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Biomedical subjects

Christoph Mundt

Publications and source records attributed to Christoph Mundt.

At least 19 recordsLinked to original sources
PubMed2007

IREL - A psychometric instrument for measuring life themes.

BACKGROUND: Although biographical narratives and work involving the meaning of biographical episodes is a central focus in any psychotherapy, there remains a lack of psychometric instruments for measuring the autobiographical construction as such. We will be presenting a theoretical model of an autobiographical construction of life themes and the Interview of Retrospective Exploration of Life themes (IREL) will be used as the basis of a psychometric instrument. The IREL takes about 90-120 min. The interrater reliability and test-retest reliability will be examined. METHODS: Two samples of 21 and 23 mentally healthy subjects were recruited. In addition to the IREL, the Beck Depression Inventory (BDI) and SCID were also used to control for psychopathological status and depressive mood. RESULTS: According to our data, biographical events can be explored objectively and reliably using the IREL. Minor test-retest variability of the affective valence of life themes is not state-dependent. CONCLUSIONS: Setting aside limitations due to the small sample sizes, the results suggest that the proposed interview is an objective and reliable instrument for measuring central issues within the subjective biographical construction (life themes).

Adult↗
PubMed2006

Stroop performance in depressive patients: a preliminary report.

BACKGROUND: The Stroop interference test requires executive control functions, in particular inhibition of a learned routine (in this case word reading). Depressive patients show deficits on tests of executive function. However, the impact of confounding variables like type of depression and anxiety level is not yet elucidated for depressive patients. This is of clinical importance, since executive functions seem to play an important role in predicting treatment response and functional outcome. METHODS: 23 depressive patients and 27 healthy subjects performed a computerized mixed trial Stroop task. Depressive patients were divided according to DSM-IV diagnosis into melancholic and non-melancholic subgroups. Furthermore the level of anxiety was assessed in all subjects. RESULTS: When depressed patients were analyzed as a whole group, they showed only a trend towards higher Stroop interference effect at the beginning of the task. When analysis was performed using according to DSM-IV defined melancholic and non-melancholic subgroups, only non-melancholic patients were impaired in the Stroop task compared to melancholic patients and healthy subjects. LIMITATIONS: The sample size was small resulting in low statistical power. Furthermore, the patients were medicated. CONCLUSIONS: The unexpected result that melancholic patients perform better than non-melancholic ones may be due to their more pronounced rigidity, which makes them more resistant against distraction. Hence, more detailed psychopathological assessment is desirable for future investigations in executive functions of melancholic patients.

Adult↗
PubMed2006

Psychosocial factors associated with knowledge about affective disorders in patients with depression.

BACKGROUND: Increasing importance is attributed to the knowledge that patients have concerning their illness. For psychiatric disorders, imparting information about the illness has become a standard part of treatment. Despite the great clinical relevance of knowledge about depression, only few empirical studies on this subject have been carried out. This study aimed to identify psychosocial factors associated with greater or lesser knowledge about affective disorders. METHODS: Sixty-one in-patients with depression were recruited and tested with the Knowledge about Depression and Mania Inventory. RESULTS: Almost all patients sought specific information about their disorder prior to admission to hospital. There were large differences in patients' knowledge about the disorder and their choice of information source. Older and less educated patients had less knowledge about affective disorders. Patients with less illness knowledge also have a less favourable illness concept, poorer interpersonal relationships and more passive coping strategies. CONCLUSIONS: The results show that knowledge about affective disorders is a central illness characteristic that has numerous implications for the ability to cope with the disorder, as well as for psychotherapeutic management. The results contribute to a clarification of the relationship between psychoeducation and psychotherapy.

Adult↗
PubMed2006

[The exploration of the depressive personality disorder].

