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Biomedical subjects

R D Stieglitz

Publications and source records attributed to R D Stieglitz.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Quality assurance in inpatient treatment of depression. Aspects of quality monitoring and external quality assurance exemplified by a pilot project of inpatient treatment of depression].

Aspects of a Pilot Study on Depression Treatment According to Quality Monitoring and External Quality Assurance: Experiences and results of a pilot study on quality of the treatment of depressed inpatients in 4 different psychiatric hospitals (2 state mental hospitals, 1 university clinic, 1 psychiatric clinic at a city general hospital) according to so-called process and outcome quality, are reported. Outcome data (self-ratings, observer rating, clinical global impression admission versus discharge, patient satisfaction with treatment, duration of inpatient stay/and patient data are reported while comparing the 4 hospitals. Difficulties and problems of data collection, assessments and comparison of 4 different hospitals are discussed.

Adult↗
PubMed1996

Serum concentrations of thyroid hormones in patients with nonseasonal affective disorders during treatment with bright and dim light.

Serum concentrations of thyroxine (T4), triiodothyronine (T3), and thyrotropine were measured in 34 patients with nonseasonal affective disorders before and after 1 week of light treatment. Nineteen of these patients received bright white light (2500 lx) and 15 dim red light (50 lx) for 2 hours daily in the mornings over a 1-week period. Slight but significant reductions in the rating scores for the depressive symptomatology were found for both the bright-and dim-light groups, but there were no significant differences between the two groups. The improvement is thus most likely a placebo effect. Surprisingly, the small changes in the severity of the depressive symptoms in the group as a whole were significantly correlated to the changes in the serum levels of T4 during the weeks of bright- and dim-light treatment, respectively. The more a patient improved, the further his or her T4 level fell and vice versa. The fluctuations in the concentrations of T4 during light treatment were significantly greater in the depressed patients than in a group of 12 healthy controls who also received bright or dim light, whereas the changes in T3 were significantly smaller than those of the healthy controls. The pronounced fluctuations in T4 levels were probably not secondary to changes in mood. Rather, they are likely to reflect changes in tissue (intracellular) metabolism of T4, which may be involved in the mechanisms underlying the fluctuations in mood in these patients.

Adult↗
PubMed1996

Design of the ICD-10 field trial of the Diagnostic Criteria for Research in German-speaking countries.

The design of the international multicentric field trial on ICD-10, chapter V (F) "Mental and Behavioural Disorders (including disorders of psychological development): Diagnostic Criteria for Research' including some modifications for the study in German-speaking countries is described. The different stages of the study, the assessment instruments, and the database are presented.

Adult↗
PubMed1996

Schizophrenia, schizotypal and delusional disorders (F2). Results from the ICD-10 field trial of the Diagnostic Criteria for Research in German-speaking countries.

The results of the ICD-10 field trial of the Diagnostic Criteria for Research in German-speaking countries concerning section F2, "Schizophrenia, schizotypal and delusional disorders', are presented. From a total of 39 cases (written case reports and video tapes) 5 met the criteria for schizophrenia (F20) with 201 ratings. The majority of clinicians rated the ease of diagnosis, confidence of diagnosis, and goodness of fit positive. The reliability of the 2-character diagnoses was excellent (F2; kappa = 0.88), as was the case for the category schizophrenia (F20; kappa = 0.89) and was higher than in the comparable study concerning the Clinical Diagnostic Guidelines.

Adolescent↗
PubMed1995

Instruments in the assessment of psychosomatic and neurotic disorders.

The introduction of DSM-III/DSM-III-R and ICD-10 implies fundamental innovations to the diagnostic process. The changes relate both to formal aspects (e.g. symptom and time-related criteria) and to content (e.g. the abandonment of the concept of neurosis). Additionally, specific assessment instruments are introduced. However, other aspects important for the description and treatment of patients easily become neglected when concentrating on a system of diagnoses which aim at the classification of patients by groups of disorders. The present article will present instruments which make it possible to do justice to both points of view.

Humans↗
PubMed1995

[Suicidal behavior of depressed patients at inpatient admission].

