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Biomedical subjects

Z Rihmer

Publications and source records attributed to Z Rihmer.

At least 19 recordsLinked to original sources
PubMed1998

Decreasing tendency of seasonality in suicide may indicate lowering rate of depressive suicides in the population.

The seasonality of suicide is well known and a repeatedly demonstrated phenomenon. The authors analyzed the seasonality of 148 suicide events on Gotland between 1981 and 1996. A marked and significant seasonality with a spring and summer peak was found between 1981 and 1989, when the prescription of antidepressants was relatively low and stable. However, this seasonality disappeared in the period between 1990 and 1996, when prescription of antidepressants increased dramatically, indicating that more and more depressed patients were pharmacologically treated. As the seasonality of suicide in the population is the reflection of the seasonal nature of depressive suicides, the result suggests that a decreasing tendency of seasonality in suicide may indicate the lowering rate of depressive suicides in the given population.

Adolescent↗
PubMed1998

SSRI supplementation of antimanic medication in dysphoric mania.

The authors report on a 42-year-old female inpatient with bipolar I disorder, whose dysphoric mania responded rapidly and completely while her antimanic medication (lithium, carbamazepine, clozapine, haloperidol and clonazepam) was supplemented by 20 mg of paroxetine daily. The practical and theoretical importance of this case is briefly discussed.

Adult↗
PubMed1996

Strategies of suicide prevention: focus on health care.

Suicide is a major health problem, showing an increasing tendency in many developed countries. In this synthetic review, having briefly described the possible risk factors of suicide, those recent strategies that have been proved to be effective methods of reducing the suicide rate are summarised. Psychiatric illness, first of all the affective disorders (particularly in the case of a previous suicide attempt), are the most powerful predictors of this manner of death. Early recognition and appropriate treatment of affective and other psychiatric disorders, as well as aftercare of persons with a high suicidal risk are, consequently, the most successful methods of preventing suicide. Training health-care workers in order to increase their knowledge on the means of suicide prevention and educating patients so as to improve their compliance is highly beneficial. Since health care professionals can help only those patients who contact them, public education on the symptoms, dangers and the treatable nature of depression, other psychiatric illnesses and psychological crises becomes also very important.

Cause of Death↗
PubMed1996

Antidepressant-induced hypomania in obsessive-compulsive disorder.

Out of ten consecutive patients with DSM-III-R obsessive-compulsive disorder without any previous history of bipolarity, three patients showed antidepressant-induced hypomania (clomipramine, one patient; fluvoxamine, two patients) within the first 5 to 8 weeks of the drug treatment. These data support the previous results on a strong association between obsessive-compulsive disorder and bipolar affective illness.

Adolescent↗
PubMed1995

Depression and suicide on Gotland. An intensive study of all suicides before and after a depression-training programme for general practitioners.

In 1983 and 1984, the Swedish Committee for the Prevention and Treatment of Depression (PTD) organised a postgraduate training programme on the diagnosis and treatment to all the general practitioners on Gotland, Sweden. In the following years, the frequency of suicide and inpatient care for depression decreased significantly, as well as the frequency of sick leave for depression. The results of the Gotland study have provided evidence for the view that early recognition and adequate treatment of depression is one essential method of suicide prevention (Rutz et al., 1989; Rutz et al., 1992). A detailed retrospective clinical analysis, of all 115 consecutive suicide victims on Gotland between 1981 and 1992 presented in this study, showed that male gender and violent methods were overrepresented. 50 suicides had a DSM-III-R axis I diagnosis and half of them (n = 25) had primary major depression. Bipolar II disorder was relatively overrepresented in this sample. After the PTD programme, the proportion of depressive suicides was significantly lower than before. This finding strongly suggests that the significant decrease in the suicide rate after the PTD programme is a direct result of the robust decrease in depressive suicides of the area served by trained GPs. The practical importance of this finding is briefly discussed.

Adolescent↗
PubMed1994

[Regional distribution of working physicians, diagnosed cases of depression and suicide mortality in Hungary].

