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Biomedical subjects

H R Wacker

Publications and source records attributed to H R Wacker.

15 recordsLinked to original sources
PubMed2003

Seasonality in affective disorders in Switzerland.

OBJECTIVE: To estimate the prevalence of seasonal affective disorder (SAD) and its subsyndromal form (S-SAD) in Switzerland (47 degrees N). METHOD: A representative sample from all three language areas of Switzerland (n = 980) were given a structured telephone interview using the extended Seasonal Pattern Assessment Questionnaire (SPAQ+). A smaller, but also representative sample in the city of Basel filled in the SPAQ+ form as well as undergoing a structured diagnostic interview. RESULTS: In this Swiss sample, 2.2% of the population presented with symptom severity of SAD, 8.9% with S-SAD. In Basel, a much higher prevalence of SAD was found. Seasonal problems occurred more often in patients with the Diagnostic and Statistical Manual (DSM)-III diagnosis of major affective disorders than in those with pure anxiety disorders or no psychiatric diagnosis. CONCLUSION: These estimates for SAD in Switzerland are similar to those found in the Zürich Study, using other methods, and for populations in the UK, with the limitations inherent in retrospective questionnaire studies.

Adult↗
PubMed2000

[Epidemiology and comorbidity of depressive disorders].

Recent epidemiological surveys in general populations of different countries of the world found lifetime prevalence rates of major depressions between 3.3% and 17%. For dysthymia (depressed mood over a period of at least two years with at least two concomitant depressive symptoms) the prevalence rate was found to be between 2% and 7%. The prevalence rates of major depressions and dysthymia are usually higher for females than for males. Bipolar disorders can be observed in about 1% of a general population over lifetime, and they seem to be somewhat more common among males than females. Divorced and separated persons have a higher risk of suffering from major depressions than married persons. Major depressions are thought to be more common among members of the lowest social class than among people belonging to the upper classes. Major depressions usually start between the age of 25 and 30 years, and the age of onset of bipolar disorders is between the age of 18 and 30 years. For western industrial nations a secular trend towards an increase in the prevalence of major depressions may be presumed. However, such a secular trend has not yet been confirmed, owing to biases associated with methodological problems. A notable comorbidity of major depressions can be observed with all anxiety disorders, obsessive-compulsive disorders, eating disorders, post-traumatic stress disorder, disorders of impulse control, abuse and dependence of alcohol and of other legal and illegal drugs, pathological gambling, migraine, fibromyalgia and irritable bowel syndrome. This observation has led to the concept of an "affective spectrum". This phenomenon has to be kept in mind during the diagnostic process and treatment.

Adolescent↗
PubMed1997

Unaltered monocyte function in patients with major depression before and after three months of antidepressive therapy.

Monocyte phenotypes and functions were studied in 22 patients with major depression, and compared with those of 22 matched healthy controls. Immune measures were performed before and after dexamethasone suppression, and after 4 and 12 weeks of moclobemide therapy in patients. Seven patients terminated after 4 weeks because of treatment failure; 11 out of 15 patients responded to therapy after 12 weeks. Monocyte human leukocyte antigen class II and CD14 antigen expression, tumor necrosis factor production, and plasma interferon-gamma and neopterin did not differ in patients before treatment and controls. The reaction to dexamethasone was also similar in patients and controls. Neither antidepressive treatment per se nor the clinical response to it affected any immunological parameter. In conclusion, corticosteroid-controlled monocyte functions were similar in untreated and treated depressed patients and in controls, and unrelated to the clinical course of the disease.

Adolescent↗
PubMed1997

[Diagnosis and therapy of anxiety disorders].

Anxiety disorders may be encountered by the medical practitioner in the form of phobias, panic disorder or generalized anxiety disorder. A phobia is characterized by a strong, irrational fear of a given object or situation, often resulting in avoidance behavior. Phobic patients usually respond well to cognitive behavioral therapy. Panic disorder, which is distinguished by recurring, unexpected attacks of fear not bound to particular situations, may also be treated with cognitive behavioral therapy and/or with clomipramin, benzodiazepines or selective serotonin reuptake inhibitors. Patients with generalized anxiety disorder, the main symptom of which is a persistent, free-floating fear over a period of at least several months, may be helped through relaxation techniques, counseling and/or medication with low doses of sedating tricyclic compounds or short-term treatment with benzodiazepines. This article will describe anamnestic findings and the results of clinical examinations of patients with anxiety disorders. Factors to be considered in differential diagnosis will be discussed.

