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Biomedical subjects

H Hinterhuber

Publications and source records attributed to H Hinterhuber.

At least 37 records · Page 2Linked to original sources
PubMed2000

In-patient suicide in psychiatric hospitals.

OBJECTIVE: In-patient suicides continue to be a matter of concern in hospital psychiatry. In-patients at risk for suicide need to be identified. METHOD: In-patient suicides in two psychiatric hospitals were assessed over a time-span of 8 years. Cases were detected by comparing police suicide data with the hospitals' admission and discharge records. Further information was then gathered from patients' records. RESULTS: During the period under investigation 44 in-patients committed suicide, the majority of them being diagnosed with affective disorders (45.4%) or schizophrenia (27.3%). The most commonly used method was 'jumping in front of a vehicle' (34.1%); 79.5% were treated in an open ward at the time of their suicide, 15.9% in a locked unit. The majority of open ward suicides happened outside the hospital; 39.4% of patients had left the ward without giving notice. CONCLUSION: Additional cautionary measures are warranted especially for patients in open wards.

Adult↗
PubMed1999

Polypharmacy in psychiatric treatment. Patterns of psychotropic drug use in Austrian psychiatric clinics.

There are great variations in the way psychotropic drugs are prescribed. Most experts are in favour of psychopharmacological monotherapy, but little is known about the extent to which it is actually practised. A survey of the psychopharmacological medication of all patients under treatment was carried out in three Austrian psychiatric clinics of various types on two separate days. A psychiatric university clinic, the psychiatric department of a general hospital and a regional mental hospital were selected for the survey. It was established that only 8% to 22% of the patients underwent psycho-pharmacological monotherapy and that the patients received 2.2 to 3.3 psychotropics on average. Five to 22% of the patients received five or more psychotropic agents. The results are presented in more detail in relation to the diagnoses of schizophrenia and depression. The rare occurence of monotherapy might be due to unsound treatment regimens in some instances, but much more to a general trend in psychiatry fostering polydrug use.

Adult↗
PubMed1999

[Subjective quality of life of schizophrenic patients. Effect of treatment setting, psychopathology and extrapyramidal motor drug effects].

OBJECTIVE: In a cross-sectional study in 79 schizophrenic patients the quality of life (QOL) of a group of community-based patients under supervision of an outpatient unit (n = 47) and a group of long-stay patients in an inpatient rehabilitation centre in the same area (n = 32) was compared. METHODS: The patients' QOL was evaluated using the Lancashire Quality of Life Profile. Moreover psychopathology and extrapyramidal-motoric side-effects were assessed. RESULTS: Long-stay patients had a more distinct psychopathological symptomatology and more severe side-effects than community-based patients. After adjustment for psychopathology and side-effects, the subjective QOL of long-stay patients was significantly reduced in two out of eight life domains: housing and leisure activities. While psychopathology was negatively correlated with QOL, a subgroup with very marked psychopathology showed unexpectedly high QOL ratings. CONCLUSIONS: Results suggest that psychopathology is a stronger predictor of subjective QOL than side-effects and treatment setting. Patients with very distinct psychopathology probably use lower standards than others when evaluating their QOL which should be taken into consideration when analysing this type of data.

Adult↗
PubMed1999

[Long-term treatment of depressive illnesses].

Depressive and bipolar disorders are affective disorders of chronic nature characterized by the occurrence of depressive episodes with or without manic episodes. Pharmacologic treatment must not be stopped with remission, i.e. cessation of depressive symptoms. Relapse prevention must be carried on over 4-6 months, in many cases maintenance therapy has to be continued for years if not lifelong. Treatment strategies include antidepressants, lithium and anticonvulsants for all of which efficacy in long-term treatment of depression has been shown. In this phase of therapy information and motivation--besides periodical clinical and drug level checks--in order to establish compliance in patients remain important tasks of treating physicians.

Anticonvulsants↗
PubMed1998

Synaptic loss reflected by secretoneurin-like immunoreactivity in the human hippocampus in Alzheimer's disease.