Early recognition of suicidal behavior is of extreme importance for avoidance of this cause of death. The risk of suicide attempts is particularly high in psychiatric illness, and among hospital in-patients especially in those with depression. Thus, the risk of suicide should be estimated in the first interview after admission to a psychiatric hospital. Our study analysed the routine documentation of such interviews on admission to the Psychiatrische Klinik der Freien Universität in Berlin: 41% of all depressive patients were suicidal. Suicidal and non-suicidal depressive patients could be differentiated by the following traits: suicidal patients were younger, had been younger at the initial onset of depressive illness, had made more suicide attempts in the past, and had a greater number of relatives who had committed suicide or made suicide attempts. They were more often single or divorced, and had fewer children of their own. Their psychopathology was characterized by a more strongly developed syndrome of depression, hostility and apathy. These findings point to a pattern of characteristics that are linked with suicidal behavior, which can be used to estimate the risk of suicide right at the beginning of a stay in hospital.

Adult↗
PubMed1994

Somatoform disorders--diagnostic concept, controlled clinical trials, and methodological issues.

The paper summarizes the concept of somatoform disorders, which was first introduced in the Diagnostic and Statistical Manual of Mental Disorders in its third edition in 1980. The relevant clinical trials related to this concept are reviewed. On the basis of this experience, the present study discusses methodological requirements for clinical trials, including inclusion and exclusion criteria, measurements of efficacy and safety, and statistical considerations, in the hope that this will stimulate the use of this diagnostic entity in the future.

Clinical Trials as Topic↗
PubMed1994

Psychopathology and the analysis of therapeutic effects.

The different domains of psychopathological research are described. An example of taxonomies that may be relevant for therapy is given. For the apathy scale of the AMDP system it is demonstrated that there is an equivalent severity of this syndrome in acute paranoid hallucinatory schizophrenia and in unipolar depression. In schizophrenia the apathy syndrome may subsume some, if not all, of the negative symptoms, that cause major problems for therapy. A common pathophysiological factor for the syndrome in the two diseases is discussed. A systematic psychopathological approach to the identification of pathophysiological factors of drug effects and their involvement in psychiatric diseases, including experimental variables, is characterized.

Humans↗
PubMed1994

Implications of the concepts "coping" and "quality of life" for criteria of course and outcome.

The Berlin Coping Study is a prospective longitudinal project with schizophrenic patients investigating the relationship between coping strategies and course and outcome. We find that some psychological issues relevant for both clinical practice and psychiatric research, and especially for pharmacological therapy, have been rather neglected up to now. The investigation of coping strategies leads to accentuating the patients' subjective individual views concerning their demands, goals, and coping activities in daily living and their schizophrenic illness. The concept of quality of life is increasingly receiving attention in various domains of professional care and it is very relevant to the issues discussed here. Consequences of this approach for therapy and research are outlined.

Adaptation, Psychological↗
PubMed1993

[Possibilities for psychological intervention in persistent delusions and persistent acoustic hallucinations in schizophrenic patients].

In practice the therapy of treatment resistant psychotic symptomatology (delusions and hallucinations) is a difficult and up to now unsolved problem. This overview presents and discusses behaviour therapy oriented studies (in the main part single case studies). The majority of studies show that it is in principle possible to influence this symptomatology. Because of methodological limitations of many studies finally some proposals for future research are discussed.

Adaptation, Psychological↗
PubMed1992

Blood serotonin, serum melatonin and light therapy in healthy subjects and in patients with nonseasonal depression.

The 24-h rhythms of blood serotonin and serum melatonin were determined in 39 unmediated inpatients with nonseasonal affective disorder and in 14 healthy men and women after 7 days of morning bright-light (2500 lx) or dim-light (50 lx) treatment. Bright-light treatment led to a more than 50% decrease in the Hamilton Rating Scale for Depression (HRSD) score in 4/19 patients and dim light in 1/17 patients. After light treatment the mesor (the daily mean estimated by cosinor analysis) of patients' and subjects' melatonin levels did not change significantly, nor was there a correlation between phase change and decrease in HRSD score. We observed after bright- and dim-light treatment a consistent increase in blood serotonin in patients and healthy subjects, which differed significantly between healthy subjects and patients. These findings suggest the involvement of serotonergic mechanisms following light therapy.

Depressive Disorder↗
PubMed1991

Phototherapy in nonseasonal depression.

