Biomedical subjects

O Benkert

Publications and source records attributed to O Benkert.

172 records · Page 10Linked to original sources

PubMedDate not supplied

Specificity of lactate response in panic disorder, panic with concurrent depression and major depression.

Lactate infusions with 0.5 molar sodium lactate in a dose of 10 ml/kg within 20 min were given to patients with panic disorder (n = 6), panic attacks with concurrent major depression (n = 7) and major depression without panic (n = 5). Lactate-induced anxiety and symptom attacks without panic were seen more often in the groups with panic attacks, but a full-blown panic attack was provoked in only four subjects, all belonging to the groups with a history of panic attacks. The low incidence of lactate-induced panic attacks can be explained by differences in the procedure that aimed at reducing expectancy biases and baseline anxiety.

Adolescent↗

PubMedDate not supplied

Three dimensions of depression in patients with acute psychotic disorders: a replication study.

Depressive symptoms in psychotic disorders are of high relevance but seem to be heterogeneous when assessed with a standard rating scale. The present analysis is a replication study on the dimensionality of the Bech-Rafaelsen Melancholia Scale (BRMES) in acutely psychotic patients with substantial depression defined according to a functional approach across the nosological borders of schizophrenia with major affective symptoms, schizoaffective disorder, depressed subtype, and major depression with psychotic features. The baseline data of 123 patients participating in a multicenter pharmacological trial were evaluated with structural equation models. A previously reported three-dimensional model of the BRMES comprising the facets retardation, depressive core symptoms, and accessory depressive symptoms was cross-validated by confirmatory factor analysis (CFA). The three-dimensional model proved to be superior to one-, two-, or four-factor models with respect to goodness-of-fit (goodness-of-fit index [GFI] = 0.91 and comparative fit index [CFI] = 0.89) and parsimony (adjusted GFI [AGFI] = 0.85). When comparing the present model with the previously reported model, a highly satisfactory correspondence emerged (CFI = 0.87). The results corroborate our previous findings that depression-like symptoms in acutely psychotic patients assessed by the BRMES can best be represented by a three-dimensional model and should not be treated as a homogeneous syndrome.

Acute Disease↗

PubMedDate not supplied

The primary care evaluation of mental disorders (PRIME-MD), German version: a comparison with the CIDI.

There is a need for the development and evaluation of diagnostic instruments suitable for daily use in primary care offices that can improve recognition rates of psychopathology. The objective of this study is the comparison of the German version of the Primary Care Evaluation of Mental Disorders (PRIME-MD), a short structured diagnostic instrument, with the Composite International Diagnostic Interview (CIDI) and to gather some information on the usefulness of the PRIME-MD. Seven hundred and four patients were assessed three times, once using the physician's clinical judgement, subsequently, administering the PRIME-MD, DSM-IV version and finally, with the CIDI. The CIDI was administered on a different occasion within 1 week after the PRIME-MD evaluation by independent interviewers over the telephone. At the end of the study, the participating physicians answered a few feedback questions on the usefulness of PRIME-MD. Sensitivity (0.73), specificity (0.67), overall accuracy (0.70) were good for any psychiatric disorder. According to the diagnostic categories of mood disorders, anxiety disorders, eating disorders, and alcohol-related disorders, the sensitivity of PRIME-MD was good (0.67-0.80). For somatoform disorders, sensitivity was poor. Specificity, accuracy, and negative predictive values were good-to-excellent for all diagnostic categories. Kappas range from poor (0.12 somatoform disorders) to satisfactory (0.62 alcohol related disorders). Average time for administering PRIME-MD was 11 min. The results demonstrated that the German version of the PRIME-MD may be useful in primary care settings to enhance recognition of mental disorders by primary care physicians, even without being formally trained in diagnosing mental disorders.

Female↗

PubMedDate not supplied

A randomized, double-blind comparison of a rapidly escalating dose of venlafaxine and imipramine in inpatients with major depression and melancholia.

