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W Maier

Publications and source records attributed to W Maier.

At least 361 records · Page 20Linked to original sources
PubMed1991

Avoidance behaviour: a predictor of the efficacy of pharmacotherapy in panic disorder?

The impact of the avoidance behaviour on the psychopharmacological treatment of panic disorder was explored in the Cross National Collaborative Panic Study (n = 1134 patients); in this double blind randomized trial alprazolam, imipramine and placebo were compared during an 8-week treatment period. Patients with extensive avoidance behaviour (agoraphobia) had the most profit from the active drugs. Counter expectancy these specific drug effects were most pronounced in avoidance behaviour. Active drugs (in particular imipramine) were especially more effective than placebo if the patients presented with associated avoidance behaviour. The results suggest that agoraphobia defines more a particular type of anxiety disorder overlapping with panic disorder than merely a severe state of panic disorder.

Adult↗
PubMed1991

The reliability of the SADS-LA in a family study setting.

The joint-rater and test-retest reliability study of two translated versions of the SADS-LA (Schedule for Affective Disorders and Schizophrenia--Lifetime version--modified for the study of anxiety disorders), one in French and the other in German, have been tested in family study settings, in a sample of patients and first-degree relatives. The test-retest reliability study demonstrated that identification of major affective disorders and schizophrenia was performed with sufficient reliability; however, diagnoses of subtypes of major disorders (e.g. bipolar II disorder) and identification of minor disorders was less reliable. The implications of these findings in phenotype identification during family studies in psychiatry are discussed.

Adult↗
PubMed1991

The impact of the endogenous subtype on the familial aggregation of unipolar depression.

The endogenous/non-endogenous distinction of unipolar major depression is widely accepted, as is the family study approach to the validation of diagnostic distinctions. Rates of affective disorders were examined in 689 first-degree relatives of 184 patients with unipolar major depression and were compared with 312 first-degree relatives of 80 healthy controls. Only unipolar depression and alcoholism were more common in families of depressed probands compared with families of healthy controls. As a variety of diagnostic definitions of endogenous depression have been proposed, probands and relatives were diagnosed in a polydiagnostic manner. None of the five diagnostic definitions of endogenous depression was able to identify patients with an increased familial risk of unipolar depression.

Arousal↗
PubMed1991

Unipolar depression in the aged: determinants of familial aggregation.

Late-onset depression (greater than or equal to 60 years) is believed to be less associated with a risk of depression in first-degree relatives than early-onset depression. However, family studies in elderly probands fitting the current methodological standards of family studies are not available. The reported family study in geriatric inpatients with unipolar major depression (n = 92) supported the proposed relationship between age at onset and the proposed familial loading. A comparison to families of age-matched controls (n = 33) revealed that relatives of probands with late-onset depression are still at an increased risk of depression. However, late-onset depression was not more common in families of probands with late-onset depression than in families of probands with early-onset depression. Besides the age at onset, the recurrence of depressive episodes defined distinct patterns of familial aggregation.

Adult↗
PubMed1991

[Tube function in sudden hearing loss].

The function of the Eustachian tube was assessed in 50 patients suffering from sudden hearing loss, using the pressure chamber impedance method. We investigated the existence of a relationship between sudden hearing loss and the occurrence of a patulous tube. We could not observe more patulous tubes in patients with sudden hearing loss compared to a control group with healthy ears. We registered the parameters "tissue resistance pressure" and "tubal opening pressure", both characterising the passive qualities of the Eustachian tube. There was no indication of a facilitated passive tubal opening nor a tendency to a patulous tube among our patients. Statistical evaluation of these parameters showed no significantly different tubal function on comparing the right and the left ear, as well as the ear affected by sudden hearing loss and the healthy ear. We conclude that there is no relationship between sudden hearing loss and patulous tube.

Adolescent↗
PubMed1991

[Flow-directed application of contrast media for computed tomography].

A contrast injector for CT developed by the manufacturers C. H. Ulrich, Ulm, was tested in animal experiments and clinically. The pre-clinical investigation involved injection into 30 dogs. Subsequently the injector was used clinically in 1882 patients. The totally automatic programmed injector showed a high degree of reliability. By standardizing the contrast medium injection, it was possible to obtain optimal image quality.

Animals↗
PubMed1991

An interdisciplinary study towards a multiaxial classification of male sexual dysfunction.

The classification of male sexual dysfunction (SD) was investigated in a multidisciplinary study involving a sample of 25 outpatients whose phenomenology, course and biologic comorbidity is described. All 25 patients were suffering from arousal disorders; 9 men complained of lack of desire and 9 of orgasm disorders. For the vast majority (19/25), the arousal disorder preceded the other sexual dysfunctions. Eleven patients suffered from a psychopathological disorder according to DSM-III or DSM-III-R (Axis I and II), with general anxiety, major depression and obsessive-compulsive personality being the most common disorders. Only 6 patients were free of any organic disorder or pathological laboratory finding known to be related to sexual dysfunction. These results served as the basis for analyzing the fit of our data in the most prominent classification systems DSM-III, DSM-III-R, Mainz multiaxial classification model and the traditional dichotomy model. According to our data, the comorbidity of biologic and mental conditions was very high, as most patients (60%) suffered from more than one etiologic factor known to be related to SD. Based on these results, a modification of the DSM-III-R system is suggested.

