Search Results - (Author, Cooperation:M. H. Schmidt)

2011-04-19

Nature Publishing Group (NPG)

0028-0836

1476-4687

Biology

Chemistry and Pharmacology

Medicine

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Physics

Acetylation ; Animals ; Endothelial Cells/cytology/*enzymology ; *Gene Expression Regulation ; Gene Knockout Techniques ; Gene Silencing ; HEK293 Cells ; Humans ; Mice ; Mutation ; Receptor, Notch1/metabolism ; Receptors, Notch/*metabolism ; Signal Transduction/*physiology ; Sirtuin 1/*genetics/*metabolism ; Zebrafish/embryology/genetics

2018-03-09

BioMed Central

1472-6831

Medicine

article

1985

Empirische Untersuchung ; Affektive Entwicklung ; Psychologie ; Kind ; Psychiatrie ; Schwierigkeit ; Hyperaktives Kind

Zeitschrift für Kinder- und Jugendpsychiatrie, Bd. 13 (1985) H. 1, S. 16-23, 0301-6811

German

book

2005

Aufmerksamkeits-Defizit-Hyperaktivitäts-Störung ; Genetik

German

1469-7610

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Psychology

Abstract In an epidemiological longitudinal study, 356 out of 399 8-yr old children were re-examined at age 13. Prevalence rates for psychiatric disorders of about 16% remained constant during adolescence. The course of emotional disorders proved very promising, while that of conduct disorders was extremely unfavorable. Remission of psychiatric disorders was also influenced by an improved psychosocial environment within the family. Development of disorders in initially healthy children was related to prior learning disabilities and stressful life events. More effective approaches in the treatment of conduct disorders as well as early detection of detrimental familial conditions and learning disabilities are called for.

Electronic Resource

1469-7610

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Psychology

Abstract An epidemiological field investigation of 399 8-yr-old children was unable to support basic assumptions of the clinical MBD concept (existence of a homogeneous syndrome, specific psychopatholgy, evidence of increased perinatal risks). Using a multi-level case definition procedure and factor-analytic data aggregation, nearly complete independence was found among the diagnostical levels of neurophysiology, neuropsychology and specific skills. Main results were replicated after the application of several alternative models of case definition and were further confirmed by data from a clinical sample. Present findings emphasize the necessity to reconsider the concept of MBD and its practical consequences.

Electronic Resource

1469-7610

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Psychology

Abnormal psychosocial factors, assessed both clinically and by raters blind to clinical presentation, were examined in 21 hyperkinetic and 26 conduct disordered children. Blind raters found the frequency of psychosocial adversities to be similar in the two disorders. By contrast the clinical rater, who did know the diagnosis of patients, rated adverse psychosocial situations as much lower in hyperkinetic children than in children with conduct disorder. Logistic regression showed, particularly in the category of abnormal intrafamilial relationships (Lack of warmth in parent child relationship, Hostility or scapegoating of the child, Intrafamilial discord among adults), effects of the interaction between rater and knowledge of diagnosis. Clinical raters should be aware of abnormal psychosocial situations in hyperkinetic children and assess possible adverse effects on parents and children. Researchers should be aware of a possible bias in research interviews.

Electronic Resource

1433-9285

Springer Online Journal Archives 1860-2000

Medicine

Summary A sophisticated composite measure of social status proved to be more appropriate for child psychiatric research than traditional simple indicators such as the father's occupational prestige. However, when the complicated calculation of the combined measure is taken into consideration and weighed against the resulting minor advantages, its use in standard investigations does not seem economically justifiable. A u-shaped nonlinear association was observed between the social status of the parents and their child's psychiatric disorder rating. While Family Adversity Index scores are undoubtedly more valuable predictors of an individual's psychiatric risk, the intimate contents of this instrument make it less suitable for screening purposes than social-class indicators. When measures of social mobility were computed separately for both parents, no influence of the father's intragenerational mobility was detected. Other findings suggest the existence of (at least) two different groups of mothers of children with psychiatric disorders, one group having high depressivity scores, the other showing much upward social mobility. No connections were found between husband-wife differences in social status and their child's psychiatric rating.

