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G Stadtmüller

Publications and source records attributed to G Stadtmüller.

6 recordsLinked to original sources
PubMed1999

[Management of mental health and primary care. Development and evaluation of a training program based on the PLISSIT approach].

Deficits in current approaches of psychosomatic and psychiatric education for general practitioners are reviewed. A skill-based training was developed in line with the four step counseling approach of the "PLISSIT" approach: The GP helps in first step ("permission") the patient to accept his problem and assesses informations about causing and maintaining factors of his symptomatology. In the second step he should provide information about the disorder and reverse misunderstanding and passivity (Limited Information). The GP's should develop preliminary strategies for change in the third step ("coping strategies", "symptom management", "special suggestions") and preparate the intensive phase of therapy as the last step. First results of the evaluation of the training program are presented demonstrate the effectiveness and acceptance of the education program.

Disease Management↗
PubMed1993

REM sleep parameters in the discrimination of probable Alzheimer's disease from old-age depression.

Thirteen dementia of the Alzheimer type (DAT) patients and fifteen old-age major depressive disorder (OAD) patients were investigated by polysomnography. The sleep was recorded during two nights after a 1 week wash-out period of psychotropic drugs. No statistically significant differences between the two groups were found concerning sleep continuity or architecture. The amount of REM sleep was significantly lower in DAT in comparison with OAD patients (11.7% verses 18.5%). Also, total REM density as well as the density of the first REM period were significantly lower in the DAT compared with the OAD patient group (15.8% verses 32.5%, 14.9% verses 38.1%, respectively). REM latency did not differ between both groups. Because REM latency is known from other studies to be shortened in depressed patients due to a cholinergic hyperactivity, the opposite finding, i.e., prolongation of REM latency, was expected for DAT patients. This assumption, however, could not be confirmed in the present study. It is concluded that REM density may better differentiate between DAT and OAD.

Aged↗
PubMedDate not supplied

The value of REM sleep parameters in differentiating Alzheimer's disease from old-age depression and normal aging.

Pseudodementia as a common trait in elderly depressives presents a major problem in gerontopsychiatry, especially for the differential diagnosis between Old-Age Depression (OAD) and Dementia of the Alzheimer Type (DAT). The present polysomnographic study examined parameters of sleep continuity, sleep architecture, and REM sleep to differentiate DAT from OAD. The investigation was based on the theoretical framework of the cholinergic-aminergic imbalance model of depression, the cholinergic deficit hypothesis of Alzheimer's disease and the reciprocal interaction model of Non-REM/REM sleep regulation, according to which REM sleep parameters should have high discriminative value to differentiate OAD and DAT. We investigated 35 DAT patients, 39 OAD patients and 42 healthy controls for two consecutive nights in the sleep laboratory. The DAT patients were in relatively early/mild stages of the disease, the severity of depression in the OAD group was moderate to severe. Depressed patients showed characteristic 'depression-like' EEG sleep alterations, i.e. a lower sleep efficiency, a higher amount of nocturnal awakenings and decreased sleep stage 2. Sleep continuity and architecture in DAT was less disturbed. Nearly all REM sleep measures differentiated significantly between the diagnostic groups. OAD patients showed a shortened REM latency, increased REM density and a high rate of Sleep Onset REM periods (SOREM), whereas in DAT REM density was decreased in comparison to control subjects. REM latency in DAT was not prolonged as expected. To assess the discriminative power of REM sleep variables a series of discriminant analyses were conducted. Overall, 86% of patients were correctly classified, using REM density and REM latency measures. Our findings suggest that REM density as an indicator of phasic activity appears to be more sensitive as a biological marker for the differential diagnosis of OAD and DAT than REM latency. The results support the role of central cholinergic neurotransmission in REM sleep regulation and the pathogenesis of DAT and OAD.

Aged↗
PubMedDate not supplied

[Premorbid psychological processes in patients with Alzheimer's disease and in patients with vascular dementia].

We analyzed the premorbid biographies of 21 patients with Alzheimer's disease for possible common features. Eleven age-matched patients suffering from vascular dementia served as a control group. The observations from our qualitative study indicate that persons with a conflict-avoiding, submissive, premorbid personality predominate among Alzheimer patients. Persons who later became Alzheimer patients tended to leave important daily-life decisions to their partners (or other persons of reference). Prior to the onset of the very first neuropsychological deficits, persons who later became Alzheimer patients were found to stay in a lasting situation in which they were subject to a treatment that could be designated as "caring tutelage." Subsequently, most patients became subject to an increasingly patronizing and restricting treatment. Further elements that were frequently found as part of the premorbid development were physical or psychological burden, loss of social contacts, and loss of motivation. In contrast, assertive and dominant premorbid traits predominated in the group of vascular patients. The premorbid biographical situation of persons who later became vascular patients was characterized by a loss of the control which these persons had hitherto exerted over partners, their families, or the situation at their working place. We advance the hypothesis that in Alzheimer's disease the described psychological phenomena are part of a preclinical process, during which biological, psychological, and social factors interact, finally joining into the clinical stage of the disease. Possibilities for psychotherapeutic interventions are discussed.

Adult↗