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Biomedical subjects

V Arolt

Publications and source records attributed to V Arolt.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Heart patient with depressive disorder. Proper treatment method].

Mild and severe depressive disorders are an independent risk factor for cardiac mortality following myocardial infarction, and possibly also for coronary heart disease. The depressive symptoms should always be treated despite the fact that an influence on the cardiac situation has not (yet) been empirically shown. For treatment, selective serotonin re-uptake inhibitors, but also other substances, are available, together with brief psychotherapeutic techniques and the promotion of social support.

Antidepressive Agents↗
PubMed2001

Review of immunological and immunopathological findings in schizophrenia.

The involvement of immunological and immunopathological mechanisms in the etiopathogenesis of schizophrenia has been a matter of research, with recently increasing effort. This article reviews the findings focusing on postmortem neuropathology, the blood-brain barrier, antibodies, acute phase proteins, immunocompetent cells, and activation markers of immunocompetent cells. Evidence for the two primarily postulated hypotheses (the infectious hypothesis and the autoimmune hypothesis) is critically discussed. On the basis of the findings, perspectives for future research are outlined aiming at a precise and consequent strategy to elucidate a potential involvement of immune mechanisms in the etiopathogenesis of schizophrenia.

Humans↗
PubMed2001

Different immune patterns in melancholic and non-melancholic major depression.

The search for immune patterns in major depression has thus far resulted in ambiguous findings, probably because patient samples are psychiatrically heterogeneous. We therefore focused on a detailed classification of subtypes of major depression, comparing patients with melancholic and non-melancholic major depression. Inpatients suffering from acute major depression were diagnosed and subclassified according to DSM IV criteria. Cell counts were determined by FACS analysis and morphology. Cytokine production (IL-2, IFN-gamma, IL-10) upon mitogen stimulation was measured by ELISA in a whole blood assay. Non-melancholic patients showed increased counts of leukocytes, lymphocytes and NK-cells in the acute stage of disease and after two and four weeks of treatment. Their lymphokine production was unchanged compared to that of healthy controls. Melancholic patients on the other hand demonstrated normal cell counts but a decreased production of IL-2, IFN-gamma and IL-10 during the acute stage of disease followed by a normalization with clinical improvement. Melancholic and non-melancholic patients showed different immune patterns. Classifying melancholic and non-melancholic patients is helpful towards the identification of immune characteristics typical for these diseases.

Adult↗
PubMed2001

Inflammatory markers in major depression and melancholia.

BACKGROUND: There is evidence that patients with major depression (MD) also suffer an inflammatory immune reaction. However, the results remain ambiguous. This could be due to the psychiatrically heterogeneous patient samples investigated in many published studies. Since melancholic depression is psychopathologically and possibly etiologically different from non-melancholic MD, we focused on investigating immune parameters in these two subgroups. METHODS: 43 in-patients suffering from acute major depression were diagnosed, sub-classified according to DSM IV criteria, and compared to 43 matched healthy controls. Cell counts were determined by morphology, and acute phase proteins [c-reactive protein (CRP), alpha(2)-macroglobulin (A2M), haptoglobin (HP)] were measured by laser nephelometry. Cytokine production (IL-1beta) upon mitogen stimulation was measured by ELISA in a whole blood assay. RESULTS: Non-melancholic patients showed increased monocyte counts and A2M serum concentrations in the acute stage of disease and after 2 and 4 weeks of treatment. Melancholic patients demonstrated a decreased monocyte count upon admission and after 4 weeks of treatment. HP levels and IL-1beta production were unchanged in all studied subjects. LIMITATIONS: Medication of the patients varied. The differentiation between melancholic and non-melancholic depression was performed clinically and was not performed using any standardized instrument. CONCLUSION: Melancholic and non-melancholic patients show different immune patterns. This differentiation might clarify immunological findings in MD and point towards etiological factors that are involved in the development of various subtypes of MD.

Acute-Phase Proteins↗
PubMed2001

S-100B is increased in melancholic but not in non-melancholic major depression.

BACKGROUND: Recent evidence suggests that neurodegeneration may be involved in the pathophysiology of major depression. The astroglial peptide S-100B was shown to be increased in many diseases causing neuronal cell damage or degeneration. METHOD: S-100B plasma levels were determined in 28 patients with major depression and 28 matched healthy controls using an immunofluorometric sandwich assay. RESULTS: Patients suffering from melancholic depression showed significantly increased S-100B levels compared to healthy controls while non-melancholic patients demonstrated normal levels. LIMITATIONS: Medication of patients varied. The differentiation between melancholic and non-melancholic patients was performed clinically without using a standardized instrument. CONCLUSIONS: Neurodegeneration or axonal remodeling may be involved in the pathogenesis of melancholic depression.