Electronic Resource

1433-9285

Springer Online Journal Archives 1860-2000

Medicine

Zusammenfassung Für mehrstufig angelegte epidemiologische Untersuchungen ist das Problem der Verweigerer besonders drängend, weil sich die Quoten über die Stufen aufsummieren und bei hohen Verweigererquoten Zweifel an der Repräsentativität der Ergebnisse auftreten. Bei einer entsprechenden kinderpsychiatrischen Untersuchung an achtjährigen Kindern in Mannheim trat eine Quote von 38,5% über vier Untersuchungsstufen auf. Es wurden die Eltern, die an der Untersuchung teilnahmen mit denen, die im Verlaufe der Untersuchung verweigerten und mit denen, die die Gesamtuntersuchung von vornherein ablehnten, verglichen. Letztere waren Gegenstand einer speziellen Verweigereruntersuchung. Die von Cox et al. (1977) bei einer Verweigererquote von 8,4% berichteten Ergebnisse, daß Kinder von Verweigerern speziell im Urteil der Lehrer verhaltensauffälliger sind, konnten wirnicht bestätigen. Die Kinder der verweigernden Eltern hatten einen geringeren IQ, mehr Schulschwierigkeiten, waren aber nicht auffälliger in bezug auf psychiatrische Symptome als die Teilnehmer. Die Ergebnisse sind also im Hinblick auf eine allgemeine Auffälligkeit der Kinder uneinheitlich. Erklärungen hierfür sind: unsere hohe Verweigererquote, mögliche Dissimulationstendenzen und unter Umständen eine unterschiedliche Teilnahmemotivation. Die von Cox et al. berichteten Ergebnisse betreffen vermutlich den harten Kern der Verweigerer. Die Prävalenz kinderpsychiatrischer Auffälligkeit wird deshalb in unserer Untersuchung nicht stärker unterschätzt als in Studien mit geringen Quoten.

Summary Problems of non-response and refusal to co-operate acquire special significance in multi-stage epidemiological surveys, since the proportion of the survey sample which is affected tends to increase at each successive stage of the enquiry and may be so high as to throw serious doubt on the representative nature of the research findings. In an investigation of psychiatric disorder among 8-year-old children in Mannheim, the total proportion of refusal at any of the four stages of the enquiry amounted to 38.5%. Parents who co-operated at all stages were compared, both with those who refused further co-operation at a later stage and with those who refused from the outset. The latter group formed the subject of a special sub-study of refusers. The finding reported by Cox et al. (1977), that children of refusers score higher on average than other children on teachers' ratings for behaviour disturbance could not be confirmed. Children whose parents refused had on average a lower IQ and more scholastic difficulties than those whose parents were co-operative, but did not appear to be more deviant in behaviour. There is thus no firm evidence from this study of an excess of psychiatric disorder among the children of refusers. Reasons postulated for this discrepant finding include the high over-all refusal rate in the present study, a possible tendency to dissimulation among the refusal subgroup and also possible variation among different samples in the motives for participation or refusal. The association reported by Cox et al., whose refusal rate was much lower (8.4%), probably relates to a small hard-core group of refusers. The prevalence of psychiatric disturbance found in the present study is, therefore, unlikely to have been more seriously underestimated than in other surveys with lower refusal rates.

Electronic Resource

1433-9285

Springer Online Journal Archives 1860-2000

Medicine

Summary At two points in time a cohort of Mannheim children born in 1970 participated (at the ages of 8 and 13) in a broadly designed epidemiological survey in child psychiatry. The rate of dropouts from t1 to t2 was 18.1%, a figure which did not, however, result in a misrepresentation of the “true” prevalence of psychiatric disorders. Overall there was no significant difference between those who cooperated and those who dropped out. A closer look at the dropouts, however, leads to the conclusion that it is necessary to distinguish between neutral dropouts who are simply inaccessible, and passive and active refusers. Active refusal of cooperation occurred both on the part of the parents as well as the children. The so called ‘neutral’ dropout was mainly found in a mobile upper social class. A problem group (fortunately very small) consists of the passive refusers who failed to keep several appointments without explicitly cancelling. Active parent and child refusers did not appear equivalent as the child refusers were mainly girls who were above average achievers while the parent refusers were mainly parents of boys who were below average achievers. That is why special precautions should be taken for a scheduled t3-survey.

