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D O Nutzinger

Publications and source records attributed to D O Nutzinger.

At least 19 recordsLinked to original sources
PubMed2004

Conditional-associative learning in eating disorders: a comparison with OCD.

The acquisition of conditional associations using neutral and individually threatening verbal stimuli was assessed in 16 females with anorexia nervosa (AN), obsessive-compulsive disorder (OCD), bulimia nervosa and normal controls, respectively. Groups did not differ in terms of age, sex, intelligence, depression, verbal memory and verbal fluency measures. Patients and controls were widely comparable on tests assessing neuropsychological functioning. In the conditional-associative learning (CAL)-task only anorectic and OCD-patients displayed an impaired performance with neutral material but not with individually threatening material. Such a deficit was not evident in bulimics or in normal controls. These findings support the assumptions from functional neuroimaging investigations in AN and OCD and provide evidence that obsessive and compulsive behavior could have its origin within common neurobiological dysfunctions. The CAL possibly serves as a functional correlate of a neurophysiological dysfunction in obsessive-compulsive spectrum disorders.

Adolescent↗
PubMed2001

The hypothalamic-pituitary-thyroid axis in agoraphobia, panic disorder, major depression and normal controls.

BACKGROUND: Much interest has been drawn to the investigation of the hypothalamic-pituitary-thyroid (HPT)-axis in patients suffering from depression or panic disorder. However, there is no data concerning agoraphobia. METHODS: Patients with panic disorder, agoraphobia, major depression were compared to normal controls (total n=88) in respect to HPT axis, obtaining basal TSH and administering a TRH test. RESULTS: Normal controls and agoraphobics showed significantly higher Delta(max) TSH than depressives and panic patients. There were no differences between agoraphobics and normal controls. CONCLUSIONS: Agoraphobia, unlike depression or panic disorder, seems to be less biologically determined in respect to the HPT-axis.

Adult↗
PubMed1996

Effect of fluvoxamine on total serum cholesterol levels during weight reduction.

BACKGROUND: The effect of fluvoxamine versus placebo on serum cholesterol levels in obese women undergoing behavior therapy for weight reduction was evaluated. METHOD: Forty obese female outpatients undergoing 13 weeks of a behaviorally oriented treatment program for weight reduction were randomly assigned to double-blind treatment with fluvoxamine 100 mg/day (N = 18) or placebo (N = 22). Total serum cholesterol levels were measured before and after the 13-week study period. RESULTS: Patients of the two treatment groups did not differ in age, weight, body mass index, cholesterol levels before treatment, and the extent of weight reduction during treatment. Cholesterol levels were significantly lower after fluvoxamine treatment than before, whereas cholesterol levels remained unaltered after placebo administration. Patients with initially high total cholesterol levels (> or = 200 mg/dL) showed a significantly larger reduction than patients with desirable cholesterol levels. However, there was no interaction between treatment and initial cholesterol level. CONCLUSION: The results might suggest a cholesterol-lowering effect of fluvoxamine.

Adult↗
PubMed1994

Alexithymia and somatization: relationship to DSM-III-R diagnoses.

In previous studies, results from psychometric measures suggested an association between alexithymia and somatization. However, alexithymia has not been examined in relation to somatoform disorders and other standard psychiatric diagnoses. In the present study, the prevalence of DSM-III-R diagnoses was determined by SCID interviews among 45 psychiatric inpatients with functional somatic syndromes. In addition, the Toronto Alexithymia Scale (TAS) and the SCL-90-R were administered. Of the sample, 42.2% scored in the alexithymic range of the TAS. The alexithymic patients presented significantly more psychological turmoil and overall psychopathology on the SCL-90-R, as well as a significantly higher number of current DSM-III-R diagnoses. However, alexithymia was unrelated to DSM-III-R somatoform disorders and other DSM-III-R diagnoses, as well as the course of illness. These results suggest that assessing clinical features in addition to psychometric measures seems to be necessary for further validating the potential role of the alexithymia construct in somatic symptom formation.

Adolescent↗
PubMed1991

Anxiety induced by cardiac perceptions in patients with panic attacks: a field study.

