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Biomedical subjects

H Helmchen

Publications and source records attributed to H Helmchen.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Noninvasive tomographic measurement of regional cerebral blood flow].

The measurement of the regional cerebral bloodflow by means of the dynamic single-photon-emission-computed tomography is a method of examination which is completely free of risk for the patient, causes no inconvenience and can be repeated whenever it seems necessary. This method gives a quantitative explanation for the distribution of the effective cerebral perfusion and can only be substituted by the very complicated positron-emission-computed tomography. As well as the exact assessment of the hemodynamic relevance of cerebral vascular disease, this method enables us to prove whether or not in various types of psychiatric disorders an interference in the regional perfusion exists. This method can also contribute to the clarification of pathogenic mechanisms, as well as to the nosological classification of specific psychopathological conditions.

Adult↗
PubMed1984

Adverse drug reactions. An epidemiological study at psychiatric hospitals.

A drug monitoring system has been established at psychiatric university hospitals in Berlin, Goettingen, and Munich since 1979 in order to investigate adverse reactions to psychotropic drugs. This report describes the system and presents results obtained over 3 years. 504 randomly selected patients were observed by Intensive Drug Monitoring; 75% of them had an adverse drug reaction (ADR) during hospitalization that was assessed as possible, probable, or definite including all grades (I-III) of severity. 5,096 other patients were monitored by Organized Spontaneous Reporting during treatment with psychotropic drugs: ADRs were responsible for drug withdrawal (severity grade III) in about 10% of them. Parkinsonism, psychomotor disturbance, akathisia, delirium, oversedation and increased transaminases were the most frequent ADRs of this kind. The relative frequency of ADRs was calculated, and ADR-profiles established for drugs most frequently withdrawn. The impact of ADRs on ongoing therapy of patients was assessed. Reliable data obtained by drug monitoring systems can be expected to aid in therapeutic decisions in patients with special risks of side effects to psychotropic drugs.

Adult↗
PubMed1983

From AMP to AMDP.

Explore the source record for details and available documents.

Feeding and Eating Disorders↗
PubMed1981

Problems of informed consent for clinical trials in psychiatry.

The author begins by considering what kinds of questions should be used to establish informed consent, and particularly seeks to establish criteria for a valid consent; both for the person who asks the patient for consent, and for the person who judges the consent as a valid one. Then some variables--duration, severity and kind of illness, and type of personality--are considered that may influence consent. With regard to the discrepancy between the law and reality, it is proposed not to interpret the requirements of the law in a sense of all-or-none but as a demand that must be adapted adequately in content and in time to the individual patient and that they should be embedded in the therapeutic process that is an expression of the so-called "therapeutic privilege." Finally, it is asked, what are the consequences of information and consent on the results of therapy as well as of research? The necessity of empirically based research to answer these unsolved questions is emphasized.

Clinical Trials as Topic↗
PubMed1981

Serum DBH and platelet MAO in patients with depressive disorders.

Km and V of serum dopamine-beta-hydroxylase and platelet monoamine-oxidase (MAO) were determined in the depressive and manic state as well as after recovery in patients with affective psychoses and in the depressive state of patients with neurotic depression. DBH and MAO values were measured also in age- and sex-matched controls. The Km and V values of each enzyme failed to differ between patients and healthy controls or between patients during and after an episode of illness. The ratio of V of serum DBH (tyramine as substrate) tended to be lower in patients independent of their psychopathological state than in controls. The findings fail to support the notion that characteristics of the peripheral enzymes measured provides a reliable indicator of a biological disposition to depression, but are consistent with the notion that the balance of monoamine may play a role in certain psychopathological states.

Affective Disorders, Psychotic↗
PubMed1980

Multiaxial systems of classification. Types of axes.

Introductory remarks on the pros and cons of psychiatric diagnosis and classification lead to the conclusion that these are necessary tools for adequate and effective therapy, care and counselling of the psychically ill individual as well as for progress in research resulting in improvement of disease prevention or mental health care planning, etc. for all members of the community. The way to improve the tool of classification by multiaxial classification is illustrated by several existing systems and explanation of their underlying concepts. In discussing the various unsolved questions and difficulties one can conclude that multiaxial classification currently is at the very least a valuable tool of psychiatric education and training.