Adult↗
PubMed2001

Attention training in the cognitive rehabilitation of schizophrenic patients: a review of efficacy studies.

OBJECTIVE: To review the literature on effects of attention and cognitive training on attentional functioning in schizophrenic patients. METHOD: Relevant efficacy studies were identified by literature searches (in Medline, Current Contents, Psyclit, and Psyndex databases) and through the reference lists of key papers. RESULTS: Re-examination of findings from nine methodologically adequate studies using computer-based or non-computer-based training procedures provided inconsistent results. On 16 of 35 outcome measures significant performance improvements were observed from pre-treatment to post-treatment but on the majority of the applied measures no performance improvement could be determined. In general, treatment effect sizes but also power of tests were low. For nearly all the outcome measures for which differential training effects were reported there also exist contradictory outcome results. CONCLUSION: There is inconclusive evidence that attention training is effective in schizophrenia. Longitudinal efficacy studies are needed in which different aspects of attention are systematically exercised and assessed.

Attention↗
PubMed2001

Increased S100B blood levels in unmedicated and treated schizophrenic patients are correlated with negative symptomatology.

S100B, a calcium-binding protein produced by astroglial cells, is a marker of astroglial cellular integrity. It has been shown to be increased in acute brain damage and neurodegeneration. A recent study showed increased S100B levels in medicated acutely psychotic patients with schizophrenia. The study presented here included 26 drug-free patients with acute schizophrenia and 26 matched healthy controls. S100B blood concentrations were determined using a quantitative immunoassay upon admission and after 6 weeks of neuroleptic treatment. The PANSS was used to investigate psychopathology. Unmedicated schizophrenic patients showed significantly increased S100B levels compared to matched healthy controls. After 6 weeks of treatment, 11 patients showed normal S100B levels while in 15 patients the levels remained increased. These patients showed significantly higher PANSS negative scores upon admission and after 6 weeks of treatment. Schizophrenic patients display a loss of astroglial integrity which is not caused by neuroleptic medication. Continuously increased S100B levels are associated with negative symptomatology.

Adult↗
PubMed2001

Mental disturbances and perceived complexity of nursing care in medical inpatients: results from a European study.

AIMS AND OBJECTIVES: The relationship between mental disturbances - anxiety and depression, somatization and alcohol abuse - on admission to internal medicine units and perceived complexity of care as indicated by the nurse at discharge was studied. The goal was to study the utility of short screeners for mental disturbances to select patients for case-management on admission. DESIGN: The study had a cohort design: patients were included on admission and followed through their hospital stay until discharge. The study was conducted within the framework of the European Biomed 1 Risk Factor study. RESEARCH METHODS AND INSTRUMENTS: In the first 3 days of admission the patients were interviewed by a trained health care professional, who scored the SCL-8D, a somatization questionnaire based on the Whiteley-7 and the CAGE. At discharge, nurses rated the complexity of the patient's care. RESULTS: Patients with high scores on anxiety and depression (SCL-8D) and on somatization received higher ratings on perceived nursing complexity than those with low scores, with and without control for age, severity of illness and chronicity. The actual nursing intensity and medical care utilization, as measured daily by means of a checklist, could not explain these relations. No differences were found between patients with high or low scores on alcohol abuse. CONCLUSIONS: The study shows a potential use of screeners for mental disturbances to detect patients for whom nurses might need additional help. However, mental disturbance is not the sole criterion: functional status and other variables that predict medical and nursing care utilization should be included in a screening strategy for case-management programmes.

Activities of Daily Living↗
PubMed2001

[Termination of pregnancy for fetal abnormality--a traumatic experience?].

The diagnosis of a lethal anomaly of the fetus can affect a pregnant woman in a traumatic way. Almost immediately she has to decide whether she wishes the pregnancy to be terminated or not. Literature shows that such a loss is very difficult to cope with, and can lead to social isolation and depression. Contrary to popular belief the loss felt by the woman is at least the same to that following a stillbirth. Problems arise when the woman has difficulties in expressing her feelings, has a lack of self-esteem or receives very little social support. The prenatal diagnosis evokes an acute grief reaction. Only few studies are available regarding length, course and severity of grief in this case. Although an abortion through a fetal anomaly is a traumatic experience, research is vague on the trauma caused. Present day research of the psychological sequelae after the termination will be summarized. In respect to the current trauma-research lies the question of which psychiatric conditions arise from such a traumatic experience.

Abortion, Induced↗
PubMed2001

[The course of infantile autism through adulthood. An overview of long-term follow-up data].

