Search PubMed⌕ Search

Biomedical subjects

J Angst

Publications and source records attributed to J Angst.

At least 181 records · Page 10Linked to original sources
PubMed1978

The course of affective disorders. I. Change of diagnosis of monopolar, unipolar, and bipolar illness.

All patients suffering from affective psychoses (ICD 296) who were admitted to the Psychiatric University Clinic of Zurich between 1959 and 1963 were studied in a follow-up investigation until 1975. Of 254 affective psychoses, 95 were bipolar patients (37.4%) and 159 were monopolar (62.6%). The sample of bipolar patients was complemented with all patients who had been admitted in the period 1959--1963 because of manic or mixed manic-depressive syndromes. This paper describes the change of diagnosis in the two diagnostic groups. In 10% (N = 20) of monopolar depression cases there was a change of diagnosis to bipolar affective illness. An analysis shows that the diagnosis of patients with three or more depressive episodes (unipolar depressives) was especially prone to change. A mathematical correction of some diagnostic errors leads to the conclusion that the ratio of unipolar depression to bipolar illness may be about 1:1. A major source of diagnostic error lies in the change of affective to schizo-affective illness. Up to now, no clinical criterion exists that would exclude this error, which was found in 6% (n=12) of the monopolar but also in 7.5% (n = 3) of the bipolar index patients. It is recommended that studies of affective disorders should be based on truly representative samples of the illness, including patients with one or two episodes, and that the term 'unipolar depression' be used synonymously with the term 'monopolar depression,' originally created by Kleist (1947) and Leonhard (1957).

Affective Symptoms↗
PubMed1978

The course of affective disorders. II. Typology of bipolar manic-depressive illness.

A representative sample of 95 hospitalized bipolar manic-depressive patients was followed up from 1959 to 1975. The mean age of the group at the time of this study was 61 years. It was observed that female bipolar patients demonstrate depression much more frequently than mania, while male patients show a symmetric distribution of both manic and depressive syndromes. The longitudinal occurrence of syndromes remains more or less constant; for instance, individual patients do not tend to go into depression with increasing age. The study shows that even after three episodes 29% of all bipolar patients would still have been misdiagnosed as unipolar depression. An attempt is made to classify bipolar patients into three subtypes, 'preponderantly manic,' 'preponderantly depressed,' and a 'nuclear' type. Male patients belong mainly to the latter with an equal proportion of the first and third subtype. In contrast, female patients belong mainly to the depressed subtype. The findings are discussed assuming either a heterogeneity of bipolar disorders or a threshold model of affective disorders suggested by Gershon et al. (1976).

Adult↗
PubMed1978

[Interrater reliability of amp symptoms (author's transl)].

Two psychiatrists examined 48 patients (25 depressed and 23 schizophrenic). Each documented the symptoms on AMP sheets 3 (psychopathologic symptoms) and 4 (somatic signs, first column only). The study deals with 139 AMP symptoms. Seventy could be judged concerning symptom exists/does not exist. Of these 70 symptoms, 45 showed a good or moderate interrater reliability. Specific symptoms had a better reliability than nonspecific. Symptoms described by the patients had a better reliability than those judged by the doctor alone. The results indicate that expanded use of the AMP system in its present form is problematic. Work on a new version of the AMP system has already begun.

Anxiety↗
PubMed1978

Double-blind comparison of bromperidol and perphenazine.

Within the scope of a clinical double-blind study, effects and side effects of Bromperidol and Perphenazine were compared. Forty newly-hospitalized schizophrenic patients were included in the trial. Assessments were made on days 0, 2, 5, 10, 20, and 30. Data were documented by means of the AMP system, the EPRS scale of Simpson and Angus, and a Brief Ward Behaviour Rating Scale. Laboratory tests and ECGs were performed before and after treatment. Treatment was scheduled for 30 days and dosages were established depending on effects and side effects. We found a therapeutic effective mean daily dose of 6 mg for Bromperidol and 20 mg for Perphenazine. Both substances caused autonomic and extrapyramidal side effects and, in a few patients, temproary fatigue. The employed dosage caused no strong sedation. To sum up, Bromperidol and Perphenazine can be described as highly potent and well tolerated antipsychotic drugs. We observed stronger efficacy and earlier onset of action with Bromperidol. The superior effect of Bromperidol cannot be explained by a higher dosage as compared with Perphenazine, since both substances showed a similar severity of extrapyramidal side effects, and the dosage of both substances was established individually for each patient, depending on effects and side effects.

