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Lehmann J, Pilz MJ, Holzner B, Kemmler G, Giesinger JM. General population normative data from seven European countries for the K10 and K6 scales for psychological distress. Sci Rep 2023; 13:18389. [PMID: 37884547 PMCID: PMC10603032 DOI: 10.1038/s41598-023-45124-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
The 10-item Kessler Psychological Distress scale (K10) and its 6-item short-form version (K6) measure psychological distress, particularly anxiety or depressive symptoms. While these questionnaire scales are widely used in various settings and populations, general population normative data are rarely available. To facilitate the interpretation of K10 and K6 scores, we provide normative general population data from seven European countries. We used an online survey to collect K10 data from general population samples in Austria, Italy, Germany, France, the Netherlands, Poland and Spain. We calculated the age- and sex-specific normative values separately for each country. For more specific estimates of K10 and K6 scores for individuals or groups, we also established a multivariable regression model based on socio-demographic and health data. In total, N = 7,087 adults participated in our study (51.6% women; mean age, 49.6 years). The mean K10 score in the total sample was 8.5 points (standard deviation, 7.3) on 0-40 points metric, with mean scores in individual countries ranging from 6.9 (the Netherlands) to 9.9 (Spain). Women showed higher scores than men and younger participants scored higher than older participants. Our study is the first to present normative K10 and K6 data from several European countries using a consistent sampling approach. These reference values will facilitate the interpretation of K10 and K6 scores in clinical research and practice and also highlight the variation in psychological distress levels across countries and groups according to their socio-demographic and health characteristics.
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Affiliation(s)
- J Lehmann
- Health Outcomes Research Unit, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 43, 6020, Innsbruck, Austria
| | - M J Pilz
- Health Outcomes Research Unit, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 43, 6020, Innsbruck, Austria
| | - B Holzner
- University Hospital of Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria
| | - G Kemmler
- University Hospital of Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria
| | - J M Giesinger
- Health Outcomes Research Unit, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 43, 6020, Innsbruck, Austria.
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Nolte S, Liegl G, Petersen MA, Aaronson NK, Costantini A, Fayers PM, Groenvold M, Holzner B, Johnson CD, Kemmler G, Tomaszewski KA, Waldmann A, Young TE, Rose M. General population normative data for the EORTC QLQ-C30 health-related quality of life questionnaire based on 15,386 persons across 13 European countries, Canada and the Unites States. Eur J Cancer 2018; 107:153-163. [PMID: 30576971 DOI: 10.1016/j.ejca.2018.11.024] [Citation(s) in RCA: 237] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/10/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 health-related quality of life questionnaire is one of the most widely used cancer-specific health-related quality of life questionnaires worldwide. General population norm data can facilitate the interpretation of QLQ-C30 data obtained from cancer patients. This study aimed at systematically collecting norm data from the general population to develop European QLQ-C30 norm scores and to generate comparable norm data for individual countries in Europe and North America. METHODS We collected QLQ-C30 data from the general population across 11 European Union (EU) countries, Russia, Turkey, Canada and United States (n ≥ 1000/country). Representative samples were stratified by sex and age groups (18-39, 40-49, 50-59, 60-69 and ≥ 70 years). After applying weights based on the United Nations population distribution statistics, we calculated QLQ-C30 domain scores to generate a 'European QLQ-C30 Norm' based on the EU countries. Further, we calculated QLQ-C30 norm scores for all 15 individual countries. RESULTS A total of 15,386 respondents completed the online survey. For the EU sample, most QLQ-C30 domains showed differences by sex/age, with men scoring somewhat better health than women, while age effects varied across domains. Substantially larger differences were seen in inter-country comparisons, with Austrian and Dutch respondents reporting consistently better health compared with British and Polish respondents. CONCLUSIONS This study is the first to systematically collect EORTC QLQ-C30 general population norm data across Europe and North America applying a consistent data collection method across 15 countries. These new norm data facilitate valid intra-country as well as inter-country comparisons and QLQ-C30 score interpretation.
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Affiliation(s)
- S Nolte
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, VIC, Australia.
| | - G Liegl
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - M A Petersen
- Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - N K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - A Costantini
- Psycho-Oncology Unit, Sant'Andrea Hospital Sapienza, University of Rome, Rome, Italy
| | - P M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - M Groenvold
- Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - B Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - C D Johnson
- University of Southampton, Southampton, United Kingdom
| | - G Kemmler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - K A Tomaszewski
- Health Outcomes Research Unit, Department of Gerontology, Geriatrics, and Social Work, Faculty of Education, Ignatianum Academy, Krakow, Poland
| | - A Waldmann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany; Ministry for Health and Consumer Protection, Hamburg Cancer Registry, Hamburg, Germany
| | - T E Young
- East & North Hertfordshire NHS Trust Including Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom
| | - M Rose
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Quantitative Health Sciences, Outcomes Measurement Science, University of Massachusetts Medical School, Worcester, MA, USA
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Mizuno Y, Hofer A, Frajo-Apor B, Wartelsteiner F, Kemmler G, Pardeller S, Suzuki T, Mimura M, Fleischhacker WW, Uchida H. Religiosity and psychological resilience in patients with schizophrenia and bipolar disorder: an international cross-sectional study. Acta Psychiatr Scand 2018; 137:316-327. [PMID: 29141100 DOI: 10.1111/acps.12838] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The impact of religious/spiritual activities on clinical outcomes in patients with serious mental illnesses remains controversial, which was addressed in this international cross-sectional study. METHOD Three-hundred sixty-nine subjects were recruited from Austria (n = 189) and Japan (n = 180), consisting of 112 outpatients with paranoid schizophrenia, 120 with bipolar I disorder (DSM-IV), and 137 healthy controls. Religiosity was assessed in terms of attendance and importance of religious/spiritual activities, while resilience was assessed using the 25-item Resilience Scale. General linear models were used to test whether higher religiosity will be associated with higher resilience, higher social functioning, and lower psychopathology. The association between levels of spiritual well-being and resilience was also examined. RESULTS Attendance of religious services (F[4,365] = 0.827, P = 0.509) and importance of religion/spirituality (F[3,365] = 1.513, P = 0.211) did not show significant associations with resilience. Regarding clinical measures, a modest association between higher importance of religion/spirituality and residual manic symptoms was observed in bipolar patients (F[3,118] = 3.120, P = 0.029). In contrast to the findings regarding religiosity, spiritual well-being showed a strong positive correlation with resilience (r = 0.584, P < 0.001). CONCLUSION The protective effect of religiosity in terms of resilience, social functioning, and psychopathology was not evident in our sample. Spiritual well-being appears more relevant to resilience than religiosity.
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Affiliation(s)
- Y Mizuno
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - A Hofer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - B Frajo-Apor
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - F Wartelsteiner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - G Kemmler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - S Pardeller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - T Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Neuropsychiatry and Clinical Ethics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - M Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - W W Fleischhacker
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - H Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Geriatric Mental Health Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Hofer A, Mizuno Y, Wartelsteiner F, Wolfgang Fleischhacker W, Frajo-Apor B, Kemmler G, Mimura M, Pardeller S, Sondermann C, Suzuki T, Welte A, Uchida H. Quality of life in schizophrenia and bipolar disorder: The impact of symptomatic remission and resilience. Eur Psychiatry 2017; 46:42-47. [PMID: 28992535 DOI: 10.1016/j.eurpsy.2017.08.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 08/18/2017] [Accepted: 08/20/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQOL) is significantly affected in individuals with schizophrenia or bipolar I disorder (BD-I). The current study investigated whether symptomatic remission and resilience might differently impact HRQOL in these patients. METHODS Fifty-two patients with schizophrenia and 60 patients suffering from BD-I from outpatient mental health services as well as 77 healthy control subjects from the general community were included into a cross-sectional study. HRQOL and resilience were assessed using the WHOQOL-BREF and the Resilience Scale. In patients, psychopathology was quantified by the Positive and Negative Syndrome Scale or the Montgomery Asberg Depression Rating Scale and the Young Mania Rating Scale, respectively. RESULTS Notably, both patient groups showed lower HRQOL and resilience compared to control subjects, non-remitted patients indicated lower HRQOL than remitted ones. The effect of remission on HRQOL was significantly larger in patients with BD-I than in those with schizophrenia but did not explain the difference in HRQOL between groups. Resilience predicted HRQOL in all three groups. When accounting for the effect of resilience among remitted patients, only the difference in HRQOL between schizophrenia patients and control subjects was significant. CONCLUSION These findings demonstrate the impact of symptomatic remission and resilience on HRQOL of both patients suffering from schizophrenia and BD-I and indicate that these factors are especially relevant for HRQOL of patients with BD-I.
