Http Dx Doi Org 10 1080 13811110590512813, Jul 1, 2006
Under the common roof of the German Research Network on Depression and Suicidality, scientists, m... more Under the common roof of the German Research Network on Depression and Suicidality, scientists, medical doctors, psychotherapists, and several of the most relevant institutions of the German health care system are aligned to proceed against the overlapping health problems of depression and suicidality. The project addresses professionals and scientists, affected patients and their relatives, and the total population at the same time. Comprehensive public relations activities contribute to an overall sensitization concerning the topics of depression and suicidality and inform about diagnosis and treatment options. The network is funded by the German Ministry of Education and Research and was established in 1999. Since then more than 20 individual projects have been initiated. Meanwhile more and more results of these projects become available and increasing efforts are undertaken to transfer these results into elements of standard health care.
Dementia and Geriatric Cognitive Disorders, Feb 1, 2003
A variety of studies have demonstrated that motor disorders, parkinsonism and extrapyramidal moto... more A variety of studies have demonstrated that motor disorders, parkinsonism and extrapyramidal motor symptoms (EPMS) are common in patients with Alzheimer's disease (AD). Several studies have reported an association of EPMS with severity, progression and poor prognosis of AD. The majority of these studies used clinical assessments for the rating of EPMS. In this study, kinematic handwriting analysis was used to quantify differences in fine hand motor function in patients with probable AD and mild cognitive impairment (MCI, as an assumed initial stage of AD) compared to depressed patients and healthy controls. Both patients with MCI and patients with probable AD exhibited loss of fine motor performance. Movements of AD patients were significantly less regular than those of healthy controls.
This study investigated the effect on brain morphology of an interleukin-1beta genetic polymorphi... more This study investigated the effect on brain morphology of an interleukin-1beta genetic polymorphism (C-->T transition at position -511) in patients with schizophrenia. In vivo magnetic resonance imaging and genotype analysis were used in the examination of 44 male schizophrenic patients and 48 healthy male comparison subjects. No association between the interleukin-1beta polymorphism and schizophrenia was detected. Within the patient group, bifrontal-temporal gray matter volume deficits and generalized white matter tissue deficits in allele 2 carriers (genotype T/T or C/T) were found. In contrast, the interleukin-1beta polymorphism had no influence on brain morphology within the healthy subjects. The data suggest that allele 2 within the promoter region of the interleukin-1beta gene at position -511 contributes to structural brain alterations in patients with schizophrenia.
Depression is one of the most frequently encountered mental health disorders in primary care. The... more Depression is one of the most frequently encountered mental health disorders in primary care. The health and financial burden caused by this disorder emphasise the clinical importance of depressive disorders. Research shows that these conditions often remain unrecognised and untreated. The aim of this study is to analyse if and how primary care physicians identify this condition in comparison to the patients' self-evaluation. A total of 1,233 cases in 32 primary care physicians' offices were examined to see if symptoms of depression were recognised. The assessment procedures were evaluated, too. In this study, the prevalence of depressive disorders was 10%, and the recognition rate of primary care physicians 45%. These results underscore the importance of improving physicians' recognition of depression and use of ICD-10 criteria for differential diagnosis. Conclusions must be drawn for a specific training of primary care physicians that focuses on the improvement of diagnosis and treatment of depressed patients.
Neuropsychiatrie Klinik Diagnostik Therapie Und Rehabilitation Organ Der Gesellschaft Osterreichischer Nervenarzte Und Psychiater, 2008
OBJECTIVE: Depressive episodes can begin abruptly or start very slowly (over weeks). This relevan... more OBJECTIVE: Depressive episodes can begin abruptly or start very slowly (over weeks). This relevant clinical feature of affective disorders has not been systematically investigated so far. The aim of this study was to analyze speed of onset of depressive episodes in patients with unipolar depression (UD) and bipolar affective disorders (BD).METHODS: 158 adult patients with UD (N = 108) and BD (N = 50) were examined using the structured "Onset-of-Depression Inventory". Only patients without acute critical life events preceding the onset were included in the study.RESULTS: There was a significant positive correlation between speed of onset of the present and that of the preceding depressive episode (rho = 0.66; p < 0.001). The association between speed of onset and speed of decay of depressive episodes failed to be significant (rho = 0.20; p = 0.09). Patients with bipolar disorder were found to develop depressive episodes significantly faster than patients with major depression (p < 0.001): Whereas depressive episodes started in 58% of patients with bipolar disorder within one week, this was only the case in 7.4% of patients with major depression.CONCLUSIONS: Within subjects, the speed of onset of depression is similar across different episodes. In the absence of acute critical life events, rapid onset of depressive episodes (within one week) is typical for bipolar depression, but not for unipolar depression. A rapid onset of depressive episodes might point to BD in patients with solely depressive episodes in the past and to subgroups with different neurobiological pathogenetic mechanisms.
