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Biomedical subjects

Carsten Spitzer

Publications and source records attributed to Carsten Spitzer.

At least 19 recordsLinked to original sources
PubMed2026

Effects of quetiapine on cognitive functioning in schizophrenia: evidence for the remyelination hypothesis?

Postmortem findings, neuroimaging data, and in-vitro models suggest a decrease in number and density of oligodendrocytes is driving cognitive deficits in schizophrenia (SCZ). Second-generation antipsychotics are discussed to improve oligodendrocyte dysfunction with most conclusive evidence available for quetiapine (QET). We postulate that sustained QET treatment leads to cognitive improvement in SCZ, particularly, in tests with high demands for working memory function. We further hypothesize that these effects are moderated by polygenic factors associated with hippocampus-related brain volumes, general white matter integrity, and/or oligodendroglia-related SCZ risk. Using data of the prospective PsyCourse study, we identified 166 patients with SCZ spectrum disorder receiving QET at one or two consecutive visits plus 166 matched patients without QET. Polygenic scores were calculated for subcortical brain volumes, measures of white matter integrity, and for cell type-specific genetic SCZ risks. QET treatment was consistently associated with improved cognitive function independent of time, specifically, in tests with high, but not with low to medium working memory load. Polygenic analyses did not reveal significant moderation effects. In contrary, low genetic SCZ risk specific for genes related to human oligodendrocyte function was associated with higher cognitive performance independent from QET. While we observed improved cognitive performance under QET in high working memory tests, we did not find evidence that polygenic factors associated with hippocampus-related brain volumes, white matter integrity, or oligodendroglia-related SCZ risk moderate this association. Thus, our tentative findings do not provide evidence for the hypothesis that polygenic estimates of hippocampal remyelination capacities influence the association between QET and cognitive performance in SCZ.

Humans↗
PubMed2007

Attention problems among children with a positive family history of alcohol abuse or dependence and controls. Prevalence and course for the period from preteen to early teen years.

This longitudinal study investigated the scope and course of attention problems over a period of time from preteen (ages 7-12 years) to early teen years (ages 13-17 years). We compared symptoms in subjects with and without a family history (FH) of alcohol abuse or dependence from among families without evidence of antisocial personality disorder. Evaluations of attention problems for the offspring were based on the Child Behavior Checklist and a validated semistructured interview carried out with the mother. The findings indicate no higher risk for attention problems and attention-deficit hyperactivity disorder (ADHD)-like symptoms in the children of families with an alcohol use disorder. Regarding the course of problems, the ADHD symptom count tended to decrease over time, especially for children without a FH of alcohol abuse or dependence. Further research will be needed to determine whether results can be replicated with families from different social strata and including subjects with the antisocial personality disorder.

Adolescent↗
PubMed2006

[Observed, pursued, disintegrated--mental disorders among victims of non-criminal repressions in the former GDR].

OBJECTIVE: While there are numerous studies on the mental sequelae of political imprisonment in the former German Democratic Republic (GDR), there is little knowledge about the prevalence of mental disorders in victims of other forms of political persecution. METHODS: 74 individuals, who were subject to non-criminal repressions in the GDR, were investigated by means of a standardized psychiatric interview. RESULTS: They had been exposed to a variety of reprisals such as observations, purposeful indiscretions, arranged professional failure and other forms of social marginalization. At least one mental disorder was found in 60 % of the participants. Affective disorders were the most common ones with a lifetime prevalence of 38 %, followed by anxiety (23 %) and somatoform disorders (28 %). CONCLUSIONS: The frequency of mental disorders in our sample of politically persecuted people was higher than in the general population and similar to that of political prisoners, who only show higher rates of anxiety and posttraumatic stress disorders.

Adult↗
PubMed2006

Sixty years later: post-traumatic stress symptoms and current psychopathology in former German children of World War II.

BACKGROUND: The aim of the study was to determine the amount of trauma impact, post-traumatic stress symptoms and current psychopathological distress in a sample of former German children of World War II. METHODS: 93 participants were recruited through the local press, and assessed using the modified Post-traumatic Diagnostic Scale (PDS) and the Symptom Checklist (SCL-90-R). RESULTS: Subjects reported a high qualitative and quantitative degree of trauma exposure. 13.8% reported PTSD-related symptoms after the war, and 10.8% reported current symptoms. PTSD symptoms after World War II were significantly correlated with current psychopathological distress. CONCLUSIONS: In line with other studies, our data document a high degree of trauma exposure during warchildhood. In comparison with other studies on PTSD in warchildren, there is a persisting high prevalence of war-associated PTSD symptoms in this sample. Despite some methodological limitations, our data underline the urgent need for further studies on the ageing group of former children of World War II.

