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Müller JL, Koller M, Müller S, Pollmächer T. [The forensic addiction rehabilitation center-Not a Gallic village of paternalism]. Nervenarzt 2023; 94:463-465. [PMID: 37010590 DOI: 10.1007/s00115-023-01458-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 04/04/2023]
Affiliation(s)
- Jürgen L Müller
- Schwerpunktprofessur für Forensische Psychiatrie, Universitätsmedizin Göttingen, Rosdorfer Weg 70, 37081, Göttingen, Deutschland.
| | - M Koller
- Schwerpunktprofessur für Forensische Psychiatrie, Universitätsmedizin Göttingen, Rosdorfer Weg 70, 37081, Göttingen, Deutschland
| | - S Müller
- Schwerpunktprofessur für Forensische Psychiatrie, Universitätsmedizin Göttingen, Rosdorfer Weg 70, 37081, Göttingen, Deutschland
| | - T Pollmächer
- Schwerpunktprofessur für Forensische Psychiatrie, Universitätsmedizin Göttingen, Rosdorfer Weg 70, 37081, Göttingen, Deutschland
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Abstract
Since ancient times, the close connection between disturbed sleep and mental disorders has been well known. And yet, it was not until the middle of the 20th century that these connections could be studied in detail, after the EEG and REM sleep were discovered. Especially the study of the sleep EEG of depressed patients has brought to light alterations of SWS and REM sleep that could be of considerable clinical value, but at least in part still await broad confirmation. In the treatment of disturbed sleep in psychiatric patients, cognitive behavioral therapy in particular has become increasingly established in recent years, whereas only limited innovations have been recorded with regard to pharmacological treatment. Only in recent years it has become clear that psychiatric disorders are often accompanied by clinically relevant somatic disorders of sleep, such as obstructive sleep apnea syndrome, and that such comorbidities urgently require attention and treatment. It is becoming increasingly clear that detailed knowledge of sleep disorders is essential for the effective treatment of mental disorders. Moreover, it is likely that the scientific study of sleep in mentally ill people still has untapped potential in terms of understanding the pathophysiology.
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Himmerich H, Fulda S, Linseisen J, Seiler H, Wolfram G, Himmerich S, Gedrich K, Kloiber S, Lucae S, Ising M, Uhr M, Holsboer F, Pollmächer T. Depression, comorbidities and the TNF-α system. Eur Psychiatry 2020; 23:421-9. [DOI: 10.1016/j.eurpsy.2008.03.013] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Revised: 03/18/2008] [Accepted: 03/22/2008] [Indexed: 12/31/2022] Open
Abstract
AbstractDepression has frequently been reported to be associated with other physical diseases and changes in the cytokine system. We aimed to investigate associations between a medical history of depression, its comorbidities and cytokine plasma levels in the Bavarian Nutrition Survey II (BVS II) study sample and in patients suffering from an acute depressive episode.The BVS II is a representative study of the Bavarian population aged 13–80 years. The disease history of its 1050 participants was assessed through face-to-face interviews. A sub-sample of 568 subjects and 62 additional acutely depressed inpatients of the Max Planck Institute of Psychiatry participated in anthropometric measurements and blood sampling. Tumor necrosis factor-α (TNF-α) and soluble TNF receptor (sTNF-R) p55 and sTNF-R p75 plasma levels were measured using enzyme-linked immunosorbent assays.A history of depression was associated with a higher incidence of high blood pressure, peptic ulcer, dyslipoproteinemia, osteoporosis, allergic skin rash, atopic eczema and thyroid disease.Within the BVS II sample, participants with a history of depression differed from subjects who had never had depression with regard to sTNF-R p55 and sTNF-R p75 levels even when controlling for age, BMI and smoking status. Acutely depressed inpatients showed even higher levels of sTNF-R p55 and sTNF-R p75 than subjects in the normal population. TNF-α levels were also significantly elevated in acutely depressed patients.These results confirm earlier studies regarding the comorbidities of depression and support the hypothesis that activation of the TNF-α system may contribute to the development of a depressive disorder.
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Gerlinger G, Deister A, Heinz A, Koller M, Müller S, Steinert T, Pollmächer T. [After the reform is before the reform : Results of the amendment processes of mental health law in German federal states]. Nervenarzt 2019; 90:45-57. [PMID: 30191253 DOI: 10.1007/s00115-018-0612-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND On the basis of mental health law, which differs between the federal states in Germany, courts can order the involuntary commitment of people with severe mental disorders in psychiatric hospitals, if they present a danger to themselves or to others. Due to decisions of the highest courts, these laws have been subject to revision since 2011. The aim of this paper is to analyze and compare the results of the revision processes in order to define the need for action for federal and state legislature. MATERIAL AND METHODS Research of the current status of the revision processes in the federal states and a comparative analysis. The state laws were compared on the basis of selected particularly relevant areas with respect to human rights and treatment. RESULTS In spite of the revisions the state laws are extremely heterogeneous and in many states do not fully comply with the requirements of the United Nations Convention on the Rights of Persons with Disabilities (UN-CRPD) or the highest courts' decisions. CONCLUSION The state laws should be harmonized, particularly where they restrict basic and human rights, e. g. regarding prerequisites and objectives of involuntary commitment and coercive measures.