In panic disorder bodily sensations appear to play an important role as a trigger for anxiety. In our psychophysiological model of panic attacks we postulate the following vicious circle: individuals with panic attacks perceive even quite small increases in heart rate and interpret these changes as being catastrophic. This elicits anxiety and a further increase in heart rate. To evaluate this model we conducted a field study of 28 subjects with panic attacks and 20 healthy controls. A 24 hr ambulatory ECG was recorded and the subjects were instructed to report any cardiac perceptions during this period and to rate the anxiety elicited by these perceptions. The incidence of cardiac perceptions was about the same in both groups, but only subjects with panic attacks reported anxiety associated with such perceptions. Analysis of the ECGs revealed that in both groups heart rate accelerations preceded cardiac perceptions. Following cardiac perceptions, the healthy controls showed a heart rate deceleration, whereas the subjects with panic attacks had a further acceleration. This heart rate increase after cardiac perceptions was positively related to the level of anxiety elicited by the perceptions. These results provide clear evidence in support of the vicious circle model of panic attacks.

Adult↗
PubMed1991

[Cardiovascular factors of cardiac phobia--a field study].

The interaction between psychological and physiological factors was studied with a field approach in 28 patients with cardiac phobia and 20 healthy controls. A 24-hour ambulatory ECG was recorded, and the subjects were instructed to report their activities and any cardiac perception during this period. Additionally, psychological tests assessing well-being (Bf-S), bodily complaints (B-L), and state and trait anxiety (Stai-S and Stai-T) were administered. The groups did not differ in the mean cardiovascular parameters, however patients with cardiac phobia and healthy controls showed clear differences in the strength and direction of correlations between psychological and physiological variables. The incidence of cardiac perceptions was about the same in both groups, but only patients with cardiac phobia attributed the perceptions to an internal stimulus and associated the perceptions with anxiety. Depending on the anxiety elicited by the cardiac perceptions, the patients with cardiac phobia showed heart rate accelerations, which did not occur in healthy controls. This study confirms a psychosomatic process between psychological and physiological variables, which seems to be able to explain the development and maintenance of cardiac phobia.

Adult↗
PubMed1990

Prognosis of cardiac phobia.

The 36 inpatients who entered this prospective study were admitted to hospital because of cardiac phobia. Their treatment consisted of a behavior therapy program. Twenty-nine of them could be reexamined after 2 1/2 years: 41% were free of symptoms during more than 75% of the follow-up period; 59% suffered recurrences of their anxiety. One patient had committed suicide. A lower educational level, being single, and interpersonal difficulties and conflicts were the sociodemographic factors associated with a poor prognosis; a long pretreatment period of illness and the presence of depression or agoraphobia on admission were significantly more frequently correlated with an unfavorable outcome. The onset sequence of depression, agoraphobia and anxiety attacks was also of prognostic relevance.

Behavior Therapy↗
PubMed1990

[Psychosocial and clinical predictors of the disease course in patients with cardiac phobia and panic attacks].

Patients suffering from cardiac phobia or neurocirculatory asthenia (also known as cardiac neurosis or effort syndrome) represent a uniform disease group due to the typicality of the signs and symptoms and of the course of the disease; this group should be distinguished from the broad spectrum of cardiovascular disorders. There is close agreement with panic disorder according to DSM III, one of the reasons being that cardiac phobia was originally the model pattern for defining that disorder. In the present prospective study the significance of psychosocial and clinical factors for the prediction of the further course of the disease was studied in 36 patients with cardiac phobia treated on an inpatient basis for the first time, 29 of whom could be followed up by a checkup 2 1/2 years later. The duration of the disease before treatment, as well as difficulties in various social spheres, especially in partnership problems, were found to be variables exercising a particularly strong influence on the course of illness. The variables concerning the marital status and school education were also found to be statistically relevant predictors. Familial stress and the appeal-for-help behaviour of these patients were also recorded. The results of the study point to the importance of psychosocial factors as major coursemodifying factors and underline the need to pay particular attention to this part of the treatment.

Anxiety Disorders↗
PubMed1990

[Panic attacks and panic syndrome--diagnosis and therapy].

Paroxysmal states of anxiety that cannot be traced back to somatic causes have been called panic attacks since the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM III) of the American Psychiatric Association. This term has since been accepted as part of psychiatric everyday language in many countries. The present review discusses initially the diagnostic and differential diagnostic aspects against the background of nosological classifications as practised to date, with particular emphasis on the requirements of the practising psychiatrist. The authors of this review hold the opinion that whereas the phenomenon of panic attack is a valid concept, the conceptualisation of a panic disorder is still largely hypothetical. The often observed "natural history"--after panic attacks, anticipatory anxiety, coupling of attacks to certain situations, avoidance of these situations, as well as agoraphobia, depressivity, self-medication with tranquilisers and alcohol, hypochondriacal fears with increased consultation of doctors, and family conflicts may develop--requires early therapeutic intervention. Hence, the second part of this article presents the pharmacological and psychotherapeutical treatment methods for panic attacks and their complications as developed and successfully tried out during the past few years. The efficacy has been proven of drug therapy on the one hand of prophylactic treatment using tricyclic antidepressives, MAO-inhibitors and alprazolam or clonazepam, and on the other hand also of a non-continuous attack-related treatment strategy. Of the more recent psychotherapeutic methods, relaxation methods and the cognitive treatment of panic attacks are discussed. This direct focus on panic attacks seems to be more promising than the conventional treatment methods centered on secondary symptoms such as anticipatory anxiety or agoraphobia.