Previous reports have shown that bright light exposure may benefit patients with seasonal depression. In the present study, the possible therapeutic effect of bright light in nonseasonal major depressive disorder was examined. Forty-two depressed patients not receiving additional antidepressant medication were exposed to bright white light of 2500 lux or dim red light of 50 lux over one week for two hr daily in the morning. The change in depressive symptoms was assessed by rating scales (Hamilton Depression Rating Scale, CGI) and by self-rating scales (Depression Scale, Complaint List, Visual Analogue Scale). Consistent for all ratings, the decrease in depressive symptoms after bright white light was only slight and not different from dim red-light exposure. Contrary to the findings in seasonal affective disorder, phototherapy administered over one week for two hr daily is not effective in nonseasonal major depressive disorder.

Adult↗
PubMed1991

Side-effects of phototherapy in nonseasonal depressive disorder.

The data of the Berlin light therapy study were systematically reinvestigated for side-effects of light therapy as described in the literature. Forty-two patients with major depressive disorder (RDC), who also met the criteria of ICD-9 (296.1 and 296.3), were included. Patients were either given bright white-light treatment (2,500 lux) or dim red-light treatment (50 lux) from 7.20 a.m. to 9.20 a.m. every morning for a period of seven days. The study did not reveal any differences in side-effects between the two treatments. The results are discussed in relation to the two different treatment conditions.

Depressive Disorder↗
PubMed1991

Diurnal variations of mood and sleep disturbances during phototherapy in major depressive disorder.

The influence of diurnal variations of mood (DVM) and sleep disturbances on treatment response was investigated in 42 patients with major depressive disorder (not SAD) under the treatment of either bright white light (2,500 lx) or dim red light (50 lx). We found only a slight influence in certain subscales of DVM and no influence of sleep disturbances. These results are discussed under a clinical point of view and with respect to phase shift theories of depressive disorders.

Adult↗
PubMed1990

Effect of bright white light therapy on non-seasonal depressive disorder. Preliminary results.

In this study, the effect of bright white light (2500 lux) and dim light (50 lux) were assessed in 30 patients with non-seasonal major depressive disorder randomly assigned to either procedure. Patients met RDC for major depressive disorder and ICD-9 criteria (296.1 and 296.3). During a 7-day period, the patients were exposed to bright white light (2500 lux) or dim light (50 lux) from 7.00 to 9.00 h daily. The severity of depression was assessed with observer scales (AMDP system, Hamilton depression scale, CGI) and through self-evaluation by self-rating scales (depression scale and list of complaints by von Zerssen). No difference was noted between bright light therapy and dim light, though a significant reduction of depressive symptomatology was observed for all patients during the study. These findings are discussed from a clinical point of view.

Adult↗
PubMed1990

Effect of bright white light on non-seasonal depressive disorder.

In previous research, the therapeutic effect of bright white light for so so-called seasonal affective disorder was clearly confirmed. The aim of the present study was to evaluate possible beneficial effects of bright white light in non-seasonal depression. 30 patients fulfilling RDC-criteria for major depressive disorder were randomly assigned to a 7 day exposure from 7.20 to 9.20 a.m. The degree of illness was ascertained both objectively with observer rating scales (Hamilton Depression Scale, AMDP-system) and through self-rating scales (Complaint List and Depression Scale by von Zerssen). No difference was noted between bright light and dim light though a significant reduction of depressive symptomatology was observed for all patients during the treatment. These results were consistent for both observer rating and self-rating. In conclusion, bright white light has no superior effect as compared to dim light exposure in non-seasonal depression.

Aged↗
PubMed1990

The influence of phototherapy on serotonin and melatonin in non-seasonal depression.

Circadian profiles of melatonin in serum and serotonin in blood were assessed before and after 7 days of artificial light treatment in 30 patients with non-seasonal depression and 12 healthy subjects. Patients and volunteers were allocated at random to either dim (50 lux) or bright light (2,500 lux) for 2 hours daily. The study has not been completed yet. Preliminary findings are presented here. Light treatment modifies marginally the circadian melatonin profiles of depressed patients and healthy subjects; however, it augments blood serotonin throughout the day. This increase is seen in all patients and healthy subjects after bright as well as dim light. These results suggest that the influence of light is more pronounced on serotonin than melatonin metabolism.

Adult↗