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Affiliation(s)
- A Hofer
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria.
| | - Y Mizuno
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan; Institute of Psychiatry, Psychology and Neuroscience, King's College London, Department of Psychosis Studies, London, UK
| | - F Wartelsteiner
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - W Wolfgang Fleischhacker
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - B Frajo-Apor
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - G Kemmler
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - M Mimura
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - S Pardeller
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - C Sondermann
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - T Suzuki
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - A Welte
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - H Uchida
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
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Deisenhammer E, Schmid S, Kemmler G, Moser B, Delazer M. Decision Making Under Ambiguity and Under Risk in Depressed Suicide Attempters, Depressed Non-Attempters and Healthy Controls. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionStudy results on decision-making (DM) abilities in suicidal individuals are conflicting. Most studies have focused on DM under ambiguity and included patients with a lifetime history of suicide attempts.ObjectiveTo assess DM abilities with two different instruments in recent suicide attempters.MethodsThe study sample consisted of three groups. Group 1 (SA) were currently depressed inpatients having attempted suicide within the previous six months. Group 2 (NSA) consisted of depressed inpatients without a lifetime history of suicide attempts. Group 3 (CG) was a healthy control group. Besides depression severity, impulsiveness and suicidal intent (SA group only) DM was assessed using the Iowa gambling task (IGT) for DM under ambiguity and the game of dice task (GDT) for DM under risk.ResultsA total of 78 participants (SA group, n = 21; NSA group, n = 31; CG, n = 26) were included into the study. Significant between group differences were found regarding marital status, current partnership, smoking status, depression score, impulsiveness score and family history of psychiatric disorders (all discriminating controls from patients but not between SA and NSA groups). The three groups did not differ with regard to IGT scores. Concerning GDT, the SA group showed significantly lower scores compared to the two other groups, implying a readiness for more risky decisions in suicide attempters versus non-attempters and controls.ConclusionSuicide attempters appear to make more risky decisions compared to depressed non-attempters as well as healthy controls even if the DM under ambiguity patterns do not differ.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Sojer P, Kainbacher S, Kemmler G, Freudenthaler H, Deisenhammer E. The impact of trait emotional intelligence and resilience on suicidal behavior in university students. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionSuicidal ideation has repeatedly been reported as a predecessor of suicidal behavior. Several neuropsychological parameters have been associated with suicidal ideation. Emotional intelligence (EI) and resilience, which play an important role in the emergence of psychiatric disorders may also be related with suicidality.ObjectivesThe main objective of this study was to investigate the relationship of trait EI and resilience with suicidal ideation. Moreover, we hypothesized that EI and resilience would be correlated with each other and that they were moderating variables between stressful life events and suicidal ideation.MethodsA total of 277 male and female students without current psychiatric diseases were recruited per online questionnaire asking for lifetime and 4-weeks suicidal ideation and demographic data and containing the Resilience Scale of Wagnild and Young, the Connor Davidson Resilience Scale and, for the measurement of trait EI, the Self-Report Emotional Ability Scale. Additionally, we applied the Social Readjustment Rating Scale to assess stressful life events.ResultsWe found significant negative correlations between lifetime and in part 4-weeks suicidal ideation and intrapersonal trait EI as well as resilience. Trait EI and resilience were interrelated. There was no significant moderating effect of trait EI or resilience on the relationship between SRRS score and suicidality.ConclusionAssessing EI and resilience as trait factors might be helpful in the prospective identification of suicidal individuals.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Oberguggenberger A, Meraner V, Sztankay M, Beer B, Weigel G, Oberacher H, Kemmler G, Czech T, Holzner B, Wildt L, Sperner-Unterweger B, Daniaux M, Hubalek M. Can we use gonadotropin plasma concentration as surrogate marker for BMI-related incomplete estrogen suppression in breast cancer patients receiving anastrozole? BMC Cancer 2017; 17:226. [PMID: 28351392 PMCID: PMC5371265 DOI: 10.1186/s12885-017-3208-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 03/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND BMI has been suggested to impact on estrogenic activity in patients receiving anastrozole resulting in a reduced treatment efficacy in obese women. Current evidence in this regard is controversially discussed. Since estradiol is inversely correlated with gonadotropins it can be assumed that an impact of BMI is also reflected by gonadotropin plasma concentrations. We aim at investigating the impact of BMI on the hormonal state of breast cancer (BC) patients receiving anastrozole indicated by LH, FSH and SHBG as well as estradiol. METHODS We determined gonadotropin-, estradiol- and anastrozole- serum concentrations from postmenopausal, early stage breast cancer patients receiving upfront anastrozole within routine after care. Gonadotropin plasma concentrations were derived from the routine laboratory examination report. A liquid chromatography tandem mass spectrometry method was used for the measurement of anastrozole serum concentrations. BMI was assessed within the routine after-care check-up. RESULTS The overall sample comprised 135 BC patients with a mean age of 65.3 years. BMI was significantly correlated with LH, FSH and SHBG. This association was neither influenced by age nor by anastrozole serum concentrations according to the regression model. Despite aromatase inhibition 12% of patients had detectable estrogen levels in routine quantification. CONCLUSION Obese women have an altered hormonal situation compared to normally weight women under the same dose of anastrozole. Our study findings are a further indicator for the relevance of BMI in regard of anastrozole metabolism and possible estrogenic activity indicated by gonadotropin plasma level.
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Affiliation(s)
- A Oberguggenberger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - V Meraner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - M Sztankay
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - B Beer
- Institute of Legal Medicine and Core Facility Metabolomics, Innsbruck Medical University, Muellerstrasse 44, 6020, Innsbruck, Austria
| | - G Weigel
- Central Institute for Medical and Chemical Laboratory Diagnostics, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria
| | - H Oberacher
- Institute of Legal Medicine and Core Facility Metabolomics, Innsbruck Medical University, Muellerstrasse 44, 6020, Innsbruck, Austria
| | - G Kemmler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - T Czech
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstraße 35, 6020, Innsbruck, Austria
| | - B Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - L Wildt
- Department of Gynecological Endocrinology and Reproductive Medicine, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria
| | - B Sperner-Unterweger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - M Daniaux
- Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria
| | - M Hubalek
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstraße 35, 6020, Innsbruck, Austria.
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Frajo-Apor B, Kemmler G, Pardeller S, Plass T, Mühlbacher M, Welte AS, Fleischhacker WW, Hofer A. Emotional intelligence and non-social cognition in schizophrenia and bipolar I disorder. Psychol Med 2017; 47:35-42. [PMID: 27640523 PMCID: PMC5744852 DOI: 10.1017/s0033291716002324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The different patterns of Emotional Intelligence (EI) deficits in schizophrenia and bipolar I disorder are are not yet well understood. This study compares EI levels among these groups and highlights the potential impact of non-social cognition on EI. METHOD Fifty-eight schizophrenia and 60 bipolar outpatients were investigated using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the Brief Assessment of Cognition in Schizophrenia (BACS). Analyses of covariance were performed with adjustment for the BACS composite score. RESULTS Compared to bipolar subjects, schizophrenia patients showed significantly lower levels in both EI and non-social cognition. After adjustment for the BACS composite score, the difference in EI was lost. The mediation analysis revealed that differences between schizophrenia and bipolar patients in strategic EI are almost fully attributable to the mediating effect of non-social cognition. CONCLUSIONS Our findings suggest that in both schizophrenia and bipolar patients EI is strongly influenced by non-social cognitive functioning. This has to be taken into account when interpreting MSCEIT data in comparative studies in serious mental illness and emphasizes the importance of cognitive remediation.
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Affiliation(s)
- B. Frajo-Apor
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - G. Kemmler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - S. Pardeller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - T. Plass
- Department of Psychiatry and Psychotherapy, Paracelsus Medical University, Salzburg, Austria
| | - M. Mühlbacher
- Department of Psychiatry and Psychotherapy, Paracelsus Medical University, Salzburg, Austria
| | - A.-S. Welte
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - W. W. Fleischhacker
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - A. Hofer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
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Wartelsteiner F, Mizuno Y, Frajo-Apor B, Kemmler G, Pardeller S, Sondermann C, Welte A, Fleischhacker WW, Uchida H, Hofer A. Quality of life in stabilized patients with schizophrenia is mainly associated with resilience and self-esteem. Acta Psychiatr Scand 2016; 134:360-7. [PMID: 27497263 DOI: 10.1111/acps.12628] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Improving quality of life (QoL) is an important objective in the treatment of schizophrenia. The aim of the current study was to examine to what extent resilience, self-esteem, hopelessness, and psychopathology are correlated with QoL. METHOD We recruited 52 out-patients diagnosed with schizophrenia according to DSM-IV criteria and 77 healthy control subjects from the general community. In patients, psychopathology was quantified by the Positive and Negative Syndrome Scale. The following scales were used in both patients and control subjects: the Berliner Lebensqualitätsprofil, the Resilience Scale, the Rosenberg Self-Esteem Scale, and the Beck Hopelessness Scale to assess QoL, resilience, self-esteem, and hopelessness respectively. RESULTS Patients with schizophrenia presented with significantly less QoL, resilience, self-esteem, and hope compared to healthy control subjects. In patients, QoL correlated moderately with resilience, self-esteem, and hopelessness and weakly with symptoms. With respect to the latter, particularly depression and positive symptoms were negatively correlated with QoL. CONCLUSION Our results highlight the complex nature of QoL in patients suffering from schizophrenia. They underscore that significant efforts are necessary to enhance resilience and self-esteem and to diminish hopelessness as well as affective and positive symptoms in patients with schizophrenia.
