Browsing by Author "Staedt, J."

Objective: We wanted to compare geriatric psychiatric patients and their management in an integrated (with other adult age groups) care in the Psychiatric University Hospital of Gottingen (IGV) compared to those in a separated (according to age) care in the Psychiatric University Hospital of Magdeburg (SGV). The latter provides care for a certain area, while the former is not obliged to. Method: We performed standardized chart reviews of randomly selected groups of patients, who had been treated in the IGV (n = 104) and the SGV (n = 144) in the years 1998 and 1999. Results: The SGV patients were significantly older (71.8 8.9 years versus 67.2 +/- 7.4 years), more often bereaved and/or living alone. The SGV patients' treatment was initiated by law in 23.2% (IGV 3%) of the cases. Inpatient pretreatment of psychic disorders was reported in 40% of the SGV patients and in only 3.9% of IGV patients, respectively. In addition, the SGV patients had significantly more complicating diseases, like cerebro- and cardiovascular or neurological diseases. Conclusion: Older, more serverely psychic and somatic ill patients were treated in the SGV. In general for about half of the cases, the hospital treatment had been the first psychiatric treatment at all. Since both are university departments differences in patient pro ' file seem to be influenced by care system (integrated versus separated and obligatory).

Objective: We wanted to compare geriatric psychiatric patients and their management in an integrated (with other adult age groups) care in the Psychiatric University Hospital of Gottingen (IGV) compared to those in a separated (according to age) care in the Psychiatric University Hospital of Magdeburg (SGV). Compared to the former, the latter is also involved in the regional obligatory care system. Method: We performed standardised chart reviews of randomly selected groups of patients, wo had been treated in the IGV (n = 104) and the SGV (n = 144) in the years 1998 and 1999. Results: Most patients of the SGV suffered from organic brain diseases/dementia (SGV: 57.6 %; IGV: 36.6 %). In the IGV, depression (51 %) and addiction (27.9%) were the most frequent diagnoses. Disabilities of vision, audition, speech or tremor and muscle diseases were more often found in the SGV. Specialised diagnostics were performed mostly in the SGV. Both institutions treated the majority of patients with antipsychotic drugs. A program of ergotherapy and physiotherapy was significantly more often documented in the SGV. Nearly half of the SGV patients were released into changed living environments (IGV: 12.9%). Conclusion: Patients with further progressed organic brain diseases/dementia as well as older, psychically and somatically more severely ill patients were treated more frequently in the SGV. Obligatory care seems to be the reason for this and not separation or integration. In general, separated care according to age seems to provide a more diversified treatment approach for the elderly.

It has been proposed that sleep disturbances, especially reduced delta sleep, are related to a poor outcome in schizophrenia. To determine whether long-term treatment with neuroleptics can promote sleep disturbances by increasing the risk of a nocturnal myoclonus syndrome (NMS) ( = periodic movements in sleep) related insomnia, we performed all-night polysomnography in 10 chronically ill schizophrenic patients who had been under neuroleptic therapy for a mean of 27 years. NMS-related insomnia was detected in all 10 patients. Potential pathophysiological relationships between long-term neuroleptic therapy and NMS occurrence are discussed. Our findings suggest that long-term administration of neuroleptics favours the appearance of insomnia. Copyright (C) 2000 John Wiley & Sons, Ltd.

This paper presents a brief historical review of the beginning of scientific studies on sleep research and evaluation of the electrophysiological basics. Subsequently, hypotheses are presented and discussed on phylogenesis and function of NONREM- and REM-sleep as well as aspects of the regulation of energy conservation and temperature. Sleep may have first evolved out of rest/activity cycles. Later on, with the evolution of complex brains, sleep may also assume importance in development and maintenance of these structures. Hence, special emphasis is placed on the influence of NONREM and REM sleep on the reorganisation of neuronal networks.