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W Gaebel

Publications and source records attributed to W Gaebel.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Interferon-induced paranoid psychosis. Review of the literature and case report].

Adverse neuropsychiatric effects under interferon treatment have often been reported. However, the pathogenetic mechanisms have not yet been fully explored. Most frequent are affective disorders, but psychotic decompensations can also occur, as reported in the following case. Thus, taking a detailed psychiatric history is required before starting a therapy with interferon, since past and current psychiatric disorders might imply an increased risk for psychiatric adverse effects.

Adult↗
PubMed2002

[Attitude of the population to schizophrenic patients in 6 federal German large cities].

In a research project of the German Research Network on Schizophrenia, public attitudes towards people with schizophrenia were studied within a public education project. In six German cities, 7,246 persons aged 16 or older were interviewed in a telephone survey. Knowledge of schizophrenia, social distance, and proposals for activities to improve the public acceptance of mentally ill persons were inquired. Most of the persons interviewed expressed positive attitudes towards people with schizophrenia. Better public education about mental illnesses and the opportunity for closer contact to mentally ill persons were rated as important to improve the public acceptance of these individuals.

Adolescent↗
PubMed2002

Public attitudes towards people with mental illness in six German cities: results of a public survey under special consideration of schizophrenia.

OBJECTIVES: Attitudes of the urban population in Germany towards people with mental illness were investigated in this study. The results are compared with those of attitude surveys conducted by other research centres participating in the World Psychiatric Association's (WPA) global anti-stigma-programme "Fighting Stigma and Discrimination because of Schizophrenia - Open the Doors" (WPA 1998). METHODS: A total of 7246 German-speaking persons aged 16 and over were interviewed in private households in six German cities by telephone using a standardised questionnaire. The respondents were asked about their knowledge in regard to schizophrenia, their social distance towards people with schizophrenia and estimations of the social stigmatisation of mental patients in general. RESULTS: 33.1 % of the interviewees were able to name causes of schizophrenia. 76.5 % of the interviewees believe that people with schizophrenia often or very often need prescription drugs to control their symptoms. 81.1 % believe that most people would pass over the job application of a former mental patient in favour of another applicant. CONCLUSIONS: Improvements in the education of the public about mental illnesses and provision of the opportunity for personal contact with mentally ill people are considered to be important measures for promoting the acceptance of the mentally ill by the public.

Adolescent↗
PubMed2002

Alcohol dependence and gender-role orientation.

OBJECTIVE: The overall increase of female alcoholism is supposed to be associated with the change of the traditional female role, and it is especially seen as a consequence of role convergence or gender-role conflicts. The aim of the present pilot study is to explore whether the approach of gender-role orientation would be empirically useful in contributing to these hypotheses. METHOD: One hundred twelve patients with alcohol dependence meeting DSM-III-R criteria were explored after detoxification; gender-role orientation was measured by a German version of the "Extended Personal Attributes Questionnaire", categorising gender-role orientation into four subgroups: masculine, feminine, androgynous, and undifferentiated. RESULTS: In comparison with a population-based sample, there are significant differences in the distribution of the four subgroups of gender-role orientation, showing a predominance of the undifferentiated self-concept in the alcoholic sample (49%). Alcoholic females describe themselves as rather undifferentiated, and rather feminine than masculine. Low masculinity and low femininity, as well as high femininity, correlate positively with distress, depressiveness, social anxiety, insecurity and concomitant personality disorders. CONCLUSION: Our data do not support the convergence hypothesis related to gender-role orientation, but support the traditional feminine self-concept as an unspecific risk factor for vulnerability. The question whether an undifferentiated self-concept could be a specific risk factor for alcoholism is discussed.

Adult↗
PubMed2002

Out-patient behaviour therapy in alcoholism: treatment outcome after 2 years.