Age Factors↗
PubMed2006

The role of trauma and PTSD-related symptoms for dissociation and psychopathological distress in inpatients with schizophrenia.

BACKGROUND: To investigate the relationship between dissociative experiences, psychopathological distress, a history of trauma and posttraumatic symptoms in adult schizophrenia. METHODS: Eighty-seven schizophrenic inpatients returned self-questionnaires [Dissociative Experience Scale (DES); Symptom Checklist (SCL-90-R); PTSD Symptom Scale (PDS)]. Based upon this self-rating, 14 of the participants fulfilled the cut-off definition of PTSD according to DSM-IV criteria, 43 had a history of trauma without a self-rated diagnosis of PTSD. DES scores were also compared to a convenience sample of 297 non-clinical controls. RESULTS: We found no significant impact of trauma alone but a significant influence of posttraumatic symptomatology on the level of current psychopathological distress (GSI) and the DES subscale absorption. However, in logistic regression, posttraumatic symptomatology was associated with GSI but not with DES. Schizophrenic patients even without trauma or posttraumatic symptoms had significantly higher scores in all three DES subscales than non-clinical controls. CONCLUSION: Pronounced posttraumatic symptoms in schizophrenia are associated with severe additional psychopathological distress whereas the increase in dissociation (absorption) in this group of patients may be secondary to the increase in symptom load. However, schizophrenia itself seems to be associated independently from trauma and pathological posttraumatic conditions with a broad range of dissociative symptoms.

Adolescent↗
PubMed2006

Transcallosal inhibition in patients with and without alexithymia.

OBJECTIVE: Previous results indicated a facilitated transcallosal inhibition via the corpus callosum (CC) in alexithymic male students. This study investigates transcallosal inhibition in alexithymic and nonalexithymic psychiatric inpatients. METHOD: Transcallosal inhibition was elicited by means of transcranial magnetic stimulation (TMS) of the primary motor cortex. Seven right-handed male and 12 female psychiatric patients with Toronto Alexithymia Scale (TAS-20) scores of > or = 61 and 12 patients with TAS-20 scores of < 51 were investigated. The transcallosal conduction time (TCT) reflects the TMS-induced inhibitory cortical activity that is mediated via the CC. RESULTS: There was a significant effect of alexithymia on TCT (Wilks lambda = 0.76; F = 4.1; d.f. = 2, 26; p = 0.027) indicating that alexithymic patients had shorter bidirectional TCTs than nonalexithymic patients. The in-between models showed a significant impact of alexithymia on both right to left TCT (F = 4.8; d.f. = 1; p = 0.038) and left to right TCT (F = 5.0; d.f. = 1; p = 0.033). Neither gender nor scores of depression (Montgomery-Asberg Depression Rating Scale) had any significant effects on TCT. CONCLUSION: Our results confirm and extend the previous findings of a facilitated, bidirectional transcallosal inhibition in alexithymia to male and female psychiatric inpatients. Facilitated transcallosal inhibition should be considered as a neurobiological correlate of alexithymia.

Adult↗
PubMed2006

Individual characteristics, familial experience, and psychopathology in children of mothers with borderline personality disorder.

OBJECTIVE: The aim of this study was to examine individual characteristics, familial experience, and psychopathology of children of mothers with borderline personality disorder (BPD). METHOD: Children of mothers with BPD were compared to children of mothers (1) with depressive disorders, (2) with cluster C personality disorders, and (3) without psychiatric conditions, including temperament dimensions, perceived parenting behavior, and psychopathology. RESULTS: Compared to other groups, children of mothers with BPD demonstrated higher scores on the temperament dimension of harm avoidance. Moreover, they tended to perceive their mothers as being overly protective. Regarding psychopathology, these children exhibited a higher prevalence of emotional and behavioral problems than comparison groups. Particularly significant was the finding that children of mothers with BPD described themselves as having very low self-esteem. CONCLUSIONS: Children of mothers with BPD are exposed to a combination of risk factors and are at greater risk of emotional, behavioral, and somatic problems. Early treatment of children at risk may help prevent these children from developing severe psychopathology.

Adolescent↗
PubMed2006

Frequency, clinical and demographic correlates of pathological dissociation in Europe.

Although pathological dissociation (PD) has received increasing scientific attention in Anglo-American countries, European research on the frequency, clinical and demographic correlates of this discontinuous construct are lacking. An 8-item subscale of the Dissociative Experiences Scale, called the DES-Taxon, was administered to five samples comprising a non-clinical population, students, unselected psychiatric inpatients, eating-disordered inpatients and psychosomatic outpatients with a total of 1,759 adult participants. In the two non-clinical samples, the frequency of PD ranged between 0.3 and 1.8%. Its prevalence was highest in the psychiatric inpatients (5.4%) followed by the eating disorders (4.8%) and the psychosomatic outpatients (2.2%). PD was seen in all diagnostic groups and it was associated with more psychopathological distress and younger age. PD is frequently found in clinical populations in European countries, too. However, methodological problems relating to its empirical determination might obscure the clinical and scientific value of the construct.

