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Biomedical subjects

J C Krieg

Publications and source records attributed to J C Krieg.

At least 19 recordsLinked to original sources

Cholinergic REM sleep induction test in subjects at high risk for psychiatric disorders.

The influence of the cholinergic agonist RS 86 on electroencephalographic (EEG) sleep was investigated in 21 healthy members of families identified as being at high risk for psychiatric disorders and in 17 healthy control subjects without any personal or family history of a psychiatric illness. In comparison to the placebo night, the administration of RS 86 led to a shortening of rapid eye movement (REM) latency in both groups. This effect, however, was much more pronounced in the high-risk group, whereas in the control subjects the arousal system and the slow-wave sleep during the first nonREM period were more affected. These observations suggest that the cholinergic action on sleep regulating mechanisms has differing preferential targets in high-risk probands and in control subjects.

Adult

Lifetime and six-month prevalence of mental disorders in the Munich Follow-Up Study.

The Lifetime and 6 month DSM-III prevalence rates of mental disorders from an adult general population sample of former West Germany are reported. The most frequent mental disorders (lifetime) from the Munich Follow-up Study were anxiety disorders (13.87%), followed by substance (13.51%) and affective (12.90%) disorders. Within anxiety disorders, simple and social phobia (8.01%) were the most common, followed by agoraphobia (5.47%) and panic disorder (2.39%). Females had about twice the rates of males for affective (18.68% versus 6.42%), anxiety (18.13% versus 9.07%), and somatization disorders (1.60% versus 0.00%); males had about three times the rates of substance disorders (21.23% versus 6.11%) of females. Being widowed and separated/divorced was associated with high rates of major depression. Most disordered subjects had at least two diagnoses (69%). The most frequent comorbidity pattern was anxiety and affective disorders. Simple and social phobia began mostly in childhood or early adolescence, whereas agoraphobia and panic disorder had a later average age of onset. The majority of the cases with both anxiety and depression had depression clearly after the occurrence of anxiety. The DIS-DSM-III findings of our study have been compared with both ICD-9 diagnoses assigned by clinicians independently as well as other epidemiological studies conducted with a comparable methodology.

Adolescent

All-night electroencephalographic sleep and cranial computed tomography in depression. A study of unipolar and bipolar patients.

All-night electroencephalographic (EEG) sleep recording and cranial computed tomography were performed in 24 inpatients with major depression (14 unipolar, 10 bipolar). The patients showed the characteristic "depression-like" EEG sleep alterations and their ventricular brain ratio (VBR) was increased compared with the control subjects. No major differences were found between the unipolar and the bipolar groups. There was a close and positive association between the VBR values and several measures of slow wave sleep. It is hypothesized that this relationship is due to an altered function of the limbic-hypothalamic-pituitary-adrenocortical axis in depression that affects both EEG sleep and brain morphology.

Adult

Body size perception and body satisfaction in restrained and unrestrained eaters.

In 21 restrained and 20 unrestrained eaters body size perception was measured using the video distortion technique (VDT), the image marking procedure (IMP) and the kinesthetic size estimating apparatus (KSEA). Body satisfaction was assessed by questionnaires (Body Shape Questionnaire, Dieting scale of the Eating Attitudes Test). Restrained eaters showed no systematic over- or underestimation of the body size but less perceptual accuracy (in VDT and KSEA). Furthermore, they were clearly more dissatisfied with their bodies than unrestrained eaters. Both findings were unrelated to each other. In both groups depressive mood or thoughts seemed to be associated with body dissatisfaction but not with body size misperception. Objective body measures (body mass index, body fat content) were not related to either body size perception or body satisfaction. The findings suggest that a perceptual uncertainty in regard to body size (either for visual or for somatosensory aspects) has already developed in restrained eaters, which may constitute a predisposition for more overt forms of body size misperception as found in eating disorder patients.

Behavior Therapy

Predictors of short-term treatment outcome in bulimia nervosa inpatients.

Recent studies, mostly performed on bulimic outpatients, did not find consistent predictors of treatment outcome in bulimia nervosa. This is the first study to investigate anamnestic and clinical factors predictive of the short-term outcome of hospital treatment in 31 female bulimia nervosa patients with a mean age of 22.9 yr. Treatment outcome was assessed by several self-rating instruments measuring different features of the specific and unspecific psychopathology of bulimia nervosa. The most relevant predictors of the outcome of the 8-week hospital treatment were duration of previous inpatient treatments for bulimia, the intensity of anorexic tendency and the pretreatment level of depression. The majority of predictors tested did not show a strong relationship to treatment outcome. The findings are discussed in relation to results of other studies as well as to possible implications for treatment and research.

Adult

Panic disorder and major depression: a comparative electroencephalographic sleep study.

Family studies suggest some common etiological factors in panic disorder and depression. The observation of characteristic depression-like polysomnographic alterations in panic disorder patients would further underline the assumed biological interface between the two psychiatric disorders. In a polysomnographic study of 22 inpatients with panic disorder, 12 inpatients with major depression, and 12 control subjects, we found that both groups of patients had one major feature of depression-like sleep: a shortened rapid eye movement (REM) latency. However, the patterns of the first hours of polysomnography showed more differences than similarities between these psychiatric disorders, indicating that the shortened REM latency apparently is merely a common final pathway of different alterations in sleep regulation. Our findings, therefore, provide more evidence against than for a significant biological interface between panic disorder and depression.

Adolescent

Cortisol levels and vigilance in eating disorder patients.