OBJECTIVE: The main aim of the study was the evaluation of out-patient behavioural approaches in alcohol dependence. Additionally, the persistence of treatment effects and the impact of psychiatric comorbidity in long-term follow-up was examined. METHOD: A total of 120 patients were randomly assigned to non-specific supportive therapy or to two different behavioural therapy programmes (coping skills training and cognitive therapy) each comprising 26 weekly sessions; the follow-up period lasted 2 years. RESULTS: Patients undergoing behavioural therapy showed a consistent trend towards higher abstinence rates; significant differences between the two behavioural strategies could not be established. Moreover, the results indicate a reduced ability of cognitive impaired patients to cope with short-time abstinence violations and at a reduced benefit from behavioural techniques for patients with severe personality disorders. CONCLUSION: Behavioural treatment yielded long-lasting effects and met high acceptance; yet, still in need of improvement is the development of specific programmes for high-risk patients.

Adult↗
PubMed2002

[Editorial].

Explore the source record for details and available documents.

Adolescent↗
PubMed2001

EEG-correlates of facial affect recognition and categorisation of blurred faces in schizophrenic patients and healthy volunteers.

The ability to recognise emotional expressions of faces and the ability to categorise blurred and non-blurred faces and complex objects was tested in 16 schizophrenic in-patients and 16 healthy volunteers. EEGs were recorded during performance of the tasks and event-related potentials were compared between groups. Patients performed worse than healthy volunteers in recognition of facial affect but not in categorisation of blurred faces. Furthermore, within a 180-250ms latency range patients showed reduced amplitudes during affect recognition compared with controls but not during categorisation of blurred faces. Amplitudes recorded at frontal electrode sites were associated with performance in facial affect recognition. These results provide a first clue to the neurophysiological basis of the widely reported facial affect recognition deficit in schizophrenic patients.

Adult↗
PubMed2001

[Prevalence and clinical significance of computerized tomography verified idiopathic calcinosis of the basal ganglia].

With increasing CT examinations of the cerebrum, the discovery of basal ganglia calcification becomes more frequent. In order to correlate these calcifications to the symptoms believed to be accompanied with Fahr's disease 2318 cranial CT scans were examined. There was an overall incidence of basal ganglia calcification of 12.5%. The most frequent location was the globus pallidus (96.4%). In the examined population there was no correlation found between the calcifications and symptoms having been described with striopallidentate calcifications.

Aged↗
PubMed2001

Out-patient behaviour therapy in alcoholism: impact of personality disorders and cognitive impairments.

OBJECTIVE: We investigated whether alcoholic patients with comorbid personality disorders and those with cognitive impairments would benefit in a different way from different behaviour therapy strategies. METHOD: After detoxification, 120 alcoholics were assigned randomly to one of three out-patient treatment programmes comprising 'coping skills training', 'cognitive behaviour therapy' or unspecific supportive control therapy. Personality disorders and cognitive impairments were assessed at the beginning of the 6-month treatment period. RESULTS: The impact of concomitant personality disorders or cognitive impairments was generally only moderate and mainly independent from treatment condition. However, alcoholic patients relapsing within 6 months after detoxification showed a higher rate of personality disorders (especially antisocial and borderline) and slightly more cognitive deficits (especially in verbal memory and visuomotor functions) than abstainers even before therapy. CONCLUSION: The high amount of early relapses and drop-outs probably hindered larger differentiated treatment effects. Hypotheses will be retested in treatment completers using forthcoming follow-up data.

Alcoholism↗
PubMed2001

Out-patient behaviour therapy in alcoholism: relapse rates after 6 months.

OBJECTIVE: In spite of the increasing interest in out-patient treatment programmes for alcoholics, there still exist only a few experimental studies on this issue. In this still ongoing study the efficacy of different behaviour therapy strategies is to be examined. METHOD: One hundred and twenty patients were assigned randomly to non-specific supportive therapy or to two forms of behavioural therapy (coping skills training and cognitive therapy). Behavioural treatment comprised 26 weekly sessions; follow-up examinations will take place every 6 months over 2 years. RESULTS: Patients undergoing behavioural therapy showed less drop-outs and significantly higher rates of abstinence compared with supportive treatment. Nevertheless, statistically significant differences between the two behavioural therapy strategies could not be established so far. CONCLUSION: Preliminary results demonstrate the feasibility and efficacy of behaviour therapy programmes in the out-patient treatment of alcoholism. Furthermore, they stress the importance of professional psychiatric and psychotherapeutic engagement in the field of addiction.

