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Wilhelm J, Heberlein A, Frieling H, Kornhuber J, Bleich S, Hillemacher T. Association of prolactin serum levels and severity of alcohol dependence and withdrawal symptoms. PHARMACOPSYCHIATRY 2011. [DOI: 10.1055/s-0031-1292560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Lenz B, Heberlein A, Bayerlein K, Frieling H, Kornhuber J, Bleich S, Hillemacher T. The TTTAn aromatase (CYP19A1) polymorphism is associated with compulsive craving of male patients during alcohol withdrawal. Psychoneuroendocrinology 2011; 36:1261-4. [PMID: 21414724 DOI: 10.1016/j.psyneuen.2011.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 02/16/2011] [Accepted: 02/16/2011] [Indexed: 11/18/2022]
Abstract
Alcoholism is associated with alterations of the hypothalamus-pituitary-gonadal hormone axis. We recently reported a leptin-mediated relation between the CAGn polymorphism of the androgen receptor and craving during alcohol withdrawal. This study investigated whether the TTTAn polymorphism of the aromatase (CYP19A1) is equally linked to craving. An association between TTTAn and compulsive craving (p=0.029) was revealed in our sample of 118 male alcohol addicts at day of hospital admission. Genotype-dependent subgroups showed differences in that the patients with short alleles suffered from lower compulsive craving during withdrawal than those with the longer alleles (p=0.027). The additional inclusion of leptin revealed no further significant association in the present study. Our finding is a further step on the way to elucidate the genesis of craving for alcohol with its extensive underlying interactions of different genetic and non-genetic factors. Future investigations should enrol women and consider sex hormone levels for further clarification of the observed TTTAn-craving relationship.
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Wenzel C, Meister M, Bleich S, Hillemacher T, Choi Y, Sudraba V, Dave V, Cacciaglia R, Loche A, Corsico N, Priestley A, Loche A, Simonetti F, Cacciaglia R, Rupp CI, Kemmler G, Kurz M, Hinterhuber H, Fleischhacker WW, Wodarz N, Grundl A, Weber F, Appel S, Arnold L, Tretter F, Sudraba V, Rancans E, Dave V, Barrett SP, Kogoj D, Addolorato G, Ferrulli A, Mouzas I, Okruhlica L, Poldrugo F, Schlaff G, Zima T, Lesch O, Walter H. TREATMENT * P71 * PHARMACOLOGICAL TREATMENT STRATEGIES IN ALCOHOL DETOXIFICATION AND RELAPSE PREVENTION: RESULTS OF A NATIONAL ONLINE SURVEY. Alcohol Alcohol 2011. [DOI: 10.1093/alcalc/agr121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Eberlein CK, Buchholz V, Rhein M, Wilhelm J, Kornhuber J, de Zwaan M, Bleich S, Frieling H. How the serotonin transporter gene (SLC6A4) shapes the phenotype in eating disorders: a role for genotype and promoter methylation. PHARMACOPSYCHIATRY 2011. [DOI: 10.1055/s-0031-1292469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Bleich S, Heberlein A, Hillemacher T, Fernandez-Sola J, Brandon-Warner E, McKillop IH. S19 * ESBRA/EASL JOINT SYMPOSIUM: CURRENT THERAPY OF PATIENTS WITH ALCOHOLIC LIVER DISEASE * S19.1 * THERAPY OF ALCOHOL ADDICTION. Alcohol Alcohol 2011. [DOI: 10.1093/alcalc/agr109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wrzosek M, Lukaszkiewicz J, Jakubczyk A, Wrzosek M, Matsumoto H, Wojnar M, Lee J, Lee B, Choi M, Chai Y, Choi I, Janu