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Affiliation(s)
- F Wartelsteiner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - Y Mizuno
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - B Frajo-Apor
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - G Kemmler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - S Pardeller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - C Sondermann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - A Welte
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - W W Fleischhacker
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - H Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - A Hofer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria.
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Norman R, Viney R, Aaronson NK, Brazier JE, Cella D, Costa DSJ, Fayers PM, Kemmler G, Peacock S, Pickard AS, Rowen D, Street DJ, Velikova G, Young TA, King MT. Erratum to: Using a discrete choice experiment to value the QLU-C10D: feasibility and sensitivity to presentation format. Qual Life Res 2016; 25:2401. [PMID: 27060090 DOI: 10.1007/s11136-016-1289-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- R Norman
- School of Public Health, Curtin University, Perth, Australia. .,Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia.
| | - R Viney
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia
| | - N K Aaronson
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J E Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D S J Costa
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia
| | - P M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - G Kemmler
- Innsbruck Medical University, Innsbruck, Austria
| | - S Peacock
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.,Canadian Centre for Applied Research in Cancer Control (ARCC), Vancouver, Canada.,British Columbia Cancer Agency, Vancouver, Canada
| | - A S Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - D Rowen
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D J Street
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, Australia
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.,St James's Hospital, Leeds, UK
| | - T A Young
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - M T King
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia.,Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
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King MT, Costa DSJ, Aaronson NK, Brazier JE, Cella DF, Fayers PM, Grimison P, Janda M, Kemmler G, Norman R, Pickard AS, Rowen D, Velikova G, Young TA, Viney R. QLU-C10D: a health state classification system for a multi-attribute utility measure based on the EORTC QLQ-C30. Qual Life Res 2016; 25:625-36. [PMID: 26790428 DOI: 10.1007/s11136-015-1217-y] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE To derive a health state classification system (HSCS) from the cancer-specific quality of life questionnaire, the EORTC QLQ-C30, as the basis for a multi-attribute utility instrument. METHODS The conceptual model for the HSCS was based on the established domain structure of the QLQ-C30. Several criteria were considered to select a subset of dimensions and items for the HSCS. Expert opinion and patient input informed a priori selection of key dimensions. Psychometric criteria were assessed via secondary analysis of a pooled dataset comprising HRQOL and clinical data from 2616 patients from eight countries and a range of primary cancer sites, disease stages, and treatments. We used confirmatory factor analysis (CFA) to assess the conceptual model's robustness and generalisability. We assessed item floor effects (>75 % observations at lowest score), disordered item response thresholds, coverage of the latent variable and differential item function using Rasch analysis. We calculated effect sizes for known group comparisons based on disease stage and responsiveness to change. Seventy-nine cancer patients assessed the relative importance of items within dimensions. RESULTS CFA supported the conceptual model and its generalisability across primary cancer sites. After considering all criteria, 12 items were selected representing 10 dimensions: physical functioning (mobility), role functioning, social functioning, emotional functioning, pain, fatigue, sleep, appetite, nausea, bowel problems. CONCLUSIONS The HSCS created from QLQ-C30 items is known as the EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D). The next phase of the QLU-C10D's development involves valuation studies, currently planned or being conducted across the globe.
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Affiliation(s)
- M T King
- Psycho-Oncology Cooperative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.
- Central Clinical School, Sydney Medical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
| | - D S J Costa
- Psycho-Oncology Cooperative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - N K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J E Brazier
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D F Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - P M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - P Grimison
- Chris O'Brien Lifehouse, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - M Janda
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - G Kemmler
- Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria
| | - R Norman
- School of Public Health, Curtin University, Perth, WA, Australia
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, NSW, Australia
| | - A S Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - D Rowen
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital, Leeds, UK
| | - T A Young
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - R Viney
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, NSW, Australia
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Norman R, Viney R, Aaronson NK, Brazier JE, Cella D, Costa DSJ, Fayers PM, Kemmler G, Peacock S, Pickard AS, Rowen D, Street DJ, Velikova G, Young TA, King MT. Using a discrete choice experiment to value the QLU-C10D: feasibility and sensitivity to presentation format. Qual Life Res 2015; 25:637-49. [PMID: 26342928 DOI: 10.1007/s11136-015-1115-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE To assess the feasibility of using a discrete choice experiment (DCE) to value health states within the QLU-C10D, a utility instrument derived from the QLQ-C30, and to assess clarity, difficulty, and respondent preference between two presentation formats. METHODS We ran a DCE valuation task in an online panel (N = 430). Respondents answered 16 choice pairs; in half of these, differences between dimensions were highlighted, and in the remainder, common dimensions were described in text and differing attributes were tabulated. To simplify the cognitive task, only four of the QLU-C10D's ten dimensions differed per choice set. We assessed difficulty and clarity of the valuation task with Likert-type scales, and respondents were asked which format they preferred. We analysed the DCE data by format with a conditional logit model and used Chi-squared tests to compare other responses by format. Semi-structured telephone interviews (N = 8) explored respondents' cognitive approaches to the valuation task. RESULTS Four hundred and forty-nine individuals were recruited, 430 completed at least one choice set, and 422/449 (94 %) completed all 16 choice sets. Interviews revealed that respondents found ten domains difficult but manageable, many adopting simplifying heuristics. Results for clarity and difficulty were identical between formats, but the "highlight" format was preferred by 68 % of respondents. Conditional logit parameter estimates were monotonic within domains, suggesting respondents were able to complete the DCE sensibly, yielding valid results. CONCLUSION A DCE valuation task in which only four of the QLU-C10D's ten dimensions differed in any choice set is feasible for deriving utility weights for the QLU-C10D.
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Affiliation(s)
- R Norman
- School of Public Health, Curtin University, Perth, Australia. .,Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia.
| | - R Viney
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia
| | - N K Aaronson
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J E Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D S J Costa
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia
| | - P M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - G Kemmler
- Innsbruck Medical University, Innsbruck, Austria
| | - S Peacock
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.,Canadian Centre for Applied Research in Cancer Control (ARCC), Vancouver, Canada.,British Columbia Cancer Agency, Vancouver, Canada
| | - A S Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - D Rowen
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D J Street
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, Australia
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.,St James's Hospital, Leeds, UK
| | - T A Young
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - M T King
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia.,Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
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Defrancesco M, Kemmler G, Huber R, Deisenhammer EA. [Correlation of mental activity with cognitive functions in mild cognitive impairment and early stage dementia]. Nervenarzt 2014; 85:350-355. [PMID: 23455983 DOI: 10.1007/s00115-013-3738-3] [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: 06/01/2023]
Abstract
INTRODUCTION Mental activities have been suggested to influence the risk and course of dementia. This study was performed in order to assess the association of various mental activities with diagnosis and cognitive functions in an elderly population. METHODS A total of 191 memory clinic patients (mean age 71.7 ± 10.7 years) were included in this study. Participants completed a standardized neuropsychological test battery, a clinical interview, and a semistructured interview to assess mental activities. RESULTS Of the 191 patients, 39 were diagnosed as cognitively intact, 72 had mild cognitive impairment, and 80 mild Alzheimer's disease. Group comparisons of mental activity scores revealed differences for the variables art, culture, media consumption, travelling, and cognitive activities. Correlation analysis showed a significant association of culture, media consumption, travelling, and cognitive activities with cognitive functions. CONCLUSION Our results suggest that mental activities may influence the extent of cognitive impairment and possibly the risk for Alzheimer's disease.
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Affiliation(s)
- M Defrancesco
- Universitätsklinik für Allgemeine und Sozialpsychiatrie, Abteilung für Psychiatrie und Psychotherapie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich,
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Strobl EM, Oberguggenberger A, Meraner V, Beer B, Giesinger J, Kemmler G, Oberacher H, Sperner-Unterweger B, Holzner B, Marth C, Hubalek M. Hat der CYP 2D6 Genotyp Einfluss auf Nebenwirkungen und Adherence? Prämenopausale Brustkrebs-Patientinnen unter Tamoxifen-Therapie. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1336791] [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] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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15
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Berger A, Oberguggenberger A, Sztankay M, Meraner V, Beer B, Oberacher H, Giesinger J, Kemmler G, Egle D, Gamper EM, Sperner-Unterweger B, Holzner B, Marth C, Hubalek M. Wird die Toxizität einer adjuvanten Therapie mit Aromataseinhibitoren unterschätzt? Zusätzliche Informationen durch Patientinnen Feedback Fragebögen. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1336792] [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] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Blasko I, Hinterberger M, Kemmler G, Jungwirth S, Krampla W, Leitha T, Heinz Tragl K, Fischer P. Conversion from mild cognitive impairment to dementia: influence of folic acid and vitamin B12 use in the VITA cohort. J Nutr Health Aging 2012; 16:687-94. [PMID: 23076510 DOI: 10.1007/s12603-012-0051-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Increased serum homocysteine and low folate levels are associated with a higher rate of conversion to dementia. This study examined the influence of vitamin B12/folic acid intake on the conversion from mild cognitive impairment (MCI) to dementia. PARTICIPANTS A community dwelling cohort of older adults (N=81) from the Vienna Transdanube aging study with MCI. DESIGN Prospective study with a retrospective evaluation of vitamin intake. MEASUREMENTS Laboratory measurements, brain magnetic resonance imaging, and cognitive functioning were assessed at baseline and at five-year follow-up. RESULTS The self-reported combined use of folic acid and vitamin B12 for more than one year was associated with a lower conversion rate to dementia. Serum levels of homocysteine and vitamin B12 as measured at baseline or at five years were not associated with conversion. Higher folate levels at baseline in females predicted a lower conversion rate to dementia. The assessment of brain morphological parameters by magnetic resonance imaging revealed higher serum folate at baseline, predicting lower medial temporal lobe atrophy and higher levels of homocysteine at baseline, predicting moderate/severe global brain atrophy at five years. Users of vitamin B12 or folate, independent of time and pattern of use, had lower grades of periventricular hyperintensities and lower grades of deep white matter lesions as compared to non-users. CONCLUSIONS These results from a middle European study support observations on the protective ability of folate in MCI patients with respect to conversion to dementia; they also point to a participation of homocysteine metabolism on processes associated with brain atrophy.
