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Abstract
ZusammenfassungHintergrund: Das übergeordnete Ziel der Erstellung einer S3-Leitlinie zur Diagnostik und Therapie bipolarer Störungen war es, die Versorgung bipolarer Patienten in Deutschland auf einem qualitativ hohen Niveau zu gestalten. Um den aktuellen Versorgungszustand vor Einführung der Leitlinie abbilden und Verbesserungspotenziale aufdecken zu können, wurde eine Befragung von Mitgliedern der beiden die Leitlinie erarbeitenden Gesellschaften durchgeführt. Methoden: Die Befragung wurde von September 2009 bis Februar 2010 mittels Fragebogen durchgeführt. Die meisten Fragen wurden eigens für die Erhebung konzipiert, zusätzlich wurden validierte Instrumente zur Erhebung der aktuellen Stimmungslage und Einschätzung der Lebensqualität verwandt. Ergebnisse: Die Rücklaufquote betrug 40%. Die Dauer vom Auftreten der ersten Symptome bis zur korrekten Diagnosestellung war mit zwölf Jahren, bzw. mit fast neun Jahren bei Patienten mit Diagnosestellung innerhalb der letzten 15 Jahre, sehr lang. Die Mehrheit der befragten Patienten wird regelmäßig im Verlauf von ihrem Arzt betreut. Die Ergebnisse zur Einschätzung der Zufriedenheit mit der Behandlung und Lebensqualität zeigen Verbesserungspotenzial. Schlussfolgerungen: Aus den Ergebnissen geht hervor, dass ein hohes Maß an Engagement der Betroffenen erforderlich war, um eine adäquate Versorgung zu organisieren. Und es zeigten sich in dieser Kohorte weitere Verbesserungspotenziale, die bei „durchschnittlichen” Patienten wahrscheinlich noch größer sind. Für eine Versorgung bipolarer Patienten in Deutschland auf einem qualitativ hohen Niveau müssen vielfältige Initiativen gestärkt werden, wie die Umsetzung entsprechender Leitlinien, die Unterstützung der Patienten bei der Entwicklung einer hohen Selbstkompetenz und der Aktivitäten von Patienten- und Angehörigenorganisationen sowie bei der Realisierung zeitgemäßer Versorgungsmodelle.
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Sommer C, Garbusow M, Jünger E, Pooseh S, Bernhardt N, Birkenstock J, Schad DJ, Jabs B, Glöckler T, Huys QM, Heinz A, Smolka MN, Zimmermann US. Strong seduction: impulsivity and the impact of contextual cues on instrumental behavior in alcohol dependence. Transl Psychiatry 2017; 7:e1183. [PMID: 28763064 PMCID: PMC5611726 DOI: 10.1038/tp.2017.158] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 06/13/2017] [Indexed: 11/16/2022] Open
Abstract
Alcohol-related cues acquire incentive salience through Pavlovian conditioning and then can markedly affect instrumental behavior of alcohol-dependent patients to promote relapse. However, it is unclear whether similar effects occur with alcohol-unrelated cues. We tested 116 early-abstinent alcohol-dependent patients and 91 healthy controls who completed a delay discounting task to assess choice impulsivity, and a Pavlovian-to-instrumental transfer (PIT) paradigm employing both alcohol-unrelated and alcohol-related stimuli. To modify instrumental choice behavior, we tiled the background of the computer screen either with conditioned stimuli (CS) previously generated by pairing abstract pictures with pictures indicating monetary gains or losses, or with pictures displaying alcohol or water beverages. CS paired to money gains and losses affected instrumental choices differently. This PIT effect was significantly more pronounced in patients compared to controls, and the group difference was mainly driven by highly impulsive patients. The PIT effect was particularly strong in trials in which the instrumental stimulus required inhibition of instrumental response behavior and the background CS was associated to monetary gains. Under that condition, patients performed inappropriate approach behavior, contrary to their previously formed behavioral intention. Surprisingly, the effect of alcohol and water pictures as background stimuli resembled that of aversive and appetitive CS, respectively. These findings suggest that positively valenced background CS can provoke dysfunctional instrumental approach behavior in impulsive alcohol-dependent patients. Consequently, in real life they might be easily seduced by environmental cues to engage in actions thwarting their long-term goals. Such behaviors may include, but are not limited to, approaching alcohol.
