Helmut Beckmann - Böcker

Dementia of Alzheimer type (DAT), multiinfarct dementia (MID) and dementia occurring in the course of Parkinson's disease (PD +D) now make up one of the largest categories of chronic diseases in the elderly. In addition to the burden those illnesses impose on the affected individuals and their families they consume large socio-economic re- sources. In the light of all the above mentioned features, it seemed to us that a Symposium on behalf of the 125th Anniversary of Birth of Aloys Alzheimer was particularly well-suited to help to advance research on Alzheimer's disease and other dementias. This International Symposium combined with a Satellite Symposium about "Clinical Aspects of Alz- heimer Dementias" took place in June 1989 in Wiirzburg and has been organized by the Psychiatric Departments of the Universities of Wiirzburg and Munich (H. Beckmann, K. Maurer, P. Riederer, H. Hippius and H. Lauter) and the Department of Pathochemistry and General Neurochemistry of the University of Heidelberg (S. Hoyer).In the chapters which follow, thorough reviews of recognized authorities in the field of dementia are given in the four main fields of epidemiology, neuropathology, neurochemistry and clinics. This Symposium and the edition of this book would not have been possible without the generous support of E. Merck, Darmstadt. In particular we gratefully acknowledge the efforts undertaken by Mr. Hernandez-Meyer to organizing this symposium and to publish this book. Furthermore we are grateful to the secretarial help by Mrs. Moeslein, Miss Philipp and Miss Grabner.

Based on sophisticated clinical descriptions and characteristic symptom patters occurring during the long-term course of psychiatric diseases, Leonhards classification requires that all the clinical features fit for a diagnosis to be made. Always using his own life-long case studies, Leonhard divided the endogenous psychoses into five main nosological groups: on the one hand, the prognostically favourable unipolar affective psychoses, bipolar affective psychoses and cycloid psychoses, and, on the other hand, the prognostically unfavourable unsystematic and systematic schizophrenia. In the meantime, the reliability and validity of this classification have been confirmed by scientific studies and early results provide guidelines for the different origins and varied therapeutic approaches for the specific disease profiles.

Contradictory results in schizophrenia research are generally explained as being due to genetic heterogeneity and multiple factor heredity in relationship to manifold environmental factors. The book reports a short overview of all relevant twin studies on schizophrenic psychoses and provides data and case histories on a systematic twin study based on a polydiagnostic approach carried out by two independently working psychiatrists. In addition to the internationally applied operational diagnostic systems of DSM-III-R and ICD 10 Leonhard's subclassification of schizophrenic psychoses was used. Up to now this sophisticated methodological approach is unique in the world. The data provide strong evidence that the spectrum of psychoses with schizophrenic and schizophrenia-like symptoms is not a continuum of diseases. At least in Leonhard's three major groups of cycloid psychoses, unsystematic schizophrenias and systematic schizophrenias genetic, somatic and psycho-social factors play a completely different etiological role. Cycloid psychoses and systematic schizophrenias are predominantly caused by "environmental" factors.In unsystematic schizophrenias, however, genetic predisposition is the main etiological factor and environmental factors are subordinate.

Das Buch behandelt die jüngsten Entwicklungen in der biologischen Psychiatrie. Einleitend werden die Grundlagen der modernen Neurotransmitterforschung und ihr Bezug zu unterschiedlichsten psychischen Erkrankungen dargestellt. Von namhaften Referenten aus dem Bereich der Grundlagenforschung und der Klinik wird im Hauptteil des Bandes die Bedeutung unterschiedlicher Transmittersysteme für die Genese der wichtigsten psychiatrischen Krankheitsgruppen erörtert und diskutiert. Hierbei werden auch die neuesten Ergebnisse und Methoden der Rezeptorforschung behandelt. Ziel des Buches ist es, einen umfassenden Überblick über den derzeitigen Stand biologischer Forschung im Gesamtgebiet der Psychiatrie zu geben.

Das Buch stellt die bisher einzige Zwillingstudie der Welt mit 'endogenen' psychotischen Zwillingsprobanden auf der Basis eines polydiagnostischen Designs dar. Moderne, operationalisierte Klassifikationssysteme (DSM und ICD) werden verglichen mit der Nosologie Karl Leonhards (1904 - 1988). Ausfuhrliche Fallberichte von 64 kranken Zwilingsprobanden, die an Psychosen des schizophrenen Spektrums leiden, verdeutlichen die diagnostischen Entscheidungen. Die Ergebnisse der Studie werden auf der Grundlage der gesamten bisherigen Zwillingsliteratur und neuester Erkenntnisse in der Schizophrenieforschung diskutiert. Das Spektrum der Psychosen des schizophrenen Formenkreises ist offensichtlich kein Krankheitskontinuum sondern besteht aus verschiedenen Untergrupen mit ganz unterschiedlichen genetischen, somatischen und psychosozialen Ursachen.

Based on sophisticated clinical descriptions and characteristic symptom patters occurring during the long-term course of psychiatric diseases, Leonhards classification requires that all the clinical features fit for a diagnosis to be made. Always using his own life-long case studies, Leonhard divided the endogenous psychoses into five main nosological groups: on the one hand, the prognostically favourable unipolar affective psychoses, bipolar affective psychoses and cycloid psychoses, and, on the other hand, the prognostically unfavourable unsystematic and systematic schizophrenia. In the meantime, the reliability and validity of this classification have been confirmed by scientific studies and early results provide guidelines for the different origins and varied therapeutic approaches for the specific disease profiles.