Electronic Resource

1433-8491

Key words Attention-deficit hyperactivity disorder ; Comorbidity ; Frontal lobe ; Auditory selective-attention ; Mismatch negativity (MMN) ; Negative difference wave (Nd) ; Tic disorder ; Conduct disorder

Springer Online Journal Archives 1860-2000

Medicine

Abstract In children with attention-deficit hyperactivity disorder (ADHD) some deficits in auditory information processing seem to exist. Further, comorbidity of ADHD with conduct disorder (CD) and tic disorder (Tic) is quite common but not yet fully understood. Thus, we investigated the effects of these two disturbances, when combined with ADHD, on electrophysiological correlates of auditory information processing. An auditory selective-attention task was used, and temporal as well as frontal lobe sensitive event-related electrical brain activity indicators like mismatch negativity (MMN) and negative difference wave (Nd), as well as P300 were registered in four groups of children (healthy controls, ADHD-only, and combined ADHD + CD as well as ADHD + Tic; total number 42). Performance measures showed that ADHD + CD had a higher impact on errors and reaction times than ADHD + Tic. The MMN effect indicated that all ADHD groups showed lower MMN amplitudes compared to normals, but only the group with ADHD + CD suffered from a significant deficiency in automatic auditory information processing. Nd and P300 amplitudes showed no significant group differences. It may be assumed that neurodynamic sufficiency in ADHD-only and ADHD + Tic children seems to be similarly impaired while there might be a greater deficit in ADHD + CD.

Electronic Resource

1435-165X

Key words Specific speech articulation disorder – expressive language disorder – receptive language disorder – specific reading disorder – specific spelling disorder

Springer Online Journal Archives 1860-2000

Medicine

Abstract  Data from a prospective longitudinal study on the development of children born at biological and psychosocial risk were utilised to examine language and learning abilities of 320 children at ages 4.5 and 8 years. Following the research criteria of the ICD-10, specific developmental disorders of speech and language and specific developmental disorders of scholastic skills were diagnosed. Data were also provided for a clinical and general low achievement group according to less stringent criteria. Frequencies in the risk population were low for specific disorders (ICD-10) (0.6%–3.7% depending on age and type of disorder). Higher frequencies were found when a clinical definition (0.6%–13.6%) or overall low achievement score (0.6%–18.6%) was chosen. The impact of well-documented organic and psychosocial risks was analysed. Organic risk affected language abilities at 4.5 years of age but neither language nor learning abilities at 8 years of age. Psychosocial aspects of a child's environment proved to be associated with both specific language and learning abilities. Stability of language disorders, association between language and reading/spelling disorders as well as gender effects were investigated.

Electronic Resource

1435-165X

Key words Underweight – Asperger's disorder – anorexia nervosa

Springer Online Journal Archives 1860-2000

Medicine

Abstract The study explores the common clinical impression and previously reported finding by Hebebrand et al. (7) of reduced body weight in male children and adolescents with Asperger's disorder (AD). Body weight and height of 36 consecutively admitted male patients with AD were retrospectively assessed for the calculation of body mass indices (BMI, kg/m2). The BMIs were transformed to percentile ranks and plotted into BMI-centiles representative for the German population. In addition, comorbid psychopathology was assessed to explore a possible relationship between associated psychopathology and body weight. The mean BMI-centile of all patients was 34.7 ± 31.8 and, thus, differed significantly from the mean centile of an age- and gender-matched psychiatric control group, which was 52.7 ± 28.3. Thirteen patients had a BMI below the 10th centile and five even below the third. Three of the latter presented with disturbed eating behaviour. Altogether four patients showed disturbed eating behaviour. They had a significantly lower mean BMI-centile than the rest of the group. The BMI-centiles of patients with other additional psychopathology did not differ significantly from the mean percentile of the whole cohort. The results clearly show an increased risk for underweight and disturbed eating behaviour in patients with Asperger's disorder which should be evaluated in further studies.

