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Biomedical subjects

I Heuser

Publications and source records attributed to I Heuser.

18 recordsLinked to original sources
PubMed1990

[Panic attacks and avoidance behavior].

In a crossectional investigation based on a group of 122 patients with panic attacks, compiled from a variety of hospitals and therapy institutions, 97 patients were found to be suffering from panic disorder as a relevant medical problem. The disease, however, is often identified in an unsatisfactory manner. Avoidance behaviour (extensive or limited) associated with a severe form of panic disorder, was evident in more than one-half of the group (60%). In these patients the incidence of panic attacks is higher, anxiety is more marked, and there are more often additional anxiety disorders (generalised anxiety, sociophobia). These results underline the importance of early recognition and specific treatment of panic disorder to prevent development of avoidance behaviour.

Adult↗
PubMed1989

Computed tomography in depression: association between ventricular size and psychopathology.

The relationship between psychopathology and brain alterations, measured by computed tomography (CT), was investigated in 44 depressed patients. Comparisons of ventricle-brain ratio (VBR) between "endogenous" vs. "nonendogenous" subgroups, classified by six distinct diagnostic systems, revealed no significant differences. The VBR and the width of the third ventricle correlated significantly with scores on the Brief Psychiatric Rating Scale, the Global Assessment Scale, the Bech-Rafaelsen Melancholia Scale, the Rating for Emotional Blunting, and the Scale for the Assessment of Negative Symptoms, but not with scores on the Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety. Item analyses of the Bech-Rafaelsen Melancholia Scale revealed that retardation-related items were most significantly correlated with ventricular size. The wider diameter of the third ventricle in psychotic patients was associated with higher scores on retardation in the psychotic subgroup, whereas the greater distances of both Sylvian fissures showed no relationship to psychomotor retardation. No significant correlations were found between CT values and anxiety, suicidal impulses, somatic complaints, and sleep disturbances.

Adult↗
PubMed1989

Diagnostic determinants of response to treatment with tricyclic antidepressants: a polydiagnostic approach.

In an attempt to find diagnostic predictors of treatment response, 45 inpatients with major depression in a randomized trial received amitriptyline or imipramine for 23 days after a washout period of 16 days. A polydiagnostic approach was applied to the classification of endogenous depression. Only a minority of diagnostic schedules for endogenous depression proved predictive of a more favorable course during antidepressant treatment: the criteria of D. F. Klein, the Newcastle Scale II, and the Vienna Research Criteria. The symptoms of nonreactivity of mood and diurnal variation were the only endogenous symptoms with predictive ability. In addition, psychotic features and secondary depression predicted an unfavorable course, whereas characteristics of previous course (bipolarity, recurrence) were not predictive.

Adult↗
PubMed1989

Human CRH stimulation response during acute withdrawal and after medium-term abstention from alcohol abuse.

We compared the baseline cortisol secretory pattern and ACTH and cortisol responses to hCRH (100 micrograms) in eight patients acutely withdrawn from ethanol and 12 patients who abstained from ethanol for two to six weeks. Acute withdrawal from ethanol was characterized by elevated baseline cortisol and blunted ACTH release after hCRH, while medium-term abstention was associated with normalized cortisol secretion but persistence of decreased ACTH output following stimulation. These findings support an altered corticotrophic CRH receptor function in detoxified sober alcoholics. The pathophysiology underlying the blunted ACTH response to hCRH in medium-term ethanol abstention appears to be different from that in acute alcohol withdrawal and hypercortisolemic depression.

Adrenocorticotropic Hormone↗
PubMed1988

Response of ACTH and cortisol to human corticotropin-releasing hormone after short-term abstention from alcohol abuse.

The authors administered 100 micrograms human corticotropin-releasing hormone (h-CRH) to alcohol-dependent subjects after short-term abstention from alcohol abuse and observed that these patients released significantly less adrenocorticotrophic hormone (ACTH) than a control group. Cortisol responses were also blunted, but this effect was less pronounced. These findings indicate that hypercortisolism in alcohol withdrawal is driven by a central neurotransmitter/receptor disturbance rather than by peripheral alterations.

Adrenocorticotropic Hormone↗
PubMed1988

Improving depression severity assessment--I. Reliability, internal validity and sensitivity to change of three observer depression scales.