Currently, only a small percentage of patients with depressive disorders receive adequate pharmac... more Currently, only a small percentage of patients with depressive disorders receive adequate pharmacological or psychotherapeutic treatment. Apart from deficits in diagnosis and treatment, misconceptions and prejudice with regard to depression on the part of the public at large are major reasons for this situation. Fear of medical treatment, in particular, is common. Within the framework of a multilevel depression and suicide prevention program conducted in Nuremberg (&quot;Nuremberg Alliance against Depression&quot;) in the years 2001 and 2002, an intensive public awareness campaign was undertaken; two telephone surveys were carried out to evaluate the outcome in comparison with a control region. The results revealed that awareness and knowledge of the condition among the public was considerably improved,while negative attitudes towards antidepressant medication remained unchanged.
OBJECTIVE: The term "Internet Addiction" implies that by using the pathological agent "Internet" ... more OBJECTIVE: The term "Internet Addiction" implies that by using the pathological agent "Internet" an addiction-like behavior with a negative psychosocial outcome occurs. By using the pathogenetically more neutral term "Pathological Internet Use" (PIU) it is examined how frequently such behavior occurs in isolation and thus possibly as an independent condition and how often it occurs in the context of other psychiatric diseases. In the latter case PIU might merely be the consequence or a symptom of another underlying psychiatric disease.METHODS: 30 persons with PIU were compared to 31 with intensive but not pathological internet use. A structured psychiatric diagnostic interview was carried out.RESULTS: The main finding is that in the group with PIU a psychiatric diagnosis was found in 27 of 30 persons (e. g. anxiety disorders: 50.0 %). In the group without PIU only 7 of 31 individuals (e. g. anxiety disorders: 12.9 %) had a psychiatric diagnosis.CONCLUSIONS: The finding that PIU occurs mostly in combination with other psychiatric diseases has a lot to commend against "Internet addiction" as a frequent and independent disease and gives reason for further in-depth studies to consider other psychiatric disorders in people exhibiting PIU with regard to diagnosis and therapy.
... Strobel et al. (2003), however, studied 60 healthy students or staff members from Dresden Uni... more ... Strobel et al. (2003), however, studied 60 healthy students or staff members from Dresden University and described stronger LD in subjects with the l/l allele than in those with the l/s allele, which was recently replicated by the same group (Hensch et al. ... (2003) and Hensch et al. ...
Zusammenfassung Manische Patienten weisen in reizarmen Situationen häufig massive, mit der Elekt... more Zusammenfassung Manische Patienten weisen in reizarmen Situationen häufig massive, mit der Elektroenzephalographie nachweisbare Vigilanzabfällen bis hin zu „micro sleeps“ innerhalb der ersten Minute auf (Labilität der Vigilanzregulation). Postuliert wird, dass die manische Symptomatik durch Schaffung einer reizintensiven Umwelt der Vigilanzstabilisierung dient. Es werden theoretische Argumente und empirische Belege präsentiert, nach denen nicht nur die Symptomatik bei Manie, sondern auch bei Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung
Journal of Psychiatry Neuroscience Jpn, Jul 1, 2007
ObjectiveSerotonergic dysfunction is considered to be involved in the pathophysiology of borderli... more ObjectiveSerotonergic dysfunction is considered to be involved in the pathophysiology of borderline personality disorder (BPD). The aim of this study was to investigate serotonin transporter availability in patients with BPD as a marker of the central serotonergic system.MethodsEight unmedicated patients with BPD and 9 healthy control subjects received single photon emission computed tomography (SPECT) 4 hours after injection of 185 MBq [I-123] ADAM (2-([2-([dimethylamino]methyl)phenyl]thio)). As a measure of brain serotonin transporter (SERT) availability, ratios of specific-to-nonspecific [I-123] ADAM binding for the brainstem and hypothalamus were calculated with an occipital reference. Levels of impulsiveness and depressive symptoms were assessed with the Barratt Impulsiveness Scale and the Beck Depression Inventory.ResultsMean specific-to-nonspecific ratios showed a 43% higher brainstem and a 12% higher hypothalamus ADAM binding in patients, compared with control subjects. We found significant correlations of ADAM binding with both age and impulsiveness but not depression. Associations of BIS scores with ADAM binding remained significant after controlling for age and depression (r = 0.69, p < 0.01).ConclusionThe study provides evidence of a serotonergic dysfunction in patients with BPD and suggests a serotonergic component in the pathophysiology of the disorder. SERT binding reflected the level of impulsiveness as a common feature in BPD.ObjectifOn considère que le dysfonctionnement sérotoninergique joue un rôle dans la pathophysiologie