Anxiety Disorders↗
PubMed1990

[Depression and anxiety--a study for validating subtypes of depression].

Psychopathological analysis of the patterns of symptoms in 176 depressive in-patients disclosed in 73.3% of all patients the presence of anxiety symptoms: of these, 38.6% merely had diffuse anxiety, whereas 34.7% showed either additionally or alone specific anxiety symptoms such as phobias and panic attacks. Similar to the results obtained by dividing the patients into an "endogenous" and "neurotic" group, namely, that there was no difference between the subtypes in respect of triggering the depressive episodes by life events, or in respect of the suicide rate 30 months after discharge and in respect of a chronic course developing during the 2 years following the discharge, there was likewise no difference with regard to these criteria if the patients were subdivided into depressive patients without anxiety and those with anxiety symptoms. However, a subdivision of the depressive patients with anxiety symptoms into a group having only free-floating anxiety and a group with specific anxiety symptoms, resulted in a clear association with these criteria: If a phobia or panic attacks were present, triggering by life events was far more frequent than if there was only free-floating was more often chronic in the first group, but there was no difference in suicidality. The results indicate that it will be necessary to provide for a more differentiated classification of anxiety symptoms before deciding in clinical routine what steps to take wherever depression and anxiety symptoms are present side by side. The same applies to treatment studies.

Adjustment Disorders↗
PubMed1987

[Panic attacks and cardiac phobia].

In this study 36 patients with cardiac phobia were examined prior to hospitalisation and 29 of them were re-examined after 2.5 years. An analysis of the clinical pictures showed that all of the patients met the DSM III criteria for panic disorder. The follow-up results indicated that the anxiety attacks often recurred despite treatment; on the other hand, the patients felt significantly less threatened by the symptoms and consequently showed less help-seeking behaviour. The attack symptomatology was characterized by a uniform picture and thus played, at best, a limited role in predicting the course of the illness. According to DSM III cardiac phobia is listed under the somatoform disorders as hypochondriasis; this seems to be an unfortunate decision and ought to be revised.

Adolescent↗
PubMed1985

Emotional problems during weight reduction: advantages of a combined behavior therapy and antidepressive drug therapy for obesity.

Depressive symptoms may increase in a subgroup of obese individuals shortly after beginning a weight-reducing diet. Therefore an additional antidepressive medication should have a positive effect on the course and results of therapy. This hypothesis was tested in three different institutional settings, with identical therapeutic programs. In this study there were 23 obese women. Therapeutic strategies were concerned with an increase of self-control over eating behavior, the improvement of social skills, and the establishment of new problem-solving abilities. Doxepin was used as the anti-depressant in a double blind procedure. Our results seem to support the hypothesis of this study: depressive symptoms markedly increased soon after the beginning of weight-reduction; additional antidepressive medication helped to improve the symptoms and in the long term had a positive effect on the rate of weight loss.

Adult↗
PubMed1985

The influence of depression on the outcome of cardiac phobia (panic disorder).

In a prospectively constructed study 29 patients with cardiac phobia were examined prior to hospitalization and again after a follow-up period of 2.5 years. When first examined a high percentage (82.8%) of these patients showed a depression in addition to suffering from anxiety symptoms. The findings demonstrate that an additional affective disorder constitutes a prognostically unfavorable factor, particularly in the case of a 'secondary' depression. Compared with patients suffering from a 'primary' depression these patients more frequently exhibited a chronic course of the depression (at the 1% level of significance) and had a significantly smaller chance of being free of cardiophobic complaint (p = 0.002) at the last examination. An attempt to categorize cardiac phobia according to DSM-III revealed that the present classification does not provide a satisfactory solution. The frequent presence of a depression in these patients strongly indicates that a clarification of the controversial opinions which continue to exist with regard to a linkage between depressive disorders and anxiety disorders would need further research; in such studies it would seem preferable not to employ a hierarchic classification procedure, in view of the fact that all cross-sectional psychopathological symptoms should be taken into consideration. Our findings also point to the advisability of paying closer attention to course traits in studying this question.

Adult↗