Secretoneurin is a recently described peptide derived by endoproteolytic processing from secretogranin II, previously named chromogranin C. In this study, we have investigated the distribution of secretoneurin-like immunoreactivity in the human hippocampus in controls and in Alzheimer's disease patients, and compared the staining pattern to that of calretinin. Secretoneurin-like immunoreactivity is present throughout the hippocampal formation. At the border of the dentate molecular layer and the granule cell layer, a band of dense secretoneurin immunostaining appeared. In this part, as in the area of the CA2 sector, the high density of secretoneurin-immunoreactivity coincided with calretinin-like immunoreactivity. The mossy fibre system displayed a moderate density of secretoneurin-immunoreactivity. In the entorhinal cortex, a particularly high density of secretoneurin-immunoreactivity was observed. The density of secretoneurin-like immunoreactivity was significantly reduced in the innermost part of the molecular layer and in the outer molecular layer of the dentate gyrus in Alzheimer's disease. For calretinin-like immunoreactivity, a less pronounced decrease was found in the innermost part of the molecular layer. About 40-60% of neuritic plaques were secretoneurin-immunopositive. This study shows that secretoneurin is distinctly distributed in the human hippocampus and that significant changes of secretoneurin-like immunoreactivity occur in Alzheimer's disease, reflecting synaptic loss.

Aged↗
PubMed1998

[Epidemiology of schizophrenic disorders].

Epidemiological research has demonstrated that schizophrenic disorders disorders occur in all countries and in all cultures with a relatively comparable frequency and with the same symptomatics. Furthermore, it was also demonstrated that the incidence of this disorder has not increased in the past 180 years. The clinical epidemiological findings have activated various research approaches: The protective effect of estrogen appears to explain the later occurrence of schizophrenic disorders and their more favourable course in women. Other areas of applied epidemiology (comorbidity research, ecological and social epidemiology) and their effects on suicide prevention are also discussed. Thanks to improved knowledge of prevalence and incidence, of distribution and the various social and ecological factors in schizophrenic disorders epidemiological research has been able to demonstrate that it has acquired increasing significance for basic research.

Adolescent↗
PubMed1997

[Railroad suicides and attempted suicides in Austria 1990-1994. Extending the hypothesis mass media transmission of suicidal behavior].

Suicide on railways (either by being run over by or jumping in front of a train) is one of the "hardest' suicide methods. In Austria, 617 suicides or attempted suicides on railways were registered between 1990 and 1994. This amounts to 5.73% of all suicides committed in this period with women showing a higher percentage than men. In both men and women there was a predominance of younger age groups; the mean age was higher in women than in men (48.0 vs 40.4 years). There was a significant increase in suicides or attempted suicides on railways after a television report on the stress suffered by train drivers concerning possible suicides. Persuading the mass media to treat the subject of "suicide' with reserve and with greater caution, even when not presenting a distinct suicide model, may be of importance in general suicide prevention.

Adolescent↗
PubMed1997

General life satisfaction and domain-specific quality of life in chronic schizophrenic patients.

Subjective quality of life (QOL) has often been assessed through questionnaires or structured interviews focusing on the person's satisfaction with various life domains. In particular, most QOL instruments for psychiatric patients are based on this concept. We report on a study casting some doubts on the rationale of this approach. We investigated the QOL of 48 chronic schizophrenic outpatients with a long-term disease history (at least 20 years) using a German version of the Lancashire QOL Profile. The interrelations between general life satisfaction, satisfaction with specific life domains, psychological well-being and psychopathology were studied using correlation analysis and multiple linear regression. Of the life domains assessed, only two, namely social relations and health, contributed significantly to the patients' general life satisfaction, while the others (including work, leisure, family relations and housing) did not. The subscales on psychological well-being (self-esteem, affective state) as well as psychopathology were found to be more closely associated with general life satisfaction than almost all life domains considered. The findings are discussed with regard to the specific situation of the group of patients investigated. They give indications that the life domain approach to measuring QOL has its limitations, in particular when applied to patients having adapted to a very restricted everyday life.

Adult↗
PubMed1997

Spontaneous abortion and psychosomatics. A prospective study on the impact of psychological factors as a cause for recurrent spontaneous abortion.

