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J Angst

Publications and source records attributed to J Angst.

At least 55 records · Page 3Linked to original sources
PubMed1995

Outcome of a clinical cohort of unipolar, bipolar and schizoaffective patients. Results of a prospective study from 1959 to 1985.

In a prospective study, 186 unipolar depressives and 220 cases of bipolar disorder meeting DSM-III criteria for major depression or mania were followed up. Subjects were classified according to polarity and the presence or absence of schizophrenic symptoms, into four diagnostic subgroups: unipolar depression, bipolar disorder, unipolar schizoaffective disorder and bipolar schizoaffective disorder. At the last follow-up in 1985, 53% of the patients had deceased. Eleven percent of the sample (17% of all deaths) had committed suicide. The risk of suicide was associated with clinical severity and onset prior to the age of 60. However, there was no difference in suicide rates according to sex or diagnostic subgroup. Late onset of affective illness was associated with chronicity, which occurred in 10 to 19% of cases. Recovery was more frequent among unipolar than among bipolar patients. The 5-year remission rates (i.e. 26% in unipolars, 16% in bipolars) were independent of the number of episodes.

Adult↗
PubMed1995

Course of a clinical cohort of unipolar, bipolar and schizoaffective patients. Results of a prospective study from 1959 to 1985.

This paper reports the results of a 27 year prospective study of 186 unipolar depressives and 220 bipolar disorders meeting DSM-III criteria for major depression or mania. Subjects were classified into four diagnostic subgroups, according to polarity and presence or absence of schizophrenic symptoms: unipolar depression, bipolar disorder, unipolar schizoaffective disorder and bipolar schizoaffective disorder. Course parameters were assessed for all samples. As the sequence of subtypes of affective and schizoaffective disorders progresses from unipolar depression, schizodepression, pure affective bipolar disorder to schizobipolar disorder, a systematic decrease in age of onset and length of episode can be observed. When compared to unipolar disorders (unipolar depression and schizodepressive disorder), bipolar (bipolar and schizobipolar) disorders showed more periodicity, characterized by greater number of total episodes, more episodes per year, but with shorter episodes and cycles. Despite the lower age of onset among schizoaffective subjects compared to pure affective disorders, the only difference in course between the two groups was a greater frequency in episodes requiring hospitalization among schizoaffectives.

Adult↗
PubMed1995

[Epidemiology of the bipolar spectrum].

The majority of epidemiologic studies indicate a prevalence rate of bipolar disorder of between 0 to 1.6% in the population. Some studies using other instruments have suggested lifetime prevalence rates of between 3 and 6.5%. Higher rates are often obtained when a wider range of cases belonging to the bipolar spectrum are included in data, for instance, cyclothymia or atypical bipolar illness. The Zurich cohort community study reported a prevalence rate of 5.5% for bipolar disorder and, moreover, found evidence for the existence of "brief hypomania", a condition characterized by short episodes of 1-3 days duration and a high recurrence. The prevalence rate found for this group was 2.2%, and is as such comparable in validity to DSM IV hypomania or mania measured by family history of depression, history of suicide attempts and treatment of depression. The quality of life for brief hypomanics is starkly reduced.

Bipolar Disorder↗
PubMed1994

The Zurich Study: XXIII. Epidemiology of headache syndromes in the Zurich cohort study of young adults.

This study examines the 1 year prevalence rates of headache syndromes in an epidemiologic cohort study of young adults ages 29-30 in Zurich, Switzerland. The 1 year prevalence rates of headache subtypes were 3.3% for migraine with aura and 21.3% of migraine without aura as defined by the International Headache Society (IHS) criteria. The demographic distribution, clinical features, sequelae, and treatment patterns of subjects with specific headache subtypes are described. The rates of migraine are compared to those of other community samples that have employed the IHS criteria for headache subtypes. Subjects with migraine reported pervasive impairment in nearly every life role including occupation, leisure, and social relationships. Despite the substantial degree of impairment in occupational and social functioning that was associated with migraine, an extremely low proportion of subjects had received professional treatment for headache. These results suggest that a concerted effort should be directed towards education regarding the classification of headache and the availability of efficacious treatment for migraine.

Absenteeism↗
PubMed1994

Premorbid personality traits of men who develop unipolar or bipolar disorders.

In 1972, all Swiss males in the Canton of Zurich who reported for a compulsory medical examination for selection for military service were given the Freiburg Personality Inventory. This was repeated in half the sample on three subsequent occasions. From 1983 to 1988, an effort was made to identify all male psychiatric cases. There were 99 unipolars and 26 bipolars. The unipolars who had their age of onset after the personality testing displayed elevated scores on a constellation of symptoms labelled autonomic lability which consisted of items that correlated highly with neuroticism. The trait endured even when it was retested at age 36 years. The bipolars did not differ from the controls in any respect on any occasion.

