Biomedical subjects

M Hautzinger

Publications and source records attributed to M Hautzinger.

At least 19 recordsLinked to original sources

PubMed2007

[Reliability and validity of the Revised Beck Depression Inventory (BDI-II). Results from German samples].

BACKGROUND: The Beck Depression Inventory (BDI) underwent revision in 1996 (BDI-II) with the goal of addressing DSM-IV depression criteria. The present study assessed psychometric properties of the German version of the BDI-II. PATIENTS AND METHODS: The BDI-II was translated into German and evaluated in a series of studies with clinical and nonclinical samples. RESULTS: The content validity of the BDI-II has improved by following DSM-IV symptom criteria. Internal consistency was satisfactorily high (alpha>or=0.84), and retest reliability exceeded r>or=0.75 in nonclinical samples. Associations with construct-related scales (depression, dysfunctional cognitive constructs) were high, while those with nonsymptomatic personality assessment (NEO-FFI) were lower. The BDI-II differentiated well between different grades of depression and was sensitive to change. CONCLUSION: The German BDI-II demonstrates good reliability and validity in clinical and nonclinical samples. It may now replace the older version of the BDI for assessing self-rated severity of depression and course of depressed symptoms under treatment.

Adolescent↗

PubMed2005

A new quality-of-life measure for men experiencing involuntary childlessness.

BACKGROUND: Infertility may considerably reduce quality-of-life. Many of the existing generic quality-of-life measures, which often focus on physical impairments, do not represent the specific complaints of infertile patients. In this article, we report on the development and validation of the TLMK (Tübinger Lebensqualitätsfragebogen für Männer mit Kinderwunsch), an instrument for measuring quality-of-life in male patients with involuntary childlessness. METHODS: The first version of the questionnaire, which consisted of 91 items, was administered to 275 men who attended andrology and gynaecology clinics for fertility evaluations. After the questionnaires were scored, item analysis and reduction, principal component analysis and internal consistency analyses were conducted. RESULTS: The final version of the TLMK consists of 35 items in four scales and provides an internally consistent quality-of-life profile for men experiencing involuntary childlessness. Convergent and discriminant validity was supported through the correlation of the TLMK scales with established questionnaires on life satisfaction (FLZ) and partnership (PFB). CONCLUSION: The TLMK provides information about the quality-of-life in men experiencing involuntary childlessness and was found to be easy to administer and acceptable to patients. It may be used to assess patients' baseline and ongoing quality-of-life during fertility treatment and as an outcome variable in the evaluation of integrated psychological counselling.

Adult↗

PubMed2005

[Combination treatment with SSRI and cognitive behavior therapy for relapse prevention of alcohol-dependent men. Results of a randomized, controlled multicenter therapeutic study].

BACKGROUND: This study evaluates the serotonergic antidepressant nefazodone (SSRI) vs placebo (PL) and specific cognitive-behavioral therapy (CBT) vs nondirective group counseling (GC) for relapse prevention in alcohol dependence in a large, prospective, randomized and placebo-controlled, double-blind study at three German university centers. METHODS: Male patients fulfilling at least five criteria for alcohol dependence according to DSM-IV and ICD-10 were eligible, after detoxification, for one of the following treatment combinations: SSRI+CBT, SSRI+GC, PL+CBT, and PL+GC. The SSRI or PL were administered throughout the evaluation period of 15 months. CBT or GC was applied during the first 12 weeks as group therapy according to operationalized manuals. The main outcome measures (assessed at 3 and 12 months of treatment) were the cumulative number of abstinent days, the amount of ethanol consumed during specified evaluation periods of 3 and 12 months, the number of relapses, and the duration of time until first relapse. RESULTS: After 12 weeks of treatment, no statistically significant differences in any outcome measure were observed between the four treatment combinations. After 52 weeks, the only significant difference was observed in the amount of ethanol consumed, with the SSRI+GC group showing higher intake. CONCLUSIONS: The results of this carefully designed clinical trial suggest that the four treatment combinations do not differ substantially in their efficacy in relapse prevention of nondepressed, severely alcohol-dependent patients. Nefazodone may even promote ethanol drinking in a subset of patients. Cognitive-behavioral therapy as performed in this study was associated with little additional benefit compared with structured GC.

