Swiss Archives of Neurology, Psychiatry and Psychotherapy

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Open AccessBook Review

Eric M. Wassermann, Charles M. Epstein, Ulf Ziemann, Vincent Walsh, Tomáš Paus, Sarah H. Lisanby: The Oxford Handbook of Transcranial Stimulation

by EMH Swiss Medical Publishers Ltd.

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 50; https://doi.org/10.4414/sanp.2010.02119 - 1 Jan 2010

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Abstract

Das «Oxford Handbook of Transcranial Stimulation » ist ein Übersichtswerk über die Methode der transkraniellen Magnetstimulation (TMS) [...] Full article

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Open AccessBook Review

Mirror Neuron Systems. The Role of Mirroring Processes in Social Cognition

by EMH Swiss Medical Publishers Ltd.

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 49-50; https://doi.org/10.4414/sanp.2010.02123 - 1 Jan 2010

Abstract

Soziale Kognition wird unter Neurowissenschaftlern aktuell heiss diskutiert. Zentral ist die Frage, welche Fähigkeit es uns ermöglicht, das Verhalten anderer Menschen häufig korrekt vorauszusagen und ihre Emotionen und Motive aus ihrem Verhalten ableiten zu können [...] Full article

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Open AccessBook Review

Traumatische Schädigungen des Nervensystems

by EMH Swiss Medical Publishers Ltd.

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 49-50; https://doi.org/10.4414/sanp.2010.02122 - 1 Jan 2010

Abstract

Synergistisch decken die zwei Autoren als klinische Neurologen bzw [...] Full article

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Open AccessBook Review

Der Psychoanalyse auf der Spur

by EMH Swiss Medical Publishers Ltd.

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 49-50; https://doi.org/10.4414/sanp.2010.02121 - 1 Jan 2010

Abstract

1975 fing Caroline Neubaur an, über psychoanalytische Kongresse zu schreiben, für die Frankfurter Allgemeine, für die Süddeutsche Zeitung und für den Rundfunk [...] Full article

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Open AccessBook Review

Vom Lebensleid zu psychischen Krankheiten

by EMH Swiss Medical Publishers Ltd.

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 49-50; https://doi.org/10.4414/sanp.2010.02120 - 1 Jan 2010

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Abstract

Die Schwarzweisszeichnungen des Autors, Ausdruck seiner Betroffenheit vom Leiden der Mitmenschen, erschüttern auch uns zutiefst in ihrer averbalen Botschaft [...] Full article

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Open AccessNews

Aktualitäten

by Karl Studer

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 48; https://doi.org/10.4414/sanp.2010.02135 - 1 Jan 2010

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Abstract

Die Bedeutung der psychischen Gesundheit wird in der Schweiz unterschätzt [...] Full article

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Open AccessArticle

Professeur Alfred Bader: une nécrologie

by Pierre Baumann

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 46-47; https://doi.org/10.4414/sanp.2010.02131 - 1 Jan 2010

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Abstract

Avec le décès récent (11 mars 2009) du professeur Alfred Bader, la psychiatrie suisse a perdu un collègue, dont la renommée dans le domaine de la psychopathologie de l’expression était internationale [...] Full article

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Open AccessArticle

Schreber as interpreter and thinker

by Zvi Lothane

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 42-45; https://doi.org/10.4414/sanp.2010.02130 - 1 Jan 2010

Cited by 4 | Viewed by 31

Abstract

Ever since the publication of the Denkwürdigkeiten eines Nervenkranken in 1903 [1], Daniel Paul Schreber (1842–1911) has been regarded as a paradigm; an illustrative case history for the use of descriptive or dynamic psychiatrists and a formula for psychoanalysts, rather than a person [...] Read more.

Ever since the publication of the Denkwürdigkeiten eines Nervenkranken in 1903 [1], Daniel Paul Schreber (1842–1911) has been regarded as a paradigm; an illustrative case history for the use of descriptive or dynamic psychiatrists and a formula for psychoanalysts, rather than a person with a life and ideas [...] Full article

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Open AccessArticle

Rehabilitation des Parkinsonsyndroms

by Fabio Baronti

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 38-41; https://doi.org/10.4414/sanp.2010.02132 - 1 Jan 2010

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Abstract

The great majority of parkinsonian patients greatly benefit from a carefully adjusted pharmacological therapy and/or functional neurosurgery. However, both therapeutic approaches can merely improve the dopaminergic symptoms of the disease. In advanced stages, patients’ QoL is mostly impaired by the complication of long-term [...] Read more.