L, Rackova S, Horacek J, Sanchez-Catalan M, Hipolito L, Marti-Prats L, Orrico A, Zornoza T, Granero L, Polache A, Marti-Prats L, Sanchez-Catalan M, Orrico A, Hipolito L, Zornoza T, Polache A, Granero L, Sanchez-Catalan M, Marti-Prats L, Hipolito L, Orrico A, Zornoza T, Granero L, Polache A, Milivojevic V, Kranzler HR, Covault J, Glahn A, Wenzel C, Wilhelm J, Frieling H, Heberlein A, Bleich S, Hillemacher T, Colombo G, Lobina C, Carai MAM, Gessa G, Cacciaglia R, Loche A, Kuthcer E, Egorov A, Filatova E, Kulagina K, Filatova EV, Kuther E, Kulagina K, Egorov AY, Loi B, Lobina C, Maccioni P, Carai MAM, Gessa G, Colombo G, Ledesma J, Aragon CMG, Quoilin C, Didone V, Quertemont E, Kemppainen H, Raivio N, Kiianmaa K, Pascual-Mora M, Couto BRD, Minarro J, Guerri C, Alfonso-Loeches S, Pascual-Mora M, Urena-Peralta J, Pascual-Lucas M, Morillo MJ, Renau-Piqueras J, Guerri C, Marin M, Esteban-Pretel G, Ponsoda X, Romero A, Ballestin R, Lopez C, Megias L, Timoneda J, Molowni A, Renau-Piqueras J, Escrig MA, Aragon CMG, Raivio N, Tiraboschi E, Saarikoski ST, Castren E, Kiianmaa K, Tarragon E, Balino P, Aragon CM, Camarini R, Soares SL, Carrara-Nascimento PF, Godinho RO, Scavone C, Tarragon E, Aragon CM, Balino P, Aragon CM, Kanuri G, Kreusch F, Quertement E, Closon C, Didone V, Masson S, Seutin V, Quertemont E, Durazzo TC, Fryer SL, Hutchison KE, Mon A, Meyerhoff DJ, Nummi KP, Salaspuro M, Vakevainen S, Ukai W, Shirasaka T, Hashimoto E, Yoshinaga T, Kaneta H, Kigawa M, Igarashi T, Watanabe K, Tateno M, Ishii T, Saito T, Lallemand F, Ward RJ, De Witte P, Verbank P, Fiore M, Ceccanti M, Ceccanti M. POSTER SESSION 1: BASIC RESEARCH AND INTERNAL MEDICINE * BASIC RESEARCH * P01 * ASSOCIATION BETWEEN FOK I VITAMIN D RECEPTOR (VDR) GENE POLYMORPHISM AND IMPULSIVENESS IN ALCOHOL-DEPENDENT PATIENTS. Alcohol Alcohol 2011. [DOI: 10.1093/alcalc/agr117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jerlhag E, Simms JA, Hyytia P, Bartlett SE, Zetterberg H, Engel JA, Landgren S, Weinland C, Porcu P, Morrow A, Muschler M, Lenz B, Frieling H, Kornhuber J, Hillemacher T, Bleich S. S10 * ADDICTIVE BEHAVIOUR: NEW FINDINGS FROM APPETITE REGULATING PEPTIDES, THE HYPOTHALAMUS-PITUITARY-ADRENAL AND THE -GONADAL AXIS * S10.1 * THE ROLE OF THE CENTRAL GHRELIN SYSTEM IN REWARD FROM ADDICTIVE DRUGS. Alcohol Alcohol 2011. [DOI: 10.1093/alcalc/agr100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Murray MM, Chick J, Gill J, Tsang C, Black H, Hillemacher T, Grassel E, Karagulle D, Baier D, Bleich S, Donath C, Barroso T, Barbosa A, Mendes A, Riegler AJ, Erfurth A, Kapusta N, Kogoj D, Schmid R, Walter H, Lesch OM, Jakovljevic MB, Jovanovic M, Nikic K, Radovanovic A, Pirkovic I, Dejanovic SD, Yamada T. FREE ORAL COMMUNICATIONS 1: ALCOHOL AND HEALTH * O1.1 * THE ROLE OF THE NIH IN RESPONSE TO THE GLOBAL BURDEN OF ALCOHOL AND HEALTH: OPPORTUNITIES FOR USA-EUROPEAN COLLABORATION. Alcohol Alcohol 2011. [DOI: 10.1093/alcalc/agr093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hillemacher T, Heberlein A, Muschler MAN, Bleich S, Frieling H. Opioid modulators for alcohol dependence. Expert Opin Investig Drugs 2011; 20:1073-86. [DOI: 10.1517/13543784.2011.592139] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Reichel M, Beck J, Mühle C, Rotter A, Bleich S, Gulbins E, Kornhuber J. Activity of Secretory Sphingomyelinase Is Increased in Plasma of Alcohol-Dependent Patients. Alcohol Clin Exp Res 2011; 35:1852-9. [DOI: 10.1111/j.1530-0277.2011.01529.