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Affiliation(s)
- C Sommer
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - M Garbusow
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - E Jünger
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - S Pooseh
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - N Bernhardt
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - J Birkenstock
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - D J Schad
- Social and Preventive Medicine, Area of Excellence Cognitive Sciences, University of Potsdam, Potsdam, Germany
| | - B Jabs
- Department of Psychiatry and Psychotherapy, Zentrum für Psychische Gesundheit Weißer Hirsch, Dresden, Germany
| | - T Glöckler
- Department of Psychiatry and Psychotherapy, Zentrum für Psychische Gesundheit Weißer Hirsch, Dresden, Germany
| | - Q M Huys
- Translational Neuromodeling Unit, Hospital of Psychiatry, University of Zürich and Swiss Federal Institute of Technology, Zürich, Switzerland,Psychiatry, Psychosomatics and Psychotherapy, University of Zürich, Zürich, Switzerland
| | - A Heinz
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - M N Smolka
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - U S Zimmermann
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany,Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Fetscherstraße 74, Dresden 01307, Germany. E-mail:
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Lewitzka U, Jabs B, Fülle M, Holthoff V, Juckel G, Uhl I, Kittel-Schneider S, Reif A, Reif-Leonhard C, Gruber O, Djawid B, Goodday S, Haussmann R, Pfennig A, Ritter P, Conell J, Severus E, Bauer M. Does lithium reduce acute suicidal ideation and behavior? A protocol for a randomized, placebo-controlled multicenter trial of lithium plus Treatment As Usual (TAU) in patients with suicidal major depressive episode. BMC Psychiatry 2015; 15:117. [PMID: 25986590 PMCID: PMC4458032 DOI: 10.1186/s12888-015-0499-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 05/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lithium has proven suicide preventing effects in the long-term treatment of patients with affective disorders. Clinical evidence from case reports indicate that this effect may occur early on at the beginning of lithium treatment. The impact of lithium treatment on acute suicidal thoughts and/or behavior has not been systematically studied in a controlled trial. The primary objective of this confirmatory study is to determine the association between lithium therapy and acute suicidal ideation and/or suicidal behavior in inpatients with a major depressive episode (MDE, unipolar and bipolar disorder according to DSM IV criteria). The specific aim is to test the hypothesis that lithium plus treatment as usual (TAU), compared to placebo plus TAU, results in a significantly greater decrease in suicidal ideation and/or behavior over 5 weeks in inpatients with MDE. METHODS/DESIGN We initiated a randomized, placebo-controlled multicenter trial. Patients with the diagnosis of a moderate to severe depressive episode and suicidal thoughts and/or suicidal behavior measured with the Sheehan-Suicidality-Tracking Scale (S-STS) will be randomly allocated to add lithium or placebo to their treatment as usual. Change in the clinician administered S-STS from the initial to the final visit will be the primary outcome. DISCUSSION There is an urgent need to identify treatments that will acutely decrease suicidal ideation and/or suicidal behavior. The results of this study will demonstrate whether lithium reduces suicidal ideation and behavior within the first 5 weeks of treatment. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02039479.
