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Biomedical subjects

J Angst

Publications and source records attributed to J Angst.

At least 127 records · Page 7Linked to original sources
PubMed1985

The Zurich Study. VI. A continuum from depression to anxiety disorders?

A representative sample of 456 persons from the normal population aged 22 and 23 years was used to study the overlap of depression with anxiety disorders. The 1-year prevalence rate for major depression (DSM-III), minor depression, and anxiety disorder together was 16.4%. The observed cases of major depression occurred in 36% with anxiety disorder, the cases with minor depression in 60%. On the level of symptoms assessed by a semistructured clinical interview and on the level of self-assessed items of the symptom check list SCL-90, the overlap was even greater. The main finding was that subjects with both diagnoses, depression and anxiety disorder, were more severely affected in general. Discriminant analyses of the SCL-90 scales together with the qualitative distribution of SCL items characterizing depression, anxiety, or phobia, did not disprove the hypothesis of a continuum.

Adult↗
PubMed1985

A family study of psychotic symptomatology in schizophrenia, schizoaffective disorder, unipolar depression, and bipolar disorder.

An evaluation was made of schizophrenics (140), schizoaffectives (40), unipolar depressives (59), and bipolars (30), and their relatives who had a chart diagnosis of psychosis or depressive neurosis. The purpose was to determine whether the psychosis (delusions and hallucinations) was transmitted independently of the illness itself. If this were true, there would be an excess of pairs of probands and relatives both positive for psychosis and pairs of relatives and probands both negative for psychosis when compared to relatives and probands who were not concordant for the variable. This was found to be true in schizophrenia and schizoaffective disorder and is probably the result of the simple transmission of an illness which includes the presence of psychotic symptoms in the definition. Thus, this would be a manifestation of the genetic propensity in schizophrenia. For the affective disorders there was no evidence that psychotic probands were more likely than the nonpsychotic to have psychotic relatives. So far the reason why some patients have psychosis and others not in the affective disorders remains unexplained.

Bipolar Disorder↗
PubMed1985

The diagnostic value in assessing mood congruence in delusions and hallucinations and their relationship to the affective state.

An examination was carried out on 140 schizophrenics, 34 schizoaffective manics, 6 schizoaffective depressives, 59 unipolars, and 30 bipolars to determine the variables of affective states and mood-congruent and mood-incongruent psychotic symptoms. These patients had been admitted to a hospital in Zürich and were systematically diagnosed, using both clinical and computer-derived systems. Forty-eight patients (18%) had both mood-congruent and incongruent psychotic symptoms. However, the affective disorders usually showed mood-congruent symptoms and the schizophrenics the mood-incongruent types. The schizoaffectives were likely to show both types. There was a marked dissociation between affective states and mood congruence in the schizophrenics. Though the majority of these patients showed depressive syndromes, they were quite unlikely to have mood-congruent symptoms. Likewise, 25% of the schizophrenics had manic-like syndromes, which contrasted with the fact that they rarely had mood-congruent psychotic delusions and hallucinations.

Adult↗
PubMed1985

Stability of psychotic symptomatology (delusions, hallucinations), affective syndromes, and schizophrenic symptoms (thought disorder, incongruent affect) over episodes in remitting psychoses.

A study was made on 140 schizophrenics, 40 schizoaffectives, 59 unipolar depressives, and 30 bipolar affective disorder patients in order to determine the quality of psychopathology over multiple episodes. The schizoaffectives were the most likely to have multiple episodes. Among the schizophrenics, there were few episodes that lacked psychotic symptoms, but almost half of the episodes for the schizoaffectives were associated with an absence of psychotic symptoms. Three-quarters of the patients with unipolar depression and bipolar illness showed no psychotic symptoms either congruent or noncongruent. There was a striking finding that all diagnoses were associated with a decrease in psychotic symptoms over time. These psychotic symptoms (delusions and hallucinations) became particularly more scarce among the schizoaffectives, unipolars, and bipolars. There was a 50% to 67% decrease of episodes with psychotic symptoms as more episodes occurred. For schizophrenia and schizoaffective disorder the first ten episodes were very similar to each other for affective syndromes, formal thought disorder and/or incongruent affect, and delusions and hallucinations. It was not until much time had passed that the symptom pictures changed.