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Biermann T, Dippel O, Bergner M, Keller J, Coffey C, Sperling W, Bleich S, Kornhuber J, Reulbach U. Assaults in the elderly--a population-based study with victim and perpetrator characteristics. J Forensic Sci 2011; 56:669-73. [PMID: 21361939 DOI: 10.1111/j.1556-4029.2011.01712.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of the present epidemiological study was to investigate characteristics of assaults in the elderly aged 65 years and above from the perspective of the victim and perpetrator. This population-based study included 23,142 assaults (according to §§ 224/226 StGB of German criminal law) that were recorded in Bavaria, Germany, from 1999 to 2005. The population-based ratio of serious crimes of battery for the elderly in comparison with the reference population was markedly lower (0.10; 95% CI: 0.09-0.11) in suspects aged more than 65 years and 0.08 (95% CI: 0.07-0.09) for the injured above 65 years. Elderly perpetrators differed significantly concerning the manner of the assault (p < 0.001). They committed less crimes in urban areas (56.1% vs. 68.8%) and were victimized significantly more in rural areas (p < 0.001; 41.2% vs. 30.2%). Violence in the elderly differs from that of the younger population. Further research is warranted to establish prevention measures.
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Hintzen AK, Cramer J, Karagülle D, Heberlein A, Frieling H, Kornhuber J, Bleich S, Hillemacher T. Does alcohol craving decrease with increasing age? Results from a cross-sectional study. J Stud Alcohol Drugs 2011; 72:158-62. [PMID: 21138722 DOI: 10.15288/jsad.2011.72.158] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Long-term studies on patients with impulsive behavior have shown a decrease of symptoms with increasing age. Alcohol craving has many analogies in psychopathology with obsessive-compulsive behavior patterns. The aim of the present study was to find evidence of a possible decrease of craving in elderly alcohol-dependent patients. METHOD One hundred ninety-eight alcohol-dependent patients at the beginning of alcohol withdrawal therapy were included in this study. The extent of craving was measured using the Obsessive Compulsive Drinking Scale on the day of hospital admission before starting the detoxification regime and 1 week after admission. RESULTS Linear regression analysis showed a significant negative association between craving and age after 1 week of treatment (no association at admission). T test for independent samples confirmed lower obsessive-compulsive craving in older patients. CONCLUSIONS The lack of association between craving and age at the beginning of the detoxification can be explained by the influence of other different (e.g., neurobiological) parameters during acute withdrawal. At the end of the physical detoxification after 1 week of treatment, a significant negative association between patient's age and Obsessive Compulsive Drinking Scale score occurred, which points to a decrease of alcohol craving in later years. Alterations in endocrinological functions or in mesolimbic neurotransmission are discussed as possible reasons for this finding.
