Swiss Archives of Neurology, Psychiatry and Psychotherapy

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Open AccessBook Review

Roland Haas: Wörterbuch der Psychologie und Psychiatrie. Deutsch-Englisch/Englisch-Deutsch

by B. Küchenhoff

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 294; https://doi.org/10.4414/sanp.2004.01519 - 1 Jan 2004

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Abstract

Wer sich heute in der Psychiatrie und Psychotherapie aktuell kundig machen will, sei es für die Praxis oder in der Forschung, kann auf die Lektüre englischsprachiger Zeitschriften und Bücher nicht verzichten [...]
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Open AccessBook Review

Buchbesprechungen Livres Book reviews

by E. Hurwitz

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 293-294; https://doi.org/10.4414/sanp.2004.01521 - 1 Jan 2004

Abstract

Roland Haas: Wörterbuch der Psychologie und Psychiatrie Deutsch–Englisch/Englisch–Deutsch [...]
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Open AccessBook Review

Buchbesprechungen Livres Book reviews

by E. Hurwitz

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 293-294; https://doi.org/10.4414/sanp.2004.01518 - 1 Jan 2004

Abstract

Roland Haas: Wörterbuch der Psychologie und Psychiatrie Deutsch–Englisch/Englisch–Deutsch [...]
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Open AccessCommunication

Klaus Taschwer, Benedikt Föger: Konrad Lorenz - Biographie

by K. Studer

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 292-293; https://doi.org/10.4414/sanp.2004.01520 - 1 Jan 2004

Abstract

5. IV-Revision [...]
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Open AccessCommunication

Aktualitäten Actualités News

by K. Studer

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 292-293; https://doi.org/10.4414/sanp.2004.01517 (registering DOI) - 1 Jan 2004

Abstract

5. IV-Revision [...]
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Open AccessArticle

Erfahrungen mit dem therapeutischen Einsatz von Clozapin

by Marco C. G. Merlo, F. Müller-Spahn, F. Seywert, W. Strik and D. Umbricht

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 286-291; https://doi.org/10.4414/sanp.2004.01509 - 1 Jan 2004

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Abstract

Im folgenden werden die 1997 veröffentlichten Empfehlungen für den therapeutischen Einsatz von Clozapin [1] auf den Stand des heutigen Wissens angepasst. Sie geben lediglich die Meinung dieses Expertengremiums wieder. Jeder Arzt, der sich für eine der dargestellten. Empfehlungen entscheidet, handelt im Rahmen seiner [...] Read more.

Im folgenden werden die 1997 veröffentlichten Empfehlungen für den therapeutischen Einsatz von Clozapin [1] auf den Stand des heutigen Wissens angepasst. Sie geben lediglich die Meinung dieses Expertengremiums wieder. Jeder Arzt, der sich für eine der dargestellten. Empfehlungen entscheidet, handelt im Rahmen seiner ärztlichen Kurierfreiheit selbstverantwortlich. Full article

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Open AccessArticle

Casuistique: Psychopathologie chez l’enfant d’âge préscolaire: quel type de thérapie choisir?

by Nathalie Nanzer

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 283-286; https://doi.org/10.4414/sanp.2004.01515 - 1 Jan 2004

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Abstract

At the age of 3 or 4 years, we know that the child is still very dependent on his or her parents’ projections, but s/he is also beginning to consolidate her or his internal representations. With preschool children who need psychiatric help, it [...] Read more.

At the age of 3 or 4 years, we know that the child is still very dependent on his or her parents’ projections, but s/he is also beginning to consolidate her or his internal representations. With preschool children who need psychiatric help, it is often difficult to dissociate the part of the conflict which concerns the parent–child relationship from the conflict that is already internalised by the little patient. However, this distinction is very important when the therapist has to choose between several different types of treatment for the child and his or her family. Personalitytype and type of conflictuality are factors that will help the therapist to select the most advantageous treatment method. This text will concentrate exclusively on psychodynamicoriented therapies using examples of child individual psychotherapy, which tries to understand intrapsychic conflicts, and parent–child psychotherapy, which studies the transitional area between the parent and the young child*(Winnicott 1970).Throughaclinical case of a little patient who successively benefited from both of these treatments, we try to illustrate and better understand the advantages and insufficiencies of both these therapies. Full article

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Open AccessStudy Protocol

Psychiatry and science

by Charles Kleiber

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 281-283; https://doi.org/10.4414/sanp.2004.01514 - 1 Jan 2004