A double-blind, randomized, parallel study in 167 hospitalized patients with major depression and melancholia was conducted to determine if rapidly escalated doses of venlafaxine produced an earlier response, compared with rapidly escalated doses of imipramine. The daily dose of venlafaxine was rapidly increased to 375 mg/day over a five-day period, was maintained at this level for 10 days, and then was reduced to 150 mg/day for the remainder of the study. The imipramine dose was rapidly increased to 200 mg/day over five days and was maintained at this level to the end of the study. The primary efficacy variables were time to response and time to sustained response on the HAM-D and MADRS. No differences in the response rates on the HAM-D or MADRS were observed between treatments. However, among patients who demonstrated a response on the HAM-D, there was a significantly faster onset of response (p = 0.036) and sustained response (p = 0.018) in the venlafaxine group. The median time to response on the HAM-D among responders was 14 days with venlafaxine and 21 days with imipramine. However, no differences between treatments were observed among responders on the MADRS (median time to response: 15 days for venlafaxine, 18 days for imipramine). Study events were reported in 69% of venlafaxine-treated patients and 76% of imipramine-treated patients. In severely depressed patients with melancholia, a faster onset of response was observed with venlafaxine on the HAM-D, but not the MADRS, and maximal tolerated doses of venlafaxine and imipramine were comparable for overall efficacy. These results confirm and extend previous observations and suggest that venlafaxine may have an early onset of action and may produce a rapid response in hospitalized patients with severe depression complicated by melancholia.

Adult↗

PubMedDate not supplied

The Calgary Depression Rating Scale for Schizophrenia: development and interrater reliability of a German version (CDSS-G).

A German version of the Calgary Depression Rating Scale for Schizophrenia (CDSS-G) approved by the author of the original scale is presented comprising a semi-structured interview for 9 items to sensitively and specifically assess depression in schizophrenia and related disorders. The process of translation is outlined and the finally derived CDSS-G was investigated with respect to interrater reliability in three studies. To keep comparability with the CDSS source version a standard procedure was used. Two trained raters jointly assessed ten schizophrenic patients (study I). In a second study, videotapes with the CDSS-G were presented to clinically inexperienced raters (study II, N = 14/15) to test the agreement on the CDSS-G in this sample. Finally, in a third study clinically experienced researchers participated in a rater training (study III, N = 34). They carried out CDSS ratings on three patients with mild depressive symptoms. The dependence of interrater reliability on depression severity was investigated for all studied patients. Both intraclass correlation coefficients (ICC) and weighted kappa coefficients (kappa(w)) were calculated. The results revealed a high ICC = 0.97 in study I for the total CDSS-G score. Single item ICC values were all above 0.70. The results of study II revealed somewhat lower agreement on CDSS-G items and total scores in psychiatric novices with however acceptable values of kappa(w)>0.50 for the total scores. Study III yielded satisfactory results (0.66<kappa(w)<0.76) for clinically experienced psychiatrists in schizophrenic patients with mild depression. The results demonstrate adequate to excellent interrater reliability of the CDSS-G corroborating the results of the original version in different settings.

Adult↗

PubMedDate not supplied

Serial position effects in dementia of the Alzheimer type.

BACKGROUND: The aim of the present study was to analyse serial position effects for immediate and delayed free recall in patients with dementia of the Alzheimer type and controls. EXPERIMENT 1: 44 patients with dementia of the Alzheimer-type and 24 non-demented controls were asked for immediate and delayed free recall of 12 schematic drawings of common objects presented at the rate of 10 s/picture. Steep primacy effects were obtained at all delays in controls. By contrast, primacy effects were significantly impaired in patients with dementia at all delays of recall. Small immediate and delayed recall recency effects were found in both, patients and controls. EXPERIMENT 2: 19 patients with dementia of the Alzheimer type and 21 controls were asked for immediate and delayed free picture recall with presentation rates of 10, 5 and 1 s/picture. Again, primacy effects were significantly impaired in demented patients versus controls. With shorter presentation times, immediate recall recency effects were more pronounced than with longer presentation times, and no delayed recall recency effects were found. CONCLUSIONS: Primacy effect is impaired for immediate and delayed recall in dementia of the Alzheimer type. By contrast, immediate recall recency effect and possibly also long-term recency effect are preserved. The loss of the primacy effect contributes to the impairment of episodic memory in dementia of the Alzheimer type. Therefore further research is warranted into pharmacological and psychological interventions that might re-establish the primacy effect. Possibly, the orientation of demented patients might be improved by psychological techniques that rely on long-term recency effect.