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Affiliation(s)
- G Gerlinger
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde, Reinhardtstr. 27b, 10117, Berlin, Deutschland.
| | - A Deister
- Zentrum für Psychosoziale Medizin, Itzehoe, Deutschland
| | - A Heinz
- Klinik für Psychiatrie und Psychotherapie CCM, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - M Koller
- Landgericht Göttingen, Göttingen, Deutschland
| | - S Müller
- Klinik für Psychiatrie und Psychotherapie CCM, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - T Steinert
- Klinik für Psychiatrie und Psychotherapie I, Universität Ulm, Weissenau, Deutschland
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Behr M, Acker J, Cohrs S, Deuschle M, Danker-Hopfe H, Göder R, Norra C, Richter K, Riemann D, Schilling C, Weeß HG, Wetter TC, Wollenburg LM, Pollmächer T. [Prevalence of sleep-related breathing disorders of inpatients with psychiatric disorders]. Nervenarzt 2018; 89:807-813. [PMID: 29876601 DOI: 10.1007/s00115-018-0545-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sleep-related breathing disorders seriously impair well-being and increase the risk for relevant somatic and psychiatric disorders. Moreover, risk factors for sleep-related breathing disorders are highly prevalent in psychiatric patients. The aim of this study was for the first time in Germany to study the prevalence of obstructive sleep apnea syndrome (OSAS) as the most common form of sleep-related breathing disorder in patients with psychiatric disorders. METHODS In 10 psychiatric hospitals in Germany and 1 hospital in Switzerland, a total of 249 inpatients underwent an 8‑channel sleep polygraphy to investigate the prevalence of sleep apnea in this group of patients. RESULTS With a conspicuous screening result of 23.7% of the subjects, a high prevalence of sleep-related breathing disorders was found to occur among this group of patients. Male gender, higher age and high body mass index (BMI) were identified as positive risk factors for the detection of OSAS. DISCUSSION The high prevalence indicates that sleep apnea is a common sleep disorder among psychiatric patients. Although OSAS can lead to substantial disorders of the mental state and when untreated is accompanied by serious somatic health problems, screening procedures are not part of the routine work-up in psychiatric hospitals; therefore, sleep apnea is presumably underdiagnosed in psychiatric patients. In view of the results of this and previous studies, this topic complex should be the subject of further research studies.
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Affiliation(s)
- M Behr
- Zentrum für psychische Gesundheit, Klinikum Ingolstadt, Ingolstadt, Deutschland
| | - J Acker
- Klinik für Schlafmedizin, Bad Zurzach, Schweiz
| | - S Cohrs
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Rostock, Rostock, Deutschland
| | - M Deuschle
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für seelische Gesundheit, Mannheim, Deutschland
| | - H Danker-Hopfe
- Kompetenzzentrum Schlafmedizin, Klinik für Psychiatrie und Psychotherapie der Charité, Berlin, Deutschland
| | - R Göder
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
| | - C Norra
- LWL-Klinik Paderborn, Paderborn, Deutschland
| | - K Richter
- Klinik für Psychiatrie und Psychotherapie, Klinikum Nürnberg Nord, Nürnberg, Deutschland
| | - D Riemann
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - C Schilling
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für seelische Gesundheit, Mannheim, Deutschland
| | - H-G Weeß
- Schlafzentrum am Pfalzklinikum Klingenmünster, Klingenmünster, Deutschland
| | - T C Wetter
- Schlafmedizinisches Zentrum, Klinik für Psychiatrie und Psychotherapie, Universität Regensburg am Bezirksklinikum, Regensburg, Deutschland
| | - L M Wollenburg
- Zentrum für psychische Gesundheit, Klinikum Ingolstadt, Ingolstadt, Deutschland
| | - T Pollmächer
- Zentrum für psychische Gesundheit, Klinikum Ingolstadt, Ingolstadt, Deutschland.
