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Ackl N, Schreiber YA, Ising M, Sonntag A, Auer DP. Evaluation of 1H-MRS as diagnostic marker for mild cognitive impairment and dementia. PHARMACOPSYCHIATRY 2004. [DOI: 10.1055/s-2003-825252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sonntag A, Bischkopf J, Ritz A, Jakob A, Angermeyer MC. [Wishes of nursing home residents concerning their life situation--results of a qualitative study]. Z Gerontol Geriatr 2003; 36:280-6. [PMID: 12937933 DOI: 10.1007/s00391-003-0093-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2001] [Accepted: 05/04/2002] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study examined the wishes of nursing home residents concerning their life situation in the nursing home. METHODS Using a qualitative study design, a representative sample of nursing home residents (n = 1656) of 24 nursing homes in a city situated in the eastern part of Germany were interviewed. RESULTS The analyses of residents' wishes lead to major domains such as the quality of care, interpersonal contact, architecture and organization of the house, diversification, financial support, as well as themes like health and death and the wish to leave the nursing home. Residents focus on an individualized approach to care. CONCLUSIONS Nursing home residents' views support the need to improve the psychological and social aspects of the quality of care. Implications of and consequences for the organization of care and concepts of nursing are discussed.
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Murck H, Nickel T, Künzel H, Antonijevic IA, Schill J, Zobel A, Steiger A, Sonntag A, Holsboer F. State markers of depression in sleep EEG: dependency on drug and gender in patients treated with tianeptine or paroxetine. Neuropsychopharmacology 2003; 28:348-58. [PMID: 12589388 DOI: 10.1038/sj.npp.1300029] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Tianeptine enhances while paroxetine inhibits serotonin reuptake into neurons; however, both show an antidepressive action. A subgroup of 38 depressed patients from a drug trial comparing the efficacy of tianeptine with that of paroxetine was studied with regard to their effects on sleep regulation, especially in relation to treatment response. We recorded sleep EEGs at day 7 and day 42 after the start of treatment with either compound, which allows measurement of changes due to the antidepressive medication in relation to the duration of treatment. Spectral analysis of the non-REM sleep EEG revealed a strong decline in the higher sigma frequency range (14-16 Hz) in male treatment responders independent of medication, whereas nonresponders did not show marked changes in this frequency range independent of gender. The patients receiving paroxetine showed less REM sleep and more intermittent wakefulness compared to the patients receiving tianeptine. REM density after 1 week of treatment was a predictor of treatment response in the whole sample. Psychopathological features with regard to the score in single items of the HAMD revealed predictive markers for response, some of which were opposite in the gender groups, especially those related to somatic anxiety. Changes in REM density were inversely correlated to the changes in HAMD in the paroxetine, but not the tianeptine, group. Our data suggest the importance of taking gender into account in the study of the biological effects of drugs. The study further points to the importance of the higher sigma frequency range in the sleep EEG of non-REM sleep and REM density as a marker of treatment response.
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Frieboes RM, Sonntag A, Yassouridis A, Eap CB, Baumann P, Steiger A. Clinical outcome after trimipramine in patients with delusional depression - a pilot study. PHARMACOPSYCHIATRY 2003; 36:12-7. [PMID: 12649769 DOI: 10.1055/s-2003-38087] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The treatment of delusional depression is a major challenge in psychopharmacology. Hypothalamic-pituitary-adrenocortical (HPA) overdrive may contribute, via increased dopaminergic activity, to the pathophysiology of the disorder. Trimipramine appears to be an interesting potential candidate, since it is an atypical antidepressant that is known to inhibit HPA activity. In a four-week open trial we investigated its effects in 15 inpatients with delusional depression. The dosage was increased within 7 days up to 300 - 400 mg/d and was then maintained for three weeks. Psychometric assessments and safety monitoring were conducted weekly. Assessment of the HPA activity was achieved by a combined dexamethasone suppression/corticotropin-releasing hormone stimulation (Dex/CRH) test before and after four weeks of treatment. Therapeutic response was defined as a decrease in the HAMD-score of at least 50 %. Eight out of 13 completers were rated as responders. Therapeutic response was associated with L, D-trimipramine concentrations higher than 160 ng/ml. Intent-to-treat analysis showed significant improvement in psychometric variables. Despite the high dosage, the substance was generally well tolerated, with the exception of one patient who suffered from a hypotensive reaction. Mean +/- SD concentration of L-trimipramine and D-trimipramine were 138 +/- 61 ng/ml and 119 +/- 50 ng/ml at a final dose of 346 +/- 50 mg/d. The ACTH and cortisol area under the curve in the Dex/CRH tests decreased significantly, reflecting a decrease of activity in the HPA system. We suggest that the clinical use of high-dose trimipramine in delusional depression seems to be a promising treatment strategy.