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Affiliation(s)
- I Blasko
- Department of Psychiatry and Psychotherapy, Division of General and Social Psychiatry, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
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Hofer A, Bodner T, Kaufmann A, Kemmler G, Mattarei U, Pfaffenberger NM, Rettenbacher MA, Trebo E, Yalcin N, Fleischhacker WW. Symptomatic remission and neurocognitive functioning in patients with schizophrenia. Psychol Med 2011; 41:2131-2139. [PMID: 21426601 DOI: 10.1017/s0033291711000353] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [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: 11/06/2022]
Abstract
BACKGROUND A cross-sectional study was conducted in participants with schizophrenia to explore a potential association between the patients' remission status and neurocognitive functioning and to examine whether these factors have an impact on functional outcome. METHOD Psychopathological symptoms were rated by means of the Positive and Negative Syndrome Scale with symptom remission being assessed by applying the severity component of the recently proposed remission criteria. Tests for the cognitive battery were selected to cover domains known to be impaired in patients with schizophrenia. Next to pre-morbid intelligence, attention performance, executive functioning, verbal fluency, verbal learning and memory, working memory and visual memory were assessed. The joint effect of remission status and neurocognitive functioning on treatment outcome was investigated by logistic regression analysis. RESULTS Out of 140 patients included in the study, 62 were symptomatically remitted. Mean age, education and sex distribution were comparable in remitted and non-remitted patients. Remitted patients showed significantly higher values on tests of verbal fluency, alertness and optical vigilance. Both symptomatic remission as well as performance on tests of working memory and verbal memory had a significant effect on the patients' employment status. CONCLUSIONS In the present study neuropsychological measures of frontal lobe functioning were associated with symptomatic remission from schizophrenia. In addition, both symptomatic remission and performance on tests of working memory and verbal memory had a significant effect on the patients' employment status. Longitudinal follow-up data are needed to determine how the associations of these determinants of functional outcome interact and change over time.
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Affiliation(s)
- A Hofer
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, Biological Psychiatry Division, Innsbruck, Austria.
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hubalek M, Oberguggenberger A, Beer B, Meraner V, Oberacher H, Sperner-Unterweger B, Kemmler G, Holzner B, Marth C. Abstract P5-11-10: Gonadotropins Plasma Levels Are Significantly Influenced by Body Mass Index in Postmenopausal Breast Cancer Patients Undergoing Endocrine Therapy with Aromatase Inhibitors: Is This a Surrogate Marker for Serum Estrogen Bioactivity? Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p5-11-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Estrogens play a crucial role in breast carcinogenesis and progression. The third-generation aromatase inhibitors (AIs) have therefore become the first choice endocrine drugs for post-menopausal women with breast cancer, since they present greater efficacy when compared with tamoxifen. However, mode of action, side effects and tolerability are distinct compared to tamoxifen. In this study, we evaluated clinical side-effects, levels of gonadotropin, prolactin, progesterone and estradiol in postmenopausal women undergoing endocrine treatment with aromatase inhibitors.
Materials and Methods: 128 postmenopausal patients undergoing endocrine therapy with aromatase inhibitors were included in the study. They completed the assessment at their regular 3-month check up. For the assessment of side-effects and symptom burden we used the FACT-B/+ES and the HADS. Blood samples were collected within the routine blood collection and measurement of follicle stimulation hormone (FSH), luteinizing hormone (LH), progesterone, estradiol and prolactin plasma levels were performed by Immunoassay. Data were analyzed using Spearman rank correlation.
Results: We found a significant negative correlation of LH and FSH with body mass index (BMI) of postmenopausal breast cancer patients (LH r=- 0.281, p=0.014; FSH r=-0.250, p=0.029) receiving aromatase inhibitors. Analyses revealed a significant positive correlation for LH and FSH levels with subjectively experienced weight gain (LH r=0.499, p=0.008; FSH r=0.550, p=0.003), dyspareunia and vaginal dryness. Moreover, patients with a BMI ≥25 had significantly more gynaecological symptoms (dyspareunia p=0.008 and vaginal dryness p=0.026) than patients witha lower BMI. Progesterone was significantly associated with subjective weight gain (r=0.248, p=0.014). Prolactin significantly correlated with loss of sex drive (r=0.256, p=0.050), mood swings (r=0.239, p=0.050) and irritability (r=0.244, p=0.046).
Conclusion: Our results reveal distinct endocrine changes among postmenopausal breast cancer patients undergoing endocrine treatment with AIs. These results confirm the central role of estrogens in the evolution of adverse events to aromatase inhibitors. The main observation in this study, however, was the correlation of BMI and levels of hormone influenced by estrogenic activity. LH and FSH which are under control of various estrogen metabolites, were significantly associated with the BMI and might therefore serve as surrogate marker of estrogenic activity in serum of breast cancer patients. Direct measurement of estradiol (E2) showed no correlation with BMI indicating the influence of various other estrogen metabolites on the secretion of gonadotropins. Analysis of serum estrogen receptor bioactivity in these patients is currently underway.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-11-10.
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Affiliation(s)
- M Hubalek
- Medical University Innsbruck, Austria
| | | | - B Beer
- Medical University Innsbruck, Austria
| | - V Meraner
- Medical University Innsbruck, Austria
| | | | | | - G Kemmler
- Medical University Innsbruck, Austria
| | - B Holzner
- Medical University Innsbruck, Austria
| | - C. Marth
- Medical University Innsbruck, Austria
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Hubalek M, Oberguggenberger A, Meraner V, Giesinger J, Kemmler G, Sperner-Unterweger B, Beer B, Oberacher H, Marth C, Holzner B. Abstract PD08-02: The Impact of Patient Reported Outcomes (PRO) on the Evaluation of Therapy Related Side-Effects and the Improvement of Adherence to Endocrine Treatment in Breast Cancer Patients. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-pd08-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Long term treatment regimen with significant side effects may diminish a patient's quality of life (QOL) and consequently undermine adherence. Endocrine treatment for breast cancer causes various side effects, which can lead to early discontinuation of this effective therapy. Current knowledge on patients’ quality of life (QOL) impairments caused by endocrine therapy originates from clinicians’ impressions and expert ratings. This runs the risk of underestimating the effects of endocrine therapy on patients’ quality of life. Patient reported outcome (PRO) may provide higher accuracy and may therefore essentially contribute to medication evaluation and clinical decision making. In this study, we report on the patient reported outcome (PRO) related to endocrine therapy in early breast cancer.
Methods: Pre-and postmenopausal breast cancer outpatients treated with aromatase inhibitors (AIS) or tamoxifen were approached at their routine control appointment with the treating physician. We conducted a comprehensive PRO assessment comprising the following scales: FACT-B/+ES and HADS (high scores indicate high symptoms). In a short, semi-structured interview data on patients’ general medication intake behavior were collected focusing on the intake of complementary and alternative medicine (CAM)
Results: We analyzed PRO data of 240 patients undergoing endocrine treatment. 66.6% received AI therapy, 71.9% were postmenopausal. We found high levels of symptom burden in this study group: 55.9% had moderate to severe bone pain, 47.8% menopausal symptoms and 49.1% loss of sex drive. Postmenopausal women in the AI group had significantly more symptoms on the endocrine subscale (mean 24.25 vs. 16.42, p=0.045), significantly more anxiety (mean 8.8 vs. 5.11, p=0.036) and depression (mean 8.75 vs. 3.86, p=0.011). In the tamoxifen group premenopausal patients scored significantly higher on all scales. Moreover, patients who used complementary substances had a significant lower physical well-being (22.70 vs. 24.39, p=0.007) and more endocrine symptoms (22.63 vs. 16.30, p=0.004).
