathologie ; Keywords Psychopharmacology ; Suicide ; Schizophrenia ; Risk facotrs ; Psychopathology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract For all 5.352 patients treated for schizophrenia at the Psychiatric Hospital of the University of Munich in 1981 and 1992, detailed routine and data processing-assisted documentations were made of the psychopharmacological therapies. Nineteen of the patients committed suicide while undergoing inpatient treatment; the control group consisted of all other patients (n=5.333). More than 77 sociodemographic and anamnestic variables as well as 195 items from the admission summaries were taken into account while comparing the groups. Furthermore, the pharmacological data were classified according to drug groups and comparison was based on the mean frequency of prescription of each group. We analyzed the mean number of prescriptions for neuroleptics, tranquilizers, and antidepressants, which were further differentiated into sedating and nonsedating types. For frequently administered drugs, mean daily doses were also compared. Bivariate analysis of the data suggests that the suicide cases presented depressive signs, symptoms, and tendencies already present on admission more frequently than with controls; the same applies to previously attempted suicides. Discriminating analysis showed that the variables “feeling of loss of feelings,“ thought insertion,”“visible depression,”“free-floating anxiety,”“suicidal tendencies,” and “previously attempted suicide” have the greatest predictive value with respect to suicide, in descending order. No differences in psychopharmacological treatment between suicides and controls were found, apart from a significantly higher percentage of antidepressive treatments and a higher mean number of antidepressant prescriptions for the suicides.
    Notes: Zusammenfassung Bei allen 5.352 im Zeitraum 1981–1992 in der Psychiatrischen Klinik der Universität München stationär aufgenommenen schizophrenen Patienten wurde systematisch sowohl eine Routinedokumentation mit dem AMDP-System als auch eine computergestützte Dokumentation der pharmakologischen Behandlung durchgeführt. 19 dieser Patienten suizidierten sich während des stationären Aufenthaltes, wobei die Kontrollgruppe aus allen übrigen Patienten gebildet wurde (n=5.333). In den Gruppenvergleich gingen alle soziodemographischen und krankheitsanamnestischen Variablen sowie alle Items des AMDP-Aufnahmebefundes ein. Ferner wurden die pharmakologischen Daten nach Medikamentengruppen zusammengefasst und hinsichtlich der Verordnungshäufigkeiten der jeweiligen Pharmakagruppen verglichen. Die bivariate Auswertung zeigte neben häufigeren Suizidversuchen in der Vorgeschichte ein bei den säteren Suizidenten bereits bei Aufnahme häufiger vorliegendes depressiv-suizidales Syndrom, wobei diskriminanzanalytisch in absteigender Reihenfolge die Variablen “Gefühl der Gefühllosigkeit”, “Gedankeneingebung”, “beobachtete Depression”, “frei flottierende Angst”, “Suizidalität” und “Suizidversuch in der Vorgeschichte” die größte prädiktive Kraft in Richtung Suizid entfalteten. Mit Ausnahme einer signifikanten Erhöhung sowohl des prozentualen Anteils der antidepressiv behandelten Patienten als auch der mittleren Anzahl der Antidepressivaverordnungen in der Suizidgruppe fanden sich keine Anhaltspunkte für eine zwischen den beiden Gruppen wesentlich differierende psychopharmakologische Behandlung.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Anaesthesist 48 (1999), S. 507-518 
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Postoperatives Delir ; Postoperative psychiatrische Störungen ; Therapie ; Prophylaxe ; Key words Postoperative delirium ; Postoperative psychiatric disturbance ; Treatment ; Prophylaxis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract After surgical operations delirium can occur as a serious and possible lethal complication in about 5–15% of patients. Additionally, risk factors such as old age, polymedication, organic and psychiatric diseases raise the incidence. After open-heart- and orthopedic surgery more than half of the patients are affected. Delirium has negative effects on postoperative mobilization and reconvalescence and prolongs treatment on the ward. It is discussed in the literature that delirium may induce dementia in older patients. The correction of metabolic- and electrolyte imbalances, as well as the therapy of neurologic and psychiatric diseases, belongs to prophylactic treatment. Environmental conditions which facilitate reorientation of the patient after operation have beneficial effects. Some success has been achieved by using the nootropic substance piracetam as a prophylactic. In acute treatment, the butyrophenon-neuroleptic haloperidol is the drug of choice. In delirium caused by intoxication with anticholinergic agents, physostigmin is indicated. Benzodiazepines, clonidine and clomethiazole are used in particular for the treatment of withdrawal delirium.