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Stelzner G, Riedel-Heller SG, Sonntag A, Matschinger H, Jakob A, Angermeyer MC. [Determinants of psychotropic drug utilization in homes for the elderly and in nursing homes]. Z Gerontol Geriatr 2001; 34:306-12. [PMID: 11584715 DOI: 10.1007/s003910170054] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A large proportion of the residential and nursing home population is mentally ill. The causes for increased prescription of psychotropic drugs other than mental disorders have been discussed. This study presents data on the role of the individual's characteristics and institutional conditions on psychotropic drug use in residents of residential and nursing homes. Therefore the psychotropic drug use of 4 old-people's homes in Leipzig (Germany) was reviewed. Sociodemographic characteristics and a number of behavioral patterns of the residents were examined. Regression analysis revealed associations of age, gender and certain behavioral patterns (e.g., agitation, insomnia with nightly disturbances) and psychotropic drug use. Beyond that, psychotropic drug use varied among the 4 institutions' practices. Further research should be aimed at gaining insight into the interplay of these individual and institutional influences on psychotropic drug use in order to develop specific interventions to optimize treatment.
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Zobel AW, Nickel T, Sonntag A, Uhr M, Holsboer F, Ising M. Cortisol response in the combined dexamethasone/CRH test as predictor of relapse in patients with remitted depression. a prospective study. J Psychiatr Res 2001; 35:83-94. [PMID: 11377437 DOI: 10.1016/s0022-3956(01)00013-9] [Citation(s) in RCA: 261] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The development and course of depression is causally linked to impairment of central regulation of the hypothalamic-pituitary-adrenocortical (HPA) system. Previous research documented that the combined dexamethasone/corticotropin-releasing hormone (DEX/CRH) test identifies HPA dysfunction with high sensitivity. We evaluated the predictive validity for medium-term outcome of the cortisol response in the combined DEX/CRH test in 74 remitted patients previously suffering from major depressive disorder. Of the 74 patients, 61 remained in stable remission and 13 relapsed during the first 6 months after discharge from the hospital. Although the cortisol and ACTH responses in the DEX/CRH test did not differ between the two groups of patients on admission, the responses differed significantly just before discharge (P< 0.05). We defined two dichotomous variables as prediction rules indicating (1) the change between admission and discharge in the cortisol response to the DEX/CRH test, and (2) the effect of the CRH infusion on cortisol as compared to the baseline level in the DEX/CRH test prior to discharge only. An elevated cortisol response in the DEX/CRH test was correlated with a four- to six-fold higher risk for relapse than in individuals with a normal cortisol response. The two proposed rules for predicting relapse within the first 6 months after discharge could be optimized by including age and gender. Hence, an exaggerated cortisol response in the combined DEX/CRH test predicts the recurrence of depressive psychopathology. The test performance can be further optimized if gender and age are taken into account.
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Mönnikes H, Tebbe J, Grote C, Sonntag A, Pluntke K, Sturm K, Arnold R. Involvement of CCK in the paraventricular nucleus of the hypothalamus in the CNS regulation of colonic motility. Digestion 2001; 62:178-84. [PMID: 11025366 DOI: 10.1159/000007811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The effects of cholecystokinin octapeptide (CCK(8)), the CCK-A receptor antagonist, MK-329, and the CCK-B receptor antagonist, L-365, 260, microinfused into the paraventricular nucleus of hypothalamus (PVN) on colonic motor function was investigated in awake rats, chronically implanted with a microinjection cannula into the PVN and a catheter into the proximal colon. In fasted rats, bilateral microinfusion of CCK(8) at doses of 1.5 and 3.0 microg/rat into the PVN stimulated colonic transit, as shown by a significant increase in the geometric center by 47 and 54%, respectively. This effect of CCK(8) was site-specific to the PVN, since microinjection of the peptide into sites outside of but adjacent to PVN had no effect. In non-fasted rats, L-365,260 bilaterally microinjected into the PVN at a dose of 1.5 microg/rat inhibited propulsive colonic motor function; colonic transit time significantly increased by 73% in comparison to the control condition. Microinfusion of the CCK-A antagonist into in the PVN did not affect colonic transit. These results show that the PVN is a responsive site for the central CCK(8)-induced modulation of colonic motility. The data suggest, that endogenous CCK in the paraventricular nucleus of the hypothalamus unfolds a stimulatory effect on colonic transit through action on CCK-B receptors.
