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Steffen Moritz

Publications and source records attributed to Steffen Moritz.

47 records · Page 3Linked to original sources
PubMed2003

Increased automatic spreading of activation in thought-disordered schizophrenic patients.

Previous research on semantic priming in schizophrenia has produced conflicting findings. While several studies provided evidence for an enhanced cognitive spreading of activation in schizophrenia patients with formal thought disorder, other research has failed to replicate. The aim of the present study was to resolve some of the ambiguities in the literature. Thirty-two schizophrenic patients (12 with and 20 without symptoms of formal thought disorder according to the PANADSS) and 65 healthy controls were compared in a semantic priming task using word pronunciation. Irrespective of baseline condition (neutral or unrelated condition) patients with formal thought disorder (TD) exhibited a significantly greater indirect semantic priming effect than both non-TD patients and healthy controls. Known confounding variables such as length of illness, neuroleptic dosage and psychomotor slowness did not moderate priming. Results further strengthen the spreading activation model of formal thought disorder put forward by Maher/Manschreck and Spitzer. Data indicate that hyper-priming is not confined to lexical decision tasks. Possible reasons why several studies have failed to replicate greater priming in TD schizophrenic patients are discussed.

Adult↗
PubMed2003

Impact of comorbid depressive symptoms on nonverbal memory and visuospatial performance in obsessive-compulsive disorder.

INTRODUCTION: Recent research has suggested that some executive dysfunctions in obsessive-compulsive disorder (OCD) represent an epiphenomenon of comorbid depressive symptoms. The present study investigated whether the impact of comorbid depressive symptoms on cognitive dysfunction in OCD extends to nonverbal memory impairment. METHODS: A total of 32 OCD patients and 20 healthy controls took part in the study. Participants were administered a neurocognitive battery with a focus on nonverbal memory and visuospatial functions. RESULTS: While evidence was provided that neurocognitive processes necessitating visuospatial transformation and visuoconstruction are deficient in OCD patients regardless of comorbid depressive symptoms, nonverbal memory dysfunctions were only apparent for patients with elevated scores in the Hamilton Depression (HDRS) Rating Scale (total score > or = 8). Correlations with subscores of the HDRS revealed that core depressive symptoms are related to nonverbal memory deficits in OCD. Mental rotation, middle discrimination, and position discrimination were found to be unaffected in OCD. Y-BOCS scores, length of illness, onset of illness, number of hospital admissions, and checking compulsions were not associated with neurocognitive disturbances. CONCLUSIONS: Nonverbal memory is disturbed in only a subgroup of OCD patients displaying elevated HDRS scores (HDRS > or = 8). It is claimed but awaits further empirical testing that differences in depression profile across OCD studies have contributed to inconsistencies in prior investigations on neurocognitive functioning in OCD. Our results are questioning the hypothesis that nonverbal deficits are a causal factor for the development of checking compulsions.

Journal Article↗
PubMed2003

Objective and subjective efficacy as well as tolerability of olanzapine in the acute treatment of 120 patients with schizophrenia spectrum disorders.

The aim of the present study was to evaluate the objective and subjective efficacy as well as tolerability of olanzapine in acute treatment of schizophrenia spectrum disorders under naturalistic non-selective conditions. Inpatients with schizophrenia spectrum disorders, consecutively admitted over an 18-month period, treated with olanzapine, were included. Diagnoses were made according to ICD-10 criteria based on repeated clinical assessments. Efficacy and tolerability of olanzapine were assessed at baseline and at the end of inpatient acute treatment including Positive and Negative Symptom Scale (PANSS), Clinical Global Impression, subjective assessments, UKU and biological investigations. One hundred and twenty non-selected patients who met ICD-10 criteria for schizophrenia (73%), schizophreniform disorder (14%) or schizoaffective disorder (13%) were treated with olanzapine 15.3+/-5.2 mg/day. Baseline severity (PANSS total mean score 102.2) was higher compared to various admittance studies (PANSS total mean score 86-90). In 32% of patients (n=38), olanzapine treatment was discontinued, mainly because of inefficacy for positive (89%, n=34) and/or negative (95%, n=36) symptoms and/or because of adverse events (37%, n=14). Response rates as improvement in PANSS total score (after > or =3 weeks of treatment) of > or =20%, 30% or 40% were 68%, 55% and 35%, respectively. Response rates in post-hoc defined treatment resistant patients were not significantly different from non-refractory patients. Sedation (26%) was the most common side-effect, followed by weight gain (22%). With regards to subjective efficacy, 30% of the patients were not satisfied with the efficacy of olanzapine, while only 6% of the patients reported a not satisfying subjective tolerability. According to duration of olanzapine treatment, the results for patients, who remained in hospital, revealed a faster increase of weight compared to admittance studies (7 kg in 14 weeks versus 7 kg in 38 weeks). Olanzapine has been found to be effective and tolerable, also under naturalistic acute treatment conditions. Compared to previous double-blind admittance studies, patients had a higher severity of illness at entry and a lower > or =40% PANSS total score response rate. By contrast to previous results, mean dose of olanzapine was similar for multiple- and first-episode patients, and weight gain was more severe. The results underline the need of Phase IV studies for the assessment of clinical antipsychotic efficacy and tolerability.

Administration, Oral↗
PubMed2003

Reliable change indexes for memory performance in schizophrenia as a means to determine drug-induced cognitive decline.

