In Switzerland, evaluation of work capacity in individuals with mental disorders has come under c... more In Switzerland, evaluation of work capacity in individuals with mental disorders has come under criticism. We surveyed stakeholders about their concerns and expectations of the current claim process. We conducted a nationwide online survey among five stakeholder groups. We asked 37 questions addressing the claim process and the evaluation of work capacity, the maximum acceptable disagreement in judgments on work capacity, and its documentation. Response rate among 704 stakeholders (95 plaintiff lawyers, 285 treating psychiatrists, 129 expert psychiatrists evaluating work capacity, 64 social judges, 131 insurers) varied between 71% and 29%. Of the lawyers, 92% were dissatisfied with the current claim process, as were psychiatrists (73%) and experts (64%), whereas the majority of judges (72%) and insurers (81%) were satisfied. Stakeholders agreed in their concerns, such as the lack of a transparent relationship between the experts' findings and their conclusions regarding work cap...
... 5-10, 2003, Fort Lauderdale, USA (2003) 3. Stefani, O., Karaseitanidis, I.: Designing 3D Inpu... more ... 5-10, 2003, Fort Lauderdale, USA (2003) 3. Stefani, O., Karaseitanidis, I.: Designing 3D Input Devices for Immersive Environments, IEEE SMC 2004 Conference Proceedings IEEE Conference on Systems, Man & Cybernetics Den Haag, The Netherlands 2004-10-10 - 2004-10 ...
Lithium is known to be neurotoxic at higher serum levels. In rare cases patients develop symptoms... more Lithium is known to be neurotoxic at higher serum levels. In rare cases patients develop symptoms of intoxication or full blown intoxications even when lithium levels are normal. Our aim was to detect predicting factors of lithium neurotoxicity at normal serum lithium levels in order to allow prevention of those constellations. We report two cases of severe lithium intoxications at normal serum lithium levels and review the current literature concerning lithium neurotoxicity at normal serum levels. It appears that the probability of developing signs of lithium intoxications in patients treated with lithium is increased with advanced age, co-morbidity with pre-existing neurological or other general diseases, especially those associated with fever, and in combination with the use of antipsychotics, antidepressants or mood stabilizers. The serum lithium level does not necessarily detect an intoxication. In patients developing signs of intoxication under lithium therapy, further investi...
In Switzerland, psychiatric evaluations of work capacity for determining a person's eligibili... more In Switzerland, psychiatric evaluations of work capacity for determining a person's eligibility for disability benefits are being criticised for a lack of transparency and high inter-rater variability. The aims of this study were to learn about the current practice of psychiatrists, to explore possible sources for lack of transparency and variability, and to contrast practice with current professional guidance. A national online-survey among psychiatrists who performed five or more evaluations of work capacity per year. Based on discussions with experts and a literature review, we structured questions focusing on reporting on work capacity, the description of a claimant's previous job, and measures of quality assurance. A total of 129 psychiatrists responded (31% of estimated 412 eligible psychiatrists). The majority reported using instructions of the insurers (77%), peer consulting (65%) and process guidelines (51%). They expressed a claimant's work capacity as free tex...
The failure to inhibit pleasurable but inappropriate urges is associated with frontal lobe pathol... more The failure to inhibit pleasurable but inappropriate urges is associated with frontal lobe pathology and has been suggested as a possible cause of pedophilic behavior. However, imaging and neuropsychological findings about frontal pathology in pedophilia are heterogeneous. In our study we therefore address inhibition behaviorally and by means of functional imaging, aiming to assess how inhibition in pedophilia is related to a differential recruitment of frontal brain areas. Eleven pedophilic subjects and 7 nonpedophilic controls underwent fMRI while performing a go/no-go task composed of neutral letters. Pedophilic subjects showed a slower reaction time and less accurate visual target discrimination. fMRI voxel-level ANOVA revealed as a main effect of the go/no-go task an activation of prefrontal and parietal brain regions in the no-go condition, while the left anterior cingulate, precuneus and gyrus angularis became more activated in the go condition. In addition, a group × task interaction was found in the left precuneus and gyrus angularis. This interaction was based on an attenuated deactivation of these brain regions in the pedophilic group during performance of the no-go condition. The positive correlation between blood oxygen level-dependent imaging signal and reaction time in these brain areas indicates that attenuated deactivation is related to the behavioral findings. Slower reaction time and less accurate visual target discrimination in pedophilia was accompanied by attenuated deactivation of brain areas belonging to the default mode network. Our findings thus support the notion that behavioral differences might also derive from self-related processes and not necessarily from frontal lobe pathology.