The great majority of parkinsonian patients greatly benefit from a carefully adjusted pharmacological therapy and/or functional neurosurgery. However, both therapeutic approaches can merely improve the dopaminergic symptoms of the disease. In advanced stages, patients’ QoL is mostly impaired by the complication of long-term pharmacological treatment and/or by the non-motor symptoms of the disease. As the latter do not correlate with the progressive loss of dopaminergic neurons, they are poorly controlled by the dopaminergic therapy. Rehabilitation is a low-cost, broad-spectrum and side-effect-free treatment. Although the available evidence does not (yet) fulfill the Cochrane reviews’ criteria, several clinical and neurophysiologic studies, as well as alternative methods of literature analysis, strongly suggest that it should belong to the standards of care for Parkinson’s disease. Furthermore, increasing evidence suggests that interventions aiming to influence the basic mechanisms of this movement disorder (i.e., cueing) may produce longer lasting benefit. However, rehabilitation should not merely address the motor symptoms of the disease. Clinical management of complicated cases may be improved by referral to a specialised centre. A round-the-clock observation of motor and non-motor complications through specially trained personal allows correct interpretation of the individual problems and selection of appropriate therapeutic strategies. The coordinated and synergic intervention of experienced physiotherapists, occupational therapists, speech therapists and specialised nurses can further improve the results of the individually optimised drug treatment. Psychological support and social counseling may further help reducing the burden of the disease on patients and their caregivers. Non-pharmacological treatment options are even more important in parkinsonisms, which are characterised by a progressive and often total loss of the clinical response to levodopa. In these patients, rehabilitation represents perhaps the only chance to reduce the progression of disability and, possibly, its costs. Full article

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Open AccessArticle

Stratégies thérapeutiques dans la maladie de Parkinson avancée

by Pierre R. Burkhard

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 33-37; https://doi.org/10.4414/sanp.2010.02128 - 1 Jan 2010

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Abstract

Therapeutic strategies in advanced Parkinson’s disease Parkinson’s disease encompasses a variety of motor and non motor symptoms whose assessment and therapy become more and more complex as the dis ease progresses. Besides motor fluctuations, dyskinesia, gait impairment and postural instability, patients may exhibit [...] Read more.

Therapeutic strategies in advanced Parkinson’s disease Parkinson’s disease encompasses a variety of motor and non motor symptoms whose assessment and therapy become more and more complex as the dis ease progresses. Besides motor fluctuations, dyskinesia, gait impairment and postural instability, patients may exhibit many other problems including orthostatic hypotension, constipation, incontinence, sleep difficulties, de pression, behavioural abnormalities and cognitive decline. In this article, current therapeutic strategies aiming at improving these complications in individual patients are briefly reviewed. Full article

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Open AccessCommunication

Zur Pathophysiologie des Normaldruckhydrozephalus

by Johannes Lemcke and Ullrich Meier

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 30-32; https://doi.org/10.4414/sanp.2010.02126 - 1 Jan 2010

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Abstract

The idiopathic normal pressure hydrocephalus is clinically and radiologically obvious but its pathophysiology in the area between hemodynamics and CSF-dynamics remained unclear for a long time. In contrast to other neurodegenerative diseases a surgical therapy was possible, but has been performed strictly phenomenologically. [...] Read more.

The idiopathic normal pressure hydrocephalus is clinically and radiologically obvious but its pathophysiology in the area between hemodynamics and CSF-dynamics remained unclear for a long time. In contrast to other neurodegenerative diseases a surgical therapy was possible, but has been performed strictly phenomenologically. With the phase contrast MRI diagnostics, the pathophysiology is understood as a loss of compliance in the basal cerebral arteries. These findings may have an impact on the interpretation of many neurodegenerative diseases. Full article

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Open AccessArticle

Epidémiologie des comportements agressifs en psychiatrie hospitalière: état des lieux dans le canton de Fribourg

by Virginie Salamin, Aline Schuwey-Hayoz and Graziella Giacometti Bickel

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 23-29; https://doi.org/10.4414/sanp.2010.02129 - 1 Jan 2010

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Abstract

Background: Violence and aggression are quite common phenomena in mental hospitals. The incidence rates of aggressive incidents in adult psychiatric care vary considerably between studies and countries. However, violence has to be carefully assessed to improve the quality of psychiatric care. Patient’s [...] Read more.

