PubMed Health⌕ Search

Biomedical subjects

R Tölle

Publications and source records attributed to R Tölle.

At least 55 records · Page 3Linked to original sources

Sleep deprivation and circadian rhythm in depression.

The effect of total sleep deprivation for one night on the depressive state (measured using the depression rating scale of Bojanovsky and Chloupkova) and the patients' actual state of well being (measured using the self-rating scale of von Zerssen) is investigated in a group of 40 randomly selected inpatient depressives (29 endogenous depressives, 11 neurotic depressives) over a period of 36 h. The endogenous depressives exhibited a statistically significant change. The total index of the depression scale improved by 22.6%, recorded as a 'daily mean difference'. The individual symptoms of depressive mood, lack of interest, inhibition and inappetence were significantly improved. The feature of vital disorders and its common appearance with diurnal variations correlates positively with the degree of sleep deprivation effect. The symptomatology of the neurotic depressive patients also showed a significant improvement but the relatively small group of particularly severe neurotic depressives who also exhibited vital disorders is not representative. In a group of cases, sleep deprivation caused reversion in the depressive symptomatology not only during the night of deprivation but influenced the diurnal rhythm of the depressive symptomatology on the following day, in a therapeutically favourable direction. The results are compared with those of other studies. The methodological problems are discussed and methodological improvements for further investigation are proposed.

Adjustment Disorders↗

Circadian rhythm of circulatory functions in depressives and on sleep deprivation.

Continuous examinations of circulatory functions in three 24-hour periods, before, during and after sleep deprivation, were carried out on 26 endogenous depressives and 10 neurotic depressives. The blood pressure recordings scarcely revealed relevant findings. The diurnal rhythm of heart rate in endogenous depressives is less pronounced than in healthy subjects, a phasal shift not being noted. A correlation between diurnal variation of depression symptomatology and the circadian rhythm of hear rate could be presumed on the basis of these findings. The heart rate curve is further flattened, almost levelling off, on sleep deprivation. The extent of this change is related to the therapeutic effect of sleep deprivation. A less pronounced diurnal rhythm of heart rate was also noted in neurotic depressives; however, there was no relationship between the therapeutic effect of sleep deprivation and its influence on heart rate.

Adjustment Disorders↗

[Family constellation in mental disorder. results and methods of statistical investigations of family size, birth order and sib position (author's transl)].

Possibilities, difficulties and results of statistic investigations on the relation between schizophrenia, depression, neurosis and alcoholism are reported: The schizophrenic patients showed an excess of single childs and children of large sibship. In depressive patients the eldest are overrepresented. In neurotics single and eldest children are more numerous than in the general population. In alcoholic males tha last born und specially the youngest children are overrepresented. But nearly al of the relations found here have been contested by some other authors. The results are different because of the different methods. The reasons are explained in the second part of this study. The methodical differences consist in variable diagnosis, inadmissible selection, investigation without direct interviews, different statistical methods, summation of heterogenous samples and nonrepresentative controls. Methodical consequences for further investigations are discussed.

Alcoholism↗

[Total and partial sleep deprivation in the treatment of depression: preliminary communication].

Sleep deprivation (SD) has been proved to be an effective measure of antidepressive treatment (especially in endogenous depression). In a new study, 125 SD were examined on 93 depressed patients. The therapeutic benefit of SD on endogenous depression consists not only of the nightly clear up but also of provoking or improving a typical day wave the day after DS. A period of at least 36 h is necessary to survey the total effect of this method. The best results are achieved in patients with severe endogenous depression, especially in those with the typical day wave and distinct somatic symptoms. The effect of partial SD (for the second half of the night) is almost the same as that of total SD. The advantages of partial SD are: the patient can stand it easier, more often, and - in the company of a suited person - even at home. Finally, it is less complicate in clinical routine than selective REM-deprivation.

Depression↗

[Circulatory function in depression with the circadian rhythm uninfluenced or modified (author's transl)].

The effect of sleep deprivation (SD) on the altered circadian rhythm of endogenous-depressed patients has been investigated. 61 patients (39 endogenous- and 22 neurotic-depressed) with normal cardio-circulatory activities were tested: During SD-night pulse rate is less lowered in endogenous than in neurotic depression. The increase of systolic blood pressure is quicker and higher in endogenous than in neurotic depression. - Surveying the patients for 72 h (before, during and after SD), pulse rate in endogenous- and neurotic-depressed is less markedly fluctuating than in normal individuals. There is a close connection between the circadian fluctuationsof the depressive symptoms and of the pulse rates. The more SD improves depressive symptoms the more it also flattens the wave of pulse rates. - The circadian courses of systolic blood pressure in endogenous- and neurotic-depressed and in normal subjects are nearly the same. SD markedly flattens the circadian rhythm of blood pressure. In neurotic depression, SD does not clearly alter the course of pulse and blood pressure rates.

Adjustment Disorders↗