Adult↗

PubMed2005

Reliability and validity of the form 90 interview.

OBJECTIVE: Alcohol consumption is a central variable in substance abuse research and treatment. The study reports the psychometric characteristics of the German version of the Form 90 interview for the assessment of recent alcohol consumption. METHOD: Reliability was evaluated in a test-retest study (7 days) with 30 consecutively admitted psychiatric inpatients with alcohol dependence. Validity of Form 90 was assessed with a second sample of 60 alcohol-dependent inpatients. RESULTS: Form 90 demonstrated good to excellent retest reliability for the central variables of alcohol consumption. Retest reliability Pearson correlation coefficients (r) ranged from 0.76 to 0.99 and Intraclass Correlation Coefficients (ICC) ranged from 0.74 to 0.98. Reliability coefficients proved to be stable throughout the whole assessment window (90 days). Confidence intervals demonstrated sufficient precision of measures of alcohol consumption. Validity was supported by significant correlations of the amount of alcohol consumed with outcome parameters of the Lifetime Drinking History Interview (r=0.47 and 0.58), gamma-glutamyltransferase on admission to detoxification treatment (r=0.37), physical withdrawal symptoms (r=0.56) and the withdrawal symptom index (r=0.48). CONCLUSIONS: Form 90 presented evidence of good to excellent psychometric properties, and its applicability to clinical populations of alcohol-dependent patients in German-speaking countries could be confirmed.

Adult↗

PubMed2004

[Cognitive behavioral therapy for depressed older outpatients--a controlled, randomized trial].

OBJECTIVE: There is a lack of scientific evidence of psychotherapy with depressed elderly. In a controlled randomized trial we compare a cognitive behavioral group intervention with a waiting list control condition. It is expected that cognitive behavior therapy is more efficient in reducing depressive symptoms than the control group at post-treatment as well as at follow-up. METHOD: A total of 100 older adults presently fulfilling the diagnosis of a depressive disorder but not showing any signs of cognitive impairment were randomly assigned (ratio 2 : 1) to either cognitive behavior therapy (N=65) or to waiting list condition (N=35). Assessment took place at pre-treatment, after 3 months of treatment or waiting, and after 6 months follow-up. RESULTS: As expected, cognitive behavior group therapy was superior to waiting list control in all measures at post-treatment as well as at follow-up (intent-to-treat analysis). These effects are statistically and clinically relevant and not influenced by parallel treatment with antidepressant medication. After cognitive behavior therapy 36 patients were in complete remission but only 4 after three months of waiting. Six patients in the control group became even worse during the 3 months waiting while only 1 patient under cognitive behavior therapy has to be considered as treatment failure. DISCUSSION: Cognitive behavioral group treatment is a well accepted, successful intervention for older adults. Waiting for treatment is problematic. It does not only produce no changes in symptomatology but even leads to worsening of depression in a large number of subjects.

Aged↗

PubMed2003

[Psychiatric comorbidity in risk groups of opioid addiction: a comparison between opioid dependent and non-opioid dependent prisoners (in jail due to the German narcotics law)].

Individuals who do not develop opioid dependence although they have access to opioids might differ with regard to psychiatric risk factors from opioid-exposed subjects who developed opioid dependence. To test this assumption, the present investigation compared individuals who were in jail due to the German "Dangerous Drugs Act" (i. e. particular risk group due to facilitated opioid availability) according to presence or absence of opioid dependence and psychiatric comorbidity in each group. This study design is in line with the assumption that in addition to the (postulated) environmental risk factor of facilitated availability of opioids, psychiatric risk factors enhance the likelihood for the development of opioid dependence. Opioid addicts represent a risk group, not only for other forms of substance dependence, but also psychiatric disorders like anxiety disorders, suicide attempts and specific forms of personality disorders. However the difference between opioid dependent subjects and non-opioid dependent controls was less marked than initially postulated. Alcoholism of non-opioid dependent prisoners also was associated with depressive episodes, anxiety disorders as well as cocaine dependence. Despite the high frequency of life-time psychiatric comorbidity in the opioid dependent sample, this increased comorbidity was not paralleled by psychiatric treatment. In general, the sample of prisoners investigated here, was characterized by a high frequency of psychiatric disorders including substance dependence.