In Switzerland, evaluation of work capacity in individuals with mental disorders has come under c... more In Switzerland, evaluation of work capacity in individuals with mental disorders has come under criticism. We surveyed stakeholders about their concerns and expectations of the current claim process. We conducted a nationwide online survey among five stakeholder groups. We asked 37 questions addressing the claim process and the evaluation of work capacity, the maximum acceptable disagreement in judgments on work capacity, and its documentation. Response rate among 704 stakeholders (95 plaintiff lawyers, 285 treating psychiatrists, 129 expert psychiatrists evaluating work capacity, 64 social judges, 131 insurers) varied between 71% and 29%. Of the lawyers, 92% were dissatisfied with the current claim process, as were psychiatrists (73%) and experts (64%), whereas the majority of judges (72%) and insurers (81%) were satisfied. Stakeholders agreed in their concerns, such as the lack of a transparent relationship between the experts' findings and their conclusions regarding work cap...
... 5-10, 2003, Fort Lauderdale, USA (2003) 3. Stefani, O., Karaseitanidis, I.: Designing 3D Inpu... more ... 5-10, 2003, Fort Lauderdale, USA (2003) 3. Stefani, O., Karaseitanidis, I.: Designing 3D Input Devices for Immersive Environments, IEEE SMC 2004 Conference Proceedings IEEE Conference on Systems, Man & Cybernetics Den Haag, The Netherlands 2004-10-10 - 2004-10 ...
Lithium is known to be neurotoxic at higher serum levels. In rare cases patients develop symptoms... more Lithium is known to be neurotoxic at higher serum levels. In rare cases patients develop symptoms of intoxication or full blown intoxications even when lithium levels are normal. Our aim was to detect predicting factors of lithium neurotoxicity at normal serum lithium levels in order to allow prevention of those constellations. We report two cases of severe lithium intoxications at normal serum lithium levels and review the current literature concerning lithium neurotoxicity at normal serum levels. It appears that the probability of developing signs of lithium intoxications in patients treated with lithium is increased with advanced age, co-morbidity with pre-existing neurological or other general diseases, especially those associated with fever, and in combination with the use of antipsychotics, antidepressants or mood stabilizers. The serum lithium level does not necessarily detect an intoxication. In patients developing signs of intoxication under lithium therapy, further investi...
In Switzerland, psychiatric evaluations of work capacity for determining a person's eligibili... more In Switzerland, psychiatric evaluations of work capacity for determining a person's eligibility for disability benefits are being criticised for a lack of transparency and high inter-rater variability. The aims of this study were to learn about the current practice of psychiatrists, to explore possible sources for lack of transparency and variability, and to contrast practice with current professional guidance. A national online-survey among psychiatrists who performed five or more evaluations of work capacity per year. Based on discussions with experts and a literature review, we structured questions focusing on reporting on work capacity, the description of a claimant's previous job, and measures of quality assurance. A total of 129 psychiatrists responded (31% of estimated 412 eligible psychiatrists). The majority reported using instructions of the insurers (77%), peer consulting (65%) and process guidelines (51%). They expressed a claimant's work capacity as free tex...
The failure to inhibit pleasurable but inappropriate urges is associated with frontal lobe pathol... more The failure to inhibit pleasurable but inappropriate urges is associated with frontal lobe pathology and has been suggested as a possible cause of pedophilic behavior. However, imaging and neuropsychological findings about frontal pathology in pedophilia are heterogeneous. In our study we therefore address inhibition behaviorally and by means of functional imaging, aiming to assess how inhibition in pedophilia is related to a differential recruitment of frontal brain areas. Eleven pedophilic subjects and 7 nonpedophilic controls underwent fMRI while performing a go/no-go task composed of neutral letters. Pedophilic subjects showed a slower reaction time and less accurate visual target discrimination. fMRI voxel-level ANOVA revealed as a main effect of the go/no-go task an activation of prefrontal and parietal brain regions in the no-go condition, while the left anterior cingulate, precuneus and gyrus angularis became more activated in the go condition. In addition, a group × task interaction was found in the left precuneus and gyrus angularis. This interaction was based on an attenuated deactivation of these brain regions in the pedophilic group during performance of the no-go condition. The positive correlation between blood oxygen level-dependent imaging signal and reaction time in these brain areas indicates that attenuated deactivation is related to the behavioral findings. Slower reaction time and less accurate visual target discrimination in pedophilia was accompanied by attenuated deactivation of brain areas belonging to the default mode network. Our findings thus support the notion that behavioral differences might also derive from self-related processes and not necessarily from frontal lobe pathology.
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Papers by Ralph Mager