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Biomedical subjects

A Gjerris

Publications and source records attributed to A Gjerris.

At least 19 recordsLinked to original sources
PubMed2004

Relationship between mood and TSH response to TRH stimulation in bipolar affective disorder.

Moderate to severe depression and mania are associated with a reduced thyroid stimulating hormone (TSH) response to TSH releasing hormone (TRH). Continued reduction of this response after clinical recovery seems indicative of early relapse. The aim of the present study was to test the relationship between mild changes in mood and the TSH response to TRH stimulation in patients with bipolar affective disorder. Nineteen outpatients with bipolar affective disorder were followed prospectively for three years. Every third month, mood symptoms were rated using the 17-item Hamilton Depression Rating Scale (HAMD-17) and the Bech-Rafaelsen Mania Scale (BRMS). A TRH test was performed in connection with each rating session (IV injection of 200 microg TRH), and serum TSH was measured at 0, 20, and 60 min. The maximum TSH response (D-max TSH) and the temporal change in D-max TSH between succeeding rating sessions (DD-max TSH) were determined. Psychometric rating and TRH data were obtained for a total of 198 examinations. The temporal change in mood symptom rating score was negatively correlated with the temporal change in D-max TSH, thus suggesting that increasing severity of mood symptoms was related to a reduced TSH response to TRH stimulation. The temporal change in TSH response to TRH stimulation correlated with the actual score on an overall index of symptom severity. In conclusion, milder fluctuations in mood in bipolar affective disorder seem to correlate with the TSH response to TRH stimulation: Increasing severity of mood symptoms seems to be associated with reduced TSH response.

Adult↗
PubMed2001

Ward atmosphere in acute psychiatric in-patient care: patients' perceptions, ideals and satisfaction.

OBJECTIVE: To investigate the relationship between patients' perception of the real and ideal ward atmosphere and their satisfaction. METHOD: Patients filled in the Ward Atmosphere Scale (WAS, Real and Ideal Form) and a satisfaction questionnaire. Patient characteristics were derived from clinical assessments. RESULTS: WAS ratings were almost independent of patient characteristics. Patients in locked wards perceived more anger and aggression and patients subjected to coercive measures perceived less autonomy and practical orientation. Patient satisfaction was predicted by higher scores on the WAS Relationship- and System Maintenance dimensions, explaining 41% of the variance. In particular support, order and organization predicted satisfaction. Except from the areas of anger/aggression and staff control, patients gave the 'ideal' ward higher ratings on all subscales. The perceived gap between the 'ideal' and 'real' ward explained 45% of variance in satisfaction. CONCLUSION: Patients' perception of ward atmosphere is a clinically meaningful measure appearing to be a strong predictor of satisfaction.

Acute Disease↗
PubMed1999

Sharing the responsibilities: the roles of the government.

Developments in psychiatry have been steered by a number of factors influencing decisions taken by the politicians. Some of the more typical factors that could be mentioned are: political attitudes; trend phenomena in the population; economic aspects; and evidence-based knowledge. Bearing in mind the results of developments in psychiatry during the last decades, psychiatrists are encouraged to live up to their responsibility by focusing on scientific results, when giving their advice to politicians. Hopefully political initiatives will, in the future, primarily be based on evidence about psychiatric treatment.

Evidence-Based Medicine↗
PubMed1998

[Bipolar affective disorder. A retrospective study of 158 patients in a well-defined geographical region].

A cohort of 158 patients was identified from 723 patients admitted in 1990 or treated as outpatients in 1991 for affective disorders in three university hospitals in Copenhagen, covering a well-defined catchment area. The cohort was subclassified for seasonal pattern according to DSM-III-R. Meteorological data of temperature, hours of sunshine, rainfall and wind-velocity expressed as mean values/month were obtained from the Institute of Meteorology in Copenhagen. There was no relationship between the annual dis- tribution of affective episodes and meteorological data, neither in the total cohort nor in the subgroup of patients with seasonal patterns The present study does not support the hypothesis that a relation exists between start of a new episode and the season or climatic condition.

Adult↗
PubMed1997

The Major Depression Rating Scale (MDS). Inter-rater reliability and validity across different settings in randomized moclobemide trials. Danish University Antidepressant Group.

