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Biomedical subjects

W Maier

Publications and source records attributed to W Maier.

At least 379 records · Page 21Linked to original sources
PubMed1990

Drug treatment of panic disorder: early response to treatment as a predictor of final outcome.

One of the core problems in clinical research is the detection of early changes in target symptoms that predict future therapeutic outcome. To analyze potential predictors of outcome, data of a multicenter study on patients with panic disorder were used. A total of 1010 patients were randomly allocated either to alprazolam, imipramine or placebo treatment. Early improvement in the number of spontaneous panic attacks within the first week of treatment predicted outcome exclusively in the alprazolam group. In contrast, placebo responders and nonresponders were differentiated by early changes in anticipatory anxiety intensity. For tricyclic antidepressants such as imipramine an evaluation period of more than one week is required to allow conclusions about outcome.

Adult↗
PubMed1990

[Contribution of genetics to research in the etiology of depressive diseases].

The familial aggregation of depressive disorders is a major cue for the etiology of depression. The review of family, twin, adoption and linkage studies demonstrates that genetic transmission is involved in the manifestation of bipolar affective disorders but it explains only part of the variance; the evidence of a genetic basis of unipolar depression is less clear; this is the case for endogenous depression, too. It ist recommended to examine if personality features may contribute to an improvement in the identification of the phenotype in genetic studies in unipolar and bipolar depression.

Adoption↗
PubMed1990

[The use of imaging techniques in the diagnosis of pancreatic diseases].

The present paper discusses the use of modern imaging procedures in the diagnosis of various pancreatic diseases. Specific examination patterns are referred to their underlying pathological pancreatic processes to allow the best possible interpretation of the results of each technique. At present, magnetic resonance imaging does not play a decisive role in the diagnosis of either pancreatitis or pancreatic tumorous masses.

Acute Disease↗
PubMed1990

[Panic attacks and avoidance behavior].

In a crossectional investigation based on a group of 122 patients with panic attacks, compiled from a variety of hospitals and therapy institutions, 97 patients were found to be suffering from panic disorder as a relevant medical problem. The disease, however, is often identified in an unsatisfactory manner. Avoidance behaviour (extensive or limited) associated with a severe form of panic disorder, was evident in more than one-half of the group (60%). In these patients the incidence of panic attacks is higher, anxiety is more marked, and there are more often additional anxiety disorders (generalised anxiety, sociophobia). These results underline the importance of early recognition and specific treatment of panic disorder to prevent development of avoidance behaviour.

Adult↗
PubMed1989

The interface of clinical psychopharmacology and psychopathology.

Four areas of common interest for clinical psychopharmacology and psychopathology are identified: (1) the diagnostic-based approach in clinical psychopharmacology; (2) the characterization of psychotropic drugs according the main psychopathologically defined target symptoms; (3) prediction of treatment response; (4) development of rating scales. The current state of research strategies in these areas is discussed and the need for new strategies is stressed. In particular, diagnosis-based research strategies in clinical psychopharmacology are not fully justified by empirical data; an alternative approach is discussed.

Humans↗
PubMed1989

Computed tomography in depression: association between ventricular size and psychopathology.

The relationship between psychopathology and brain alterations, measured by computed tomography (CT), was investigated in 44 depressed patients. Comparisons of ventricle-brain ratio (VBR) between "endogenous" vs. "nonendogenous" subgroups, classified by six distinct diagnostic systems, revealed no significant differences. The VBR and the width of the third ventricle correlated significantly with scores on the Brief Psychiatric Rating Scale, the Global Assessment Scale, the Bech-Rafaelsen Melancholia Scale, the Rating for Emotional Blunting, and the Scale for the Assessment of Negative Symptoms, but not with scores on the Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety. Item analyses of the Bech-Rafaelsen Melancholia Scale revealed that retardation-related items were most significantly correlated with ventricular size. The wider diameter of the third ventricle in psychotic patients was associated with higher scores on retardation in the psychotic subgroup, whereas the greater distances of both Sylvian fissures showed no relationship to psychomotor retardation. No significant correlations were found between CT values and anxiety, suicidal impulses, somatic complaints, and sleep disturbances.

Adult↗
PubMed1989

Diagnostic determinants of response to treatment with tricyclic antidepressants: a polydiagnostic approach.

In an attempt to find diagnostic predictors of treatment response, 45 inpatients with major depression in a randomized trial received amitriptyline or imipramine for 23 days after a washout period of 16 days. A polydiagnostic approach was applied to the classification of endogenous depression. Only a minority of diagnostic schedules for endogenous depression proved predictive of a more favorable course during antidepressant treatment: the criteria of D. F. Klein, the Newcastle Scale II, and the Vienna Research Criteria. The symptoms of nonreactivity of mood and diurnal variation were the only endogenous symptoms with predictive ability. In addition, psychotic features and secondary depression predicted an unfavorable course, whereas characteristics of previous course (bipolarity, recurrence) were not predictive.