Adult↗
PubMed1994

Neurasthenia in a longitudinal cohort study of young adults.

This study examines the concept of neurasthenia in a longitudinal cohort of young adults selected from a community sample of the canton of Zurich, Switzerland. The major focus is on the validity of the case definition of neurasthenia. Close approximations of the proposed descriptive and research definitions of the ICD-10 are employed as well as the concept of 'irritable weakness' as described in 1831 by Kraus (1926-1932). The prevalence of neurasthenia defined according to the ICD-10 criteria was: 1% across 10 years and 0.9% in 1988 for a duration criterion of > or = 3 months; and 8.1% across 10 years and 12% in 1988 for a duration criterion of > or = 1 month. The duration criterion of > or = 3 months appeared to be excessively restrictive to represent individuals with neurasthenia in the community. Subjects with 1 month episodes of neurasthenia exhibited sufficient differences from controls and similarities to subjects with anxiety or depressive disorders to justify a 1 month duration criterion for neurasthenia in community samples. The clinical significance of neurasthenia was indicated by the magnitude of subjective distress, and occupational and social impairment reported by the majority of the cases. Prospective assessment of the longitudinal course of neurasthenia revealed that approximately 50% of the cases continued to exhibit this disorder at follow-up. Our findings suggest that neurasthenia is equally likely to represent an early manifestation of affective illness as it is a consequence in those neurasthenic subjects who exhibited comorbid affective disorders. The magnitude, chronicity, impairment, longitudinal stability and distinction from anxiety and depression associated with this condition in the general population, suggest that neurasthenia is an important diagnostic entity for which additional validation studies should be undertaken.

Adult↗
PubMed1994

Psychopathology and headache syndromes in the community.

The present study investigated the association between psychopathology and headache in a prospective longitudinal epidemiologic study of a cohort of 19- and 20-year-olds in Zurich, Switzerland. Prevalence rates of psychopathology by headache subtype were examined both cross-sectionally and longitudinally. Psychiatric disorders were evaluated using a direct interview administered by experienced clinicians. Personality was assessed using the Freiburg Personality Inventory and the Symptom Checklist 90. In general, subjects with migraine had more affective and anxiety disorders and exhibited elevated rates of neuroticism and somatization compared to nonmigraine subjects. When examined by headache subtype, migraineurs with aura exhibited greater rates of psychopathology and more personality abnormalities than any of the other headache subtypes or controls. In contrast to clinical wisdom, subjects with tension-type headache did not differ from controls in rates of psychopathology or on any of the personality or symptom factors.

Adolescent↗
PubMed1994

Heterogeneity of depression. Classification of depressive subtypes by longitudinal course.

This paper describes the application of prospective longitudinal data from an epidemiological sample of young adults to define subtypes of major depression. Depression was classified on a spectrum from subthreshold manifestation of symptoms and duration at one end, to cases with recurrent episodes of depression meeting duration criteria for major depressive episodes at the other. There was a direct relationship between the severity of depression over the longitudinal course and both duration and recurrence of depressive episodes. The subgroup of depression with recurrence of both brief and longer duration episodes could be discriminated on most of the indicators of validity including symptoms, impairment, family history, and suicide attempts. In light of the young age of this cohort, the strong history of suicide attempts and other complications of depression among the subjects with recurrent depression was striking. These findings underscore the importance of employing course as a classification criterion of depression, and the inclusion of subthreshold episodes of depression in the characterization of course.

Adult↗
PubMed1994

Diagnostic criteria for migraine. A validity study.

To identify the optimum combination of symptoms for the International Headache Society (IHS) diagnostic criteria for migraine, the criteria were systematically assessed for validity using an epidemiologic sample from Zurich, Switzerland. The indicators of validity used included subjective distress, occupational impairment, family history of migraine, and treatment. The symptoms that provided the best discrimination between migraine and other headache subtypes were photophobia, phonophobia, and osmophobia, in combination with gastrointestinal symptoms. The evaluation of the validity of the IHS classification of migraine is impeded by several factors, including: the presence of multiple headache syndromes within an individual, the tendency for headache characteristics to change over a lifetime, the effects of headache treatments in obscuring syndromes, and the lack of generalizability of findings based on clinical samples. The methods used in this study serve as a model for applying statistical techniques for evaluating the validity of diagnostic criteria. The findings, however, should be replicated in additional studies to determine their generalizability to specific demographic and clinical subgroups.

Adult↗
PubMed1994

Recurrent brief depression: the Zurich Study.

