Despite its chequered history, Kahlbaum's 1874 description of catatonia (tension insanity) and its categorization as a clinical illness is in outline still valid. Kahlbaum also acknowledged the ...existence of catatonia in children. Corresponding case studies have also been analyzed. The originators and disciples of the Wernicke-Kleist-Leonhard school proved catatonia in early childhood as a discrete entity with specific psychopathology. This does not mean that catatonic symptoms do not occur in other illnesses and in particular in organic psychoses. These are, however, of a totally different nature. Autism, as first described in connection with schizophrenic negativism by Bleuler in 1910, is one of the key symptoms of schizophrenia. As identified by Kanner in 1943, abnormal social interaction and communication, together with retarded development, are the main characteristics of autism in early childhood. Asperger's concept of autistic disorder (1944), although based on psychopathological theory, did not include retardation in development as an aspect. Consequently, autistic behavior can occur in a variety of mental disorders. Research into possible etiological and pathogenetic factors has been undertaken, but no clear link found as yet.
Body-image disturbances and low self-esteem have been implicated in the pathogenesis of eating disorders. This study investigated self-perception of body and personality among adolescent ballet ...dancers in a cross-sectional survey. Two questionnaires assessing “my body right now” and “my personality right now,” using semantic differentials were completed by 90 ballet school students and 156 controls. Adolescent female dancers (ages 13 to 17 years) scored higher than age-matched controls and 11- to 12-yr.-old peers on Undesirability and Sensitivity for personality and Unattractiveness for body. For both subscales of personality, differences were also found between male and female dancers; female ballet students scored higher. Within the control group a difference could be found only for Sensitivity on which girls scored higher than boys. Male dancers did not differ from controls except for a lower score on the Body mass measure. Adolescent female dancers showed a distinct answering profile for 7 of 16 semantic differentials in each questionnaire implicating less favorable body image and self-esteem. Interventions focused particularly on enhancing self-esteem may be useful in the prevention of psychopathology in adolescent ballet dancers.
In 1932 Franz Kramer (1878–1967) and Hans Pollnow (1902–43)
described a hyperkinetic syndrome in children. Basically the symptoms described
coincide with what is nowadays regarded as Attention ...Deficit Hyperactivity Disorder
(ADHD) or Hyperkinetic syndrome. The authors of the study thus went down in the
history of child and adolescent psychiatry with their eponymous Kramer-Pollnow
syndrome, and have had a lasting influence on the development of the concepts
relating to this topic. Both worked together at the psychiatric and neurological
hospital at Berlin’s Charité under its head Karl Bonhoeffer,
but as they were both Jewish they were forced to emigrate after the Nazis seized
power. Until now, little has been known about their further fate and careers, so
this study gives the first comprehensive account of their lives, based on documents
found in the archives. It also presents an overview of their work.
Karl Kleist (1879–1960) was instrumental in pioneering German neuro-psychiatry and neuropsychology, including the description of frontal, constructional, limb-kinetic (innervatory) and psychomotor ...apraxias, frontal akinesia and aspontaneity, as well as object and form blindness. Besides isolating episodic twilight states, involutional paranoia and symptomatic (especially influenza) psychoses, he was particularly involved in applying Wernicke’s syndromatic and Kraepelin’s prognostic and aetiological principles to classify ‘neurogenous’ psychoses by refuting the assumption of mixed entities whenever possible. Thus, his phasophrenias denoted manic-depressive illness, unipolar affective disorders and marginal, i.e., atypical psychoses. The rather benign cycloid psychoses form the most prominent examples of the latter. Schizophrenias, on the other hand, were limited to poor long-term catamnestic outcomes. Kleist conceptualized the core group of schizophrenic illnesses as psychic system diseases – hence the origin of the term ‘systematic schizophrenias’ within the Wernicke-Kleist-Leonhard School. Kleist was mainly influenced by Wernicke and his psychic reflex arc, but Ernst Mach’s empiriocriticism, Theodor Meynert’s cerebral connectionism, and associationism also shaped his outlook. Kleist’s localization of cerebral functions by lesion analyses was indeed the best available at the time and continues to reveal insights to the interested reader. From his Frankfurt School, which may have been the last of a completely unified neuropsychiatry, came sound representatives of psychiatry, neurology and neurosurgery.
