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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Nervenarzt 68 (1997), S. 591-592 
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Mianserin ; Tranylcypromin ; Kardiale Vorschädigung ; Hypertone Blutdruckwerte ; Key words Mianserin ; Tranylcypromine ; Cardiac disease ; Hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary As compared to other tri- and tetracyclics, antidepressant therapy in patients suffering also from cardiac disease with mianserin is known to be relatively safe. Hypertensive effects of mianserin have not been described so far. We report a case of a 64 years old patient with a dilatative cardiomyopathy and left anterior hemiblock, who developed hypertension (maximum: 180/125 mmHg) during mianserin treatment. Previous treatment with tranylcypromine has been stopped two weeks before. After discontinuance of mianserin blood pressure rapidly came back to normal values. The possible noradrenergic and serotonergic mechanisms of this phenomenon are discussed in relation to pretreatment with tranylcypromine.
    Notes: Zusammenfassung Mianserin gilt in der antidepressiven Behandlung von kardial vorgeschädigten Patienten im Vergleich zu anderen tri- und tetrazyklischen Antidepressiva als eher unbedenklich. Blutdrucksteigernde Wirkungen sind nicht zu erwarten. Im dargestellten Fall wurde ein 64jähriger Patient mit vorbekannter dilatativer Kardiomyopathie und Linksschenkelblock nach Vorbehandlung mit Tranylcypromin auf Mianserin umgestellt, woraufhin sich eine medikamentös nur schwer zu beeinflussende hypertone Blutdrucksteigerung (Maximum: 180/125 mmHg) entwickelte. Nach Absetzen von Mianserin kam es zu einer raschen Blutdrucknormalisierung. Die der Blutdrucksteigerung zugrundeliegenden möglichen noradrenergen und serotonergen Wirkmechanismen werden auf dem Hintergrund der Vorbehandlung mit Tranylcypromin diskutiert.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Wahn ; Wahnentstehung ; Urteilsverhalten ; Key words Delusion ; Origin of delusion ; Decision making
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Delusion as a phenomenon was always in the focus of psychiatric interest. Explanations for its origin reach from disturbed perception or affect to deficits in cognition. In our study we investigated 20 deluded, 20 depressive and 20 healthy subjects in order to find out differences in decision making, while a neutral test situation. Our hypothesis was that deluded subjects need less information for decision making and tend less to change their decision, made before, than both control groups will do this. For examination our hypothesis a modified version of “Probabilistic Inference Task” by Philips and Edwards was performed. In summary we found that deluded subjects need less information for decisions making than the control groups. Furthermore, decision making of deluded subjects seems more impulsive and less referring to formal logical criteria than it was found in depressed and healthy volunteers.
    Notes: Zusammenfassung Das Phänomen Wahn steht seit jeher im Zentrum des psychiatrischen Interesses. Die in der Vielzahl von Hypothesen zur Wahnentstehung diskutierten Ursachen reichen von Störungen der Wahrnehmung oder des Affektes bis hin zu kognitiven Störungen. In unserer Untersuchung mit 20 wahnhaften, 20 depressiven und 20 gesunden Probanden gingen wir der Frage nach, ob sich zwischen den drei genannten Gruppen Unterschiede im Urteilsverhalten während einer neutralen Testsituation aufzeigen lassen. Unsere Hypothese dabei war, daß wahnhafte Probanden zur Urteilsbildung deutlich weniger Information heranziehen und an ihren einmal gefällten Urteilen rigider festhalten, als dies bei einer gesunden und depressiven Kontrollgruppe der Fall ist. Zur Überprüfung der Hypothesen wurde eine modifizierte Version des “Probabilistic Inference Task” von Philips and Edwards eingesetzt. Zusammenfassend zeigte sich, daß die Gruppe der wahnhaften Probanden zur Entscheidungsfindung signifikant weniger Informationen als die beiden Kontrollgruppen benötigte. Das Urteilsverhalten insgesamt erschien bei den wahnhaften Probanden deutlich impulsiver und weniger auf formallogisch nachvollziehbaren Kriterien beruhend als dies in den beiden anderen Probandengruppen der Fall war.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 248 (1998), S. 296-300 
    ISSN: 1433-8491
    Keywords: Key words Bipolar-I depression ; Switch ; Antidepressants ; Mood stabiliser
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Medical records of 158 patients with bipolar depression were analysed for the incidence of a switch from depression to maniform states (mania and hypomania). Relation to psychopharmacological treatment was investigated. Thirty-nine (25%) patients of the total sample had switched to a maniform state during the treatment period in the hospital. Among that group the phenomenon occurred in 23 patients (15%) as a hypomania and in 16 patients (10%) as a mania. Patients with a switch were significantly more often treated with tricyclic antidepressants (TCA) than patients without switch (79.5% vs 51.3%). Mood stabilising medication might reduce the risk for switching, especially in patients treated with TCA; however, it seems not totally sufficient, since 59% of the switched patients received mood stabilisers. The switch phenomenon was not associated with sociodemographic or clinical data.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1433-8491
