0000000000066915
AUTHOR
Martin Hautzinger
Fragile-X carrier females: evidence for a distinct psychopathological phenotype?
The present study examined 35 mothers (29 premutation carriers) of children with fragile-X syndrome in measures of intelligence and psychiatric disorders by comparing them with two control groups: a) 30 mothers of children in the general population and b) 17 mothers of non-fra-X retarded children with autism. Premutation carriers had a higher frequency of affective disorders than mothers from the general population. Preliminary data indicate that normally intelligent premutation carriers of the fra-X genetic abnormality have a similar frequency of affective disorders (DSM-III-R criteria [APA, 1987]) than mothers of autistic children. Neither carriers of the premutation nor carriers of the f…
Two-Year Stability of Psychosis Proneness Scales and Their Relations to Personality Disorder Traits
Two-year stability of Physical Anhedonia (PhA), Perceptual Aberration (PER), and Magical Ideation (MI) scale scores and their relation to personality disorder traits were examined. Additionally, the effects of a time-lagged (prospective) versus concurrent measurement of psychosis proneness and personality disorder traits were studied to examine the specificity of MI, PER, and PhA. With a non-college-student sample (n = 404), stability for PhA was sufficiently high, but for PER and MI, stability was moderate to low. The correlations between personality disorder traits and psychosis proneness scales demonstrate that simultaneous assessment leads to a more nonspecific pattern of associations f…
SEQUENTIALLY ADJUSTED RANDOMIZATION TO FORCE BALANCE IN CONTROLLED TRIALS WITH UNKNOWN PREVALENCE OF COVARIATES: APPLICATION TO ALCOHOLISM RESEARCH
In treatment outcome studies with small to medium sample sizes (n200), the balance of groups with regard to important factors, which sometimes occur at low prevalence, is indispensable for adequate interpretation. This study tested a method for use in clinical alcoholism research, an uncomplicated procedure for satisfactory randomization of patients to different treatments, taking into account relevant background variables.An easily applicable modification of Efron's biased coin method for the randomization of treatments within strata of unknown but low prevalence was compared with the original approach and alternative methods by computer simulation (10,000 runs). An application example for…
Randomised placebo-controlled trial of moclobemide, cognitive–behavioural therapy and their combination in panic disorder with agoraphobia
BackgroundIn the treatment of panic disorder with agoraphobia, the efficacy of pharmacological, psychological and combined treatments has been established. Unanswered questions concern the relative efficacy of such treatments.AimsTo demonstrate that moclobemide and cognitive–behavioural therapy (CBT) are effective singly and more effective in combination.MethodFifty-five patients were randomly assigned to an eight-week treatment of: moclobemide plus CBT; moclobemide plus clinical management (‘psychological placebo’); placebo plus CBT; or placebo plus clinical management.ResultsComparisons between treatments revealed strong effects for CBT. Moclobemide with clinical management was not superi…
Impaired cognitive control over emotional material in euthymic bipolar disorder.
Abstract Background Previous research suggests that bipolar disorder (BD) is characterized by deficits in cognitive control (CC). Impaired CC has been found in high-risk samples and is associated with the maintenance of BD symptoms. It remains unclear, however, whether BD is characterized by a general deficit in CC or by a deficit that is specifically related to the processing of emotional material. Methods The sample consisted of 42 remitted bipolar patients and 39 healthy controls (HC). We examined whether BD individuals display impaired CC when confronted with negative as well as positive material using an arithmetic inhibition task that required inhibition of pictorial stimulus material…
Fragebogen zur Messung der psychosozialen Belastungen bei chronisch-entzündlichen Darmerkrankungen (FBCED): Konstruktion und Evaluation
The "Inflammatory Bowel Disease Stress Inventory (IBD-SI)" measures a broad spectrum of disease-specific every day stress factors in patients with inflammatory bowel disease (IBD). Based on a multistage factor analysis on 300 CED patients, the final form comprises 32 items assigned to 8 different domains: depressed mood, doctor-patient relationship, anxiety about loss of bowel control, occupational impairment, worries about deteriovation, stress from medical treatment, impairment of sexuality/partnership and physical complaints. In addition, a global stress score can be obtained. The reliability values of the 8 subscales with 4 items each indicate a good internal consistency (alpha = 0.76 -…
Suicide attempts in chronically depressed individuals: What are the risk factors?
Abstract Chronically depressed individuals have a high suicide risk. However, it is an open question whether previously observed risk factors for suicide attempts also apply to chronic depression or whether there are specific risk factors related to chronic-recurrent illness. We drew from a large group of chronically depressed individuals seeking psychotherapy to investigate demographic and psychological factors related to previous suicide attempts. Participants took part in the SCID and filled out established questionnaires. Among 368 chronically depressed individuals (68.7% women; Mage = 40.95 years), 75 participants (19.4%) reported previous suicide attempts. Men were more likely to have…
Combination treatment with nefazodone and cognitive-behavioral therapy for relapse prevention in alcohol-dependent men: a randomized controlled study.
