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Biomedical subjects

R Bridler

Publications and source records attributed to R Bridler.

13 recordsLinked to original sources
PubMed2006

Brain imaging in psychiatry - a study of 435 psychiatric in-patients at a university clinic.

OBJECTIVE: The use of brain imaging in psychiatry still lacks clear guidelines. We investigated the referral practice, outcome and predictive factors of neuroimaging in a Swiss psychiatric university clinic. METHOD: Medical files were reviewed retrospectively for 435 consecutively hospitalized patients who were subjected to neuroimaging. The association between the sociodemographic and clinical characteristics and the scan results was analyzed using bivariate and multivariate analyses. RESULTS: Of overall examinations, 69.4% were normal, 16.3% equivocal and 14.3% abnormal; 2.9% of scans ordered for screening only showed pathology. Neurologic signs and advanced age of patients predicted abnormal scan findings, whereas other variables such as EEG results showed no significant association. CONCLUSION: Our results support the need for clear indications for using brain imaging in psychiatric in-patients. Focal neurologic signs and advanced patient age seems to predict abnormal scan results. However, these criteria are not sufficiently sensitive to predict significant scan findings in all patients.

Adult↗
PubMed2004

Ethnicity-independent genetic basis of functional psychoses: a genotype-to-phenotype approach.

The functional psychoses schizophrenia, schizoaffective disorder, and bipolar illness represent complex clinical syndromes that are characterized by phenotypic heterogeneity. Yet evidence from numerous studies suggests that (1) the prevalence of schizophrenia and bipolar illness is with 1% very similar across ethnicities, and (2) a strong genetic component is involved in the disorders' pathogenesis. Using data from different US-American ethnicities (77 families with a total of 17 unaffected and 170 affected sib pairs; 276 marker loci), we searched for ethnicity-independent oligogenic susceptibility loci for which the between-sib genetic similarity in affected sib pairs deviated from the expected values. Specifically, we addressed the question of the extent to which genetic risk factors and their interactions constitute multigenic inheritance of functional psychoses across populations and might constitute universal targets for treatment. Our novel multivariate genotype-to-phenotype search strategy was based on a genetic similarity function that allowed us to quantify the inter-individual genetic distances d(x(i), x(j)) between the allelic genotype patterns x(i), x(j) of any two subjects i, j with respect to n loci l(1), l(2), em leader l(n). Thus, we were able to assess the between-ethnicity, the within-ethnicity, and the within-family genetic similarities. The problem of ethnicity-independent vulnerability was addressed by treating the Afro-American families as "training" samples, while the non-Afro-American families served as independent "test" samples. We evaluated the between-sib similarities, which were expected to deviate from "0.5" in affected sib pairs if the region of interest contained markers close to vulnerability genes. The reference value "0.5" was derived from the parent-offspring similarities that are always 0.5, irrespective of the affection status of parents and offspring. We found 12 vulnerability loci on chromosomes 1, 4, 5, 6, 13, 14, 18, and 20, that were reproducible across the two samples under comparison and therefore, likely to constitute an ethnicity-independent, oligogenic vulnerability model of functional psychoses. The elevated vulnerability appeared to be unspecific and to act in such a way that exogenous factors become more likely to trigger the onset of psychiatric illnesses.

Algorithms↗
PubMed2002

Development of specific social skills training programmes for schizophrenia patients: results of a multicentre study.

OBJECTIVE: The efficacy of three newly developed cognitive social skills training programmes for residential, vocational and recreational functioning (experimental groups) were compared with a traditional social skills training programme (control group) referring to cognitive and social abilities, psychopathology and generalisation effects. METHOD: One hundred and five patients with a diagnosis of schizophrenia or schizoaffective disorder according to ICD-10 criteria were selected and assigned to the different treatment groups, using a matching procedure. The treatment phase lasted 6 months. A follow-up assessment was carried out after 1 year. RESULTS: Higher global therapy effects were obtained on almost all dependent variables in the experimental groups. Analyses of variance and covariance indicated higher symptom reduction for the experimental groups, but significantly greater improvements in some cognitive variables for the control group. Correlation analysis suggested associations between improvement of social behaviour with symptom reduction and improvements of cognitive skills. CONCLUSION: In view of these favourable effects, the developed cognitive social skills training programmes might facilitate the abilities of schizophrenia patients for their integration in the community.