Electronic Resource

1435-165X

Munchausen Syndrome by Proxy ; Child ; Factitious Illness ; Parental Personality Disorders ; Sexual Abuse ; Psychopathology ; Case Reports

Springer Online Journal Archives 1860-2000

Medicine

Résumé On parle de “Syndrôme de Munchausen par procuration” chez des enfants, qui présentent des troubles organiques résultant de manipulations de leurs responsables éducatifs. Des blessures, l'administration de médicaments, de drogues ou de poison — même chez des enfants très jeunes — ont pour effet de provoquer et simuler un tableau clinique sévère. Il s'agit d'un désordre psychiatrique rare — les chiffres exacts de prévalence sont difficiles à évaluer. Le Syndrome est décrit chez l'enfant à partir de l'âge de trois semaines jusqu'à 12 ans. L'âge moyen est de trois ans et quart. La mortalité chez les enfants porteurs d'un syndrome de Munchausen par procuration est estimé à 9%. Dans trois des quatre cas présentés le tableau clinique est dominé par des symptômes d'ordre neurologique. De manière supplémentaire trois mères rapportent un abus sexuel de leurs enfants. Les mères se caracterisent par leur incompétence et inconséquence éducative; souvent elles sont sans soutien éducatif de leur partenaire. Dans l'interaction mère — enfant les enfants ont un comportement dominant envers leur mère. La non-efficacité des interventions psychothérapeutiques peut être liée a un pourcentage élevé de troubles de la personnalité chez les parents.

Zusammenfassung Die Diagnose Münchhausen “Stellvertreter Syndrom” wird bei Kindern gestellt, die Symptome einer organischen Erkrankung zeigen, die durch Manipulationen von Eltern oder anderen Sorgeberechtigten hervorgerufen werden. Vielfach werden bereits im frühen Kindesalter den Kindern Verletzungen beigebracht, Drogen, Gifte oder Medikamente verabreicht, um die klinischen Merkmale schwerer Erkrankungen vorzutäuschen. Obwohl genaue Angaben zur Häufigkeit fehlen, kann man insgesamt von einer seltenen Störung ausgehen. Es gibt zahlreiche Hinweise dafür, daß es sich beim Münchhausen Stellvertreter Syndrom um die seltene, aber sehr schwere Ausprägungsform in einer größeren Gruppe von Störungen gleichartigen klinischen Bildes handelt, für die man den Begriff der vorgetäuschte Störungen geprägt hat. In dieser Gruppe werden auch die Kinder erfaßt, deren Mütter ausschließlich Symptome und eine zugehörige Krankheitsgeschichte erfinden, die aber keine körperlichen Eingriffe (einschließlich Drogen- und Medikamentenverabreichung) vornehmen, um organische Symptome zu simulieren. Unklar ist, ob eine solche Unterscheidung notwendig und hilfreich ist. Bisher fehlen Hinweise auf Unterschiede in der Prognose im Langzeitverlauf zwischen den Untergruppen. Die Symptomatik eines Münchhausen Stellvertreter Syndroms konnte bereits bei Kindern im Alter von 3 Wochen beobachtet werden und wurde noch bei 12jährigen gefunden. In einer größeren Studie wurde ein mittleres Alter von 3 3/4Jahren für den Zeitpunkt der Diagnosestellung ermittelt. Die Sterblichkeitsrate wird auf 9 Prozent geschätzt. Bei den vier Kindern, über deren Symptomatik hier berichtet wird, standen bei drei zentralnervöse Störungen im Vordergrund. Drei Mütter gaben zusätzlich den Verdacht des sexuellen Mißbrauchs ihrer Kinder an. Die motivationalen Aspekte lassen deudiche Unterschiede erkennen. Bei drei Müttern bestand der Wunsch nach Schutz des Kindes vor realem oder vermeintlichem sexuellem Mißbrauch des Kindes. Alle Mütter hatten mindestens eine gescheiterte eheliche Beziehung. Im Erziehungsverhalten wirkten sie unsicher, inkompetent und inkonsistent; von ihren Partnern, sofern vorhanden, erhielten sie keine erzieherische Unterstützung. In der Mutter-Kind Interaktion vermochten die Kinder über die Mütter zu dominieren. Der hohe Anteil an Persönlichkeitsstörungen bei den hier beschriebenen Sorgeberechtigten könnte der Grund für das häufig berichtete Scheitern psychotherapeutischer Interventionen sein.

