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  • Schizophrenia  (7)
  • Apomorphine  (4)
  • Lithium  (2)
  • 1
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Lebensqualität ; Metaanalyse ; Depressive ; Schizophrene ; Facettenanalyse ; Modulares System ; Key words Quality of life ; Metaanalysis ; Depression ; Schizophrenia ; Facet analysis ; Modular system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The construct Quality of Life (QoL) is investigated by metaanalysis of eight (inter)nationally validated questionnaires in a multicenter study. Data have been collected in a mentally healthy (n=479), a depressed (n=171) and a schizophrenic (n=139) sample. Conventional psychometric criteria and a facet analytical methodology have been applied. The resulting questionnaire „Modular System for Quality of Life” (MSQoL) consists of a core module with 47 items (one „G-factor” and six subdimensions), which is sufficiently valid for all three samples. Additionally, there are four specific modules (demography, family, partnership, profession). No specific modules can be identified for the psychopathological subgroups. The validated radex structure for subjective QoL offers the opportunity for a cumulative research design and for adaptations to the actual setting.
    Notes: Zusammenfassung In einer von der Arbeitsgruppe „Lebensqualität (LQ)” der „Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie” (AMDP) unterstützten multizentrischen Studie wird das Konstrukt Lebensqualität (LQ) anhand von acht (inter)national validierten Erhebungsinstrumenten sowie einer gesunden (n=479), einer depressiven (n=171) und einer schizophrenen (n=139) Stichprobe metaanalytisch untersucht. Neben herkömmlichen psychometrischen Kriterien liegt der methodische Schwerpunkt dabei auf einem facettenanalytischen Vorgehen. Der resultierende Fragebogen „Modulares System zur Lebensqualität” (MSLQ) besteht aus einem für alle 3 Stichproben hinreichend validen Kernmodul mit 47 Items (ein „G-Faktor” und 6 Subdimensionen) sowie 4 spezifischen Modulen (Demographie, Familie, Partnerschaft, Beruf). Für die psychopathologischen Subgruppen lassen sich keine spezifischen Module etablieren. Die validierte Struktur der subjektiv eingeschätzten Lebensqualität (in Form einer facettenanalytischen Radexkonstellation) bietet die Möglichkeit zu einer kumulativ angelegten Forschung und einer untersuchungsspezifischen Anpassung des MSLQ.
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  • 2
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Psychopharmakologie ; Suizid ; Schizophrenie ; Risikofaktoren ; Psychopathologie ; Keywords Psychopharmacology ; Suicide ; Schizophrenia ; Risk facotrs ; Psychopathology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract For all 5.352 patients treated for schizophrenia at the Psychiatric Hospital of the University of Munich in 1981 and 1992, detailed routine and data processing-assisted documentations were made of the psychopharmacological therapies. Nineteen of the patients committed suicide while undergoing inpatient treatment; the control group consisted of all other patients (n=5.333). More than 77 sociodemographic and anamnestic variables as well as 195 items from the admission summaries were taken into account while comparing the groups. Furthermore, the pharmacological data were classified according to drug groups and comparison was based on the mean frequency of prescription of each group. We analyzed the mean number of prescriptions for neuroleptics, tranquilizers, and antidepressants, which were further differentiated into sedating and nonsedating types. For frequently administered drugs, mean daily doses were also compared. Bivariate analysis of the data suggests that the suicide cases presented depressive signs, symptoms, and tendencies already present on admission more frequently than with controls; the same applies to previously attempted suicides. Discriminating analysis showed that the variables “feeling of loss of feelings,“ thought insertion,”“visible depression,”“free-floating anxiety,”“suicidal tendencies,” and “previously attempted suicide” have the greatest predictive value with respect to suicide, in descending order. No differences in psychopharmacological treatment between suicides and controls were found, apart from a significantly higher percentage of antidepressive treatments and a higher mean number of antidepressant prescriptions for the suicides.
