Clinical course and personality in reactive, compared with nonreactive, delusional disorder.

Objective: Reactive delusional disorder (DD) (with a precipitating factor) has been postulated to differ clinically from nonreactive DD and to show a better prognosis. Our study tests this hypothesis in a sample of patients with persistent DD (International Classification of Diseases, 10th Revision) or DD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) followed during a period of more than 10 years.

Method: As part of a long-term study on DD, 19 patients with DD and a stressful life event preceding the onset of the disorder were compared with 24 DD patients without such a life event.

Acute and transient psychotic disorders versus persistent delusional disorders: a comparative longitudinal study.

Aim: The aim of this work is to investigate differences between two non-schizophrenic, non-organic psychotic disorders, namely persistent delusional disorders (PDD) and acute and transient psychotic disorders (ATPD) according to ICD-10.

Method: In a prospective and longitudinal study, we compared all 43 inpatients with PDD who were treated at Halle-Wittenberg University Hospital during a 14-year period to a previously investigated cohort of 41 patients with ATPD in regard to demography, long-term symptomatic outcome, and social consequences. Sociobiographical data were collected using a semi-structured interview.

The psychotic "continuum".

Research has shown that an exact delineation of prototypic disorders, such as schizophrenia and mood disorders, is not possible. There are presumably genetically determined overlaps between a schizophrenic and an affective spectrum giving rise to psychotic disorders that have features of both prototypes. Such psychotic disorders, which are called paratypes, for example schizoaffective disorder or acute and transient psychotic disorder, have clinical and paraclinical similarities and form a continuum between the two prototypes.

Delusional disorders--are they simply paranoid schizophrenia?

Objectives: This article tries to give an answer to the question of whether International Classification of Diseases (ICD-10) persistent delusional disorder (PDD) or Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) delusional disorder (DD) is simply paranoid schizophrenia (PS). Because ICD-10 PDD and DSM-IV DD are identical, we use DD as a synonym.

Methods: A prospective and longitudinal study compared all inpatients with DD treated at the Halle-Wittenberg university hospital during a 14-year period with a previously investigated selected cohort of patients with PS.

Gender-related features of persistent delusional disorders.

This paper presents gender-related features of Delusional Disorder. It is part of the Halle Delusional Syndromes Study (HADES-Study). All inpatients fulfilling the DSM-IV/ICD-10 criteria of Delusional Disorder/Persistent Delusional Disorder (DD) during a 14-year period were included and followed up for an average of 10.

Bipolar I disorder with mood-incongruent psychotic symptoms: a comparative longitudinal study.

Objectives: The purpose of this paper is to demonstrate similarities and differences between bipolar I patients with and without mood-incongruent symptoms (MIS) over a long period of time, independently of longitudinal syndromatic constellations.

Methods: The Halle bipolarity longitudinal study (HABILOS) prospectively investigates 182 patients meeting the DSM-IV criteria for bipolar I disorders over a long period of time (x;- = 16.84 years).

Psychiatry's 200th birthday.

Professor Johann Christian Reil of Halle, Germany, first introduced the term 'psychiatry' in 1808. He argued that mental illness should be treated by physicians and that psychiatry required the very best medical practitioners. He stressed the important relationships between physical and mental factors in illness and the role of psychotherapy as one of the main treatment approaches in medicine.

Atypical symptoms in hospitalised patients with major depressive episode: frequency, clinical characteristics, and internal validity.

Objective: The objective was (1) to assess the frequency of atypical depression (AD) in depressed inpatients; (2) to compare clinical features of patients with atypical and nonatypical depression (Non-AD) (3) to evaluate the meaning of single psychopathological symptoms with special respect to mood reactivity.

Method: Diagnoses of 1073 inpatients were assessed according to DSM-IV using SCID (Structured Clinical Interview for the DSM-IV) and AMDP (Association for Methodology and Documentation). Diagnosis of atypical depression was defined according to criteria of the DSM-IV specifier for AD.

The longitudinal polymorphism of bipolar I disorders and its theoretical implications.

Background: The longitudinal course of bipolar I disorders is often characterized by a polymorphism, which means that different kinds of episodes develop during the illness. This study investigated the characteristics, similarities and differences of the long-term course of bipolar I patients regarding the dominance of various kinds of episodes.

Methods: One hundred eighty-two (182) patients with DSM-IV bipolar I disorder were longitudinally investigated (approximately 17 years duration of the illness) with standardized instruments.

Temperament and personality in bipolar I patients with and without mixed episodes.

Background: Personality and temperament are supposed to have an impact on the clinical expression and course of an affective disorder. There is some indication, that mixed episodes result from an admixture of inverse temperamental factors to a manic syndrome. In a preliminary report [Brieger, P.