Adult↗
PubMed1985

Social disability in schizophrenia: the controlled prospective Burghölzli study. I. Case-finding, research design, and characteristics of samples.

The Psychiatric University Hospital Zürich (Burghölzli') is taking part in the 'WHO Collaborative Study on the Assessment and Reduction of Psychiatric Disability'. This multicenter project aims to assess the development of social disability for schizophrenic psychoses of relatively recent onset. This paper provides a brief review of underlying concepts, the prospective procedure, and the screening criteria applying to all centers. The research team at 'Burghölzli' has greatly extended the general design. Apart from the "obligatory" assessment of 69 first admitted schizophrenics (initial assessment on first hospitalization or outpatient treatment and follow-ups after 1, 2, and 5 years) we have also interviewed a control sample of 60 healthy persons (including a 2-year follow-up) and an 'extreme' sample of 46 chronic schizophrenic outpatients legally entitled to disability pension. Moreover, we have used several supplementary assessment instruments. This paper is to discuss the purpose of our extended research design. All cohorts are described with respect to screening criteria, sampling procedure, and some basic characteristics; furthermore, a review is given of the additional assessment instruments. It is intended to provide basic information for subsequent papers dealing with results from the study.

Adult↗
PubMed1985

Social disability in schizophrenia: the controlled prospective Burghölzli study II. Premorbid living situation and social adjustment--comparison with a normal control sample.

The assessment of premorbid adjustment in schizophrenia has gained increasing interest in psychiatric research. Numerous studies have provided evidence on the predictive power of premorbid adjustment in the course and outcome of schizophrenic psychoses, but only little systematic research has been done on this topic comparing schizophrenics and healthy persons. In this study we have analyzed the premorbid life situation and social adjustment of 69 first onset schizophrenics in contrast to 60 healthy subjects. The comparisons between these samples showed significant differences for nearly all areas assessed, indicating a premorbid disablement of the schizophrenics both for quantitative and qualitative aspects of social functioning. Compared to that of healthy people, the size of the schizophrenics' social network is markedly reduced and often characterized by a strong link to their family of origin. In general, the schizophrenics fail to establish close relationships or engage in social contact. Moreover, they tend to withdraw from existing relationships, especially heterosexual ones. Even when the schizophrenics appear quite normal on formal criteria (such as partnership or employment situation), further analyses often reveal problems, e.g., conflicts at work or reticence with partners. The results of this study clearly demonstrate the necessity of assessing not only formal criteria but also behavioral patterns and emotions of the persons concerned.

Adolescent↗
PubMed1985

The Zurich Study--a prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. IV. Recurrent and nonrecurrent brief depression.

How common and how significant are brief depressive episodes (BDE) lasting less than 2 weeks? The authors propose splitting the BDE into two groups: one occurring monthly over 1 year of observation, termed 'recurrent brief depression' (RBD), and those occurring less frequently, labeled 'nonrecurrent brief depression' (NRBD). From a medical point of view, the RBD are a relevant group. Different thresholds of definition are tested, the narrowest of which (including occupational impairment and predetermined minimum number of symptoms) is accepted for 'case'-definition. The such defined RBD (SYM) group differs from major depression only by length and frequency of episodes. In a young cohort, its 1-year prevalence rate was found to be 4.4% (males 3.9%, females 4.9%). One-third of these cases needed treatment, a fourth suffered from pronounced subjective and social impairment as well as from persistent suicidal ideation. The self-reporting of subjective impairment, assessed with the SCL-90 symptom inventory and an analog-rating, yields high scores which are in no way inferior to major depression diagnosed with RDC, DSM-III or EDE (SYM) criteria. The RBD (SYM) demonstrate less hypomania than the major depressive disorders. On the other hand, a family history of depression is equally frequent across all groups. The validity of the RBD (SYM) group has yet to be confirmed by a follow-up study, and further research is needed to delineate it from secondary depression. The findings largely support the hypothesis of a continuum from mild and short to more severe, longer lasting depressive syndromes, but they do not exclude heterogeneity of RBD (Angst and Dobler-Mikola 1984b).(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1985

Switch from depression to mania--a record study over decades between 1920 and 1982.