Computers↗
PubMed1980

Erythrocyte COMT-activity in patients with affective disorders.

COMT enzyme characteristics (Km, V, ratio of meta/paramethylation) were determined in the red blood cells of 20 patients with endogenous depression, in 20 healthy controls matched as to age and sex, as well as in 10 patients with mania, and 10 patients with neurotic depression. Assessment was done twice, i.e. before and after remission in patients with endogenous depression and in the manic patients. If male and female patients are considered together there was no statistical difference between the COMT characteristics of these patient groups, either before or after remission. Only the bipolar patients showed a higher COMT-activity (V) than their individually matched controls. If however, only the female patients are taken into consideration, COMT-activity of the patients with endogenous depression vs. controls is significantly increased by 60%. This difference can be demonstrated also after remission ("free interval") though statistical significance is reached only for the unipolar group. Further in vitro experiments indicate that antidepressant drugs do not possess a relevant influence on COMT-activity. Ranking the mean COMT-values leads to the following order: matched controls (< neurotic depression < unipolar depression < bipolar depression, which would be in good agreement with theoretical expectations based on the amine hypothesis of depression. Compared with normal male subjects COMT-activity of female controls is significantly lower. On the other hand, the female patients with endogenous depression show a significantly higher enzyme activity than the corresponding male patients.

Affective Symptoms↗
PubMed1980

[Drug monitoring in psychiatry (author's transl)].

The Study Group for Drug Surveillance in Psychiatry (AMUP) has been working since July 1978 as a task force group of the "Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie" (AGNP). A protocol was designed for the initiation of drug monitoring in psychiatric hospitals. With support of the Bundesgesundheitsamt, Berlin, the first part of this project was started as a practicability study in the psychiatric hospitals of the Universities of Berlin, Göttingen, and Munich and in the municipal hospital of Schleswig. The study includes 7650 in-patients. It is based on the following methods: intensive drug monitoring, organized spontaneous monitoring of adverse drug reactions and registration of drug applications. This drug monitoring system in psychiatry will be expanded to other psychiatric hospitals, and eventually to out-patient clinics as well as private practices within the next two years.

Costs and Cost Analysis↗
PubMed1979

Depression and monoamine oxidase.

1. The first part of the paper is devoted to a critical review on the possible relationships between depression and monoamine oxidase. 2. This study describes the results of an investigation of MAO-activity in depression, using new approaches and methodology. This methodology was developed because the literature data indicated that a) previous results are difficult to compare because of varying methods and diverse target populations used; b) previous methodological deficiencies do not allow to draw definite conclusions about the relationship between MAO-activity and depression. 3. The present investigation selected 35 psychiatric patients according to clearly defined diagnostic criteria (20 endogenous depressive, 10 neurotic depressive, and 5 manic patients) matched to 25 healthy control-subjects. 4. The Michaelis-constant (Km), the maximum reaction speed (Vmax), and the 50% enzyme inhibition by tranylcypromine (IC50) of platelet-MAO were determined during and after recovery from the depressive or manic episode using 3 substrates (tyramine, tryptamine, and phenylethylamine). 5. The present investigation, in contrast to conventional methodology, utilized three different substrates at different concentrations. Significant correlations were demonstrated for the Vmax-values of each of the three substrates, whereas the Km and the IC50 (tranylcypromine)-values varied for each substrate. 6. The results show that there were no differences between the characteristics of the platelet-MAO in depressive or manic patients and those of normal subjects. Furthermore, treatment with tricyclic antidepressants had no effect on MAO-activity. A previous investigation indicated that the MAO-properties in human brain tissue were similar to that in human platelets.

Adult↗
PubMed1979

[Psychiatric prognosis in epilepsies].

It was illustrated by examples how psychical disturbances of epileptics can be used as indicators a) for brain lesions which cause the epilepsy too, b) for epileptic activity of the brain itself, and c) for the consequences of epilepsies of long duration. Furthermore, how they can be used as predictors for the success of the epileptic during his life. This course-related arrangement of psychical disturbances which predict a negative prognosis corresponds with measures for prevention of the development of psychical disturbances, for therapeutic diminishing or removal of existing psychical disturbances, and for prophylaxis (or tertiary prevention resp.) of negative psychical consequences or relapses of epilepsy. These measures should improve the life-success of the epileptic patient.

Affective Symptoms↗