The Major Depression Rating Scale (MDS) has been derived from the Hamilton Depression Scale and the Melancholia Scale. The MDS contains the nine DSM-IV items for major depression which all have anchoring scores from 0 to 4; hence, the theoretical score range is up to 36. The Major Depression Rating Scale has in this study been psychometrically analysed in randomized moclobemide trials. The results showed that the MDS had higher internal validity than the Hamilton Depression Scale. Thus, the homogeneity of the items was higher; factor analysis identified only one general depression factor (after 4 weeks of treatment explaining more than 50% of the variance). The inter-rater reliability of the two scales was of the same high level. The ability to measure changes (external validity) was tested in randomized clinical trials with moclobemide versus tricyclics (clomipramine and notriptyline) performed in Denmark in the psychiatric setting as well as in the general practice. The results showed that in the psychiatric setting tricyclics were superior to moclobemide with effect sizes ranging between 0.43 and 0.53. The highest effect size was obtained with the Melancholia Scale and the Major Depression Rating Scale, while the Hamilton Depression Scale was below 0.50. In the general practice setting no difference was found between moclobemide and clomipramine. In conclusion, the Major Depression Rating Scale has been found to have a more homogeneous factor structure than the Hamilton Depression Scale, but still with the same level of reliability and external validity. However, studies are needed to standardize the scale, especially in the general practice setting.

Antidepressive Agents↗
PubMed1995

[Child psychiatric intervention in connection with district psychiatry. A 2-year experimental project with child psychiatric consultation].

The aim of the study was to describe the requirement for child psychiatric intervention in children of psychiatric patients treated within community psychiatry and to test the possibilities for intervention in practice. The study was carried out in a community psychiatric centre in Copenhagen, to which a child psychiatrist was associated as a consultant for two years. Assessment of known risk factors for child psychiatric illness was carried out in the families of all patients admitted to the centre who had children aged 0-14 years. Intervention was systematically carried out and described. The project was evaluated in a survey among the staff of the centre. Sixty-five patients, of which the majority were women, and 86 children were evaluated. The most frequent diagnoses were psychosis and personality disorder. More than half of the children were less than three years old. Fourteen children had no contact with their ill parent and 13 were placed in care. Ten families were referred to child psychiatric treatment. Primary intervention was carried out in six cases. A questionnaire among the members of the psychiatric staff showed that the project was well accepted and considered to be of great profit to the patients and their children. We conclude that a high frequency of risk factors for child psychiatric illness were identified in families of patients in community psychiatry. The community psychiatric setting made preventive intervention possible at a time where no such measures otherwise would have been taken. It is therefore recommended that child psychiatrists are integrated in community psychiatry as consultants.

Adolescent↗
PubMed1995

[The adolescent psychiatric clientele in a district psychiatric center].

This study is retrospective and based on the charts of 44 adolescents (age 17-22) admitted to a Danish community psychiatric centre during the first 32 months after the opening of the centre. The social status of the adolescents, reasons for admission, previous treatment and need for psychiatric treatment are presented. The adolescents were generally a little older than a typical adolescent psychiatric clientele, and comparatively many of them had rather mild psychiatric conditions. A characteristic feature of these patients was a certain instability in their contact to the centre. Although many of them had long-lasting basic disabilities (e.g. personality disorders), only a few of them achieved a stable treatment alliance with the ward. This indicates difficulties of integrating an adolescent clientele in a community psychiatric centre that primarily takes care of adult patients.

Adolescent↗
PubMed1995

[Seasonal affective disorders].

In 1984 Rosenthal described for the first time the syndrome "Seasonal Affective Disorder", SAD, characterized by annual recurrent depressive episodes in the autumn and winter months possibly followed by mania/hypomania in the summer months. The depressive phases showed atypical symptoms such as hypersomnia, carbohydrate-craving, and weight gain. Melatonin seems to be an indicator of disturbed circadian rhythm rather than the cause of SAD. The importance of other circadian and annual biological rhythm in relation to SAD and other depressive syndromes is quite unknown. SAD differs from classical manic-depressive disorders by frequency, severity, symptomatology, and the typical seasonal variations, and is probably not a subgroup of the classical affective disorders, but an extreme variation of the normal seasonal affective variations seen in the general population. Light therapy can be used successfully in depressive states in SAD.

Circadian Rhythm↗
PubMed1994

[User evaluation of a psychiatric day center].