Dimensions underlying outcome criteria in bipolar I disorder.

Objective: Various subjective and objective criteria are used to assess outcome in bipolar disorder. In this study, we explored to what extent they reflect distinct categories and whether underlying dimensions can be identified.

Patients And Methods: One-hundred and twenty-one subjects with at least three episodes of bipolar I disorder (DSM-IV) were assessed on average 4.

Beyond the Kraepelinian dichotomy: acute and transient psychotic disorders and the necessity for clinical differentiation.

The concept of acute and transient psychoses is, together with that of schizoaffective disorders, a challenge by the Kraepelinian dichotomy. Although these conditions have some similarities to schizophrenia, they differ significantly from schizophrenia regarding onset, duration, prognosis, gender and premorbid adaptation. They show some similarities with bipolar disorders.

Gender- and violence-related prevalence of mental disorders in prisoners.

Objectives: To clarify the prevalence of mental diseases including personality disorders in a sample of German prisoners regarding delinquency and gender specificity.

Method: Crime history, present state and lifetime mental disorders, as well as personality disorders, were assessed amongst 415 inmates and compared regarding gender and type of delinquency.

Results: Female offenders more often committed homicide while male offenders more frequently committed assault and robbery.

Self-amputation of penis and tongue after use of Angel's Trumpet.

This case report draws attention to the dramatic consequences of the consumption of Angel's Trumpet. Angel's Trumpet contains alkaloids (especially scopolamine, as well as hyoscyamine, atropine and other alkaloids) in a relatively high concentration. When intoxicated with Angel's Trumpet, patients can suffer hallucinations, motoric restlessness, overtalkativeness, convulsive sobbing and sexual excitement, as well as aggressive and autoaggressive behaviour.

Is there evidence in the EEG for increased epileptiform activity in ICD-10 acute and transient psychotic disorder?

Background: The aim of this study was to examine whether there is electroencephalographic evidence for an increased epileptiform activity in the EEG of ICD-10 acute and transient psychotic disorders (ATPD; F23) as a hint for a closer relationship to epilepsy.

Methods: We analyzed the EEGs of 39 inpatients with ATPD, comparing them with 'positive' schizophrenic and bipolar schizoaffective controls matched for age and gender. The evaluation was performed visually and qualitatively using a rating scale of demonstrated reliability.

Longitudinal follow-up in acute and transient psychotic disorders and schizophrenia.

We prospectively studied the long-term course of individuals with acute and transient psychotic disorders and a control group with positive schizophrenia matched for age and gender. Follow-up investigations using standardised instruments were performed at three time-points covering 7 years after the index episode or 12 years after the first episode. During follow-up, those with positive schizophrenia experienced a deterioration in their general functioning whereas those with acute and transient psychotic disorders retained their high level of functioning.

Is the psychopathology of acute and transient psychotic disorder different from schizophrenic and schizoaffective disorders?

Objective: This study explores psychopathological aspects of acute and transient psychotic disorders (ATPD), a diagnostic category introduced with ICD-10, to elucidate its relationship with schizophrenia and schizoaffective psychoses.

Methods: We recruited all consecutive inpatients fulfilling the ICD-10 criteria of ATPD (F23) during a 5-year period as well as control groups with "positive" schizophrenia (PS) and bipolar schizoaffective disorder (BSAD) matched for gender and age at index episode. For the evaluation of psychopathological parameters during index episode a standardized symptom list was used.

Factorial structure and internal consistency of the German TEMPS-A scale: validation against the NEO-FFI questionnaire.

Background: The purpose of the study was to evaluate the psychometric properties of the German version of the TEMPS-A questionnaire. Besides the reliability of the temperament scales, validity was the focus of interest. Therefore, the relationship between the TEMPS-A and the well-established personality questionnaire NEO-FFI, whose factors show theoretical overlap with temperaments, was investigated.

Dimensions of personality disorders in offenders.

Background: Owing to criticisms of current concepts of personality disorders such as high comorbidity, criteria overlap and arbitrary thresholds of categorical diagnoses, a dimensional assessment is proposed that considers interrelations between different personality disorders. Results of previous factor analyses using dimensional personality disorder scores have indicated that one underlying dimension shows strong similarities to the concept of psychopathy and is similarly related to criminal recidivism.

Aim: The authors examined the underlying dimensions of ICD-10 personality disorders, to analyse their association with criminal behaviour in general, and with specific criminal history variables.

[Quality of life in unipolar depressive and bipolar affective patients].

Objective: To assess subjective quality of life (QOL) of subjects with unipolar depressive and bipolar affective disorders.

Methods: 153 consecutive psychiatric in-patients were assessed with standardized interviews. Prior to discharge QOL was assessed with WHOQOL-bref.