Adult↗
PubMed2001

[Strategies of long-term medication in schizophrenia].

Schizophrenia is a relapsing disorder. The main goal of neuroleptic long-term treatment is relapse prevention, which is empirically well proven. Availability of different kinds of treatment strategies including new antipsychotic drugs with improved risk/benefit profile allow long-term treatment to be individually tailored. Treatment guidelines developed mainly by the scientific medical societies can help the practitioner in making the right decisions.

Antipsychotic Agents↗
PubMed2001

[Outpatient behavioural treatment in alcoholism: alcohol consumption and sociodemographic factors].

In spite of the increasing interest in outpatient treatment programmes for alcohol dependents, there still exist only a few experimental studies on this issue. Moreover, the interaction between abstinence and sociodemographic factors has been only rarely explored. In this study, the efficiency of different behaviour therapy strategies was examined: 120 patients were randomly assigned to nonspecific supportive therapy or to 2 forms of behavioural therapy (coping skills training and cognitive therapy). Behavioural treatment comprised 26 weekly sessions; follow-up examinations took place every 6 months over 2 years. Patients undergoing behavioural therapy showed less drop outs and significantly higher rates of abstinence and also of reemployment and satisfaction with their job situation compared to those under supportive treatment. At the same time, the employment status proved to be a valid predictor of treatment success, whereas there was only a weak (negative) impact of an existing partnership on abstinence. Statistically significant differences between the 2 behavioural therapy strategies could be established in neither respect.

Adult↗
PubMed2001

A prospective study of factors influencing adherence to a continuous neuroleptic treatment program in schizophrenia patients during 2 years.

Dropout from prophylactic neuroleptic treatment is one major reason for relapse in schizophrenia patients. There is a lack of prospective studies on factors that predict medication adherence. We investigated factors suspected to predict dropout from continuous neuroleptic treatment in a 2-year prospective study involving 122 outpatients with a DSM-III-R diagnosis of schizophrenia. Forty-two (34.4%) were classified as patient-related dropouts. No significant difference between compliant patients and dropouts was found with regard to sociodemographic variables, except that compliant patients were significantly older. Also, no differences in psychopathology were seen at the beginning of treatment, but compliant patients had a longer duration of illness. Compliant patients had higher doses of neuroleptics in the initial stabilization phase and correspondingly showed more extrapyramidal signs. Physicians rated compliant patients from the beginning as more cooperative. These patients also showed significantly higher scores in positive treatment expectations. In a stepwise regression analysis, positive illness concepts, the global assessment of functioning (GAF), and the physicians' view of patients' cooperation predicted 19 percent of the variance. We concluded that the prediction of dropouts is insufficient and remains largely an unsolved problem. Future research should focus more on context factors in the search for clinically meaningful explanations of patient dropout from treatment.

Adult↗
PubMed2001

Subcortical correlates of craving in recently abstinent alcoholic patients.

OBJECTIVE: This study investigated functional cerebral correlates of craving in alcoholic patients and examined the state/trait characteristics of the regional cerebral network implicated in craving. METHOD: Functional magnetic resonance imaging (fMRI) was used to map cerebral response elicited by ethanol odor in 10 male patients with alcohol dependence who had undergone detoxification and 10 matched nonpatients. After 3 weeks, during which the patients underwent standardized behavioral therapy with psychopharmacological intervention, all subjects were studied a second time with fMRI to evaluate the effects of therapy on the functional cerebral correlates of craving. RESULTS: In the alcoholic patients, cue-induced craving before treatment elicited activation primarily in the subcortical-limbic region of the right amygdala/hippocampal area and in the cerebellum. After treatment, activation was found in the superior temporal sulcus, while subcortical or cerebellar participation was no longer present. Comparison subjects showed no comparable amygdala or cerebellar activation during ethanol stimulation and demonstrated no change in activation pattern between measurements. CONCLUSIONS: This investigation points to state-dependent neurobiological correlates of cue-induced craving in alcoholic patients and suggests that these correlates can be influenced by therapeutic interventions. The presence of emotional aspects of craving is suggested by amygdala activation.