The initial conception of manic depressive illness by Kraepelin included short and mild depressive and hypomanic states in the nosologic category of affective illnesses. A longitudinal epidemiologic study in Switzerland (the Zurich Study) identified brief, but recurrent, episodes of depression with severity of symptoms, impairment, and distress equivalent to major depression. The concept of recurrent brief depression was further confirmed in recent community and general practice studies. The diagnostic criteria for recurrent brief depression require the presence of at least five of nine depressive symptoms analogous to the symptoms of major depression, yet a duration of less than 2 weeks (in general 1 to 3 days), a recurrence of at least 12 times a year, and the evidence of work impairment. The 1-year prevalence in the general population is about 5% and the lifetime prevalence 16%. Recurrent brief depression may develop into major depression and vice versa in about the same percentage of cases. It is associated with considerable suicidality and treatment-seeking and is comorbid with anxiety disorders. Patients with combined major and recurrent brief depression are more severely affected, have a higher suicide attempt rate, and have an increased frequency of treatment-seeking than patients with only one condition. Further studies are needed to establish appropriate treatment strategies.

Adult↗
PubMed1993

The Zurich Study. XVII. Sexual abuse in childhood. Frequency and relevance for adult morbidity data of a longitudinal epidemiological study.

In the course of a 10-year longitudinal investigation of young Swiss adults, childhood sexual abuse was assessed at the age of 30 years. It was reported by 11.5% of women and by 3.5% of men; 56% of the females had been abused by relatives (none of the males), 20% by fathers. Abuse cases tended to be more depressed and anxious; they reported more suicide attempts and more sexual problems than controls and also slightly more psychiatric symptoms and neuroticism. Childhood familial risk factors were more frequent for abuse cases than for controls. Depression at adult age was more strongly connected with early familial risk factors than with early sexual abuse.

Adult↗
PubMed1993

The Zurich Study: XXI. Sexual dysfunctions and disturbances in young adults. Data of a longitudinal epidemiological study.

In a cohort of young Swiss adults, sexual disturbances and dysfunctions were assessed by interview four times between ages 20 and 30 years. Over 10 years almost every second female and every third male subject reported disturbances. In females at age 30 years, the prevalence of orgasmic difficulties and of dyspareunia corresponded to non-clinical samples of other studies. Also, in accordance with the literature, impaired interest was much more prevalent in females. In males and females, sexual disturbances were to some extent associated with anxiety and depression; in addition, in women, they were also associated with social phobia and eating disorders. With regard to neuroticism, negative affect and reports of an unsatisfactory childhood, subjects with temporary disturbances resembled more strongly those with chronic problems than controls. Compared with the controls, women's sexual disturbances were more chronic and more strongly associated with minor psychiatric symptoms and personality deviance; this finding was less pronounced in men.

Adult↗
PubMed1993

The Zurich Study. XVIII. Obsessive-compulsive disorders and syndromes in the general population.

The cross-sectional and longitudinal association between obsessive-compulsive syndrome (OCS) and other psychiatric problems and the course over 11 years was examined in a Swiss cohort of young adults. As the prevalence of obsessive-compulsive disorders, defined according to the DSM-III was very low (n = 5), we applied a lower diagnostic threshold based on obsessive-compulsive symptoms and social impairment, to define an OCS. The weighted lifetime prevalence rate for OCS at age 30 years was 5.5%. The mean age of onset was 17.1 +/- 4.9 years for males, and 19.1 +/- 5.1 year for females. OCS was associated with all subtypes of depressive disorders as well as with social phobia and agoraphobia. Although the longitudinal analysis showed no stability at the diagnostical level, there was some stability on the symptom level. Perhaps subjects with OCS learned in time to cope and to live with their symptoms without suffering.

Adaptation, Psychological↗
PubMed1993

The Zurich Study. XIX. Patterns of menstrual disturbances in the community: results of the Zurich Cohort Study.

This paper reports on the prevalence of emotional and somatic symptoms of the pre- and peri-menstrual phases of the female reproductive cycle among women who participated in a 10-year prospective epidemiologic cohort study of young adults in Zurich, Switzerland. The association between menstrual syndrome and sociodemographic features, personal habits, and psychopathology is investigated. The findings confirm those of previous studies, which have shown that symptoms of menstrual syndrome are quite common in non-clinical samples in the community, and increase with age. Women with menstrual problems could be distinguished from other women in a number of domains, including demographic characteristics such as nulliparity, higher educational level, distressing life events, lack of oral contraceptive use, psychiatric disorders, and personality traits. The combined evidence for a strong association between menstrual syndrome and anxiety, both in the subjects and their relatives, suggests that menstrual problems may represent a manifestation of underlying anxiety disorders rather than strictly affective disorders as traditionally believed.

Adult↗