PubMed Health⌕ Search

Biomedical subjects

R Tölle

Publications and source records attributed to R Tölle.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Repeating antidepressive sleep deprivation therapy (partial sleep deprivation)].

UNLABELLED: Repeated partial sleep deprivation (in the second half of the night) is investigated in respect of therapeutic effectivity as part of antidepressive treatment. 31 inpatients suffering from endogenous depression were subjected to walking therapy three times at intervals of one week. RESULTS: The antidepressive efficacy of sleep deprivation is individually (both interindividually and intraindividually) very different. Regular response is rare, but so is repeated non-response. Even if one or several waking therapies remain ineffective, further attempts can eventually result in marked antidepressive effects. Hence a repetition of this antidepressive measure is indicated, the more so since it is easy to carry out and does not produce side effects.

Adult↗
PubMed1989

Combination of behavioral smoking cessation with transdermal nicotine substitution.

Effects of a transdermal nicotine substitution on psychological smoking cessation were investigated in a double-blind prospective study. 131 smokers were randomly assigned to three treatment conditions: All smokers underwent nine weeks of self-controlled smoking cessation. During six weeks one group was additionally treated with nicotine patches continuously releasing nicotine through the skin into the blood circuit. The second group received placebo patches; while the third group was treated with behavioral training alone. Treatment effects were measured by daily cigarette consumption. Nicotine-treated subjects reached significantly higher abstinence rates during and at the end of treatment than both placebo- and control-subjects: 69% in the nicotine condition, 51.2% and 44.4% under placebo and control conditions respectively. Effects are influenced by initial cigarette consumption, with the light smokers benefitting most from the nicotine patch. Self-assessments suggest an aversive effect of transdermal nicotine on cigarette taste. Our results, although not yet verified by long-term observations, demonstrate that transdermal nicotine substitution significantly enhances the effectiveness of behavioral smoking cessation methods.

Administration, Cutaneous↗
PubMed1988

[Neurosis and melancholia].

Melancholias (endogenous depressions) are also observed in neurotic persons, in character neuroses (personality disorders) as well as symptomatic neuroses. The neurotic disorders are demonstrable before, to some extent during and also after the melancholic phase. From casuistics, melancholias, particularly in cases of anxiety neurosis, cardiac neurosis, compulsion neurosis and depressive neurosis are reported on. The frequency of this concurrence is difficult to determine. Instead of making a diagnosis under any circumstances, it is nosologically more conclusive and clinically more beneficial to start from two independent diseases, which interfere in one patient.

Adult↗
PubMed1987

[Melancholia as a secondary disease. On the coincidence of endogenous depression with another psychiatric disease].

Melancholias (endogenous depression) not only occur in previously psychically healthy individuals, but also in patients with neurotic and personality disorders, in addicted patients, schizophrenics, in brain-damaged patients and psychically ill geriatric patients, epileptics and mentally handicapped. This concurrence has received little attention in the past; dual diagnoses are still uncommon in psychiatry. The nosological, diagnostic and therapeutic implications are discussed.

Depressive Disorder↗
PubMed1987

Circadian rhythm of free urinary cortisol, temperature and heart rate in endogenous depressives and under antidepressant therapy.

UNLABELLED: Free cortisol in urine, temperature and heart rate were examined in 81 endogenous depressives and 15 healthy controls in five successive 24-hour rhythms. The nocturnal mean value, amplitude, phase position of the minima and period length were calculated. MAIN RESULTS: cortisol secretion is to be found in larger quantities in depressives than in healthy controls. The amount of cortisol is again raised after a period of sleep deprivation and simultaneously the amplitude becomes larger. Temperature measurements revealed an enlargement of the amplitude following treatment with tricyclic antidepressants. A minimal increase in heart rate is evident in endogenous depressives in comparison with healthy subjects. The heart rate in the entire circadian course is significantly increased by antidepressants. All three variables showed a phase advance of the nocturnal minima in endogenous depression. Alterations in period length could not be detected. The findings were discussed in regard to chronobiological dissertations on endogenous depression.

Adult↗
PubMed1987

On the daily rhythm of depression symptomatology.

UNLABELLED: Diurnal variation of the symptomatology of endogenous depression (melancholy) was examined by means of 4 scales on 5 consecutive days in 24 untreated patients and in 63 patients under antidepressant drugs and after sleep deprivation. RESULTS: the group means exhibit a sinus-type daily curve with morning low (but not significant). This so-called typical diurnal variation is more often found than other definable diurnal variations. The frequency cannot, however, be specified with one figure, because the quota varies, according to the criteria used, between 36.1 and 4.2%. The so-called typical diurnal variation is thus irregular, and intraindividually it also proved to be unstable. It is not specific for endogenous depressions. There is evidence of frequent shorter (ultradian) variations of depression symptomatology that are, however, difficult to record. Pharmacological therapy has little influence on the depressive diurnal variation. Sleep deprivation can revert the inverse diurnal variation and provoke a typical diurnal variation. After methodological deliberations the diagnostic and therapeutic implications are discussed.