Anti-Anxiety Agents↗
PubMed1997

[Diagnosis, epidemiology and comorbidity of anxiety disorders].

Fears and apprehensions which significantly impair a person's everyday life and which cannot be attributed to an organic brain disturbance or to other mental disorders or physical problems are grouped together in the class of "anxiety disorders". Three types of anxiety disorders can be distinguished on the basis of clinical picture and the course of development of symptoms: phobias, panic disorder and generalized anxiety disorder. Recent epidemiological studies indicate that anxiety disorders are one of the most common kinds of mental disorder. More than a fourth of the persons surveyed in a general population have suffered from an anxiety disorder at some point in their lives. Phobias occur most frequently, with social phobias being the most common according to the latest studies (lifetime prevalence of 13.3% to 16%). The lifetime prevalence of panic disorder is estimated at 1.2% to 3.5%, depending on the diagnostic system (DSM-III-R, ICD-10) and survey instruments used. Generalized anxiety disorder is estimated to have a lifetime prevalence of between 1.9% and 6.6%. Overall, anxiety disorders tend to occur more often in women than in men. Onset is usually in childhood or adolescence. All anxiety disorders have a high lifetime comorbidity with other mental disorders. The frequency of anxiety disorders occurring in combination with affective disorders and substance abuse and dependence over the span of a lifetime is significantly high. Increased risk of suicide is an important factor to consider when assessing these patients, especially in the case of panic disorder or social phobias.

Adolescent↗
PubMed1991

[Attitude of ambulatory psychiatric patients to psychopharmacologic treatment].

By means of a semistructured interview 51 nonpsychotic new outpatients of the Psychiatric University Outpatient Clinic, Basle, Switzerland, were asked about their expectation of being treated with a psychotropic medication during the ensuing therapy. Their conceptualizations about the modes of action of psychopharmacological drugs were also studied. In addition, their emotionally connoted attitudes towards these modes of action were elucidated. 2/3 of those patients who have been treated with a psychopharmacological medication by their family doctor expected that also their psychiatrist at the outpatient clinic prescribed a psychotropic medication, whereas only 1/6 of those patients without a corresponding experience stated to expect a psychopharmacological treatment. Patients who have previously been treated psychopharmacologically stated significantly more often that psychotropic drugs had an effect on emotional processes and compared them significantly less often to alcohol or addictive drugs of the drug subculture than patients without the experience of previous psychotropic medication. Patients expecting to receive psychotropic drug gave significantly more often positive emotional connotations about the presumed modes of action of these drugs than patients without such an expectation. It can be concluded that previous experiences with psychotropic medication evokes the expectancy of also receiving a psychopharmacological treatment during an ensuing therapy at the Psychiatric Outpatient Clinic. Furthermore the experience of a psychopharmacological treatment induces mainly emotionally positive connotated conceptualizations about the modes of action of psychotropic medication.

Adult↗
PubMed1989

Longitudinal study on the consumption of analgesics, tranquilizers and hypnotics by healthy Swiss men over a 13-year period (1972-1985).

This study describes the course of medical drug consumption (analgesics, tranquilizers, and hypnotics) in 843 identical, healthy men between the ages of 20 and 33 years. In 1972-1973, 4082 randomly selected 20-year-old Swiss military recruits were interviewed with a standardized questionnaire about parental drug consumption and their own consumption of tobacco, alcohol, analgesics, tranquilizers, hypnotics, and illegal drugs. In 1979, 1658 and, in 1985, 1554 men from the original sample were asked identical and similar questions via questionnaires sent by mail. The results presented concern the 843 men who took part in all three phases. The medical drugs these men consumed most often were analgesics. However, there was a significant decrease in the number of men who took these drugs either seldom or repeatedly during the observation period (28.6% vs 21.0%; P less than 0.001). There was also a significant decrease in the proportion of men who used tranquilizers (8.7% vs 4.9%; P less than 0.01); however, the proportions of men taking hypnotics were the same in 1972-1973 and in 1985 (5.4% vs 5.2%). In the study population, repeated consumption of analgesics and/or hypnotics and/or tranquilizers at the age of 20 significantly increased the probability that the subjects would habitually consume analgesics at the age of 33. Repeated parental consumption of hypnotics increased the probability that the sons would significantly increase their consumption of hypnotics and/or tranquilizers between the ages of 20 and 33. The results are discussed against the background of other findings concerning the epidemiology of drug consumption.