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Affiliation(s)
- U. Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Dresden, D-01307 Germany
| | - B. Jabs
- Psychiatric Department of the Municipal Hospital Dresden-Neustadt, Dresden, Germany
| | - M. Fülle
- Psychiatric Department of the Municipal Hospital Dresden-Neustadt, Dresden, Germany
| | - V. Holthoff
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Alexianer Krankenhaus Hedwigshöhe, Berlin, Germany
| | - G. Juckel
- Department of Psychiatry, Psychotherapy, Prevention Medicine, LWL-University Clinic Bochum, Ruhr University Bochum, Bochum, Germany
| | - I. Uhl
- Department of Psychiatry, Psychotherapy, Prevention Medicine, LWL-University Clinic Bochum, Ruhr University Bochum, Bochum, Germany
| | - S. Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-Universit, Frankfurt, Germany
| | - A. Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-Universit, Frankfurt, Germany
| | - C. Reif-Leonhard
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-Universit, Frankfurt, Germany
| | - O. Gruber
- Center for Translational Research in Systems Neuroscience and Psychiatry, Clinic for Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - B. Djawid
- Coordination Centre for Clinical, Trials (KKS) Dresden, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden
, Germany
| | - S. Goodday
- Department of Epidemiology Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - R. Haussmann
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Dresden, D-01307 Germany
| | - A. Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Dresden, D-01307 Germany
| | - P. Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Dresden, D-01307 Germany
| | - J. Conell
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Dresden, D-01307 Germany
| | - E. Severus
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Dresden, D-01307 Germany
| | - M. Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Dresden, D-01307 Germany
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Unterecker S, Hiemke C, Greiner C, Haen E, Jabs B, Deckert J, Pfuhlmann B. The effect of age, sex, smoking and co-medication on serum levels of venlafaxine and O-desmethylvenlafaxine under naturalistic conditions. Pharmacopsychiatry 2012; 45:229-35. [PMID: 22426847 DOI: 10.1055/s-0031-1301366] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Venlafaxine (VEN) is a modern antidepressant which exerts both serotonin and norepinephrine reuptake inhibition. In this study we examined the influence of age, sex, smoking, and co-medication on serum levels of VEN and its metabolite O-desmethylvenlafaxine (ODVEN) in patients treated with VEN under naturalistic conditions. METHODS We retrospectively evaluated 478 TDM analyses of VEN requested in the Pychiatric University Hospitals of Mainz, Regensburg, and Würzburg. The determination of serum levels was performed by virtually identical chromatographic methods in the TDM laboratories of the participating hospitals. RESULTS Serum levels varied widely on each dose level. Women had about 30% higher dose-corrected serum levels of VEN and ODVEN than men (p<0.01), and patients older than 60 years showed about 46% higher levels of both compounds than younger ones (p<0.01). In smokers, mean serum levels of ODVEN were 21% lower than in non-smokers. Combining these variables a considerable increase of the differences between the subgroups was found indicating an additive effect. ANOVA over the 8 different groups was significant for ODVEN (p<0.01) and sum (p<0.01), but not for VEN (n.s.). Co-medication with other psychotropic drugs was associated with a decreasing ODVEN/VEN ratio indicating a reduced metabolism in patients receiving polypharmacy. DISCUSSION These findings show that TDM is useful to identify factors affecting the pharmacokinetic properties of VEN. It is concluded that sex, age and smoking should be considered for optimal dosing of patients with VEN.
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Affiliation(s)
- S Unterecker
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
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Unterecker S, Pfuhlmann B, Hiemke C, Greiner C, Haen E, Jabs B, Kruggel-Bachmann S, Deckert J. Additive effects of sex, age and smoking on serum levels of venlafaxine and O-desmethylvenlafaxine under naturalistic conditions. Pharmacopsychiatry 2011. [DOI: 10.1055/s-0031-1292304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Pfuhlmann B, Hiemke C, Unterecker S, Burger R, Riederer P, Deckert J, Jabs B. The influence of inflammatory reactions on the serum concentration of clozapine. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zwanzger P, Diemer J, Jabs B. Comparison of combined psycho- and pharmacotherapy with monotherapy in anxiety disorders: controversial viewpoints and clinical perspectives. J Neural Transm (Vienna) 2008; 116:759-65. [PMID: 18810307 DOI: 10.1007/s00702-008-0116-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Accepted: 08/20/2008] [Indexed: 11/26/2022]
Abstract
Anxiety disorders are among the most frequent psychiatric disorders. Experimental evidence supports both psychotherapy as well as pharmacotherapy as effective treatments. There is, however, a controversy concerning the efficacy of a combination of both approaches. While some studies suggest that combined treatment enhances efficacy, others report conflicting results. This article traces the positions in this debate. We present the results from two recent meta-analyses and discuss implications for clinical practice and further research. We suggest that a research strategy that strives to establish differential indications based on patient characteristics should be preferred over attempts to reach a global judgement of the question, which appears too simplistic given the complexity of the issue.
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Affiliation(s)
- P Zwanzger
- Department of Psychiatry and Psychotherapy, University of Munster, Albert-Schweitzer-Strasse 11, 49149 Munster, Germany.
