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Andreas Warnke

Publications and source records attributed to Andreas Warnke.

23 records · Page 2Linked to original sources
PubMed2004

[Paroxetine versus clomipramine in female adolescents suffering from anorexia nervosa and depressive episode--a retrospective study on tolerability, reasons for discontinuing the antidepressive treatment and different outcome measurements].

OBJECTIVES: So far, there have only been few studies concerning the question of indication and efficacy of antidepressive medication in children and adolescents with anorexia nervosa and depressive episode in the course of an inpatient treatment. In addition, there is a lack of studies comparing the tolerability and efficacy of different antidepressants given to anorectic patients of this particular age group. This study compares paroxetine, a specific SRI, with clomipramine, a TCA with SRI activity, concerning the frequency and quality of adverse side effects, the frequency and the reasons for discontinuating the antidepressive treatment and different outcome measurements. METHODS: 83 female patients, aged 10.9 to 18.1 years, who underwent an inpatient treatment at the Departement of Child and Adolescent Psychiatry and Psychotherapy at the University of Wuerzburg, Germany, were enrolled in this retrospective study. All of them met the ICD-10 criteria for anorexia nervosa and depressive episode and received an antidepressant medication with clomipramine or paroxetine. We collected data from basic documentation, treatment reports, and the multiaxial classification (MAS). Outcome measurements were the duration of treatment (days) and the increase of body weight (kg/m2). RESULTS: The discontinuation of the antidepressive treatment due to adverse side effects or a lack of efficacy was significantly more frequent with clomipramine than paroxetine (33.3 vs. 15.4%). The increase of body weight (2.8 vs. 2.6 kg/m2) was similar in both groups, but the duration of treatment was significantly shorter under paroxetine (71.9 vs. 96.5 days). CONCLUSIONS: A shorter duration of treatment, faster increase of body weight, lower percentage of dicontinuating the antidepressive medication and last but not least economic reasons lead to the conclusion, that paroxetine should be preferred in female adolescents with anorexia nervosa and depressive episode. However, prospective studies are needed to confirm our findings.

Adolescent↗
PubMed2003

Elevated physical activity and low leptin levels co-occur in patients with anorexia nervosa.

Low leptin levels are an endocrinological hallmark of acute anorexia nervosa (AN); a subthreshold leptin secretion in adipocytes as a consequence of a reduced energy intake is presumed to be the major trigger of the adaptation of an organism to semistarvation. The aim of the current study is to define symptoms of AN that are potentially linked to low leptin levels. For this purpose, quantitative somatic and psychopathological variables were obtained in 61 inpatients with acute AN (study group 1) upon referral for inpatient treatment, and they were concomitantly blood sampled to allow determination of serum leptin levels. Correlations between these variables and logarithmic transformed (lg10) leptin levels were descriptively assessed. Apart from the well-known correlations between leptin levels and anthropometric measurements, the strongest correlation was observed between lg10 serum leptin levels and expert ratings of motor restlessness (r = -0.476; nominal P = 0.003) upon use of visual analog scales. We thus generated the hypothesis that physical activity levels in AN patients are related to serum leptin levels. This hypothesis was tested in an independent study group of 27 adolescent inpatients (study group 2) who were also assessed upon referral. Physical activity levels, which, in this study group, were assessed with the activity module of the expert rating form of the Structured Inventory for Anorexic and Bulimic Syndromes, were significantly correlated with lg10 leptin levels (r = -0.51; one-sided P = 0.006). A regression model based on the independent variables body mass index and lg10 leptin levels explained 37% of the variance of physical activity (R(2) = 0.37; P = 0.003); only the lg10 leptin levels contributed significantly to the variance (P = 0.003). Our results suggest that, similar to semistarvation-induced hyperactivity in rats, hypoleptinemia in patients with AN may be one important factor underlying the excessive physical activity.

Acute Disease↗
PubMed2002

Multicenter P300 brain mapping of impaired attention to cues in hyperkinetic children.

OBJECTIVE: To measure specific neurophysiological attention deficits in children with hyperkinetic disorders (HD; the ICD-10 diagnosis for severe and pervasive attention-deficit/hyperactivity disorder [ADHD]). METHOD: In a multicenter sample of 148 children with HD and control children aged 8 to 14 years, event-related potential maps were recorded during a cued continuous performance test (A-X/O-X). Maps to cues (requiring attention but no response) and distractors and performance were tested for differences between age- and sex-matched HD and control groups (n = 57 each), as well as between clinics (n = 5). RESULTS: The N1, P3a, and P3b maps revealed reliable attention effects, with larger amplitudes after cues than after distractors, and only minor differences across clinics. Children with HD missed more targets, made more false alarms, and had larger N1 followed by smaller P3b amplitudes after cues than did controls. Cue-P3b amplitude correlated with detecting subsequent targets. Cue-P3b tomography indicated posterior sources that were attenuated in children with HD. CONCLUSIONS: Brain mapping indicates that children with HD attend to cues (preceding potential targets) with increased initial orienting (N1) followed by insufficient resource allocation (P3b). These multiple, condition-specific attention deficits in HD within 300 msec extend previous results on ADHD and underline the importance of high temporal resolution in mapping severe attention deficits.

Adolescent↗