Adult↗
PubMed1977

[The epidemiology of drug, cigarette and alcohol consumption in young men].

In view of the recent rise in drug consumption, a 3-year longitudinal study of 19-year-old men was conducted to investigate development of consumption behavior. Consumption of cigarettes and alcohol was also considered. The aim was to obtain information about the development of consumption by 19-year-old men (increase, decrease, etc). The follow-up sample consisted of 841 men in the Canton of Zurich who had been selected from a complete survey of men born in 1952. They answered a questionnaire at the age of 19 and again three years later. The results show that drug, cigarette and alcohol show a different development of consumption in the ages between 19 and 22 years. The percentage of drug consumers had decreased from 23.3 percent to 14.8 percent. In approximately 4 percent there is a high risk of dependence in addition to absence of social integration. The percentage of cigarette smokers did not change (approximately 53 percent), but the number of cigarettes smoked per day increased. For alcohol there is a general increase in consumption. For all three substances, heavy consumption at the age of 19 increases the risk of heavy consumption at the age of 22.

Adult↗
PubMed1977

The treatment of depression with L-5-hydroxytryptophan versus imipramine. Results of two open and one double-blind study.

In the last few years several open studies supported the hypothesis that L-5-HTP may be an effective antidepressant. Because of the lack of a controlled double-blind trial we started our own investigations to confirm this hypothesis in L-5-HTP. In 1972 we performed two open dose finding trials with L-5-HTP in combination with Benzerazide. These open studies were followed by a double-blind trial comparing L-5-HTP in combination with Benzerazide to Imipramine in 30 patients. Assessments were carried out on day 0, 5, 10, 15 and 20. For data collection we used the Hamilton Rating Scale for Depression, the AMP-system, a Global Rating Scale of Severity of Depression and a Brief Rating Scale for the Behaviour on the ward. In this article we report only a part of the results, mainly on the findings with the AMP-system and the Hamilton Rating Scale for Depression. During our double-blind trial we could not find any significant difference in efficacy of L-5-HTP and Imipramine. The same was found in an open trial. Furthermore the L-5-HTP results showed no difference compared with the results of an Imipramine treatment in 40 patients in earlier double-blind studies. L-5-HTP and Imipramine caused different patterns of side effects. L-5-HTP caused mainly gastrointestinal side effects and Imipramine caused mainly dryness of the mouth and tremor. The gastrointestinal side effects caused by L-5-HTP seemed to be dose dependent.

5-Hydroxytryptophan↗
PubMed1977

[AMP system: longitudinal studies of psychopathologic and somatic symptoms. An empiric investigation of the problem of side effects (author's transl)].

The psychopathologic and somatic state of 681 psychiatric patients were investigated in longitudinal studies within the scope of different psychopharmacologic trials. Most psychologic symptoms occur less frequently, whereas somatic symptoms are found to increase, which suggests side effects from psychotropic drugs. The analyses show that the AMP-system can be reduced by 49 (possibly 45) symptoms, as initial findings and developments show that these symptoms are rare, and do not allow of differentiation between diagnostic groups.

Adenosine Monophosphate↗
PubMed1977

Open trial and double-blind clinical trial of the antidepressant Ro 8-1998 in comparison with imipramine.

Based on the results of an open trial with Ro 8-1998 (chemic name: N,N-dimethyl-3-(1-methyl-5H-dibenzo(a,d)cycloheptene-5-ylidene)-propylamine N-oxide hydrochloride) in 11 endogenous depressed outpatients a double-blind trial with imipramine was proposed. Therapeutic efficacy and side effects of Ro 8-1998 and imipramine were compared in a double-blind trial with 30 patients who were newly hospitalized. Most of them suffered from endogenous depression. On days 0, 5, 10, 15 and 20 the patients were examined and the symptoms were documented with the AMP system, the Hamilton scale for depression, a behaviour rating and the "global depression rating Zurich". Ro 8-1998 caused a decrease of systolic blood pressure, an increase of heart frequency and urea. Twelve out of 15 patients showed a decrease of white blood cells. In four patients the number of white blood cells dropped below 4,000. Statistical analyses proved both substances to be potent antidepressants. The therapeutic efficacy of Ro 8-1998 was at least equal to that of imipramine. Further trials with bigger groups of patients are necessary to show whether the trend towards a better antidepressant efficacy of Ro 8-1998 can be reproduced.