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Wedegärtner F, Arnhold-Kerri S, Sittaro NA, Lohse R, Dietrich D, Bleich S, Geyer S. Invalidität und Tod bei Erwerbsfähigen mit Depressionen. PSYCHIATRISCHE PRAXIS 2011; 38:135-41. [DOI: 10.1055/s-0030-1265956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Heberlein A, Schuster R, Frieling H, Glahn A, Bleich S, Hillemacher T. Impact of disease concepts on attitudes towards alcohol dependent patients. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72466-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IntroductionStigmatizing attitudes regarding mentally ill people are common (Rusch et al., 2010). Study result suggest that the degree of stigmatization may depend on concepts of psychiatric diseases (Crisafulli et al., 2008).AimsWe aimed to investigate the impact of a sole neurobiological vs. a sole sociodynamic disease concept on the attitudes of students towards the alcohol dependent patients (Crisafulli et al., 2008).Methods200 students were randomly assigned to read information explaining alcohol dependence sole neurobiologically/sociodynamically. Subsequently, the students completed a series of questionnaires (adapted from Crisafulli et al. (2008)) regarding their attitudes towards the alcohol dependent patients. Attitudes were compared to attitudes of students not exposed to any disease concept.ResultsConsistent with former study results we found increased blaming and decreased willingness to finance therapy in those students exposed to the sociodynamic explanation. Attitudes regarding blaming and harmfulness of the alcohol dependent patients were increased in the neurobiological and sociodynamic group compared to the un-exposed control group.ConclusionsInformation regarding possible causalities regarding the development of alcohol dependence is associated with more negative attitudes towards alcohol dependent patients in the questioned students compared to unexposed controls. This may be reasoned by the recognition of alcohol dependence as a manifestation of mental illness and the subsequent inclusion of the alcohol dependent patients in the prejudices and acts of discrimination commonly leveled against the mentally ill. Therefore, multimodal interventions rather than medicinal information seem to be necessary in order to decrease stigmatization of the alcohol dependent patients.
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Szycik G, Ye Z, Mohammadi B, Dillo W, te Wildt B, Samii A, Frieling H, Bleich S, Münte T. Maladaptive connectivity of broca’s area in schizophrenia during audiovisual speech perception: an FMRI study. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)73216-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
IntroductionNatural speech perception relies on both, auditory and visual information. Both sensory channels provide redundant and complementary information, such that speech perception is enhanced in healthy subjects, when both information channels are present.ObjectivesPatients with schizophrenia have been reported to have problems regarding this audiovisual integration process, but little is known about which neural processes are altered.AimsIn this study we investigated functional connectivity of Broca’s area in patients with schizophrenia.MethodsFunctional magnetic resonance imaging (fMRI) was performed in 15 schizophrenia patients and 15 healthy controls to study functional connectivity of Broca’s area during perception of videos of bisyllabic German nouns, in which audio and video either matched (congruent condition) or die not match (incongruent; e.g. video = hotel, audio = island).ResultsThere were differences in connectivity between experimental groups and between conditions. Broca’s area of the patient group showed connections to more brain areas than the control group. This difference was more prominent in the incongruent condition, for which only one connection between Broca's area and the supplementary motor area was found in control participants, whereas patients showed connections to 8 widely distributed brain areas.ConclusionsThe findings imply that audiovisual integration problems in schizophrenia result from maladaptive connectivity of Broca's area in particular when confronted with incongruent stimuli and are discussed in light of recent audio visual speech models.
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Graessel E, Luttenberger K, Bleich S, Adabbo R, Donath C. Home nursing and home help for dementia patients: Predictors for utilization and expected quality from a family caregiver's point of view. Arch Gerontol Geriatr 2011; 52:233-8. [DOI: 10.1016/j.archger.2010.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 03/24/2010] [Accepted: 03/30/2010] [Indexed: 10/19/2022]
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Donath C, Grässel E, Baier D, Pfeiffer C, Karagülle D, Bleich S, Hillemacher T. Alcohol consumption and binge drinking in adolescents: comparison of different migration backgrounds and rural vs. urban residence--a representative study. BMC Public Health 2011; 11:84. [PMID: 21299841 PMCID: PMC3045949 DOI: 10.1186/1471-2458-11-84] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 02/07/2011] [Indexed: 11/15/2022] Open
Abstract