Background: Violence and aggression are quite common phenomena in mental hospitals. The incidence rates of aggressive incidents in adult psychiatric care vary considerably between studies and countries. However, violence has to be carefully assessed to improve the quality of psychiatric care. Patient’s psychopathology, ward or environmental characteristics and staff variables may contribute to the development of aggressive interactions. The goal of this study is to describe the frequency and severity of aggressive incidents in various adult inpatient treatment wards and to identify their correlates. Methods: We conducted a prospective study in seven wards in a mental hospital (admission wards, specialized wards for mood disorders, substance abuse, psychoses and crisis intervention). All aggressive incidents were recorded with the revised Staff Observation Aggression Scale (SOAS-R) over a 24-month period. Demographical data and diagnosis were routinely assessed. Result: The sample comprised 2671 treatment episodes of 1655 patients and a total of 95 365 treatment days. 157 patients (9.5%) were recorded as being aggressive at least once, mostly male patients. A total of 498 aggressive incidents were registered during the study period. The global incidence rate per 100 treatment days was 0.52, which was highest in the substance abuse division (1.04). In most cases, aggression was against staff (47%). Younger age, a longer length of stay and male gender were associated with a higher risk for aggressive incidents. Patients with personality disorders (ICD-10 F6) have a 4.3 significantly increased risk of aggression compared to patients with neurotic, stress-related or somatoform disorders (ICD-10 F4). The prevalence of aggressive behaviour is highest among substance abuse (29%) and psychotic (23%) patients (ICD-10 F1 and F2). Frequency of aggressive behaviour is correlated to the monthly admission and discharge rates of the wards (respectively t = 0.32 and t = 0.30), thus indicating a relation to the “patients’ movements” in the wards. It appears that it is not crowding per se but the monthly rate of admissions in the ward that is the best predictor of the frequency of aggressive incidents, controlling for ward size. Conclusion: The incidence rates are rather low compared to those reported from other mental hospitals in Switzerland. This could in part be explained by lower “patient turnover” rates, with less turmoil in the wards (even if the wards were overcrowded) and less changes in relational and spatial dynamics. Thus, violent behaviour is related to both individual and situational factors, even if the relevance of situational factors should be further investigated. Full article

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Open AccessArticle

Stationäre Psychiatrische Kurzzeit-Krisenintervention am Basler Universitätsspital

by Frank Wernicke, Rolf-Dieter Stieglitz and Anita Riecher-Rössler

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 17-22; https://doi.org/10.4414/sanp.2010.02124 - 1 Jan 2010

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Abstract

Objectives: The University Hospital Basel serves as a District General Hospital for a population of about 200 000 residents. Service users are referred via general or specialist practitioners or the hospital’s own emergency department. Their stay is usually limited to four days [...] Read more.

Objectives: The University Hospital Basel serves as a District General Hospital for a population of about 200 000 residents. Service users are referred via general or specialist practitioners or the hospital’s own emergency department. Their stay is usually limited to four days and patients receive treatment by a multi-professional team of nurses, psychiatrists and social workers. Patients with acute suicidal ideation, risk of violence to others, psychotic decompensation or predominantly dependence problems are not considered for admission. Methods: a) Self-rated, Symptom Checklist-90-R (SCL-90-R) and the Wellbeing Scale according to Zerssen (Bf-S/Bf-S’), and observer-rated, Clinical Global Impressions (CGI) and Social and Occupational Functioning Scale (SOFAS), questionnaires were completed for 150 admissions and combined with routinely collected information. b) After six months, 89 admissions were included in a follow-up re-evaluation of the subsequent outcomes. This consisted of patients completing another SCL-90-R and answering other questions about the outcome. Results: a) Most of the admitted patients (84.6%) had previously been or were currently receiving psychiatric treatment and 42.7% had been admitted to a psychiatric hospital before. The average SCL-90-R Global Severity Index (GSI) of 1.68 and Bf-S + Bf-S’/2 mean 37.07 (SD 13.34) revealed high levels of psychopathology. The most frequent diagnoses were affective disorders (ICD-10 F3) with 48.7%, followed by 24.7% neurotic and psychosomatic disorders (ICD-10 F4) and 17.3% schizophrenia and delusional disorders (ICD-10 F2). b) Patients with affective disorders were more likely to reply. In hindsight 84.3% rated the treatment at the KIS as helpful. The SCL-90-R GSI dropped by 50% (0.82). 17.2% of the responding patients additionally had used inpatient treatment. The possibility of being at some distance from a distressing situation was often felt to be helpful (67.4%). More than half of all patients reported a significant change in their personal circumstances, i.e., living conditions, relationships or work circumstances. Conclusions: A brief inpatient-based crisis intervention service can be effective in helping patients with significant mental health problems to move on to outpatient-based follow-up arrangements. Many patients in this study experienced significant changes in their personal circumstances following their admission. They reported benefits from being at some distance from acutely distressing situations and this would suggest that, even in an era of community-based psychiatric services, brief inpatient-based crisis intervention services can play an important role in supporting patients in acute situations. Full article

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Open AccessArticle

Differences in therapeutic alliance when working with an interpreter: a preliminary study

by Olga L. Boss-Prieto, Yves de Roten, Abdelhak Elghezouani, Alexandra Madera and Jean-Nicolas Despland

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 14-16; https://doi.org/10.4414/sanp.2010.02127 - 1 Jan 2010

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Abstract

This preliminary study aims to analyze the therapeutic alliance in a crosscultural triadic setting, where there is a therapist and a client who speak a different language but are able to interact thanks to an interpreter/cultural mediator. The participants’ (therapists, clients, interpreters) representations [...] Read more.