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Dietl T, Dirlich G, Vogl L, Nickel T, Sonntag A, Strian F, Lechner C. Enhanced long-latency somatosensory potentials in major depressive disorder. J Psychiatr Res 2001; 35:43-8. [PMID: 11287055 DOI: 10.1016/s0022-3956(01)00006-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Bodily misperceptions are a frequent symptom in major depressive disorder. A reduced ability to deflect attention from somatosensory stimuli may contribute to the generation of unpleasant bodily sensations and co-occur with altered habituation of the brain electric reactions to somatosensory stimuli. The aim of the present study was to explore whether attention-related components of somatosensory evoked potentials (SSEP) and the habituation of these components are altered in major depression. Fifteen patients with major depressive disorder were compared to an age- and gender-matched group of 15 healthy controls. A series of identical, intrusive but not painful electric stimuli were applied to the left index finger for 48 min. Averaged SSEP were computed from multichannel EEG recordings for consecutive recording blocks of the experiment, each block containing 162 stimuli. Based on these data the habituation process of late components of the SSEP was analysed in two latency intervals (50-150, 170-370 ms). Patients showed significantly enhanced reactions throughout the entire experiment. The persistence of enhanced SSEP components throughout the habituation process may be caused by a deficit in reducing the activity of attention-related brain processes concerned with intrusive, yet behaviourally irrelevant, continued stimulation in the state of major depression.
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Zobel AW, Nickel T, Künzel HE, Ackl N, Sonntag A, Ising M, Holsboer F. Effects of the high-affinity corticotropin-releasing hormone receptor 1 antagonist R121919 in major depression: the first 20 patients treated. J Psychiatr Res 2000; 34:171-81. [PMID: 10867111 DOI: 10.1016/s0022-3956(00)00016-9] [Citation(s) in RCA: 553] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Clinical and preclinical data suggest that unrestrained secretion of corticoctropin-releasing hormone (CRH) in the CNS produces several signs and symptoms of depression and anxiety disorders through continuous activation of CRH(1) receptors. This led to the development of drugs that selectively antagonize CRH(1) receptors suppressing anxiety-like behavior in rats and also in monkey models of anxiety. These findings led to a clinical development program exploring the antidepressive potential of R121919, a water-soluble pyrrolopyrimidine that binds with high affinity to human CRH(1) receptors and is well absorbed in humans. This compound was administered to 24 patients with a major depressive episode primarily in order to investigate whether its endocrine mode of action compromises the stress-hormone system or whether other safety and tolerability issues exist. The patients were enrolled in two dose-escalation panels: one group (n=10) where the dose range increased from 5-40 mg and another group (n=10) where the dose escalated from 40 to 80 mg within 30 days each. Four patients dropped out because of withdrawal of consent to participate (three cases) or worsening of depressive symptomatoloy in one case. We found that R121919 was safe and well tolerated by the patients during the observation period. Moreover, the data suggested that CRH(1)-receptor blockade does not impair the corticotropin and cortisol secretory activity either at baseline or following an exogenous CRH challenge. We also observed significant reductions in depression and anxiety scores using both, patient and clinician ratings. These findings, along with the observed worsening of affective symptomatology after drug discontinuation, suggests that the pharmacological principle of CRH(1)-receptor antagonism has considerable therapeutic potential in the treatment and the prevention of diseases where exaggerated central CRH activity is present at baseline or following stress exposure.
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Ströhle A, Antonijevic IA, Steiger A, Sonntag A. [Dependency of non-benzodiazepine hypnotics. Two case reports]. DER NERVENARZT 1999; 70:72-5. [PMID: 10087521 DOI: 10.1007/s001150050403] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
With the introduction of the non-benzodiazepine hypnotics zopiclone and zolpidem it was expected to have hypnotics without side effects and risks characteristically seen with benzodiazepines. We report two cases with high-dose usage and dependency of non-benzodiazepine hypnotics. Both patients were prescribed the drugs to treat sleep disturbances occurring during a depressive episode. While one patient had a polysubstance abuse there was no evidence for an abuse history in the other patient. To reduce withdrawal symptoms long-acting benzodiazepines were given to both patients. Thus, it seems that not only patients with a history of substance abuse but also patients with a psychiatric disorder are at risk for abuse of non-benzodiazepine hypnotics. Considering the increasing number of case reports with abuse and dependence of zopiclone and zolpidem it seems necessary to reevaluate the dependency risk of the currently available non-benzodiazepine hypnotics.