Adult↗
PubMed1989

[The value of non-contrast computed tomography in acute pancreatitis].

The value of non contrast computed tomography for the early diagnosis and staging of acute pancreatitis has been investigated in 90 patients. The volume of the pancreas and of extra-pancreatic inflammatory infiltrates was statistically significantly larger in necrotising pancreatitis than in interstitial pancreatitis. The extent of intrapancreatic hypodensity (below 40 HU) showed no significant correlation with the pathologically determined extent of pancreatic necrosis. Densitometry of the extrapancreatic infiltrate indicates its nature with considerable accuracy (oedematous-inflammatory or haemorrhagic-necrotising).

Acute Disease↗
PubMed1989

Drug- and disease-induced changes of human cardiac beta 1- and beta 2-adrenoceptors.

Cardiac beta-adrenoceptor density and subtype distribution has been determined in different kinds of heart failure. A decrease in cardiac beta-adrenoceptor function appears to be a general phenomenon in all kinds of heart failure. However, cardiac beta 1- and beta 2-adrenoceptors seem to be differentially affected in different kinds of heart failure: while in end-stage idiopathic dilated cardiomyopathy the diminished cardiac beta-adrenoceptor function is due to a selective loss in beta 1-adrenoceptors, in mitral valve disease, tetralogy of Fallot and end-stage ischaemic cardiomyopathy it is characterized by a concomitant reduction in beta 1- and beta 2-adrenoceptors. Chronic treatment of heart failure patients with beta-adrenoceptor antagonists leads to an up-regulation of cardiac beta-adrenoceptors, but in a subtype-selective fashion: beta 1-selective antagonists increase only cardiac beta 1-adrenoceptors, whereas non-selective antagonists increase both beta 1- and beta 2-adrenoceptors. Such a (subtype-selective) 'recovery' of cardiac beta-adrenoceptors may be one reason for the beneficial effects of low-dose beta-adrenoceptor antagonist treatment in patients with severe heart failure.

Adolescent↗
PubMed1989

A German validation study of the inventory to diagnose depression.

The Inventory to Diagnose Depression (IDD), a self-rating scale designed to identify major depressive episodes (MDE) according to DSM-III, was validated in a sample of 83 inpatients. Depending whether the time criterion of MDE was included or omitted, 63 or 77 patients obtained a syndrome diagnosis of MDE established by means of a structured clinical interview (Polydiagnostic Interview) which served as yardstick. Sensitivity (84.1% with time criterion, 89.6% without time criterion), specificity (60%, 50%), predictive value (67.8%, 64.2%) and kappa (0.43, 0.29) were calculated and found to necessitate improvement for a reasonable application of the IDD in epidemiological and clinical settings. Adapting the IDD algorithm to DSM-III-R diagnosis of MDE, analogous results were obtained.

Adult↗
PubMed1989

Avoidance behaviour and major depression in panic disorder: a report from the Cross-National Collaborative Panic Study.

Avoidance behaviour and secondary major depression are both frequent in clinical samples of patients with panic disorder. Their status is unclear: indicators of severity of panic disorder or indicators of separate psychiatric disorders. Among the data of the Cross-National Collaborative Panic Study (n = 1,168) we found that especially avoidance behaviour defines more severe states of panic disorder (earlier age at onset, higher frequency of panic attacks and higher level of psychopathology); co-occurrence of major depression is less clearly associated with more severe panic disorder. The results are compatible with the DSM-III-R concepts of comorbidity of panic disorder and major depression and of subtyping panic disorder by avoidance behaviour.

Adult↗
PubMed1988

One-year follow-up of panic disorder. Outcome and prognostic factors.

A 1-year follow-up study was carried out in 77 patients with panic attacks (panic disorder). Of these patients 43% were remitted; avoidance behaviour and chronic anxiety were more persistent than panic attacks within the 1-year period. The main predictor for features of anxiety in the follow-up was avoidance behaviour. The most prominent prognostic factor for features of depression was the history of previous depressive episodes. Female patients had a poorer outcome than male patients.

Adult↗
PubMed1988

Improving depression severity assessment--I. Reliability, internal validity and sensitivity to change of three observer depression scales.

The Hamilton Depression Scale (HAMD) is the most commonly used scale for depression severity assessment and for antidepressant treatment evaluation. Alternative scales have been proposed by Bech and Rafaelsen (BRMS) and by Montgomery and Asberg (MADRS) to try to overcome the shortcomings of HAMD: they are based on different concepts of severity and different scaling procedures. Comparisons with respect to reliability, validity and ability to detect change have been performed using these scales in different samples. The BRMS proved superior. This result makes it necessary to question the usual procedure of testing the efficacy of antidepressants by means of HAMD alone. Problems in defining the severity of depression and in testing the validity of severity scales are discussed.

Adult↗