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  • Schizophrenia  (7)
  • Manische Psychosen  (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
    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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  • 4
    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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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 227 (1979), S. 301-317 
    ISSN: 1433-8491
    Keywords: Manic psychoses ; Beta blockers ; Manische Psychosen ; Beta-Blocker
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Im Rahmen einer doppelblind durchgeführten, placebokontrollierten Studie wurden sechs manische Patienten mit hohen Dosen doder d- und dl-Propranolol behandelt. Dabei wurden folgende Variablen gemessen: Propranolol-Dosis, Propranolol-Serumkonzentration, Pulsfrequenz, Blutdruck und Psychopathologie. In allen Fällen konnte eine klinische Besserung festgestellt werden, aber hohe Dosen waren erforderlich, um einen befriedigenden therapeutischen Effekt zu erreichen. Die antimanische Wirksamkeit von d-Propranolol erschien, verglichen mit der von dl-Propranolol, um etwa 50% geringer. Aus diesem Ergebnis kann geschlossen werden, daß wenigstens ein Teil der antimanischen Wirksamkeit von Beta-Blockern unabhängig ist von den beta-blockierenden Eigenschaften dieser Substanzen.
    Notes: Summary Six manic patients were treated with high doses of d-propranolol or d- and dl-propranolol in a double-blind, placebo controlled study. The following variables were measured: propranolol dosage, propranolol serum concentration, pulse frequency, blood pressure, and psychotic behavior. In all cases an improvement was noticed. High dosages were necessary to obtain sufficient effect. The antimanic property of d-propranolol was approximately 50% smaller than the antimanic property of dl-propranolol. We conclude that at least some part of the antimanic action of beta-blockers is independent from the beta-blocking property.
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  • 6
    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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  • 7
    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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  • 8
    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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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 249 (1999), S. 305-312 
    ISSN: 1433-8491
    Keywords: Key words Corpus callosum ; Schizophrenia ; MRI ; Etiology of schizophrenia ; Family history
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous MRI studies have shown differences in corpus callosum size between schizophrenic patients and controls. The corpus callosum (CC), as the main interhemispheric fiber tract, plays an important role in interhemispheric integration and communication. Though MRI studies suggest smaller CC in schizophrenia, there are still conflicting findings. Using in vivo magnetic resonance imaging, it was investigated whether the midsagittal area of CC differs between twenty-three right-handed male schizophrenic patients and twenty-three matched controls. Total CC area, five subregions of CC, total brain volume, gray and white matter were measured. No differences between schizophrenic patients and controls were found regarding all CC measurements, total brain volume, and gray matter tissue. However, a significant reduction of white matter tissue in the patient group emerged. There was no correlation between CC morphology and clinical variables such as age of onset, length of illness or symptom severity. Interestingly, five schizophrenic patients with a positive family history of schizophrenia showed significant reduction of the subregion C3, associated with a reduced total brain and gray and white matter volume. Significant reduction in the CC and its subregions was not confirmed in this group of patients with schizophrenia. In the subgroup of schizophrenic patients with a positive family history of schizophrenia, a significant reduction of the subregion corresponding to a part of the trunk of the CC was found.
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