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Sonntag A. [Determinations of MAG3 clearance according to the whole-body principle and to related methods]. Nuklearmedizin 1996; 35:132-9. [PMID: 9005407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
To answer the question for the most effective use of all usually available information, the MAG3 clearance was determined by different methods: firstly in an optimated whole-body technique for reference, further for comparison by means of a camera background-curve and a dedicated evaluating procedure, and in addition according to the compartmental principle (Sapirstein), by the latter method also simultaneously together with the hippurate clearance. Two simplified methods were applied as well, a non-invasive one and a single-sample method. The results revealed the relatively unpretentious camera technique to be nearly equivalent to more expensive procedures, but qualitatively superior to those methods, which are unnecessarily oversimplified.
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Sonntag A, Rothe B, Guldner J, Yassouridis A, Holsboer F, Steiger A. Trimipramine and imipramine exert different effects on the sleep EEG and on nocturnal hormone secretion during treatment of major depression. DEPRESSION 1996; 4:1-13. [PMID: 9160649 DOI: 10.1002/(sici)1522-7162(1996)4:1<1::aid-depr1>3.0.co;2-s] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In a 4-week double-blind clinical trial we compared the effects of the tricyclic antidepressants trimipramine and imipramine on the sleep EEG and on nocturnal bormone secretion in 20 male inpatients with major depression. Both treatments produced rapid significant clinical improvement in depression without severe adverse effects. However, the two drugs had markedly different neurobiologic profiles. Trimipramine enhanced rapid eye movement (REM) sleep and slow wave sleep, whereas imipramine suppressed REM sleep and showed no effect on slow wave sleep. Total sleep time and the sleep efficiency index increased under trimipramine but not under imipramine. Nocturnal cortisol secretion decreased with trimipramine but remained unchanged with imipramine. In contrast to imipramine, trimipramine induced an increase in prolactin secretion compatible with its known antagonism at dopamine (D2) receptors. Imipramine induced a decrease in growth hormone secretion during the first half of the night. Neither of the drugs induced significant changes in plasma testosterone concentration. We conclude that trimipramine is an antidepressant with sleep-improving qualities that possibly acts through inhibition of hypothalamic-pituitary-adrenocortical system activity by a yet unknown mechanism.
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Sonntag A. Bestimmung der MAG3-Clearance nach dem Ganzkörperprinzip und nach verwandten Methoden. Nuklearmedizin 1996. [DOI: 10.1055/s-0038-1629827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungZur Klärung der Frage, wie die gesamte im Regelfall vorhandene Information optimal genutzt werden kann, wurde die MAG3-Clearance nach verschiedenen Methoden bestimmt: zum ersten als Referenz in optimierter Ganzkörpertechnik, weiter zum Vergleich mittels Kamera-Untergrundkurve und eigens dafür entwickeltem Auswerteverfahren, außerdem nach dem Kompartimentprinzip (Sapirstein), dabei auch simultan mit der Hippuranclearance. Schließlich kamen noch zwei vereinfachte Methoden zur Anwendung, eine »unblutige« und eine Single-Sample-Methode. Das keine besonderen Anforderungen stellende Kameraverfahren erwies sich dabei den aufwendigeren Methoden gegenüber als nahezu gleichwertig, den unnötig stark vereinfachten Verfahren gegenüber aber als qualitativ überlegen.
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Wingenfeld P, Michalk DV, Sonntag A, Paas S, Minor T, Isselhard W. Protective effect of taurine on hypoxia and reoxygenation-induced damage of human colon cells (HT 29). ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1996; 403:213-22. [PMID: 8915358 DOI: 10.1007/978-1-4899-0182-8_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In this experimental model, taurine administered during hypoxia markedly reduced the cell damage due to O2 deficiency, and the beneficial effect outlasted the period of reoxygenation. The mechanisms for the improved survival rates are postulated to be a reduced osmoregulatory disturbance of cellular integrity, improved Ca2+ homeostasis and induction of accelerated cellular growth processes. In our simplified cell culture model the UW solution seems to be the most appropriate solution for the cold (hypoxic) preservation of human colon cells. We conclude, that within this experimental model and under these experimental conditions, taurine supplementation of the conventionally used preservation solutions improved the solutions markedly. Considering our previous studies, taurine seems to be a potent endogenous protective agent against cellular deterioration due to hypoxia and reoxygenation.