Adult↗
PubMed1977

Antipsychotic effects, side effects and effective dosis of the butyrophenone lenperone (AHR 2277).

Three open studies with Lenperone were performed. 50 hospitalized schizophrenic patients were treated 20-30 days with Lenperone. The therapeutic effective dose was 30-50 mg/day. The highest daily dosage was 90 mg. Patients were examined on fixed observation days and the findings were documented by means of the AMP system. AMP data were analyzed at symptom and syndrome level and compared using an analysis of covariance. In the described dosage Lenperone acted only little sedating, strong antipsychotic and caused only a few single extrapyramidal and little autonomic side effects. The dosage is limited because of the effect on heart and blood circulation. Lenperone caused a good improvement of depressive symptoms in the schizophrenic patients. Lenperone was well tolerated and slowed a rapid onset of its antipsychotic effect. It caused a steady improvement of productive schizophrenic symptoms. For better knowledge of the profile of the effects of Lenperone, a trial in depressive paranoid syndromes, for example schizoaffective psychoses, would be interesting; a double-blind trial in comparison to a well-known antipsychotic would be very useful.

Adult↗
PubMed1977

[Comparison of the effects of pipothiazine palmitate and fluphenazine decanoate. Results of a multicenter double-blind trial].

Fluphenazine decanoate and pipothiazine palmitate were compared concerning their effect and side-effects. 61 schizophrenic patients were treated up to 6 months in a multicenter double-blind trial. Assessments were made on day 0 and after 5, 10, 17 and 22 weeks of treatment using the AMP system. Pipothiazine palmitate was injected every 4th week and fluphenazine decanoate every 3rd week. The most often applied dosage was 100 mg pipothiazine palmitate and 25 or 37.5 mg fluphenazine decanoate. Data analysis of the AMP system at the symptom level showed the better antipsychotic effect of pipothiazine palmitate. A comparison between the two groups by means of analysis of covariance at the syndrome level showed no statistical significant differences between the effects of fluphenazine decanoate and pipothiazine palmitate.

Antipsychotic Agents↗
PubMed1976

[Clinical double-blind study with two different dosages of maprotiline (150 and 225 mg per day) (author's transl)].

Effects and side-effects of 150 mg and 225 mg maprotiline per day were compared by means of a double-blind trial in 20 depressed inpatients. The first 2 days patients received a high initial dosage of 300 mg per day. Patients were examined on days 0, 2, 5, 10, 15, 20, and 30. Symptoms were evaluated by the AMP system and the Hamilton scale for depressions. Laboratory examinations were carried out on days 0, 10, 20, and 30. Exanthemas developed in five patients, three of whom were on the higher dosage. Moreover, the lower dosage caused less fine hand tremor. Coinciding with the beginning of treatment a linear decrease of depressive symptoms was noted. This demonstrates the rapid onset of the antidepressant effect. Moreover, contrary to what has been stated for antidepressants generally, the onset of action was frequently noted well before 10-20 days of treatment. Some patients improved within a few days while others needed more time. The time lag until antidepressants influence depressive symptoms shows pronounced individual differences. No significant difference between the two dosages was found. The profiles show a better antidepressant effect for the higher dosage; however, because of a higher incidence of side-effects on the higher dosage of maprotiline, it cannot be recommended as routine. On the other hand, depressive inpatients should receive a daily dosage of at least 150 mg. Our findings suggest a dose-effect relationship for maprotiline.

Adult↗
PubMed1976

[Development of drug, alcohol and tobacco consumption. Comparison between 2 studies from 1971 and 1974 in the canton Zurich].

Consumption of drugs, alcohol and tobacco has been compared in two populations of 19-year-old men, of 1971 (2785) and 1974 (1617), drawn from three different geographical regions of the Canton of Zurich. The hypothesis that the percentage of drug users has risen over the last three years was not confirmed: as previously, 25% have had experience of drugs. As expected, however, there was more regular and heavy drug users in 1974 than in 1971. Also, there is a more marked trend towards extension of drug consumption to rural areas than in 1971. The percentage of cigarette smokers has remained stable, but per capita cigarette consumption has increased. Contrary to expectation, alcohol consumption showed the sharpest rise in all three regions. The study suggests that drug consumption is not to be considered in isolation but in conjunction with the use of alcohol and tobacco.

Adolescent↗