Alfred Fischer | Fachhochschule für Ökonomie und Management - University of Applied Sciences (original) (raw)

Papers by Alfred Fischer

Research paper thumbnail of Therapeutic alliance in forensic psychiatric hospitals: An empirical study

Http Dx Doi Org 10 1080 09585189708412274, Jan 4, 2008

Research paper thumbnail of Schizophrene Psychosen und Kliniksuizid Risikofaktoren, psychopharmakologische Behandlung

Research paper thumbnail of Psychopharmacological therapy and suicide of inpatients with depressive psychoses

Http Dx Doi Org 10 1080 13811119808260444, Sep 27, 2007

Data on the psychopharmacological treatment of 3792 inpatients with mono-or bipolar depression du... more Data on the psychopharmacological treatment of 3792 inpatients with mono-or bipolar depression during a twelve-year period were routinely documented in a systematic way by means of an electronic data processing system. Thirty-three of these patients committed suicide while in hospital; the remaining patients were used as controls (n = 3759). To identify possible differences in the pharmacological treatment of suicides and controls the data were classified according to the following drugs and drug groups: antidepressants, neuroleptics, tranquilizers, hypnotics, lithium, biperiden, beta-adrenergic blocking drugs, placebos and others. A comparison was made of how frequently the drugs were prescribed and of the mean number of prescriptions of neuroleptics, tranquilizers and antidepressants; the latter were in addition differentiated in sedating and non-sedating drugs. Moreover the mean daily dose of frequently used substances was compared. Whereas no significant difference for the groups was found with respect to the percentage of patients undergoing neuroleptic treatment, the mean number of prescriptions of neuroleptics was significantly higher at 1.3 per patient for the suicides than for the controls at 0.8 per patient. Furthermore a tendency towards a lower frequency of the prescription of lithium together with a lower mean dosage emerged for the suicides. No other hints of differences in the psychopharmacological treatment of suicides were found.

Research paper thumbnail of Therapeutic alliance in forensic psychiatric hospitals: An empirical study

The Journal of Forensic Psychiatry, 1997

This paper presents the first results of an application of empirical research methods of psychoth... more This paper presents the first results of an application of empirical research methods of psychotherapy in forensic psychiatric hospitals in Germany. Data were collected in a study on therapeutic alliance conducted in four forensic facilities in Bavaria, Baden-Württemberg and Hesse in the summer of 1994, comprising 137 patients and their therapists. Quality of therapeutic alliance was rated by therapists and

Research paper thumbnail of Risk factors for suicides of inpatients with depressive psychoses

European Archives of Psychiatry and Clinical Neuroscience, 1998

Research on identifying the relevant risk factors for suicides is faced with a multitude of metho... more Research on identifying the relevant risk factors for suicides is faced with a multitude of methodological problems. The present study attempts to improve on some of these problems and to isolate those risk factors that are accessible in the early stages of the treatment of inpatients. A total of 3792 inpatients with monopolar or bipolar depression were treated during the period 1981-1992. Suicides (n=33) and controls (n=3759) were compared with respect to 77 sociodemographic and anamnestic variables and 195 standardised items of the admission summary. In addition to an analysis of contingency tables a discriminant analysis was performed. The suicide rate of patients with depressive psychosis was 2.7 times higher than the average rate of 0.324% for the entire clinic. Suicidal tendencies on admission proved to be the best predictor with a frequency of 91% in the suicide group and 40% in the control group, previous attempted suicide being the second best predictor. We conclude that the rate of inpatient suicide may have been underestimated for methodological reasons in the past decades. Many of the risk factors discussed in the literature may be of little predictive value at least in the initial stages of hospital treatment.

Research paper thumbnail of Schizophrene Psychosen und Kliniksuizid

Research paper thumbnail of Psychopharmacological therapy and suicide of inpatients with depressive psychoses

Archives of Suicide Research, 1998

Data on the psychopharmacological treatment of 3792 inpatients with mono-or bipolar depression du... more Data on the psychopharmacological treatment of 3792 inpatients with mono-or bipolar depression during a twelve-year period were routinely documented in a systematic way by means of an electronic data processing system. Thirty-three of these patients committed suicide while in hospital; the remaining patients were used as controls (n = 3759). To identify possible differences in the pharmacological treatment of suicides and controls the data were classified according to the following drugs and drug groups: antidepressants, neuroleptics, tranquilizers, hypnotics, lithium, biperiden, beta-adrenergic blocking drugs, placebos and others. A comparison was made of how frequently the drugs were prescribed and of the mean number of prescriptions of neuroleptics, tranquilizers and antidepressants; the latter were in addition differentiated in sedating and non-sedating drugs. Moreover the mean daily dose of frequently used substances was compared. Whereas no significant difference for the groups was found with respect to the percentage of patients undergoing neuroleptic treatment, the mean number of prescriptions of neuroleptics was significantly higher at 1.3 per patient for the suicides than for the controls at 0.8 per patient. Furthermore a tendency towards a lower frequency of the prescription of lithium together with a lower mean dosage emerged for the suicides. No other hints of differences in the psychopharmacological treatment of suicides were found.