Background This study evaluated the serotonergic antidepressant nefazodone versus placebo and specific cognitive-behavioral therapy (CBT) versus nondirective group counseling (GC) for relapse prevention in alcohol dependence in a large prospective, randomized, and placebo-controlled double-blind study at 3 German university centers. Method 242 male patients fulfilling at least 5 criteria for alcohol dependence according to DSM-IV and ICD-10 were eligible, after detoxification, for one of the following treatment combinations: nefazodone + CBT, nefazodone + GC, placebo + CBT, and placebo + GC. Either nefazodone or placebo was administered throughout the evaluation period of 15 months. Either …
How to measure sustained psychic transformations in long-term treatments of chronically depressed patients: Symptomatic and structural changes in the LAC Depression Study of the outcome of cognitive-behavioural and psychoanalytic long-term treatments.
Worldwide, the pressure on psychoanalysis to prove the results of its treatments according to the criteria of so-called evidence-based medicine has increased. While a large number of studies on the results of psychoanalytic short-term therapies are now available, such studies are still largely lacking on psychoanalysis and psychoanalytic long-term therapies. In a large multicentre study, the results of psychoanalytical and cognitive-behavioural longterm therapies in chronically depressed patients were compared, Both psychotherapies led to statistically highly significant changes in depressive symptoms three years after the start of the treatments However, the focus of psychoanalytic treatme…
Medikamente zur Behandlung von sexuellen Störungen
Folgende Storungen sind im Rahmen der psychiatrischen Pharmakotherapie — weitgehend oder auch nur ansatzweise — zu beeinflussen: Erektionsstorungen bzw. Storungen der sexuellen Erregung bei der Frau, vermindertes sexuelles Verlangen, Ejaculatio praecox, gesteigertes sexuelles Verlangen und substanzinduzierte sexuelle Funktionsstorungen. Fur andere Diagnosen im Bereich sexueller Storungen sind keine pharmakotherapeutischen Studien bekannt.
Neuropsychological profiles of FMR-1 premutation and full-mutation carrier females
Abstract The present French–German investigation of fragile-X syndrome (fra-X) was undertaken to disentangle genetic from environmental effects on cognitive performance as assessed with the following measures: Wechsler Adult Intelligence Scale-Revised (WAIS-R), Wisconsin Card Sorting Test, Trail-Making Test, Tower of Hanai, Verbal Fluency Test, Stroop Test, short-term and consolidation memory, and the d2 task. Groups with different genotypes ( n =11 mothers with a full mutation in the FMR-1 gene of fra-X children; n =65 mothers with a premutation in the FMR-1 gene of fra-X children; n =18 siblings of these mothers with normal CGG repeats) and with different psychosocial stressors from fra-X…
Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs
AM Vicente - Cross-Disorder Group of the Psychiatric Genomics Consortium Most psychiatric disorders are moderately to highly heritable. The degree to which genetic variation is unique to individual disorders or shared across disorders is unclear. To examine shared genetic etiology, we use genome-wide genotype data from the Psychiatric Genomics Consortium (PGC) for cases and controls in schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). We apply univariate and bivariate methods for the estimation of genetic variation within and covariation between disorders. SNPs explained 17-29% of the variance in …
“Abnormal Response to Negative Feedback”
Zusammenfassung: Es wurden alkoholabhängige Patienten unter Stressbedingungen neuropsychologisch untersucht. Fragestellung: Zeigt sich wie bei depressiven Patienten eine abnorme Reaktion auf negative Rückmeldung oder gar eine generelle Stressanfälligkeit? Die alkoholabhängigen Patienten wurden in der Testbatterie zur Aufmerksamkeitsprüfung (TAP) nach negativer Rückmeldung tendenziell langsamer und die Kontrollpersonen tendenziell schneller. Insgesamt ergab sich ein signifikanter Unterschied in Visuellem Scanning und Reaktionswechsel. Damit ist die “abnormal response to negative feedback” nicht spezifisch für depressive Patienten. Unter 90 dBA Lärm als Stressor zeigten sich dagegen keine Ef…
Cue exposure in alcohol dependent patients: preliminary evidence for different types of cue reactivity.