A group of 36 patients who had had at least two consecutive spontaneous abortions and who desired to have children was subjected to a psychosomatic investigation before a biomedical diagnostic screening programme was started. A semi-structured interview regarding sociodemographic data, current relationship, social support, education, occupation and medical anamnesis was carried out. In addition, all women completed four standardized questionnaires on the topics of anxiety, somatization disorder, life satisfaction and depression. A control group of 36 women, matched for age and occupation, was subjected to the same psychosomatic investigation. The findings of the diagnostic screening programme showed that 16 women had abortions because of physical abnormality, and 15 women had no physically confirmed cause (in five women, the investigations were not completed). Following recurrent spontaneous abortion, 18 women had a successful pregnancy within 2 years, and 18 women were still childless. The comparison between patients and the control group revealed that patients with recurrent abortion were significantly more satisfied with their life quality regarding leisure time, financial situation and occupation. No significant differences were observed in any other variables. Patients who suffered spontaneous abortions due to a physical disorder showed partner relationship of longer duration, and more frequent miscarriages. Women with successful pregnancy within 2 years after recurrent miscarriage were significantly younger and had fewer physically related abortions compared with women who remained childless. In summary, psychological factors seem to be of subordinate importance as a cause for recurrent spontaneous abortion. Moreover, physical abnormalities in the reproductive system have a predominant impact on the prediction of a future successful pregnancy.

Abortion, Habitual↗
PubMed1996

Suicide in south Tyrol 1980-1992: influence of affiliation to different language groups.

National suicide rates differ widely throughout Europe. The reasons for this are still unclear. Besides differences in actual suicide figures, different assessment methods and certification strategies have been suggested. This study examines the ethnic influence on suicide rates of South Tyrol, an Italian province bordering on Austria. The region has historically been under the cultural influence of both countries, with its population composed of three ethnic groups: the German-, Italian- and Ladinian-language groups. The study shows a significant correlation between the male suicide rate and the proportion of the German-language group. The ethnic suicide rates of Italian- and German-speaking people in South Tyrol were found to approximate each other, in comparison with the national rates for Italy and Austria, as a possible result of cultural interaction.

Age Factors↗
PubMed1996

[Possibilities and goals of natural science psychiatry].

Psychiatry has become one of the most complex and most difficult, but perhaps also one of the most promising fields of investigation in modern medicine. Psychiatric research involves interdisciplinary cooperation, by which alone, multi-level investigations in all areas, ranging from studies in molecular biology to analyses of complex social interactions, can be carried out. Successful research calls for multilevel strategies and multi-level models. Psychiatric research aims at achieving two goals: first, prevention of psychiatric illnesses, their optimal treatment, as also improvement of the quality of life of patients constitute the therapeutic aim; the second target is to deepen our understanding of the biological and psychological processes of the underlying pathology and of those factors that serve to protect the patient from existing risk situations. Advances in neuropsychiatric research support the realistic assumption that we are on the brink of discovering the biological basis of various psychiatric illnesses and that in the near future we would also succeed in assessing the influence of environmental factors on their course.

Biological Psychiatry↗
PubMed1995

Distribution of secretoneurin-like immunoreactivity in comparison with that of substance P in the human spinal cord.

Secretoneurin (SN), a neuropeptide of 33 amino acids, was determined in comparison with substance P (SP) by immunocytochemistry in normal human spinal cord. The density of secretoneurin-like immunoreactivity (SN-IR) was high in the superficial dorsal horn and in the lateral column of autonomic arcs. The ventral horn displayed low to moderate density of SN-IR and prominently outlined motoneurons. The congruent distribution of SN and SP to the termination of primary afferents may indicate that SN is involved in modulation of pain.

Ganglia, Parasympathetic↗
PubMed1995

Tardive dyskinesia prevalence rates during a ten-year follow-up.