A representative sample of 908 hospital records covering admissions between 1920 and 1982 for depression was analyzed in order to assess the switch rate to hypomania/mania. The results are the following: (1) Over the decades of this century there has been a substantial increase in hospital admissions in Zurich for both depression and mania, but the ratio remained constant. (2) Due to this increase the clinicians can observe more spontaneous switches from depression to mania, which favors the assumption of a causal relationship when treatment is applied. (3) 64 of the 908 patients (7.0%) admitted for depression switched to hypomania or mania. Hypomania was observed in 48 cases (5.3%) and mania in 16 cases (1.7%). (4) The analysis of predisposing factors to a switch has resulted in a simple finding. Bipolar patients (including schizomanics) have an 8-fold higher switch rate (28.9%) than the unipolars (3.7%). The switchers are equally distributed over the two sexes and do not differ in the frequency of a family history of affective psychoses, schizophrenia, schizoaffective disorders, or suicide. (5) Bipolarity correlates positively with 'higher number of previous episodes', with 'readmitted' and with 'switch'. Therefore, studies selecting readmissions [Lewis and Winokur 1982] overrepresent switchers purposely. (6) A loglinear analysis together with some univariate strategies show that over the decades (from 1920 to 1982) there was no significant increase in switches of unipolar or bipolar patients. In conclusion, there is no evidence for a treatment-induced switch. This result is in line with Prien et al. [1973] and with Lewis and Winokur [1982].

Age Factors↗
PubMed1985

[Premorbid personality of schizophrenic patients].

This review summarizes different studies on schizophrenics regarding their premorbid personality. Schizophrenics do not average other social classes (father's profession) than endogenous or reactive depressives do, nor do they differ from the general population in that respect. On the other hand, schizophrenics show an inferior schooling achievement, as compared to depressives, and partially for that reason belong to lower social classes prior to the onset of their illness. Detailed studies of the respective social network show that schizophrenics develop in a less emancipated manner than controls, that they stick more to their families of origin, and that they engage in fewer interpersonal relationships. The latter not only are quantitatively inferior to those of healthy people, but also in quality; their relationships are often distant and alienated. In a prospective epidemiological study, 28 schizophrenics were assessed with a multi-dimensional personality test, the FPI, on average 2 years prior to the onset of their illness. The selfrating results show that schizophrenics are introverted premorbidly, as compared to control groups; it is assumed that this personality trait will be understood as "schizoid" in non-selfrating. Surprisingly, schizophrenics premorbidly have a normal neuroticism score, i.e. they are not more irritable, more aggressive, more depressive or emotionally unstable than controls.

Achievement↗
PubMed1984

The Zurich study--a prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. I. Problem, methodology.

The purpose and methodology of a 4-year longitudinal study based on a cohort aged 20 years are presented. A two-stage procedure was chosen; in 1978, 2201 males and 2346 females, aged 19-20, were examined. This sample was representative of the respective age group in the Canton of Zurich. From high and low-scorers (SCL-90), 292 males and 299 females were randomly selected for interview and for a prospective study. Subsequent investigations were carried out by questionnaires and by a personal interview. The instruments chiefly consisted of a semi-structured interview (SPIKE), a clinical syndrome list (SL), a 90-item symptom check list (SCL-90R), a life-event-inventory, scales measuring coping behavior and dissimulation, and an extensive sociological interview dealing with sociodemographic characteristics and social adjustment. This paper gives an account of the methodological aspects of the study.

Adaptation, Psychological↗
PubMed1984

The Zurich study. II. The continuum from normal to pathological depressive mood swings.

