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  • 1
    Electronic Resource
    Electronic Resource
    Narkolepsie Eine Erkrankung im Aufbruch (2000)
    Springer
    Der Nervenarzt 71 (2000), S. 807-812 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Narkolepsie ; Kataplexie ; REM-Onset ; DQB1*0602 ; DQA1*0102 ; Epidemiologie ; Keywords Narcolepsy ; Cataplexy ; REM onset ; DQB1*0602 ; DQA1*0102 ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The signs of narcolepsy have been known since the last century and the tetrad of symptoms was described 50 years ago: excessive sleepiness, cataplexy, sleep paralysis, and hallucinations. Polysomnography typically shows decreased sleep and REM sleep latency, and laboratory testing reveals a high association with the human leucocyte antigens (HLA) DQB1*0602 and DQA1*102. Acute studies suggest disturbances in the orexin (hypocretin) neurotransmitter system. However, the exact pathophysiology is still unclear. In Germany, about 1500 patients diagnosed with narcolepsy are known. The prevalence in Caucasian populations is estimated at 50/100,000. Thus, the number of undiagnosed patients is likely to be high.
    Notes: Zusammenfassung Die Merkmale der Narkolepsie sind seit dem letzten Jahrhundert bekannt, die Tetrade der Zeichen wurde zuerst in den 50er Jahren beschrieben: ausgeprägte Tagesmüdigkeit, Kataplexien, Schlafparalyse und einschlaf- oder aufwachbezogene Halluzinationen. Polysomnographisch sind eine verkürzte Einschlaf- und REM-Latenz typisch, labordiagnostisch das menschliche Leukozyten-Antigen (HLA) in DQB1*0602 und DQA1*0102. Die exakte Pathophysiologie ist unbekannt, jedoch deuten neuere Studien auf Störungen im Orexin(Hypokretin)-Neurotransmittersystem hin. Man kennt etwa 1.500 Patienten in Deutschland mit Narkolepsie. Die Prävalenzrate in kaukasischen Populationen wird mit ca. 50/100.000 angegeben, so dass eine hohe Dunkelziffer vermutet wird.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050668
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  • 2
    Electronic Resource
    Electronic Resource
    Mental illness in a representative sample of homeless men in Munich, Germany (1996)
    Springer
    European archives of psychiatry and clinical neuroscience 246 (1996), S. 185-196 
    Details
    ISSN: 1433-8491
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of the study was to reliably assess the 6-month and lifetime prevalence of mental illness according to DSM-III criteria in a representative sample of homeless individuals in the city of Munich, Germany. Because the characteristics of the homeless population were unknown, we first conducted a pre-sampling survey to determine a proportionate allocation of the main interviews in three nested sampling strata. For the pre-sampling we approached 300 males, who appeared tobe homeless, for a brief interview; of these, 271 were homeless according to our definition and were allocated to one of three sectors (“shelter”, “meal services”, “outdoor”). Thereafer, we randomly sampled homeless males in these three strata until the indicated allocations were met. The Diagnostic Interview Schedule (DIS) was used for diagnostic classification according to DSM-III in the main interview. Results from this representative urban sample show that the mean age of the homeless males was 43 years; most were unmarried or divorced, had a relatively low level of school education and a long duration of homelessness. Based on the main interviews with 146 homeless males the following lifetime prevalence rates were obtained: 91.8% for substance use disorder (82.9% alcohol dependence), 41.8% for affective disorders, 22.6% for anxiety disorders and 12.4% for schizophrenia. Of the homeless males in Munich, 94.5% had at least one DIS/DSM-III axis I diagnosis. Six-month prevalence data is also presented. Results are compared with those of a very similar study on homeless individuals in Los Angeles, which also used DIS/DSM-III diagnoses. In comparison with representative community samples in the United States and in Germany, mental illness was much more frequent among homeless individuals in Munich as well as in Los Angeles. Implications for health care planning are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02188952
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  • 3
    Electronic Resource
    Electronic Resource
    Analysis of sleep EEG microstructure in subchronic paroxetine treatment of healthy subjects (1997)
    Springer
    Psychopharmacology 132 (1997), S. 44-49 
    Details
    ISSN: 1432-2072
    Keywords: Key words Microstructure ; Sleep EEG ; Spectral power analysis ; Paroxetine ; Healthy subjects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Paroxetine is a selective and potent serotonin reuptake inhibitor and its efficacy for the treatment of depression has been proven. Under acute and subchronical treatment regimens, disturbances of the regular sleep pattern are a reported side effect of the drug. The present study was therefore performed to investigate the impact of subchronic treatment with the selective serotonin reuptake inhibitor paroxetine on the microstructure of the sleep EEG. The study especially addressed the question of subchronic effects of paroxetine medication (30 mg/day) in eight healthy male volunteers in a double blind, placebo-controlled crossover design. Conventional sleep EEG parameters and a spectral power analysis for different sleep stages after 4 weeks of treatment were computed. Additionally, the correlation of certain EEG rhythms across the night was calculated in order to detect subtle dynamical EEG alterations, not necessarily obvious when regarding conventional EEG analysis. Although we could not detect any alterations of the spectral power values in certain frequency bands either during NREM nor during REM sleep following subchronic paroxetine medication, the dynamical EEG attributes across the night revealed a significant enhancement of the correlation between certain EEG rhythms mainly during NREM sleep.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002130050318
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Differential patterns of mental disorders among the homeless in Madrid (Spain) and Los Angeles (USA) (1998)
