Search PubMed⌕ Search

Biomedical subjects

W Gaebel

Publications and source records attributed to W Gaebel.

At least 91 records · Page 5Linked to original sources
PubMed1994

Orthostatic challenge during neuroleptic test dose: a possible predictor of short-term outcome.

Cardiovascular measurements were used as indicators of autonomic arousal during an orthostatic challenge test without medication and after a test dose of 150 mg perazine in 20 acute schizophrenic patients. Unmedicated schizophrenics showed elevated heart rates and elevated systolic and diastolic blood pressure in comparison to healthy volunteers. After a test dose of 150 mg perazine, responders (using BPRS outcome criteria after 23 days) showed a pronounced orthostatic heart rate reaction in comparison to nonresponders. Results are discussed in relation to arousal theories and central dopaminergic activity in schizophrenia.

Adult↗
PubMed1993

Early neuroleptic intervention in schizophrenia: are prodromal symptoms valid predictors of relapse?

All recently completed controlled two-year studies on intermittent, early neuroleptic intervention treatment have failed to compare favourably with studies on maintenance treatment concerning relapse prevention. The reason for this failure is still unclear. Therefore the implicit, but as yet unproven, hypothesis that a relapse can be predicted from prodromal symptoms was tested from the perspective of our German multicentre study. Results demonstrate that this is not the case. Possible reasons for and clinical implications of this negative finding are discussed.

Adult↗
PubMed1993

The importance of non-biological factors in influencing the outcome of clinical trials.

The outcome of clinical drug trials is influenced both by biological and by non-biological factors. Non-biological factors can be subdivided into methodological factors and non-drug factors. The former are related to the definition and measurement of treatment course, response, and outcome itself; the latter cover characteristics of the patient, the treatment milieu, the patient's milieu apart from treatment, and (planned) psychosocial interventions. Although their mechanism of interaction with treatment outcome is not yet fully understood, these non-drug factors should be routinely monitored in clinical trials for three practical reasons: (a) to control for the heterogeneity of outcome; (b) to develop individualised outcome predictors; and (c) to promote the development of individualised guidelines for treatment indication.

Clinical Trials as Topic↗
PubMed1993

[Neurobiological determinants of schizophrenic diseases. Concept, strategy and methods of a research program].

Biological research in schizophrenia aims at clarifying the etiopathogenesis of schizophrenic psychoses and developing causal therapies. Besides the necessary coordination of available resources, the scientific success of such a research program depends mainly on adequate concepts, research strategies, and methods of assessment. The present paper discusses some of these conceptual research aspects.

Brain↗
PubMed1993

[Are visual and auditory perception modified in psychopathological assessment of expressive markers of psychiatric patients?].

The assessment of nonverbal expression (e.g. facial action, speech, body movements, etc.) are an important aspect of the diagnostic and prognostic process in psychiatric patients. By means of observer rating scales' expression is usually assessed on different observation levels. It appears that visual and auditory perception of expression interfere with one other. In the present study it was demonstrated, that ratings of certain attributes of expression was significantly more inconsistent in schizophrenic than in depressed patients, provided information was simultaneously displayed to both visual and auditory channels of perception. A "disintegration" of the components of expression in schizophrenics may explain why raters get differings impressions of the patient's overall expression. Moreover, the description of expressive behaviors seems to be influenced by diagnostic stereotypes. The development of a more objective method of assessment would therefore be promising.

Adolescent↗
PubMed1992

Facial expression and emotional face recognition in schizophrenia and depression.