    Notes: Zusammenfassung Bei allen 5.352 im Zeitraum 1981–1992 in der Psychiatrischen Klinik der Universität München stationär aufgenommenen schizophrenen Patienten wurde systematisch sowohl eine Routinedokumentation mit dem AMDP-System als auch eine computergestützte Dokumentation der pharmakologischen Behandlung durchgeführt. 19 dieser Patienten suizidierten sich während des stationären Aufenthaltes, wobei die Kontrollgruppe aus allen übrigen Patienten gebildet wurde (n=5.333). In den Gruppenvergleich gingen alle soziodemographischen und krankheitsanamnestischen Variablen sowie alle Items des AMDP-Aufnahmebefundes ein. Ferner wurden die pharmakologischen Daten nach Medikamentengruppen zusammengefasst und hinsichtlich der Verordnungshäufigkeiten der jeweiligen Pharmakagruppen verglichen. Die bivariate Auswertung zeigte neben häufigeren Suizidversuchen in der Vorgeschichte ein bei den säteren Suizidenten bereits bei Aufnahme häufiger vorliegendes depressiv-suizidales Syndrom, wobei diskriminanzanalytisch in absteigender Reihenfolge die Variablen “Gefühl der Gefühllosigkeit”, “Gedankeneingebung”, “beobachtete Depression”, “frei flottierende Angst”, “Suizidalität” und “Suizidversuch in der Vorgeschichte” die größte prädiktive Kraft in Richtung Suizid entfalteten. Mit Ausnahme einer signifikanten Erhöhung sowohl des prozentualen Anteils der antidepressiv behandelten Patienten als auch der mittleren Anzahl der Antidepressivaverordnungen in der Suizidgruppe fanden sich keine Anhaltspunkte für eine zwischen den beiden Gruppen wesentlich differierende psychopharmakologische Behandlung.
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 335 (1987), S. 673-679 
    ISSN: 1432-1912
    Keywords: Apomorphine ; Conditioning ; Dopamine receptors ; Stereotyped behaviour ; Akinesia ptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Interactions between the direct (unconditioned) behavioural effects apomorphine and its conditioned effects after pairing with previously neutral stimuli were studied. Rats were injected once daily for 3–12 times, with apomorphine (2.0 mg/kg or 0.5 mg/kg or 0.07 mg/kg s.c. the dose kept constant in each series), in the presence of defined environmental stimuli (a wire cage in association with an acoustic and an olfactory stimulus) as conditional stimuli. The two larger doses produced stereotyped sniffing, licking, and gnawing, the smallest dose akinesia, ptosis, yawning and penile erections. During the conditioning phase, the drug produced most of the effects with increasing intensity and in the case of the stereotypies, there also was a shift to higher scores of stereotypy, with a reduced latency in onset of the signs. On the test day, 1 day after the last administration of apomorphine, the conditioned rats as well as “pseudoconditioned” controls were treated with a test dose of apomorphine in the presence of the conditional stimuli. Pseudoconditioned rats had been treated with the same pharmacological schedule of apomorphine and had the same familiarity with the stimuli, but both were kept separate. A test dose of 0.5 mg/kg of apomorphine produced stereotypies with a significantly higher score and shorter latency in onset in conditioned than in pseudoconditioned rats. Rats conditioned with the lowest dose showed a significantly longer total duration and a shorter latency in onset of akinesia and ptosis. In rats conditioned with the largest dose (2.0 mg/kg), administration of the lowest dose on the test day produced no stereotypies; neither the akinesia nor the ptosis were different between conditioned and pseudoconditioned rats, but yawning occurred with a higher frequency and a shorter latency in pseudoconditioned rats. When rats were conditioned with the lowest dose and tested with 0.5 mg/kg, the level of stereotypies was identical in both groups of rats, whereas akinesia and ptosis were not observed. Yawning and penile erections occurred more frequently, but for short periods only, in conditioned rats. The results showed that apomorphine-induced stereotypies, akinesia and ptosis could be conditioned, and the conditioned effects mimicked the unconditioned responses, which depended on the dose. Conditioned and unconditioned signs of an increased dopaminergic neurotransmission, observed after large doses of apomorphine, thus acted in a synergistic way; the same applied to conditioned and unconditioned signs observed after a small dose and were perhaps due to a decreased dopaminergic transmission. In contrast, when conditioned and unconditioned signs acted in a mutually antagonistic way (increased vs. decreased dopaminergic transmission), the unconditioned signs predominated.
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  • 4
    ISSN: 1432-2072
    Keywords: Apomorphine ; Conditioned dopaminergic activity ; Stereotyped behaviour ; Dopamine autoreceptors ; Dopamine metabolism ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated whether pharmacological effects of the dopamine agonist apomorphine can be conditioned by establishing an association of apomorphine administration with exteroceptive cues. Apomorphine was repeatedly administered and subsequently, the rat was put into a test cage and exposed to an acoustic and an olfactory stimulus (“conditioned rats”). Control animals (“pseudoconditioned” rats) were treated with the same pharmacological schedule of apomorphine not temporally associated with the stimuli. On the test day, both groups were injected with saline and exposed to the stimuli described. The stereotyped behaviour produced by large doses of apomorphine (0.5 or 2.0 mg/kg SC), namely sniffing, licking and gnawing, could be conditioned in a pronounced way. During the conditioning period, a change in the stereotypies was observed with regard to the time-course (earlier occurrence) and to the character of the stereotypies (from sniffing to licking and gnawing), when 0.5 mg/kg apomorphine was used, but not with the dose of 2.0 mg/kg. The conditioned responses showed a relatively uniform distribution during the observation period with some increase towards the end of the observation period. Some signs produced by a low dose of apomorphine (0.07 mg/kg SC), namely hypomotility and ptosis, but not yawning, could also be conditioned, although in a less pronounced way. An intermediate dose of apomorphine (0.18 mg/kg SC) produced both signs observed after large doses and those observed after a small dose, occurring alternatingly. Both types of signs could be conditioned using this dosage. Conditioning did not alter striatal or mesolimbic dopamine turnover. These results suggest that only behavioural signs due to an activation of postsynaptic dopamine receptors, but also some symptoms produced by an activation of dopamine autoreceptors can be conditioned.
