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Biomedical subjects

W Rössler

Publications and source records attributed to W Rössler.

At least 37 records · Page 2Linked to original sources
PubMed2003

The Zurich Study: participation patterns and Symptom Checklist 90-R scores in six interviews, 1979-99.

OBJECTIVE: The Zurich study is a longitudinal study in psychiatric epidemiology that started in the late 1970s. The sixth interview in 1999 provides the basis to investigate and update the participation and drop-out patterns of the Zurich subjects. METHOD: Aside from descriptive analyses, particular attention was paid to the Symptom Checklist 90-R (SCL-90-R), used initially to stratify the Zurich sample. RESULTS: The initial proportions of high-scorers vs. low-scorers (two-thirds vs. one-third) have not changed significantly in the 367 subjects who participated in the 1999 interview. More detailed analyses indicate a selective and changing dependence of participation/drop-out on health status as measured by the SCL-90 R. In recent interviews drop-out has become more likely in subjects with extremely high SCL scores and in subjects with low SCL scores. CONCLUSION: Drop-out in the Zurich Study is associated with extreme SCL scores.

Adult↗
PubMed2003

Which individuals with affective symptoms seek help? Results from the Zurich epidemiological study.

OBJECTIVE: Several factors influence whether individuals with affective disorders seek help. The Zurich cohort study provides an opportunity to explore patient-based factors without confounding with problems of access. This study aims to identify features which predict help-seeking behaviour in symptomatic individuals and to explore failure of help seeking in those who did not. METHOD: Characteristics of currently symptomatic 40-year-old individuals in a stratified epidemiological sample were tested against help-seeking behaviour using bivariate statistics and logistic regression. Individual predictors were identified and interaction effects tested. RESULTS: Thirty-one per cent of the 364 subjects sought help in the preceding year. Past treatment and living alone were significantly associated with treatment. Total number of symptoms and several individual symptoms correlated with treatment in the bivariate analyses but regression analysis identified "unfounded self-reproach" and "hopelessness" interacting with social support to predict the best treatment. CONCLUSION: Social support is strongly protective against needing help in the presence of distressing affective symptoms unless these symptoms become elaborated into conclusions about their meaning and prognostic significance.

Adult↗
PubMed2002

Public attitude to compulsory admission of mentally ill people.

OBJECTIVE: Assessing the public attitude to compulsory admission of mentally ill in Switzerland and analyzing the influence of demographic, psychological, and sociological factors. METHOD: We conducted a representative telephone survey with 1737 interviewees. In a logistic regression analysis compulsory admission was used as the dependent variable. RESULTS: More than 70% of the respondents display a positive attitude to compulsory admission. Education, negative stereotypes, and living in the French speaking part of Switzerland are predictors for accepting compulsory admission whereas older age, extreme political opinion, and rigid personality traits show an inverse effect. Negative emotions, anomie, social distance, and contact to mentally ill have no significant influence. CONCLUSION: The mostly positive attitude to compulsory admission suggests that the public trust in psychiatry to deal with the assigned responsibility.

Adult↗
PubMed2001

Neuron-glia communication via nitric oxide is essential in establishing antennal-lobe structure in Manduca sexta.

Nitric oxide synthase recently has been shown to be present in olfactory receptor cells throughout development of the adult antennal (olfactory) lobe of the brain of the moth Manduca sexta. Here, we investigate the possible involvement of nitric oxide (NO) in antennal-lobe morphogenesis. Inhibition of NO signaling with a NO synthase inhibitor or a NO scavenger early in development results in abnormal antennal lobes in which neuropil-associated glia fail to migrate. A more subtle effect is seen in the arborization of dendrites of a serotonin-immunoreactive neuron, which grow beyond their normal range. The effects of NO signaling in these types of cells do not appear to be mediated by activation of soluble guanylyl cyclase to produce cGMP, as these cells do not exhibit cGMP immunoreactivity following NO stimulation and are not affected by infusion of a soluble guanylyl cyclase inhibitor. Treatment with Novobiocin, which blocks ADP-ribosylation of proteins, results in a phenotype similar to those seen with blockade of NO signaling. Thus, axons of olfactory receptor cells appear to trigger glial cell migration and limit arborization of serotonin-immunoreactive neurons via NO signaling. The NO effect may be mediated in part by ADP-ribosylation of target cell proteins.

