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W Maier

Publications and source records attributed to W Maier.

At least 325 records · Page 18Linked to original sources

Cognitive functioning and anhedonia in subjects at risk for schizophrenia.

This study investigated the performance of individuals with familiar loading of schizophrenia (healthy siblings of schizophrenic inpatients) on three neuropsychological tasks assumed to require frontal lobe functions: Trail Making Test (TMT), verbal fluency and Wisconsin Card Sorting Test (WCST). Healthy siblings of schizophrenics differed in performance from healthy controls not only on the WCST, but also on the Trail Making Test and the verbal fluency task. Furthermore, scores of physical anhedonia, assessed in a self-report rating scale (Chapman et al., 1976) were also significantly higher in the high risk group than in the control sample. However, healthy siblings of schizophrenics did not differ from controls with regard to experiences of perceptual aberrations, measured by the same method (Chapman et al., 1978). Neuropsychological performance and elevated anhedonia scores in the high risk group were interpreted under the conceptual framework of vulnerability markers: they were supposed to represent a trait shared by family members of schizophrenic probands. Amongst the neuropsychological tests, there were significant correlations between the physical anhedonia score and WCST and Trail Making test performance in the group of healthy siblings of schizophrenics, but not in the control group.

Adult↗

[Topical anesthesia of the tympanic membrane and tubal function--is there a correlation?].

The influence of topical anaesthesia of the tympanic membrane on Eustachian tube function was investigated using the pressure chamber impedance method, thus obtaining quantitative data. Anaesthesia was performed by application to the tympanic membrane of small cotton balls containing lidocaine and dimethylsulfoxide. We did not observe significant alterations of tubal parameters after unilateral or bilateral anaesthesia. Our observations are in contrast to investigations published by Nagai. We suppose that differences in methods of topical anaesthesia are responsible for this discrepancy. Our technique of topical anaesthesia of the tympanic membrane excludes any effect on the Eustachian tube, thereby avoiding negative consequences of middle ear pressure on wound healing.

Anesthesia, Local↗

[Effects of a change in environmental pressure on spontaneous nystagmus in patients with cochleovestibular diseases].

Cochlear and vestibular effects of variation of middle ear pressure have been discussed for more than 50 years. In 1975, Densert reported on temporary improvement of hearing threshold in patients suffering from Ménière's disease after reduction of air pressure in a pressure chamber. One year later Ingelstedt observed reduction of spontaneous nystagmus under this condition. The transmission of relative overpressure from the middle ear to the labyrinth with consecutive decongestion of the hydropic endolymphatic system to the saccus was thought to be the cause of this phenomenon. Meanwhile a direct effect of labyrinthine pressure on the activity of the inner ear and labyrinth in healthy subjects and animals has been described. In order to gain further information on the phenomenon observed by Densert and Ingelstedt we performed investigations on patients suffering from several cochleovestibular diseases. Chamber pressure was altered and simultaneous electronystagmographic recording was performed. As a striking result, we observed a reduction of the pathological spontaneous nystagmus in a majority of patients with vestibular damage during and after the reduction of chamber pressure. Many of these subjects showed a partial restitution of nystagmus if the chamber pressure was increased again. This observation was made in patients with Méni ere's disease, vestibular neuritis and sudden hearing loss with vestibular involvement. Hence, we conclude that this phenomenon is not specific for Ménière's disease. A transmission of middle ear pressure to the labyrinth may be an explanation of our observations.

Air Pressure↗

The role of obstetric complications in schizophrenia.

The importance of obstetric complications in sporadic and familial psychoses was analyzed in 43 schizophrenic and 28 chronic schizoaffective patients. Patients and first-degree relatives were diagnosed using Research Diagnostic Criteria and the best-estimate procedure. Mothers of patients were interviewed for histories of pregnancy and obstetric complications in their offspring. Patients had more often suffered perinatal complications (42%) than their siblings (29%). The risk for obstetric complications and secondary cases of psychosis was enhanced in relatives of patients with a history of obstetric complications. Siblings with obstetric complications had a low incidence of psychoses; therefore, obstetric complications could not explain the occurrence of secondary cases of psychosis in siblings. Patients with familial psychoses had a higher incidence of obstetric complications than did sporadic cases (without reaching statistical significance). There was no inverse relationship between the history of obstetric complications in patients and the morbid risk of first-degree relatives for psychoses. The familial versus sporadic distinction revealed no subgroups where obstetric complications were of special relevance.

Adult↗

The distinction of bipolar II disorder from bipolar I and recurrent unipolar depression: results of a controlled family study.