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Abstract
The phenomenon of folie à deux has been a topical issue in psychiatry for more than a century. Mainly, genetic and psychodynamic factors are discussed controversially in terms of their relevance to the etiology of folie à deux. In this paper, effort is taken to reconceive the topic applying the criteria of a differentiated psychopathological classification. Based on the literature and on two own cases, we try to elaborate characteristical psychopathological features of folie à deux patients. We hypothesize that at least a substantial fraction could be classified as "folie simultanée" when Leonhard's criteria of the affect-laden paraphrenia are considered.
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Affiliation(s)
- B Jabs
- Klinik und Poliklinik für Psychiatrie und Psychotherapie der Universität Würzburg (Direktor: Prof. Dr. J. Deckert)
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Pfuhlmann B, Gerlach M, Burger R, Gonska S, Unterecker S, Jabs B, Riederer P, Deckert J. Therapeutic drug monitoring of tricyclic antidepressants in everyday clinical practice. J Neural Transm Suppl 2007:287-296. [PMID: 17982905 DOI: 10.1007/978-3-211-73574-9_35] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Data about therapeutic drug monitoring (TDM) of psychotropic medications are often obtained from samples of highly selected individuals, who may not be representative for the average psychiatric patient. These data therefore may have limitations with regard to their transferability to everyday clinical practice. Therefore studies under naturalistic conditions are important to clarify the full clinical relevance of TDM. We retrospectively evaluated all TDM-analyses of the tricyclic antidepressants (TCA) amitriptyline and clomipramine during a 12-month period in an unselected sample of patients in a standard clinical setting. We especially examined the relationship between serum levels on one hand and clinical response and adverse effects on the other hand. In patients with amitriptyline, responders showed a significantly higher serum level than non-responders, whereas in patients with clomipramine a serum level within the recommended therapeutic range was associated with clinical response. We also found significantly higher serum concentrations in patients with adverse effects compared to patients without adverse effects in the clomipramine group. No such relationship could be shown in patients treated with amitriptyline. Our results suggest that therapeutic ranges in naturalistic settings in some ways differ from those obtained in controlled clinical settings and that TDM studies in everyday clinical practice are necessary and beneficial.
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Affiliation(s)
- B Pfuhlmann
- Department of Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany.
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Jabs B, Althaus G, Bartsch A, Schmidtke A, Stöber G, Beckmann H, Pfuhlmann B. Sind zykloide Psychosen atypische manisch-depressive Erkrankungen? Nervenarzt 2006; 77:1096-100, 1102-4. [PMID: 16502008 DOI: 10.1007/s00115-006-2077-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Whereas a growing body of evidence suggests that cycloid psychoses have to be separated from schizophrenic psychoses, their relations to bipolar affective disorder are less clear. PATIENTS AND METHODS In a controlled family study, we recruited 46 patients with cycloid psychosis (CP), 33 with manic-depressive illness (MDI), and 27 controls. Three hundred fifty-six of 389 living first-degree relatives were personally examined by experienced psychiatrists blinded to the diagnosis of the index proband. RESULTS The relatives of CP patients showed significantly lower morbidity risk of functional psychoses than relatives of patients with MDI in Kaplan-Meier life table calculation. The morbidity risk for functional psychoses in relatives of patients with CP did not differ significantly from that in relatives of controls. CONCLUSION These results suggest that CP are etiologically different from bipolar affective psychoses and cannot be integrated into the spectrum of bipolar affective disorders. The findings provide further evidence for a nosological independence of CP.
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Affiliation(s)
- B Jabs
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany.
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Pfuhlmann B, Jabs B, Althaus G, Schmidtke A, Bartsch A, Stöber G, Beckmann H, Franzek E. Cycloid psychoses are not part of a bipolar affective spectrum: results of a controlled family study. J Affect Disord 2004; 83:11-9. [PMID: 15546641 DOI: 10.1016/j.jad.2004.03.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2004] [Revised: 03/17/2004] [Accepted: 03/19/2004] [Indexed: 11/28/2022]
Abstract
BACKGROUND Whereas a growing body of evidence suggests that cycloid psychoses have to be separated from schizophrenic psychoses, their relations to bipolar affective disorder are less clear. To further clarify this issue a controlled family study was undertaken. METHODS All living and traceable adult first-degree relatives of 45 cycloid psychotic, 32 manic-depressive and 27 control probands were personally examined by an experienced psychiatrist blind to the diagnosis of the index proband. Data about not traceable relatives were collected by the "Family-History"-Method. A catamnestic diagnosis was established for each of the 431 relatives blind to family data. Age-corrected morbidity risks were calculated using the life-table method. RESULTS Relatives of cycloid psychotic patients showed a significantly lower morbidity risk for endogenous psychoses in general and manic-depressive illness compared to relatives of patients with manic-depressive illness. The familial morbidity risk for cycloid psychoses was low and did not differ significantly in both proband groups. Relatives of cycloid psychotic patients however did not differ significantly from relatives of controls regarding familial morbidity. LIMITATIONS Our time-consuming methodical procedure implicated a relatively small number of participants due to restricted personnel resources. The restriction to hospitalised probands could possibly cause a limited representativity of the study sample. CONCLUSIONS Our results suggest that cycloid psychoses are aetiologically different from manic-depressive illness and could not be integrated into a spectrum of bipolar affective disorders. The findings provide further evidence for a nosological independence of cycloid psychoses.