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Abstract

Do you know, Ladies and Gentlemen, do you know the story of the “balloonist” [...]
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Open AccessArticle

Patient coordination style during the first session of therapy: relationship with early alliance, patient’s characteristics and outcomes

by Véronique Beretta, Y. de Roten, M. Drapeau, A.-Ch. Plancherel and J.-N. Despland

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 273-280; https://doi.org/10.4414/sanp.2004.01513 - 1 Jan 2004

Cited by 2 | Viewed by 64

Abstract

In the past two decades, psychotherapy researchers and clinicians postulated that the therapeutic alliance is a key component in psychotherapy. Metaanalyses confirm this assumption and conclude that alliance is a powerful predictor of therapeutic outcome for various forms of treatments, problems and patients. [...] Read more.

In the past two decades, psychotherapy researchers and clinicians postulated that the therapeutic alliance is a key component in psychotherapy. Metaanalyses confirm this assumption and conclude that alliance is a powerful predictor of therapeutic outcome for various forms of treatments, problems and patients. In the literature, various measures of alliance are mentioned but not much is known about the behavioural correlates and the nature of this process. The coordination construct is a way to analyse the micro-process involved in the interactional process. Defined by Westerman and Foote (Psychotherapy 1995;32:222–32) as “how well a patient relates his or her contributions in the exchange to the therapist’s contributions and to the patient’s own contributions at other points in time”, the patient’s coordination style (PCS) focuses on the complex interaction process and defensive pattern involved in the problematic patient’s behaviour. Our hypothesis is that the coordination construct involves conversational collaboration needed to create a strong alliance. The aim of the study is to investigate this hypothesis by analysing the interaction between patient and therapist. Furthermore, the influence of patient’s characteristic on patient’s coordination style at the beginning of the therapy is explored. Moreover, in line with findings in the alliance literature, we expect to find a relationship between coordination style and therapeutic outcome. The data consisted in 60 self-referred outpatients with anxiety and depressive disorders (with/without cluser C personality disorders) that completed the Brief Psychodynamic Intervention in the Adult Psychiatry outpatient unit of the University of Lausanne (Switzerland). Coordination style was assessed at the first session by means of the coordination scales and alliance was measured by the Helping Alliance Questionnaire (Haq-I), patient’s version administrated after each session of treatment. Patient’s characteristics are measured in terms of global symptomatic distress (SCL-90), social adjustment (SAS), interpersonal problems (IIP) and overall level of defensive functioning (DMRS). Outcome of treatment consists of reduction in symptomatic distress (SCL-90, HAMA, HDRS) and positive evolution of social adjustment. As predicted, patient coordination style was closely related to the therapeutic alliance as assessed by the patient. Furthermore, patient’s coordination style in the first session was a good predictor of the development of the alliance during early sessions of Brief Psychodynamic Intervention. Results showed that coordination was largely influenced by patient’s characteristics. The global symptomatic distress, the level of social maladjustment and specific interpersonal problems (hostility and domineering) were correlated to a non-coordinated style. However, coordination was not related to outcome in Brief Psychodynamic Intervention. With regard to these results, the specific roles of therapist and patient in developing early alliance are discussed. Full article

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Open AccessReview

Psychiatrische Prognose im Strafrecht bei älteren Jugendlichen und jungen Erwachsenen: Erste Ergebnisse zur Konstruktion eines Prognoseinstruments

by Ramon Meier, A. Dittrich and A. Andreae

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 264-272; https://doi.org/10.4414/sanp.2004.01512 - 1 Jan 2004

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Abstract

Prognosis confronts forensic psychiatrists with a very difficult problem in criminal court cases and is again and again the topic of controversial discussions. Generally accepted standards hardly exist, the choice of predictors is unclear, and valid criteria for prognosis are largely lacking. This [...] Read more.