Abstract The term Munchausen syndrome by proxy is used to diagnose children presenting symptoms of an organic disorder resulting from manipulations initiated by their caretakers. Even in early infancy it happens that injuries are induced, and that drugs, poisons or medicine are administered in order to provoke and feign clinical symptoms of severe diseases. Exact data on prevalence are not available but it is obvious that Munchausen syndrome by proxy is a rare psychiatric disorder. There is a body of evidence that Munchausen syndrome by proxy is nothing but the extreme of a broader clinical entity for which the term factitious illness has been introduced. In this group children are included whose mothers invent a history of disease in order to produce symptoms without actually damaging their children. It is not well established whether such a distinction is necessary and whether there are differences in long-term outcome. Onset of symptoms is as early as three weeks up to twelve years, and mean age of diagnosis according to a more comprehensive study is 3 1/4 year. The estimated mortality rate of children with Munchausen syndrome by proxy is 9 percent. In three of the four cases of children reported here clinical presentations were dominated by symptoms of central nervous disorders. All mothers showed unsure and inconsistent parental behaviour and inefficient coping. None of them received support from their partners, if present. In interaction the children always wanted to dominate their mothers. The high amount of personality disorders observed in the caretakers might be the reason for the often reported failure of psychotherapeutic interventions.

Electronic Resource

1435-165X

Key words Early onset psychoses ; schizoaffective episodes ; outcome ; social functioning

Springer Online Journal Archives 1860-2000

Medicine

Abstract This study examines educational/occupational outcome and social functioning of adolescents treated for psychosis (mean onset age 16.1 yrs±1.3). In a sample of 157 subjects, 26 patients with schizoaffective episodes (defined as any episode meeting ICD-9 criteria for schizoaffective psychosis, occurring at any time during the course of illness) were compared to 101 patients with schizophrenia, and to 30 affective disordered patients, all without schizoaffective episodes. Follow-up information (mean interval 7.3 yrs ±4.3) was obtained on 130 subjects.The three groups did not differ concerning sex, duration of first inpatient treatment, symptoms and social competence at discharge, nor at follow-up. At the time of outcome subjects with schizoaffective episodes showed greater similarities to schizophrenic than to severe affective disorder. Educational and occupational impairment was found in 72% of the schizoaffective group (schizophrenic group 79%, affective group 40%), obvious or more severe social disability in 86% of the schizoaffective group (schizophrenic 79%, affective 40%). Disabilities regarding performance of specific social roles and specific downward educational and occupational drifts were found to be more marked in schizoaffective than in affective disorder. Implications for further research and clinical practice are discussed.

Electronic Resource

1435-165X

Key words Anorexia nervosa ; menstrual cycle ; ovarian morphology ; outcome

Springer Online Journal Archives 1860-2000

Medicine

Abstract In sixteen adolescent anorectic inpatients with secondary amenorrhea pelvic ultrasound examination of the ovaries was performed at lowest weight and after weight recovery. The outcome was assessed six months later at follow-up, assigning the patients to the categories of good, intermediate and poor outcome according to the modified Morgan and Russell criteria. At lowest weight all patients’ ovaries were smaller than expected for age. After weight recovery the good outcome group had mature and fully developed ovaries whereas the ovarian morphology of patients with poor outcome remained prepubertal. The ovarian volume in the good outcome group was significantly higher than in the poor outcome group. From a threshold BMI of 17.8 upwards we observed a positive linear correlation between BMI and ovarian volume. At BMI 18 the probability for recovered ovaries was 53% rising to 82% at BMI 19.8, which was the highest noting in our study. Nevertheless, we could not find a clear cut-off BMI for definite prediction of recovered ovaries. Therefore, in patients with anorexia nervosa pelvic ultrasound is a very suitable method for determining the target weight required for recovery of ovarian function and resumption of menses. Normalized ovaries indicate favourable outcome and physical recovery.