This preliminary study aims to analyze the therapeutic alliance in a crosscultural triadic setting, where there is a therapist and a client who speak a different language but are able to interact thanks to an interpreter/cultural mediator. The participants’ (therapists, clients, interpreters) representations associated with the notion of therapeutic alliance, and the level of alliance between each group was obtained and compared. Clients (N = 9) were all from Albanese origin. The results show that the three groups of participants give particular meanings to the alliance and tend to evaluate their alliance level differently. The interpreter’s mediating role in the construction of the therapeutic alliance is discussed. Full article

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Open AccessReview

Therapie der Opioidabhängigkeit – ein Update

by Marc Vogel, Sylvie Petitjean, Stefan Borgwardt, Gerhard A. Wiesbeck and Marc Walter

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 5-13; https://doi.org/10.4414/sanp.2010.02125 (registering DOI) - 1 Jan 2010

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Abstract

After the heroin-wave in Switzerland in the 1980s and 1990s and the establishment of successful maintenance therapies for harm reduction in many western countries, the first evidence-based guidelines for the treatment of opioid dependence appeared. Prevalence of heroin use in Switzerland has decreased [...] Read more.

After the heroin-wave in Switzerland in the 1980s and 1990s and the establishment of successful maintenance therapies for harm reduction in many western countries, the first evidence-based guidelines for the treatment of opioid dependence appeared. Prevalence of heroin use in Switzerland has decreased subsequently in recent years with a large proportion of patients enrolled in maintenance therapies. In this review, pharmacological and psychosocial treatment strategies for opioid dependence are described and discussed with particular regard to current guidelines from European and American medical societies. Opioid dependence is a chronic brain disease associated with neuroadaptive processes and structural changes that lead to substance craving and relapses despite of negative consequences. Like all substance use disorders, opioid-related disorders comprise acute intoxication, harmful use, dependency and withdrawal states. These diagnoses are discussed in short. Comorbid psychiatric disorders as well as multiple substance use are frequent among opioid-dependent subjects and may complicate an effective treatment. Diagnosis and treatment of comorbidity are therefore crucial and necessary to fundamentally improve the prognosis of opioid dependence. Standardised questionnaires and interviews can be used for this purpose. Treatment in acute phases usually begins with the assessment of physical complications and detailed drug anamnesis. It is followed by the withdrawal of additionally consumed substances like cocaine, benzodiazepines and alcohol. Opioid withdrawal can be treated with agonists as well as other medication directed at specific symptoms. Already at this stage, patients should be motivated to begin maintenance treatment, although abstinence can be a reasonable goal for patients with a short history of opioid abuse as well as in subsequent stable phases of the disorder. Agonist maintenance treatment with methadone or buprenorphine constitutes the first-line therapy at this time. Maintenance treatment with slow-release morphine is currently still carried out as “off-label use”. Maintenance with diacetylmorphine (Heroin) is regarded as an important treatment alternative after aborted or failed maintenance therapy and has been established in diverse European countries. Motivational interviewing and contingency management are well-examined psychotherapeutic interventions effective in the treatment of substance- related disorders. Furthermore, disorder-specific psychotherapies enable the integrated treatment of comorbid personality disorders or depressive disorders in parallel to substance use and show positive effects on the course of opioid dependence. Further research is needed to improve our understanding of the neurobiological mechanisms underlying this disorder. Moreover it should aim to advance the efficacy of medical and psychotherapeutic treatments and identify subgroups of patients that can be targeted by specific interventions. Innovative techniques like neuroimaging will provide new options and insights. Full article

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Open AccessEditorial

Neurologie

by Claudio Bassetti

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 4; https://doi.org/10.4414/sanp.2010.02134 - 1 Jan 2010

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Abstract

Die drei neurologischen Beiträge dieser Nummer des Schweizer Archivs passen gut zum Ziel der Zeitschrift, den Leserinnen und Lesern eine Fort- und Weiterbildung zur ganzen Breite der klinischen Neurofächer anzubieten [...] Full article

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Open AccessEditorial

Psychiatrie

by Dora Knauer

Swiss Arch. Neurol. Psychiatry Psychother. 2010, 161(1), 3; https://doi.org/10.4414/sanp.2010.02133 - 1 Jan 2010

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Abstract

Ce premier numéro de l’année 2010 au sujet de la psychiatrie nous offre des articles originaux très variés, qui recouvrent de manière éclectique les préoccupations actuelles de notre discipline et nous induisent à des réflexions essentielles sur des sujets d’importance [...] Full article

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Swiss Arch. Neurol. Psychiatry Psychother., Volume 161, Issue 1 (01 2010) – 17 articles

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