Animals↗
PubMed2001

[Early detection of schizophrenic psychoses].

Difficulties in early detection of schizophrenic psychosis are two-fold: the non-specificity of the prodromal symptoms and the skepticism to or the rejection of the medical treatment by the patient. In this paper we focus on the central role of the GP. Due to the long-lasting trustful relationship with the patient's family he is able to establish a contact to the patient. Questions for the assessment of the most mentioned prodromal symptoms (behaviour, affectivity, cognition) are indicated. Further steps in the evaluation as well as differential diagnoses are pointed out. Finally, the importance of early detection of psychosis and the GP's role herein is shown.

Antipsychotic Agents↗
PubMed2001

Fenvalerate treatment affects development of olfactory glomeruli in Manduca sexta.

Low doses of fenvalerate, a widely used type-II pyrethroid insecticide, have been shown previously to produce abnormal olfactory centers in the brain and abnormal olfactory-mediated behavior in beetles (Wegerhoff et al. [1998] Neuroreport 9:3241-3245). Here, we use the experimental advantages of the moth Manduca sexta to explore the cellular changes that lead to these abnormalities. Our results indicate that treatment with fenvalerate may affect multiple aspects of the development of the primary olfactory centers, the antennal lobes, in Manduca, including ingrowth of olfactory receptor axons, axon fasciculation, and targeting within the antennal lobe, and intercellular signaling between the receptor axons and the glial cells that ordinarily surround and stabilize the developing olfactory glomeruli.

Animals↗
PubMed2001

Lay recommendations on how to treat mental disorders.

BACKGROUND: Beliefs about the helpfulness of interventions are influencing the individual help-seeking behavior in case of mental illnesses. It is important to identify these beliefs as professional helpers are asked to consider them in their treatment recommendations. OBJECTIVE: Assessing lay proposals for an appropriate treatment of mental illnesses. METHODS: We conducted a representative opinion survey in Switzerland. Eighteen treatment proposals were presented with respect to a vignette either depicting schizophrenia or depression. Respondents were asked to indicate the proposals considered to be helpful for treatment and those considered to be harmful, respectively. RESULTS: 'Psychologist,' 'general practitioner,' 'fresh air, and 'psychiatrist' were mostly proposed as being helpful. Among several psychiatric treatment approaches 'psychotherapy' was favored, while psychopharmacological treatment and electroconvulsive therapy were only proposed by less than one-fourth of the interviewees. Especially psychotropic drugs were considered to be harmful. Treatment by a psychiatrist was regarded as being more helpful for schizophrenic individuals than for depressive persons. For a person experiencing a life crisis, treatment by a psychiatrist and psychological treatment were viewed as being harmful, and non-medical interventions were preferred. However, for persons thought to be mentally ill, psychiatric and psychopharmacological treatments were recommended. CONCLUSION: Mental health professionals are regarded as being helpful although their treatment methods are seen as being less helpful. A clear distinction is made between lay proposals for depression and schizophrenia. However, the perception of whether a condition is considered to be an illness or a life crisis has significantly more influence on lay treatment proposals than the cited diagnosis in the vignette.

Adolescent↗
PubMed2001

Needs for mental health care and service provision in single homeless people.

BACKGROUND: Specific problems in sampling methodology, case-finding strategies and a standardised needs assessment in mentally ill homeless people have contributed to their being neglected as a mental health care clientele. METHOD: We assessed a representative sample of homeless people (n=102) in the highly industrialised city of Mannheim (Germany) regarding their prevalence of mental disorders (using the SCID) and their needs for mental health care (using the NCA). RESULTS: We found high prevalences, with 68.6% of all assessed homeless persons having a current mental disorder. Thus, needs for mental health care were very common, with unmet needs predominating in all problem areas, which was supported by a very weak service utilization. Thus, even in a region with a comprehensive community mental health care network, like the study area, mentally ill homeless people are widely under-provided. CONCLUSIONS: Results suggest that the traditional shelter system for homeless people carries most of the mental health care burden for their clientele and must be supported by adequate interventions from community-based mental health care services. A closer connection of both sectors and a better co-ordination of the care offers seems to be a prerequisite for helping to reduce unmet mental health care needs in this specific high-risk group.

