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F Müller-Spahn

Publications and source records attributed to F Müller-Spahn.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Computer-assisted individualized memory training in Alzheimer patients].

Memory training programs for cognitively impaired patients have often been criticized for their lack of relevance to everyday activities. We therefore report our experience with two patients suffering from probable Alzheimer's disease who were trained with a new computer-based program recently developed by our research group. An everyday task of personal relevance to the patient was simulated and trained on a PC touch screen using personal photographs of the patient's surroundings and biography. The patient's training performance (time, mistakes, number of advices) improved substantially. While psychopathometric tests showed no significant effects with regard to general cognitive performance, levels of motivation were high and there was a positive acceptance of the training, signs of emotional activation and of a transfer of the trained skills into real situations.

Activities of Daily Living↗
PubMed1994

[Prognosis of depression in the elderly].

Depressive syndromes are, with dementia, the most frequent psychiatric disorders in the elderly. The etiology of depressive syndromes can be reactive, endogenous, and neurotic as well as organic. Recent studies could show, that about 60% of the elderly patients clearly improve under treatment. Therefore the earlier opinion of a dramatically poorer outcome has to be revised. The presence of simultaneously occurring somatic illness, positive family history, certain personality traits and severity of disease could exert a bad influence on clinical outcome. Medical treatment should consider the special pharmacological features in higher age, and should be combined with psychotherapy as well as a close involvement of the relatives.

Aged↗
PubMed1994

Cytosolic free [Ca2+] in mononuclear blood cells from demented patients and healthy controls.

There is increasing evidence that the neurodegenerative processes in Alzheimer's disease (AD) may be related to alterations in calcium homeostasis and that these metabolic changes are not necessarily restricted to the central nervous system. However, previous studies investigating [Ca2+]i in fibroblasts, lymphoblasts, platelets and lymphocytes of AD patients gave inconclusive results, since increase, decrease and no alteration in [Ca2+]i were found in AD patients compared with controls. With respect to the importance of establishing altered Ca2+ homeostasis in peripheral cells, we have investigated [Ca2+]i in circulating mononuclear cells of patients with AD, multi-infarct dementia, age-associated memory impairment and healthy controls. [Ca2+]i was evaluated using the fluorescent dye fura-2 before and during stimulation with phythaemagglutinin (PHA). In our study we failed to find major differences in resting [Ca2+]i and in response to stimulation with 25 micrograms/ml and 100 micrograms/ml PHA in cells of AD patients as compared with all other groups investigated. There was only a tendency towards a decrease in [Ca2+]i in AD after stimulation with PHA. Thus the present findings suggest that [Ca2+]i evaluation in mononuclear cells does not have diagnostic value in discriminating AD patients from other demented patients. However, there might be some difference in [Ca2+]i values between early- and late-onset AD, which could have pathophysiological importance.

Adult↗
PubMed1994

Clinical presentation of depression in the elderly.

Depressive syndromes and dementia are the most frequent psychiatric disorders in the elderly. Reactive depressive syndromes can be associated with the restriction of social competence due to increasing multi-morbidity, loneliness, social isolation, the consequences of retirement, interpersonal conflicts, and the loss of partners or close relatives. Endogenous depressive syndromes in the elderly are frequently combined with diffuse and changing somatic complaints, psychomotor restlessness and agitation. Furthermore, depressive syndromes can be caused by somatic illness, degenerative disorders, other organic diseases or certain drugs. The presence of simultaneously occurring somatic illness, positive family history, certain personality traits, and severity of disease could exert an adverse influence on clinical outcome. Medical treatment should consider the special pharmacological features of old age, and should be combined with psychotherapy as well as a close involvement of the relatives.

Aged↗
PubMed1993

[Atypical neuroleptics, pharmacology and clinical importance].

Since the development of clozapine the investigation of atypical neuroleptic compounds has become increasingly relevant. Compared with classic neuroleptics they are distinguished by either fewer or absent (clozapine) extrapyramidal side effects, some of them also by lower increases of serum prolactin concentrations. Pharmacologically they are a group of heterogeneous substances. At the level of transmitter systems a high 5HT2/D2-ratio is regarded as the best criterion to distinguish between atypical and classic neuroleptics. Further differences involve: the preferred effects of atypical neuroleptics on mesolimbic D2 receptors compared to striatal dopaminergic neurotransmission; a higher potency of some atypical neuroleptics to antagonize D1-receptors; the increase of serum corticosterone concentrations by some of the atypical neuroleptics.

