Department of Psychiatry

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To facilitate surveys of individuals residing in institutions in preparation for discharge, we developed the Discharge Planning Quality Rating Survey (DPQRS), a chart review instrument for trained raters to evaluate the relevant clinical information. German Journal of Psychiatry 2002; 5(4):95-114 http://www.gjpsy.unigoettingen.de/gjp-article-brasic-quality.pdf

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Oral monologues, written notes, and drawings by the subject document the presence of likely bipolar II and histrionic personality disorders in an artistic senior citizen. German Journal of Psychiatry 2002;5(1):5-23 http://www.gjpsy.uni-goettingen.de/gjp-article-brasic-article4-text.pdf

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The occurrence of likely bipolar II and histrionic personality disorders in a senior citizen is confirmed by means of the creative works of the subject in multiple media. German Journal of Psychiatry 2002;5(1):5-23 http://www.gjpsy.uni-goettingen.de/gjp-article-brasic-article4-figures.pdf

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Greater putamen dopamine release was seen in adults with Tourette's syndrome than in comparison subjects after a pharmacologic challenge with amphetamine. American Journal of Psychiatry 2002;159(8):1329-1336

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Conversion symptoms often occur in cases of severe psychosocial stress including sexual abuse. The presentation of conversion disorder in childhood may convince examing clinicians to institute medical and surgical interventions. Prompt identification of the condition and institution of appropriate treatment facilitates speedy recovery. Vigorous search for treatable neurological and medical diseases is indicated. Mood and anxiety disorders are likely to develop in individuals with converion disorders in childhood and adolescence. Proactive involvement of child protective services may be required to prevent further child abuse and neglect. German Journal of Psychiatry 2002;5(2):51-61 http://www.gjpsy.uni-goettingen.de/gjp-article-brasic-conversion.pdf

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Assessing dosages provides a means to identify serious errors in the administration of psychoactive medications. The procedure is suitable for screening purposes of large numbers os subjects on a daily basis. German Journal of Psychiatry 2000;3(3):7-12

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Autistic disorder, an extremely disabling syndrome with onset in early childhood, is associated with multiple comorbid conditions. Although autistic disorder is heterogeneous in its manifestations, there is a subgroup of individuals with autistic disorder who display movements that appear to be unique for the disroder. Hand flapping and a variety of movements termed stereotypies may be pathognomonic of autistic disorder. Therefore, identification of a movement disorder characteristic of autistic disorder may imply that the individual has autistic disorer. Medical Hypotheses 1999;53(1):48-49

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Schizophrenia is a syndrome that is believed to have its onset during very early corticogenesis of the affected patient. The subsequent structural and functional cerebral variations observed in people with schizophrenia suggest an altered overall pattern of brain morphology. The alterations in cerebral structure and function in schizophrenia suggest that an early disturbance of the central nervous sensory modality may be occurring in the patient. Placing the structural and functional cerebral deficits reported in schizophrenia within the context of normal brain structure and function provides a neurological basis to identify early pathological molecular mechanisms and programs that may be resulting in schizophrenia. Medical Hypotheses 2000;55(4):314-318

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Dopamine antagonists ameliorate the dyskinesias, aggression, and inattention of some persons with mental retardation and behavioral problems. However, the beneficial effects of dopamine antagonists must be weighed against the adverse effects including withdrawal and tardive dyskinesias. German Journal of Psychiatry 2001;4(1):9-16 http://www.gjpsy.uni-goettingen.de/gjp-article-brasic3.pdf

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Quinine-induced thrombocytopenia presented as bright red blood per rectum in a 64-year-old man with villous adenoma of the rectum precipitated by the voluminous consumption of tonic water for leg cramps for 2 or 3 weeks before his admission. This occurrence of rectal bleeding associated with the ingestion of tonic water by a man with villous adenoma of the rectum suggests that health warnings are needed on containers of tonic water, bitter lemon, and other quinine-containing beverages to prevent the morbidity and the mortality sustained by susceptible individuals who consume them, unaware of the medical risks. Mayo Clinic Proceedings 2001;76:863-864 [letter] http://www.mayo.edu/proceedings/2001/aug/7608le.pdf

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A two-compartment, three-parameter model is best for the kinetic analysis of regions of interest and for parametric imaging of the distribution volume and K1 for human dynamic single photon emission computed tomographic studies of a ligand specific for the alpha 4/beta 2 neuronal nicotinic acetylcholine receptor subtype. Nuclear Science Symposium Conference Record, 2001 IEEE (Institute of Electrical and Electronics Engineers) 2001;3:1335-1340

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The diagnosis and treatment of nervous and mental disorders is enhanced by the utilization of in vivo imaging of neurotransmitter systems. Clinical Neuroscience Research 2001;1:35-45

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To assess the quality of the administration of psychoactive medication treatment, we administered the Psychoactive Medication Quality Assurance Rating Survey (PQRS), a reliable instrument for assessing the quality of the utilization of psychoactive medication via chart review by trained raters to a simple random sample of 78 residents of an intermediate care facility for persons with mental retardation. By evaluating the clinical information, decision processes, and provisions for monitoring treatment outcome with the use of psychoactive medication, this survey utilizing the PQRS revealed multiple serious deficiencies indicting the need for immediate intervention with the institution consistent with other surveys utilizing different methods. However, a simple screening of residents for excessive dosages and inappropriate conbinations of psychoactive agents detected no serious errors. Thus, we demonstrated that the PQRS fulfills its purpose to identify deficits in the utilization of psychoactive medications that are overlooked by mere determination of thigh doses and atypical combinations. We conclude that the PQRS is a reliable and valid instrument for surveys of the administration of psychoactive medication.

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To facilitate surveys of psychoactive medication treatment, we developed the Psychoactive Medication Quality Assurance Rating Survey (PQRS), a 140-item chart review instrument for trained raters. Although the PQRS is appropriate for annual surveys, it is too long for regular monthly reviews. Therefore, we developed the PQRS Screening Criteria composed of 22 independent categorical items of the PQRS and two transformed items, These 24 categorical items exhibit sound reliability in the form of Cohen's kappa greater than or equal to .4 and Cronbach's alpha of .938. The PQRS Screening Criteria are a reliable tool for frequent clinical reviews.