Prognosis confronts forensic psychiatrists with a very difficult problem in criminal court cases and is again and again the topic of controversial discussions. Generally accepted standards hardly exist, the choice of predictors is unclear, and valid criteria for prognosis are largely lacking. This is especially true for the group of older teenagers and young adults with a so-called “Multiproblem Syndrome”. The present study investigates the extent to which relevant aspects of criminal behaviour in this population can be predicted from path analysis by means of features characterising precrime behaviour, personality development and state of socialisation. 457 probands from stationary social training and psychiatric institutions were investigated along with a representative comparison group taking into account their biographical background (basis data), social situation (DINX) and psychopathology from a developmental perspective (DIAD). After a follow-up period of 12 years, the names of these individuals were searched for in the federal criminal record. Using factor analysis, an overall number of 35 predictor variables was reduced to 8 factors. A model for the prediction of the probability for future delinquence was then developed from a subsequent discriminance analysis (split-half method). By means of this predictive model, 74% of the probands could be correctly classified according to the occurrence or non-occurrence of delinquency anytime during an average course of 12 years (χ2 = 51.3; df = 1; p <0.0001). The positive predictive value lies at 0.78, the sensitivity at 0.65 and the specificity at 0.82. This result gives an indication of the prognostibility of delinquent behaviour over the long period of 12 years for older teenagers and young adults with multiple behaviour disturbances. Full article

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Open AccessReview

Die Nosologie schizophrener Psychosen – Konzepte von Eugen Bleuler und der Schule Wernicke/Kleist im historischen Streit

by Frank Pillmann and A. Möller

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 254-263; https://doi.org/10.4414/sanp.2004.01510 - 1 Jan 2004

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Abstract

Eugen Bleuler’s notion of schizophrenia has become an undisputed basis of the international diagnostic systems in psychiatry. At the time of its formation, however, it has not been without critics and had to stand up to alternative concepts. This paper explores the relationship [...] Read more.

Eugen Bleuler’s notion of schizophrenia has become an undisputed basis of the international diagnostic systems in psychiatry. At the time of its formation, however, it has not been without critics and had to stand up to alternative concepts. This paper explores the relationship between Bleuler’s doctrine of schizophrenia and the competing concepts of Carl Wernicke and Karl Kleist. The comparison reveals how Bleuler with his clinical-psychological point of view and the Wernicke/Kleist School with their biological-pathogenetic approach necessarily had to reach different conclusions. In Bleuler’s writings, Wernicke was mentioned predominantly in critical terms. Wernicke’s clinical method of examination war characterised as insufficient by Bleuler, his diagnostic terms were judged unfavourably and his prognostic abilities were questioned. Most importantly, Bleuler rejected the idea of cerebral localisation central to Wernicke’s thought and later carried on by Kleist. The neuropathological explanation of psychotic symptoms Bleuler deemed to be a fruitless endeavour. In contrast, he favoured psychological explanations, e.g. of psychomotor disturbances in schizophrenia. In this respect Bleuler drew on his large clinical experience, but he certainly also was influenced by psychoanalysis. Wernicke died in 1905 and thus could not react to Bleuler’s seminal writings on schizophrenia. However, he clearly pointed out his views with respect to Kraepelinian diagnostics. Wernicke could find no use in the concept of dementia praecox, and he was sceptical on the concept of disease entities delineated by criteria that included aspects of aetiology and course. Instead, he conceived a two-tier diagnostic system primarily relying on the localisation of the disturbed function within the brain, only secondarily considering questions of aetiology, and thus prognosis. It was this peculiar nosological stance that separated Wernicke not only from Kraepelin, but also from most contemporary psychiatrists. Bleuler rightly felt that his concept of schizophrenia could not be reconciled with Wernicke’s diagnostic principles. It was Wernicke’s pupil Kleist who continued to represent the neuropathological school in psychiatry, although he soon abandoned Wernicke’s peculiar diagnostic system in favour of disease entities again including aetiological and prognostic elements. Kleist adopted a concept of schizophrenia classifying it as an analogue to neurological disorders marked by system degeneration such as Chorea Huntington. Consequently, Kleist reproached Bleuler with an undifferentiated and unduly extended use of the term “schizophrenia”. In their writings Bleuler on one side and Wernicke/Kleist on the other were harshly critical of each other. Both positions stood unreconciled as the opponents, rooted in their respective basic assumptions, could not fully appreciate the other’s arguments. With respect to the further development of psychiatry, Bleuler’s nosological concept has proven by far the more influential. However, recent developments of biological research in schizophrenia also threw new light on the theories of Wernicke and Kleist. The analysis of the historical dispute between Bleuler and Wernicke/Kleist may therefore foster the understanding of contemporary controversies in the nosology of schizophrenia. Full article

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Open AccessArticle

Troubles hyperactifs avec déficit de l’attention chez les enfants et les adolescents: situation actuelle et perspectives de traitements médicamenteux

by Michel Bader, L. Junier, F. Ansermet and O. Halfon

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 243-253; https://doi.org/10.4414/sanp.2004.01511 - 1 Jan 2004

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Abstract

Since Bradley’s report in 1937 that described the efficacy of racemic amphetamine sulfate in the treatment of children with disruptive behaviours, numerous studies have documented the safety, efficacy and tolerability of psychostimulant treatment for children and adolescents with attentiondeficit/hyperactivity disorder (ADHD).Stimulants should generally [...] Read more.