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  • 5
    ISSN: 1432-2072
    Keywords: Schizophrenia ; negative symptoms ; clinical trials ; psychiatric status rating scales ; neuroleptics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There is little agreement about the methodology of clinical trials of antipsychotic drugs in patients with negative symptoms. A literature review revealed wide variation in experimental design, rating scales and study duration. This reflects differing views as to the definition and response to treatment of negative symptoms. Some degree of standardization would improve comparability of studies and aid the development of new compounds. Patients included in such studies should have displayed negative symptoms for at least 6 months. Depressive symptoms, positive schizophrenic symptoms and extrapyramidal signs may all influence or be confused with negative symptoms and may respond to treatment; they should be at a low level at baseline and should be measured during the study period. Studies should last at least 8 weeks. Several scales are available for measuring negative symptoms and are reviewed; a global impression score should be used additionally.
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  • 6
    ISSN: 1432-2072
    Keywords: Key words Amisulpride ; Atypical antipsychotic ; Schizophrenia ; Haloperidol ; Productive symptoms ; Secondary negative symptoms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Amisulpride is a substituted benzamide with high selectivity for dopaminergic D2 and D3 receptors. This study compared 800 mg/day amisulpride and 20 mg/day haloperidol in patients with acute exacerbations of schizophrenia. This multicenter, double-blind trial involved 191 patients allocated, after a 1 to 7-day wash-out period, to amisulpride (n = 95) or haloperidol (n = 96) for 6 weeks. Improvement of mean BPRS total score was 48% for amisulpride and 38% for haloperidol (NS), whereas improvement in the Negative PANSS subscale was greater in the amisulpride group (37%) compared to haloperidol (24%) (P = 0.038). CGI scores showed a higher number of responders in the amisulpride (62%) than in the haloperidol group (44%) (P = 0.014). More extrapyramidal symptoms measured with the Simpson-Angus scale were provoked in the haloperidol group (P = 0.0009). Amisulpride is at least as effective as haloperidol in the treatment of acute exacerbations of schizophrenia, and is more effective in the treatment of negative symptoms whilst causing less parkinsonism.
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  • 7
    ISSN: 1432-2072
    Keywords: Apomorphine ; Stereotypy ; Environmental influence ; Automatic recording ; Dopamine ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The topography of stereotyped behaviour produced by apomorphine in rats was studied by using either a scoring system, based on observation in a wire cage, or by quantification of horizontal and vertical activities, and of the total distances run in an open field, using an automatic recording system. The latter design was combined with a classification of the type of stereotyped behaviour observed during recording. In addition, the reproducibility of the nature of the stereotyped behaviour and its dose-dependence in individual animals was evaluated. In rats observed in a wire cage, apomorphine at lower doses (0.25 or 0.50 mg/kg SC) produced stereotyped sniffing. Increasing the doses led to stereotyped licking and the largest dose (5.00 mg/kg SC) produced predominantly stereotyped gnawing, as was demonstrated graphically. The type of behaviour produced by 2 mg/kg apomorphine in the open field was reproduced well in individuals after a second administration 4 days later. The shift from sniffing to gnawing was observed in most, but not all of the individually classified animals after administration of the largest dose (5 mg/kg). The locomotor part of motility was highest in “sniffing animals” and lower when gnawing occurred. The non-locomotor part of motility was low in “sniffing rats” and increased when licking and gnawing occurred. In some of the animals a characteristic “climbing” behaviour was observed in addition after the larger doses, which did not interfere with sniffing, licking or gnawing. A combination of classification by observation and automatic recording seems the most appropriate way to study the topography of stereotyped behaviour produced by apomorphine.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 229 (1980), S. 1-16 
    ISSN: 1433-8491
    Keywords: Manic psychoses ; Valproate ; GABA ; Lithium ; Manische Psychosen ; Valproat ; GABA ; Lithium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Unter Verwendung eines doppel-blinden ABA-Designs mit Placebo-Kontrolle wurde bei 5 Patienten mit akuter Manie eine mögliche antimanische Wirkung des GABA-ergen Anticonvulsivums Valproat untersucht. Bei 4 Patienten wurde eine deutliche Besserung beobachtet, während ein Patient auf Valproat nicht reagierte. Bei 7 weiteren Patienten mit häufig wiederkehrenden Phasen einer manischen oder maniformen schizoaffektiven Psychose, die auf die Lithium-Prophylaxe nicht ansprachen, wurde eine Dauerbehandlung mit Valproat in Kombination mit kleinen Lithium-Dosen durchgeführt. (In einem Fall wurde nur Valproat, ohne Lithium, gegeben.) Im Verlauf einer Beobachtungsphase von 1 1/2–3 Jahren wurde bei keinem dieser Patienten ein Rückfall beobachtet. Es wird die Hypothese vorgeschlagen, daß grundsätzlich GABA-erge Anticonvulsiva antimanische Eigenschaften aufweisen und daß auch der spezifische antimanische Effekt von Lithium auf einer GABA-ergen Wirkungskomponente beruht. Eine mögliche pathophysiologische Bedeutung zentraler GABA-Systeme bei affektiven und organischen Psychosen (z.B. Porphyrie, Delirium tremens) wird auf der Basis pharmakopsychiatrischer Überlegungen diskutiert.