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Riemann D, Baum E, Cohrs S, Crönlein T, Hajak G, Hertenstein E, Klose P, Langhorst J, Mayer G, Nissen C, Pollmächer T, Rabstein S, Schlarb A, Sitter H, Weeß HG, Wetter T, Spiegelhalder K. S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen. Somnologie 2017. [DOI: 10.1007/s11818-016-0097-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Adorjan K, Steinert T, Flammer E, Deister A, Koller M, Zinkler M, Herpertz SC, Häfner S, Hohl-Radke F, Beine KH, Falkai P, Gerlinger G, Pogarell O, Pollmächer T. Zwangsmaßnahmen in deutschen Kliniken für Psychiatrie und Psychotherapie. Nervenarzt 2016; 88:802-810. [DOI: 10.1007/s00115-016-0261-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bassetti CL, Ferini-Strambi L, Brown S, Adamantidis A, Benedetti F, Bruni O, Cajochen C, Dolenc-Groselj L, Ferri R, Gais S, Huber R, Khatami R, Lammers GJ, Luppi PH, Manconi M, Nissen C, Nobili L, Peigneux P, Pollmächer T, Randerath W, Riemann D, Santamaria J, Schindler K, Tafti M, Van Someren E, Wetter TC. Neurology and psychiatry: waking up to opportunities of sleep. : State of the art and clinical/research priorities for the next decade. Eur J Neurol 2015; 22:1337-54. [DOI: 10.1111/ene.12781] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 06/05/2015] [Indexed: 12/22/2022]
Affiliation(s)
- C. L. Bassetti
- Department of Neurology; Inselspital, Bern University Hospital; University of Bern; Bern Switzerland
| | - L. Ferini-Strambi
- Division of Neuroscience; Sleep Disorders Centre; Università Vita-Salute San Raffaele; Milan Italy
| | - S. Brown
- Institute of Pharmacology and Toxicology; University of Zürich; Zürich Switzerland
| | - A. Adamantidis
- Department of Neurology; Inselspital, Bern University Hospital; University of Bern; Bern Switzerland
| | - F. Benedetti
- Department of Clinical Neurosciences; Scientific Institute and University Vita-Salute San Raffaele; Milan Italy
| | - O. Bruni
- Department of Developmental and Social Psychology; Sapienza University; Rome Italy
| | - C. Cajochen
- Psychiatric University Clinic; Basel Switzerland
| | - L. Dolenc-Groselj
- Division of Neurology; Institute of Clinical Neurophysiology; University Medical Centre Ljubljana; Ljubljana Slovenia
| | - R. Ferri
- Department of Neurology; Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS); Troina Italy
| | - S. Gais
- Medical Psychology and Behavioural Neurobiology; Eberhard Karls Universität Tübingen; Tübingen Germany
| | - R. Huber
- Department of Paediatrics; Children's University Hospital; Zurich Switzerland
| | - R. Khatami
- Sleep Centre; Klinik Barmelweid AG; Barmelweid Switzerland
| | - G. J. Lammers
- Department of Neurology and Clinical Neurophysiology; Leiden University Medical Centre; Leiden The Netherlands
- Sleep Wake Centre SEIN; Stichting Epilepsie Instellingen Nederland; Heemstede The Netherlands
| | - P. H. Luppi
- UMR 5292 CNRS/U1028 INSERM; Centre de Recherche en Neurosciences de Lyon (CRNL); Team “Physiopathologie des réseaux neuronaux responsables du cycle veille-sommeil”; Université Claude Bernard Lyon I; Lyon France
| | - M. Manconi
- Sleep and Epilepsy Centre; Neurocentre of Southern Switzerland; Civic Hospital (EOC) of Lugano; Lugano Switzerland
| | - C. Nissen
- Department of Clinical Psychology and Psychophysiology/Sleep Medicine; Centre for Mental Disorders; Freiburg University Medical Centre; Freiburg Germany
| | - L. Nobili
- Centre of Epilepsy Surgery ‘C. Munari’; Niguarda Hospital; Milan Italy
| | - P. Peigneux
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit; CRCN - Centre de Recherches Cognition et Neurosciences and UNI - ULB Neurosciences Institute; Université Libre de Bruxelles (ULB); Brussels Belgium
| | - T. Pollmächer
- Center of Mental Health; Klinikum Ingolstadt; Ingolstadt Germany
| | - W. Randerath
- Institut für Pneumologie; Krankenhaus Bethanien gGmbH; Universität Witten/Herdecke; Solingen Germany
| | - D. Riemann
- Department of Clinical Psychology and Psychophysiology/Sleep Medicine; Centre for Mental Disorders; Freiburg University Medical Centre; Freiburg Germany
| | - J. Santamaria
- Neurology Service; Hospital Clínic of Barcelona; Institut d'Investigació Biomèdiques August Pi i Sunyer (IDIBAPS); Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED); Barcelona Spain
| | - K. Schindler
- Department of Neurology; Inselspital, Bern University Hospital; University of Bern; Bern Switzerland