Adult↗
PubMed2001

Disturbed facial affect recognition in patients with schizophrenia associated with hypoactivity in distributed brain regions: a magnetoencephalographic study.

OBJECTIVE: The authors sought to identify brain mechanisms underlying the well-documented facial affect recognition deficit in patients with schizophrenia. Since this deficit is stable over the course of the illness and relatively specific for schizophrenic disorders, it was expected that knowledge about the related brain mechanisms would provide substantial information about the pathophysiology of the illness. METHOD: Fifteen partly remitted schizophrenic inpatients and 12 healthy volunteers categorized facial expressions of emotion and performed two control tasks while magnetoencephalographic recordings were done by means of a 148-channel whole head system, which revealed foci of high cerebral activity and their evolution in time. Anatomical sites were defined through coregistrated magnetic resonance images. RESULTS: The magnetoencephalography data recorded in response to facial expressions of emotion revealed that patients generated weaker activations (primary current density) in inferior prefrontal, temporal, occipital, and inferior parietal areas at circumscribed latencies. Group differences did not occur in basic visual areas during a first sensory-related activation between 60 and 120 msec. Behavioral performance was associated with strength of activation in inferior prefrontal areas, the right posterior fusiform gyrus region, right anterior temporal cortex, and the right inferior parietal cortex. CONCLUSIONS: Disturbed facial affect recognition in schizophrenic patients might be a result of hypoactivity in distributed brain regions, some of them previously related to the pathophysiology of schizophrenic disorders. These regions are probably working within a spatially and temporally defined circuitry.

Adult↗
PubMed2001

Disturbance of serotonin 5HT2 receptors in remitted patients suffering from hereditary depressive disorder.

AIM: The characteristics of 5HT2 receptor binding were investigated in major depression in vivo using positron emission tomography and the radioligand F-18-altanserin. METHODS: Twelve patients from families with high loading of depression living in a geographically restricted region were examined and compared with normal control subjects. At the time of the PET measurement all patients were remitted; in some of them remission was sustained by antidepressive medication. Binding potential was assessed by Logan's graphical analysis method. RESULTS: The binding of F-18-altanserin was about 38% lower in patients than in healthy controls (p < 0.001). A multiple regression analysis revealed that this difference was mainly induced by depression rather than by medication. CONCLUSIONS: The data suggest that 5HT2 receptors are altered in depression. We present evidence for a reduction of the receptor density, which might be usable as trait marker of subjects susceptible for depressive illness.

Adult↗
PubMed2000

The hypothalamic-pituitary-thyroid axis in patients with schizophrenia.

Serum concentrations of thyroxine (T(4)), triiodothyronine (T(3)), reverse triiodothyronine (rT(3)) and thyrotropine (TSH) were measured in 31 acutely ill in-patients with schizophrenia before and after four weeks of treatment with the phenothiazine derivative perazine. The serum levels of all the above hormones were also determined in 19 schizophrenic patients in remission who were receiving no medication, 20 schizophrenic patients in remission taking neuroleptic drugs, and 24 patients with residual-type schizophrenia. The serum levels of T(4) of acutely ill schizophrenic patients were elevated, while those of T(3), rT(3) and TSH were normal. Their T(4) levels showed a positive correlation with the severity of illness and the degree of clinical response to neuroleptic treatment. There was a significant fall in serum concentrations of T(4) and rT(3) during four weeks of drug treatment and the decrease was significantly correlated to clinical response. No abnormalities in the serum concentrations of any of the hormones measured were found in schizophrenic patients in remission or in residual-type schizophrenia. In conclusion, our results indicate that the elevated serum levels of T(4) may be specific for acutely ill schizophrenic patients and that neuroleptic medication may affect thyroid hormone metabolism, this interaction being involved in the mechanism of action of these drugs.

Acute Disease↗