Lately the concept of the depressive personality disorder has been regarded more often again in the context of chronic and subthreshold forms of depression. The purpose of the present study was the psychometric evaluation of a German version of the "Depressive Personality Disorder Inventory" (DPDI), which is a questionnaire for the exploration of the depressive personality disorder. A total of 138 depressive patients and controls were included in the study. The inter-rater-reliability as well as the internal consistency and the test-retest-reliability of the DPDI revealed satisfactory and good results. A short version of the DPDI was developed by means of a factor analysis. Medium correlations were found between the DPDI and two interviews for the depressive personality disorder. These results are discussed and it is concluded that the DPDI as well as its short version are reliable, valid and economic self-rating instruments for the exploration of the depressive personality disorder.

Adult↗
PubMed2006

[Psychometric evaluation of the German version of the temperament questionnaire TEMPS-A].

One aim of the present study was the psychometric evaluation of the German version of the questionnaire TEMPS-A of Akiskal, Mundt, Maier and Angst , which explores five affective temperaments. Another aim was to create a short version of the questionnaire. For that purpose the TEMPS-A was filled in by n = 62 in-patients who suffered from Major Depression. Then the relation between the five types of temperament and the big five personality factors was examined. The intercorrelations of the five temperament scales of the TEMPS-A showed mainly moderate associations. The correlations with the big five personality factors resulted in significant associations of all temperaments with neuroticism. By factor analyses, conducted for each scale of the TEMPS-A, we developed a short form of the TEMPS-A with 30 items. The evaluation of the TEMPS-A is just beginning. The TEMPS-A is an important basis for the further examination of the relationship between temperament and psychiatric disorders.

Adult↗
PubMed2005

Dimensions of the Typus melancholicus personality type.

The Typus melancholicus personality type (TMP) is characterised by orderliness, conscientiousness and interpersonal dependence. Several standardised instruments have been developed for the assessment of the Typus melancholicus personality. To date there has been no systematic comparison of these instruments and in particular it has been unclear whether TMP represents a single trait or a personality trait constellation. The aim of this study was the comparison of four TMP questionnaires and the investigation of the dimensionality of the personality as revealed by these questionnaires. The factorial validity of four TMP questionnaires was examined based on a sample of n = 264 psychiatric inpatients and normal controls. In a factor analysis of the items of the TMP questionnaires, four dimensions could be differentiated: Dependence, Intolerance of Ambiguity, Norm-Orientation, and Perfectionism. Psychometric evaluation showed good values for the individual items and the new TMP scales. The four subscales had a differential correlation profile in relation to the dimensions of the five-factor model of personality. The TMP scales could distinguish a group of depressed patients from a group of normal controls. The results show that TMP personality is not a single trait but consists of four related but separate traits. These can be clearly distinguished from those of the five-factor model of personality. The analysis of the TM concept therefore also represents a theoretical perspective for the integration of the personality characteristics which are relevant for depression. Based on this analysis, we constructed a multidimensional TMP inventory which forms the basis for the investigation of the effect of TM personality on clinical outcome and on psychotherapeutic treatment.

Adolescent↗
PubMed2005

Estrogen as an adjuvant therapy to antipsychotics does not prevent relapse in women suffering from schizophrenia: results of a placebo-controlled double-blind study.

The expected therapeutic effect of estrogen as an adjunct treatment to antipsychotics in women suffering from schizophrenia for relapse prevention was to be tested under real-life conditions. A multicenter, randomized, placebo-controlled, double-blind, cross-over study based on an A-B-A-B (and/or B-A-B-A) design was applied. Forty-six hypoestrogenic women with schizophrenia hospitalized for the first time or repeatedly were included in the study. Their average age was 37.9 and they had been suffering from schizophrenia for 8.4 years. During the drug treatment phases, they received a three-phase estrogen-gestagen combination drug (17beta-estradiol+norethisterone acetate) in addition to an antipsychotic drug. Significant effects of the adjuvant hormone replacement therapy on the estradiol levels could be observed, and high and low levels of estradiol prevailed in the active drug and placebo phases, respectively. We did not find any difference either in defined relapse events or in the psychopathology between estradiol replacement and placebo phases. Neither did the required antipsychotic doses or the tolerance data differ between the two phases. Thus, the results of our study do not confirm the hypothesis that a combined estradiol/antipsychotic therapy is superior to an antipsychotic monotherapy for relapse prevention.