His technical mastery and achievements seem indisputable, but his balancing acts during the Third Reich may today be questioned. Despite joining the National Socialist German Workers’ Party (NSDAP) and the local Court of Genealogical Health (Erbgesundheitsgericht), Kleist was, however, one of the few German physicians who continued to treat Jewish patients, to employ Jewish colleagues and to voice evident criticism of the policies of ‘eugenics’ and ‘euthanasia’.
This paper attempts to illuminate Kleist’s biography and life’s work in the relevant historical context.
Body weight is crucial to eating disorders. Beyond gender, age, and height it is determined by anthropometric features of physique, i. e. somatotypes. We investigated their impact on the ...anthropometric and metabolic assessment of nutritional status, psychometrics, and other clinical aspects of eating disorders. In 133 eating disordered girls (ICD-10 & DSM-IV criteria) of well-recorded catamneses, various somatometric measures (n = 133), serum leptin (n = 30), plasma tryptophan (n = 108), and psychometric scales (n = 119; EDI-64 & EAT-40) were examined, preferably on repeated occasions of their treatment and in comparison to 41 healthy controls. Somatotyping was performed by gender- and age-specific quintiles of Strömgren's Metrik Index (MI) derived from 6995 volunteers constituting the anthropometric reference.Somatotypes represent a significant factor for assessing nutritional status. Exhibiting higher EDI-64 bulimia ratings at admission, more prevalent self-induced vomiting and purgative substance abuse as well as prolonged refractory illnesses with more previous inpatient treatment trials but later admissions, heavier somatotypes were significantly underrepresented in our total clinical sample but more prevalent among bulimic eating disorders (p < 0.05). Neglecting the anthropometry of physique biases against the detection and treatment of eating disorders in heavier somatotypes at weights below general average. Henceforth, this shall be avoided by somatotyping according to frame indices.
A crude rate of mortality of 5.9% has been quoted for Anorexia nervosa (AN) in recent studies. There are different causes of death ranging from suicide to sudden death. Autopsy data are extremely ...rare about brain alterations in deceased AN patients. Reported in this study is a female patient, aged 13.5 years, who died of acute AN. Quantitative neurohistological investigation post mortem was performed on her brain. Results were compared with data obtained from a girl of the same age with no contributory neuropsychiatric findings. In the cortex of the anorexia case beside typical pyramidal neurons, a slim neuron type with one extremely long basal dendritic field was found to occur more frequently than normal. In the neurons of the AN case, the ramification pattern of single basal dendritic fields was found to be reduced and changes in the spine morphology, as well as reduction in spine density, were observed. However, a simultaneous lengthening of the terminal dendrites of higher order gave some evidence for repair mechanisms and neuronal plasticity. The AN-specific implications of these findings are discussed. The conclusion is that all AN deaths should be reported together with descriptions of causes and cerebral alterations.
Body mass index (BMI) and body type of female and male adolescent ballet dancers (n = 90) and school students (n = 156) were determined. Participants were asked for the body weight she or he would ...prefer, and ballet students were administered the Eating Attitudes Test-40 (EAT-40). Results between age groups and with reference values were compared. Both in dancers and controls, girls wanted to lose more body weight than boys, with female ballet dancers more than female controls. The desire for reducing body weight was expressed by female ballet dancers of all BMI percentiles and body types, with the highest difference between real and desired body weight in 11-, 13-, and 16-year-olds. In the other groups, a quest for lower body weight was expressed only by adolescents of higher BMI and pyknomorphic and/or mesomorphic body type. Female ballet dancers of all age groups sought to reach body weights below the 5th percentile or below 82% of normal body weight. Desired body weight change was influenced by BMI and body type and correlated positively with EAT-40 score.