Twenty-three acute schizophrenics, 21 acute major depressives (Research Diagnostic Criteria), and 15 normal controls participated in a study on facial expression and emotional face recognition. Under clinical conditions, spontaneous facial expression was assessed according to the affective flattening section of the Scale for the Assessment of Negative Symptoms. Under experimental laboratory conditions involuntary (emotion-eliciting interview) and voluntary facial expression (imitation and simulation of six basic emotions) were recorded on videotape, from which a raterbased analysis of intensity or correctness of facial activity was obtained. Emotional face recognition was also assessed under experimental conditions using the same stimulus material. All subjects were assessed twice (within 4 weeks), controlling for change of the psychopathological status in the patient groups. In schizophrenics, neuroleptic drug influence was controlled by random allocation to treatment with either haloperidol or perazine. The main findings were that schizophrenics and depressives are characterized by different quantitative, qualitative, and temporal patterns of affect-related dysfunctions. In particular, schizophrenics demonstrated a trait-like deficit in affect recognition and in their spontaneous and voluntary facial activity, irrespective of medication, drug type and dosage, or extrapyramidal side-effects. In depressives a stable deficit could be demonstrated only in their involuntary expression under emotion-eliciting interview conditions, whereas in the postacute phase a reduction in their voluntary expression became apparent. Differences in patterns of affect-related behavioral deficits may reflect dysfunctions in different underlying psychobiological systems.

Adult↗
PubMed1992

Depressive syndromes in schizophrenic patients under neuroleptic therapy. ANI Study Group Berlin, Düsseldorf, Göttingen, Munich, Federal Republic of Germany.

Schizophrenic outpatients (= 364) were assigned at random to three different treatment strategies: (1) continuous medication with neuroleptic drugs, (2) intermittent medication with crisis intervention and (3) intermittent medication with early intervention. Depressive syndromes were rated according to three different scales for depressive syndromes (Brief Psychiatric Rating Scale anxious depression factor, Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie/depression, and the self-rating Paranoid Depression Scale) after 1 and 2 years of treatment. No differences in depression scores were found between the three treatment strategies. Comparisons between patients treated with neuroleptic drugs at the time and patients without neuroleptics revealed significantly higher depression scores in the neuroleptics group in most comparisons. No differences were found between patients treated with low versus high potency neuroleptics and between oral versus depot neuroleptics. However, depression correlated with extrapyramidal symptoms.

Administration, Oral↗
PubMed1992

Early serum levels of neuroleptics do not predict therapeutic response in schizophrenia.

Thirty-six acute schizophrenics were included in a 28-day open treatment study with the neuroleptic perazine. Peak serum levels of parent drug and its main inactive metabolite desmethyl-perazine were assessed 2 hours after an oral test dose given at the beginning of the study. Whereas peak levels of perazine were not significantly different in treatment responders and nonresponders, desmethyl-perazine was significantly higher in nonresponders. The ratio between desmethyl-perazine and perazine was not predictive of (non-) response to neuroleptic treatment in schizophrenia.

Adult↗
PubMed1990

Depressive syndromes in schizophrenic patients after discharge from hospital. ANI Study Group Berlin, Düsseldorf, Göttingen, Munich.

A total of 364 schizophrenic outpatients who were stabilized for 3 months on continuous neuroleptic therapy after discharge from the hospital were rated according to three different scales for depressive syndromes (Brief Psychiatric Rating Scale anxious depression factor, AMDP/depression, and the self-rating PD-S depression scale). Between 19.5% and 27.5% of the patients were rated as depressed, or 35.7%-42.8%, when mild depressive syndromes were included. There were low, but significant correlations between demographic or life-event data and depression scores on the self-rating scale, whereas fewer correlations were found on the observer ratings. No associations were found between social adjustment and depression. Moderate correlations were found between measures of the apathetic syndrome and depression ratings, while observer ratings showed higher correlations than the self-rating. High depression scores, especially in the observer ratings, correlated with scales for global psychopathological assessment (CGI, GAS). There were significant correlations between extrapyramidal rigidity and observer rating depression scores, whereas the total amount of neuroleptics given had no influence. These results are interpreted on the basis of hypotheses about depressive syndromes in schizophrenia.

Antipsychotic Agents↗
PubMed1990

[Behavior analytic approaches of research in psychiatry].

