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Biomedical subjects

P Kielholz

Publications and source records attributed to P Kielholz.

At least 19 recordsLinked to original sources
PubMed1990

Biological study of alcohol dependence syndrome with reference to ethnic difference: report of a WHO Collaborative Study.

Inherited deficiency of acetaldehyde dehydrogenase type I (ALDH-I) was found in 43% (50/117) of normals, 33% (27/82) of schizophrenics, but only 4% (5/113) of alcoholics among Japanese. The ALDH-I deficiency was never found, however, in 146 mostly schizophrenic subjects from Europe (Basel, Moscow, Zagreb), Australia (Nedlands), India (Lucknow), Morocco (Casablanca) and Mexico (Mexico City). It was demonstrated that ALDH-I deficiency produces the flushing syndrome which inhibits the development of drinking habit and alcohol dependence syndrome.

Alcoholism↗
PubMed1990

[Treatment of drug-resistant depression by intravenous administration of antidepressants].

The proportion of depressed patients no longer responding adequately to oral antidepressive medication combined with psychotherapy now amounts to as much as 15%. Depressive states failing to lift in response to antidepressants are referred to in Europe as "therapy-resistant". Before initiating some further form of treatment in a case of therapy resistance the diagnosis as well as the antidepressive treatment given hitherto (dosage, activity profile, compliance) should be reappraised. Where the diagnosis of "therapy-resistant depression" is confirmed, intravenous infusions of antidepressants in combination with psychotherapy have been found to offer the best prospects of success. With the help of daily infusions of maprotiline (ludiomil) and/or clomipramine (anafranil) it proved possible in over 1,000 patients suffering from therapy-resistant depression to achieve a remission in 60% and a marked improvement in 20%. At various research centres in Europe where intravenous drip infusions were administered in relatively low dosages, a more rapid onset of action was observed with fewer side effects, as well as higher plasma concentrations (thanks to avoidance of the first-pass effect) and no problems with respect to compliance.

Administration, Oral↗
PubMed1986

Light treatment of seasonal affective disorder in Switzerland.

Seasonal Affective Disorder (SAD) has been characterised by two or more depressive episodes in autumn or winter (with remission the following spring or summer), decreased energy, increased sleep, increased appetite, weight gain and carbohydrate craving. SAD patients were identified in a Swiss-German population; 22 participated in a light-therapy protocol (1 week bright white light 2,500 lux or dim yellow light 250 lux, from 06-08 h and 18-20 h). Both observer and self-ratings indicated a significant diminution of depressive symptoms with both lights. One week after withdrawal from yellow light, depression ratings relapsed to previous values; remission lasted longer after bright white light. Global VAS self-rating scales for "mood" and "well-being" however, and the Hamilton scale for atypical SAD symptoms, differentiated clearly between bright and dim light: only bright light showed an improvement that persisted after withdrawal. These results suggest that even though a placebo effect cannot be excluded, 4 h explicit light exposure/day may not be a negligible quantity. Light treatment promises to be a useful non-pharmacological intervention in certain forms of depressive illness.

Adult↗
PubMed1986

Treatment for therapy-resistant depression.

Thanks to progress in the diagnosis and treatment of depression it is now possible for most cases to be treated on an out-patient basis. Only 15-20% of patients require hospitalisation, most of them because their depression has proved resistant to therapy. To overcome therapy-resistance, the following methods of treatment are available: In therapy-resistant endogenous and psychogenic depressions, mono-infusion therapy is the treatment of choice; it can also be administered on an out-patient basis. In extremely intractable cases, it is advisable to resort to combined infusion therapy, preceded by five days of relaxation therapy with oral doses of a neuroleptic, and possibly reinforced by medication with 5-hydroxytryptophan (the precursor of serotonin) or by sleep deprival. In therapy-resistant cases of so-called masked depression, marked by overtones of anxiety and hypochondriasis, infusions of maprotiline are indicated, because this anti-depressant exerts a relaxing and mildly anxiolytic action, has a stabilising influence on the autonomic nervous system, and produces a mood-brightening effect. In patients who are apathetic and devoid of drive and suffering from involutional depression or depression of old age, infusion therapy plus administration of an MAO inhibitor can be recommended. Combination of an antidepressant with a neuroleptic agent also displaying certain antidepressive properties is really indicated only in the rare cases of schizo-affective psychosis. Electroconvulsive therapy should be employed only as a last resort in extremely retarded and apathetic patients with strong suicidal tendencies, and the indication for ECT should be established with the utmost reserve.

5-Hydroxytryptophan↗
PubMed1979

The classification of depressions and the activity profile of the antidepressants.

1. Pre-requisiste for a successful treatment of depressions is an accurate diagnosis. 2. The nosological classification proposed by the WHO-ICD (International Classification of Diseases, 9th edn.) differentiates three main groups of depressive states, i.e. somatogenic, endogenous and psychogenic depressions. 3. In somatogenic depressive manifestations, first of all, the organic disease has to be treated. 4. In endogenous and psychogenic depressions, the kind of treatment and the indication for long-term therapy can be derivated by the nosological diagnosis. 5. The syndromal diagnosis determines the choice of the antidepressant with the correct activity pattern and gives also the indication for a combined treatment with beta-blockers. 6. Nosological classification, syndromal diagnosis, activity patterns of the antidepressants, the indication for long-term treatment and combined therapy are discussed.

Antidepressive Agents↗
PubMed1979

The long-term treatment of periodical and cyclic depressions with flupenthixol decanoate.

In a 2- to 3-year open study 30 patients were treated with flupenthixol decanoate (depot form). These periodic and cyclic depressive patients had side effects during treatment with lithium salts. In comparison with the depressive and manic phases before the treatment, the prophylactic effect of flupenthixol decanoate on periodic and cyclic forms of depression was similar to the effect of lithium salts.

Adult↗
PubMed1979

[Alcohol].

Explore the source record for details and available documents.

Alcoholism↗
PubMed1979

[The concept of masked depression (author's transl)].

Masked depression is an endogenous or psychogenic depressive state in which the somatic symptoms predominate while the psychical symptoms are only present in the background. Therefore it is a matter of phenomenological diagnosis. An enquiry conducted among general practitioners in Germany, France, Austria and Switzerland has shown that up to 10% of the patients consulting a physician are suffering from depression and half of the cases are masked depressions. An enquiry disclosed in 1978 among 74 practising physicians proved that 18% of the patients seeking medical advice suffer from depressive states and that about half of the cases are masked depressions. Diagnosis and therapy of masked depression are of great practical importance in everyday practice because of its frequency. The diagnosis has to be established on the basis of the depressive background symptoms. The masked depressions often show anxious-hypochondrical character and therefore have to be treated with antidepressant drugs with anxiolytic effect. The choice of the antidepressant drug with the right activity profile is decisive for the success of the therapy. Finally, there is a short review about diagnosis and therapy of masked depression.

Depression↗