Buchbesprechungen

Ohne Zusammenfassung     

Buchbesprechungen

Ohne Zusammenfassung     

Recent time trends in levels of self‐reported anxiety,mental health service use and suicidal behaviour in Stockholm

Kosidou K, Magnusson C, Mittendorfer‐Rutz E, Hallqvist J, Gumpert CH, Idrizbegovic S, Dal H, Dalman C. Recent time trends in levels of self‐reported anxiety, mental health service use and suicidal behaviour in Stockholm. Objective: To investigate recent time trends in several indicators of mental ill‐health and the patterning of these indicators between genders and younger vs. older individuals in Stockholm County. Method: Several indicators were used; self‐reported anxiety from the Swedish Survey of Living Conditions, information on psychiatric in‐patient and out‐patient care, attempted and completed suicides from national and regional registers. Gender‐ and age‐specific trends were compared for the time period of 1997–2006. Results: Self‐reported anxiety and psychiatric service use increased among young individuals of both genders, while attempted suicides increased only among young women. By contrast, these indicators decreased or remained stable in the older age group from year 2001 and onwards. Conclusion: Our data indicate a rising, and highly prevalent, mental ill‐health among the young in Stockholm County, a region representative of urbanized, secular Western societies.     

Das eosinophile Granulom des Knochens

Zusammenfassung Die Erkrankung EGr des Skelets lüft unter diesem Namen seit etwa 1940, war aber schon früher bekannt, und ist im deutschen Schrifttum mit den verschiedensten Namen bedacht worden. Das klinische Bild wird abgeleitet. Kinder und Jugendliche erkranken an irgendeiner Stelle des Skeletes, meist ohne wesentliche Beschwerden. Am Schädel entsteht eine Beule. Röntgenologisch ist die rasch fortschreitende Osteolyse charakteristisch. Die Herde sind im Schädeldach meistens ohne reaktive Randzonen, in den Extremitäten, wo sie in den Diaphysen leiegen, oval. Die dort meist vorhandenen periostalen Reaktionen gaben zu den merkwürdigsten Fehldiagnosen Veranlassung. Verwechslungen mit Osteomyelitis sind wohl am häufigsten, aber auch die Diagnose Sarkom Myelom Myelosarkom ist schon gestellt. Die Eosinophilie im Blutbild ist nicht immer vorhanden, manchmal aber erheblich. Die einherdigen Herde bleiben nach operativer Beseitigung oder Röntgenbestrahlung meistens geheilt. Es gibt auch Spontanheilungen. Die multiplen Herde können als eosinophile Granulomatose bei Kleinkindern in das Bild der Letterer-Siweschen Erkrankung übergehen. Nach eigenen Beobachtungen von Hand-Schüller-Christianschen Erkrankungen gibt es klinische Fälle, die von einem eosinophilen Granulom nicht zu unterscheiden sind. Bei der klassischen Form der Hand-Schüller-Christianschen Erkrankung mit Lückenbildung im Schädeldach, hypophysärer Beteiligung und Exophthalmus wird man sich an diese Bezeichnung halten müssen. Die überwiegende Anzahl der Autoren vertritt heute die Ansicht, daß es Übergangsfälle vom eosinophilen Granulom zum Hand-Schüller-Christian gibt. Wir schließen uns dieser Auffassung auf Grund eigener Beobachtungen an. Klinisch ist die wichtigste Tatsache die prognostische Gutartigkeit der Einherdeerkrankung EGr gegenüber der schlechten Prognose des Letterer-Siwe und der mindestens dubiösen Prognose beim Hand-Schüller-Christian (20% Mortalität). Ob eine gleiche Noxe je nach den verschiedenen Lebensaltern und je nach Reaktionslage die verschiedenen Formen der Retikulose hervorbringen kann, muß noch geklärt werden. Im Ganzen sind für die Differentialdiagnose des eosinophilen Granuloms zu fordern: klinisch gutartiger Verlauf, Symptomenarmut, Ein- oder Wenigherdigkeit der Erkrankung in Übereinstimmung mit dem Röntgenbild hinsichtlich Ort, Ausdehnung und Aussehen,und mit dem histologischen Befund. Die meisten Fehldiagnosen erklären sich aus der Diskrepanz von klinischen, Röntgen- und histologischen Bildern. Die Behandlung kann chirurgisch-konservativ oder nach histologischer Sicherung eine Röntgenbestrahlung sein.Mit 11 Textabbildungen     

Das adaptive Verhalten der Mäusenetzhaut

Zusammenfassung Das adaptive Verhalten und die spektrale Sensitivit?t der Maus-Retina wird mit der Methode der konstanten ERG-Antworten untersucht. Beim dunkeladaptierten Tier liegt die ERG-Schwelle bei Leuchtdichten von 10⁻³ Nit. Mit steigender Leuchtdichte der Testreize lassen sich a-, b- und c-Welle unterscheiden. Starke adaptive Beleuchtung vermindert die ERG-Amplituden. Bei Bestimmung der Spektralsensitivit?t, der Zuwachsschwelle und der Dunkeladaptationskurve konnte eine vom Adaptationszustand abh?ngige Wirksamkeit verschiedenfarbigen Lichtes (Purkinje-Verschiebung) nicht festgestellt werden. Die spektrale Empfindlichkeitskurve w?hrend Dunkel- und Helladaptation, gemessen bis zu einer adaptiven Beleuchtung von 5 Nit, folgt der Sehpurpurabsorption. Die Dauer der Dunkeladaptation nach intensiver adaptiver Beleuchtung betr?gt mehr als 6 Std. Ein Knick in der Dunkeladaptationskurve fehlt auch bei Prüfung mit farbigen Lichtreizen.

