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Biomedical subjects

H Kuhs

Publications and source records attributed to H Kuhs.

35 records · Page 2Linked to original sources
PubMed1990

[Phenomenologic findings in melancholia in relation to empirical studies].

This psychopathological study about the experience of anxiety in 160 melancholic and 93 neurotic depressive patients (diagnostic criteria acc. to ICD-9) aims at reconsidering earlier findings about the anthropological essence of melancholia. Anxiety seems to be especially appropriate to examine changes in time experience emphasized by phenomenological authors. Only 5% of the melancholic patients spontaneously report on alterations of the experience of time. Self reports point to a "basic disturbance of temporal development" (von Gebsattel) in melancholia. The temporal structure of the experience of anxiety however, more depends on the respective content of anxiety than on the patient group examined. On the contrary the natural matter of course in dealing with hitherto familiar affairs gets lost more often in melancholia than in non-melancholic states: Anxiety about all and everything and anxiety related to depersonalization prove to be characteristic of melancholia, even with regard to the severity of depression. The data confirm that beyond changes of time experience a "separateness from the essential conditions of natural experience" (Binswanger) comes to light in melancholia.

Adult↗
PubMed1988

Suspension of neuroleptic therapy in acute schizophrenia.

What are the effects of the abrupt discontinuation of neuroleptics (suspension therapy) in acutely schizophrenic patients with unsatisfactory remission under standard neuroleptic therapy? This question was investigated in a prospective study of 159 patients. In addition to the psychopathologic results of the AMDP system, the self rating (VAMS) and nurses' rating (NGI) of psychopathologic parameters were assessed. Indication for suspension of the neuroleptic treatment was established in 21 patients (13%) following definite criteria. Suspension therapy brings about a rapid improvement in psychopathologic results. The paranoid-hallucinatory syndrome also undergoes remission; this is to be understood as an immediate effect of suspension of therapy. In one-third of the cases complete suspension effects, in another third partial suspension effects, and in the remaining third failure occur. Further advantages of suspension therapy are the reduction in neuroleptic drug requirements and a favorable influence on the entire treatment course. The investigation does not permit any statement as regards prediction of the suspension effect or concerning the mechanism underlying the suspension therapy.

Acute Disease↗
PubMed1986

[Sleep deprivation (wakefulness therapy) as an antidepressant].

In this complete survey of publications concerning therapeutic sleep deprivation (including reports of a conference held in 1985) first the practical management and especially the advantages of sleep deprivation of the second half of the night are explained. After discussing the psychological conditions and methods of therapeutic evaluation the treatment results in endogenous depression (melancholia), the effectiveness of repetition and of combination with antidepressive pharmacotherapy, the comparison with electroconvulsive therapy and the predictors are described. Sleep deprivation is indicated in nearly every therapeutic situation, including drug-resistant melancholia, furthermore in severe neurotic depression and in depressive states of schizophrenic patients. Side effects are unimportant, and complications are almost absent. In addition psychophysiological, neuroendocrinological and biochemical investigations are reported, as far as they concern either the mechanism of action of sleep deprivation or chronobiological hypotheses of depression.

Antidepressive Agents↗
PubMed1985

[Dexamethasone suppression test in anorexia nervosa].

In patients suffering from anorexia nervosa (n = 20) a significant correlation was found between pathological DST results and weight loss. In this respect, patients with bulimic symptomatology do not differ from the main anorectic group. In addition, the correlation was unaltered by the length of the disease. These results are interpreted as indicative of secondary regulatory disturbances of the hypothalamic-hypophyseal-adrenal axis, whereas they are inconsistent with a close connection between anorexia nervosa and endogenous depression. As demonstrated by other authors, weight change exerts an influence on DST results in endogenous depression as well.

Adolescent↗
PubMed1985

Dexamethasone suppression test and sleep deprivation in endogenous depression.

The dexamethasone suppression test (DST) was carried out in 24 endogenously depressed and 15 non-endogenously depressed patients before and on the day after therapeutic sleep deprivation (SD) for one night. The diagnostic selectivity of DST results was not improved by combination with SD. The alteration of DST cortisol levels after SD, irrespective of the direction of change (so-called cortisol response) was significantly higher in endogenous depressives than in neurotic depressives. No unequivocal statement was possible on (a) the predictive value of DST data for the SD effect and (b) the relationship between neuroendocrine changes and the antidepressive effect of SD.

Bipolar Disorder↗
PubMed1982

Management of cardiac arrhythmias with tiapamil.