Conclusion:The results of our study show a significantly higher assessment of physical side-effects and psychosocial burden on part of the patients than implied by clinicians’ reports and expert ratings. PRO data may therefore provide a more accurate measure for symptom burden and contribute to individualized clinical decision making. It is an important tool to detect and effectively treat therapy related side effect to ultimately preserve adherence to endocrine treatment. According to our findings, it appears mandatory to incorporate PRO data in individualized clinical decision making to arrive at a more accurate assessment of symptom burden.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD08-02.
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Affiliation(s)
- M Hubalek
- Medical University Innsbruck, Austria
| | | | - V Meraner
- Medical University Innsbruck, Austria
| | | | - G Kemmler
- Medical University Innsbruck, Austria
| | | | - B Beer
- Medical University Innsbruck, Austria
| | | | - C Marth
- Medical University Innsbruck, Austria
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Mangweth-Matzek B, Rupp CI, Hausmann A, Gusmerotti S, Kemmler G, Biebl W. Eating disorders in men: current features and childhood factors. Eat Weight Disord 2010; 15:e15-22. [PMID: 20571316 DOI: 10.1007/bf03325276] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Disturbed interactions with one's body and with other persons are two major features in eating disorders. This study was designed to assess current and childhood characteristics of eating-disordered men. METHODS The authors interviewed 32 men with eating disorders (anorexia nervosa: N=9, bulimia nervosa: N=15, eating disorders not otherwise specified: N=8) and 43 control participants with no such history similar in age and educational status. The Structured Clinical Interview for DSM-IV was used to assess Axis I disorders and a self-designed interview to assess actual social and sexual characteristics and childhood body-focused and social behaviors including sexual and physical abuse. RESULTS The two groups differed significantly with regard to clinical, sexual and social features, with a three times higher rate of psychiatric disorders, fewer sexual and social relationships in the index group than in the controls. Eating-disordered men differed significantly from controls on most measures of body-focused and social behaviors, displaying higher rates of thumb sucking, nail biting, auto-aggressive behavior, and nudity as a familial taboo during childhood, as well as less parental bodily caressing than did controls. The index group reported significantly poorer relationships to their parents, fewer friends and persons of trust, and more often had adjustment problems at school than did their counterparts. CONCLUSIONS Our data show that disturbed interactions with one's body and with other persons in eating-disordered men are associated with a body-denying and distant family climate and an auto-aggressive, anxious and inhibited social behavior during childhood.
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Affiliation(s)
- B Mangweth-Matzek
- Innsbruck Medical University, Department of Psychiatry, Anichstr. 35, A-6020 Innsbruck, Austria.
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Rettenbacher MA, Hofer A, Kemmler G, Fleischhacker WW. Neutropenia induced by second generation antipsychotics: a prospective investigation. Pharmacopsychiatry 2010; 43:41-4. [PMID: 20175050 DOI: 10.1055/s-0030-1249071] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Clozapine is known to induce neutropenia as well as agranulocytosis. Some cases of olanzapine- and risperidone-induced neutropenia and agranulocytosis have also been reported. We prospectively investigated schizophrenia patients treated with second generation antipsychotics with respect to alterations of white blood cell counts. METHODS In an analysis of our drug monitoring program, we studied white blood cell counts in 104 patients receiving different second generation antipsychotics other than clozapine for at least six months and compared them with those of 28 patients receiving clozapine. RESULTS We found neutropenia (neutrophils <2 000/microL) in the mixed group in 17.6% and in 11.8% of patients treated with clozapine during the first 6 months. There was no statistically significant difference between those groups with respect to the risk to develop neutropenia during the investigation period. There was no case of agranulocytosis. Neutropenia was transient in all patients. Eosinophilia occurred in some patients that developed neutropenia later on but had no significant predictive value.
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Affiliation(s)
- M A Rettenbacher
- Medical University Innsbruck, Department of Psychiatry, Innsbruck, Austria.
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Valentiny C, Kemmler G, Hofer R, Stauder R. P18 Relevance of gender aspects in geriatric assessment in elderly cancer patients. Crit Rev Oncol Hematol 2009. [DOI: 10.1016/s1040-8428(09)70056-3] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Edlinger M, Hofer A, Rettenbacher MA, Baumgartner S, Widschwendter CG, Kemmler G, Neco NA, Fleischhacker WW. Factors influencing the choice of new generation antipsychotic medication in the treatment of patients with schizophrenia. Schizophr Res 2009; 113:246-51. [PMID: 19595578 DOI: 10.1016/j.schres.2009.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Revised: 06/09/2009] [Accepted: 06/14/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This prospective, naturalistic study investigated the factors influencing physicians' choice of antipsychotic drug therapy in the treatment of patients with schizophrenia. METHOD 108 in- and outpatients treated at the Department of Psychiatry of the Medical University Innsbruck who started treatment with a new generation antipsychotic (except clozapine) were included. The following factors were investigated: sociodemographic and illness-related variables, pretreatment, the reasons for change of treatment (lack of efficacy, side effects, non-compliance), side effects of pretreatment and body-mass-index (BMI). RESULTS Sociodemographic and most illness-related variables did not have an influence on the physicians' choice of medication. Risperidone was more frequently prescribed in patients with severe positive symptoms than amisulpride or quetiapine. Rigidity, orthostatic dizziness and gynecomastia during pretreatment were frequently associated with starting patients on ziprasidone. In patients with diminished sexual desire ziprasidone was preferred over olanzapine. Amisulpride was used more commonly than olanzapine if patients had experienced weight gain during pretreatment. Moreover, patients who were prescribed amisulpride had a significantly higher BMI in comparison to patients who were prescribed olanzapine. The reasons for current change of treatment, as well as the drug history (total number of antipsychotic drugs prescribed during the course of the illness) did not have an influence on the physicians' choice of antipsychotic. CONCLUSION In summary, the data suggest that side effects have a larger influence on the choice of antipsychotic than demographic or illness-related variables, except the severity of positive symptoms.
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Affiliation(s)
- Monika Edlinger
- University Clinic of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria.
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Stauder R, Valentiny C, Hofer R, Moser K, Kemmler G. 4009 Aspects of age and gender in geriatric assessment in elderly cancer patients. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70743-8] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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27
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Kemmler G, Zabernigg A, Gattringer K, Rumpold G, Giesinger J, Sperner-Unterweger B, Holzner B. A new approach to combining clinical relevance and statistical significance for evaluation of quality of life changes in the individual patient. J Clin Epidemiol 2009; 63:171-9. [PMID: 19615857 DOI: 10.1016/j.jclinepi.2009.03.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 03/04/2009] [Accepted: 03/30/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Empirical investigation of formerly proposed criteria for relevant changes of health-related quality of life (QOL) regarding their use for monitoring changes in the individual patient. Suggestion of a new criterion trying to overcome the drawbacks of former criteria. STUDY DESIGN AND SETTING QOL data were collected longitudinally in 160 cancer patients receiving chemotherapy at an oncological outpatient unit, giving rise to a total of 975 QOL assessments. QOL was measured using the European Organization on Research and Treatment of Cancer Quality of Life Core Questionnaire. Several formerly suggested criteria of relevant change (distribution based, anchor based) were compared in terms of both prevalence and statistical significance of the resulting relevant changes. RESULTS When considering criteria of relevant change suggested in the literature, high proportions (average: 42.3-48.3%) of reputedly relevant changes were found. The majority of these changes (average: 55.8-62.2%) were statistically insignificant. Combination of an increased threshold for clinical relevance with the concept of statistical significance resulted in a more meaningful change criterion. CONCLUSION Formerly recommended thresholds of relevant change in QOL appear to be unduly low when focusing on the individual patient. A modified criterion is therefore suggested for this case. However, more research is needed for validation and refinement of the proposed criterion.
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Affiliation(s)
- G Kemmler
- Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Tyrol 6020, Austria.
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Deisenhammer E, Coban-Basaran M, Mantar A, Prunnlechner R, Kemmler G, Alkin T, Hinterhuber H. Ethnic and Cultural Impact on Depressive Symptoms - a Comparison Study in Austrian and Turkish Patients. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)70862-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The cultural and ethnic background of a patient may have a significant impact on the presentation of a psychiatric disorder. In this study symptoms assessed within a major depressive episode in 3 groups of female patients were compared:1.women of Austrian origin,2.women of Turkish origin but living in Austria and3.Turkish women living in Turkey.Patients were recruited at University hospitals either in Innsbruck, Austria, or Izmir, Turkey. A total of 136 patients were included into the study. Rating instruments included the Montgomery Åsberg Depression Rating Scale (MADRS), the Beck Depression Inventory (BDI) and the Bradford Somatic Inventory (BSI). Groups differed significantly with respect to severity as well as symptom clusters. Although Austrian patients were more often treated as in-patients they appeared to be less severely depressed. Both Turkish groups, however, presented somatic symptoms significantly more often than Austrian depressed women. Austrian-Turkish patients displayed some somatic symptoms even more frequently than Turkish patients in their home-country. It is essential for the diagnosis and treatment of depression to take ethnic and cultural issues of the patients into account.