Adolescent↗
PubMed2006

Borderline personality organization and dissociation.

The relationship between Kernberg's psychodynamic model of personality organization (PO) and dissociation has not yet been explored. Seventy-two nonclinical subjects and 222 psychiatric patients completed the Dissociative Experiences Scale and the Inventory of Personality Organization. Its Reality Testing subscale emerged as the most important predictor for all facets of dissociation. Discussing our results in the framework of Fonagy and coworkers' model of mentalization, we suggest that dissociation may reflect the preoedipal "pretend" mode of psychic functioning while impaired reality testing and psychotic experiences might be indicative of the "psychic equivalent" mode.

Adolescent↗
PubMed2006

Recent developments in the theory of dissociation.

Although the construct of dissociation was introduced into psychiatry at the end of the 19th century by Pierre Janet, the term still lacks a coherent conceptualization, which is partially reflected by differences in the classification of dissociative and conversion disorders in ICD-10 and DSM-IV. Given the clinical significance of dissociative psychopathology in numerous clinical conditions, it is very valuable that various efforts have been made to refine and to specify current conceptualizations in recent years. The most promising and convincing approaches converge in subdividing dissociation into qualitatively different types, i.e. pathological versus non-pathological dissociation, and "detachment" versus "compartmentalization". We review these concepts and discuss their scientific and clinical potential as well as their limitations.

Journal Article↗
PubMed2005

Gender-specific association of alexithymia and norepinephrine/cortisol ratios. A preliminary report.

OBJECTIVE: Alexithymia and posttraumatic stress disorder (PTSD) might share a neuroendocrine pattern characterized by increased urinary norepinephrine (N) and decreased cortisol (C) levels, resulting in a high N/C ratio, at least among male alcoholics. We aimed to explore if this association can also be found in other populations. METHODS: Twenty-four-hour urine samples were obtained from 12 major depressive disorder (MDD) patients and 23 healthy controls (HC) and tested for N and free C. Participants completed the 20-item Toronto Alexithymia Scale (TAS) and the Symptom Check List (SCL). RESULTS: Controlling for depression, the neuroendocrine parameters did not differ between the MDD and HC participants nor between women and men. The TAS was not associated with N, C or the N/C ratio in the MDD and HC participants nor in females alone. However, in men, the N/C ratio correlated significantly with the TAS (r = .80). CONCLUSIONS: Our preliminary findings indicate that alexithymia is associated with an increased noradrenergic activity and a decreased basal activity of the hypothalamic-pituitary-adrenal (HPA) axis among men. This gender difference may reflect divergent underlying neurobiological processes of alexithymia in men and women.

Adult↗
PubMed2005

Alexithymia and interpersonal problems.

BACKGROUND: Interpersonal relationships are substantially codetermined by nonverbal communication, e.g. facial affect. Given the deficits of nonverbal affect recognition and expression in alexithymia, we hypothesized that alexithymics had more interpersonal problems than nonalexithymic individuals, and that the various facets of the alexithymia construct are differentially related to interpersonal problems. METHOD: 149 subjects participating in an inpatient group psychotherapy program completed the Toronto Alexithymia Scale (TAS-20) and the Inventory of Interpersonal Problems (IIP-C) at the beginning of the treatment. The IIP-C was also administered to a subgroup at the end of the treatment. RESULTS: Based on the alexithymia scores, patients were classified as low- (TAS-20 score </=51), moderate- or high-alexithymic (TAS-20 score >/=61). High-alexithymic patients had significantly more interpersonal problems than low alexithymics, particularly in the IIP-C scales indicating hostility and social avoidance. The TAS-20 subscale difficulty describing feelings showed the highest correlations with interpersonal problems (r between 0.23 and 0.55). At the end of the treatment, the high alexithymics still scored highest on the IIP-C, but the magnitude of change in interpersonal problems did not differ across the groups. CONCLUSIONS: Our findings suggest that the interpersonal style of alexithymic individuals is characterized by a cold and socially avoidant behavior, corresponding to the predominantly insecure attachment pattern found in alexithymia. Additionally, our results indicate that group psychotherapy is as helpful for alexithymic as for nonalexithymic subjects with respect to interpersonal problems. Finally, we propose that alexithymia involves a reduced capacity to use social interactions for affect regulation.

Adult↗
PubMed2004

Alexithymia and personality in relation to dimensions of psychopathology.

