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Biomedical subjects

H J Grabe

Publications and source records attributed to H J Grabe.

At least 19 recordsLinked to original sources

Impulsiveness in obsessive-compulsive disorder: results from a family study.

OBJECTIVE: Although obsessive-compulsive disorder (OCD) is usually conceptualized as an anxiety disorder some studies suggested it to be a deficit of impulse control. The purpose of this study was to assess impulsiveness in OCD families and compare it to control families. METHOD: Seventy cases and their 139 relatives were compared with 70 controls and their 134 relatives from a German family study on OCD (German Epidemiologic Network for OCD Studies). All subjects were interviewed and diagnosed according DSM-IV criteria and were administered the Barratt Impulsiveness Scale (BIS) and PADUA-Inventory to assess obsessive-compulsive symptoms. RESULTS: OCD subjects had significantly higher scores of cognitive impulsiveness. However, first-degree relatives of OCD cases and of controls had comparable BIS-11 scores. Significant associations of aggressive obsessions and checking with cognitive impulsiveness were found. CONCLUSION: OCD is a severe mental disorder that is characterized by a lack of cognitive inhibition. However, impulsiveness does not represent a familial trait in families of OCD subjects.

Adult↗

Mental and physical distress is modulated by a polymorphism in the 5-HT transporter gene interacting with social stressors and chronic disease burden.

Previous studies have yielded conflicting results as to the putative role of the functional polymorphism of the promoter region of the serotonin transporter gene (SLC6A4) in the etiology of anxiety-related traits and depressive disorders. Recently, a significant gene-environment interaction was found between life stressors, the short allele of the SLC6A4 polymorphism and depression. The aim of the present study was to investigate if such a gene-environment interaction could be replicated within a different population with a different risk structure. A total of 1005 subjects from a general population sample (Study of Health in Pomerania) were genotyped. Mental and physical distress were assessed on 38 items of the modified complaint scale (BL-38). The interaction between the SLC6A4 genotype, social stressors and chronic diseases with regard to the BL-38 score was evaluated by ANOVA. There was no independent association of genotype with mental and physical distress. However, significant interactions between genotype, unemployment and chronic diseases (F = 6.6; df = 3, 671; P < 0.001) were found in females but not in males. The genotype explained 2% of the total variance of the BL-38 score and 9.1% of the explained variance. The results partly confirm previous findings of a significant gene-environment interaction of the short allele, indicating a higher mental vulnerability to social stressors and chronic diseases. The relevance of this finding is sustained by the fact that the sample characteristics and the risk structure were highly different from previous studies.

Adaptation, Physiological↗

Mental and physical complaints in thyroid disorders in the general population.

OBJECTIVE: To test the hypothesis that untreated overt and subclinical thyroid disorders and autoimmune thyroiditis (AIT) are associated with mental and physical complaints in the general population. METHOD: A total of 3790 participants from the Study of Health in Pomerania (SHIP) with no known thyroid disorders were analyzed concerning their thyroid function (TSH, FT3, FT4), autoantibodies (TPO-Ab), their thyroid structure and size and their mental and physical complaints (Zerssen Complaint Scale). RESULTS: Overt hyperthyroidism (prevalence: 0.4%) was associated with a significantly lower total complaint-score than euthyroid subjects. Subjects with overt hypothyroidism (0.5%), subclinical hypothyroidism (0.7%), or subclinical hyperthyroidism (1.6%) were not different from controls in their total complaints. Females with AIT showed higher scores of tachycardia and anxiety independent from their thyroid function. CONCLUSION: In non-patient samples, hyperthyroidism is associated with positive effects on self-rated mental and physical health. AIT may be associated with negative effects on health also in euthyroid subjects.

Adult↗

Relation between psychological strain and carotid atherosclerosis in a general population.

