Creatine kinase associated with aggressive behavior in psychiatric patients.

INTRODUCTION: The aim of this study was to investigate to what extent pathological creatine kinase (CK) levels are associated with aggressive behavior in patients admitted to psychiatric facilities. It is based on the assumption that CK activity increases prior to a rise in motor activity and aggressive behavior. It should be noted that this assumption requires additional confirmation in more extended studies. METHOD: Over a period of 3 months, the CK levels of 317 psychiatric inpatients were assessed immediately following admission to a secure ward. During the course of the patients' stay (mean: approximately 11 days), their aggressive behavior was independently assessed using the Staff Observation Aggression Scale (SOAS-R). RESULTS: A receiver operating characteristic (ROC) analysis estimated an area under the curve (AUC) for subsequent aggressive behavior of 70.7% with a sensitivity of 70.1% and a specificity of 71.2%. When the variables involuntarily admission, lifetime history of aggression and absence of suicide attempts were also taken into account, the AUC was higher at 78.2%. CONCLUSION: Despite some methodological shortcomings in the collection of data, the study indicates that it could be useful to measure CK levels at the time of admission because elevated levels may indicate an increased risk of successive aggressive behavior for patients on secure psychiatric wards.

[Sexual dysfunctions in a group of psychiatric in-patients]. / Befragung zu sexuellen Störungen bei psychiatrisch Erkrankten.

41 mentally ill patients with sexual dysfunctions were examined by means of a semistructured interview. In this interview we tried to assess quality, intensity and duration of the sexual dysfunctions. In addition to this we developed a self-rating-scale in order to assess the patients' possibilities to talk about their sexual problems with a therapist. These attitudes were related to the attitudes of the staff towards the same issue. We found out that the dysfunctions had lasted for 11.0 years on average and that 58.8 % of the patients hadn't made any attempts for specific therapeutic steps so far. Patients with sexual dysfunctions such as erectile impotence were more interested in having additional talks about their sexual problems than patients with sexual disturbances such as libido loss. They were also more inclined to see psychiatric medication as a cause for their sexual problems. In addition to this, the complete group of the examined patients considered as to be less important that the therapist was of the same sex than the staff, particularly if the interviewer was not of the same sex. Our results confirm the thesis, that it is worth paying more attention to sexual dysfunctions of mentally ill patients, necessary therapeutic steps should be taken if possible. A positive effect of this probably seems to be a better compliance.