Antipsychotic Agents↗
PubMed2005

Plasma concentrations of estradiol in women suffering from schizophrenia treated with conventional versus atypical antipsychotics.

BACKGROUND: Low estrogen levels leading to an elevated rate of menstrual dysfunctions such as amenorrhea and irregular menstruation have been described in women with schizophrenia and have often been attributed to antipsychotic-induced hyperprolactinemia. However, there is some evidence that "hypoestrogenism" in schizophrenic women does not occur exclusively under medication with hyperprolactinemia-inducing antipsychotics. While the precise mechanism of low estrogen levels in schizophrenic women has not been elucidated yet, "hypoestrogenism" is of clinical relevance because estrogen seems to endow an antipsychotic-like effect in schizophrenia and thus positively affect the course of illness in schizophrenic women. In addition, low levels of estrogen might have a negative effect on bone mineral density and on the cardiovascular system. METHODS: To test the "hypoestrogenism hypothesis", hormone levels in 75 women with schizophrenia diagnosed according to DSM-IV and ICD-10 were determined in the follicular, periovulatory, and luteal phases of the menstrual cycle. Levels of estradiol, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone, and testosterone were assessed. RESULTS: The serum levels of estradiol were generally reduced during the entire menstrual cycle compared to normal reference values. With low levels of LH over the entire cycle and of progesterone in the luteal phase, anovulatory cycles were assumed. Hypoestrogenism was found in about 60% of the patients in accordance with a strict definition (estradiol serum level below 30 pg/ml in the follicular phase and below 100 pg/ml in the periovulatory phase). To rule out a possible effect of hyperprolactinemia on the gonadal axis and a subsequent effect on estradiol levels from treatment with conventional ("typical") antipsychotics, serum estradiol levels of patients treated with certain atypical antipsychotics known to induce only a mild increase in prolactin, or no increase at all, were compared with those from patients treated with conventional antipsychotics. The data clearly indicate high prolactin levels in the latter, but low levels in the group treated with atypical antipsychotics. In both groups, however, low levels of estradiol compared to normal reference values were measured. CONCLUSIONS: The present findings provide evidence that hypoestrogenism in schizophrenia occurs in women with and without antipsychotic-induced hyperprolactinemia. Further research should be conducted to clarify the cause of hypoestrogenism in schizophrenic women and focus on possible clinical implications.

Adolescent↗
PubMed2004

Interactive regulation of affect in postpartum depressed mothers and their infants: an overview.

Specific patterns of interaction emerging in the first months of life are related to processes regulating mutual affects in the mother-child dyad. Particularly important for the dyad are the matching and interactive repair processes. The interaction between postpartum depressed mothers and their children is characterized by a lack of responsiveness, by passivity or intrusiveness, withdrawal and avoidance, as well as a low level of positive expression of affect. Thus, an impaired capability to regulate the child's affect has been demonstrated in depressed mothers. Maternal aggression, neglect toward infants, infanticidal thoughts, as well as infanticidal behavior are mainly linked to severe postpartum depression, especially with psychotic symptoms. The findings on mother-child interaction reported in this paper are based on mothers with mild to moderate depressive disorders without psychotic symptoms. Considering the stability of interaction patterns in the course of depressive illness as well as the long-term consequences of these interactions, it seems surprising that there are still few systematic studies of depressed mothers interacting with their infants. In connection with an overview on these issues, treatment models for parent-infant psychotherapy are discussed.

Aggression↗
PubMed2004

Prefrontal-cingulate activation during executive control: which comes first?