We followed up patients in the State Psychiatric Hospital Mauer-Ohling, Mauer-Ohling, Austria, who had been examined in 1982 to determine the prevalence of tardive dyskinesia (TD). Of the 861 patients examined in 1982, 270 were still in hospital 10 years later. Only these patients were included in our study. The SKAUB (Skala für abnorme unwillkürliche Bewegungen, i.e., The German version of the Abnormal Involuntary Movement Scale) was used to quantify the occurrence of TD. The prevalence rate of TD was 3.7% in 1982 and 12.7% in 1992. The 1992 prevalence rate in patients who had not shown TD symptoms in 1982 was 11.4%. The major risk factor for TD was advanced age.

Adult↗
PubMed1994

EEG alterations in patients treated with clozapine in relation to plasma levels.

It is well known that psychotropic drugs can induce EEG alterations. Dose dependence seems established; however, there are no data concerning the impact of plasma levels. The authors investigated the influence of clozapine plasma levels on the frequency of EEG alterations. Data from 29 inpatients (18 male, 11 female, 31.7 +/- 10.2 years) receiving clozapine in a dose range between 25 and 600 mg were collected prospectively. There was no psychotropic or anticholinergic comedication. All patients had normal EEGs before taking clozapine. Fifteen patients showed pathological changes (group 2) and 14 no changes (group 1). Discriminant analysis showed that EEG changes are dependent on plasma levels (P = 0.0009, plasma levels in group 1 mean 81.6 ng/ml, +/- SD 64.6, in group 2 235.7 ng/ml, +/- 169.8). A total of 72.4% of the patients were correctly classified as having either pathological EEG changes or none by this analysis. Variables such as dose, age, sex, weight and duration of treatment were not statistically relevant. It can therefore be suggested that clozapine plasma levels are a valid indicator for the appearance of electrophysiological reactions.

Adult↗
PubMed1994

Distribution of secretoneurin-like immunoreactivity in comparison with that of substance P in the human brain stem.

Secretoneurin is a peptide of 33 amino acids generated in the brain by proteolytic processing of secretogranin II which is a member of the chromogranin/secretogranin family. The distribution of this newly characterized peptide was investigated by immunocytochemistry in the human brain stem. The staining pattern of secretoneurin-like immunoreactivity was compared with that of substance P in adjacent sections. Secretoneurin-like immunoreactivity appeared mainly in dot- and fiber-like structures with densities varying from low to very high. Only a low number of secretoneurin-immunoreactive perikarya was found. Pericellular staining of both secretoneurin-immunopositive and immunonegative cells was frequently observed in the area of the central gray, in the reticular formation and in the solitary nuclear complex. The medial part of the substantia nigra pars reticulata, the nucleus interpeduncularis, the area of the central gray, the raphe complex and the inferior olive displayed a high density of secretoneurin-like immunoreactivity. Furthermore, a very prominent staining was found in the medial, dorsal and gelatinous subnuclei of the solitary tract and the dorsal motor nucleus of vagus. The substantia gelatinosa of the caudal trigeminal nucleus and spinal cord were also very strongly secretoneurin-immunopositive. The staining patterns of secretoneurin- and substance P-like immunoreactivities were to a certain extent overlapping in several areas. The highest degree of coincidence was found in the substantia gelatinosa. This study demonstrated that secretoneurin is distinctly distributed in the human brain stem. Its distributional pattern indicates a role particularly in the modulation of afferent pain transmission and in the regulation of autonomic functions.

Adult↗
PubMed1994

A multicenter double-blind trial of paroxetine versus amitriptyline in depressed inpatients.

The phenylpiperidine derivative paroxetine is a selective serotonin reuptake inhibitor. In a double-blind 6-week trial, paroxetine was compared with amitriptyline in hospitalized patients suffering from major depression (DSM-III). One hundred fifty-three patients were enrolled in the study in seven centers in Austria and Germany. Results showed similar efficacy of both drugs after 6 weeks. The differences between groups in Montgomery-Asberg Depression Rating Scale and Clinical Global Impression ratings did not reach statistical significance at any time. Side effects were distributed similarly but with a significantly higher incidence of anticholinergic effects in patients treated with amitriptyline (p < or = 0.001), whereas agitation and insomnia were registered more often in the paroxetine group. This study supports the antidepressive efficacy of paroxetine in a sample of severely depressed inpatients.

Adolescent↗