Activity Cycles↗
PubMed1986

[Sleep deprivation (wakefulness therapy) as an antidepressant].

In this complete survey of publications concerning therapeutic sleep deprivation (including reports of a conference held in 1985) first the practical management and especially the advantages of sleep deprivation of the second half of the night are explained. After discussing the psychological conditions and methods of therapeutic evaluation the treatment results in endogenous depression (melancholia), the effectiveness of repetition and of combination with antidepressive pharmacotherapy, the comparison with electroconvulsive therapy and the predictors are described. Sleep deprivation is indicated in nearly every therapeutic situation, including drug-resistant melancholia, furthermore in severe neurotic depression and in depressive states of schizophrenic patients. Side effects are unimportant, and complications are almost absent. In addition psychophysiological, neuroendocrinological and biochemical investigations are reported, as far as they concern either the mechanism of action of sleep deprivation or chronobiological hypotheses of depression.

Antidepressive Agents↗
PubMed1985

Periodic sleep deprivation in drug-refractory depression.

For some time it has been known that total and partial sleep deprivation (in the second half of the night) produces an immediate antidepressive effect and a short-term effect of approximately 1-week duration. A 25-day trial is discussed here. 18 endogenous depressives who proved to be refractory to tricyclic antidepressive therapy were treated with periodic sleep deprivation (5 sleep deprivation treatments in the second half of the night at 5-day intervals) under continued drug therapy. The combined treatment led to a better result than would have been expected from drug therapy alone. Some of the sleep deprivation treatments effected an accelerated remission without the efficacy of treatment subsiding. In individual cases recovery occurred after one or a few partial sleep deprivation sessions. Whether in other respects sleep deprivation shortens the course of depressive phases is still unproven.

Antidepressive Agents, Tricyclic↗
PubMed1982

[Functional complaints--healthy or ill? A study of 780 working men].

The frequency of functional complaints was examined in a group of 780 health men, employees of an industrial firm, who had no evidence of organic disease, were not under medical treatment and thought of themselves as healthy. As part of a standardised examination, questions were asked about 11 possible functional complaints, in addition to ten characteristics of their work. The presence of at least one functional symptom was affirmed by 48.3%, with a mean of two symptoms per person. Headaches and sweating were most frequent. In addition to an autonomic fatigue syndrome, a headache syndrome was the most characteristic. Some functional complaints were related to work stress, with factorial analysis distinguishing between time-limited overwork and emotional strain. These findings and corresponding one in the literature suggest that functional complaints frequently occur also in healthy persons.

Headache↗
PubMed1982

[The next-to-the-last child. The significance of sibling position in psychiatric patients].

So far the sibling position "penultimate" (next to last) child has hardly been investigated. The incidence of penultimates is statistically higher that expected among neurotic and schizophrenic patients, it is supposed to be higher among female alcoholics, but not among manic depressive patients. Case studies illustrate the relationship between the penultimate position and the psychodynamic family situation. Additionally the minimal cerebral dysfunctions are considered. The theory of "'dethronement", which the penultimate child only experiences with himself but not with his siblings, is also confirmed as a life event for adult psychiatric patients. The resultant problems are interpreted in connection with family size.

Adolescent↗
PubMed1981

[Antidepressive effect of partial sleep deprivation during the 1st half of the night].

In addition to previous investigations another modification of sleep-deprivation (SD) was studied in 28 endogenous depressives: SD during the 1st half of the night. From the day of deprivation - in the self-rating from the 4th day - up to 1 week later a therapeutic effect can be observed. The psychic part of the symptomatology was more reduced than the somatic one. Compared to total and partial SD during the 2nd half of the night, there is, on average, a smaller therapeutic effect which occurs later. The diurnal variation of the depressive symptomatology is less influenced. According to the period without sleep, the circadian course of the heart rate is less and differently modified by SD during the 1st half of the night. Only an existing diurnal variation (before SD) is a predictor of the prompt effect. Implications for the mechanism of the therapeutic SD were discussed. For clinical practice, SD during the 2nd half of the night is the method of choice.

Adult↗
PubMed1980

Partial sleep deprivation as therapy for depression.

We investigated the influence of partial sleep deprivation on depressive symptoms in 30 patients with endogenous depression. The patients were awakened during the second half of the night and remained awake until the following evening. Antidepressant pharmacotherapy was not interrupted. Partial sleep deprivation significantly reduced the depression symptoms (mean value, 30.1%). The interindividual variations were considerable; deterioration was rare, and in 75% of the cases improvement occurred. Execution is simple, less stressful for the patient than total sleep deprivation, and can be carried out at home. Partial sleep deprivation has no contraindications except in the case of severe physical illness. The duration of the therapeutic effect is varied; repetition is possible. We discuss chronobiological hypothesis to explain the effect of sleep deprivation.

Aged↗