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Tuesday, 28.09.2021

Carlos Mora and Mateo Kreiker: General Psychopathology 20

 

Thomas A. Ban: The AMDP System

 

       Central to psychopharmacological research is the identification of pharmacologically homogeneous populations within the pharmacologically heterogeneous psychiatric diagnoses. The need for a pharmacological re-evaluation of psychiatric nosology (Freyhan 1959) led to the development of the AMP documentation system in German speaking countries. To overcome the difficulty of demonstrating therapeutic efficacy in pharmacologically heterogeneous diagnostic population, the BLIPS was developed in the United States. Both systems were introduced in the 1960s and are defined below.

 

The AMP System 

 

       Activities which led to the introduction of the AMP System began in the late 1950s by two independent teams of university based psychiatrists, one in the Federal Republic of Germany (FRG) and the other in Switzerland, collaborating in clinical studies with psychotropic drugs. The psychiatrists in the FRG included: D. Bente (Erlangen,) M.P. Engelmeier (Essen,) K. Heinrich (Dűsseldorf,) H. Helmchen and H. Hippius (Berlin,) and N. Schmitt (Saarbrűcken.) The psychiatrists in Switzerland included: J. Angst (Zurich,) F. Cornu (Bern,) P. Dick (Geneva,) H. Heimann (Lausanne,) and O. Pöldinger (Basel.) 

       In the early 1960s, members of the two groups, together with Peter Berner from the Department of Psychiatry, University of Vienna (Austria,) and Paul Schmidlin from Geigy, a Swiss pharmaceutical company, embarked on the development of a common documentation system for studying and characterizing the clinical effects of the new drugs. The working relationship was formalized in 1965 by the founding of the Arbeitsgemeinschaft fűr Methodik und Documentation in der Psychiatry (Working Group for the Methodology and Documentation in Psychiatry) with a secretariat at the Psychiatric Clinic of the Free University in West Berlin. The documentation system of the Working Group  (Angst, Battegay, Bente et al. 1967). In the 1970s, the acronym was, completed in 1967, was referred to as the AMP System, using the acronym changed to AMDP (Angst, Battegay, Bente et al. 1969a).

       The AMDP System consists of five integrated forms for recording: (1) Demographic Data, (2) Life Events, (3) Psychiatric History, (4) Psychopathological Symptoms (PSF) and (5) Somatic Signs (SSF). Two of the five forms, the PSF and the SSF, are suitable for the assessment of change in the clinical state of patients. The PSF includes 100 items, organized into 13 categories; the SSF consists of a catalogue of 41 physical symptoms (signs), listed under seven headings (Angst, Battegay, Bente et al. 1969b)

       The thirteen categories of the PFS: (1) intellectual deficit, (2) disorders of consciousness, (3) disturbance of orientation, (4) disturbance of attention and memory, (5) formal disorders of thought, (6) phobias and compulsions, (7) delusions,  (8) disorders of perception, (9) disorders of ego,  (10)  disturbances of affect, (11) disorders of drive and psycho-motility, (12) circadian disturbances and (13) other disturbances, including  social withdrawal, excessive social contact, aggressiveness, suicidal tendencies, self-mutilation, lack of feeling ill, lack of insight, uncooperativeness and lack of self-care. The seven headings of the SSF catalogue: (1) disturbance of sleep and vigilance, (2) appetite disturbances, (3) gastrointestinal disturbance, (4) cardiac-respiratory disturbances, (5) other autonomic disturbances, e.g., blurred vision, (6) other somatic disturbances, e.g., headache, and (7) neurological disturbance.

       Programs for computer processing of the AMP (AMDP) data were developed in the 1960s and 1970s at several centers, including Berlin, Erlangen, Munich and Zurich (Bente, Feder and Stegordner 1970).

       Since its first edition in 1971 (Sharfetterb 1971), the AMP (AMDP) Manual has been revised several times. It’s most recent, eighth edition, was published in 2007  (AMDP 2007).

       The Manual was translated into several languages, e.g., Croatian, Dutch, English, Estonian, French, Greek, Italian, Japanese, Portuguese, Russian, and Spanish, because it seemed a more suitable instrument for the delineation of the therapeutic profile of psychotropic drugs than the conventional rating scales used in clinical trials (Ban, Lehmann, Galvan et al 1974).