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Steiger A, Guldner J, Colla-Müller M, Friess E, Sonntag A, Schier T. Growth hormone-releasing hormone (GHRH)-induced effects on sleep EEG and nocturnal secretion of growth hormone, cortisol and ACTH in patients with major depression. J Psychiatr Res 1994; 28:225-38. [PMID: 7932284 DOI: 10.1016/0022-3956(94)90008-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Studies in normal human subjects and animals suggest that the neuropeptide growth hormone-releasing hormone (GHRH) is a common regulator of the sleep EEG and nocturnal hormone secretion. In healthy volunteers GHRH prompts an increase in the amount of slow wave sleep (SWS) and in growth hormone (GH) secretion and blunting of cortisol release. Inhibition of GHRH may contribute to sleep-endocrine aberrances during depression. We tested the effects of pulsatile application of 4 x 50 micrograms GHRH on the sleep EEG and simultaneously investigated nocturnal hormone secretion in 10 inpatients (four females, six males) with the acute episode of major depression. In contrast to the effects of placebo, GH secretion increased distinctly and rapid-eye-movement (REM) density decreased during the second half of night. No other significant changes in sleep-endocrine activity, including SWS, cortisol and ACTH secretion, could be observed. We assume that hypothalamic-pituitary-adrenocortical system activity and slow wave sleep are inert to the influence of GHRH during acute depression. Cortisol and ACTH remained unchanged even in a subsample of five younger (aged 19-28 years) patients. This observation is in contrast to our recent finding that cortisol secretion is blunted in young normal volunteers after GHRH. But on the other hand, GHRH is capable of stimulating GH and inducing a decrease in REM density in these subjects.
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Möller A, Wiedemann G, Rohde U, Backmund H, Sonntag A. Correlates of cognitive impairment and depressive mood disorder in multiple sclerosis. Acta Psychiatr Scand 1994; 89:117-21. [PMID: 8178661 DOI: 10.1111/j.1600-0447.1994.tb01497.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The psychopathological status of 25 inpatients suffering from clinically definite multiple sclerosis (MS) according to Poser criteria was assessed by using standardized methods (Structured Clinical Interview for DSM-III-R, Inpatient Multidimensional Psychiatric Scale, Hamilton and Montgomery-Asberg Depression Rating Scales and the Structured Interview for the Diagnosis of Alzheimer Dementia and Dementias of other Aetiology (SIDAM). Magnetic resonance (MRT) (0.5 T; T2-weighted sequence) of the brain was analysed by measuring the ventricular brain ration (VBR), the area of the corpus callosum (CC) and the extension of hyperintense lesions of the brainstem, the temporal lobes and the brain at all. Six of 25 (24%) of these moderately disabled patients (mean Extended Disability Score (EDSS) 3.3) were diagnosed to suffer from depressive mood disorder (major depression or dysthymia); 2 were demented. In correlation analysis, depression was unrelated to age, gender, duration of illness, status of disability (EDSS) or the results of cognitive assessment. No relationship between the depression scores and the different MRT measures could be identified. The presence or absence of gadolinium enhancement was also uncorrelated to depressive symptoms. Fatigue as measured by the Fatigue Severity Scale was unrelated to depression or subcortical brain atrophy (increased VBR) but significantly correlated to the area of hyperintense MRT changes in brainstem and midbrain. Cognitive impairment (decreased SIDAM scores) was correlated to the total area of hyperintense MRT changes of the brain parenchyma. The type of clinical course (relapsing-remitting vs chronic progredient) was not found to influence the affective or cognitive state in our MS patient's sample.
