PubMed Health⌕ Search

Biomedical subjects

L Hermle

Publications and source records attributed to L Hermle.

16 recordsLinked to original sources
PubMed1992

Sleep EEG effects of 3,4-methylenedioxyethamphetamine (MDE; "eve") in healthy volunteers.

3,4-methylenedioxyethamphetamine (MDE; "Eve") exerts similar psychotropic effects in humans as 3,4-methylenedioxymethamphetamine (MDMA; "Ecstasy") and is less toxic in animal studies. We conducted a double-blind, placebo-controlled, cross-over sleep electroencephalogram (EEG) study with healthy volunteers. One hundred forty milligrams of MDE or placebo were administered PO in six subjects at 11 PM. Sleep EEG was registered from 11 PM-7 AM the next morning. All subjects had a normal sleep onset latency. They all awoke 60 to 120 min after administration of MDE and stayed awake for at least 150 min (total sleep time, TST MDE < placebo and intermittent time awake MDE > placebo: p < 0.001). After again falling asleep rapid eye movement (REM) sleep was totally suppressed (REM during time in bed, TIB MDE < placebo: p < 0.001). A cyclic alternation of relatively long periods of slow wave sleep (SWS) with periods of light sleep occurred in three subjects during the second part of the night (stage 4 in second part of night MDE > placebo: p = 0.16). The effects of MDE on sleep variables largely demonstrate the stimulant, amphetamine-like properties of MDE.

3,4-Methylenedioxyamphetamine↗
PubMed1992

Mescaline-induced psychopathological, neuropsychological, and neurometabolic effects in normal subjects: experimental psychosis as a tool for psychiatric research.

The psychological, neuropsychological, and neurometabolic effects of the hallucinogenic agent mescaline were investigated in 12 normal men who were volunteers. Mescaline produced an acute psychotic state 3 1/2-4 hr after drug intake, as measured by the Brief Psychiatric Rating Scale (BPRS) and Paranoid Depression Scale (PDS). The Assessment of Altered States of Consciousness (APZ) questionnaire revealed specific effects of mescaline in the visual system. Neuropsychological effects were studied with a face/nonface decision task with known right-hemisphere advantage, in which mescaline induced a decrease of functioning of the right hemisphere. In functional brain imaging using single photon emission computed tomography (SPECT), mescaline produced a "hyperfrontal" pattern with an emphasis on the right hemisphere, which was correlated with mescaline-induced psychotic psychopathology. Our findings question the validity of the concept of hypofrontality as an explanation for schizophrenic symptomatology. The study of psychoactive substances under controlled laboratory conditions has the methodological advantage of intraindividual control, and hence, minimal variability of data.

Adult↗
PubMed1992

[Relations of model and drug-induced psychoses to schizophrenic diseases].

From the clinical point of view, substance-induced psychosis can be rather similar to schizophrenia. However, the question whether phenomenological resemblances represent similar underlying causal mechanisms is unsolved. Whereas the interest in experimentally induced psychosis was purely academic until the mid-1960s, the widespread use of "recreational" drugs provided this research with an important practical impact. With respect to a given case the differential diagnosis between schizophrenia and drug-induced psychosis it is often problematic. The differences in psychopathology refer to the disturbances of experience in general (Ichstörungen), the character of the hallucinations and the quality and quantity of the alterations of consciousness. Contrary to the sharp distinctions which used to be drawn between schizophrenia and drug-induced psychotic states, we hold that these states are rather similar, and may even represent a common underlying pathology. Hence, the renewed interest in the study on experimentally induced psychotic states using advanced methodology seems justified.

Diagnosis, Differential↗
PubMed1992

[Clinical and laboratory differentiation of alcohol withdrawal syndrome ("predelirium") and alcoholic delirium].

In a retrospective study, data from 99 male and female inpatients with alcohol withdrawal syndrome or alcohol withdrawal delirium, treated between 1977 and 1987, were analyzed. DSM-III criteria were used to assign the diagnosis of either withdrawal delirium (with obligatory clouding of consciousness) or alcohol withdrawal syndrome (without disturbances of consciousness and/or perception). No statistically significant differences between the two groups were found with respect to the red and white blood count, liver enzymes, and electrolytes. Significant differences were found in calcium levels, lymphocyte counts, and in electrophoresis. However, these differences are of no use for diagnostic purpose. Moreover, they are unspecific with respect to etiology. Hence, the distinction between alcohol withdrawal syndrome and alcohol withdrawal delirium can only be made clinically, i.e., it is dependent on the presence or absence of a clouded consciousness. This is in line with the findings published by other investigators. In the light of our metabolic findings, alcohol withdrawal syndrome and alcohol withdrawal delirium represent the two extremes of a continuum rather than two separate nosological entities.

Adult↗
PubMed1990

Psychometric, polysomnographic, and neuroendocrine measures in subjects at high risk for psychiatric disorders: preliminary results.

We report on the psychometric, polysomnographic, and neuroendocrine status of 12 subjects at high familial risk for psychiatric disorders and of 10 healthy subjects not at high risk. The psychometric measurements in the high-risk probands revealed an accentuated 'stress personality' pattern and an increased neuroticism score. Their all-night EEG sleep tended to be shallower than that of the control subjects (i.e., decreased sleep efficiency, more frequent awakenings, less slow-wave sleep), whereas they did not differ on REM sleep parameters. The challenge of the limbic-hypothalamic-pituitary-adrenocortical system with corticotropin-releasing hormone after pretreatment with dexamethasone yielded no differences in cortisol secretion between the groups. On an intraindividual level, however, all subjects at high risk except one were found to be conspicuous in at least one of the three states examined.