Aged↗

PubMedDate not supplied

Effect of presentation rate on word list learning in patients with dementia of the Alzheimer type.

The efficacy of simple interventions for the improvement of memory performance in patients with dementia of Alzheimer type (DAT) has rarely been evaluated. Therefore, we examined the effects of presentation duration and task practice on word list learning in this sample: 19 patients with DAT and 21 control subjects (with remitted major depression) repeatedly performed modifications of a word list learning task using five different presentation durations (i.e. 1, 2, 5, 10 or 20 s/word). In agreement with previous observations, prolonged visual presentation of words significantly improved recall and recognition in demented subjects, whereas task practice did not improve memory performance. The performance in the demented sample after long presentation times (20 s/item) does not reach the level of performance of the comparison group after short presentation times (1 s/item). Consequently, it seems unlikely that memory dysfunction is caused by increased item processing times in patients with dementia. To reach comparable performance of demented and controls for intervention or activation studies, presentation times must be shortened below 1 s/item in the control sample.

Aged↗

PubMedDate not supplied

Effect of repetition and inspection times on picture recall in patients with dementia of Alzheimer type.

The present study is part of a series of systematic studies intended to identify simple strategies of picture presentation to improve recall performance in demented subjects. The aims of this design were to examine the effects of elaboration by naming, 4-fold repetition and different inspection times on memory performance. 19 patients with senile dementia of Alzheimer type and 21 control subjects with remitted depression were included. Picture recall was examined using different presentation conditions on 5 consecutive days. The presentation conditions significantly influenced recall performance depending on the diagnosis and on the delay of recall. Naming of pictures did not improve later recall or recognition. In both groups repetition improved memory performance. Shorter presentation times deteriorated immediate and delayed memory performance in comparison with the control condition. Forgetting did not depend on picture inspection times in patients and control. This observation allows the use of different presentation times for further comparisons of interventions in patients and control. Even though we could provide evidence of some minor memory improvements after some interventions, i.e. prolonged inspection time and repetition, we suppose that the cognitive reserve capacity in demented subjects is limited and does not allow major memory improvements.

Aged↗

PubMedDate not supplied

Visual memory in Alzheimer patients: effects of practice, retention interval and severity of cognitive decline.

The study was aimed at estimating the effect size of practice, retention interval and dementia severity on free recall performance in Alzheimer patients. Patients met DSM-III-R criteria for dementia of Alzheimer type. Different picture sets were presented on 4 days. The forgetting curves on different days were compared using ANOVA for repeated measurements. Practice had a minor, but significant negative effect on recall performance explaining 1% of the variance in recall performance. The retention interval varied between zero and 24 h explaining 23% of the total variance. Dementia severity explained 52% of the variance. For the development of memory improvement strategies in Alzheimer patients, the repeated measurement design using intraindividual comparisons seems more powerful than group comparisons.

Aged↗

PubMedDate not supplied

Age-related alteration of the hypothalamic-pituitary-gonadal axis in sexually impotent males.

On 7 healthy normal men and 32 sexual impotent males aging between 45 and 75 years, total testosterone (T), oestradiol, luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin were measured. Additionally LH and FSH was measured after injection of 25 and 100 micrograms LHRH. The main criteria for inclusion in the study were a reduced or nonexistent capacity to have an erection during intercourse and no clinical signs of endocrine disease. The group was divided in young impotent males (group I, less than 60 years) and old impotent males (group II, at least 60 years). The healthy males served as controls (group III). None of the intergroup differences for the basal hormones were statistically significant. But 7 of the man in group I and II showed pathological low T levels (less than or equal to 300 micrograms/100 mg). The high incidence of pathological low T levels in these patients suggests that measurement of plasma T levels is recommendable in the routine diagnostic examination of all sexual impotent males. Plasma levels of LH and FSH increased significantly in all groups following injection of LHRH. At delta 25 min LH was increased significantly in group II following 100 micrograms LHRH compared to group I and III; following 25 micrograms LH and FSH was increased significantly in group II compared to group I. The present findings suggest that, while pituitary function is normal in young and old sexual impotent males, T production may be inadequate in some older patients. Since the present patients failed to show clinical signs of endocrine disease, the abnormal response to LHRH in some of the older sexual impotent males indicates that these patients had a subclinical endocrine disorder.U

Age Factors↗