Adult↗
PubMed2001

[Diagnostic principles for differential therapy of psychoses].

The pharmacotherapy of psychotic disturbances is not limited on neuroleptics, but includes Clomethiazol and Benzodiazepines (e.g. to treat delirium) or antidepressants (e.g. to treat psychotic depression) too. Even more divergent is the psychosocial treatment of different psychotic states. In this overview the diagnostic principles, needed for a differential therapy of psychotic disorders, are described.

Antipsychotic Agents↗
PubMed2001

[Drug treatment of functional psychotic disorders].

Psychotic symptoms occur in different psychiatric disorders. The principles of antipsychotic drug treatment of various non-organic psychotic disorders are discussed. In particular, the role of the so-called atypical antipsychotics is highlighted.

Acute Disease↗
PubMed2001

[Treatment of panic disorder with combination of SSRI and cognitive-behavioral therapy].

GOAL: Various forms of treatment of panic disorder with and without agoraphobia have shown good results. We examined the combination of cognitive-behavioral psychotherapy and treatment with an SSRI. METHODS: Case report and literature review. RESULT: The combination treatment shows a faster onset of therapeutic effects than cognitive-behavioral psychotherapy. However, final outcomes are comparable. CONCLUSIONS: The addition of a SSRI to cognitive-behavioral psychotherapy accelerates the onset of therapeutic effects. It does not interfere with the cognitive restructuring aimed at cognitive-behavioral psychotherapy.

Adult↗
PubMed2000

Schizophrenia and smoking: evidence for a common neurobiological basis?

Several previous investigations have suggested that the gene for the alpha 7-nicotinic receptor may play a role in the pathogenesis of schizophrenia and may be responsible for the heavy smoking among schizophrenic patients. In a study of 129 healthy controls and 127 schizophrenic, schizoaffective, and bipolar patients we have aimed 1) to confirm the potential association between schizophrenia and the alpha 7-nicotinic receptor, 2) to test the diagnostic specificity of alpha 7-receptor subunits with respect to psychiatric diagnoses, and 3) to investigate potential receptor differences between smokers and nonsmokers in the general population. Our analysis included the two dinucleotide polymorphisms D15S1360 and L76630 that are localized in a genomic fragment containing the alpha 7-nicotinic receptor gene CHRNA7. Highly significant differences (P < 0.0001) between the allele distributions of patients and controls were detected for these two markers with all three diagnostic subgroups contributing to the discrimination. An independently ascertained replication sample of 24 patients confirmed this finding. Our results suggested an unspecific vulnerability that depended on the severity of overall psychopathology in terms of the co-occurrence of psychopathology with no clear-cut boundary between the diagnostic entities. In comparison with healthy controls, this vulnerability was lowest among schizophrenics, intermediate among bipolars, and highest among schizoaffectives. As to the question of alpha 7-receptor differences between smokers and nonsmokers among the healthy control subjects, our analysis revealed no significant differences, thus indicating that the differences between patients and controls are more than just a smoker/nonsmoker distinction. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:173-177, 2000.

Bungarotoxins↗
PubMed1999

[Acute life-threatening catatonia].

Malignant catatonia is a rare, life-threatening syndrome that occurs in connection with somatic as well as psychiatric disorders, in particular with functional psychosis. Key symptoms are catatonic features combined with elevated muscle tone, hyperthermia, vegetative instability, and pathological laboratory values. Benzodiazepines, dantrolene, and ECT have been reported to be an effective treatment of malignant catatonia, whereas classic neuroleptics and anticholinergic drugs are contraindicated. If antipsychotic treatment is required, clozapine is generally used. In this article we describe a case of malignant catatonia in a 52 year old female patient and discuss the clinical picture, the treatment, and the time course of the syndrome.

Anti-Anxiety Agents↗
PubMed1997

[Acute life threatening catatonia--clinical significance and therapeutic possibilities].

Malignant catatonia, associated with different somatic and psychiatric disorders, is a rare, life-threatening syndrome. Immediate recognition and adequate treatment are essential and may be life-saving. We describe a case of malignant catatonia and discuss the clinical implications. Additionally, we review the recent literature regarding epidemiology, nosology, current pathophysiological concepts, differential diagnosis, and treatment recommendations.

Adult↗