du trouble de personnalité limite (TPL). Cette étude visait à étudier, chez les patients atteints d'un TPL, la disponibilité du transporteur de la sérotonine comme marqueur du système sérotoninergique central.MéthodesHuit patients atteints d'un TPL qui ne prenaient pas de médicament et neuf sujets témoins en bonne santé ont été soumis à une tomographie d'émission monophotonique (TEM) 4 heures après avoir reçu par injection 185 MBq [I-123] d'ADAM (2-([2-([dimethylamino]methyl)phenyl]thio)). Pour mesurer la disponibilité du transporteur de la sérotonine dans le cerveau (SERT), on a calculé des ratios de fixation spécifique:non spécifique [I-123] d'ADAM dans le tronc cérébral et l'hypothalamus en utilisant un point de référence occipital. On a évalué les niveaux d'impulsivité et de symptômes dépressifs au moyen de l'échelle d'impulsivité de Barratt (EIB) et du questionnaire de dépression de Beck.RésultatsLes ratios de fixation spécifique:non spécifique moyens ont montré que la fixation de l'ADAM était plus élevée de 43 % dans le tronc cérébral et de 12 % dans l'hypothalamus chez les patients comparativement aux sujets témoins. Nous avons constaté des liens importants entre la fixation de l'ADAM et à la fois l'âge et l'impulsivité, mais non la dépression. Les liens entre les résultats de l'EIB et la fixation de l'ADAM sont demeurés importants compte tenu de l'âge et de la dépression (r = 0,69, p < 0,01).ConclusionL'étude présente des preuves de dysfonctionnement sérotoninergique chez les patients atteints de TPL et indique la présence d'un élément sérotoninergique dans la pathophysiologie du trouble. La fixation du SERT reflète le niveau d'impulsivité, caractéristique très commune dans les cas de TPL.
... Eine Kombination aus Pharmako-und Psychotherapie ist hingegen bei minD nicht zu favorisieren,... more ... Eine Kombination aus Pharmako-und Psychotherapie ist hingegen bei minD nicht zu favorisieren, denn selbst bei akuter und rezidivprophylaktischer Behandlung der ma-joren Depression war deren Überlegenheit ... 18. Fergusson DM, Horwood LJ, Ridder EM, Beautrais AL. ...
Http Dx Doi Org 10 1080 13811110590512813, Jul 1, 2006
Under the common roof of the German Research Network on Depression and Suicidality, scientists, m... more Under the common roof of the German Research Network on Depression and Suicidality, scientists, medical doctors, psychotherapists, and several of the most relevant institutions of the German health care system are aligned to proceed against the overlapping health problems of depression and suicidality. The project addresses professionals and scientists, affected patients and their relatives, and the total population at the same time. Comprehensive public relations activities contribute to an overall sensitization concerning the topics of depression and suicidality and inform about diagnosis and treatment options. The network is funded by the German Ministry of Education and Research and was established in 1999. Since then more than 20 individual projects have been initiated. Meanwhile more and more results of these projects become available and increasing efforts are undertaken to transfer these results into elements of standard health care.
Dementia and Geriatric Cognitive Disorders, Feb 1, 2003
A variety of studies have demonstrated that motor disorders, parkinsonism and extrapyramidal moto... more A variety of studies have demonstrated that motor disorders, parkinsonism and extrapyramidal motor symptoms (EPMS) are common in patients with Alzheimer&#39;s disease (AD). Several studies have reported an association of EPMS with severity, progression and poor prognosis of AD. The majority of these studies used clinical assessments for the rating of EPMS. In this study, kinematic handwriting analysis was used to quantify differences in fine hand motor function in patients with probable AD and mild cognitive impairment (MCI, as an assumed initial stage of AD) compared to depressed patients and healthy controls. Both patients with MCI and patients with probable AD exhibited loss of fine motor performance. Movements of AD patients were significantly less regular than those of healthy controls.
This study investigated the effect on brain morphology of an interleukin-1beta genetic polymorphi... more This study investigated the effect on brain morphology of an interleukin-1beta genetic polymorphism (C--&gt;T transition at position -511) in patients with schizophrenia. In vivo magnetic resonance imaging and genotype analysis were used in the examination of 44 male schizophrenic patients and 48 healthy male comparison subjects. No association between the interleukin-1beta polymorphism and schizophrenia was detected. Within the patient group, bifrontal-temporal gray matter volume deficits and generalized white matter tissue deficits in allele 2 carriers (genotype T/T or C/T) were found. In contrast, the interleukin-1beta polymorphism had no influence on brain morphology within the healthy subjects. The data suggest that allele 2 within the promoter region of the interleukin-1beta gene at position -511 contributes to structural brain alterations in patients with schizophrenia.