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Zernig G, Geretsegger C, Hornsteiner M, Voglreiter K, Stuppaeck C, Stelzig R, Aichhorn W, Egger C, Grabher-Stoeffler G, Hiemke C, Kemmler G, Saria A. Prevalence of Lower-Than-Expected Plasma Levels in Medicated Patients Presenting for Acute Psychiatric Inpatient Treatment. Pharmacopsychiatry 2008. [DOI: 10.1055/s-0028-1088281] [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: 10/21/2022]
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Schroecksnadel K, Sarcletti M, Winkler C, Mumelter B, Weiss G, Fuchs D, Kemmler G, Zangerle R. Quality of life and immune activation in patients with HIV-infection. Brain Behav Immun 2008; 22:881-9. [PMID: 18261883 DOI: 10.1016/j.bbi.2007.12.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Revised: 12/25/2007] [Accepted: 12/27/2007] [Indexed: 01/28/2023] Open
Abstract
Depression and impaired quality of life (QoL) are frequently observed in patients suffering from HIV-infection. As an enhanced degradation of the serotonin precursor tryptophan is well documented in HIV-infected patients, disturbances in tryptophan metabolism may be causally linked to HIV-related depression. In this study, the relationship between QoL, depression, various laboratory parameters and tryptophan metabolism was investigated. To estimate QoL and mood, 152 HIV-infected patients (classified according to CDC-criteria) were requested to complete the following psychological questionnaires: BDI and MQoL-HIV. Disease progression was monitored by determination of viral load (VL), CD4(+) cell counts, haemoglobin and urinary/plasma neopterin, tryptophan and kynurenine concentrations. Increasing VL, decreasing CD4(+) cell counts, and enhanced tryptophan degradation reflected disease progression. Forty-one patients presented with mild, 22 with moderate and 14 with severe depression. BDI and MQoL scores were associated strongly with each other (rs=-0.838; p<0.001). Patients without depression had significantly lower plasma neopterin concentrations, higher CD4(+) cell counts and haemoglobin concentrations and better QoL scores (all p<0.01) than depressive patients. Furthermore, they showed lower rates of tryptophan degradation (p<0.05). Significant associations were observed between tryptophan degradation and immune activation. Haemoglobin and viral load were predictive for impaired QoL, while high urinary neopterin concentrations and low haemoglobin were the best predictors for depression. In HIV-infected patients, depressive mood and impaired QoL appear to be related to clinical parameters like immune activation, haemoglobin values and viral load.
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Affiliation(s)
- K Schroecksnadel
- Department of General Internal Medicine, Clinical Immunology and Infectious Diseases, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria
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Geretsegger C, Hornsteiner M, Voglreiter K, Stelzig R, Aichhorn W, Egger C, Kemmler G, Saria A, Stuppaeck C, Zernig G. Plasma levels of medicated psychiatric patients requiring hospitalization. Eur Psychiatry 2008. [DOI: 10.1016/j.eurpsy.2008.01.1293] [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: 11/29/2022] Open
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Walpoth M, Hoertnagl C, Mangweth-Matzek B, Kemmler G, Hinterhölzl J, Conca A, Hausmann A. Repetitive transcranial magnetic stimulation in bulimia nervosa: preliminary results of a single-centre, randomised, double-blind, sham-controlled trial in female outpatients. Psychother Psychosom 2008; 77:57-60. [PMID: 18087209 DOI: 10.1159/000110061] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Bulimia nervosa (BN) is often associated with depressive symptoms and treatment with antidepressants has shown positive effects. A shared deficient serotonergic transmission was postulated for both syndromes. The left dorsolateral prefrontal cortex was argued to regulate eating behaviour and to be dysfunctional in eating disorders. METHODS Fourteen women meeting DSM-IV criteria for BN were included in a randomised placebo-controlled double-blind trial. In order to exclude patients highly responsive to placebo, all patients were first submitted to a one-week sham treatment. Randomisation was followed by 3 weeks of active treatment or sham stimulation. As the main outcome criterion we defined the change in binges and purges. Secondary outcome variables were the decrease of the Hamilton Depression Rating Scale (HDRS), the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Scale (YBOCS) over time. RESULTS The average number of binges per day declined significantly between baseline and the end of treatment in the two groups. There was no significant difference between sham and active stimulation in terms of purge behaviour, BDI, HDRS and YBOCS over time. CONCLUSION These preliminary results indicate that repetitive transcranial magnetic stimulation (rTMS) in the treatment of BN does not exert additional benefit over placebo. A larger number of patients might clarify a further role of rTMS in the treatment of BN.
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Affiliation(s)
- M Walpoth
- Department of General Psychiatry, Innsbruck Medical University, Innsbruck, Austria.
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Hofer A, Rettenbacher MA, Edlinger M, Kemmler G, Widschwendter CG, Fleischhacker WW. Subjective response and attitudes toward antipsychotic drug therapy during the initial treatment period: a prospective follow-up study in patients with schizophrenia. Acta Psychiatr Scand 2007; 116:354-61. [PMID: 17868428 DOI: 10.1111/j.1600-0447.2007.01087.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [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: 11/29/2022]
Abstract
OBJECTIVE In this prospective study, patients with schizophrenia were followed up for 3 months to investigate the impact of sociodemographic factors, psychopathology, change in psychopathology and side effects on subjective response and attitudes toward antipsychotics during the initial treatment period. METHOD We investigated 42 patients starting treatment with a new-generation antipsychotic. Next to the registration of demographic data various rating scales were used: the Positive and Negative Syndrome Scale (PANSS), the Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale and the Drug Attitude Inventory (DAI). RESULTS Two patients experienced a first episode of the illness and were neuroleptic naïve, and 40 had suffered from at least one prior episode of schizophrenia. Longer duration of illness as well as the amelioration of psychopathological symptoms had a positive impact on subjective response to treatment. Correlations between antipsychotic-induced side effects and drug attitude tended to be weak. CONCLUSION Our results emphasize the necessity of improving psychopathological symptoms during the initial treatment period to improve attitudes toward and compliance with treatment.
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Affiliation(s)
- A Hofer
- Department of Biological Psychiatry, Medical University Innsbruck, Innsbruck, Austria.
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Widschwendter CG, Hofer A, Rettenbacher MA, Edlinger M, Kemmler G, Fleischhacker WW. Drug attitude during the initial treatment period: A prospective follow-up study in patients with schizophrenia. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991744] [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: 10/21/2022]
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Ihrenberger C, Hofer A, Benecke C, Edlinger M, Huber R, Kemmler G, Rettenbacher MA, Schleich G, Fleischhacker WW. Facial emotion recognition and its relationship to symptomatic, subjective, and functional outcomes in outpatients with chronic schizophrenia. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991761] [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: 10/21/2022]
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Hofer A, Rettenbacher MA, Edlinger M, Huber R, Bodner T, Kemmler G, Sachs G, Fleischhacker WW. Outcomes in Schizophrenia Outpatients Treated with Amisulpride or Olanzapine. Pharmacopsychiatry 2007; 40:1-8. [PMID: 17327953 DOI: 10.1055/s-2007-958520] [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: 10/23/2022]
Abstract
INTRODUCTION We compared stable patients with schizophrenia who were treated with either amisulpride or olanzapine in terms of symptomatic outcome, neurocognitive functioning, functionality, and subjective outcome. METHODS Sixty outpatients with chronic schizophrenia who had been treated with either amisulpride or olanzapine for at least six months were investigated. RESULTS The scores of positive, negative, and cognitive symptoms did not differ between the two groups, but patients treated with olanzapine had significantly lower scores on the excitement and depression/anxiety components of the PANSS. With regard to cognitive variables, patients treated with amisulpride showed significantly lower values regarding verbal fluency and significantly better verbal memory than patients treated with olanzapine. Both treatment groups were comparable with respect to functional and subjective outcome variables. DISCUSSION These observations add to the evidence that continuous treatment with different second-generation antipsychotics with relatively few side effects leads to comparable outcomes in patients with schizophrenia.
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Affiliation(s)
- A Hofer
- Department of Biological Psychiatry, Innsbruck Medical University, Austria.
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Lusser U, Kemmler G, Holzner B, Scheibner M, Desole S, Pirhofer C, Sperner-Unterweger B, Stauder R. 13 Factor analysis defines five distinct dimensions in geriatric assessment in cancer patients. Crit Rev Oncol Hematol 2006. [DOI: 10.1016/s1040-8428(13)70070-2] [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] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Holzner B, Bode RK, Hahn EA, Cella D, Kopp M, Sperner-Unterweger B, Kemmler G. Equating EORTC QLQ-C30 and FACT-G scores and its use in oncological research. Eur J Cancer 2006; 42:3169-77. [PMID: 17045472 DOI: 10.1016/j.ejca.2006.08.016] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [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: 04/05/2006] [Revised: 08/21/2006] [Accepted: 08/22/2006] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the equivalence of the European Organization for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30) and the Functional Assessment for Cancer Therapy-General (FACT-G) on the basis of corresponding subscales, and where appropriate to derive a scheme for converting QLQ-C30 scores into FACT-G scores and vice versa for use in oncological research. METHOD A calibration sample of 737 cancer patients (mean age 51.4+/-7.6 (SD), 63% female, 25% with current chemotherapy) who filled in both quality of life (QOL) questionnaires was used. Both classical test theory and the Rasch measurement model were applied. RESULTS Three of the four subscales common to both QOL instruments (physical, emotional, functional) proved suitable for equating (acceptable inter-correlations of corresponding subscales physical (r=0.77), emotional domain (r=0.60) role/functional (r=0.63) relative to their internal consistency, sufficient unidimensionality of pooled subscales, satisfactory fit to the Rasch model). Conversion tables for these subscales were generated. CONCLUSIONS The conversion tables developed in this study (physical, emotional and functional/role domain) appear promising for the comparison between EORTC QLQ-C30 and FACT-G scores of patient samples.