       The initial English translation was completed from the second edition of the Manual  (Scharfetter 1972) by Jűri Saarma, in collaboration with Thomas Ban and Heinz Lehmann in 1974. Saarma, chairman of the Department of Psychiatry at the University of Tartu (Dorpat), where Emil Kraepelin began his career, was at the time Visiting Professor with the WHO Training Program in Biological Psychiatry in Montreal, Canada  

       In 1977, the third German edition of the system, now called AMDP-III, was published (AMDP 1977). The changes in AMDP-III were significant enough to warrant a new English translation. This was prepared by Guy and Ban collaboration with D. Bobon, J. Hoenig, R. Jamieson, Y. Lapierre, A. Leeds, H. Lehmann, J. Libiger and J. Saarma, and consultation with J. Angst, P. Berner, P. Grof, M. Hamilton, H. Helmchen, M. Hollender, E. Koranyi and N. Sartorius,  and published in 1982 (Guy and Ban  1982). The advent of AMDP-III has created a similar situation for other translations (Bobon 1978;  Bobon and Saarma 1978) coordinate activities among the groups involved with AMDP outside of German speaking countries, an International AMDP Secretariat was established at The University of Liege, Belgium, under the leadership of Daniel Bobon  (Bobon, Bauman, Angst et al.1983).

 

References: 

AMDP. Das AMDP System Manual zur Dokumentation psychiatrischer Befunde. 3, Auflage. Berlin: Springer; 1977. 

AMDP. Das AMDP System Manual zur Dokumentation  psychiatrischer  Befunde. 8, űberarbeitete Auflage. Gottingen: Hogrefe; 2007.  

Angst J, Battegay R, Bente D, Cornu F, Dick P, Engelmeier  MP, Hermann H, Henrich K, Hippius H, Pöldinger W, Schmdlin P, Schmitt W, Weis P. On the Proceedings of  German and Swiss  Association  for the  study of psychiatric  documentation. Schweiz Arch Neurol Nerochir  Psychiat 1967; 100:207-11 (In German).  

Angst J, Battegay R, Bente D, Berner P,  Broeren W, Cornu F, Dick P, Engelmeier MP, Heimann H, Heinrich K, Helmchen  H, Hippius H,  Lukács G, Pöldinger W, Schmidlin P, Schmitt W, Weis P.  Clinical documentation  of psychopharmacology. (Association for Methodology  and Documentation  in Psychiatry.) In: Cerletti A, Bové FJ, editors. The Present  Status of Psychotropic Drugs . Amsterdam: Excerpta  Medica; 1969a. p. 361-5 (In French). 

Angst J, Battegay R, Bente D, Berner P, Broeren  W, Cornu  F, Dick  P, Engelmeier  MP, Heimann  H, Helmchen  H, Hippius H,  Pöldinger W,  Schmidlin P, Schmitt W, Weis P.  The documentation system of the Association  for Methodology  and Documentation  in Psychiatry  (AMP.) Arzneim  Forsch  1969b; 19:399-405 (In German).  

Ban TA, Lehmann HE, Galvan L, Pecknold JC, Climan M. A transcultural study with Comparison of  two assessment methods. Current Therapeutic Research. 1974; 16:971-89.  

Bente D, Feder  J,  Siegordner  K.  A computer program  for interregional  storage and  statistical evaluation of  AMP data.  Arzneim Forsch. 1970;  20:913-5 (In German). 

Bobon D. Conceptual  and semantic  problems raised  by the French translation of the AMP Psychopathology Scale. In: Deniker P, Radouco-Thomas C, Villeneuve A, editors. Proceedings of the Xth Cogress CINP. London: Pergamon Press; 1978. p. 1583-8.  

Bobon D, Saarma J. Summary of the First Workshop  on Translation  of the`AMP System. In: Deniker P, Radouco-Thomas C, Villeneuve A, editors. Proceedings of the Xth Congress CINP. London: Pergamon Press; 1978. p. 1555-6.  

Bobon D, Baumann U, Angst J, Helmchen H, Hippius H, editors. AMDP-System in Pharmacopsychiatry. Basel: Karger; 1983. 

Freyhan F. Selection of patients from the clinical point of view. In: Cle JO, Gerard RW, editors. Evaluation of Pharmacotherapy in Mental Illness. Washington: National Academy of Sciences; 1959. p. 372-89.  

Guy W, Ban TA. The AMDP System. Hedelberg: Springer; 1982. 

Scharfetter C.  The AMP System. Berlin: Springer; 1971 (In German). 

Scharfetter C. The AMP System. 2nd edition. Berlin: Springer; 1972 (In German).

  

November 26, 2020