Adult↗

PubMed2002

[Cognitive behavioral therapy as supplement to pharmacotherapy of manic depressive disorders. What is the empirical basis?].

Medications will be always necessary in the treatment of bipolar affective disorders. More and more, however, the importance of an adjunctive psychotherapy is emphasized. Numerous controlled therapy trials showed that unipolar depressed patients can be effectively treated with cognitive behavior therapy (CBT). Therefore a literature search was done to check for the empirical evidence concerning the efficacy of CBT for bipolar disorders. We conducted a literature search using Medline, PsycINFO, and Psyndex, considering all publications dealing with the topic "psychotherapy and bipolar disorder" till July 2001. This search resulted in 241 articles. Ten percent of these publications were considered to be controlled trials. Four studies explicitly tested the efficacy of CBT. Compared to standard medical treatment, CBT proved to be efficient concerning symptomatic and functional outcome. However, there remain many questions to be answered, e.g., if there are differential effects on the course of manic and depressive symptoms and how stable the results will be in the long run.

Antimanic Agents↗

PubMed2002

[Premenstrual dysphoric disorder. Recommendation for diagnosis of a distinct affective clinical picture].

In the research appendix of the Diagnostic and Statistical Manual of Mental Disorders (fourth edn.), premenstrual dysphoric disorder (PMDS) is classified as a cycle-related affective disorder. The cycle dependency of symptoms is the mean criterion for classifying this syndrome as a distinct etiological entity. These time-related criteria make special demands on diagnostic procedure, which must include retrospective and prospective elements. With our own study, we propose a three-step diagnostic process: (1) telephone screening, (2) retrospective diagnosis by a structured clinical interview, and (3) prospective diagnosis based on daily symptom ratings during two consecutive menstrual cycles. Following this procedure, the disorder could be verified in 4% of the original sample, which replicates the prevalence rate found in the literature.

Adult↗

PubMed2002

Hypothalamic-pituitary-adrenal axis reactivity to psychological stress and memory in middle-aged women: high responders exhibit enhanced declarative memory performance.

According to recent studies, elevated cortisol levels are associated with impaired declarative memory performance. This specific effect of cortisol has been shown in several studies using pharmacological doses of cortisol. The present study was designed to determine the effects of endogenously stimulated cortisol secretion on memory performance in healthy middle-aged women. For psychological stress challenging, we employed the Trier Social Stress Test (TSST). Subjects were assigned to either the TSST or a non-stressful control condition. Declarative and non-declarative memory performance was measured by a combined priming-free-recall-task. No significant group differences were found for memory performance. Post hoc analyses of variance indicated that regardless of experimental condition the subjects with remarkably high cortisol increase in response to the experimental procedure (high responders) showed increased memory performance in the declarative task compared to subjects with low cortisol response (low responders). The results suggest that stress-induced cortisol failed to impair memory performance. The results are discussed with respect to gender-specific effects and modulatory effects of the sympathetic nervous system and psychological variables.

Adult↗

PubMed2001

Hypomanic personality, social anhedonia and impulsive nonconformity: evidence for familial aggregation?

