[Base Rate of Probable Malingering and its Indicators in the Assessment of Mental Disorders - Retrospective Analysis of a Sample of Forensic Psychological Evaluations]. / Prävalenz nicht-authentischer Beschwerdenbilder und Indikatoren in der Begutachtung psychischer und psychosomatischer Störungen ­ retrospektive Analyse einer Begutachtungsstichprobe.

PURPOSE: Estimation of a base rate of malingering in accordance with changes of the complexity of assessment in a sample of forensic psychological evaluations. METHODS: We performed a retrospective analysis of 1175 psychological evaluations over the course of 16 years (2000-2015). RESULTS: With the use of increasingly complex methods, inconsistencies are reported more frequently and a higher rate of feigning (47,2%) in symptom validity testing is noted. However, the overall rate of malingering is only 15,8%. A uniform multi-methods approach guarantees that there does not develop any bias in the assessment across evaluators. CONCLUSION: The revealed rate of malingering matches recent reviews that call into question estimations which had yielded substantially higher rates. Symptom validity tests serve as an important decision-making tool for psychological evaluators. For the overall assessment, however, other possible inconsistencies are taken into account.

Recovery index, attentiveness and state of memory after xenon or isoflurane anaesthesia: a randomized controlled trial.

BACKGROUND: Performance of patients immediately after anaesthesia is an area of special interest and so a clinical trial was conducted to compare Xenon with Isoflurane anaesthesia. In order to assess the early cognitive recovery the syndrome short test (SST) according to Erzigkeit (Geromed GmbH) was applied. METHODS: ASA I and II patients undergoing long and short surgical interventions were randomised to receive either general anaesthesia with Xenon or Isoflurane. The primary endpoint was the validated SST which covering memory disturbances and attentiveness. The test was used on the day prior to intervention, one and three hours post extubation. The secondary endpoint was the recovery index (RI) measured after the end of the inhalation of Xenon or Isoflurane. In addition the Aldrete score was evaluated up to 180 min. On the first post-operative day the patients rated the quality of the anaesthetic using a scoring system from 1-6. RESULTS: The demographics of the groups were similar. The sum score of the SST delivered a clear trend one hour post extubation and a statistically significant superiority for Xenon three hours post extubation (p < 0.01). The RI likewise revealed a statistically significant superiority of Xenon 5 minutes post extubation (p < 0.01). The Aldrete score was significantly higher for 45 min. The scoring system results were also better after Xenon anaesthesia (p < 0.001). CONCLUSIONS: The results show that recovery from anaesthesia and the early return of post-operative cognitive functions are significantly better after Xenon anaesthesia compared to Isoflurane. The results of the RI for Xenon are similar with the previously published results. TRIAL REGISTRATION: The trial was registered with the number ISRCTN01110844 http://www.controlled-trials.com/isrctn/pf/01110844.