The aim of the study was to differentiate bipolar II, bipolar I and recurrent unipolar depression by their familial load for affective disorders. Eighty bipolar, 108 unipolar, 80 control subjects and interviewed first-degree relatives were diagnosed according to Research Diagnostic Criteria using the Schedule for Affective Disorders and Schizophrenia--lifetime version. The morbid risks for bipolar I disorder were equivalent in relatives of bipolar I (3.6%) and bipolar II (3.5%) subjects and lower in relatives of unipolar subjects (1.0%). The morbid risks of relatives for bipolar II disorder distinguished bipolar II subjects (6.1%) from bipolar I subjects (1.8%), from unipolar depressives (0.3%) and from controls (0.5%). To promote further evaluation, bipolar II disorder should be included in DSM-IV as a distinct diagnostic category.

Adolescent↗

Positive/negative symptomatology and experimental measures of attention in schizophrenic patients.

In a search for an external validation of the negative syndrome construct and the attentional impairment item on Andreasen's scale, 49 unmedicated schizophrenic patients were administered the Span of Apprehension Test and a Continuous Performance Test with two levels of difficulty. This schizophrenic sample performed significantly more poorly on the attentional tests than a comparable group of 27 healthy control subjects. Depending on the difficulty of the test we found a number of significant correlations between the SANS composite score and the pertaining attentional impairment item on the one hand and experimental indices of attentional functioning on the other hand, which might corroborate the psychopathological assumptions. The implications of these results for further attempts to validate clinical concepts of the positive/negative dichotomy by experimental means will be discussed.

Adolescent↗

Assessment of frontal lobe functioning in schizophrenia and unipolar major depression.

This study has used neuropsychological tasks--Wisconsin Card Sort (WCST), Trail Making (TMT) A and B, Verbal Fluency, Digit Span--to compare acute and currently off-medication schizophrenics, patients with unipolar nonpsychotic major depression and healthy controls. Both patient groups differed significantly from healthy controls in their neuropsychological performance. Furthermore there was only little (quantitative) difference between schizophrenics and depressed patients in the frontal lobe associated tasks: WCST, TMT and Verbal Fluency. Depressed patients tended to perform worse than schizophrenics on Digit Span, a task hypothesized to involve other than frontal areas of the brain. Although the group of depressed patients was older than the schizophrenic sample, the effect of age may not totally explain the findings. The results indicate that there do exist disturbances in frontal lobe cognitive functioning in schizophrenia and depression. Symptomatology (SANS/SAPS) and cognitive functioning in the schizophrenic group revealed only a trend for negative symptoms to be associated with worse performance in the WCST, but were significantly correlated with negative as well as positive symptoms on the TMT.

Adult↗

[Evolution and functional morphology of primate facial skulls].

Both ontogenetically and phylogenetically the facial skull of primates consists of two components: the endocranial nasal capsule, and the exocranial membrane bones. The cartilaginous nasal capsule of the fetal period constitutes the framework for the nasal cavity, and it also functions as an expansive basis for the developing facial skull. In adult animals, its ossified parts form the fragile ethmoid bone. The structure of the nasal capsule is determined on the one hand by the spatial requirements of the orbits and of the nasal cavity (with respiratory and olfactory components), and on the other hand by the biomechanical properties of the chewing apparatus. The interaction of these heterogeneous factors results in complex, species-specific compromises. Primates are characterized by a gradual reduction of their olfactory system throughout evolution and by binocular vision. Their chewing apparatus shows constructional adaptations to a varying herbivorous diet. Viewed within a phylogenetic-systematic framework, primate evolution may be taken as a natural experiment that demonstrates the influence of various factors on a complex structural system such as the nasal and facial skeleton.

Animals↗

[Cerebral seizure in naftidrofuryl infusion].

The case of a 7-year-old boy who suffered a convulsion during parenteral infusion of naftidrofuryl is reported. The effectiveness of adding naftidrofuryl to infusions designed to increase cochlear blood flow in cases of sudden hearing loss has been keenly debated in the otologic literature. Several hazards are associated with this drug, especially when the infusion is performed too fast. We recommend an individual decision for each patient suffering from cochleo-vestibular disorder based on the neurological and cardiological risk factors and the therapeutic possibilities.

Auditory Threshold↗

[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↗

[Validation of diagnoses according to psychiatric diagnostic manuals in follow-up studies, exemplified by affective and schizophrenic diseases].

The new international classification schedules ICD-10 and DSM-III-R were developed by committees of experts. These schedules need to be validated. One strategy is to conduct prospective long-term follow-up studies recruiting patients with a broad variety of syndromes diagnosed initially by previous and more recent classification schedules. Studies following this strategy are discussed and a new two-year follow-up study is presented. Several modifying psychosocial and treatment factors and methodological problems impose limitations on the interpretation of those studies with regard to the validity of applied classification schedules. Alternative validation strategies are discussed.

Affective Disorders, Psychotic↗

Evidence against linkage of schizophrenia to chromosome 5q11-q13 markers in systematically ascertained families.