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Affiliation(s)
- B Holzner
- Department of Psychiatry, Innsbruck University Hospital, Anichstr.35, A-6020 Innsbruck, Austria.
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Benke T, Köylü B, Delazer M, Trinka E, Kemmler G. Cholinergic treatment of amnesia following basal forebrain lesion due to aneurysm rupture--an open-label pilot study. Eur J Neurol 2006; 12:791-6. [PMID: 16190917 DOI: 10.1111/j.1468-1331.2005.01063.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Impairments of memory are often found after rupture and repair of aneurysms leading to a basal forebrain lesion. This open study investigated whether cholinergic substitution therapy may be a treatment option. The effect of donepezil, a cholinesterase inhibitor on memory functions was tested in an open-label, exploratory study in 11 patients with a chronic amnestic syndrome from a ruptured and repaired aneurysm of the anterior communicating artery (seven patients), the anterior cerebral (two) or the pericallosal artery (two). Mean time since onset was 75.4 months. Memory was evaluated at baseline and consecutively after 4 weeks of 5 mg donepezil daily, 8 weeks of 10 mg donepezil, and 4 weeks after drug discontinuation. Memory functions were assessed using the California Verbal Learning Test and compared with a matched group of normal, untreated controls. Tests of attention and of executive functions were also administered. Donepezil was well tolerated. Strong group effects were found at baseline and at all follow-up measurements showing profound impairments of memory functions in the patient group. Within patient statistics showed significant improvements of short and long delay free recall scores during the treatment period, both with 5 and 10 mg donepezil daily, whereas attentional and executive functions improved only non-significantly. Memory functions decreased after drug discontinuation. Repeated test administration in the control group also showed an increase of memory scores which was minor when compared with the performance change in the patient group. Donepezil may improve episodic memory functions in patients suffering from a chronic amnestic syndrome caused by rupture and repair of aneurysms of the anterior communicating, the anterior cerebral or the pericallosal artery. Future doubled-blind, placebo-controlled trials are warranted to confirm these findings.
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Affiliation(s)
- T Benke
- University Clinic of Neurology, Innsbruck, Austria.
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Giacomuzzi S, Kemmler G, Ertl M, Riemer Y. Opioid addicts at admission vs. slow-release oral morphine, methadone, and sublingual buprenorphine maintenance treatment participants. Subst Use Misuse 2006; 41:223-44. [PMID: 16393744 DOI: 10.1080/10826080500391845] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [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: 10/25/2022]
Abstract
With use of a randomized study design, quality of life (QOL) and physical symptoms of opioid addicts at admission were compared with slow-release oral morphine, methadone, and sublingual buprenorphine maintenance program participants after 6 months of treatment. The study was conducted from February to July 2004 in the outpatient drug user treatment center at University Department of Psychiatry at Innsbruck, providing maintenance treatment programs and detoxification in Tyrol, Austria. One hundred twenty opioid users seeking treatment were compared with 120 opioid-dependent patients retained for 6 months on a slow-release oral morphine, methadone, or sublingual buprenorphine maintenance program. The German version ("Berlin Quality of Life Profile") of the Lancashire Quality of Life Profile was used, and illicit opioid use was determined by urinalysis. Physical symptoms were measured by using the Opioid Withdrawal Scale. Urinalyses revealed a significantly lower consumption of cocaine and opioids in all three substitution groups than in patients at admission (p < 0.001 and p < or = 0.004, respectively). Both the buprenorphine and the methadone maintenance group showed significantly more favorable values than opioid clients at admission for stomach cramps (p < or = 0.002), muscular tension (p < or = 0.027), general pain (p < or = 0.001), feelings of coldness (p < or = 0.000), heart pounding (p < or = 0.008), runny eyes (p < or = 0.047), and aggressions (p < or = 0.009). Patients who received slow-release oral morphine treatment generally showed the least favorable QOL scores compared with patients at admission or sublingual buprenorphine and methadone clients. Patients in the sublingual buprenorphine or methadone program showed nearly the same QOL scores. The buprenorphine and the methadone maintenance group showed significantly more favorable values than opioid clients at admission regarding leisure time (p < or = 0.019), finances (p < or = 0.014), mental health (p < or = 0.010), and overall satisfaction (p < or = 0.010). Slow-release oral morphine is a well-established treatment for pain, but more research is required to evaluate it as a treatment for heroin dependence. The present data indicate that slow-release oral morphine could have some disadvantages compared with sublingual buprenorphine and methadone in QOL, physical symptoms, and additional consumption. The results further suggest that buprenorphine treatment is as effective as methadone in effects on quality of life and physical symptoms.
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Affiliation(s)
- S Giacomuzzi
- University Department of Psychiatry, Innsbruck, Austria.
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Giacomuzzi S, Ertl M, Pavlic M, Libiseller K, Riemer Y, Kemmler G, Rössler H, Grubwieser P, Rabl W, Hinterhuber H. Outpatient drug treatment centre and patterns of drug use. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918688] [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: 10/18/2022]
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Giacomuzzi SM, Riemer Y, Ertl M, Kemmler G, Rossler H, Hinterhuber H, Kurz M. Gender differences in health-related quality of life on admission to a maintenance treatment program. Eur Addict Res 2005; 11:69-75. [PMID: 15785067 DOI: 10.1159/000083035] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [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: 11/19/2022]
Abstract
We compared the gender differences in health-related quality of life (QOL) on admission to a maintenance program. 103 opioid users (65 men and 38 women) admitted to a maintenance treatment program during 2000-2002 were studied. During this period we assessed the QOL status using the German version ('Berlin Quality of Life Profile') of the Lancashire Quality of Life Profile. Physical symptoms were measured using the Opioid Withdrawal Scale. 312 urine screening tests were carried out to evaluate consumption. The female group showed significantly less additional consumption of other opiates (p = 0.043) compared with the male group. The male group showed significantly better QOL scores in self-esteem (p = 0.015), psychical health (p = 0.027), and law and security (p = 0.008). The outcome measures for withdrawal scores showed significantly less symptoms for males in twitching of muscles (p = 0.034), vomiting (p = 0.002), depressions (p = 0.004) and poor appetite (p = 0.008). In summary, both genders showed only a few significant differences on admission in terms of QOL and physical symptoms. The predominant effects of drug use appear to eclipse the gender-related role pattern. Further exploration of gender and QOL could have important theoretical and treatment implications.
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Affiliation(s)
- S M Giacomuzzi
- Department of Psychiatry, University of Innsbruck, AT-6020 Innsbruck, Austria.
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Sperner-Unterweger B, Kohl C, Meraner V, Holzner B, Bodner T, Kemmler G. Psychopharmacological treatment in cancer patients – Interactions between biological and psychological variables? Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-825519] [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: 10/25/2022]
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Oehl MA, Hummer M, Baumgartner S, Ebenbichler C, Edlinger M, Hofer A, Kemmler G, Lechleitner M, Fleischhacker WW. Alterations of glucose metabolism under treatment with atypical antipsychotics. Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-825455] [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: 10/25/2022]
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Müller J, Wissel J, Kemmler G, Voller B, Bodner T, Schneider A, Wenning GK, Poewe W. Craniocervical dystonia questionnaire (CDQ-24): development and validation of a disease-specific quality of life instrument. J Neurol Neurosurg Psychiatry 2004; 75:749-53. [PMID: 15090572 PMCID: PMC1763554 DOI: 10.1136/jnnp.2003.013441] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.7] [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: 11/04/2022]
Abstract
OBJECTIVE To develop and test a questionnaire for measuring quality of life in patients with craniocervical dystonia. METHODS A 29-item pool was developed based on semi-structured interviews of patients with cervical dystonia (CD) and blepharospasm (BSP). This preliminary questionnaire was administered to 203 consecutive patients with CD and BSP from Austrian dystonia and botulinum toxin outpatient clinics. For scale generation, a combination of exploratory factor and cluster analysis was applied. This resulted in the 24-item version of the instrument (CDQ-24) based on five subscales: Stigma, Emotional wellbeing, Pain, Activities of daily living, and Social/family life. The validity and reliability of the CDQ-24 was assessed in 231 consecutive patients with CD and BSP different from those examined with the preliminary questionnaire. This second survey included the CDQ-24, a generic QoL instrument (SF-36) and clinical rating scales. Sensitivity to change was analysed in 51 previously untreated (de novo) patients four weeks and one year following the first botulinum toxin treatment. RESULTS Internal consistency reliability was satisfactory for all subscales, with values of Cronbach's alpha ranging from 0.77 to 0.89. The CDQ-24 subscales showed moderate to high correlations with those SF-36 subscales measuring similar aspects (Pearson's correlation r = 0.50-0.73; p<0.001, each). Sensitivity to change was confirmed by highly significant improvements of all CDQ-24 subscores in the de novo patients from baseline to four week follow up. One year follow up data revealed a stable improvement. CONCLUSION The CDQ-24 is the first fully validated and disease specific questionnaire to evaluate quality of life of patients with cervical dystonia and blepharospasm and we propose its use in clinical trials as well as in daily clinical practice.