Adult↗
PubMed1988

[Alcohol, tobacco and drug use in Swiss men 20 to 33 years of age].

In a second follow-up in 1985 former military recruits were asked to fill in a standardized questionnaire concerning their consumption of alcohol, tobacco, drugs and medicines. They had been interviewed for the first time on enlistment in 1972/73 and had filled in a second, mailed questionnaire in 1979. The consumption patterns from 1972/73 to 1985 are described in subjects who participated in all three surveys. Out of the original 4082 recruits, 1103 had answered in 1979 and in 1985 the questionnaires of 843 young men could be evaluated for all three inquiries. The average amount of alcohol consumed was 118.7 g per person and week in 1972/73, 102.8 g in 1979 and 117.2 g alcohol 100% in 1985. Accordingly, the numbers of subjects belonging to the extreme consumption classes decreased significantly from 1972/73 to 1979: abstainers from 94 (11.2%) to 44 (5.2%) (p less than 0.001) and heavy drinkers (more than 350 g alcohol 100% per week) from 54 (6.4%) to 27 (3.2%) (p less than 0.001). From 1979 to 1985 the moderate drinkers (up to 150 g alcohol 100% per week) decreased from 638 (75.8%) to 568 (67.5%) (p less than 0.001) and the middle-range drinkers (160 to 350 g) increased from 133 (15.8%) to 193 (22.9%) (p less than 0.001). Concerning consumption of tobacco, the number of nonsmokers rose between 1972/73 and 1985 from 378 (45%) to 464 (55%) (p less than 0.001). The number of heavy smokers did not change significantly over the three surveys. From 1972/73 to 1979 and from 1979 to 1985 fewer (p less than 0.01) subjects increased their cigarette consumption.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking↗
PubMed1988

[Differential experience of anxiety conditions: a contribution to the diagnosis and pathogenesis of anxiety attacks. A case report].

By means of a case report about a depressive female patient suffering from clusters of attacks of various psychosomatic disorders associated with anxiety states of different degrees problems of diagnostic classification are discussed with regard to the DSM-III. The subjective experiences of anxiety during the various episodes of the patient's disease are described. A phenomenological difference between fear of death with preserved relation to reality on the one hand and "calamity anxiety" with a short-lasting breakdown of reality testing on the other hand is indicated. The neurobiological model of noradrenergic dysregulation is taken on trial to understand the various phenomenons of the disease.

Adult↗
PubMed1983

[Long-term and short-term patients in a psychiatric university-polyclinic: a comparison of their social indicators using the AMDP system].

Although a remarkable knowledge about socioeconomic variables of psychiatric outpatients has been gathered until now little is known how their social conditions influence their duration of psychiatric service utilization. In this paper two groups of clients of the University Psychiatric Outpatient Clinic of Basle with different durations of treatment were compared by using the social indicators of the AMDP-System: the first group of outpatients has been in treatment for less than one year (short term patients, KZP), the second has been in treatment for more than five years (long term patients, LZP). Long term patients are more often than short term patients unmarried. They live more often in family fragments, are/were less often in professional leading positions and are less often integrated in the labour-market. Before as well as after their first contact to the University Psychiatric Outpatient Clinic long term patients were more often hospitalized in psychiatric clinics. Social sex differences are elaborated for both groups. The heavier institutional dependence of the second group is discussed in the light of their greater social disintegration. The importance of the social indicators as determinators for the institutional selection is stressed.

Adolescent↗
PubMed1978

[Normocalcemic nephrolithiasis and primary hyperparathyroidism].

In normocalciuric and in hypercalciuric renal stone formers tubular calcium reabsorption (TRCa) was studied before and during an intravenous calcium infusion. In addition two patients with proven primary hyperparathyroidism (pHPT) were studied. TRCa was decreased in hypercalciuric stone formers whereas an increase was noted both in pHPT and in normocalciuric subjects. It is concluded that normocalciuric nephrolithiasis may be a manifestation of mild and/or early pHPT.

Absorption↗