| | - M. Tafti
- Centre for Integrative Genomics; University of Lausanne; Lausanne Switzerland
- Centre for Investigation and Research in Sleep; Vaud University Hospital; Lausanne Switzerland
| | - E. Van Someren
- Department of Sleep and Cognition; Netherlands Institute for Neuroscience; Amsterdam The Netherlands
- Departments of Integrative Neurophysiology and Medical Psychology; Center for Neurogenomics and Cognitive Research (CNCR); VU University and Medical Center; Amsterdam The Netherlands
| | - T. C. Wetter
- Department of Psychiatry and Psychotherapy; University of Regensburg; Regensburg Germany
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Wolff-Menzler C, Maier B, Junne F, Löhr M, Große C, Falkai P, Pollmächer T, Salize HJ, Nitschke R, Hauth I, Deister A, Godemann F. Versorgungsindikatoren in der Psychiatrie und Psychosomatik (VIPP) – Ein Datenbank-Projekt. Fortschr Neurol Psychiatr 2014; 82:394-400. [PMID: 25014202 DOI: 10.1055/s-0034-1366577] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- C. Wolff-Menzler
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen
| | - B. Maier
- BWL-Gesundheitsmanagement, Duale Hochschule Baden-Württemberg, Mannheim
| | - F. Junne
- Medizinische Klinik Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - M. Löhr
- Psychiatrische Pflege, Fachhochschule der Diakonie, Bielefeld
| | - C. Große
- Professur für Finanzen und Controlling, Georg-August-Universität Göttingen
| | - P. Falkai
- Direktor der Klinik, Klinikum der Universität München
| | - T. Pollmächer
- Zentrum für psychische Gesundheit, Klinikum Ingolstadt
| | - H.-J. Salize
- Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Mannheim
| | - R. Nitschke
- Medizincontrolling/Qualitätsmanagement, Zentralinstitut für Seelische Gesundheit, Mannheim
| | - I. Hauth
- Geschäftsführung, Alexianer St. Joseph-Krankenhaus Berlin-Weißensee GmbH, Berlin
| | - A. Deister
- Zentrum für Psychosoziale Medizin, Klinikum Itzehoe
| | - F. Godemann
- Klinik für seelische Gesundheit im Alter und Verhaltensmedizin, Alexianer St. Joseph-Krankenhaus Berlin-Weißensee GmbH, Berlin
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Godemann F, Falkai P, Hauth I, Salize HJ, Pollmächer T, Wolff-Menzler C. [Lump sum payment system in psychiatry and psychosomatics: concomitant research - quo vadis?]. Nervenarzt 2014; 84:864-8. [PMID: 23695005 DOI: 10.1007/s00115-013-3795-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The new lump sum payment scheme for psychiatric and psychosomatic services is coming into force in 2013. This constitutes another step on the way to performance-based financial compensation of inpatient and day hospital treatment in psychiatric and psychosomatic hospitals in Germany. This fundamental change needs to be accompanied by scientific evaluation with regards to its effects. This article reflects on the legal foundations of such evaluations and the current progress of preparation. Furthermore, own approaches for analysing the effects of the new finance scheme are presented.
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Oertel W, Riemann D, Pollmächer T. [Sleep]. Nervenarzt 2014; 85:7-8. [PMID: 24441881 DOI: 10.1007/s00115-013-3847-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- W Oertel
- Klinik für Neurologie, Philipps-Universität Marburg, Baldingerstr., 35043, Marburg, Deutschland,
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Pollmächer T, Wetter TC, Happe S, Richter K, Acker J, Riemann D. [Sleep medicine differential diagnostics in psychiatry and psychotherapy]. Nervenarzt 2013; 85:57-66. [PMID: 24356713 DOI: 10.1007/s00115-013-3895-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Complaints about disturbed sleep or increased daytime sleepiness are among the most frequent symptoms reported to psychiatrists by patients. Such complaints can be symptoms of an underlying psychiatric disorder or indicative of a separate or comorbid sleep disorder. Hence, basic knowledge in the differential diagnosis of sleep medicine pathologies is pivotal for psychiatrists and psychotherapists. In the present overview following a description of the diagnostic methods, the diagnostic work-up according to the major symptomatic clusters, namely disturbances in initiating and maintaining sleep, abnormal nocturnal movements and excessive daytime sleepiness will be presented.