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Affiliation(s)
- B Pfuhlmann
- Department of Psychiatry and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, D-97080 Wuerzburg, Germany.
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Jabs B, Krause U, Althaus G, Stöber G, Pfuhlmann B. [Comparative study of life quality in patients with cycloid and schizophrenic psychoses]. Nervenarzt 2004; 75:460-6. [PMID: 15252886 DOI: 10.1007/s00115-003-1591-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cycloid psychoses represent a nosological entity not adequately recognised by contemporary psychiatry. They show full recovery after each episode and thus have a favourable prognosis. METHODS Course, psychiatric status, social function, and quality of life (QoL) of 33 patients with cycloid psychosis and 44 schizophrenics were compared (CGI, PANSS, GAF, Strauss-Carpenter,WHOQOL-BREF).Also, 48 controls were asked to rate their QoL. RESULTS The schizophrenics developed symptoms earlier in life (P=0.009) and were hospitalized longer (P=0.001) and more frequently(P=0.01) than patients with cycloid psychosis. The latter showed better scores in the applied scales (P<0.0001). In QoL measures, cycloid psychotic patients were more satisfied than schizophrenic patients in three of four domains(P<0.01). Only in one domain did they differ from controls (P<0.01). CONCLUSION Cycloid psychoses display better course, outcome, and QoL than schizophrenia.Thus, they appear to present a useful concept deserving more clinical and scientific attention.
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Affiliation(s)
- B Jabs
- Klinik für Psychiatrie und Psychotherapie, Universität Würzburg, Würzburg.
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Jabs B, Pfuhlmann B, Beckmann H. ["Accentuated disposition"--rediscovery of an important concept in personality psychology]. Nervenarzt 2002; 73:690. [PMID: 12212534 DOI: 10.1007/s00115-002-1349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Berg D, Jabs B, Merschdorf U, Beckmann H, Becker G. Echogenicity of substantia nigra determined by transcranial ultrasound correlates with severity of parkinsonian symptoms induced by neuroleptic therapy. Biol Psychiatry 2001; 50:463-7. [PMID: 11566164 DOI: 10.1016/s0006-3223(01)01190-8] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Increased echogenicity of the substantia nigra (SN) detected by transcranial sonography is a characteristic ultrasound feature of Parkinson's disease. This ultrasound feature can also be detected in a subgroup of healthy adults. In recent studies, healthy subjects with this ultrasound feature showed a reduced [(18)F]-Dopa uptake on positron emission tomography (PET), indicating a subclinical alteration of the nigrostriatal system. This study was designed to evaluate whether the severity of neuroleptic side effects is related to the echo-feature of the SN. METHODS In the retrospective part of the study, 93 psychiatric patients with either definite and severe parkinsonism after neuroleptic treatment (n = 52) or with no or minimal parkinsonian symptoms (n = 41) were included and underwent transcranial sonography to measure the extension of hyperechogenic areas at the SN. In addition, in the prospective part 11 patients with an acute psychotic episode requiring first-ever neuroleptic treatment underwent ultrasound examination. Subsequently, neuroleptic-induced parkinsonian signs were assessed prospectively. RESULTS In the retrospective part of the study, patients with severe neuroleptic-induced parkinsonism had more extended echogenic signals at the SN than those with low echogenic SN (U-test; p <.01). The prospective part of the study showed that the severity of parkinsonian symptoms correlated with the echogenicity of the substantia nigra (Spearman's rank: p <.01). CONCLUSIONS Increased echogenicity of the substantia nigra is associated with impaired function of the nigrostriatal system that can be disclosed by neuroleptic drugs.