OBJECTIVE: To investigate the hypothesis that psychological strain is related to carotid atherosclerosis in a large general population sample. METHODS: Intima-media thickness and the prevalence of atherosclerotic plaques in the carotid arteries were quantitatively assessed by high resolution ultrasound among 2164 participants (1112 women and 1052 men, aged 45 to 75 years) of the SHIP (study of health in Pomerania), an epidemiological survey of a random sample of the population of north eastern Germany. Psychological strain was measured by 13 items reflecting typical psychological complaints. Each item was graded by the study participants on a four point scale (from 0, absent, to 3, severe) and a psychological strain score was generated by summing these 13 items. RESULTS: Mean psychological strain score was 10.8 (7.0) (median score 10) among women and 8.5 (6.2) (median score 8) among men. Psychological strain did not predict carotid intima-media thickness among either men or women. However, after adjustment for covariates, high psychological strain and carotid plaques were independently and linearly related, with plaque prevalence odds of 1.03 (95% confidence interval (CI) 1.01 to 1.05, p = 0.009) per increment of the psychological strain score among women and 1.04 (95% CI 1.01 to 1.07, p = 0.003) among men. CONCLUSIONS: This study identified a relation between general psychological strain and carotid atherosclerosis.

Aged↗

[Interhemispheric transfer and its implications for neurology and psychiatry].

The corpus callosum (CC) is the brain's most important connection between cortical areas of both hemispheres. Due to the hemispheric lateralisation of brain function, information transfer between both hemispheres is vital for an optimal performance in tasks, in which several psycho-motor functions have to be integrated. Dysfunction of the CC can lead to deficits in neuropsychological tasks and could contribute to pathologies underlying psychiatric illnesses. In this review the normal and abnormal development of the CC as well as its macro- and microscopic anatomy will be outlined. Then the detrimental effects of operative callosomy on different modalities, e. g. on vision, the somatosensory and the auditory system, will be discussed. Two electrophysiological methods will be introduced, with which interhemispheric communication can be studied: hemispheric transfer in rapid visuo-motoric tasks (CUD) and transcallosal inhibition (TI), a phenomenon which occurs in a special paradigm of transcranial magnetic stimulation. A first study found TI to be reduced in unmedicated schizophrenic patients. This suggests that an inhibition between motor cortices could be reduced in schizophrenic patients. Further results of other studies, which have analysed the CC and interhemispheric transfer in schizophrenic patients, will be introduced and discussed. In future experiments, the contribution of dysfunctions of transcallosal transfer to psychopathological symptoms and neuropsychological deficits in schizophrenia should be studied.

Animals↗

[The "AMDP-rating scale for obsessive-compulsive symptoms": The 2nd version].

The "Association of Methodology and Documentation in Psychiatry" (AMDP) has developed the 2nd version of a new observer-rated scale for a quick and precise assessment of obsessive-compulsive symptoms. The first version of the scale comprised 20 items on the dimensions "description", "distress and impairment" and "emotion and cognition". The item pool of the 2. version was enlarged to 44 items to accomplish a differentiated assessment of obsessions and compulsions and to assess the associated passive avoidance behaviour. The results of an empirical study (n = 141) demonstrated excellent internal consistency (Cronbach's alpha = 0,93), a split-half reliability of 0,83 (Spearman-Brown), a test-retest reliability of r = 0,84, a high interrater-reliability, a high differential validity and good convergent validity with the Hamburger Zwangsinventar (HZI) and the SCL-90-R. The results are presented and their implications on the final steps of the development of the scale will be discussed.

Adult↗

Lifetime-comorbidity of obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in Northern Germany.

OBJECTIVE: Inspite of the worldwide relevance of obsessive-compulsive disorder (OCD), there is a substantial lack of data on comorbidity in OCD and subclinical OCD in the general population. METHODS: German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18-64 years, living in a northern German region. RESULTS: In both genders, high rates of comorbid depressive disorders were found in OCD and subclinical OCD, whereas somatoform pain disorder was only associated with OCD. In female subjects, OCD was additionally associated with social and specific phobias, alcohol, nicotine and sedative dependence, PTSD and atypical eating disorder. CONCLUSION: Due to low comorbidity rates, subclinical OCD seems to represent an independent syndrome not restricted to the presence of other axis-I diagnoses. Comorbidity patterns show a disposition to anxiety and to depressive disorders in OCD and subclinical OCD. A broad association with obsessive-compulsive spectrum disorders could not be confirmed in our general population sample.

Adult↗

Neurotrophic factor S100 beta in major depression.