Schizophrenic and affective spectrum disorders aggregate in the families of patients afflicted with such disorders. Possible vulnerability markers for these disorders should therefore also run in families. The Chapmans and their coworkers developed the Hypomanic Personality Scale (HYP) to identify people at risk for affective disorders, and the scales Social Anhedonia (SA) and Impulsive Nonconformity (IMP) to assess schizotypy (Chapman et al., 1976, 1984; Eckblad & Chapman, 1986). The present family study investigated the familial resemblance of the HYP, SA, and IMP Scale using a maximum-likelihood approach. Index participants and their relatives (n = 717) completed a questionnaire packet that included the above-mentioned scales. Stepwise several models of familial correlations were specified and tested dealing with the influence of sex of parents and offspring and of interindividual cross-trait resemblance. For all three measures, there was evidence of familial resemblance. For SA and IMP, we found hints for possible assortative mating; additionally for HYP and IMP, an interindividual cross-trait resemblance (with correlations of 0.14 and 0.18, respectively) between family members emerged. The results support the validity of the HYP, SA, and IMP Scale. It is discussed whether HYP and IMP represent different aspects of a shared latent liability.

Adolescent↗

PubMed2000

Cue exposure in alcohol dependent patients: preliminary evidence for different types of cue reactivity.

Craving is considered to be an important phenomenon in addictive behaviours. However, there is still an unresolved debate on what craving for alcohol means, how it is best measured and which clinical and therapeutical consequences its presence or absence may imply. Cue reactivity paradigms have been developed to elicit craving under standardized experimental conditions. Here we present preliminary results characterizing alcohol-dependent patients with regard to subjective and psychophysiological aspects of exposure to alcohol-associated cues in a cue reactivity paradigm. Thirty-six patients fulfilling at least 5 criteria of alcohol dependence according to DSM-IV criteria were studied after detoxification. Cue reactivity was assessed as subjective (by visual analogue scales) and neurophysiological response (by ECG, EMG, electrodermal activity, respiratory frequency, salivation) to the presentation of the favourite alcoholic beverage or water. While 22% of the patients were both subjective and physiological responders, 42% of the subjects showed only a physiological reaction without subjective response, and 31% of the patients were neither a subjective nor a physiological reaction. Subjective responders to alcohol cues had significantly higher state anxiety levels than subjective non-responders. These results suggest that alcohol dependent patients may be divided into typological subgroups with respect to cue reactivity. Different types of cue reactivity might be important for treatment strategies involving repeated cue exposure or so-called anti-craving drugs.

Adult↗

PubMed2000

Reliability and validity of the German version of the European Addiction Severity Index (EuropASI).

OBJECTIVE: This study provides data on the psychometric characteristics of the German version of the European Addiction Severity Index (EuropASI). The ASI is a frequently used clinical and research instrument that measures problem severity among people with substance dependence. METHOD: The German ASI was used in a sample of 112 consecutively admitted male psychiatric inpatients seeking treatment for severe alcohol problems. The conceptual structure of the German ASI subscales was investigated by analyzing the intercorrelations of the severity ratings and composite scores. Internal consistency, interrater reliability and concurrent validity in terms of correlations with other assessment instruments were evaluated. RESULTS: The German ASI subscales proved to be independent or moderately correlated (-0.17 < r < 0.34). Each correlation coefficient between corresponding severity ratings and composite scores was significant (p < .0005), ranging from r = 0.47 to r = 0.93. Reliability measures indicated moderate to good internal consistency (Cronbach's alpha: 0.69-0.92) and moderate to excellent interrater reliability (intraclass correlation coefficient: 0.62-0.99). Validity was supported by significantly higher ratings in the alcohol section in alcohol dependent patients compared to patients without dependence (t = 2.99, 108 df, p = .004). Significant correlations (p < .001) were found between the alcohol use section and the Michigan Alcoholism Screening Test (r = 0.34 composite score and r = 0.44 severity rating) and between psychiatric status and the Symptom Checklist-90-revised (r = 0.55/0.51), supporting concurrent validity. CONCLUSIONS: The German version presented evidence of acceptable psychometric properties and its applicability in German-speaking countries could be confirmed.