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Maier W, Buller R, Sonntag A, Heuser I. Subtypes of panic attacks and ICD-9 classification. EUROPEAN ARCHIVES OF PSYCHIATRY AND NEUROLOGICAL SCIENCES 1986; 235:361-6. [PMID: 3743575 DOI: 10.1007/bf00381005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
No single ICD-9 category corresponds to panic disorder (DSM-III). To investigate whether patients with panic attacks can be identified by means of ICD-9, 97 patients with three panic attacks within 3 weeks were recruited from various medical centers, and were classified independently according to DSM-III and ICD-9. The ICD-9 diagnoses were scattered over a broad range of categories, and it was impossible to identify patients with panic disorder in this manner. Anxiety state, affective psychosis, and depressive neurosis were the most frequent ICD-9 diagnoses. The boundary between affective psychosis on the one hand and anxiety state and depressive neurosis on the other hand was validated by present and previous symptomatology and by cluster analysis. The boundary between anxiety state and depressive neurosis could not be validated in this way. Correspondingly, modifications of the ICD-9 classifications are proposed.
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Sonntag A. [Comparison of simple nuclear medical methods of determining renal clearance]. Nuklearmedizin 1984; 23:155-60. [PMID: 6384936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Comparative clearance determinations with a partially shielded whole-body counter, a shoulder probe, a gamma camera and also exclusively by use of the plasma activity concentration at 45 min p.i. revealed the following results: The partially shielded whole-body counter can be substituted by the shoulder probe without major loss of quality, provided that this is taken into consideration in the subsequent calculations. However, values below 250 ml/min may possibly be wrong, i.e. too high, when the camera background-curve is used for clearance determination. The very simple 45-min-clearance is recommended mostly as a method in addition or in reserve.
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Sonntag A. Einfache nuklearmedizinische Nierenclearancemethoden im Vergleich. Nuklearmedizin 1984. [DOI: 10.1055/s-0038-1624212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungVergleichende Clearancebestimmungen mit Ganzkörpermeßstand, Schultersonde, Gammakamera sowie auch allein mit Hilfe der Plasmaaktivitätskonzentration 45 min p.i. brachten folgende Ergebnisse: Der Ganzkörpermeßstand läßt sich ohne größere Qualitätseinbußen durch eine Schultersonde ersetzen, wenn dies bei der weiteren Auswertung in geeigneter Weise berücksichtigt wird. Hingegen können bei der Clearancebestimmung mittels Kamerauntergrundkurve schon Werte unterhalb von 250 ml/min unter Umständen eindeutig falsch, d.h. zu hoch, sein. Die sehr einfache 45-min-Clearance empfiehlt sich vor allem als Zusatz- oder Reservemethode.
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Sonntag A, Heil T. [Scintigraphic contribution to the demonstration of enterovesical fistulas]. ROFO-FORTSCHR RONTG 1983; 139:705. [PMID: 6421708 DOI: 10.1055/s-2008-1055984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Sonntag A. [Determination of kidney clearance by reconstruction of the whole-body retention curves from later measurements]. Nuklearmedizin 1983; 22:31-8. [PMID: 6408613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Starting from routine renal clearance measurements in a partially shielded whole-body counter, generally applicable algorithms were developed empirically which permit the reconstruction of the total course of retention up to 28 min p.i. from e.g. the 12 min and 24 min values only. By formal differentiation the instantaneous slope of the decline in retention and thus the renal clearance can be calculated employing the whole-body counting principle. Integration yields the possibility of subtracting background from renograms to calculate single renal clearances. The method offers advantages in cases of reduced measurement geometry and/or low count rates.
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Sonntag A. Bestimmung der Nierenclearance durch Rekonstruktion der Ganzkörperretentionskurve aus späteren Meßwerten. Nuklearmedizin 1983. [DOI: 10.1055/s-0037-1620596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Ausgehend von routinemäßigen Nierenclearancebestimmungen am teilabgeschirmten Ganzkörpermeßstand, wurden auf empirischem Wege allgemeingültige Algorithmen entwickelt, mit denen der gesamte Retentionsverlauf bis über 28 min p.i. beispielsweise lediglich aus dem 12-min- und dem 24-min-Wert rekonstruiert werden kann. Durch formale Differentiation läßt sich hieraus die momentane Steigung des Retentionsgefälles und damit auch die Nierenclearance nach dem Ganzkörperprinzip bestimmen. Durch Integration ergeben sich Möglichkeiten zur Untergrundsubtraktion der Nephrogramme für die Berechnung der seitengetrennten Clearance. Das Verfahren bietet vor allem Vorteile bei reduzierter Meßgeometrie und/oder bei niedrigen Zählraten.
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Paula R, Sonntag A, Martin G, Kaiser E. [Serum cholesterol. Comparative studies on the reliability of various analytic methods]. DAS MEDIZINISCHE LABORATORIUM 1977; 30:250-60. [PMID: 916965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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