Adolescent↗
PubMed1991

The Panic-Associated Symptom Scale: measuring the severity of panic disorder.

The Panic-Associated Symptom Scale (PASS) is presented as a new measurement of the severity of the core symptoms of panic disorder. This first description addresses the rationale for its design and its scoring, score distributions, test-retest reliability, correlations within the PASS and with other scales, principal component structure, and response to drug therapy. Data are presented from a large study group of patients with panic disorder (n = 1168). Problems in measuring panic disorder are discussed.

Adult↗
PubMed1991

[Familial aggregation of psychiatric disorders and the consequences for the psychiatric diagnosis].

Schizophrenic and affective disorders, anxiety disorders, and alcoholism show familial aggregation; the impact of familial aggregation on the classification and etiology of psychiatric disorders is discussed. Ideal diagnostic schedules should a) identify conditions with a substantially increased familial risk and b) reach diagnostic homogeneity in multiplex families. A review of the literature shows a) that age at onset, long-term course and comorbidity modify familial risks and should therefore be given more attention in diagnostic schedules and b) that the heterogeneity of disorders in multiplex families draws the validity of currently used diagnostic schedules into question. Against this background the hypothesis of "unitary psychosis" is discussed.

Humans↗
PubMed1990

Consistencies and discrepancies in self- and observer-rated anxiety scales. A comparison between the self- and observer-rated Marks-Sheehan scales.

The Marks-Sheehan anxiety scales are the only scales where self-ratings and observer ratings are perfectly matched by the number, the content and the scaling of the items. Therefore these scales are an excellent tool to investigate the compatibility and to study different structures in self- and observer ratings. This was done by using the data material on the Marks-Sheehan scales of the Cross National Collaborative Panic Study. In this study 1168 outpatients who met the DSM-III criteria for panic disorder were randomly allocated either to alprazolam, imipramine or placebo treatment. Our results show that the Marks-Sheehan scales are highly comparable to other established rating scales. Both scales have a similar stable and consistent factor pattern for somatic symptoms but not for psychic symptoms of anxiety. Our results provide empirical evidence that the low consistencies between self- and observer ratings reported so far can be improved by using a rating scale which matches up item for self- and observer ratings. However, other sources of disagreement can only be solved by more elaborated item descriptions and training of patients as well as raters to obtain a better compatibility between self- and observer rating scales.

Adult↗
PubMed1990

Self- and observer assessment in anxiolytic drug trials: a comparison of their validity.

Self-rating scales are considered to be less useful for comparing different treatments in anxiety patients than observer-rating scales. However, the empirical evidence for this assumption is not adequate. A self-rating inventory of 35 items related to anxiety was perfectly parallel with an observer-rating inventory. Both instruments were used in the Cross National Collaborative Panic Study to compare the efficacy of imipramine, alprazolam and placebo in an 8-week drug trial in a sample of 1168 outpatients. The variance of the self-rating assessments was about two times higher. Both scales were equally sensitive to change; however, the measurement of change by means of the self-rating scale was slightly less consistent. The discriminative power of the observer-rating scale between placebo and active treatment was two to three times higher than that of the self-rating scale; consequently the observer-rating procedure provides a more valid instrument when the efficacies of different anxiolytic treatments are compared between different groups of patients.

Adult↗
PubMed1990

Comparison of the ICD-10-classification with the ICD-9- and the DSM-III-classification of mental disorders.

The diagnostic concepts in ICD-10 show better congruence with those in DSM-III than with those in ICD-9. The diagnostic definitions used by ICD-10 and DSM-III for the majority of diagnoses turn out to be similar; the definitions of anxiety disorders and schizoaffective disorders are, however, still at variance. Consequently, the empirical results from the WHO field trial in German-speaking countries reveal a high degree of overlap between the two systems; the degree of overlap between ICD-9 and ICD-10 was lower, but still surprisingly high overall. These empirical results support the validity of ICD-10.

Humans↗
PubMed1990

ICD-10 field trial in German-speaking countries--summary, judgement and perspectives.

On the basis of the results of the field trial, the most important classificatory innovations of ICD-10, together with their advantages and disadvantages are described. The initial good acceptance of the new system could be further improved by structural modifications, such as a uniform and systematic description of the individual diagnostic categories. Criticism of content was focused on affective and neurotic disorders and adult personality disorders. When it is introduced, the psychiatric chapter of ICD-10 will surpass most of the hitherto existing psychiatric classification systems in size, differentiation and international testing.

Adolescent↗