    Notes: Zusammenfassung Nach operativen Eingriffen kommt es bei 5 bis 15% der Patienten zu einem Delir, welches eine ernste und potentiell tödliche Komplikation darstellt. Bei zusätzlich bestehenden Risikofaktoren wie hohem Alter, medikamentöser Mehrfachtherapie, somatischen und psychiatrischen Störungen findet sich eine noch wesentlich höhere Inzidenz. Bei Operationen am offenen Herzen und orthopädischen Eingriffen sind über die Hälfte der Patienten betroffen. Das Delir beeinträchtigt die postoperative Mobilisierung und Rekonvaleszenz der Patienten und führt zur Verlängerung des stationären Aufenthalts. Die Gefahr einer dementiellen Entwicklung als Spätfolge des Delir bei älteren Patienten wird in der Literatur diskutiert. Zu den Maßnahmen der Prophylaxe zählen die Behandlung von metabolischen Entgleisungen, Ausgleich von Elektrolytstörungen und Therapie von neurologischen und psychiatrischen Erkrankungen. Verhaltensmaßnahmen, die die Orientierung des Patienten nach der Operation erleichtern, haben eine günstige Wirkung. Erfolge wurden durch die prophylaktische Verabreichung des Nootropikums Piracetam berichtet. In der Akutbehandlung ist das Butyrophenon-Neuroleptikum Haloperidol Mittel der Wahl zur Sedierung. Bei Delirien auf der Grundlage einer Intoxikation mit anticholinerg wirkenden Pharmaka ist Physostigmin indiziert. Benzodiazepine, Clonidin und Clomethiazol kommen v.a. bei der Behandlung des Entzugsdelir zum Einsatz.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 232 (1982), S. 427-438 
    ISSN: 1433-8491
    Keywords: Attempted suicide ; Singular and repeated acts ; Comparative study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Im Hinblick auf soziodemographische, biographische und psychopathologische Variablen wurden 169 Patienten nach erstmaligem und 109 Patienten nach wiederholtem Suizidversuch miteinander verglichen. Die erheblichen, zum Teil statistisch hochsignifikanten Unterschiede kennzeichnen die Patienten mit mehrfachen Selbstmordversuchen als einen Personenkreis mit häufigeren Verlust- oder Trennungserlebnissen in Kindheit und Jugend sowie mit konfliktreicheren und instabileren sozialen Beziehungen im privaten wie im beruflichen Bereich. Diese Patienten kamen häufiger als die Vergleichsgruppe in psychiatrische und psychotherapeutische Behandlung, wurden häufiger als persönlichkeitsgestört oder suchtkrank diagnostiziert und prognostisch ungünstiger beurteilt. Die Übereinstimmung der Ergebnisse mit der vorliegenden Literatur, Fragen der typologischen Interpretation und versorgungspraktische Konsequenzen werden diskutiert.
    Notes: Summary After their first suicide attempts 169 patients were compared to 109 repeated suicide attempters regarding sociodemographical, biographical, and psychopathological variables. The differences between the groups characterize the repeaters as persons with more broken-home situations in childhood and youth and with more tension and instability in private and occupational relationships. These patients received more psychiatric or psychotherapeutic treatment, were more often classified as suffering from a personality disorder or addiction and their prognosis was estimated less favourable. These findings are consistent with the results of other investigations. Questions of typological interpretation and practical consequences are discussed.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 250 (2000), S. 257-261 
    ISSN: 1433-8491
    Keywords: Key words Unipolar ; Bipolar ; Depression ; Suicidality ; Suicide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of the present analyses was to evaluate differences in suicidality (past suicide attempts, suicidal thoughts at time of admission and completed suicides during the hospital stay) between bipolar and unipolar depressed inpatients. Apart from a higher frequency of past suicide attempts in bipolar depressed patients (26.6% in bipolar vs. 17.8% in unipolar patients), findings do not indicate any further differences in suicidality (suicidal thoughts (about 40% in both groups) and completed suicides during the hospital stay (0.8% in both groups)) between bipolar and unipolar patients. Factors with a predictive value for suicidal thoughts at the time of admission were a positive family history for affective disorders, past suicide attempts, and the depressive and paranoid hallucinatory syndrome (all associated with an increased risk). Female gender, an older age at hospitalisation and a longer duration of the illness were found to be associated with a lower probability for having suicidal tendencies at the time of admission. The risk for committing suicide during the hospital stay was increased if the patients had a history of past suicide attempts and suicidal thoughts at the time of admission. A more pronounced depressive syndrome at time of admission was slightly associated with a lower risk of committing suicide.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1433-8491
    Keywords: Suicide ; Attempted suicide ; Suicidal act ; Parasuicidal act ; Suicide prevention services ; Suicid ; Suicidversuch ; Suicidale Handlung ; Parasuicidale Handlung ; Selbstmordverhütungsinstitutionen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An 150 Patienten mit Tablettenselbstmordversuch warden soziale und psychiatrische Daten analysiert. Die sozialen Daten werden in Beziehung gesetzt zu einer Vergleichsgruppe von Suicidenten. Bei den psychiatrischen Daten werden insbesondere Informationen über das Selbstmordverhalten herausgearbeitet. Der letzte Teil der Untersuchung beschäftigt sich mit der Bekanntheit und der Inanspruchnahme von Selbstmordverhütungsinstitutionen.
    Notes: Summary Social and psychiatric data on patients who attempted suicide are analysed and compared with social data on a control group of persons who succeeded in committing suicide. Among the psychiatric data, information about presuicidal and suicidal behavior is elaborated. The last part of the analysis describes how many people know about and use suicide prevention services.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 249 (1999), S. 144-149 
    ISSN: 1433-8491
    Keywords: Key words Depression ; Bipolar disorder ; Lithium ; Prophylaxis ; Efficacy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract It has been reported recently that the prophylactic efficacy of lithium is a transient phenomenon in many patients. Other studies suggest sustained efficacy against affective recurrences for many years. As this issue is of major therapeutic relevance, published literature considering changes in lithium efficacy over time has been reviewed. The present review includes a critical evaluation of the data and the methodology which yielded these controversial results. Considering the published data discussed in this review, the balance of evidence does not indicate a general loss of lithium efficacy in the prophylaxis of major affective disorders. A supposed persistence of the prophylactic effects in general does not, however, exclude the reappearance of affective recurrences after years of successful treatment in individual cases. Possible reasons for this phenomenon are discussed.
    Type of Medium: Electronic Resource
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