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Biomedical subjects

M Albus

Publications and source records attributed to M Albus.

At least 91 records · Page 5Linked to original sources
PubMed1993

Prevalence of alcohol and drug abuse in schizophrenic inpatients.

All schizophrenic patients admitted consecutively either to the Psychiatric Hospital of the University of Munich (group 1, N = 183) or the Mental State Hospital Haar/Munich (group 2, N = 447) between 1.8.1989 and 1.2.1990 were examined to assess prevalence estimates for substance abuse in schizophrenic inpatients. Psychiatric diagnosis were made according to ICD-9 criteria. Psychopathology and psychosocial variables were documented by means of the AMDP-protocol on admission and discharge. The diagnostic procedure included a detailed semi-structured interview concerning the individual alcohol and drug history and sociodemographic data, the Munich Alcoholism Screening Test (MALT), a physical examination and the screening of various laboratory parameters such as GGT and MCV, among others. The results show that substance abuse is a very common problem in schizophrenics. Lifetime prevalence rates for substance abuse were estimated at 21.8% in group 1 and 42.9% in group 2, 3-month prevalence rates for substance abuse were estimated at 21.3% resp. 29.0%. Alcohol abuse was by far the most common type of abuse with prevalence estimates being 17.4% resp. 34.6%. Prevalence rates for substance abuse were much higher in the more "chronic"sample of the Mental State Hospital and in male patients. With respect to schizophrenic subtype few differences could be demonstrated with drug dependence being more common in patients with paranoid schizophrenia. The MALT proved to be a valuable screening instrument for alcohol abuse in schizophrenics with both a high specificity and sensitivity. "Dual diagnosis" schizophrenics had a significantly higher rate of suicide attempts and were less likely to be married. Possible clinical implications of these findings are discussed.

Adult↗
PubMed1993

Outcome of panic disorder with or without concomitant depression: A 2-year prospective follow-up study.

In a prospective 2-year follow-up study, 32 patients with panic disorder alone and 20 with panic disorder and concomitant depression were investigated. After controlled treatment with either imipramine or doxepin, patients received naturalistic treatment with antidepressants, benzodiazepines, and supportive psychotherapy. They were evaluated for anxiety, depression, and social disability at least every 3 months during the follow-up period. The data showed fluctuation of symptoms in both groups and a less favorable outcome for the patients with comorbid conditions. However, the overall outcome was better than that reported in other studies and indicates that panic disorder is quite responsive to appropriate treatment.

Adult↗
PubMed1993

[Group psychotherapy in patients with panic disorder and agoraphobia].

The one-year supportive group-psychotherapy (3 groups with 8-9 patients) was carried out once-weekly by two therapists in 26 patients who met the DSM-III-R criteria for panic disorder and agoraphobia. Patients filled in various ratings at the beginning and at the end of the therapy and a visual analog scale before as well as after each session. Twelve months after the end of the group-therapy the Longitudinal Interval Follow-up Evaluation (LIFE) was carried out. During the group-psychotherapy panic sensations, anxiety, nervousness and fears as well as psychosocial disability decreased. Duration of illness affected the reduction of panic sensations, anxiety, nervousness and fears during the first 6 months of the group-psychotherapy. Phobic fears and avoidance behavior mostly improved in patients with a duration of illness of more than 5 years and an additional depressive disorder. At the one-year follow-up 80% of panic patients without depressive disorder were symptom-free and reported better partner-relationships, more satisfaction, and a better social adjustment compared with panic patients with concomitant depressive disorders.

Adult↗
PubMed1992

Anxiogenic properties of yohimbine. I. Behavioral, physiological and biochemical measures.

The anxiogenic effects of yohimbine, a specific alpha-2-receptor antagonist were examined by administering 20 mg yohimbine orally to 8 panic patients on placebo treatment, 7 panic patients on alprazolam treatment and 12 controls using a double-blind randomized design, instructions that minimized the expectancy of experiencing a panic attack and two additional structured situations. Yohimbine induced more pronounced increases in anxiety and panicky ratings, norepinephrine secretion, maximum heart rate and high heart rate variability and decreases in skin temperature in panic patients compared with controls. However, possibly owing to an instructional set and experimental design that distracted patients from unpleasant bodily sensations no panic attacks were observed.

