Biomedical subjects
Publications and source records attributed to H J Grabe.
We here report a case of obsessive-compulsive symptom exacerbation during cortisone therapy in an adult patient without organic brain disorder. Possible clinical and pathophysiological considerations are discussed.
Antidepressive medication may cause impairment of psychomotor functioning relevant to psychosocial adaptation and fitness to drive. This impairment seems to be less severe by activating antidepressants (SSRI, MAOI). In clinical settings, however, polypharmacological treatment of depressive disorders is frequent. This study evaluates the influence of antidepressants and common comedications on central nervous information processing concerning the ability to drive. Inpatients (n = 44) with major depression (ICD-10) were investigated under steady state plasma level condition. The data were recorded by the Act & React Testsystem ART-90 and analyzed according to medication, severity of illness and age. 88.6% of the patients failed to pass all the tests. With respect to different groups of antidepressants, no differences in psychomotor reaction performance were observed in polydrug treatment. The impact of these results on the patients' fitness to drive is discussed.
BACKGROUND: The study investigated the following hypotheses: (1) Alexithymia is significantly associated with dissociation. (2) Pathological versus nonpathological dissociation is associated with alexithymic traits. METHODS: Psychiatric in- and outpatients (n = 173) and nonclinical subjects (n = 38) were investigated with the Toronto Alexithymia Scale (TAS-20), the FDS (German version of Dissociation Experience Scale) and the Symptom Check List (SCL-90-R; GSI). Correlation analyses followed by MANOVA and logistic regression were performed. RESULTS: Significant correlations and partial correlations, controlling for GSI, were observed between dissociation and alexithymia. The MANOVA demonstrated significantly higher scores for the two TAS-20 dimensions 'difficulty identifying feelings' and 'difficulty expressing feelings' in the group with pathological dissociation. On the basis of the TAS-20 subscores, logistic regression analysis correctly classified 72.5% of the cases into the pathological and the nonpathological dissociation group. CONCLUSIONS: These results support our hypothesis that pathological traits of dissociation are highly associated with alexithymia. A model is discussed in which alexithymic characteristics may contribute to the development of pathological dissociation and stress-related disorders such as posttraumatic stress disorder.
Previous studies have described co-occurrence between obsessive-compulsive disorder (OCD) and dissociation. We intended to evaluate the phenomenological association between different obsessive-compulsive and dissociative symptoms more precisely. Seventy patients with OCD (DSM-IV) were evaluated with the Hamburg Obsessive-Compulsive Inventory (HZI) and the Dissociation Experience Scale. Correlation and discriminant analysis were performed. The dimensions 'Checking' and 'Symmetry and Ordering' were significantly related to dissociative symptomatology. A clear-cut lack of association was found in 'Washing and Cleaning', 'Counting and Touching' and 'Aggressive Impulses and Fantasies'. HZI dimensions significantly discriminated patients with high from patients with low dissociative symptomatology. Psychodynamic and therapeutical aspects of these findings are discussed.
OBJECTIVE: In our study we explored the associations between alexithymia (Toronto Alexithymia Scale 20, TAS-20) and the dimensions and subscales of Cloninger's theoretically based and empirically validated psychobiological model of personality to further clarify the relationship between alexithymia and personality traits. METHODS: Psychiatric in- and outpatients (n = 254) were investigated with the TAS-20, the Temperament and Character Inventory (TCI) and the Symptom Check List SCL-90-R to control for the severity of current psychopathology. Correlation and regression analyses were performed. RESULTS: The regression analysis identified the TCI dimensions low self-directedness (SD), low reward dependence (RD) and to a minor degree harm avoidance (HA) as independent predictors for alexithymia. At the level of subscales, interpersonal detachment (RD3), low resourcefulness (SD3), low responsibility and blaming (SD1) and shyness with strangers (HA3) were predictors for alexithymia. The degree of explained variance of the TAS-20 scores by the TCI dimensions and subscales ranged between 43 and 45% whereas the inclusion of the general severity index into the regression models accounted for an additional 5% of the variance. CONCLUSIONS: Alexithymia is best explained by a mixture across different dimensions and subscales within Cloninger's psychobiological model of personality. However, alexithymia is captured only partly by current concepts of personality, and additional contributing psychological and biological factors need to be identified to understand alexithymia more extensively.