Background Binge drinking is a constant problem behavior in adolescents across Europe. Epidemiological investigations have been reported. However, epidemiological data on alcohol consumption of adolescents with different migration backgrounds are rare. Furthermore representative data on rural-urban comparison concerning alcohol consumption and binge drinking are lacking. The aims of the study are the investigation of alcohol consumption patterns with respect to a) urban-rural differences and b) differences according to migration background. Methods In the years 2007/2008, a representative written survey of N = 44,610 students in the 9th. grade of different school types in Germany was carried out (net sample). The return rate of questionnaires was 88% regarding all students whose teachers respectively school directors had agreed to participate in the study. Weighting factors were specified and used to make up for regional and school-type specific differences in return rates. 27.4% of the adolescents surveyed have a migration background, whereby the Turkish culture is the largest group followed by adolescents who emigrated from former Soviet Union states. The sample includes seven large cities (over 500,000 inhabitants) (12.2%), independent smaller cities ("urban districts") (19.0%) and rural areas ("rural districts") (68.8%). Results Life-time prevalence for alcohol consumption differs significantly between rural (93.7%) and urban areas (86.6% large cities; 89.1% smaller cities) with a higher prevalence in rural areas. The same accounts for 12-month prevalence for alcohol consumption. 57.3% of the rural, re-spectively 45.9% of the urban adolescents engaged in binge drinking in the 4 weeks prior to the survey. Students with migration background of the former Soviet Union showed mainly drinking behavior similar to that of German adolescents. Adolescents with Turkish roots had engaged in binge drinking in the last four weeks less frequently than adolescents of German descent (23.6% vs. 57.4%). However, in those adolescents who consumed alcohol in the last 4 weeks, binge drinking is very prominent across the cultural backgrounds. Conclusions Binge drinking is a common problem behavior in German adolescents. Obviously adolescents with rural residence have fewer alternatives for engaging in interesting leisure activities than adolescents living in cities. This might be one reason for the more problematic consumption patterns there. Common expectations concerning drinking behavior of adolescents of certain cultural backgrounds ('migrants with Russian background drink more'/'migrants from Arabic respectively Oriental-Islamic countries drink less') are only partly affirmed. Possibly, the degree of acculturation to the permissive German alcohol culture plays a role here.
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Mueller A, Mitchell JE, Crosby RD, Gefeller O, Faber RJ, Martin A, Bleich S, Glaesmer H, Exner C, de Zwaan M. Estimated prevalence of compulsive buying in Germany and its association with sociodemographic characteristics and depressive symptoms. Psychiatry Res 2010; 180:137-42. [PMID: 20494451 DOI: 10.1016/j.psychres.2009.12.001] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 12/07/2009] [Accepted: 12/09/2009] [Indexed: 10/19/2022]
Abstract
The aim of this study was to estimate the prevalence of compulsive buying and its association with sociodemographic characteristics and depressive symptoms in a nationally representative sample of the German population using the validated German version of the Compulsive Buying Scale (CBS; Faber and O'Guinn, 1992) in order to have a direct comparison with U.S. findings. The point prevalence of compulsive buying in the weighted representative sample (N=2,350) was estimated to be 6.9%. This was somewhat higher than the percentage in the American sample assessed in 2004 (5.8%). No significant difference was found between women and men (6.9% and 6.8%, respectively). Age was inversely related to the prevalence of compulsive buying. Individuals with compulsive buying reported more depressive symptoms assessed via the German version of the Brief Patient Health Questionnaire Mood Scale (PHQ-9). Further research on this topic is needed to establish a clearer delineation of when excessive buying is clinically significant and should be treated and how it could be prevented.
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Lenz B, Heberlein A, Weinland C, Frieling H, Kornhuber J, Bleich S, Hillemacher T. Androgen Receptor Polyglutamine Length Does Not Influence Serum Levels of Adipocytokines in Alcoholism: A Preliminary Retrospective Analysis. Alcohol Alcohol 2010; 46:214-6. [DOI: 10.1093/alcalc/agq090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wilhelm J, Heberlein A, Karagülle D, Gröschl M, Kornhuber J, Riera R, Frieling H, Bleich S, Hillemacher T. Prolactin Serum Levels During Alcohol Withdrawal Are Associated With the Severity of Alcohol Dependence and Withdrawal Symptoms. Alcohol Clin Exp Res 2010; 35:235-9. [DOI: 10.1111/j.1530-0277.2010.01339.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wedegaertner F, al-Warith H, Hillemacher T, te Wildt B, Schneider U, Bleich S, Breitmeier D. Motives for khat use and abstinence in Yemen--a gender perspective. BMC Public Health 2010; 10:735. [PMID: 21110889 PMCID: PMC3006386 DOI: 10.1186/1471-2458-10-735] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 11/27/2010] [Indexed: 11/10/2022] Open
Abstract