Adult↗
PubMed1992

Anxiogenic properties of yohimbine. II. Influence of experimental set and setting.

To study the pharmacological induction of stress along with psychological stress and their possible interaction, 20 mg yohimbine and placebo orally were administered to 8 panic patients on placebo treatment, 7 panic patients on alprazolam treatment and 12 controls in a double-blind crossover design. Two structured situations which can be considered as 'neutral' stressors were included: a mental arithmetic task and a continuous performance task. Mental arithmetic induced robust increases in ratings of panicky, anxiety, nervousness, heart rate and electrodermal activity, while the continuous performance task induced increases exclusively in skin conductance reaction. Patients responded to these tasks less than controls with regard to subjective ratings and electrodermal activity. Yohimbine did not potentiate the response to the tasks in the patients. In controls, heart rate during the mental arithmetic task, but not during rest, was increased after yohimbine. In contrast to other yohimbine challenge studies no panic attacks were observed. It is hypothesized that the experimental design together with an instructional set that reduces expectancy factors and the inclusion of structured and time-limited tasks in a challenge paradigm is able to reduce the anxiogenic effects of yohimbine.

Adaptation, Psychological↗
PubMed1992

Age at onset, precipitating events, sex distribution, and co-occurrence of anxiety disorders.

178 outpatients were administered to a structured interview evaluating diagnostic, illness history, and sociodemographic data of DSM-III-R anxiety disorders. Patients with panic disorder with agoraphobia were a more severely ill subgroup than patients with panic disorder without agoraphobia. Simple and social phobia had the earliest age at onset, panic disorder the latest age at onset. Conjugal stress was the most frequent event preceding the onset of the anxiety disorders. Female patients showed more severe impairment suffering more frequently from concomitant phobic avoidance, generalized anxiety, and depression compared to male patients.

Adolescent↗
PubMed1992

Differentiation of DSM-III-R anxiety disorders by severity of illness and symptom onset sequences.

187 patients were investigated by a structured interview for DSM-III-R and various clinicians' and patients' ratings. A high frequency of comorbidity between different anxiety disorders and between anxiety and depression was found. According to sociodemographic data, various anxiety disorders showed more similarities than differences. Patients with a generalized anxiety disorder showed an earlier age at onset compared to patients with panic disorder as well as a greater severity of illness and comorbidity. Avoidance behavior occurred before, simultaneous with, as well as after the onset of panic disorder.

Adult↗
PubMed1992

The Hamilton scales and the Hopkins Symptom Checklist (SCL-90). A cross-national validity study in patients with panic disorders.

The HRSD, HRSA, SCL-90 scales were psychometrically investigated in a cross-national sample of patients with varieties of non-psychotic symptoms of anxiety and depression. Across the cultural backgrounds the scores obtained from the original versions of these scales are not sufficient statistics. However, latent structure analysis has identified homogeneous subscales for depression (the HRSD) and for discomfort (an SCL subscale). High concurrent validity was found between the subscales of depression, anxiety and discomfort. In international research, inhomogeneity among scale items can be confounded with group differences which are usually ascribed to drug differences.

Adult↗
PubMed1991

The Panic-Associated Symptom Scale: measuring the severity of panic disorder.

The Panic-Associated Symptom Scale (PASS) is presented as a new measurement of the severity of the core symptoms of panic disorder. This first description addresses the rationale for its design and its scoring, score distributions, test-retest reliability, correlations within the PASS and with other scales, principal component structure, and response to drug therapy. Data are presented from a large study group of patients with panic disorder (n = 1168). Problems in measuring panic disorder are discussed.

Adult↗
PubMed1990

Consistencies and discrepancies in self- and observer-rated anxiety scales. A comparison between the self- and observer-rated Marks-Sheehan scales.

The Marks-Sheehan anxiety scales are the only scales where self-ratings and observer ratings are perfectly matched by the number, the content and the scaling of the items. Therefore these scales are an excellent tool to investigate the compatibility and to study different structures in self- and observer ratings. This was done by using the data material on the Marks-Sheehan scales of the Cross National Collaborative Panic Study. In this study 1168 outpatients who met the DSM-III criteria for panic disorder were randomly allocated either to alprazolam, imipramine or placebo treatment. Our results show that the Marks-Sheehan scales are highly comparable to other established rating scales. Both scales have a similar stable and consistent factor pattern for somatic symptoms but not for psychic symptoms of anxiety. Our results provide empirical evidence that the low consistencies between self- and observer ratings reported so far can be improved by using a rating scale which matches up item for self- and observer ratings. However, other sources of disagreement can only be solved by more elaborated item descriptions and training of patients as well as raters to obtain a better compatibility between self- and observer rating scales.