The symptoms of infantile autism were first described almost 60 years ago. In contrast to its course in puberty and adolescence, follow-up-data on the late course in adulthood are decidedly sparse. As the outcome of research in the literature, we found 21 methodologically heterogeneous follow-up-studies. The arithmetic mean age of all subjects investigated was 24.0 years. The results are supplemented by various case reports and sporadic biographical reports by affected persons. On the basis of the available data, the discontinuous and dynamic changes of course verified in puberty and adolescence are not applicable to the third and fourth decades to the same extent. Gains in competence and autonomy appear to develop in the vocational rather than in the domestic sphere. The significantly more favorable courses of the form described by Asperger are continued in adulthood. The disorder-associated lack of empathy and social interaction is by no means experienced in terms of self-satisfaction by those concerned but rather as a loss. Interpersonal sexual needs are expressed by a substantial proportion of autistic adults. The cumulative mortality rates of the follow-up-studies suggest that the mortality rate among autistic patients is higher than among their non-autistic peers.

Adult↗
PubMed2001

[A critique of the construct "alexithymia" and its measurement--the weakness of self-report and the opportunities of an objective assessment approach].

Approximately thirty years ago the term alexithymia was coined but it is still open which characteristics have to be considered core symptoms of alexithymia. A selective review of recent expert definitions reveals dynamism in defining the alexithymia construct. At present, the self-report Toronto-Alexithymia-Scales (TAS) are the most frequently used measures of alexithymia. Empirical findings regarding various aspects of validity (factorial, concurrent, and experimental construct validity data) question the validity of the Toronto-Alexithymia-Scales. Alexithymia as measured by the TAS appears not to be consistently related to physiological, affect decoding or affective vigilance characteristics. The heterogeneity of the results could be due to the fact that non-alexithymic persons such as depressed or socially anxious individuals yield high scores on the TAS; on the other hand self-report appears to be in principle a methodologically inadequate approach for the assessment of alexithymia. Objective or direct measures of alexithymic characteristics as the Levels of Emotional Awareness Scale or the prototypicity analysis of mood diaries based on adjective checklists seem to be promising assessment methods for future research.

Affective Symptoms↗
PubMed2001

Detection of facial expressions of emotions in depression.

Research on perceptual and attentional processes in depression has shown that depressed as opposed to nondepressed individuals do not exhibit a positive perceptual bias in multistimulus representations. In the present study a face-in-the-crowd task was applied to examine the relationship between depression and spatial detection of facial expression of positive and negative emotions. A face-in-the-crowd task was administered to 30 subjects (15 clinically stabilized depressed inpatients and 15 normal subjects) using displays of schematic faces. Depressed subjects showed no performance differences in the detection of negative faces and no differences in decision latency for the control condition (all neutral faces) compared to normal subjects. Depressed subjects, however, were significantly slower in responding to positive faces than normal subjects. Our data suggest that depressive mood is associated with a reduced spatial attention to positive facial expression and not with an abnormal spatial processing of negative facial expression. An implication is that lowered vigilance for facial expressions of joy and happiness may affect adversely interpersonal relationships in depressed subjects.

Adult↗
PubMed2000

Cytokine production in unmedicated and treated schizophrenic patients.

Recent findings have strengthened the hypothesis that immunological dysfunctions may contribute towards the multifactorial pathogenesis of schizophrenia. The validity of these findings is questioned by the fact that most studied subjects have received potentially immunomodulatory medication upon investigation. In order to rule out such confounding effects, 24 initially unmedicated acutely ill schizophrenic patients were studied immunologically and psychiatrically (PANSS) before and during 4 weeks of neuroleptic treatment. The production of IFN-gamma was decreased upon admission and after 2 weeks of treatment compared to matched healthy controls. No differences in IL-2 and IFN-gamma production between unmedicated and medicated states were observed. These results do not support the notion that neuroleptic medication in vivo might influence TH1 cytokine production in schizophrenia.

Antipsychotic Agents↗
PubMed2000

Eye-tracking dysfunction (ETD) in families with sporadic and familial schizophrenia.

BACKGROUND: Within the field of genetic schizophrenia research, eye-tracking dysfunction can be regarded as a putative trait marker in families with multiple occurrences of the disease (familial schizophrenia). We concentrated on families with single occurrences of schizophrenia (sporadic schizophrenia) to test whether a genetic factor may be present in these families as well. METHODS: Eye movements were recorded using infrared oculography in eight families with sporadic schizophrenia (44 members), eight families with familial schizophrenia (66 members), and nine nonpsychotic families (77 members). Triangle-wave stimuli at 15 degrees /sec and 30 degrees /sec were used, and gains (eye velocity/target velocity), rates, and amplitudes of saccades (classified as catch-up and anticipatory saccades) were determined. RESULTS: 1) In sporadic-schizophrenia families, gain values, saccade rates, and anticipatory saccade amplitudes at 30 degrees /sec differed in a statistically significant fashion from nonpsychotic families, but not from families with multiple occurrences of schizophrenia, and 2) at 30 degrees /sec, a significant effect of target direction on smooth-pursuit maintenance was observed in both sporadic- and familial-schizophrenia families. CONCLUSIONS: Our results support the hypothesis that genetic factors may be present even in sporadic-schizophrenia families and may contribute to a more precise and biologically based definition of the schizophrenia phenotype in future molecular genetic analysis.