Background Khat consumption is widespread in Yemeni society and causes problems both in economic development and public health. Preventive measures have been largely unsuccessful and the cultivation continues to proliferate. The gender-specific motives for khat use and abstinence were studied to create a toe-hold for more specific interventions. Methods In a quota sample with equal numbers of males, females, abstainers and consumers, 320 subjects were interviewed on their specific opinions about khat and its impact on subjective and public health, and on social and community functioning. Strata were compared in their acceptance and denial of opinions. Notions that could predict abstinence status or gender were identified with multivariate logistic regression analysis. Results Male khat users had a strong identification with khat use, while females were more ambivalent. The notion that khat consumption is a bad habit (odds ratio (OR) 3.4; p < 0.001) and consumers are malnuorished (OR 2.2; p = 0.046) were associated with female gender among khat users. Among the females worries about health impact (OR 3.2; p = 0.040) and loss of esteem in the family (OR 3.1; p = 0.048) when using khat predicted abstinence. Male abstainers opposed khat users in the belief that khat is the cause of social problems (OR 5.1, p < 0.001). Logistic regression reached an accuracy of 75 and 73% for the prediction of abstinence and 71% for gender among consumers. (All models p < 0.001.) Conclusions Distinct beliefs allow a differentiation between males, females, khat users and abstainers when targeting preventive measures. In accordance to their specific values female khat users are most ambivalent towards their habit. Positive opinions scored lower than expected in the consumers. This finding creates a strong toe-hold for gender-specific public health interventions.
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Kahl KG, Greggersen W, Schweiger U, Cordes J, Correll CU, Ristow J, Burow J, Findel C, Stoll A, Balijepalli C, Göres L, Lösch C, Hillemacher T, Bleich S, Moebus S. Prevalence of the metabolic syndrome in men and women with alcohol dependence: results from a cross-sectional study during behavioural treatment in a controlled environment. Addiction 2010; 105:1921-7. [PMID: 20735365 DOI: 10.1111/j.1360-0443.2010.03059.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS Prevalence of metabolic syndrome (MetS) in men and women who use alcohol has been inconsistent in the literature. The aim of this study is to compare the prevalence of MetS in patients with a diagnosis of alcohol dependence who are currently abstinent in a controlled environment, and in control subjects followed in primary care from a similar region in Northern Germany. DESIGN Cross-sectional study. SETTING In-patient cognitive behavioural therapy. PARTICIPANTS One hundred and ninety-seven men and women with alcohol dependence during behavioural treatment in a controlled environment were compared to 1158 subjects from primary care from a similar region in northern Germany. MEASUREMENTS We used the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHBLI) criteria to determine the rate of MetS and each single criterion of MetS in both groups. FINDINGS The prevalence of MetS was almost twice as high in men and women with alcohol dependence compared to control subjects (30.6% versus 17.0%). With respect to the single criteria, elevations were found for fasting glucose and blood pressure in both genders and for triglycerides in women only. High density lipoprotein (HDL)-cholesterol was higher in men and women with alcohol dependence. CONCLUSIONS Our results demonstrate an increased rate of MetS, increased blood pressure and dysregulation of glucose and lipid metabolism in alcohol-dependent patients. Whether high HDL-cholesterol has cardioprotective effects in this context remain doubtful.
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Frieling H, Römer KD, Scholz S, Mittelbach F, Wilhelm J, De Zwaan M, Jacoby GE, Kornhuber J, Hillemacher T, Bleich S. Epigenetic dysregulation of dopaminergic genes in eating disorders. Int J Eat Disord 2010; 43:577-83. [PMID: 19728374 DOI: 10.1002/eat.20745] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The pathophysiology of eating disorders such as anorexia nervosa (AN) and bulimia nervosa (BN) has been linked to an impaired dopaminergic neurotransmission, still the origin of this disturbance remains unknown. The aim of the present study was, therefore, to evaluate whether the expression of dopaminergic genes is altered in the blood of patients suffering from eating disorders and if these alterations can be explained by changes in the promoter specific DNA methylation of the genes. METHOD We used quantitative real-time PCR to measure both the expression and the promoter specific DNA methylation of the dopamine transporter (DAT), and the D2 (DRD2) and D4 receptor (DRD4) gene in the blood of 46 patients (22 AN, 24 BN) and 30 healthy controls. RESULTS Patients showed an elevated expression of DAT mRNA when compared with the controls and a downregulation of the DRD₂ expression. The upregulation of the DAT gene was accompanied by a hypermethylation of the gene's promoter in the AN and BN group while a significant hypermethylation of the DRD₂ promoter was only present in the AN group. No differences in expression or methylation were found for the other dopamine receptors investigated. DISCUSSION Our study shows a disturbed expression of dopaminergic genes that is accompanied by a dysregulation of the epigenetic DNA methylation. Further studies are necessary to provide more insight into the epigenetic dysregulation of the dopaminergic neurotransmission in the pathophysiology of eating disorders.