37 patients with either chronic atrial fibrillation (AF), atrial premature beats (APBs) or ventricular premature beats (VPBs) received tiapamil as antiarrhythmic treatment. Tiapamil reduced A-V conduction by an average 20% in the group with AF (10 patients), the magnitude of response being dependent on the initial ventricular rate. In 3 of the 7 patients with APBs, the frequency of ectopic beats was reduced following a single i.v. injection of 1 mg/kg tiapamil. In patients with VPBs (n = 20), tiapamil (i.v. injection of 1 mg/kg followed by 4-hour i.v. infusion of 50 micrograms/kg/min in 10 patients) reduced ectopic beats by 30-50% in 6 cases, these all being patients who had not responded to previous antiarrhythmic therapy. The antiarrhythmic effect was maintained by i.v. infusion of 50 micrograms/kg/min for 4 h. The antiarrhythmic effect of tiapamil consists essentially in slowing A-V conduction and reducing chronic VPBs.

Adult↗
PubMed1982

[Age dependence of increase in heart rate after vagolysis (author's transl)].

Age dependent decrease of heart rate in sinus rhythm at rest was shown under clinical and experimental conditions and correlated with a decrease of sympathetic storage granula and membranes indicated by the tissue concentrations of c-AMP, which can be regarded as a messenger at the receptor sites. A slower maximal heart rate after Atropine and a reduced increase during oral medication with Ipratropium bromide can be explained by a reduced cardiac sympathetic threshold. The mentioned age dependent differences of the sympathetic stimulation can not be deduced to myocardial changes, because CPK and CK-MB activities were similar in the different age groups.

Adult↗
PubMed1980

[Combination treatment of atrial arrhythmias with quinidine-verapamil].

Between 1977 and 1979, a combined antiarrhythmic therapy with Quinidine and Verapamil was used to treat 66 patients (aged 16 to 69 years) with chronic atrial arrhythmias of different etiology. In 60% of the 43 cases with atrial fibrillation the combined therapy was effective in reversing atrial fibrillation to regular sinus rhythm. The frequency of successful responses to Quinidine - Verapamil amounted to more than twice compared with earlier therapeutic results with Quinidine only. In 65% of the 23 cases with atrial extrasystoles or atrial tachycardias a significant reduction of the ectopics could be achieved or a regular sinus rhythm could be established. Thus, the combined therapy with Quinidine - Verapamil is very effective in abolishing chronic atrial arrhythmias, especially atrial fibrillation.

Adolescent↗
PubMedDate not supplied

Anxiety in depressive disorders.

In this psychopathological study, the subjective experience of anxiety was investigated in depressive patients by means of a semistructured interview. Both International Classification of Diseases-9 (ICD-9) diagnostic criteria (melancholia or neurotic depression; N = 160 or 93, respectively) and the DSM-III classification system (major depressive episode with or without "melancholia"; N = 63 or 153, respectively) were applied. Anxiety can be identified in virtually all patients examined. In contrast, the themes of anxiety are subject to substantial differences. There is a statistically significant correlation between the extent of anxiety and the severity of depression by the Hamilton Depression Scale (Ham-D). However, a distinction between anxiety and depression is possible in the majority of cases if the contents of anxiety are taken into account.

Adult↗
PubMedDate not supplied

Time experience in melancholia: a comparison between findings based on phenomenology and experimental psychology.

The different modes of time experience are based partly on the subjective and partly on the objective concept of time. Consequently, the phenomenon of time is accessible to both phenomenological analysis and experimental psychology. Based on disturbances in time experience in melancholic patients, this report illustrates the type of connection that exists between (qualitative) changes in the phenomenologically deducible "erlebnisimmanente" ego time or "erlebnistranseunte" universal time and (quantitative) experimental time estimation findings.

Attention↗
PubMedDate not supplied

Disturbances of vital feelings in depressive disorders.

The concept of "vital depression" as a disturbance of the vital feelings (K. Schneider) has recently been considered. While a vital-depressive syndrome is now widespread in currently valid classification systems, its contribution toward discrimination of depressive disorders and prediction of successful antidepressive pharmacotherapy is questionable. The psychological presuppositions of vital feelings are outlined with reference to Scheler's subdivision of emotional life into layers. Means of psychopathological access to the vital feelings are presented, based on the examples of "vital sadness" and "vital anxiety" in depressive disorders.

Antidepressive Agents↗
PubMedDate not supplied

The daily course of the symptomatology and the impaired time estimation in endogenous depression (melancholia).

The importance of 'typical' diurnal variations in mood (depression worse in the morning) as a diagnostic criterion of endogenous depression has been challenged in previous investigations. Disturbance in time experience may contribute towards an understanding of diurnal variation in depressive symptomatology. To examine this hypothesis a series of time estimation experiments was conducted in the course of the day. Twenty-five endogenous depressive patients (according to ICD-9) and 12 healthy controls were asked to estimate prospectively a 30-s interval on two successive days at 7.30 a.m., 11.30 a.m., 3.30 p.m. and 7.30 p.m. Simultaneously the subjects assessed their state of well-being using a visual analogue mood scale. A circadian rhythm of time estimation errors could not be detected; even in daily courses with 'typical' diurnal variations an increasingly favourable self-assessment of well-being was not accompanied by a corresponding diurnal fluctuation of time estimation. These results cast additional doubts on the significance of 'typical' diurnal variations in depressive symptomatology.

Adult↗