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Affiliation(s)
- T Pollmächer
- Zentrum für psychische Gesundheit, Klinikum Ingolstadt, Krumenauerstr. 25, 85049, Ingolstadt, Deutschland,
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Maurovich-Horvat E, Keckeis M, Lattová Z, Kemlink D, Wetter T, Schuld A, Šonka K, Pollmächer T. Hypothalamo–pituitary–adrenal axis, glucose metabolism and TNF-α in narcolepsy. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.352] [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: 11/25/2022]
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Kluge M, Pollmächer T, Schuld A. O-27 - Sleep propensity at daytime as assessed by multiple sleep latency tests (MSLT) in patients with schizophrenia increases with clozapine and olanzapine. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)74127-5] [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: 11/17/2022] Open
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Hauth I, Pollmächer T. [10 topic paper of the BDK on the new payment system in psychiatry and psychotherapy]. Psychiatr Prax 2011; 38:103. [PMID: 21394695 DOI: 10.1055/s-0031-1275226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Riemann D, Spiegelhalder K, Espie C, Pollmächer T, Léger D, Bassetti C, van Someren E. Chronic insomnia: clinical and research challenges--an agenda. Pharmacopsychiatry 2010; 44:1-14. [PMID: 21161882 DOI: 10.1055/s-0030-1267978] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Chronic insomnia afflicts up to 10% of the population in Western industrialized countries. It is characterized by delayed sleep onset, problems in maintaining sleep, early morning awakening or the feeling of non-restorative sleep coupled with significant daytime impairments on an emotional, social or professional level. It can occur as a co-morbid condition in any other medical or mental disorder, but also as a primary condition. Within the last decade new diagnostic and differential diagnostic approaches have been suggested that enhance diagnostic precision. Epidemiological data and data relating to the health care and cost situation of chronic insomnia suggest a huge burden for society. Chronic insomnia leads to a clear-cut increased risk for psychopathology (i. e., affective disorders) and probably also for cardiovascular and metabolic dysfunction. The pathophysiology of the condition is still poorly understood and will profit from integrating modern neuroscientific approaches (animal studies, molecular biology, neuroimaging, neurophysiology, etc.). Current treatment strategies are mainly based on cognitive behavioural interventions (CBT-I) and hypnotic treatment with benzodiazepine receptor agonists and sedating antidepressants. Although the effectiveness of these treatments has been clearly demonstrated, a substantial proportion of patients proves to be treatment-resistant or profits only poorly. The question of long-term pharmaceutical treatment of chronic insomnia, at least in Europe, is unresolved and urgently needs answers. Novel rational treatment avenues require clues on causes and mechanisms from integrated neuroscientific approaches. The important issues concerning insomnia treatment in the future especially in Europe will be reviewed and discussed critically.
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Affiliation(s)
- D Riemann
- Department of Psychiatry and Psychotherapy of Freiburg University Medical Center, Freiburg, Germany.
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Beitinger PA, Fulda S, Dalal MA, Wehrle R, Keckeis M, Wetter TC, Pollmächer T, Schuld A. Glucose tolerance in patients with narcolepsy. Exp Clin Endocrinol Diabetes 2010. [DOI: 10.1055/s-0030-1267025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hennings JM, Ising M, Grautoff S, Himmerich H, Pollmächer T, Schaaf L. Glucose Tolerance in Depressed Inpatients, under Treatment with Mirtazapine and in Healthy Controls. Exp Clin Endocrinol Diabetes 2009; 118:98-100. [DOI: 10.1055/s-0029-1237361] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hennings JM, Owashi T, Binder EB, Horstmann S, Menke A, Kloiber S, Messer T, Pollmächer T, Nickel T, Sonntag A, Uhr M, Ising M, Holsboer F, Lucae S. Clinical characteristics and treatment outcome in a representative sample of depressed inpatients – Findings from the Munich Antidepressant Response Signature project. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pollmächer T. [Overweight and obesity in schizophrenia--much more than a life-style issue!]. Fortschr Neurol Psychiatr 2008; 76:697. [PMID: 19053011 DOI: 10.1055/s-0028-1100834] [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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Penzel T, Hajak G, Hoffmann R, Lund R, Podszus T, Pollmächer T, Schäfer T, Schulz H, Sonnenschein W, Spieweg I. Empfehlungen zur Durchführung und Auswertung polygraphischer Ableitungen im diagnostischen Schlaflabor. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wehrle R, Beitinger P, Dalal M, Schuld A, Wetter TC, Pollmächer T. Daytime sleep after glucose intake in patients with narcolepsy. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991847] [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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Beitinger PA, Wehrle R, Fulda S, Himmerich H, Pollmächer T, Wetter TC. Metabolic and cardiovascular risk factors in narcolepsy. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991834] [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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Rathgeb-Fuetsch M, Beer U, Urmann I, Pollmächer T, Schuld A. Long-term efficacy of cognitive-behavioral therapy of patients with anxiety disorders in a hospital setting – influence of continuing psychotherapy and pharmacotherapy. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991804] [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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Fulda S, Beitinger PA, Wehrle R, Himmerich H, Pollmächer T, Wetter TC. Increased prevalence of restless legs syndrome in narcoleptic patients. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991837] [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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Lattova Z, Maurovich-Horvat E, Nia S, Pollmächer T. Prevalence of Restless Leg Syndrom in Psychiatric Population. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991840] [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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Beitinger PA, Wehrle R, Fulda S, Himmerich H, Pollmächer T, Wetter TC. Metabolic alterations in patients with narcolepsy. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972383] [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: 10/21/2022]