Adolescent↗
PubMed2001

Closure of an open drug scene--a case register-based analysis of the impact on the demand for methadone maintenance treatment.

AIMS: To assess the impact of the closure of an open drug scene on the demand for methadone maintenance treatment (MMT). DESIGN: Interrupted time series analysis of case register-based data of all MMTs performed in the canton of Zurich (Switzerland) between June 16 1992 and July 7 1997. SETTING: Five private and 14 state-controlled institutions as well as 330 general practitioners, 35 psychiatrists, and 79 other specialists offering outpatient MMT. PARTICIPANTS: 5210 opiate users with 9042 MMT episodes. MEASUREMENTS: Monthly number of entries into MMT before, during and after the closure of the Letten scene in February 1995, MMT retention rates, participants' socio-demographic and drug-related data. FINDINGS: ARIMA modelling revealed 68 (95% CI = 31-105; p < 0.001) additional MMT admissions due to the dispersion of the open drug scene without a decrease in MMT retention rates. Socio-demographic and drug-related characteristics of patients entering MMT in the month of the closure did not significantly differ from other admissions. CONCLUSIONS: Law enforcement strategies to eliminate open drug scenes may increase the demand for MMT. Sufficient treatment facilities for opioid dependence should be provided when law enforcement activities against open drug scenes are planned.

Adult↗
PubMed2001

[How do mentally ill homeless persons evaluate their quality of life].

Besides pronounced deficiencies in psychiatric research concerning homeless mentally ill in Germany, studies concerned with the quality of life of homeless mentally ill were missing until now. This study reveals in a representative sample of 102 homeless people from the City of Mannheim, Germany that--compared to the homeless without psychiatric disorders of the sample--the mentally ill homeless (prevalence 68.6%) have significantly different subjective views of their quality of life regarding the items "state of health", "physical capabilities" and "support from others". The differences were even stronger if the homeless mentally ill were compared to a group of non-homeless mentally ill schizophrenic patients (n = 104), cared for in the City's well-equipped community care services. Community care patients reported a significantly better quality of life in respect of 11 items. These results were seen as a success of the concept of community-based mental health care. The consequences for improving care strategies for homeless mentally ill are discussed.

Activities of Daily Living↗
PubMed2001

[Attitude of family of psychiatric patients to psychiatric research, especially to early detection of schizophrenic psychoses].

OBJECTIVE: To assess attitudes of relatives of mentally ill patients to psychiatric research, especially to early detection of schizophrenic psychosis, and to evaluate the potential stigmatization effect of an early diagnosis of schizophrenic psychosis. METHODS: A questionnaire was sent to relatives of mentally ill patients, all members of a self-help group in Switzerland. They were asked to answer structured questions about their personal attitude to psychiatric research in general, their willingness to support an affected person to participate in a research project, their attitude to early detection of schizophrenia and to the potential stigmatization of an early diagnosis. RESULTS: 88% of the relatives (n = 200) have a positive attitude to research in psychiatry. 47% would support their affected family member to participate in a research project whereas 39% would not. 52.5% fully share the expectation of psychiatric research to attain a better course by earlier detection of psychosis, 24.5% tend to agree. 20.5% of the respondents indicate a fear of stigmatization for the affected by earlier diagnosis, while 12% fear stigmatization for themselves. CONCLUSIONS: A surprising fact is the positive attitude of relatives to psychiatric research in general, but also to early detection of schizophrenic psychosis. But this cannot lead to the conclusion that relatives are supporting the participation of an affected family member in research. The small number of relatives that fears a stigmatization by earlier diagnosis of schizophrenic psychosis shows that stigmatization depends on other factors than the diagnosis, i.e. psychiatric hospitalization or medication side effects. These findings encourage psychiatric research to increase knowledge of the early phase of schizophrenia in favor of patients and their relatives.