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Summary With the electroretinogram as the criterion, light and dark adaptation was measured in 6 different species of mice by determining the light energy for a constant small b-wave. The electroretinogram threshold in fully dark adapted eyes was at about 10⁻³ Nit. With light stimuli of different wavelengths the energy distribution at threshold criterion was similar to the absorption spectrum of rhodopsin. During light adaptation a loss of sensitivity of about 5 log units was found. No shift of the visibility curve (Purkinje-shift) occured during light adaptation. After exposure to strong light the change of threshold during dark adaptation was more than 6 hours. There was no break in the dark adaptation curve for blue and red light. With increasing luminances a-, b-, and c-waves were seen in the electroretinogram. No differences were seen between the albino and pigmented mouse in regard to these components.

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Mit Unterstützung der Deutschen Forschungsgemeinschaft.     

Gender differences in re‐offending among psychiatrically examined Swedish offenders

Background The gender gap for violent offending is narrowing in the general population. Substance abuse and mental health problems are known risk factors for criminality. While substance abuse treatment has been associated with reduced risk of re‐offending, women seem less likely to engage than men. People misusing substances tend to be high users of emergency room (ER) services. Such use may be an indicator both of treatment failure for substance misuse and offending. Little is known about gender differences in this respect. Aims This study aims to test for gender differences in re‐offending, use of substance abuse treatment, and hospital ER visits among offenders referred for forensic psychiatric assessment in Sweden. Method The study used a longitudinal retrospective design. Data on all 31 women from a 2‐year (2000–2001) cohort of serious offenders referred for forensic psychiatric assessment in Stockholm county, and 31 men from the same cohort, were extracted from forensic service and national records. Selection of the men was by initial random sampling followed by matching on age and substance misuse. The two resulting samples were compared on health service use and re‐offending data between release and the census date (30 April 2004). Results There were no gender differences for violent re‐offending or for engagement in planned substance abuse treatment, in spite of longer time at risk for the men. Re‐offending was reduced for women but not men who did not present in the ER with physical health problems. Conclusions Our study is limited by sample size, although it included all women referred to the specialist forensic psychiatric service over 2 years, but it does indicate that differences between men and women in this situation are likely, and worthy of further study. The only way of achieving adequate sample sizes is likely to be through multi‐centre collaboration. Copyright © 2010 John Wiley & Sons, Ltd.     

Early receptor potential recordings for clinical routine

An apparatus and an electrode for early receptor potential recordings in clinical routine are introduced. One-hundred and eighty normal eyes were compared with cases of diffuse and localized retinal diseases. In retinitis pigmentosa patients a decrease in R₁ and R₂ amplitudes and in some cases a much faster time course was found. Eyes with circumscribed retinal affectations produced a wide variety of amplitudes, overlapping with the range of normals. In cases of monochromatism, the ERP recording established the diagnosis because of an absent R₁ wave.     

Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder: a feasibility study

Background

Nonsuicidal self-injury (NSSI) is a serious health risk behavior that forms the basis of a tentative diagnosis in DSM-5, NSSI Disorder (NSSID). To date, established treatments specific to NSSI or NSSID are scarce. As a first step in evaluating the feasibility, acceptability, and utility of a novel treatment for adolescents with NSSID, we conducted an open trial of emotion regulation individual therapy for adolescents (ERITA): a 12-week, behavioral treatment aimed at directly targeting both NSSI and its proposed underlying mechanism of emotion regulation difficulties.

Methods

Seventeen girls (aged 13–17; mean = 15.31) with NSSID were enrolled in a study adopting an uncontrolled open trial design with self-report and clinician-rated assessments of NSSI and other self-destructive behaviors, emotion regulation difficulties, borderline personality features, and global functioning administered at pre-treatment, post-treatment, and 6-month follow-up. Measures of NSSI and emotion regulation difficulties were also administered weekly during treatment.

Results

Ratings of treatment credibility and expectancy and the treatment completion rate (88%) were satisfactory, and both therapeutic alliance and treatment attendance were strong. Intent-to-treat analyses revealed significant improvements associated with large effect sizes in past-month NSSI frequency, emotion regulation difficulties, self-destructive behaviors, and global functioning, as well as a medium effect size in past-month NSSI versatility, from pre- to post-treatment. Further, all of these improvements were either maintained or further improved upon at 6-month follow-up. Finally, change in emotion regulation difficulties mediated improvements in NSSI over the course of treatment.

Conclusions

Results suggest the acceptability, feasibility, and utility of this treatment for adolescents with NSSID.

Trial registration

ClinicalTrials.gov (NCT02326012, December 22, 2014, retrospectively registered).