Adult↗
PubMed2000

The cerebral hemodynamics of repetitive transcranial magnetic stimulation.

Repetitive transcranial magnetic stimulation (rTMS) has been shown to be effective in the treatment of affective disorders. However, only little is known about hemodynamic physiological and safety aspects of this method. We studied the cerebral hemodynamics as measured by transcranial Doppler sonography in 20 healthy subjects during different rTMS procedures. Mean cerebral blood flow velocity (CBFV), pulsatility index (PI), and oxygen consumption were recorded continuously and averaged directly after the rTMS procedure. RTMS did not influence blood pressure, pulse rate, or blood oxygenation. There was a maximal increase of CBFV in the middle cererbal artery (MCA) of 3.6% and 5.6% during 10 Hz and 20 Hz stimulation, respectively. This increase was only seen on the stimulated left hemisphere. The PI remained unchanged during the whole procedure. It is likely that the increase of CBFV is due to dilatation of the small resistance vessels rather than due to vasoconstriction of the MCA. In terms of cerebral hemodynamics, rTMS is a safe and well-tolerated technique with a lower increase of CBFV than that seen in electroconvulsive therapy.

Adult↗
PubMed2000

A combined functional in vivo measure for primary and secondary auditory cortices.

Auditory evoked magnetic fields are reliable physiological in vivo markers of activity generated in auditory cortices. In recent years, several components of auditory evoked fields have been demonstrated with specific topographies within the auditory cortex in man. Their differential elicitation and analyses has rendered the discrimination of neural activities in primary vs. secondary auditory cortical fields possible. This in vivo measure may be of interest in a number of (neuro)psychiatric and neuropsychological disorders with central auditory deficits, in which in vivo anatomical measures do not allow a clear distinction of primary vs. secondary auditory cortex involvement. To help better understand the pathophysiology of such disorders, we developed and introduce a combined measure of steady-state field (SSR) and the N1 component of the transient evoked field. The acoustic stimulus for this paradigm consists of a 500-ms tone burst with 39-Hz amplitude modulation of the carrier frequency. This combined stimulation allows assessment of both auditory cortex components in one brief examination to be well tolerated by patients. We examined the source locations of SSR and N1 component with separate classical stimulation and combined stimulation within-session in healthy volunteer subjects. We demonstrate here that the distinct sources of steady-state (primary auditory cortex) and N1 (secondary auditory cortex) responses can be reliably measured without significant spatial distortion with this combined stimulation paradigm.

Acoustic Stimulation↗
PubMed2000

Decreased in vitro production of interferon-gamma and interleukin-2 in whole blood of patients with schizophrenia during treatment.

A pattern of aberrations in the T-cell cytokine system that is typical for autoimmune disorders has also been reported in patients with schizophrenia, namely a decreased interleukin-2 (IL-2) production and increased levels of the soluble IL-2 receptor (sIL-2R). It has also been reported that the production of interferon-gamma (IFN-gamma) may be lowered. In a longitudinal design, we studied the production of both IFN-gamma and IL-2 and their correlation in patients with schizophrenia during treatment and investigated whether associations exist between cytokine production and clinical variables. The production of IFN-gamma and IL-2 was measured in equal numbers (n = 29) of patients with schizophrenia (DSM-IV) and controls who were matched for age and gender. Patients were measured 1 day after admission (T1), after 14 (T2) and 28 (T2) days of treatment. Psychopathology was assessed after these times. The production of both IFN-gamma and IL-2 was significantly lower in patients than in controls throughout the whole investigation period (T1-T3). The productions of both cytokines were significantly correlated in controls (r = 0.60, P </= 0.001) as well as in patients with schizophrenia (mean production T1-T3: r = 0.71, P </= 0.001). No associations between cytokine measurements and psychopathology or age-at-onset could be found. Our findings of lowered and correlated IFN-gamma and IL-2 production indicate that alterations in the cytokine system of patients with schizophrenia might resemble those in autoimmune disorders. It is suggested that these immunological abnormalities are associated with acute exacerbation, rather than with a clinical subtype of schizophrenia.

Adolescent↗