Individual day-to-day variations in plasma amino acid levels in healthy persons

Fasting plasma levels of the large neutral amino acids (LNAA;L-forms) andL-tryptophan (TRP) ratios were determined in thirteen healthy volunteers (7 males, 6 females) on five consecutive mornings, and the same procedure was repeated for each individual three months later. We found characteristic overall ranges for the parameters studied, and, in addition to certain differences between the sexes, considerable inter- and intraindividual daily variations. Although the individuals showed statistically identifiable mean levels that, in the majority of subjects, were maintained over a period of three months, it is concluded that the degree of intraindividual variability does not allow us to regard a single value as "characteristic" for a given individual. This should be borne in mind in particular in follow-up studies of plasma LNAA in patients with, for example, depressive disorders.

A survey on psychiatric patients' use of non-medical alternative practitioners: incidence, methods, estimation, and satisfaction

OBJECTIVES

We investigated to what extent psychiatric inpatients consult Heilpraktiker, i.e. non-academically trained providers of complementary and alternative medicine (CAM), which diagnostic and therapeutic methods Heilpraktiker employ, how patients assess Heilpraictikers' professional competence, CAM in general and issues of satisfaction for those who have had experience with Heilpraktiker.

DESIGN

Four hundred and seventy three patients admitted to a psychiatric university department during a 9-month period filled out a questionnaire developed for this investigation.

RESULTS

About one third of the patients had consulted a Heilpraktiker, a quarter of these for their current psychiatric illness. Women were in the majority. Patients with the highest secondary school education consulted Heilpraktiker less often. There was considerable 'customer loyalty' towards Heilpraktiker. Largely the same diagnostic and treatment methods were employed for mental illness as for somatic complaints. Except for iridology, exotic or dangerous methods played a secondary role. Patients generally revealed a very positive attitude toward Heilpraktiker and CAM, although methods were rated differently. CAM enjoyed greater appreciation among women and patients who had consulted Heilpraktiker. Patients with personal experience were, on the whole, very satisfied with the professional competence, with the atmosphere in the practice and staff concern for the patient's well-being. Degree of satisfaction correlated closely with frequency of consultation. More patients with neurotic disorders considered the cost unreasonable than others, despite comparatively frequent visits.

CONCLUSIONS

Psychiatric patients seek out Heilpraktiker to a considerable degree. Especially those who have relevant experience rank Heilpraktiker highly, in particular due to their 'psychotherapeutic' attitude, but professional competence is also valued. Methods of CAM received mixed reviews from patients but are generally seen in a positive light. It is recommended that doctors collecting case history data on their patients also ask about experience with alternative practitioners and treatments.

[Psychotherapy and religion: a survey of Northern Bavarian psychotherapists]

By taking a survey of physicians and psychologists accredited as psychotherapists in Franconia (northern Bavaria), we attempted to draw conclusions about the importance of religion for the therapists themselves and for their therapeutic settings. 253 physicians and 78 psychologists returned usable questionnaires (a return rate of 70% for each group). 30% of each group were non-denominational, significantly more men than women were not religious or considered themselves "agnostic/atheistic." Catholic therapists appeared to be more loyal toward their church and more open-minded toward religion in general than protestants and non-denominationals, respectively. Around 1/5 of the psychologists had prayed for their patients. Among the psychoanalysts there were no fewer non-denominationals or agnostics/atheists than among physician/psychotherapists or behavioural therapists. The physician/psychoanalysts classified the role of religion as less important than physician/psychotherapists; however, there were marked differences between the psychoanalytic schools. Many therapists could imagine consulting a spiritual counselor in appropriate cases. The results indicate a correlation between the subjective attitude of therapists toward religion and their handling of this topic in therapeutic practice.