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Ehrenreich H, Hinze-Selch D, Stawicki S, Aust C, Knolle-Veentjer S, Wilms S, Heinz G, Erdag S, Jahn H, Degner D, Ritzen M, Mohr A, Wagner M, Schneider U, Bohn M, Huber M, Czernik A, Pollmächer T, Maier W, Sirén AL, Klosterkötter J, Falkai P, Rüther E, Aldenhoff JB, Krampe H. Improvement of cognitive functions in chronic schizophrenic patients by recombinant human erythropoietin. Mol Psychiatry 2007; 12:206-20. [PMID: 17033631 DOI: 10.1038/sj.mp.4001907] [Citation(s) in RCA: 186] [Impact Index Per Article: 10.9] [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: 12/11/2022]
Abstract
Schizophrenia is increasingly recognized as a neurodevelopmental disease with an additional degenerative component, comprising cognitive decline and loss of cortical gray matter. We hypothesized that a neuroprotective/neurotrophic add-on strategy, recombinant human erythropoietin (rhEPO) in addition to stable antipsychotic medication, may be able to improve cognitive function even in chronic schizophrenic patients. Therefore, we designed a double-blind, placebo-controlled, randomized, multicenter, proof-of-principle (phase II) study. This study had a total duration of 2 years and an individual duration of 12 weeks with an additional safety visit at 16 weeks. Chronic schizophrenic men (N=39) with defined cognitive deficit (>or=1 s.d. below normal in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)), stable medication and disease state, were treated for 3 months with a weekly short (15 min) intravenous infusion of 40,000 IU rhEPO (N=20) or placebo (N=19). Main outcome measure was schizophrenia-relevant cognitive function at week 12. The neuropsychological test set (RBANS subtests delayed memory, language-semantic fluency, attention and Wisconsin Card Sorting Test (WCST-64) - perseverative errors) was applied over 2 days at baseline, 2 weeks, 4 weeks and 12 weeks of study participation. Both placebo and rhEPO patients improved in all evaluated categories. Patients receiving rhEPO showed a significant improvement over placebo patients in schizophrenia-related cognitive performance (RBANS subtests, WCST-64), but no effects on psychopathology or social functioning. Also, a significant decline in serum levels of S100B, a glial damage marker, occurred upon rhEPO. The fact that rhEPO is the first compound to exert a selective and lasting beneficial effect on cognition should encourage new treatment strategies for schizophrenia.
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Affiliation(s)
- H Ehrenreich
- Division of Clinical Neuroscience, Max-Planck-Institute of Experimental Medicine, Göttingen, Germany.
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Pollmächer T. S08.C Experimental endotoxinemia: a powerful tool to study sleep-immune system interactions in humans. Sleep Med 2007. [DOI: 10.1016/s1389-9457(07)70042-4] [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: 11/15/2022]
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32
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Ehrenreich H, Hinze-Selch D, Stawicki S, Aust C, Knolle-Veentjer S, Wilms S, Heinz G, Erdag S, Jahn H, Degner D, Ritzen M, Mohr A, Wagner M, Schneider U, Bohn M, Huber M, Czernik A, Pollmächer T, Maier W, Sirén AL, Klosterkötter J, Falkai P, Rüther E, Aldenhoff J, Krampe H. Hemoglobin-Independent Organ Protection by EPO in Humans: Amelioration of Cognitive Loss in Chronic Schizophrenia. J Am Soc Nephrol 2007. [DOI: 10.1681/asn.2006111278] [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: 11/03/2022] Open
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Billiard M, Bassetti C, Dauvilliers Y, Dolenc-Groselj L, Lammers GJ, Mayer G, Pollmächer T, Reading P, Sonka K. EFNS guidelines on management of narcolepsy. Eur J Neurol 2006; 13:1035-48. [PMID: 16987156 DOI: 10.1111/j.1468-1331.2006.01473.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 7.7] [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
Management of narcolepsy with or without cataplexy relies on several classes of drugs, namely stimulants for excessive daytime sleepiness and irresistible episodes of sleep, antidepressants for cataplexy and hypnosedative drugs for disturbed nocturnal sleep. In addition, behavioral measures can be of notable value. Guidelines on the management of narcolepsy have already been published. However contemporary guidelines are necessary given the growing use of modafinil to treat excessive daytime sleepiness in Europe within the last 5-10 years, and the decreasing need for amphetamines and amphetamine-like stimulants; the extensive use of new antidepressants in the treatment of cataplexy, apart from consistent randomized placebo-controlled clinical trials; and the present re-emergence of gamma-hydroxybutyrate under the name sodium oxybate, as a treatment of all major symptoms of narcolepsy. A task force composed of the leading specialists of narcolepsy in Europe has been appointed. This task force conducted an extensive review of pharmacological and behavioral trials available in the literature. All trials were analyzed according to their class evidence. Recommendations concerning the treatment of each single symptom of narcolepsy as well as general recommendations were made. Modafinil is the first-line pharmacological treatment of excessive daytime sleepiness and irresistible episodes of sleep in association with behavioral measures. However, based on several large randomized controlled trials showing the activity of sodium oxybate, not only on cataplexy but also on excessive daytime sleepiness and irresistible episodes of sleep, there is a growing practice in the USA to use it for the later indications. Given the availability of modafinil and methylphenidate, and the forseen registration of sodium oxybate for narcolepsy (including excessive daytime sleepiness, cataplexy, disturbed nocturnal sleep) in Europe, the place of other compounds will become fairly limited. Since its recent registration cataplexy sodium oxybate has now become the first-line treatment of cataplexy. Second-line treatments are antidepressants, either tricyclics or newer antidepressants, the later being increasingly used these past years despite few or no randomized placebo-controlled clinical trials. As for disturbed nocturnal sleep the best option is still hypnotics until sodium oxybate is registered for narcolepsy. The treatments used for narcolepsy, either pharmacological or behavioral, are diverse. However the quality of the published clinical evidences supporting them varies widely and studies comparing the efficacy of different substances are lacking. Several treatments are used on an empirical basis, specially antidepressants for cataplexy, due to the fact that these medications are already used widely in depressed patients, leaving little motivation from the manufacturers to investigate efficacy in relatively rare indications. Others, in particular the more recently developed substances, such as modafinil or sodium oxybate, are evaluated in large randomized placebo-controlled trials. Our objective was to reinforce the use of those drugs evaluated in randomized placebo-controlled trials and to reach a consensus, as much as possible, on the use of other available medications.