Based on the well-known and strong relationship between suicide and depression, the authors investigated the regional distribution of the suicide rates, rates of diagnosed depressions and rates of working physicians in Hungary. It was found a strong significant positive correlation between the of working doctors and rate of diagnosed depressions, and both the mentioned parameters showed a strong significant negative correlation with the suicide rates. The more is the number of doctors/100,000 inhabitants, the better is the recognition of depression and the lower is the suicide rate in the given region. The rate of working doctors was significantly higher in the countries located in the western part of Hungary, which may have a role in the lower suicide mortality of this area of the country.

Depression↗
PubMed1994

The role of psychosocial and biological variables in separating chronic and non-chronic major depression and early-late-onset dysthymia.

Psychosocial (sociodemographic characteristics, loss and separation and family atmosphere in childhood, recent life events) and biological (family history, DST, TRH-test) variables were investigated in 180 patients with Major Depression (MD) and Dysthymic Disorder (DD). The aim of the study was to reveal certain differences between the chronic and non-chronic course of MD and the early- and late-onset subtypes of dysthymia. When comparing the two course patterns of MD, a higher rate of malignant tumours among first-degree relatives, a greater number of long-lasting stress situations before the index depressive episode, longer duration of the previous episodes, less frequent DST nonsuppression, and a blunted TSH response to TRH were found in patients with a chronic course of MD. Several factors seem to influence the course pattern of MD, or else the chronic form represents a subgroup within MD. The late-onset dysthymics were mainly women with a low level of education, a lower suicidal tendency, normal suppression in DST, and a lack of blunted TSH responses to TRH administration during the period of double depression. The early-onset dysthymics showed a higher number of persons who had never married, who presented a more traumatic and frustrating childhood background, and who had a higher rate of DST non-suppressors and blunted TSH responses after TRH administration during the period of their double depression. Our data suggest that late-onset dysthymia might be a biologically distinct subgroup of chronic depression.

Adolescent↗
PubMed1994

Moclobemide (Aurorix) in primary major depression.

1. Moclobemide (Aurorix) is a newly developed, effective, short-acting well tolerable and safe antidepressant which belongs to the new class of reversible monoamine-oxidase-A inhibitors. 2. Aurorix was given per os in an open clinical trial for 6 weeks to 30 patients with DSM-III diagnoses of (nonpsychotic, nonmelancholic), major depression. 3. Out of the 25 patients who completed the study 14 (56%) were responders and 11 (44%) non-responders. 4. The patients tolerated the drug very well, and no serious side-effects were noted. 5. Pretreatment biological markers (dexamethasone suppression test, platelet-MAO-B activity, 3H-imipramine binding, thyroid function) did not have a predictive value regarding the drug response.

Adult↗
PubMed1993

Dexamethasone suppression test and TRH-TSH test in subaffective dysthymia and character-spectrum disorder.

Based on Akiskal's criteria of subaffective dysthymia (SDT) and character-spectrum disorder (CSD) as the two, etiologically distinct forms of early-onset primary dysthymia, the authors investigated the dexamethasone suppression test (DST) in 18 patients with SDT and in 30 patients with CSD. TRH-TSH test was also investigated in smaller subsamples of the patients (n = 8, and n = 7, respectively). Fifty percent of the patients with SDT showed abnormal DST and TRH-TSH test results respectively, while the figures in the CSD patients were 7% and 0%. These findings suggest that SDT is a clinically diagnosable and biologically distinct subgroup within the broader category of early-onset primary dysthymia, which represents a symptomatically milder version of primary affective disorder.

Adolescent↗
PubMed1993

Suicide rate, prevalence of diagnosed depression and prevalence of working physicians in Hungary.

Based on the well-known relationship between depression and suicide, we investigated the regional distribution of the suicide rate, rate of diagnosed depression and prevalence of working physicians in Hungary. A strong significant positive correlation was found between the rate of working physicians and rate of diagnosed depression, and both parameters showed a strong significant negative correlation with the suicide rate. The more physicians per 100,000 inhabitants, the better is the recognition of depression and the lower is the suicide rate in the given region. The rate of working doctors was significantly higher in the counties located in western Hungary, which may have a role in the lower suicide mortality in this area of the country.

Depressive Disorder↗