Craving is considered to be an important phenomenon in addictive behaviours. However, there is still an unresolved debate on what craving for alcohol means, how it is best measured and which clinical and therapeutical consequences its presence or absence may imply. Cue reactivity paradigms have been developed to elicit craving under standardized experimental conditions. Here we present preliminary results characterizing alcohol-dependent patients with regard to subjective and psychophysiological aspects of exposure to alcohol-associated cues in a cue reactivity paradigm. Thirty-six patients fulfilling at least 5 criteria of alcohol dependence according to DSM-IV criteria were studied after …
Early improvement is a predictor of treatment outcome in patients with mild major, minor or subsyndromal depression
Abstract Background There is substantial evidence that early improvement (EI) under antidepressant treatment is a clinically useful predictor of later treatment outcome in patients with major depressive disorders. The aim of this study was to test whether EI can also be used as a predictor for treatment outcome in patients with mild major, minor or subsyndromal depression, i.e. patients, who are typically treated by general practitioners. Methods Analyses were carried out using data from 223 patients of a 10-weeks randomized, placebo-controlled trial comparing the effectiveness of sertraline and cognitive-behavioural therapy (CBT) in patients with mild major, minor or subsyndromal depressio…
Psychiatric genome-wide association study analyses implicate neuronal, immune and histone pathways
G.B. and S.N. acknowledge funding support for this work from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. P.H.L. is supported by US National Institute of Mental Health (NIMH) grant K99MH101367. Genome-wide association studies (GWAS) of psychiatric disorders have identified multiple genetic associations with such disorders, but better methods are needed to derive the underlying biological mechanisms that these signals indicate. We sought to identify biological pathways in GWAS data from over 60,000 participants from the Psychiatric Genomics Consortium. We developed an an…
Applying polygenic risk scoring for psychiatric disorders to a large family with bipolar disorder and major depressive disorder
Psychiatric disorders are thought to have a complex genetic pathology consisting of interplay of common and rare variation. Traditionally, pedigrees are used to shed light on the latter only, while here we discuss the application of polygenic risk scores to also highlight patterns of common genetic risk. We analyze polygenic risk scores for psychiatric disorders in a large pedigree (n ~ 260) in which 30% of family members suffer from major depressive disorder or bipolar disorder. Studying patterns of assortative mating and anticipation, it appears increased polygenic risk is contributed by affected individuals who married into the family, resulting in an increasing genetic risk over generat…
Evaluation of Treatment Integrity: The Treatment Specificity Index
Objective To differentiate between treatments in a randomized controlled trial (RCT), therapies need to display not only high purity but also high specificity. The aim of this study was to demonstrate the benefits of calculating a treatment specificity index for the evaluation of treatment differentiation. Method Based on an RCT of relapse prevention in depression, comparing a cognitive with a psychoeducational treatment, the specificity and the purity index were calculated. Results As indicated by the specificity index, both conditions differed in their levels of implemented specific and common interventions. A significant relationship was found between symptom change before a therapy sess…
Neuropsychological status of alcohol-dependent patients: increased performance through goal-setting instructions.
Aims: The effects of goal-setting instructions on neuropsychological performance of alcohol-dependent patients and control subjects were assessed. Methods: 57 alcohol-dependent patients and 59 carefully age- and education-matched healthy control subjects underwent standard neuropsychological investigation. In addition, the goal-setting paradigm was used to systematically manipulate motivation. Participants were requested to calculate simple mathematical problems repeatedly within phases of a 2-min duration receiving normal or goal setting-instructions (to increase performance in the next phase by 20%). Results: The patients demonstrated deficits in standard neuropsychological tests. Patient…
P-491 - Sensitivity to changes during antidepressant treatment: a comparison of unidimensional depression rating scales in patients with minor depression
In the efficacy evaluation of antidepressant treatments the total score of the Hamilton Depression Rating Scale (HAMD) is still regarded as the’gold standard’. Studies suggest that unidimensional subscales of the HAMD, which capture the core depressive symptoms, outperform the full HAMD regarding the detection of antidepressant treatment effects. The present study compared several unidimensional subscales of the HAMD and the Inventory of Depressive Symptomatology (IDS) regarding their sensitivity to changes in depression symptoms in a sample of patients with minor depression (MIND). Biweekly IDS-C28 and HAMD17 data from 287 patients of a 10-week randomised, placebo-controlled trial comparin…
Affektive Störungen bei Jugendlichen: Prävalenz, Komorbidität und psychosoziale Korrelate
Es liegen vergleichsweise wenige Untersuchungen zur Pravalenz depressiver Erkrankungen bei jugendlichen Jungen und Madchen vor. Aussagen zum Einfluβ von Alter, Geschlecht, Auftretensalter, Symptomdauer, Behandlungen, sozialen und psychologischen Risikofaktoren sind kaum moglich. Die vorliegende, in Oregon, USA, durchgefuhrte Bevolkerungsstudie untersuchte 1710 Jugendliche mittels verschiedener Fragebogen und klinischer Beurteilungsverfahren. Die Punktpravalenz fur unipolare Depressionen liegt bei 2,9% fur Angststorungen bei 3,2%, das Lebenszeitrisiko fur unipolare Depessionen ist 20,4% und fur Angste 8,8%. Madchen hatten generell hohere Auffalligkeitswerte, insbesondere bei Depressionen, An…