Ten pedigrees systematically ascertained in Germany were tested for linkage to chromosome 5q11-q13. In order to replicate the previous report by Sherrington et al (1988), families with a bipolar family member were omitted from the lod score calculations, all diagnoses were based upon Research Diagnostic Criteria, and four different models of the affection status were calculated, including the model for which Sherrington et al calculated the highest lod scores. None of the families investigated showed a positive lod score. Using multipoint linkage analyses, we were able to exclude the region for which a positive linkage has been reported.

Chromosomes, Human, Pair 5↗

The risk of minor depression in families of probands with major depression: sex differences and familiality.

Currently it is not clear whether minor forms of unipolar depression not matching the criteria of "major depression" should be considered as a separate diagnostic category. A controlled family study examined the familial aggregation of minor depression among probands with unipolar major depression. In the families of these probands the relative risk for minor depression was elevated by a similar magnitude to the risk for major depression. Therefore, the diagnostic category "minor depression" would not increase diagnostic sensitivity at the expense of diagnostic specificity as far as familiality is the criterion. In agreement with recent epidemiological studies, minor depression did not reveal a similar excess prevalence in females compared with males as major depression does. The variation of the sex ratio for any subtype of unipolar depression was not associated with the familiality of this disorder.

Adult↗

Differentiation between major and minor depression.

Though the concept of Major Depression was generated by clinicians using depressed inpatients as models, a polydiagnostic study in 600 psychiatric inpatients with heterogenous psychological disturbances revealed that all six competing operational definitions of Major Depression (including DSM-III-R and ICD-10) were too restrictive to serve as a general concept of depression. Another polydiagnostic study in 500 primary care outpatients showed that more than two-thirds of all non-chronic depressed cases were below the severity threshold of Major Depression: these patients are classified as Depression Not Otherwise Specified (NOS) by DSM-III-R. Loosening of the over-restrictive time criteria would broaden the concept of Major Depression so as to meet the requirements of a general concept of depression, while the definition of Minor Depression below the threshold of Major Depression would add to a reduction of cases of NOS Depression by more than 80%. For the evaluation of antidepressant drugs in outpatient samples, we propose that patients with these modified definitions of Major and Minor Depression be included, provided they meet a minimum severity criterion of 13 or more points on the Hamilton Depression Scale; four-fifths of the modified Major Depression group and one-third of the Minor Depression group do in fact meet this criterion.

Depression↗

Depression in the community: a comparison of treated and non-treated cases in two non-referred samples.

Family studies in non-patient samples may help to clarify whether or not treatment-seeking behaviour is substantially determined by clinical features of depression. Life-time risks of depression were investigated by structured clinical interviews (SADS-LA) in both a high-risk sample of depressed patients' first-degree relatives and an unscreened control sample of the general population: 34.6% of the high-risk sample versus 23.1% of controls were cases of depression, with a female preponderance in both groups. The rates of treated depression were 17.0% versus 8.5%. Female sex, greater age, higher severity of episodes, manic or hypomanic episodes recurrent course, and introverted and anancastic personality were factors increasing the rate of treated cases in both samples, as well as familial loading with treated depression. Late onset and chronicity of depression did not significantly affect these proportions, but controlling for the effects of retrospective assessment by focusing only on depression within the past year confirmed the results. However, the major finding of a familial influence in treatment-seeking behaviour might be due to a personality factor running in families, as well as to a sharing of common environmental factors.

Adult↗

The familial relation of personality disorders (DSM-II-R) to unipolar major depression.

Four hundred and fifty directly interviewed relatives of probands with non-psychotic unipolar major depression and 320 directly interviewed relatives of controls were compared by the prevalences of personality disorders (P.D.) as defined by DSM-III-R, in relation to presence or absence of the relatives' affective disorder. Overall, there was only a trend for an increased risk for P.D. in relatives of depressed patients. However, P.D. and unipolar major depression co-occurred more frequently in relatives than expected by chance. It is suggested that this association is mainly due to non-familial factors. Compared with other P.D., the relationship of borderline P.D. to major depression was not substantially stronger.

Adult↗

Personality traits in subjects at risk for unipolar major depression: a family study perspective.

Particular patterns of personality (e.g., introversion, neuroticism, obsessionality) have been found to be associated with unipolar depression by a large number of investigators; recent prospective studies have stressed neuroticism as a premorbid risk factor for depression. This study examines whether similar patterns of personality are found in relatives of affective disorder patients and of controls. First-degree relatives of normal controls and of subjects with primary unipolar depression were studied using the Munich Personality Test. Relatives in remission from an episode of unipolar depression had clearly higher levels of neuroticism and rigidity and lower levels of extraversion than controls; healthy relatives of controls had higher levels of rigidity (both sexes) and of neuroticism (males only) than controls. It is proposed that these traits are either risk factors for depression or attenuated forms of depression.

Adult↗