Psychomotor disturbances in psychiatric patients as a possible basis for new attempts at differential diagnosis and therapy. V. Evaluation of psychomotor training programs in depressed patients

Parts I-III of this series used psychometric assessment of motor performance in psychiatric patients and indicated a "psychotic-motor syndrome" (PMS) in schizophrenic and affective psychoses, which was not found in "neurotic"/reactive or healthy persons. Part IV yielded signs of concomitant brain dysfunction in these patients, demonstrated by EEG mapping as well as other (SPECT/PET) neuroimaging methods. Apart from this "basic science" interest into the pathophysiology of endogenous psychoses we engaged in the development of motor training programs using the PMS as "target" syndrome. We hypothesized, that motor training would not only improve disturbed motor behaviour, but ameliorate other symptoms of psychopathology also. These assumptions were supported in the first two independent studies involving n = 45 and n = 31 ICD-9 mono- and/or bipolar endogenous depressed patients, respectively (the studies on schizophrenic patients being reported finally as part VI of this series, along with the final version of our modified motor test battery). Examples of the motor training programs are provided in this paper, although the final version of the complete programs will be published separately for space reasons and for better availability for routine clinical use.

<i>Bacteroides </i>und Appendizitis

<i>Bacteroides fragilis </i>is frequently recovered from cases of appendicitis with perforation and from infections developing secondary to appendicitis. In order to assess the part played by <i>B. fragilis </i>in the aetiology of appendicitis, quantitative aerobic and anaerobic culture studies of the contents of 49 inflammated appendices were performed. Anaerobic gram-negative non-sporing rods were cultivated from 43 appendices in the range 10³–10⁹/g. A total of 1,473 isolates was differentiated by biochemical methods, and 1,374 cultures were found to belong to the saccharolytic species of the genus <i>Bacteroides (B. fragilis, B. thetaiotaomicron, B. vulgatus, B. distasonis </i>etc.).<i> B. fragilis </i>was detected in 31 appendices; the species predominated in 18 samples. <i>B. thetaiotaomicron, </i>recovered from 27 samples, was prevalent in 4 appendices. In one sample, <i>B. fragilis </i>and <i>B. thetaiotaomicron </i>outnumbered the other appendicular bacteria. <i>B. vulgatus </i>was cultivated from 12 appendices, but did not once constitute the prevalent group. It has been previously shown that <i>B. vulgatus </i>(43% of intestinal isolates) and <i>B. thetaiotaomicron </i>predominate in the normal large bowel flora. On the other hand, approximately 80% of pyogenic <i>Bacteroides </i>strains belong to <i>B. fragilis, B. thetaiotaomicron </i>accounting for 19% and <i>B. vulgatus </i>being virtually absent. From these striking differences in species distribution the conclusion was drawn that <i>B. fragilis </i>possesses the highest virulence for man. Species distribution within the 1,374 appendicular isolates of saccharolytic <i>Bacteroides </i>(percentages of 62, 19 and 4.3 for <i>B. fragilis, B. thetaiotaomicron, </i>and <i>B. vulgatus, </i>respectively) was very similar to that encountered in clinical specimens. From the results obtained it becomes evident that pyogenic <i>Bacteroides, </i>in particular <i>B. fragilis, </i>plays an important role in nearly 50% of cases of appendicitis.