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Publications (3)4.66 Total impact

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    ABSTRACT: Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed disorders in child and adolescent psychiatry. Patients with ADHD show increased risk for comorbid psychiatric disorders such as mood disorders, anxiety disorders, tic disorders and disruptive behavior disorders. Using criteria and methods of evidence-based medicine, in this paper possible algorithms for ADHD and comorbid disorders are presented. In conclusion, these algorithms aim to support health care professionals and can serve as guideline in decision making in pharmacotherapy. Stimulants are first-line medication treatment of ADHD without comorbid disorder. In co-existing aggression, major depressive disorder and tic disorder treatment with stimulants should be initialized at first. Only in case of unchanged persistence of comorbid symptoms specific pharmacological therapy should be combined. In comorbid anxiety disorders atomoxetine can be used as first-line treatment.
    Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater 02/2007; 21(3):187-206. · 1.38 Impact Factor
  • Ralf Gössler, Christine Vesely, Max H Friedrich
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    ABSTRACT: Self-mutilation of the genitals in man is a rare phenomenon mainly occurring in young males. The importance of conflicts about the male role, difficulties with the male identification in childhood and feeling of guilt for sexual offences are discussed in the literature. The influence of developmental crisis on this symbolic form of automutilation will be discussed in our case report. We present a case of a young schizophrenic man whose illness started in adolescence. He committed genital automutilation already in early adolescence, as a young male he autocastrated himself. We demonstrate the connection of specific problems of development in adolescence and psychopathology. Autocastration will be discussed as a "psychotic" solution of the adolescent conflict of dependence. Developmental conflicts may be important pathoplastic factors who may lead to severe psychopathology and misbehavior. Additionally to a psychopharmacological treatment a specific adolescent- and conflictoriented psychotherapy for solving the developmental conflicts in young schizophrenic patients should be established.
    Psychiatrische Praxis 06/2002; 29(4):214-7. · 1.64 Impact Factor
  • Ralf Gößler, Christine Vesely, Max H. Friedrich
    Psychiatrische Praxis 01/2002; 29(4):214-217. · 1.64 Impact Factor