The Stroop test requires executive control functions, in particular inhibition of a learned routine (in this case, word reading). The spatiotemporal analysis of brain activation during Stroop task execution was performed in 16 healthy subjects using high-density event-related potentials (ERPs) and dipole source modeling (BESA software). Scalp ERP analysis revealed the neurophysiological substrate of the interference effect: first, a greater negativity in the incongruent as compared to the congruent and neutral conditions was found between 350 and 450 ms poststimulus over left frontocentral scalp regions. Source analysis of the difference wave (incongruent-congruent) indicated that a generator localized in left prefrontal cortex (PFC) contributed to this effect. Second, immediately after the first effect, a greater positivity in the incongruent as compared to the congruent and neutral conditions developed between 450 and 550 ms poststimulus over midline frontocentral scalp regions. A generator of this effect was located in right anterior cingulate cortex (ACC). ACC activation seems to follow the activation of PFC with some overlap between the two components. Possible interpretation of this finding is that PFC signals ACC when executive control is required and ACC implements the control.

Adult↗
PubMed2003

A psychometrically derived impulsive trait related to a polymorphism in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) in a Japanese nonclinical population: assessment by the Barratt impulsiveness scale (BIS).

Although a number of studies have shown that human impulsive traits are associated with indices of central serotonin function, few researchers have investigated the relationship between a polymorphism in the serotonin transporter gene-linked region (5-HTTLPR) and a psychometrically derived impulsive trait. We determined the 5-HTTLPR polymorphism in 123 employed Japanese male adults using the polymerase chain reaction. The distribution of allelic frequency was determined and also investigated the relationship of the 5-HTTLPR polymorphism to a impulsive trait as measured by the Barratt Impulsiveness Scale, 11th version (BIS-11). The distribution of allelic frequency was found to be almost identical to that previously reported in Japanese (the frequency for the long (L)/L, L/short (S), and S/S genotypes was: 3, 28, and 68%, respectively). In a comparison between the genotype groups, the S/S genotype group significantly higher scored for the total BIS-11 and the subscale attentional impulsiveness than the L/S + L/L genotype group. These findings suggest that individuals with a homozygous S-allele may be more impulsive than those with the other genotype.

Carrier Proteins↗
PubMed2003

Executive control deficit in depression: event-related potentials in a Go/Nogo task.

Growing evidence suggests an impairment of executive control functions in depression. The aim of this study was to investigate whether depressive patients show a specific impairment of executive control in a response inhibition task and to investigate its neurophysiological correlates using event-related potentials. We analyzed data from 16 patients with unipolar depression and 16 healthy controls using an auditory Go/Nogo task. High resolution event-related potentials (ERPs) were recorded. Depressive patients performed similar to controls in the Go task, but worse in the Nogo task, which required response inhibition. ERPs revealed the neurophysiological correlate of this deficit. Both groups showed the same voltage pattern in the Go task. However, in the Nogo task depressive patients showed a reduction of an early fronto-temporal positivity in the N2 time window, which was associated with response inhibition in healthy subjects. This effect could not be explained by increased task difficulty in the Nogo task. There was no difference between groups in later stages of processing as indexed by the P3 complex. Therefore, the findings suggest a specific deficit in response inhibition, which requires executive control. This deficit is thought to reflect dysfunctional activation of the network subserving executive control during an early stage of cortical processing.

Adult↗
PubMed2003

Psychological treatments for psychosis: history and overview.

This article is part of the ISPS (International Society for the Psychological Treatment of the Schizophrenias and other Psychoses) task force report on the PORT (Patients Outcome Research Team) recommendations for treatment of schizophrenia. It reviews psychological treatment approaches in psychosis to date and assesses recent trends. The most influential therapies have been psychoanalytic/psychodynamic, cognitive behavioral (CBT), and supportive therapy.

Cognitive Behavioral Therapy↗
PubMed2002

Expressed emotion in relatives of first-episode and chronic patients with schizophrenia and major depressive disorder-a comparison.