The Hamilton Depression Scale (HAMD) is the most commonly used scale for depression severity assessment and for antidepressant treatment evaluation. Alternative scales have been proposed by Bech and Rafaelsen (BRMS) and by Montgomery and Asberg (MADRS) to try to overcome the shortcomings of HAMD: they are based on different concepts of severity and different scaling procedures. Comparisons with respect to reliability, validity and ability to detect change have been performed using these scales in different samples. The BRMS proved superior. This result makes it necessary to question the usual procedure of testing the efficacy of antidepressants by means of HAMD alone. Problems in defining the severity of depression and in testing the validity of severity scales are discussed.

Adult↗
PubMed1988

Improving depression severity assessment--II. Content, concurrent and external validity of three observer depression scales.

The Hamilton Depression Scale (HAMD), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Bech-Rafaelsen Melancholia Scale (BRMS) were compared with respect to content, concurrent and external validity in sample of 130 patients with a major depressive episode. The three scales did equally well in concurrent and external validity. The HAMD showed some deficiencies in content validity. The consequences for depression severity assessment are discussed.

Adult↗
PubMed1987

Stupor and affective state: alleviation of psychomotor disturbances by lorazepam and recurrence of symptoms after Ro 15-1788.

In a single patient suffering from a major depressive episode with melancholia (DSM-III), both severe psychomotor symptoms, such as stupor and mutism, and mood disturbances could be abolished completely and promptly by administration of the benzodiazepine lorazepam. Remission of symptoms was entirely and immediately reversed by the benzodiazepine antagonist Ro 15-1788. These drug effects were constantly reproducible. Possible mechanisms of action and the influence of GABAergic neurotransmission on affective and psychomotor state are discussed.

Adult↗
PubMed1987

Stimulation response to corticotropin-releasing hormone (CRH) in patients with depression, alcoholism and panic disorder.

Alterations in baseline and challenged pituitary-adrenocortical function constitute the most extensively studied abnormalities in affective disorders. The recent availability of corticotropin-releasing hormone (CRH) for clinical studies opened the possibility to further investigate pathophysiology underlying aberrant ACTH and cortisol secretion. When injected to depressives CRH induces a blunted ACTH but normal cortisol release. Similar response patterns were observed among patients with panic disorder and alcoholism. In these diseases, enhanced baseline pituitary adrenocortical activity appears to be driven by a CNS disturbance resulting in overactive CRH secreting neurons. In addition to these endocrine findings we observed among normal controls suppressed nocturnal slow-wave sleep and growth hormone surges during infusions of CRH. Our clinical investigations with CRH support that this neuropeptide is involved in mediation of several neuroendocrine and behavioral changes frequently observed in depressive syndromes.

Adrenocorticotropic Hormone↗
PubMed1986

Subtypes of panic attacks and ICD-9 classification.

No single ICD-9 category corresponds to panic disorder (DSM-III). To investigate whether patients with panic attacks can be identified by means of ICD-9, 97 patients with three panic attacks within 3 weeks were recruited from various medical centers, and were classified independently according to DSM-III and ICD-9. The ICD-9 diagnoses were scattered over a broad range of categories, and it was impossible to identify patients with panic disorder in this manner. Anxiety state, affective psychosis, and depressive neurosis were the most frequent ICD-9 diagnoses. The boundary between affective psychosis on the one hand and anxiety state and depressive neurosis on the other hand was validated by present and previous symptomatology and by cluster analysis. The boundary between anxiety state and depressive neurosis could not be validated in this way. Correspondingly, modifications of the ICD-9 classifications are proposed.

Agoraphobia↗
PubMed1986

Dimensional assessment of endogenous depression based on a polydiagnostic approach.

A dimensional classification according to the decisiveness of the diagnosis of endogenous depression is proposed, based on a polydiagnostic approach using latent-trait models (Rasch model). The instrument is derived from a sample of 130 depressed patients, and a cross-validation of this instrument is reported in a sample of 87 patients with major depressive episode. The utility of this scale in biological research is discussed.

Depressive Disorder↗
PubMedDate not supplied

The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders.

The Hamilton Anxiety Scale (HAM-A) was tested for reliability and validity in two different samples, one sample (n = 97) defined by anxiety disorders, the other sample (n = 101) defined by depressive disorders. The reliability and the concurrent validity of the HAM-A and its subscales proved to be sufficient. Internal validity tested by latent structure analysis was insufficient. The major problems with the HAM-A are that (1) anxiolytic and antidepressant effects cannot be clearly distinguished; (2) the subscale of somatic anxiety is strongly related to somatic side effects. The applicability of the HAM-A in anxiolytic treatment studies is therefore limited. More specific anxiety scales are needed.

Agoraphobia↗