Adult↗

PubMed1999

Neuropsychological profiles of FMR-1 premutation and full-mutation carrier females

The present French-German investigation of fragile-X syndrome (fra-X) was undertaken to disentangle genetic from environmental effects on cognitive performance as assessed with the following measures: Wechsler Adult Intelligence Scale-Revised (WAIS-R), Wisconsin Card Sorting Test, Trail-Making Test, Tower of Hanai, Verbal Fluency Test, Stroop Test, short-term and consolidation memory, and the d2 task. Groups with different genotypes (n = 11 mothers with a full mutation in the FMR-1 gene of fra-X children; n = 65 mothers with a premutation in the FMR-1 gene of fra-X children; n = 18 siblings of these mothers with normal CGG repeats) and with different psychosocial stressors from fra-X families (n = 14 siblings with a premutation but without affected children of their own) were examined. A group of mothers of non-fra-X autistic children (n = 39) formed an external control group. Previous findings were replicated concerning cognitive performance of FMR-1 full-mutation carrier mothers, who were characterized by lower overall IQ and poorer performance than the group of mothers with the FMR-1 premutation in verbal and performance subtests of the WAIS-R, tests of executive-frontal lobe functioning, and tests of sustained attention. Carriers of the FMR-1 premutation, whether they were mothers of affected children or not,performed in a similar way on all neuropsychological tasks to the intrafamilial control group without CGG amplification. On the basis of these results, it is concluded that there is no neuropsychological evidence of reduced cognitive performance of FMR-1 premutation carriers compared with performance of two control groups with normal CGG repeats. Furthermore, the psychosocial burden of raising fra-X children does not exert an environmental effect on neuropsychological test performance.

Journal Article↗

PubMed1999

Randomised placebo-controlled trial of moclobemide, cognitive-behavioural therapy and their combination in panic disorder with agoraphobia.

BACKGROUND: In the treatment of panic disorder with agoraphobia, the efficacy of pharmacological, psychological and combined treatments has been established. Unanswered questions concern the relative efficacy of such treatments. AIMS: To demonstrate that moclobemide and cognitive-behavioural therapy (CBT) are effective singly and more effective in combination. METHOD: Fifty-five patients were randomly assigned to an eight-week treatment of: moclobemide plus CBT; moclobemide plus clinical management ('psychological placebo'); placebo plus CBT; or placebo plus clinical management. RESULTS: Comparisons between treatments revealed strong effects for CBT. Moclobemide with clinical management was not superior to placebo. The combination of moclobemide with CBT did not yield significantly better short-term results than CBI with placebo. The CBT results remained stable during a six-month follow-up, although a substantial proportion of patients treated with placebo plus CBT needed additional treatment. CONCLUSIONS: CBT was highly effective in the treatment of panic disorder with agoraphobia and reduced agoraphobia to levels that were comparable to those of non-clinical controls.

Adolescent↗

PubMed1999

Two-year stability of Psychosis Proneness Scales and their relations to personality disorder traits.

Two-year stability of Physical Anhedonia (PhA), Perceptual Aberration (PER), and Magical Ideation (MI) scale scores and their relation to personality disorder traits were examined. Additionally, the effects of a time-lagged (prospective) versus concurrent measurement of psychosis proneness and personality disorder traits were studied to examine the specificity of MI, PER, and PhA. With a non-college-student sample (n = 404), stability for PhA was sufficiently high, but for PER and MI, stability was moderate to low. The correlations between personality disorder traits and psychosis proneness scales demonstrate that simultaneous assessment leads to a more nonspecific pattern of associations for MI and PER, although the correlation to schizotypal personality disorder traits were the highest. However, prospectively only MI, but neither PER nor PhA, emerged as a significant predictor for schizotypal and paranoid personality disorder traits in multiple-regression analysis. This suggests that MI may allow for a more specific assessment of psychosis proneness than PER.

Adolescent↗

PubMed1998

Genotype-phenotype relationship in female carriers of the premutation and full mutation of FMR-1.