When community mental health centres were introduced in Copenhagen, day centres were attached to them. With the purpose of highlighting users' perspective in psychiatry, 48 patients in a psychiatric day centre were included in the study one year after the opening of the day centre. User satisfaction was investigated by means of a questionnaire, which was completed by the patient, while information on other aspects of the patients' lives was gathered from interviews with the patients and from case-records. The users of psychiatric day centres were mostly schizophrenic patients. The average number of years since first contact with psychiatric services was 12. In comparison with an age and sex-matched population in Copenhagen, patients were more isolated. There was a insignificant tendency towards use of psychiatric bed capacity decreasing from the one year period before the opening of the day centre to the one year period after. The users were very satisfied with the treatment in the day centre. The majority expressed that they trusted the staff, and that they believed that the treatment in the centre had affected their situation in a positive way. It is concluded that psychiatric day centres are useful and should form a part of psychiatric services.

Cohort Studies↗
PubMed1994

The influence of community-based psychiatry in Copenhagen on the treatment of chronic psychoses.

Several factors influence the outcome of prevention of relapse in patients with chronic psychoses--mainly schizophrenia. A key word in the prophylactic treatment is compliance. Compliance is primarily related to drug treatment, but seen in a broader perspective it depends on the circumstances under which the treatment is offered. From 3 cohort investigations in Copenhagen mainly including patients with chronic psychoses, it seems as if community-based psychiatry in Copenhagen possesses some of the ingredients--high professional standard, continuity, care and support--that are considered to improve the outcome of treatment. However, suicidality and social isolation are some of the important areas that need further attention.

Chronic Disease↗
PubMed1992

Cerebrospinal fluid concentrations of neuropeptide Y in depressed patients and in controls.

Concentrations of Neuropeptide Y-like (NPY-LI) immunoreactivity in cerebrospinal fluid (CSF) were measured in a group of depressed patients (n = 24) and compared with that of control subjects (n = 12). CSF-NPY-LI was significantly reduced in the group of non-endogenously depressed patients when classified according to Newcastle Rating Scale for Depression--1971 (N-II). No significant correlation was found in the control or depressed groups between lumbar concentrations of NPY-LI and a number of other neurotransmitters.

Adult↗
PubMed1991

Moclobemide in depression: a randomized, multicentre trial against isocarboxazide and clomipramine emphasizing atypical depression.

Moclobemide was compared with isocarboxazide and clomipramine in patients with depression. A total of 167 outpatients were allocated to daily treatment with 300 mg moclobemide, 30 mg isocarboxazide or 150 mg clomipramine for 6 weeks. Moclobemide was slightly inferior to clomipramine, whereas isocarboxazide had an intermediate position. There was no interaction between treatment and atypical or nonatypical depression. Anticholinergic symptoms and orthostatic hypotension were most pronounced in the clomipramine group.

Adult↗
PubMed1989

Neuropeptides and neural cell adhesion molecule (NCAM) in CSF from patients with ALS.

In 10 patients with amyotrophic lateral sclerosis (ALS), the CSF content of the neuropeptides vasoactive intestinal polypeptide (VIP) and cholecystokinin (CCK) as well as neural cell adhesion molecule (NCAM) was investigated. Compared with normal controls, no deviations were found in CCK or NCAM, while the values of VIP were significantly lower in ALS patients. This finding may reflect a loss of motor neurons.

Adult↗
PubMed1988

Treating depression in acute stage: biochemical and clinical aspects.

The treatment of depression has advanced dramatically over the last 50 years: electroconvulsion, monoamine oxidase inhibitors (MAOIs), cyclic antidepressants - in chronological order. The amine theories have been giving guidance in the development of new antidepressant drugs and have thus been important in the selectivity of drugs acting, for example, primarily on 5-hydroxytryptamine (5-HT) reuptake. Drugs like citalopram, fluoxetine, fluvoxamine, and paroxetine are very selective in their 5-HT reuptake inhibition, so that in clinical practice they can be tested for the specific importance of this system in depression. Research on cerebrospinal fluid (CSF) has for many years been restricted to amine metabolites, but we have now been able to measure the parent neurotransmitters, thanks to international cooperation. CSF adrenaline was low, noradrenaline normal, and serotonin and dopamine increased in untreated depression. This calls for major revision of the amine theories. In addition, our animal studies have shown marked increase in CSF adrenaline after MAOIs, and long-term effect of citalopram on CSF noradrenaline. This indicates the need for enlargement of the number of transmitters in the elucidation of the biology of depression and its treatment, and that interactive counterregulations may lessen the initial selectivity of antidepressant drugs.

Acute Disease↗