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Affiliation(s)
- M Billiard
- School of Medicine, University of Montpellier, Montpellier, France.
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Schuld A, Birkmann S, Beitinger P, Haack M, Kraus T, Dalal MA, Holsboer F, Pollmächer T. Low doses of dexamethasone affect immune parameters in the absence of immunological stimulation. Exp Clin Endocrinol Diabetes 2006; 114:322-8. [PMID: 16868892 DOI: 10.1055/s-2006-924255] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Recent findings suggest an important role of subtle changes in the plasma levels of inflammatory cytokines within the brain-immune interplay. It is unclear how such changes are regulated in the absence of acute inflammatory or infectious stimuli. Endocrine systems are a good candidate, because innate immunity and the hypothalamo-pituitary-adrenal (HPA)-system are closely related: glucocorticoids have immunosuppressive properties and modulate cytokine release from stimulated mononuclear blood cells in vitro and the immune response in vivo, but it still remains unclear, whether they also modulate circulating cytokine levels in the absence of immunological stimuli. We measured the influence of 1.5 or 3.0 mg dexamethasone (DEX) per os at 09:00 or 21:00 hours on body temperature, cortisol plasma levels, differential white blood cell counts, and cytokine plasma levels in 40 healthy male volunteers using a double-blind, placebo-controlled study design. In addition to significant morning-evening differences in tympanic temperature and several immune parameters, we found that DEX-intake significantly increased tympanic temperature, decreased cortisol plasma levels, altered differential white blood cell counts and induced changes in unstimulated plasma cytokine levels. Whereas the levels of TNF-alpha and sTNF-R p75 were reduced, the levels of sTNF-R p55 increased after a transient decrease.
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Affiliation(s)
- A Schuld
- Max Planck Institute of Psychiatry, Munich, Germany.
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Himmerich H, Pollmächer T, Schaaf L. [Affective disorders and diabetes]. MMW Fortschr Med 2006; 148:37-40. [PMID: 16875377] [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] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Affective disorders increase the risk for the occurrence of type 2 diabetes, and the presence of type 1 or type 2 diabetes may contribute to the development of an affective disorder. Certain antidepressants and behavioral therapy seem to improve blood sugar levels in patients suffering from depression and type 2 diabetes, although these antidepressants may lead to weight gain. However, some antipsychotics unfavorably affect weight development and carbohydrate metabolism. In diabetic patients, the physician should be particularly alert to affective symptoms, and in mentally ill patients, he should look out for metabolic changes that may be caused by diabetogenic psychopharmacological medication.
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Affiliation(s)
- H Himmerich
- Max-PlanckInstitut für Psychiatrie, München.
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Pollmächer T. European sleep medicine is airborne. J Sleep Res 2006; 15:230. [PMID: 16704579 DOI: 10.1111/j.1365-2869.2006.00526.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Künzel HE, Schuld A, Pollmächer T. [Chronic pain and depression]. Versicherungsmedizin 2006; 58:67-72. [PMID: 16800143] [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] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Pain and depression are a severe burden on the patient and on the health system. The diseases have many common pathophysiological aspects and a high level of comorbidity. In this article the different diagnostic tools and options for the treatment of pain and depression are described. Prognostic factors for the course of the diseases are given. Documentation of the disease is important for treatment, for questions in the field of healthcare and in order to furnish a medical opinion. Important diagnostic assessments and differential diagnoses are described.