Disturbances in the serotonergic system are considered to be implicated in the pathophysiology of depressive disorders. The possible role of the neurotrophic factor S100 beta, which is suspected to regulate regeneration of serotonergic synapses, has not been investigated in depressive disorders. The S100 beta concentration in the cerebrospinal fluid was measured in 11 patients with the current diagnosis of mild or moderate depressive episodes (DSM-IV) and in 11 matched control patients. Using the t test for paired samples, the presence of a depressive episode was significantly associated with an elevation of the cerebrospinal fluid concentration of S100 beta (t = 2.6, d.f. = 10, p = 0.024). Replications of this finding in severely depressed patients are necessary to confirm the association between neurotrophic factor S100 beta and depressive disorders.

Adult↗

Prevalence, quality of life and psychosocial function in obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in northern Germany.

BACKGROUND: Despite the worldwide relevance of obsessive-compulsive disorder (OCD) there are considerable differences in prevalence rates and gender ratios between the studies and a substantial lack of prevalence data on subclinical OCD. Moreover, data on quality of life and on psychosocial function of subjects with OCD and subclinical OCD in the general population are missing to date. METHODS: German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18-64 years living in a northern German region. Specific DSM-IV based criteria for subclinical OCD were used. RESULTS: The life-time prevalence rates for OCD and subclinical OCD were 0.5% and 2%, respectively. Twelve month prevalence rates were 0.39% and 1.6%, respectively. The gender female:male ratio was 5.7 in OCD and 1.2 in subclinical OCD. In various measures of psychosocial function and quality of life, OCD and subclinical OCD were significantly impaired. However, subclinical OCD subjects did not visit mental health professionals more often than controls. CONCLUSION: Due to different epidemiological characteristics subclinical OCD might represent a syndrome distinct from OCD which is also associated with significant impairments in personal and interpersonal functions and in quality of life.

Adolescent↗

Symptoms of eating disorders in obsessive-compulsive disorder.

OBJECTIVE: Despite some empirical evidence suggesting an association between primary OCD and eating disorder (ED) within the 'obsessive-compulsive spectrum', the relationship at a symptomatological level has not been investigated. METHOD: First, comparisons of Eating Disorder Inventory (EDI) scores between 61 patients with primary OCD and 288 control subjects were performed. Secondly, the associations between EDI subscores and Hamburg Obsessive-Compulsive Inventory (HZI) dimensions in OCD patients were investigated by multiple regression analyses, controlling for the impact of general psychopathology. RESULTS: The OCD patients showed significantly higher EDI-scores than controls. However, only distinct OCD symptom dimensions were significantly associated with the core symptoms of ED in females. CONCLUSION: Our results point to a differential gender and symptom-specific relationship between OCD and ED, calling into question a simple dimensional conceptualization of the 'obsessive-compulsive spectrum'.

Adult↗

Dissociative experiences and psychopathology in conversion disorders.

The concepts of dissociation and conversion are historically linked with the first psychodynamic ideas on hysteria. However, the abolition of "hysterical neurosis" from current nosology has led to independent developments of these theoretical models. Recent studies found a high degree of somatization in dissociative disorders. However, little is known about dissociation in conversion disorders. We assessed 72 patients with conversion disorders for their dissociative and general psychopathology using the German version of the Dissociative Experience Scale (DES) and the Symptom Check List (SCL-90-R). They were compared with a control group of 96 psychiatric patients suffering from various neurotic disorders, who were matched for gender and age. Dissociative symptoms were significantly more frequent in conversion disorder patients than in controls. There were no differences in the SCL-90-R scores between the two groups. Our findings support the theory of similar psychological processes underlying conversion and dissociative disorders despite their descriptive differences.

Adult↗

The influence of clozapine and typical neuroleptics on information processing of the central nervous system under clinical conditions in schizophrenic disorders: implications for fitness to drive.