Research paper thumbnail of Therapeutic alliance in forensic psychiatric hospitals: An empirical study

Http Dx Doi Org 10 1080 09585189708412274, Jan 4, 2008

Research paper thumbnail of Schizophrene Psychosen und Kliniksuizid Risikofaktoren, psychopharmakologische Behandlung

Research paper thumbnail of Psychopharmacological therapy and suicide of inpatients with depressive psychoses

Http Dx Doi Org 10 1080 13811119808260444, Sep 27, 2007

Data on the psychopharmacological treatment of 3792 inpatients with mono-or bipolar depression du... more Data on the psychopharmacological treatment of 3792 inpatients with mono-or bipolar depression during a twelve-year period were routinely documented in a systematic way by means of an electronic data processing system. Thirty-three of these patients committed suicide while in hospital; the remaining patients were used as controls (n = 3759). To identify possible differences in the pharmacological treatment of suicides and controls the data were classified according to the following drugs and drug groups: antidepressants, neuroleptics, tranquilizers, hypnotics, lithium, biperiden, beta-adrenergic blocking drugs, placebos and others. A comparison was made of how frequently the drugs were prescribed and of the mean number of prescriptions of neuroleptics, tranquilizers and antidepressants; the latter were in addition differentiated in sedating and non-sedating drugs. Moreover the mean daily dose of frequently used substances was compared. Whereas no significant difference for the groups was found with respect to the percentage of patients undergoing neuroleptic treatment, the mean number of prescriptions of neuroleptics was significantly higher at 1.3 per patient for the suicides than for the controls at 0.8 per patient. Furthermore a tendency towards a lower frequency of the prescription of lithium together with a lower mean dosage emerged for the suicides. No other hints of differences in the psychopharmacological treatment of suicides were found.

Research paper thumbnail of Therapeutic alliance in forensic psychiatric hospitals: An empirical study

The Journal of Forensic Psychiatry, 1997

This paper presents the first results of an application of empirical research methods of psychoth... more This paper presents the first results of an application of empirical research methods of psychotherapy in forensic psychiatric hospitals in Germany. Data were collected in a study on therapeutic alliance conducted in four forensic facilities in Bavaria, Baden-Württemberg and Hesse in the summer of 1994, comprising 137 patients and their therapists. Quality of therapeutic alliance was rated by therapists and

Research paper thumbnail of Risk factors for suicides of inpatients with depressive psychoses

European Archives of Psychiatry and Clinical Neuroscience, 1998

Research on identifying the relevant risk factors for suicides is faced with a multitude of metho... more Research on identifying the relevant risk factors for suicides is faced with a multitude of methodological problems. The present study attempts to improve on some of these problems and to isolate those risk factors that are accessible in the early stages of the treatment of inpatients. A total of 3792 inpatients with monopolar or bipolar depression were treated during the period 1981-1992. Suicides (n=33) and controls (n=3759) were compared with respect to 77 sociodemographic and anamnestic variables and 195 standardised items of the admission summary. In addition to an analysis of contingency tables a discriminant analysis was performed. The suicide rate of patients with depressive psychosis was 2.7 times higher than the average rate of 0.324% for the entire clinic. Suicidal tendencies on admission proved to be the best predictor with a frequency of 91% in the suicide group and 40% in the control group, previous attempted suicide being the second best predictor. We conclude that the rate of inpatient suicide may have been underestimated for methodological reasons in the past decades. Many of the risk factors discussed in the literature may be of little predictive value at least in the initial stages of hospital treatment.

Research paper thumbnail of Schizophrene Psychosen und Kliniksuizid

Research paper thumbnail of Psychopharmacological therapy and suicide of inpatients with depressive psychoses

Archives of Suicide Research, 1998

Data on the psychopharmacological treatment of 3792 inpatients with mono-or bipolar depression du... more Data on the psychopharmacological treatment of 3792 inpatients with mono-or bipolar depression during a twelve-year period were routinely documented in a systematic way by means of an electronic data processing system. Thirty-three of these patients committed suicide while in hospital; the remaining patients were used as controls (n = 3759). To identify possible differences in the pharmacological treatment of suicides and controls the data were classified according to the following drugs and drug groups: antidepressants, neuroleptics, tranquilizers, hypnotics, lithium, biperiden, beta-adrenergic blocking drugs, placebos and others. A comparison was made of how frequently the drugs were prescribed and of the mean number of prescriptions of neuroleptics, tranquilizers and antidepressants; the latter were in addition differentiated in sedating and non-sedating drugs. Moreover the mean daily dose of frequently used substances was compared. Whereas no significant difference for the groups was found with respect to the percentage of patients undergoing neuroleptic treatment, the mean number of prescriptions of neuroleptics was significantly higher at 1.3 per patient for the suicides than for the controls at 0.8 per patient. Furthermore a tendency towards a lower frequency of the prescription of lithium together with a lower mean dosage emerged for the suicides. No other hints of differences in the psychopharmacological treatment of suicides were found.