Since Bradley’s report in 1937 that described the efficacy of racemic amphetamine sulfate in the treatment of children with disruptive behaviours, numerous studies have documented the safety, efficacy and tolerability of psychostimulant treatment for children and adolescents with attentiondeficit/hyperactivity disorder (ADHD).Stimulants should generally be considered first when initiating pharmacotherapy for most patients with ADHD, but as a part of a multimodal approach of ADHD. The most commonly prescribed and studied psychostimulants include methylphenidate (Ritaline ®), dextroamphetamine (Dexamin®), recently methylphenidate OROS (Concerta®) and mixed amphetamine salts (Adderall®). The lack of pharmacologic coverage throughout the school day may account for the apparent failure of stimulants to affect some key domains of functioning in children with ADHD. Recently sustained-release preparation of psychostimulants have been developed (Ritaline SR®, Ritaline LA®, Concerta®, Adderall XR®,[methylphenidate HCI] Metadate CD®,[dextroamphetamine] Spansules®). Since January 2003, the atomoxetine (Strattera ®) with the pharmacological profile approaching an antidepressant is approved by the FDA in United States for children and adults with ADHD. Preliminary data suggests comparable efficacy to stimulant across the ADHD symptoms spectrum without predictors available for who responds better to stimulants versus atomoxetine. The efficacy of other non-stimulants is until now not enough documented (for instance, _ 2 agonists as clonidine, tricyclic antidepressants as desipramine and nortriptyline, SSRI as fluoxetine, bupropion or modafinil). The medications are second choice alternatives for problematic cases. The prescriptions for ADHD symptoms are under the responsibility of clinicians (usage “label off”). The purpose of this paper is to briefly review the available data about the pharmacotherapy of children and adolescents with ADHD in order to provide the clinician with rational, empirically based strategies. This paper especially describes the medications available in Switzerland, as the short- and long-acting Ritaline®, Dexamin® and Concerta®. The effects of slow-release preparations of methylphenidate are reported. A persistent question attached to ADHD is the allegation that stimulant therapy can lead to substance abuse or drug addiction in either adolescence or adulthood. This paper briefly reviews the available data about this topic. Scientific data have shown that there is no evidence at this time that long-term treatment with stimulants or other psychoactive drugs prescribed for the treatment of children or adolescents with ADHD is associated with high rates of substance abuse later in life. During the past decade epidemiologic studies have documented high rates of psychiatric comorbidity among children with ADHD, as conduct disorders, oppositional defiant disorders, anxiety disorders, mood disorders and learning disabilities. If not recognised and not treated, the combination of comorbid symptoms and ADHD may lead to high morbidity and disability with poor long-term prognosis. The choice of the currently available drugs in Switzerland is still limited, and the clinician is in an unpleasant situation when the effectiveness of the methylphenidate is insufficient or patients develop problematic side effects. The clinicians in Switzerland await with interest the introduction of new preparations of psychostimulants, as the methylphenidate OROS (Concerta®) or Ritaline LA® wich have an action of long duration, or the atomoxetine (Strattera®) with the pharmacological profile approaching an antidepressant. The introduction of other preparations already marketed in the United States could widen the pallet of drugs indicated in the treatment of the ADHD in the child and the teenager. For particular clinical indications, as associated depression major or behavioural problems, the physician can be brought to prescribe other drugs. Current clinical experience suggests that multimodal approach of ADHD is necessary for a successful treatment. Pharmacologic treatments may lead to improvement not only in core behavioural symptoms of ADHD but also in associated impairments including cognition and social skills, but other therapeutic approaches may also be very helpful. Full article

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Open AccessEditorial

Editorial

by Dora Knauer

Swiss Arch. Neurol. Psychiatry Psychother. 2004, 155(6), 241-242; https://doi.org/10.4414/sanp.2004.01516 - 1 Jan 2004

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Abstract

Les articles présentés dans ce numéro de notre Revue nous permettent de parcourir certaines problématiques propres à notre domaine de spécialité, traversant les âges et les questionnements relatifs à nos préoccupations actuelles [...]
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Swiss Arch. Neurol. Psychiatry Psychother., Volume 155, Issue 6 (01 2004) – 13 articles

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