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Schroeder M, Krebs MO, Bleich S, Frieling H. Epigenetics and depression: current challenges and new therapeutic options. Curr Opin Psychiatry 2010; 23:588-92. [PMID: 20644477 DOI: 10.1097/yco.0b013e32833d16c1] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Epigenetics comprises heritable but concurrent variable modifications of genomic DNA defining gene expression. The aim of this publication is to review the field of epigenetics in depression. Within this scope, we outline potential therapeutic options evolving in this young field of psychiatric research. RECENT FINDINGS Recently published papers show that epigenetic mechanisms like histone modifications and DNA methylation affect diverse pathways leading to depression-like behaviors in animal models. Adverse alterations of gene expression profiles, including glucocorticoid receptor or brain-derived neurotrophic factor, were shown to be inducible by early life stress and reversible by epigenetic drugs. Postmortem studies revealed epigenetic changes in the frontal cortex of depressed suicide victims. There exists profound evidence for histone deacetylase inhibitors to be a novel line of effective antidepressants via counteracting previously acquired adverse epigenetic marks. SUMMARY Because of the complex causal factors leading to depression, epigenetics is of considerable interest for the understanding of early life stress in depression. The current research regarding epigenetic pharmaceuticals is promising and deserves further attention in depression and psychiatry in general, and may strike out new ways towards individually tailored therapies.
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Ehrlich S, Weiss D, Burghardt R, Infante-Duarte C, Brockhaus S, Muschler MA, Bleich S, Lehmkuhl U, Frieling H. Promoter specific DNA methylation and gene expression of POMC in acutely underweight and recovered patients with anorexia nervosa. J Psychiatr Res 2010; 44:827-33. [PMID: 20176366 DOI: 10.1016/j.jpsychires.2010.01.011] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2009] [Revised: 01/08/2010] [Accepted: 01/26/2010] [Indexed: 12/01/2022]
Abstract
Proopiomelanocortin (POMC) and its derived peptides, in particular alpha-MSH, have been shown to play a crucial role in the regulation of hunger, satiety and energy homeostasis. Studies in patients with anorexia nervosa (AN) suggest an abnormal expression of appetite-regulating hormones. Hormone expression levels may be modulated by epigenetic mechanisms, which were recently shown to be implicated in the pathophysiology of eating disorders. We hypothesised that POMC promoter specific DNA methylation and gene expression will be affected by malnutrition and therefore differ in AN patients at distinct stages of the disorder. Promoter specific DNA methylation of the POMC gene and expression of POMC mRNA variants were determined in peripheral blood mononuclear cells (PBMC) of 30 healthy control women (HCW), 31 underweight (acAN) and 30 weight-recovered patients with AN (recAN). Malnutrition was characterized by plasma leptin. Expression of the functionally relevant long POMC mRNA transcript was significantly correlated with leptin levels and higher in acAN compared to recAN and HCW. Expression of the truncated form and mean promoter DNA methylation was similar in all three subgroups. Methylation of single CpG residues in the E2F binding site was inversely related to POMC expression. Our preliminary data on pattern of POMC regulation suggests an association with the underweight state rather than with persisting trait markers of AN. In contrast to POMC expression in the central nervous system, peripheral POMC mRNA expression decreased with malnutrition and hypoleptinemia. This may represent a counterregulatory mechanism as part of the crosstalk between the immune and neuroendocrine systems.
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