Adult↗
PubMed1988

[Significance of model psychoses].

Empirical findings and arguments in the hitherto controversial field of experimental psychosis are reviewed historically and systematically. Similarities and differences of experimental psychosis and schizophrenia are discussed on the background of disturbances of perception, consciousness and ego experience ("reflektierender Ich-Rest"). Better psychopathological, biochemical and neuropsychological assessment strategies could lead to a revival of experimental psychosis which some brief suggestions are made for.

Hallucinogens↗
PubMed1988

[Karl Wilmanns (1873-1945)--a biobibliographic view of a psychiatric era].

The Heidelberg University school of psychiatry was mainly shaped by the personality of Emil Kraepelin (1876-1926) who won world-wide recognition at the end of the 19th century during the discussions on "dementia praecox". It was his personality that made Heidelberg a fulcrum of a growing new scientific self-assurance that had no precedent in clinical psychiatry which no longer needed the disciplines of neuropathology and neurophysiology as pillars of support to gain recognition among the experts. Although the scientific achievements of Wilmanns cannot be rated as highly as those of E. Kraepelin and K. Jaspers, it is a fact that the period between 1918 and 1933 during which the Department of Psychiatry of the University of Heidelberg as represented by the University Hospital of Psychiatry, was headed by Karl Wilmanns, was the most fruitful period of the "Heidelberg School". 1933 was not only a political but also a psychiatric turning-point. Karl Wilmanns was one of the first of the well-known university teachers who was dismissed from office for political reasons. With his exit the Heidelberg School came to an end, and with it the discipline of psychopathology as a fundamental part of psychiatry- which had been the true progeny of that school. The references outline the influence of biological though on the "zeitgeist" of psychiatry. The contradictions, inhumanity and seduction of this line of thinking were not sufficiently recognised in all their aspects and consequences even by critical minds such as that of K. Wilmanns.

Bibliographies as Topic↗
PubMed1987

Neuroleptic malignant syndrome: observations on altered consciousness.

A young man with a previously untreated schizophrenia developed a neuroleptic malignant syndrome (NMS) on the second day of neuroleptic treatment. The dominant symptom was deep coma. The NMS occurred on the second day of neuroleptic therapy with rapidly progressing mental deterioration, temperature elevation, and extrapyramidal signs. After anticholinergics were injected the patient regained consciousness. This suggests that a cholinergic hyperactivity in the central nervous system (rather than hyperthermia) is responsible for the disturbance of consciousness in NMS. The experimental evidence that central cholinergic systems are stimulated by neuroleptics is discussed. It is concluded that anticholinergics might be helpful in treating coma during NMS.

Adult↗
PubMed1987

[Hemispheric laterality and early childhood autism. A case study of the etiologic and nosologic problem of the autistic syndrome in childhood].

Most studies on childhood autism emphasize a left hemispheric disturbance. In the presented case a primary right (and only secondary left) hemispheric dysfunction seems to be obvious. This seems to be true also for other reports in the literature. Supported by the hypermasculine aspect of our patient a pathological intrauterine testosterone level is suggested to be responsible for the observed altered cerebral asymmetry and consecutive hemispheric dysfunction. The advantage of such neuropsychologic findings and hypothesis should stimulate further studies on autism and other psychiatric disturbances.

Autistic Disorder↗
PubMed1986

[Degeneration theory in psychiatry].

Degeneration (called "dégénérescence" in French and "Degenerationslehre" in German terminology) as a theory of human retrogression manifested by degenerative signs in individuals, was a major factor in medicine and especially in psychiatry during the second half to the 19th century and at the beginning of the 20th century. Theories of retrogression seemed to supply conclusive hypothetic explanatory models for a wide variety of deviations from so-called "standard" values of health criteria for neurological diseases, brain disorders and mental diseases. The theory of degeneration, or retrogression, was closely interlinked with the complex ideological pattern that formed the background of philosophy and natural science during the nineteenth century. The theory of degeneration experienced mutual interaction and stimulation by the interplay with various other theories that were "en vogue" at that time, such as the development of positivistic natural science and of the theory of evolution, which in turn gave birth to the theories of social Darwinism, eugenics, genetics and to the development of biological-vitalistic approaches. In contrast with the other fields of medicine, anatomic pathology was unable to uncover any aetiological linkups for the various types of mental diseases. Hence, the theories of degeneration seemed to offer a conclusive concept for the genesis of mental disorders. The concept of degeneration was based on the theory of polymorphism which in turn positioned the wide range of neurological, mental and brain diseases within the descending series of progressing degeneration.

Europe↗
PubMed1986

[Differential diagnosis of acute life threatening catatonia and malignant neuroleptic syndrome--a case report].

This study reports the development of a severe life threatening catatonia in a 19 years old woman. Initially she displayed paranoia and hallucinations, which were complicated under neuroleptic treatment by extended rigor, temperature and autism. ECT led to a certain improvement of all symptoms, but complete recovery was only reached after neuroleptic drug withdrawal. The course of this case shows that the differential-diagnosis between genuine "pernicious" catatonia and the neuroleptica malignant syndrome is very difficult clinically. Therefore, before the application of ECT, an observation period without any neuroleptic drugs is recommended in similar cases with rigor, stupor and raised temperature, to avoid additional risks by narcosis and ECT itself. Diagnostic and therapeutic outlines are given.

Adult↗