    Keywords: Key words Follow-up study ; Schizophrenia ; Deficit ; syndromes ; Prediction of outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study is a follow-up study on broadly defined schizophrenic disorders. Patients were assessed standardized at the time of their first hospitalization (admission and discharge) and reassessed in an standardized manner 15 years later. The aim of the analyses presented here was to evaluate the frequency of patients with markedly expressed negative symptoms in terms of deficit syndrome and to analyze which of the variables assessed at the time of first hospitalization were predictive concerning deficit syndromes at follow-up. Results indicate that nearly one third of patients have developed a deficit syndrome 15 years after their first hospitalization. These patients are characterized by severe impairments in important areas of life, such as partnership or employment. Furthermore, apart from more pronounced negative symptoms, these patients also have more paranoid-hallucinatory symptoms than schizophrenic patients without deficit syndromes. Predictive signs for non-development of a deficit syndrome 15 years later were good global functioning, female gender, pronounced depressive symptoms and good treatment response concerning negative and paranoid-hallucinatory symptoms at first hospitalization. A longer duration of symptoms prior to first hospitalization, lack of a partnership, pronounced negative symptoms at admission and at discharge were predictive of developing a deficit syndrome. Results are discussed with regard to the literature and to methodological limitations.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-2072
    Keywords: Key words Auditory evoked potentials ; Serotonin ; Depression ; Response prediction ; Augmenting/reducing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Rationale: A serotonergic dysfunction is supposed to play a pathogenetic role in depression, but there is a considerable number of non-responders in the acute treatment of depression with serotonergic agents like SSRI. Thus, an indicator of central serotonergic activity could lead to a more specific pharmacological treatment of depression. In animal and human data there is a growing amount of evidence that a strong loudness dependency of late auditory evoked potentials (LDAEP) is an indicator of low serotonergic activity and vice versa. Objective: In 29 depressive inpatients (DSM-III-R diagnosis 296.x in 28 patients, 300.4 in one patient), the hypothesis was tested that a strong LDAEP prior to treatment can predict a better clinical outcome under SSRI treatment over 4 weeks. Results: Patients with a strong pre-treatment LDAEP had a significantly greater decrease of depressive symptoms (Hamilton Scale for Depression) after 4 weeks than patients with a flat LDAEP. Significantly more responders fell into the group with a high LDAEP. Contrary to what might be expected, a second recording in a subsample of 19 patients after 4 weeks of treatment failed to show changes in the LDAEP. Conclusion: Our finding confirms the hypothesis that a strong LDAEP, indicating a low serotonergic activity, is related to a favorable response to acute SSRI treatment in depression. The LDAEP is a promising tool for the prediction of response to serotonin agonists in depression and it seems to be of clinical importance.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 250 (2000), S. 257-261 
    ISSN: 1433-8491
    Keywords: Key words Unipolar ; Bipolar ; Depression ; Suicidality ; Suicide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of the present analyses was to evaluate differences in suicidality (past suicide attempts, suicidal thoughts at time of admission and completed suicides during the hospital stay) between bipolar and unipolar depressed inpatients. Apart from a higher frequency of past suicide attempts in bipolar depressed patients (26.6% in bipolar vs. 17.8% in unipolar patients), findings do not indicate any further differences in suicidality (suicidal thoughts (about 40% in both groups) and completed suicides during the hospital stay (0.8% in both groups)) between bipolar and unipolar patients. Factors with a predictive value for suicidal thoughts at the time of admission were a positive family history for affective disorders, past suicide attempts, and the depressive and paranoid hallucinatory syndrome (all associated with an increased risk). Female gender, an older age at hospitalisation and a longer duration of the illness were found to be associated with a lower probability for having suicidal tendencies at the time of admission. The risk for committing suicide during the hospital stay was increased if the patients had a history of past suicide attempts and suicidal thoughts at the time of admission. A more pronounced depressive syndrome at time of admission was slightly associated with a lower risk of committing suicide.
    Type of Medium: Electronic Resource
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