The present French-German cooperative study focuses on the genotype-phenotype relationship of mutations of the FMR-1 gene and psychiatric conditions in mothers with a full mutation in the FMR-1 gene of fra-X children (n=13), mothers with a premutation in the FMR-1 gene of fra-X children (n=61), as well as premutated siblings of these mothers without affected children (n=17) and two non-mutated control groups: (1) siblings of these mothers with normal CGG repeat (n=18); and (2) mothers of non-fra-X autistic children (n=42). Mothers with a full mutation in the FMR-1 gene and mothers with a premutation in the FMR-1 gene did not differ in the frequency of any axis I disorder; however, both groups were diagnosed with social phobia more often than the control group of mothers of autistic children. Moreover, mothers with a premutation in the FMR-1 gene of fra-X children and their siblings with the premutation (without affected offspring) revealed a similar frequency of social phobia. Furthermore avoidant personality disorder was more common in groups of carriers of the full premutation than in siblings without mutation or than the control group of mothers with autistic children. On the basis of our data, we therefore suggest that social avoidance (expressed as social phobia or avoidant personality disorder) has been underestimated in previous studies of carriers with the FMR-1 full mutation or premutation. Comorbidity of axis I and axis II psychiatric diagnoses was mainly restricted to the group of carriers of the full mutation and carriers of the premutation of FMR-1. Correlations between size of CGG repeat and IQ as well as CGG and age of onset of axis I diagnosis were non-significant. IQ of subjects had no impact on presence or absence of axis I and/or axis II diagnoses.

Adult↗

PubMed1996

Fragile-X carrier females: evidence for a distinct psychopathological phenotype?

The present study examined 35 mothers (29 premutation carriers) of children with fragile-X syndrome in measures of intelligence and psychiatric disorders by comparing them with two control groups: a) 30 mothers of children in the general population and b) 17 mothers of non-fra-X retarded children with autism. Premutation carriers had a higher frequency of affective disorders than mothers from the general population. Preliminary data indicate that normally intelligent premutation carriers of the fra-X genetic abnormality have a similar frequency of affective disorders (DSM-III-R criteria [APA, 1987]) than mothers of autistic children. Neither carriers of the premutation nor carriers of the full mutation in the fra-X group obtained a diagnosis of the schizophrenia-spectrum (schizophrenia, schizophreniform disorder, and schizoaffective disorder). Carriers of the fra-X full mutation had considerably lower IQ than carriers of the fra-X premutation. There was a negative correlation between length of CGG repeats and IQ which failed to reach significance in both groups of fra-X carriers. Psychiatric morbidity was not restricted to carriers of the fra-X full mutation only but was also present in normal intelligent premutation carriers. Furthermore the age of onset of psychiatric morbidity in both groups of mothers of fra-X children as well as the group of mothers with autistic children was much earlier than the age when mental retardation had been diagnosed in their children. Increased psychosocial burden of raising a developmentally retarded child and/or feelings of guilt of being a fra-X carrier can therefore not fully explain our findings (three-fold higher frequencies of affective disorders compared to mothers from the general population).

Adult↗

PubMed1993

Olfactory event-related potentials in psychosis-prone subjects.

Previous studies in schizophrenic patients have suggested that there are changes in olfactory sensitivity. In order to externally validate a psychometrical assessment of the psychosis-risk indicated by schizotypic factors, this study was carried out to determine whether changes in olfactory perception could be determined even for persons merely at risk of developing schizophrenia. These 'psychosis-prone' subjects consistently scored high in either the scale for 'physical anhedonia' (PA) or the scale for 'perceptual aberration' (PAB). Thus, three groups were investigated (control, n = 11; PA, n = 12; PAB, n = 12). Each subject participated in one testing session where the two odorants, vanillin (pleasant) and hydrogen sulphide (unpleasant), were applied by means of a specially designed delivery apparatus. Subjects rated both the intensity and the hedonic quality of the stimuli. In addition, olfactory event-related potentials (OERP) were recorded after dichotomous stimulation. In general, there were only few significant differences between the three groups investigated. Contrary to expectations, ratings for pleasantness of vanillin were highest in PA subjects compared to PAB subjects and controls (p < 0.05). Correspondingly, OERP amplitudes in response to vanillin were largest within the PA group (p < 0.05). For hydrogen sulphide, PAB subjects showed the smallest OERP amplitudes (p < 0.05). In addition, it was observed that female subjects had significantly larger OERP amplitudes when compared to male subjects (p < 0.05), which possibly indicates gender differences in olfactory sensitivity.

Adult↗