Electronic Resource

1435-165X

Early onset psychoses ; schizoaffective episodes ; outcome ; social functioning

Springer Online Journal Archives 1860-2000

Medicine

Abstract This study examines educational/occupational outcome and social functioning of adolescents treated for psychosis (mean onset age 16.1 yrs±1.3). In a sample of 157 subjects, 26 patients with schizoaffective episodes (defined as any episode meeting ICD-9 criteria for schizoaffective psychosis, occurring at any time during the course of illness) were compared to 101 patients with schizophrenia, and to 30 affective disordered patients, all without schizoaffective episodes. Follow-up information (mean interval 7.3 yrs ±4.3) was obtained on 130 subjects. The three groups did not differ concerning sex, duration of first inpatient treatment, symptoms and social competence at discharge, nor at follow-up. At the time of outcome subjects with schizoaffective episodes showed greater similarities to schizophrenic than to severe affective disorder. Educational and occupational impairment was found in 72% of the schizoaffective group (schizophrenic group 79%, affective group 40%), obvious or more severe social disability in 86% of the schizoaffective group (schizophrenic 79%, affective 40%). Disabilities regarding performance of specific social roles and specific downward educational and occupational drifts were found to be more marked in schizoaffective than in affective disorder. Implications for further research and clinical practice are discussed.

Electronic Resource

1435-165X

Oligoantigenic diet ; hyperactivity attention deficit disorder ; conduct disorder

Springer Online Journal Archives 1860-2000

Medicine

Abstract A crossover ‘placebo’-controlled, double-blind design was used to examine the effectiveness of an oligoantigenic diet in 49 children with hyperactive/disruptive behavior disorder. Effects of diet were compared with those yielded by stimulant medication (methylphenidate). The study was conducted in an inpatient unit at the Department of Child and Adolescent Psychiatry, Central Institute of Mental Health, Mannheim. Change in behavior was measured in standardized situations by trained raters, including behavior assessment when testing with CPT and PAT, during a free play situation, and at school. Twelve children (24%) showed significant behavioral improvement in two behavior ratings during diet relative to control diet conditions. Methylphenidate used in 36 children yielded more responders (44%) than diet. The amount of positive changes in behavior in those who received both treatments was about the same. Although only effective in a minority of children, dietary treatment cannot be neglected as a possible access to treating hyperactive/disruptive children and merits further investigation.

Electronic Resource

1435-165X

Key words Oligoantigenic diet ; hyperactivity ; attention deficit disorder ; conduct disorder

Springer Online Journal Archives 1860-2000

Medicine

Abstract A crossover ’placebo‘-controlled, double-blind design was used to examine the effectiveness of an oligoantigenic diet in 49 children with hyperactive/disruptive behavior disorder. Effects of diet were compared with those yielded by stimulant medication (methylphenidate). The study was conducted in an inpatient unit at the Department of Child and Adolescent Psychiatry, Central Institute of Mental Health, Mannheim. Change in behavior was measured in standardized situations by trained raters, including behavior assessment when testing with CPT and PAT, during a free play situation, and at school. Twelve children (24%) showed significant behavioral improvement in two behavior ratings during diet relative to control diet conditions. Methylphenidate used in 36 children yielded more responders (44%) than diet. The amount of positive changes in behavior in those who received both treatments was about the same. Although only effective in a minority of children, dietary treatment cannot be neglected as a possible access to treating hyperactive/disruptive children and merits further investigation.

Electronic Resource

1435-165X

Eating disorders ; intellectual functioning ; psychological testing

Springer Online Journal Archives 1860-2000

Medicine

Abstract The aim of this study was to investigate the intellectual functioning of a large group of eating disordered adolescents in order to test two hypotheses, viz, that the intellectual functioning of eating disordered adolescents conforms to the normal distribution, and that eating disordered adolescents do not perform better in verbal abilities than in nonverbal abilities. Standard intelligence tests were applied to 190 consecutive out- and inpatients with eating disorder diagnoses. The results were compared with those of a group of patients with other disorders, similar in age, sex, SES, and year of admission. The IQ of the eating disordered patients was significantly higher than that of patients in the comparison group. Patients in the comparison group and bulimic patients, but not anorexic patients, showed better nonverbal than verbal intellectual performance.

Electronic Resource