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Affiliation(s)
- J Müller
- University Hospital of Neurology, Innsbruck, Austria. University Hospital of Psychiatry, Innsbruck, Austria
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Pfausler B, Beer R, Engelhardt K, Kemmler G, Mohsenipour I, Schmutzhard E. Cell index--a new parameter for the early diagnosis of ventriculostomy (external ventricular drainage)-related ventriculitis in patients with intraventricular hemorrhage? Acta Neurochir (Wien) 2004; 146:477-81. [PMID: 15118885 DOI: 10.1007/s00701-004-0258-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED Temporary intraventricular catheters for managing acute obstructive hydrocephalus caused by intraventricular haemorrhage carry a high risk of developing ventriculostomy-related ventriculitis (VRV). The aim of this prospective study was to validate a new parameter for the early detection of an intraventricular infection. METHODS Patients with external ventricular drainage due to intraventricular haemorrhage were enrolled in this prospective study. Leucocytes and erythrocytes in cerebrospinal fluid (CSF) and peripheral blood as well as bacteriological and chemical analysis of both were examined daily. The ratio of leucocytes to erythrocytes in CSF and leucocytes to erythrocytes in peripheral blood was calculated (so called cell index (CI)) and these values were compared with the "conventionally diagnosed" drain-associated ventriculitis. Furthermore, the CI values of the non-ventriculitis and ventriculitis group were compared using the t-test with adjustment for unequal variances (Welch test). RESULTS Thirteen patients with an external ventricular drainage (EVD) expected to be in place for more than seven days were enrolled. Seven patients developed a bacteriologically proven VRV (time 0) within 12 days (mean 8.57). Diagnosis of VRV by CI was possible up to 3 days (mean 2.28) prior to conventional diagnosis. P values (Welch test) showed a significant difference on days -3 (P = 0.03), -2 (P = 0.03) and -1 (P = 0.012) - i.e. 3, 2 or 1 day, respectively, prior to the time point when the CSF culture grew staphylococci -, when compared with the mean cell indices of the controls, and a highly significant difference on time 0 (P < 0.001). CONCLUSION The calculated CI allows the diagnosis of nosocomial VRV in patients with intraventricular haemorrhage at a very early point of time.
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Affiliation(s)
- B Pfausler
- Department of Neurology, University Hospital Innsbruck, Innsbruck, Austria.
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Hausmann A, Kemmler G, Walpoth M, Mechtcheriakov S, Kramer-Reinstadler K, Lechner T, Walch T, Deisenhammer EA, Kofler M, Rupp CI, Hinterhuber H, Conca A. No benefit derived from repetitive transcranial magnetic stimulation in depression: a prospective, single centre, randomised, double blind, sham controlled "add on" trial. J Neurol Neurosurg Psychiatry 2004; 75:320-2. [PMID: 14742619 PMCID: PMC1738930] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has been reported to demonstrate slight effects in the treatment of depression. Hence, a novel bilateral versus unilateral and sham stimulation design was applied to further assess rTMS' antidepressant effects. Forty one medication free patients with major depression, admitted to a psychiatric unit specialising in affective disorders, were consecutively randomised into 3 groups. Group A1 (n = 12) received unilateral active stimulation consisting of high frequency (hf) rTMS over the left dorsolateral prefrontal cortex (LDLPC) and subsequent sham low frequency (lf) rTMS over the right dorsolateral prefrontal cortex (RDLPC). Group A2 (n = 13) received simultaneous bilateral active stimulation consisting of hf-rTMS over the LDLPC and lf-rTMS over the RDLPC. Group C (n = 13) received bilateral sham stimulation. Stimulation was performed on 10 consecutive workdays. All patients received antidepressant medication on the first day of stimulation, which was continued during and after the stimulation period. As no significant difference in antidepressant outcome between group A1 and A2 was found, the two groups were pooled. The time course of the outcome variables Hamilton depression rating scale (HDRS(21)) and Beck depression inventory (days 0, 7, 14, 28) by repeated measures analysis of variance revealed no significant group differences (in terms of a group by time interaction), whereas there was a significant effect of time on all three outcome variables in all groups. The results suggest that rTMS as an "add on" strategy, applied in a unilateral and a bilateral stimulation paradigm, does not exert an additional antidepressant effect.
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Affiliation(s)
- A Hausmann
- University Hospital Innsbruck, Department of General Psychiatry, Innsbruck, Austria.
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Kemmler G, Schmied B, Shetty-Lee A, Zangerle R, Hinterhuber H, Schüssler G, Mumelter B. Quality of life of HIV-infected patients: psychometric properties and validation of the German version of the MQOL-HIV. Qual Life Res 2004; 12:1037-50. [PMID: 14651421 DOI: 10.1023/a:1026114004548] [Citation(s) in RCA: 20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine the psychometric properties of the recently developed German version of the Multidimensional Quality of Life Questionnaire for HIV/AIDS (MQOL-HIV) and to test its performance in a sample of HIV-infected patients. METHODS Two-hundred and seven outpatients with HIV/AIDS were interviewed with the German version of the MQOL-HIV; 109 patients were interviewed a second time approximately 2 weeks later. Patients also completed the Beck Depression Inventory (BDI) and the World Health Organization Disability Assessment Schedule II (WHODAS II). RESULTS The German version of the MQOL-HIV showed satisfactory internal consistency (r: 0.74-0.85, sexual functioning: r = 0.61) and test-retest reliability in most subscales (r: 0.74-0.89, medical care: r = 0.67). Convergent validity with WHO-DAS II and BDI was satisfactory for most domains. Exploratory factor analysis yielded a seven-factor solution with separate factors for physical, emotional, cognitive, social and financial aspects, sexual functioning and medical care. CD4 count and source of infection were associated with most QOL domains, whereas age and gender showed no major impact on QOL. High rates of missing values were seen in the partnership domain and substantial ceiling effects in the area of medical care. CONCLUSIONS Overall the German version of the MQOL-HIV showed satisfactory reliability and validity. However, the domains of partnership, sexuality and medical care should generally receive more emphasis in future research on QOL assessment in patients with HIV/AIDS and the MQOL-HIV may be improved in these domains.
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Affiliation(s)
- G Kemmler
- Department of Psychiatry, Otto Wagner Hospital, Vienna, Austria.
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Abstract
OBJECTIVE To identify weather factors associated with an increased risk of suicide. In a number of prior studies an influence of meteorological conditions on the incidence of suicide or attempted suicide has been suggested. METHOD Official data on the suicide cases of the state of Tyrol, Austria, assessed over a period of 6 years (n = 702) were correlated with a number of meteorological factors assessed at eight weather stations. RESULTS The risk of committing suicide was significantly higher on days with high temperatures, low relative humidity or a thunderstorm and on days following a thunderstorm. The multiple logistic regression analysis left "temperature" and "thunderstorm on the preceding day" as significant factors, even after adjustment for sociodemographic and geographical variables. CONCLUSION Within the interaction of psychological and environmental influences in the development of suicidal ideation and behaviour, specific meteorological conditions may additionally contribute to the risk of suicide in predisposed individuals.
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Affiliation(s)
- E A Deisenhammer
- Department of General Psychiatry, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
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Abstract
We examined 77 obese patients treated with bariatric surgery in order to analyse treatment success, and compare those with a good or a poor outcome. The subjects, who were recruited one year after undergoing adjustable gastric banding, were asked questions concerning their sociodemographic status, postoperative course, past and present weight status, eating behaviours and difficulties in changing eating habits. Furthermore, we also used two body image questionnaires, and considered the patients' evaluations of positive and negative changes, as well as their wishes for the future. There were no preoperative differences between the 71% of patients in the good outcome group and the 29% in the poor outcome group. With regard to the postoperative course, the poor outcome group had more problems in adapting to new eating behaviours, experienced significantly more post-surgical complications, and had a persistently negative body evaluation. Both groups were satisfied with their achieved weight loss achieved, and their improved self-esteem and mobility. Adjustable gastric banding seems to be successful in inducing weight loss and allowing a better quality of life. However, factors such as postoperative complications, the ability and willingness to adopt new eating attitudes, and an improved body image seem to be crucial for therapeutic outcome.
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Affiliation(s)
- A Hotter
- Department of Psychosomatics, University Clinic of Psychiatry, Innsbruck, Austria.
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