    Springer
    Social psychiatry and psychiatric epidemiology 33 (1998), S. 514-520 
    Details
    ISSN: 1433-9285
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this paper we compare rates of mental disorders (major depression, dysthymia, cognitive impairment, and schizophrenia) among homeless people in Madrid and Los Angeles (LA) and examine the ordering of the onset of both conditions (i.e., homelessness and mental disorders). In the Madrid study, 262 homeless persons were interviewed using the CIDI. In the LA study, 1563 homeless persons were interviewed with the DIS. To make an item-by-item comparison, we combined the databases from both studies to submit a single database to statistical analyses. Results showed no significant differences in DSM-III-R life-time prevalence rates of mental disorders between both samples. However, the Madrid sample showed higher 12-month prevalence rates of dysthymia and cognitive impairment as compared to the LA sample. Most subjects across both cities first experienced symptoms of their mental disorders before first becoming homeless. The only significant difference was that all of the depressed adults in Madrid experienced depression prior to first becoming homeless, whereas this was the case for only 59.1% of LA depressed homeless people. We discuss the reasons for these cultural differences and their implications for cross-national public health research and intervention.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001270050088
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  • 5
    Electronic Resource
    Electronic Resource
    Pathways to homelessness among the mentally ill (2000)
    Springer
    Social psychiatry and psychiatric epidemiology 35 (2000), S. 444-450 
    Details
    ISSN: 1433-9285
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Background: Persons with mental illness are over-represented among the homeless relative to the general population, and mental illness is most likely one of many vulnerabilities that confer risk for homelessness. Method: This paper elucidates the pathways to homelessness for persons with mental illness by comparing and contrasting groups of mentally ill homeless persons, non-mentally ill homeless persons, and housed mentally ill persons drawn from RAND's Course of Homelessness (COH) study and the Epidemiological Catchment Area (ECA) survey. Results: Homeless persons share childhood histories of economic and social disadvantage. The mentally ill homeless appear to have a “double dose” of disadvantage: poverty with the addition of childhood family instability and violence. Among the mentally ill homeless, those who became homeless prior to becoming mentally ill have the highest levels of disadvantage and disruption; while those who become homeless after becoming ill have an especially high prevalence of alcohol dependence. Conclusions: Mental illness may play a role in initiating homelessness for some, but is unlikely in and of itself to be a sufficient risk factor for homelessness. In addition to outreach and treatment programs for adult mentally ill homeless persons, emphasis should be placed on interventions with children and on addressing more pervasive causes of homelessness.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001270050262
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  • 6
    Electronic Resource
    Electronic Resource
    Adjuvante Ganzkörper- akupunktur bei Depression Eine placebokontrollierte Studie unter standardisierter Mianserintherapie (1998)
    Springer
    Der Nervenarzt 69 (1998), S. 961-967 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Akupunktur ; Depression ; Mianserin ; Placebokontrolliert ; Key words Acupuncture ; Depression ; Mianserine ; Placebo-controlled study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In order to examine the efficacy of whole body acupuncture additionally applied to drug treatment in depression, a single-blind placebo-controlled study with 70 inpatients administered to three different treatment groups has been carried out. All patients were pharmacologically treated with the tetracyclic antidepressant mianserin. The verum group (n=22) received acupuncture at specific points considered to be effective in the treatment of depression. The placebo group (n=24) was treated with acupuncture at non-specific locations and the control group (n=24) received only pharmacological treatment. Acupuncture was applied three times a week over a period of four weeks. Psychopathology was rated by judges blind to verum/placebo conditions twice a week over eight weeks with the CGI, GAS, BRMS and BfS rating scales. Additionally applied acupuncture improved the course of depression more than pharmacological treatment with mianserin did by itself. However, we could not detect any differences between placebo and verum acupuncture.
    Notes: Zusammenfassung Um die Wirksamkeit einer begleitenden Ganzkörperakupunktur bei Patienten mit einer Depression zu untersuchen, wurden 70 stationäre Patienten in eine placebokontrollierte Studie eingeschlossen und randomisiert auf 3 Behandlungsgruppen aufgeteilt. Während alle 3 Gruppen pharmakologisch mit dem tetrazyklischen Antidepressivum Mianserin behandelt wurden, erhielt die Verumakupunkturgruppe (n=22) zusätzlich eine Akupunktur an spezifischen Punkten, die als wirksam in der Behandlung einer Depression angesehen werden. Die Placeboakupunkturgruppe (n=24) wurde mit einer Akupunktur an nicht spezifischen Punkten behandelt, und die Kontrollgruppe (n=24) wurde nur mit Mianserin behandelt. Die Akupunktursitzungen fanden dreimal pro Woche über einen Zeitraum von vier aufeinanderfolgenden Wochen statt. Die psychopathologische Symptomatik wurde zweimal pro Woche über einen Zeitraum von acht aufeinanderfolgenden Wochen mittels der Instrumente CGI, GAS, BRMS und BfS beurteilt. Die Besserung des psychopathologischen Befundes von Patienten, die akupunktiert wurden (Verum- und Placeboakupunktur), war signifikant höher als bei Patienten, die mit Mianserin alleine behandelt wurden. Es ergab sich jedoch kein Unterschied zwischen den beiden Akupunkturgruppen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050370
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