    Notes: Summary A possible antimanic property of the GABA-ergic anticonvulsant valproate was examined by use of a double-blind placebo-controlled ABA design in 5 acutely ill manic patients. In 4 cases a marked improvement was observed after valproate medication whereas one patient showed no response. Seven further patients with frequently recurrent episodes of a manic or maniform schizoaffective psychosis, irresponsive to lithium prophylaxis, were chronically treated with valproate in combination with low doses of lithium (one case only with valproate). Over an observation period of 1 1/2–3 years none of the patients exhibited a relapse. It is proposed that, in general, GABA-ergic anticonvulsants possess antimanic properties and that the specific antimanic effect of lithium is due to a GABA-ergic mode of action. The possible role of GABA-systems in affective disorders and in organic types of psychoses (e.g., porphyria-psychosis, delirium tremens) is discussed on the basis of pharmacopsychiatric considerations.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 234 (1984), S. 118-124 
    ISSN: 1433-8491
    Keywords: Life-events ; Neurosis ; Schizophrenia ; Depression ; Stress ; Lebensereignisse ; Neurosen ; Schizophrenie ; Depression ; Stress
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An einer Stichprobe von 112 psychisch kranken Patienten wurde im Vergleich mit 70 körperlich Kranken analysiert, wie hdufig psychische Erkrankungen im Zusammenhang mit belastenden Lebensereignissen stehen. Es zeigten sich erhebliche Unterschiede der Life-event-Belastung zwischen den psychisch Kranken and der Kontrollgruppe sowie zwischen den einzelnen diagnostischen Gruppen. Die Life-event-Belastung war am ausgeprdgtesten bei den neurotisch Kranken. Auch bei den endogenen Psychosen, insbesondere bei den Schizophrenien, fand sich eine vermehrte Life-event-Belastung. Verschiedene Methoden (objektive Belastungswerte nach Paykel, vom Patienten angegebene Negativscores, Synthese aus objektiven and subjektiven Bewertungen) führten bei den Gruppenvergleichen zu vergleichbaren Resultaten. Vom Patienten als positiv bewertete Life-events standen nicht in Zusammenhang mit psychischen Erkrankungen.
    Notes: Summary A sample of 112 psychiatric inpatients were examined in comparison to 70 somatic inpatients with respect to the question, how frequent psychiatric diseases were in correlation with stressful life-events. There were significant discrepancies concerning life-event stress between the diagnostic subgroups. The life-event stress was most important in the neurotic patients, also patients suffering from endogenous psychoses, especially schizophrenics, showed an increased life-event stress. Different methods (objective stress scores suggested by Paykel, self-rating scores concerning negative experiences, and a synthesis between these two methods) led to similar results. Experiences, rated positive by the patients, showed no correlation with psychiatric diseases.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 235 (1986), S. 263-268 
    ISSN: 1433-8491
    Keywords: Dexamethasone suppression test ; Depression ; Schizophrenia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Endogenous depressive and schizophrenic patients demonstrated the same frequency of pathological DST results after admission. After 3 weeks of psychopharmacological treatment the percentage of abnormal DST results was significantly reduced in both groups, although the treatment conditions were different. A correlation between the DST non-suppression and intensity of depression was observed only in the depressive group, not in the schizophrenic group. Normalization of DST results in depressive patients was mostly associated with an improvement of depressive scores. Other course patterns of DST results did not seem to be combined with psychopathological changes. From this data it has to be concluded that DST non-suppression is in some part related to depressive symptoms, but is not characteristic or specific for endogenous depression or for depressivity.
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