Adult↗
PubMed2001

[Vocational rehabilitation of the mentally ill - an evaluation of the Vocational Rehabilitation Center in Zurich, Switzerland].

OBJECTIVE: The aim of the Vocational Rehabilitation Center in Zurich (VRC) is to reintegrate mentally ill persons into the primary labour market, mainly by prevocational training followed by continuous professional support for employed individuals. The present study evaluated the impact of the VRC. METHODS: The job and financial situation of 68 trained persons was assessed up to two years after the training. Additionally, their vocational history and sociodemographic data were analysed. RESULTS: Before the training, only 9 % had a job, while two years after the course 42 % were employed in competitive jobs. On the other hand, using an ordinal scale, two years after the training, 78 % of the patients were found in a better job situation than before the course. Likewise, the financial situation of 52 % of the clients has improved within those two years. The strongest correlation with success was the intensity of support after the training. CONCLUSIONS: The VCR is effective in training mentally ill patients for the primary job market. Continuous professional support is vital for ongoing success.

Adult↗
PubMed2001

Case management and assertive community treatment in Europe.

OBJECTIVE: Case management studies from Europe and the United States continue to yield conflicting results. At a symposium at the World Psychiatric Conference in Hamburg in 1999, researchers from four European countries explored the possible reasons for differences in outcome. They also examined reasons for the differing foci of case management studies across the different cultures. The authors summarize the symposium's findings. METHODS: Individual case presentations were given of studies and services from the United Kingdom (three studies), Sweden (two studies), Germany, and Italy (one each). Outcomes, methodologies, and national service context were examined. RESULTS AND CONCLUSIONS: A significant influence of national culture is evident both in the acceptability of case management and in approaches to researching it. Case management is perceived as an "Anglophone import" in Italy but is now national policy for persons with severe mental illness in the other three countries. Studies from the United Kingdom emphasized methodological rigor, with little attention to treatment content, whereas those from Sweden accepted a less disruptive research approach but with a more prescriptive stipulation of treatment content. Studies from Italy and Germany emphasized the importance of differing descriptive methodologies. Marked differences in the range of social care provision were noted across Europe. Overall, European researchers are less concerned than U.S. researchers with studying the impact of case management on hospital use.

Case Management↗
PubMed2000

Importance of timing of olfactory receptor-axon outgrowth for glomerulus development in Manduca sexta.

In the moth Manduca sexta, development of glomeruli in the antennal (olfactory) lobes (ALs) follows a precise timetable and involves interactions of olfactory receptor cell (ORC) axons with AL glial cells and neurons. To study the importance of timing for these intercellular interactions, we experimentally desynchronized the development of the ALs and the ORCs by altering the temperature of the developing antenna and brain for defined periods of time during development. Selective cooling of the antenna relative to the body resulted in a delay of ORC-axon outgrowth, and slightly warming the antenna while cooling the body caused precocious ingrowth of axons into the AL. Whereas cooling of the antenna for 24 hours caused only a delay in the formation of glomeruli, cooling for 48 hours led to significant disruption of glomerular development. Glial cells did not form normal glomerular borders, and glomeruli were shaped abnormally. Axons of pheromone-specific ORCs projected to their correct target, but terminal branches within the macroglomerular complex (MGC) were not clearly segregated. The results suggest that proper formation of glial glomerular borders requires interaction of ORC axons and glial cells within a sensitive period, whereas targeting of ORC axons appears to be effective over extended periods in development. Precocious ingrowth of ORC axons after warming the antenna and cooling the body for 48 hours resulted in enlarged protoglomeruli. Glial borders formed normally, but a subpopulation of MGC-specific ORC axons grew past the MGC. The decreased accuracy of targeting in these cases suggests that targeting mechanisms are not fully developed before the time when ORC axons normally would enter the brain.

Age Factors↗