Animals↗
PubMed1993

Early neuroleptic intervention in schizophrenia: are prodromal symptoms valid predictors of relapse?

All recently completed controlled two-year studies on intermittent, early neuroleptic intervention treatment have failed to compare favourably with studies on maintenance treatment concerning relapse prevention. The reason for this failure is still unclear. Therefore the implicit, but as yet unproven, hypothesis that a relapse can be predicted from prodromal symptoms was tested from the perspective of our German multicentre study. Results demonstrate that this is not the case. Possible reasons for and clinical implications of this negative finding are discussed.

Adult↗
PubMed1993

[Paranoid psychosis in a patient with hypothyroidism and vitamin B12 deficiency].

The case of a 39 year old in-patient with a paranoid syndrome is presented. During the course of examination, a vitamin B12 deficiency as well as a hypothyreosis were found, which seemed to have a common cause in an autoimmune disease. The paranoid symptoms disappeared completely under treatment with vitamin B12 and thyroid hormones. Moreover, the neuropsychological deficit improved markedly. The relationship between psychiatric symptoms and organic disease, and also the differential diagnosis, is discussed.

Adult↗
PubMed1992

Depressive syndromes in schizophrenic patients under neuroleptic therapy. ANI Study Group Berlin, Düsseldorf, Göttingen, Munich, Federal Republic of Germany.

Schizophrenic outpatients (= 364) were assigned at random to three different treatment strategies: (1) continuous medication with neuroleptic drugs, (2) intermittent medication with crisis intervention and (3) intermittent medication with early intervention. Depressive syndromes were rated according to three different scales for depressive syndromes (Brief Psychiatric Rating Scale anxious depression factor, Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie/depression, and the self-rating Paranoid Depression Scale) after 1 and 2 years of treatment. No differences in depression scores were found between the three treatment strategies. Comparisons between patients treated with neuroleptic drugs at the time and patients without neuroleptics revealed significantly higher depression scores in the neuroleptics group in most comparisons. No differences were found between patients treated with low versus high potency neuroleptics and between oral versus depot neuroleptics. However, depression correlated with extrapyramidal symptoms.

Administration, Oral↗
PubMed1992

[New aspects in the diagnosis, pathogenesis and therapy of schizophrenic negative symptoms].

The treatment of negative symptoms requires a thorough diagnostic assessment. Their lack of homogeneity has important clinical implications. Negative symptoms are unspecific for schizophrenia, differ in cause and manifestation, and may appear at all stages of the illness. There is much evidence for the responsivity of negative symptoms to pharmacological and psychosocial treatment. This paper gives a short survey of the historical development of the concept of negative symptoms, the development of scales specifically measuring both negative and positive symptoms, and various recently discussed hypotheses concerning pathogenesis and treatment strategies. Important is a therapeutic concept individually adjusted to the patient's needs, including pharmacological, psychotherapeutic and social measures.

Antipsychotic Agents↗
PubMed1991

[Effectiveness and tolerance of zotepine in a double-blind comparison with perazine in schizophrenic patients].

40 inpatients suffering from a schizophrenia (ICD-9) were treated with either zotepine or perazin. The study was continued for a period of 28 days. Assessment of clinical efficacy was effected via BPRS, AMDP, CGI and SANS; tolerance was assessed by means of Simpson's scale. In addition, EEG, ECG and laboratory controls were conducted. The overall therapeutic efficacy was good, and it was not possible to distinguish one group from the other, i.e. both substances were equally effective, judged by means of the psychopathometric tools that were at our disposal. In 11 patients of the zotepine group and in 9 patients of the perazin group, slight extrapyramidal symptoms were observed. No clinically relevant changes were seen in EEG, ECG and laboratory controls in both groups.

Adult↗
PubMed1991

[Clinical effectiveness of zotepine in treatment of negative schizophrenic symptoms. Results of an open and a double-blind controlled trial].