OBJECTIVE: The authors examined the capacity of alexithymia to predict a broad range of psychiatric symptoms relative to that of other personality dimensions, age, and gender. METHOD: The Toronto Alexithymia Scale, the Temperament and Character Inventory, and the SCL-90-R were administered to 254 psychiatric patients. Multivariate linear regression analyses were performed. RESULTS: The difficulties identifying feelings factor of the Toronto Alexithymia Scale significantly predicted all SCL-90-R subscale scores and was particularly effective, relative to the personality dimensions of the Temperament and Character Inventory, in predicting somatization. The Temperament and Character Inventory dimensions emerged as distinct and conceptually meaningful predictors for the different SCL-90-R subscales. CONCLUSIONS: A broad range of current psychopathology is associated with difficulties in cognitively processing emotional perceptions. Further research needs to clarify whether alexithymia represents a risk factor for mental illness and poorer outcome.

Affective Symptoms↗
PubMed2004

Dissociation, hemispheric asymmetry, and dysfunction of hemispheric interaction: a transcranial magnetic stimulation approach.

The authors investigated the hypothesis that dissociation may represent a functional dysconnectivity syndrome using a transcranial magnetic stimulation (TMS) approach. Transcranial magnetic stimulation investigations that included motor thresholds and the transcallosal conduction time (TCT) reflecting the interhemispheric transfer were performed in 74 right-handed students. All subjects completed the Dissociative Experience Scale. The high dissociators had a significantly lower left hemispheric excitability than right hemispheric excitability. They also had a significantly shorter TCT from the left to the right hemisphere than did the low dissociators. These results suggest that the neural basis of dissociation may involve a cortical asymmetry with a left hemispheric superiority or, alternatively, a lack of right hemispheric integration.

Adolescent↗
PubMed2004

[The relationship between OPD features of personality structure and symptom-related and interpersonal outcome of inpatient psychotherapy].

OBJECTIVE: To investigate the prognostic relevance of the axis "structure" of operationalized psychodynamic diagnostics (OPD) with respect to the symptom-related and interpersonal outcome of inpatient psychotherapy by applying group comparisons as well as individual criteria. METHODS: The structural level of 102 psychiatric inpatients was related to the general and dissociative psychopathology (SCL-90; FDS-20) as well as interpersonal problems (IIP) at the beginning and at the end of inpatient treatment. RESULTS: There was a tendency toward an association between the structural level and psychopathological improvement. However, we did not find any clear relationship between structure and interpersonal difficulties either at the beginning or during the course of the treatment. The structural dimensions did not correlate with the reduction of psychopathology or interpersonal problems. From the patients perspective, however, overall personality structure, defence and object perception were important predictors for therapy success. CONCLUSIONS: In correspondence with other studies our findings suggest that consistent predictions on therapy outcome in regards to psychopathology and interpersonal problems are not possible on the basis of the axis "structure". The possible implications for a differential therapy indication are discussed.

Adult↗
PubMed2002

[On the validity of the axis "Structure" of operationalized psychodynamic diagnostics].

OBJECTIVES: As part of the concurrent validity, we aimed to empirically study the association between the axis IV (structure) of the Operationalized Psychodynamic Diagnostics (OPD) and corresponding constructs, which were assessed byself-report measures. METHODS: The structural level of 132 psychiatric inpatients was related to the findings of the Borderline-Personality-Inventary (BPI) and the Toronto-Alexithymia-Scale (TAS-20). RESULTS: Analyses of variances indicated that patients with a good structural level scored lower on the BPI and its subscales than those with a low level. However, posthoc comparisons revealed that significant differences were only found between the good and the moderate or the low level respectively. There was no association between the structure and alexithymia. CONCLUSIONS: Despite some methodological limitations our findings point at a satisfactory validity of the axis "structure" of the OPD. However, its limited ability to discriminate between patients with a moderate and a low level of structural integration needs further attention.

Adult↗
PubMed2000

[Posttraumatic stress disorder, dissociation and self-destructive behavior in borderline patients]

We studied traumatic childhood experiences, comorbid posttraumatic stress disorders (PTSD), dissociation and self-destructive behavior in 30 inpatients with a borderline personality disorder. A standardized interview for the assessment of PTSD, the Dissociative Experience Scale and the Symptom-checklist were administered. Results were compared to a control of inpatients with neurotic disorders matched for gender and age. Borderline patients showed significantly more childhood sexual and physical abuse as well as emotional neglect than the control patients. Of the borderline patients, 67% met criteria for PTSD and only 13% of the control group. Dissociative symptoms were significantly more frequent in borderline patients and predicted in combination with PTSD symptoms and self-destructive behavior. We discuss our findings with respect to their etiological and clinical significance and propose a model for self-destruction in borderline patients which focusses on dissociation and trauma.

Journal Article↗