The present study investigates the psychomotor performance of schizophrenic inpatients receiving neuroleptic medication and comedication according to their clinical demands in regard to their fitness to drive. The hypothesis was tested that even under polydrug medication, the clozapine-treated patients (n = 10) would have a superior performance compared to the patients taking classical neuroleptics (n = 18). The data were collected by technical equipment (Act and React Testsystem) measuring reaction time, vigilance, visual perception and stress tolerance. The patients' driving ability turned out to be equally impaired in both treatment groups; 11% of the patients passed all tests without major impairment; 32% of the patients showed some impairments that required individual evaluation of their driving ability; 57% were considered to be severely impaired and driving could not be recommended. Except for one test, no significant group differences in psychomotor reaction performance were obtained. These results are discussed concerning limitations and consequences.

Adult↗

Relationship of dissociation to temperament and character in men and women.

OBJECTIVE: This study approaches the question of nature and nurture of dissociative phenomena. Within Cloninger's concept of personality, character traits are thought to develop in response to environmental stimuli and conditions during childhood and adolescence, whereas temperament traits are considered to be genetically predisposed. The hypothesis is tested that dissociative symptoms are associated with distinct character traits but not with temperament dimensions. METHOD: Psychiatric patients (N = 191) and healthy subjects (N = 41) were evaluated for dissociative symptoms (Dissociative Experience Scale), temperament and character (Temperament and Character Inventory), and current psychopathology (SCL-90-R). Regression analyses for women and men were calculated separately. RESULTS: For both genders, the character traits of self-transcendence and self-directedness were significant and independent predictors for dissociation. CONCLUSIONS: These results support the hypothesis that dissociative symptoms are caused by environmental factors and point against a genetic predisposition in the development of dissociative symptoms.

Adolescent↗

[Not Available].

This review summarizes from biological research in obsessive-compulsive disorder. In particular, functional brain imaging studies investigating the effects of Symptom provocation, of behavioral and pharmacological treatment on brain activity and findings from neurochemical studies are presented with regard to the serotonergic System. We discuss a neurobiological model integrating the findings from brain imaging, functional anatomy and behavioral concepts which favors a functional imbalance within the orbitofrontal - basal ganglia - thalamus ciruit and focus on hypothesis for further research.

Functional anatomy↗

[Not Available].

Though the use of elaborated and standardized behavioral therapy strategies has been successful in treatment evaluation and in areas of neurobiological research, numerous psychoanalytically orientated therapists will exhibit fear and avoidance behavior while facing terms like "standardization", "treatment evaluation studies" and "neurobiology". In our comment, we aim to initiate a successful therapeutic process by intensified reality testing and repeated exposure therapy.

Neurobiology↗

[Organization of telephone counseling for psychosocial emergencies. An evaluation after 12 months].

OBJECTIVE: To improve the community-based health care in the area of Bonn a telephone consulting service and a mobile crisis intervention service have been established during a two year pilot project. The regional needs and structural demands have been assessed. RESULTS: During the first 12 months the number of calls increased from 15 in November 1996 to 76 in October 1997. In all, 432 calls were received. Most calls lasted from 10 to 30 minutes. 89% of the callers were female, 77% were in the age range between 30 and 45 years. Two-thirds of the callers had prior psychiatric treatments. Most callers suffered from loneliness and deficient coping strategies. CONCLUSION: The prove regional demands have led to a continuation of the project and an extension of the mobile crisis intervention service.

Adult↗

[Development of the AMDP module for identification of obsessive- compulsive symptoms. Conceptualization and empirical results].

Results of epidemiology and comorbidity studies have recently demonstrated the psychopathological relevance of obsessive-compulsive symptoms. Therefore the "Arbeitsgemeinschaft für Methodik und Diagnostik in der Psychiatrie" (AMDP) has started to develop a rating scale for a quick and precise assessment of obsessive-compulsive symptoms. The actual version of the scale comprises 20 items on the dimensions "description", "distress and impairment" and "emotion and cognition". The results of a first empirical study (n = 137, psychiatric in- and outpatients) demonstrated excellent internal consistency (Cronbach's alpha = 0.92), a split-half reliability of 0.89 (Spearman-Brown), a test-retest reliability of r = 0.86 and good convergent validity with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Hamburger Zwangsinventar (HZI). The factor-analytical distribution of the 20 items revealed a 4-factor structure of the scale. The results are presented and their implications on further steps of the development of the scale are discussed.

Adult↗