The clinical action of Zotepine was examined in an open and in a randomised double-blind controlled study in in-patients displaying a productive or minus pattern of symptoms within the framework of a schizophrenic disease or schizoaffective psychosis. The present paper discusses only the results achieved in treating schizophrenic minus patterns of signs and symptoms. In Study I 20 schizophrenic patients were treated with two different Zotepine dosages. Group 2 (n = 12) showed at an average daily dose of 168 +/- 15 mg (150-190 mg) a significant improvement (p less than 0.05) of the anergy subscore in the BPRS scale as well as a significant improvement of the subscores affective flattening, anhedonia/asociality and attentional imparvement in the SANS scale, compared with Group 1 (n = 8) with an average daily dose of 270 +/- 37 mg (240-340 mg). This improvement developed already during the first two weeks of the treatment. In Study II the antipsychotic action of Zotepine compared to that of perazine was studied under double-blind conditions. The average daily dose in the Zotepine group (n = 20) was around 241 +/- 70 mg (106-396 mg), in the perazin group (n = 19) at 348 +/- 09 mg (214-575 mg). With regard to the BPRS subscore anergy and all the subscores of the SANS scale, there was a distinct improvement without significant group differences. Both substances were comparably well tolerated.

Adult↗
PubMed1990

Depressive syndromes in schizophrenic patients after discharge from hospital. ANI Study Group Berlin, Düsseldorf, Göttingen, Munich.

A total of 364 schizophrenic outpatients who were stabilized for 3 months on continuous neuroleptic therapy after discharge from the hospital were rated according to three different scales for depressive syndromes (Brief Psychiatric Rating Scale anxious depression factor, AMDP/depression, and the self-rating PD-S depression scale). Between 19.5% and 27.5% of the patients were rated as depressed, or 35.7%-42.8%, when mild depressive syndromes were included. There were low, but significant correlations between demographic or life-event data and depression scores on the self-rating scale, whereas fewer correlations were found on the observer ratings. No associations were found between social adjustment and depression. Moderate correlations were found between measures of the apathetic syndrome and depression ratings, while observer ratings showed higher correlations than the self-rating. High depression scores, especially in the observer ratings, correlated with scales for global psychopathological assessment (CGI, GAS). There were significant correlations between extrapyramidal rigidity and observer rating depression scores, whereas the total amount of neuroleptics given had no influence. These results are interpreted on the basis of hypotheses about depressive syndromes in schizophrenia.

Antipsychotic Agents↗
PubMed1989

Influence of CGP 361A, propranolol and diazepam on autonomous reactions to different stressors.

1. To evaluate the influence of beta-blockers and minor tranquilizers on autonomous stress response, 40 healthy subjects selected with regard to personality traits were randomly assigned to 5 groups. 2. Mental arithmetic induced the most pronounced increase in heart rate (HR), blood pressure and epinephrine secretion. 3. Beta-blockers reduced HR increases due to mental stress, whereas the minor tranquilizer reduced skin conductance level throughout the whole trial. 4. Our data provide evidence that different structured situations induce specific response patterns that are differentially modified by beta-blockers and minor tranquilizer.

Adrenergic beta-Antagonists↗
PubMed1988

Haloperidol plasma level after a test dose as predictor for the clinical response to treatment in acute schizophrenic patients.

In a fixed-dose, double-blind study, the clinical response of schizophrenic patients to a high (0.40 mg/kg) or a low (0.15 mg/kg) dose of haloperidol (HL) was compared. The relationship between HL steady-state plasma levels and clinical improvement was examined. The utility of HL plasma level after a single test dose (0.05 mg/kg) in predicting the clinical response to treatment was evaluated. No difference in clinical improvement was observed between the two groups as a whole, although the high-dose group had a faster initial improvement. The high-dose group showed more extrapyramidal effects during treatment. No relationship was found between HL steady-state levels and clinical improvement. For the low-dose group, HL plasma level after the test dose was significantly positively correlated with the improvement after eight days of treatment. The test dose HL plasma level was no predictor of the clinical response to treatment in the high-dose group. The possibility of predicting the clinical response of schizophrenic patients to treatment from the plasma level after a test dose is still an open question that requires further studies.

Acute Disease↗