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Affiliation(s)
- D Berg
- Department of Neurology, Bayerische Julius-Maximilians-Universität, Würzburg, Germany
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Neumärker KJ, Greil H, Brümmerhoff A, Bzufka MW, Dudeck U, Neumärker U, Rohde W, Fallgatter AJ, Jabs B, Pfuhlmann B, Bartsch AJ. [Somatotype-specific anthropometry and eating disorders]. Z Kinder Jugendpsychiatr Psychother 2001; 29:239-42. [PMID: 11524900 DOI: 10.1024/1422-4917.29.3.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- K J Neumärker
- Universitätsklinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Universitätsklinikum Charité, Campus Mitte, Medizinische Fakultät, Humboldt-Universität zu Berlin, Würzburg.
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Neumärker KJ, Greil H, Brümmerhoff A, Bzufka M, Dudeck U, Neumärker U, Rohde W, Fallgatter A, Jabs B, Pfuhlmann B, Bartsch A. Somatotypspezifische Anthropometrie und Essstörungen. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie 2001. [DOI: 10.1024//1422-4917.29.3.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- K.-J. Neumärker
- Universitätsklinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters (Direktor: Prof. Dr. K.-J. Neumärker), Universitätsklinikum Charité, Campus Mitte, Medizinische Fakultät der Humboldt-Universität zu Berlin, Germany
| | - H. Greil
- Fachgebiet Humanbiologie, Universität Potsdam (Leitung: Prof. Dr. H. Greil), Germany
| | - A. Brümmerhoff
- Universitätsklinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters (Direktor: Prof. Dr. K.-J. Neumärker), Universitätsklinikum Charité, Campus Mitte, Medizinische Fakultät der Humboldt-Universität zu Berlin, Germany
| | - M.W. Bzufka
- Universitätsklinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters (Direktor: Prof. Dr. K.-J. Neumärker), Universitätsklinikum Charité, Campus Mitte, Medizinische Fakultät der Humboldt-Universität zu Berlin, Germany
| | - U. Dudeck
- Universitätsklinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters (Direktor: Prof. Dr. K.-J. Neumärker), Universitätsklinikum Charité, Campus Mitte, Medizinische Fakultät der Humboldt-Universität zu Berlin, Germany
| | - U. Neumärker
- Universitätsklinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters (Direktor: Prof. Dr. K.-J. Neumärker), Universitätsklinikum Charité, Campus Mitte, Medizinische Fakultät der Humboldt-Universität zu Berlin, Germany
| | - W. Rohde
- Institut für Experimentelle Endokrinologie (Direktor: Prof. Dr. W. Rohde), Universitätsklinikum Charité, Campus Mitte, Medizinische Fakultät der Humboldt-Universität zu Berlin, Germany
| | - A.J. Fallgatter
- Klinik für Psychiatrie und Psychotherapie (Direktor: Prof. Dr. Dr. h.c. H. Beckmann), Bayerische Julius-Maximilians-Universität, Würzburg, Germany
| | - B. Jabs
- Klinik für Psychiatrie und Psychotherapie (Direktor: Prof. Dr. Dr. h.c. H. Beckmann), Bayerische Julius-Maximilians-Universität, Würzburg, Germany
| | - B. Pfuhlmann
- Klinik für Psychiatrie und Psychotherapie (Direktor: Prof. Dr. Dr. h.c. H. Beckmann), Bayerische Julius-Maximilians-Universität, Würzburg, Germany
| | - A.J. Bartsch
- Klinik für Psychiatrie und Psychotherapie (Direktor: Prof. Dr. Dr. h.c. H. Beckmann), Bayerische Julius-Maximilians-Universität, Würzburg, Germany
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Jabs B, Berg D, Merschdorf U, Pfuhlmann B, Bartsch A, Toyka K, Beckmann H, Becker G. P02.360 Differences in echogenicity of substantia nigra in patients with different subtypes of the schizophrenic spectrum. Eur Psychiatry 2000. [DOI: 10.1016/s0924-9338(00)94767-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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