The longitudinal study of a cohort of 591 men and women aged 20 and 21 years respectively at outset, and 23/24 years at a subsequent investigation, was analyzed for the manifestation of depressive syndromes. The syndromes were grouped according to their duration: 1 week once or twice per year (group B), 1 week three or more times per year (C), 2 weeks (D), 4 weeks (E) and 3 months (F). Prevalence rates are given over 1 month, 3 months and 1 year, subdivided by sex. Unexpected identical prevalence rates are found for both sexes up to 3 months. Over 1 year, the ratio shifts to favor the women. Setting out from the hypothesis of a continuum of depressive mood from normal to pathological, groups B to E were examined with respect to the prevailing symptomatology (assessed with an interview and a self-rating questionnaire, the SCL-90R). We found no relevant qualitative differences, only a trend of somatic symptoms becoming more prominent along with increasing duration of episode. Symptomatology thus does not point to further classification. Other criteria, such as subjective impairment, social impairment, illness behavior, discussing depressive mood with parents/friends/employer, treatment, all favor the assumption of a continuum of depressive syndromes from normal to pathological.

Adjustment Disorders↗
PubMed1984

The Zurich study. III. Diagnosis of depression.

A 23- to 24-year-old age group representative of the general population of the Canton of Zurich, was used to detect depression. The classifications obtained by means of the Feighner, RDC and DSM-III criteria are compared with our own concept, which differs in some aspects. A minimum of 2 weeks of depression is labeled as EDE (extensive depressive episode). Instead of the presence of a minimum number of depressive symptoms, social impairment at work is first examined as a case-defining criterion (EDE[WORK]); in a second step, a diagnostic threshold of three, and five, depressive symptoms for males and females respectively is adopted (EDE[SYM]). The consequences are presented relating to prevalence, incidence, sex distribution, overlap with other diagnostic concepts, severity, bipolarity and family history. An unequal sex distribution in depression is shown to be an artifact of definition. Preference should go to a case-definition that could be specifically adapted to a given problem. On the whole, the DSM-III and EDE(WORK) criteria appear to be too broad. We will henceforth prefer the RDC and EDE(SYM) criteria, which both, however, necessitate further methodological and empirical study.

Adjustment Disorders↗
PubMed1984

The definition of depression.

Prevalence figures of depression usually show a sex ratio for males:females of 1:2. This unequal ratio has been examined by varying the time periods for the calculation of prevalance rates and the criteria for case definition. Based on results of a 20-23 yr-old cohort of 591 males and females studied in Switzerland, some evidence was found to support the hypothesis that an unequal sex ratio is partially due to unequal reporting of depressive symptoms and to differential forgetting, perhaps linked with the male role in society. It is not yet possible to extend the results of this study to older cohorts. Further research would be desirable.

Adult↗
PubMed1984

Do the diagnostic criteria determine the sex ratio in depression?

The 1-year prevalence rates and sex ratio of dysphoric mood, brief (BDE, less than 2 weeks) and extensive (EDE, greater than or equal to 2 weeks) depressive episodes and major depression (RDC, DSM-III) from an epidemiologic study are presented. Factors influencing the sex ratio are analyzed: subjective suffering from EDE, social and work impairment were found to an equal degree in both genders. Factors favoring female preponderance: women report more symptoms, men most probably forget symptoms, frequency and length of less recent depressions more readily, women see a physician or proceed to self-medication much more often. Consequently, the identical minimum symptom number for both genders is questioned and occupational impairment suggested as an alternative case-defining criterion.

Adult↗
PubMed1984

Antipsychotic efficacy of fluperlapine. An open multicenter trial.

In an open multicenter trial 46 schizophrenic patients were treated with fluperlapine for 20 days. A mean daily dosage of 300-400 mg appeared to be an effective antipsychotic treatment in most cases. The marked antipsychotic effect was accompanied by a good improvement of depressive symptoms. Extrapyramidal side effects were extremely rare.

Adult↗