Relatives of first-episode and chronic schizophrenic and depressed patients were examined with respect to their expressed emotion (EE) status. The two aims of the study were to (1) investigate whether relatives of first-episode patients differed from family members of chronic patients, and (2) whether EE indices of relatives of schizophrenic patients were comparable to those of depressed subjects. Twenty patients of each diagnostic group (DSM-III-R and DSM-IV) were included, i.e. a total of 80 patients. The EE status of key relatives was assessed with the Five-Minute Speech Sample on the basis of critical comments and emotional overinvolvement. Additionally, the new criterion 'covert criticism' was applied to detect indirect expressions of critique. Relatives of first-episode and chronic patients of both diagnostic groups did not differ significantly regarding their EE status; in first-episode patients, 52.5% of relatives were classified high EE; in chronic patients, 45%. Moreover, EE indices of relatives of schizophrenic and depressed patients were comparable. Analysis revealed 52.5 and 45% high-EE relatives in the depression and the schizophrenia subsamples, respectively. Thus, the overall incidence of high-EE relatives was comparable to numbers reported in the literature. In our study EE status of relatives was not disease-specific, and it was independent of chronicity of illness.

Adult↗
PubMedDate not supplied

A comparative study of nonspecific depressive symptoms and minor depression regarding functional impairment and associated characteristics in primary care.

BACKGROUND: Milder forms of depression are highly prevalent in the clinical setting as well as in primary care. However, it is still unclear whether there are distinguishable groups among the various subthreshold syndromes and to what extent they are associated with impairment, thus requiring treatment. Therefore, the study aimed at comparing the degree of impairment in 2 groups of subthreshold depressive patients (nonspecific and minor depressive) with nondepressive patients and with major depressive patients. Another aim of the study was to evaluate the spectrum hypothesis of depressive syndromes. SAMPLING AND METHODS: A sample of 619 primary care patients was studied using the self-administered Patient Health Questionnaire (PHQ). After defining subthreshold depressive syndromes on a criterion basis, frequencies, sociodemographic factors, and impairment of nondepressive, subthreshold depressive, and major depressive patients were compared. RESULTS: Nonspecific depressive symptoms (NDS) were diagnosed in 9.1% of the study subjects and minor depression in 6.2%. Subjects with subthreshold depressive disorders did not differ from each other or from subjects with major depression regarding sociodemographic risk factors such as age, sex, or marital status. Yet, a continually increasing impairment from NDS to minor depression to major depression could be found. Moreover, the investigated groups differed with regard to the severity index. CONCLUSIONS: The results of the study are in accordance with the spectrum hypothesis of depressive syndromes ranging from NDS to minor depression to major depression. Patients with subsyndromal depression showed significant functional impairment to the extent that at least some of these patients probably had a disorder requiring treatment.

Activities of Daily Living↗
PubMedDate not supplied

Preferences for treatment in primary care: a comparison of nondepressive, subsyndromal and major depressive patients.

OBJECTIVE: In recent years, patients' preferences concerning treatment of emotional distress in general and of depression in particular have received more emphasis in the clinical setting as well as in research. METHODS: The treatment preferences of 607 primary care patients were assessed in a cross-sectional study using a questionnaire. Besides having the opportunity to choose between psychotherapy and pharmacological treatment, the patients could also decline or choose both treatment options at one time. Moreover, the preferences of subsyndromal, major depression and nondepressive patients were compared. RESULTS: A total of 305 (51%) patients exclusively preferred psychotherapy and 110 (18%) exclusively preferred pharmacological treatment. Although 70 (12%) patients declined both forms of treatment, 113 (19%) could imagine using both treatment options. Patients with subsyndromal depression did not differ from patients with major depression in their preferences. Both groups, however, less frequently declined pharmacological treatment compared to nondepressive patients. CONCLUSIONS: Patients with subsyndromal and major depression are similar in the primary care setting with regard to their treatment preferences. The preference for combination treatment is rather low, which should be considered in routine clinical care [corrected]

Adult↗