Some psychotropic medications frequently prescribed in schizophrenia, especially agents that contain anticholinergic properties, have adverse effects on learning and memory. Given the impact of memory on both functional and symptomatic outcome in schizophrenia, it is important to determine if patients suffer from medication-related memory impairment. This study provides a statistical methodology for identifying medication-related changes in memory functioning. Reliable change estimates were determined for Rey Auditory Verbal Learning Test performance in 38 inpatients with schizophrenia. When an 80% confidence criterion was applied, improvement or decline of 12 words in the total score (sum score: Trials 1-5) cannot be attributed to measurement error. These findings should help clinicians better understand cognitive side effects and facilitate decision making regarding changes to individual patient's psychopharmacotherapy.

Adult↗
PubMed2002

Dimensional structure of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).

The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is a widely used instrument to assess obsessive-compulsive symptomatology. The present study provides evidence that the Y-BOCS is best represented by a three-dimensional model comprising severity of obsessions (factor 1), severity of compulsions (factor 2) and resistance to symptoms (factor 3). On the basis of exploratory factor analysis, this structure was found for both baseline (n = 109) and discharge ratings (n = 68) following a multimodal cognitive-behavioral intervention. The factor solution remained essentially unchanged when two optional items (items 1b and 6b) were dropped from analysis. The three-factor structure was replicated with confirmatory factor analysis and showed better fit than previously proposed single- and two-factor models. For future research, we propose a new Y-BOCS scoring algorithm that takes this factor structure into account. A further result was that resistance significantly declined in response to cognitive-behavioral intervention, whereas drug treatment alone did not seem to moderate this variable according to previous research conducted by Kim et al. [Psychiatry Research 51 (1994) 203-211].

Adult↗
PubMed2002

Neurocognitive performance in first-episode and chronic schizophrenic patients.

Previous research on neuropsychological disturbances in first-episode and chronic schizophrenic patients has provided mixed results which can be partially attributed to methodological inconsistencies. For the present study, 70 schizophrenic patients (40 with chronic and 30 with first-episode schizophrenia) were compared to 30 healthy controls on a large battery of neuropsychological tests. Special attention was paid to potential confounds such as differences in psychopathology, age and educational level between the schizophrenic sub-samples. Healthy controls performed better than both first-episode and chronic patients in almost all cognitive domains (P < 0.01), while the patient samples did not differ in any of the tasks. Results were confirmed in a second series of analyses in which patient subgroups were equated for sociodemographic background variables. The present results confirm recent data collected in longitudinal studies, thus, lending further support for a neurodevelopmental model of schizophrenia. It is suggested that neuropsychological disturbances occur early in schizophrenia and do not worsen in the course beyond age-related decrement. Possible reasons why previous research has produced contradictory findings are discussed.

Adult↗
PubMed2002

Executive functioning in obsessive-compulsive disorder, unipolar depression, and schizophrenia.

The present study investigated whether schizophrenic, unipolar depressive, and obsessive-compulsive psychiatric patients show a distinguishable profile in tasks considered sensitive to frontal lobe functioning. Three psychiatric samples, each comprising 25 patients with little symptomatic overlap, were compared to 70 healthy controls. Participants completed several executive tasks (Wisconsin Card Sorting Test (WCST), verbal fluency, digit span, Stroop, and Trail-Making). Except for age, which was entered as a covariate, subjects did not differ in any sociodemographic background variable. Healthy controls showed superior performance relative to depressive and schizophrenic patients who exhibited comparable deficits in all tasks. Obsessive-compulsive disorder (OCD) patients revealed dysfunctions in the Trail-Making Tests A and B and in the fluency task. Dysfunctions in the domains of working memory, verbal fluency, distractibility, and concept formation were not confined to a specific psychiatric population.

Journal Article↗
PubMedDate not supplied

Quality of life in obsessive-compulsive disorder before and after treatment.

BACKGROUND: The assessment of Quality of Life (QoL) is an important tool for elucidating target symptoms that are particularly bothersome to patients. The present study was designed to explore predictors of decreased QoL in obsessive-compulsive disorder (OCD) patients and to explore which aspects of QoL are most affected in OCD. Furthermore, the study investigated changes in QoL after treatment and the association between QoL change scores with symptomatic outcome. In line with prior research, it was expected that low QoL in OCD patients would be most pronounced for the emotional and social aspects of the construct. METHODS: Seventy-nine OCD patients were initially recruited. Patients were assessed with the SF-36 both before and after treatment. Norm values were derived from the general population to characterize status of impairment. OCD patients were contrasted with published SF-36 scores from 2 OCD samples as well as a newly recruited psychiatric and healthy control sample. RESULTS: Correlations with QoL were most pronounced for depression severity and number of OCD symptoms. Apart from low social and emotional QoL in the majority of patients, a large subgroup also reported lower physical well-being. Decreased scores on this subscale were mainly associated with length of illness, depression, and number of compulsions. Overall, QoL was significantly improved in therapy responders relative to nonresponders. CONCLUSIONS: The results largely correspond to previous findings showing that OCD patients share severely compromised well-being. Somewhat unexpected from previous research, QoL deficits were not restricted to emotional and social aspects of QoL but extended to somatic domains. The present results suggest that clinicians should thoroughly explore for depression as well as physical impairments in OCD patients, which, when present, may be additionally targeted to achieve comprehensive treatment success.

Adaptation, Psychological↗