Adult↗
PubMed1990

Self- and observer assessment in anxiolytic drug trials: a comparison of their validity.

Self-rating scales are considered to be less useful for comparing different treatments in anxiety patients than observer-rating scales. However, the empirical evidence for this assumption is not adequate. A self-rating inventory of 35 items related to anxiety was perfectly parallel with an observer-rating inventory. Both instruments were used in the Cross National Collaborative Panic Study to compare the efficacy of imipramine, alprazolam and placebo in an 8-week drug trial in a sample of 1168 outpatients. The variance of the self-rating assessments was about two times higher. Both scales were equally sensitive to change; however, the measurement of change by means of the self-rating scale was slightly less consistent. The discriminative power of the observer-rating scale between placebo and active treatment was two to three times higher than that of the self-rating scale; consequently the observer-rating procedure provides a more valid instrument when the efficacies of different anxiolytic treatments are compared between different groups of patients.

Adult↗
PubMed1990

Schizophrenia, schizotypal and delusional disorders (section F2): results of the ICD-10 field trial.

To determine whether the use of ICD-10 provides greater diagnostic reliability than ICD-9, a field trial of the ICD-10 draft (WHO, 1987) was carried out. A total of 1,778 diagnoses made on the basis of ICD-10, ICD-9 and, in part, DSM-III were established by 134 clinicians in 10 centres using case reports and interviews. The corrected reliability coefficients of schizophrenic disorders obtained with ICD-10, with kappa-coefficients of reliability of 0.69 for the 2-character category and 0.67 for the 3-character category are higher than those reported for the diagnosis of schizophrenia made without specified criteria, but lower than those reported for DSM-III. Despite the operationally defined diagnostic guidelines, diagnostic discrepancies still persist when organic disturbances, substance abuse or psychogenic features are additionally present. The diagnoses of each rater remain stable on change over from ICD-9 to ICD-10. Our data suggest that ICD-10 is suitable for worldwide use in diagnosing schizophrenia.

Adult↗
PubMed1990

ICD-10 field trial in German-speaking countries--summary of the quantitative empirical results.

The summary of the quantitative results of the ICD-10 field trial in German-speaking countries shows a adequate acceptance of ICD-10. The figures for interrater reliability for the diagnostic categories are adequate for most categories considering the comparatively low level of familiarity with the new system. The high degree of overlap between the diagnostic categories in ICD-9 and ICD-10 is an indication of the validity of ICD-10. The major source of disagreement is the relocation of several diagnostic categories to different sections.

Austria↗
PubMed1990

ICD-10 field trial in German-speaking countries--summary, judgement and perspectives.

On the basis of the results of the field trial, the most important classificatory innovations of ICD-10, together with their advantages and disadvantages are described. The initial good acceptance of the new system could be further improved by structural modifications, such as a uniform and systematic description of the individual diagnostic categories. Criticism of content was focused on affective and neurotic disorders and adult personality disorders. When it is introduced, the psychiatric chapter of ICD-10 will surpass most of the hitherto existing psychiatric classification systems in size, differentiation and international testing.

Adolescent↗
PubMed1990

Drug treatment of panic disorder: early response to treatment as a predictor of final outcome.

One of the core problems in clinical research is the detection of early changes in target symptoms that predict future therapeutic outcome. To analyze potential predictors of outcome, data of a multicenter study on patients with panic disorder were used. A total of 1010 patients were randomly allocated either to alprazolam, imipramine or placebo treatment. Early improvement in the number of spontaneous panic attacks within the first week of treatment predicted outcome exclusively in the alprazolam group. In contrast, placebo responders and nonresponders were differentiated by early changes in anticipatory anxiety intensity. For tricyclic antidepressants such as imipramine an evaluation period of more than one week is required to allow conclusions about outcome.

Adult↗