Elevated plasma levels of cortisol, as well as deficits in cognitive processes such as attention, have been observed in patients with eating disorders. The association between plasma cortisol and performance in vigilance task was studied in 17 patients with bulimia nervosa or anorexia nervosa during the acute phase of their eating disorder. In comparison to normal young women, the patients had a significantly lower hit rate in a discrimination task and showed an impaired perceptual sensitivity index. They also displayed significantly longer reaction times to hits, but not to false alarms. Cortisol levels of the patients were significantly higher than those of the normal controls. When patients were divided according to their median cortisol level, the patients with higher levels performed significantly more poorly than did the patients with lower levels. In the total patient sample, cortisol levels showed a significant negative correlation with hit-rate (r = -.54) and a significant positive correlation with reaction time to hits (r = .70). Other clinical characteristics were not related to cognitive performance. These results suggest a possible role of cortisol in the development of attentional deficits in eating disorder patients.

Adult

Brofaromine in panic disorder: a pilot study with a new reversible inhibitor of monoamine oxidase-A.

The therapeutic efficacy of brofaromine--a new reversible and short acting MAO-A inhibitor--was evaluated in 14 inpatients with a panic disorder. In an open trial, the patients were treated with placebo during the first week and with 150 mg brofaromine per day during the following four weeks. In all patients a distinct improvement in both anxiety and depressive symptoms was observed under the active drug. Treatment outcome was the same in patients with and without a concomitant major depressive episode. No side-effects of any note were reported. Our findings suggest that the MAO-A inhibitor brofaromine is an effective drug in the treatment of anxiety disorders.

Adult

Pain sensitivity in anorexia nervosa and bulimia nervosa.

Pain threshold was measured with short heat stimuli using a contact thermode in 19 patients with anorexia nervosa, 20 patients with bulimia nervosa, and 21 control subjects. Both patient groups had significantly elevated pain thresholds compared with the control subjects. In the total sample, no substantial covariation could be demonstrated among pain threshold and clinical, physiological, metabolic, or psychological data. However, in separate regression analyses pain threshold correlated significantly (negatively) with local skin temperature in the anorectic patients and almost significantly (positively) with body weight in the bulimic patients. This finding suggests that the reduced pain sensitivity in the two kinds of eating disorders might have different causes.

Adult

Nocturnal sleep in Huntington's disease.

Nocturnal sleep was studied in 16 inpatients with Huntington's disease. In comparison with healthy controls, patients exhibited a disturbed sleep pattern with increased sleep onset latency, reduced sleep efficiency, frequent nocturnal awakenings, more time spent awake and less slow wave sleep. These abnormalities correlated in part with duration of illness, severity of clinical symptoms, and degree of atrophy of the caudate nucleus. Patients showed an increased density of sleep spindles.

Adult

Brain morphology and sleep EEG in patients with Huntington's disease.

In 12 patients with Huntington's disease, the relationship between brain morphology, nocturnal sleep EEG, and clinical variables was studied. Global cerebral atrophy did not significantly correlate with sleep parameters, whereas atrophy of the caudate nuclei was associated with reduced slow wave sleep and increased time spent awake. Several clinical parameters (e.g., anergia and thought disturbance scores of the Brief Psychiatric Rating Scale, illness duration and global clinical assessment) showed significant correlations with global cerebral atrophy. Similar studies in other neuropsychiatric disorders demonstrate associations between sleep alterations and brain morphological changes of different localizations, thus pointing to a complex relationship between both. It can be hypothesized that the caudate nuclei may be involved in sleep regulation; indirect evidence from studies with positron emission tomography (PET) point in the same direction.

Adult

Nocturnal sleep EEG in patients with HIV infection.

Nocturnal sleep was studied in 14 human immunodeficiency virus (HIV)-positive patients without opportunistic infections of the central nervous system. Seven patients had no bodily complaints at the time of the investigation. Patients exhibited an impaired nocturnal sleep with longer sleep onset latency, reduced total sleep time, reduced sleep efficiency, and more time spent awake and in stage 1. Stage 2 sleep was significantly decreased; in 2 cases, sleep spindle density was extremely low. REM latency was reduced and correlated negatively with depressive symptomatology, while the percentages of REM and slow wave sleep were normal. No significant differences in sleep parameters were present among patients in different stages of the illness, or between patients with and without bodily complaints. Ventricular size and sulcal width on computed tomography scans correlated with sleep variables indicating reduced sleep quality, and with REM density. Decreased tryptophan plasma levels were associated with shorter and less efficient sleep, and with reduced stage 2 sleep. The findings demonstrate that sleep EEG investigations can be valuable for detecting and monitoring central nervous system affection in HIV-positive individuals.

AIDS Dementia Complex

Assessment of somatosensory indicators of polyneuropathy in patients with eating disorders.

The somatosensory functions of small-diameter nerve fibres were tested on the lower and upper extremities in nine patients with anorexia nervosa, ten patients with bulimia nervosa and ten control subjects, by analysing warmth, cold, and pain thresholds. To test large-diameter nerve fibres, the vibration threshold was also measured. Both patient groups had markedly elevated pain thresholds compared with the control subjects. In contrast, warmth and cold thresholds were only suggestively elevated while vibration thresholds were not at all increased in the patients. A distal-proximal pattern of somatosensory deficits, suggestive of peripheral polyneuropathy, was not observed. Hence, a peripheral polyneuropathy affecting small or large afferent fibres as a consequence of an eating disorder seems to be a rare event.

Adult