Biologically oriented psychiatric research usually relies more on abstract nosological concepts than on purely descriptive psychopathological syndromes. However, biological validation of psychiatric diagnoses has not been possible so far. More recent findings emphasize the nosological unspecificity, but syndromal specificity of biological data. It seems promising therefore to differentiate psychopathological descriptions more clearly by using objective methods of behavioural assessment and analysis. Concept, methods and examples of this empirical approach will be outlined.

Humans↗
PubMed1989

Visual search, eeg, and psychopathology in schizophrenic patients.

Twenty acutely admitted schizophrenic inpatients diagnosed according to RDC and 8 normal controls were instructed to search for a randomly located target letter (Z) in ten lists of 284 distractor letters of either rounded or angular shape projected on a screen (23 degrees x 15 degrees). Eye movements were recorded using infrared corneal reflection-pupil centre measurement. Search performance was defined as the search time in seconds from onset of the display until localization of the target. The EEG was recorded simultaneously in schizophrenics, in whom assessment took place shortly after admission and before discharge. The psychopathological status was assessed at the same time with the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms. Search performance was not significantly different in schizophrenics and normal controls, but was heavily affected by target/distractor similarity in both groups. Moreover, search performance in schizophrenics was not significantly affected by illness severity. However, search performance was differently related to negative and positive symptoms. Schizophrenics and normal controls differed with respect to the relationship between search performance and visuomotor microbehaviour. Additionally, two relatively time-stable eye movement patterns in schizophrenics could be distinguished, which were differently related to psychopathology, performance measures and EEG.

Adult↗
PubMed1989

Visuomotor behavior in schizophrenia.

The diagnosis of "positive" schizophrenia relies heavily on reported symptoms. Behavioral signs, however, play an important role in "negative" schizophrenia. Their advantage is that they can be assessed objectively and quantitatively. Thus, their measurement can improve both the precision of the diagnostic process and the phenomenological basis of biologically oriented research. The assessment of various types of visuomotor behavior (e.g., eye fixations, saccades, smooth-pursuit eye movements) with different functions and anatomic organization, and of their trait- and state-related disturbances in schizophrenia are an example of this kind of research. Whether analyzed from an interactional or an individual perspective, visuomotor behavior is best understood within a broader neurobiological frame of reference. In combination with brain imaging techniques it is an important tool with which to explore brain behavior relationships in schizophrenia and other related psychoses.

Behavior↗
PubMed1988

Prediction of neuroleptic on-drug response in schizophrenic in-patients by EEG.

The subjects were 34 acutely ill in-patients who met the RDC criteria of schizophrenic psychosis, and 4 EEGs were recorded from each patient before, 2 h and 24 h after oral intake of a single dose of 150 mg perazine, and on the 28th day of the neuroleptic treatment period. As a criterion of clinical response a decrease of at least 66% in the schizophrenia-specific sum score of the Brief Psychiatric Rating Scale on day 28 relative to the baseline value was decided upon. The EEGs were assessed using a newly developed procedure which takes into consideration 4 derivations simultaneously. As we tried to search out EEG variables with predictive value the statistical data analysis underlying our findings should largely by regarded as exploratory. Independent of day, responders (R) showed a tendency towards more low voltage desynchronized epochs (non-A stage) than non-responders (NR). Thus, R exhibited a higher degree of dynamic variability or a broader range of control of the spontaneous vigilance fluctuation (dynamic lability) than NR (dynamic rigidity). Furthermore, R and NR differed with respect to their time-dependent changes of non-A epoch frequencies before medication. While R showed a monotonous increase which is typical for normals, NR did not. Because of considerable inter-individual variability these group differences could not be used for individual prediction of the therapy response. By means of a qualitative data analysis R could be distinguished from NR with regard to various test dose-induced changes of the topographical distribution of absolute alpha power. All the group differentiating variables showed a time course of the same kind: R showed a prompt and ample deflection and the same recovery of baseline; NR, in contrast, showed no significant deflections at all. These findings are in line with the results concerning the dynamics of vigilance and certain claims of earlier authors according to which EEG changeability should be decisive for therapeutic outcome.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