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Kaufmann C, Wehrle R, Wetter TC, Holsboer F, Auer DP, Pollmächer T, Czisch M. Brain activation and hypothalamic functional connectivity during human non-rapid eye movement sleep: an EEG/fMRI study. ACTA ACUST UNITED AC 2005; 129:655-67. [PMID: 16339798 DOI: 10.1093/brain/awh686] [Citation(s) in RCA: 188] [Impact Index Per Article: 9.9] [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: 11/14/2022]
Abstract
Regional differences in sleep EEG dynamics indicate that sleep-related brain activity involves local brain processes with sleep stage specific activity patterns of neuronal populations. Macroscopically, it is not fully understood which cerebral brain regions are involved in the successive discontinuation of wakefulness. We simultaneously used EEG and functional MRI on 9 subjects (6 female: mean = 24.1 years, 3 male: mean = 26.0 years) and analyzed local blood oxygenation level dependent signal changes linked to the transition from wakefulness to different non-rapid eye movement (NREM) sleep stages (according to Rechtschaffen and Kales) of the first sleep cycles after 36 h of total sleep deprivation. Several brain regions throughout the cortex, the limbic lobe, the thalamus, the caudate nucleus, as well as midbrain structures, such as the mammillary body/hypothalamus, showed reduced activity during NREM sleep across all sleep stages. Additionally, we found deactivation patterns specific to NREM sleep stages compared with wakefulness suggesting that a synchronized sleeping state can be established only if these regions interact in a well-balanced way. Sleep stage 2, which is usually linked to the loss of self-conscious awareness, is associated with signal decreases comprising thalamic and hypothalamic regions, the cingulate cortex, the right insula and adjacent regions of the temporal lobe, the inferior parietal lobule and the inferior/middle frontal gyri. The hypothalamic region known to be of particular importance in the regulation of the sleep-wake cycle shows specific temporally correlated network activity with the cortex while the system is in the sleeping state, but not during wakefulness. We describe a specific pattern of decreased brain activity during sleep and suggest that this pattern must be synchronized for establishing and maintaining sleep.
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Affiliation(s)
- C Kaufmann
- Max Planck Institute of Psychiatry, Munich, Germany
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Dzaja A, Schneider HJ, Wehrle R, Stalla GK, Pollmächer T. Plasma ghrelin levels during and after pregnancy. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-920473] [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: 10/19/2022]
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Himmerich H, Fulda S, Künzel HE, Pfennig A, Dzaja A, Cummings DE, Pollmächer T. Ghrelin plasma levels during psychopharmacological treatment. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918717] [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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41
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Rathgeb-Fuetsch M, Beer U, Urmann I, Pollmächer T, Schuld A. Cognitive-behavioral therapy of patients with pure and comorbid panic disorder in a hospital setting–a comparison of therapy response. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918808] [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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Beitinger PA, Dalal MA, Wehrle R, Fulda S, Schuld A, Wetter TC, Pollmächer T. Impaired glucose tolerance in patients with narcolepsy. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Himmerich H, Fulda S, Schaaf L, Beitinger PA, Schuld A, Pollmächer T. Does antidepressant therapy improve glucose metabolism? Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918715] [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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Reisinger B, Mueller E, Kropp-Hartmann B, Wölflick D, Zimmerer C, Schuld A, Pollmächer T. Metabolic abnormalities in patients with chronic psychiatric disorders receiving long-term psychopharmacological treatment. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918809] [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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Himmerich H, Binder EB, Künzel HE, Schuld A, Lucae S, Uhr M, Pollmächer T, Holsboer F, Ising M. Successful antidepressant therapy restores the disturbed interplay between TNF-alpha system and HPA axis. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918716] [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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Wehrle R, Kaufmann C, Wetter TC, Holsboer F, Auer DP, Pollmächer T, Czisch M. Functional neuroanatomical correlates of spectral EEG power during NREM sleep. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918867] [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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Mueller E, Stöhr K, Weixler C, Kuenzel HE, Schuld A, Pollmächer T. Efficacy of electroconvulsive therapy for depressive disorders in a Bavarian district hospital. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918785] [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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Nickel T, Sonntag A, Backmund M, Pollmächer T. Depression during therapy with interferon alpha--how long should an antidepressant treatment last? Pharmacopsychiatry 2005; 38:102-4. [PMID: 15744637 DOI: 10.1055/s-2005-837813] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Although depressive symptoms are well-known side effects of interferon alpha (IFNalpha), it is uncertain if these symptoms decline with the cessation of IFNalpha therapy. We report on a 47-year-old man who, apart from former drug abuse, never had suffered from a psychiatric disorder. However, he had a family history burdened with the suicide of his mother and his twin sister. After a depressive symptomatology during the IFNalpha therapy, which had been tolerably treated by mirtazapine, he committed a suicide attempt six months after the parallel termination of IFNalpha and antidepressant treatment. Two aspects of this case report should be emphasised. First, patients with an increased risk for psychiatric complications of interferon therapy must be followed closely for a depressive symptomatology and treated aggressively if symptoms arise. Second, this case report shows the relapse of depressive symptoms far beyond the end of the interferon treatment. If an antidepressant treatment is necessary during IFNalpha therapy this should not be stopped prematurely with the termination of the interferon medication.
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Künzel HE, Schuld A, Pollmächer T. Sleepwalking associated with reboxetine in a young female patient with major depression--a case report. Pharmacopsychiatry 2005; 37:307-8. [PMID: 15551201 DOI: 10.1055/s-2004-832692] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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50
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Himmerich H, Kraus T, Pollmächer T. Epidemiology and mechanisms of weight gain induced by psychotropic drugs. Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-825377] [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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