Depression is one of the most frequently encountered mental health disorders in primary care. The... more Depression is one of the most frequently encountered mental health disorders in primary care. The health and financial burden caused by this disorder emphasise the clinical importance of depressive disorders. Research shows that these conditions often remain unrecognised and untreated. The aim of this study is to analyse if and how primary care physicians identify this condition in comparison to the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; self-evaluation. A total of 1,233 cases in 32 primary care physicians&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; offices were examined to see if symptoms of depression were recognised. The assessment procedures were evaluated, too. In this study, the prevalence of depressive disorders was 10%, and the recognition rate of primary care physicians 45%. These results underscore the importance of improving physicians&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; recognition of depression and use of ICD-10 criteria for differential diagnosis. Conclusions must be drawn for a specific training of primary care physicians that focuses on the improvement of diagnosis and treatment of depressed patients.
Neuropsychiatrie Klinik Diagnostik Therapie Und Rehabilitation Organ Der Gesellschaft Osterreichischer Nervenarzte Und Psychiater, 2008
OBJECTIVE: Depressive episodes can begin abruptly or start very slowly (over weeks). This relevan... more OBJECTIVE: Depressive episodes can begin abruptly or start very slowly (over weeks). This relevant clinical feature of affective disorders has not been systematically investigated so far. The aim of this study was to analyze speed of onset of depressive episodes in patients with unipolar depression (UD) and bipolar affective disorders (BD).METHODS: 158 adult patients with UD (N = 108) and BD (N = 50) were examined using the structured "Onset-of-Depression Inventory". Only patients without acute critical life events preceding the onset were included in the study.RESULTS: There was a significant positive correlation between speed of onset of the present and that of the preceding depressive episode (rho = 0.66; p < 0.001). The association between speed of onset and speed of decay of depressive episodes failed to be significant (rho = 0.20; p = 0.09). Patients with bipolar disorder were found to develop depressive episodes significantly faster than patients with major depression (p < 0.001): Whereas depressive episodes started in 58% of patients with bipolar disorder within one week, this was only the case in 7.4% of patients with major depression.CONCLUSIONS: Within subjects, the speed of onset of depression is similar across different episodes. In the absence of acute critical life events, rapid onset of depressive episodes (within one week) is typical for bipolar depression, but not for unipolar depression. A rapid onset of depressive episodes might point to BD in patients with solely depressive episodes in the past and to subgroups with different neurobiological pathogenetic mechanisms.
Currently, only a small percentage of patients with depressive disorders receive adequate pharmac... more Currently, only a small percentage of patients with depressive disorders receive adequate pharmacological or psychotherapeutic treatment. Apart from deficits in diagnosis and treatment, misconceptions and prejudice with regard to depression on the part of the public at large are major reasons for this situation. Fear of medical treatment, in particular, is common. Within the framework of a multilevel depression and suicide prevention program conducted in Nuremberg (&quot;Nuremberg Alliance against Depression&quot;) in the years 2001 and 2002, an intensive public awareness campaign was undertaken; two telephone surveys were carried out to evaluate the outcome in comparison with a control region. The results revealed that awareness and knowledge of the condition among the public was considerably improved,while negative attitudes towards antidepressant medication remained unchanged.
OBJECTIVE: The term "Internet Addiction" implies that by using the pathological agent "Internet" ... more OBJECTIVE: The term "Internet Addiction" implies that by using the pathological agent "Internet" an addiction-like behavior with a negative psychosocial outcome occurs. By using the pathogenetically more neutral term "Pathological Internet Use" (PIU) it is examined how frequently such behavior occurs in isolation and thus possibly as an independent condition and how often it occurs in the context of other psychiatric diseases. In the latter case PIU might merely be the consequence or a symptom of another underlying psychiatric disease.METHODS: 30 persons with PIU were compared to 31 with intensive but not pathological internet use. A structured psychiatric diagnostic interview was carried out.RESULTS: The main finding is that in the group with PIU a psychiatric diagnosis was found in 27 of 30 persons (e. g. anxiety disorders: 50.0 %). In the group without PIU only 7 of 31 individuals (e. g. anxiety disorders: 12.9 %) had a psychiatric diagnosis.CONCLUSIONS: The finding that PIU occurs mostly in combination with other psychiatric diseases has a lot to commend against "Internet addiction" as a frequent and independent disease and gives reason for further in-depth studies to consider other psychiatric disorders in people exhibiting PIU with regard to diagnosis and therapy.
... Strobel et al. (2003), however, studied 60 healthy students or staff members from Dresden Uni... more ... Strobel et al. (2003), however, studied 60 healthy students or staff members from Dresden University and described stronger LD in subjects with the l/l allele than in those with the l/s allele, which was recently replicated by the same group (Hensch et al. ... (2003) and Hensch et al. ...
Zusammenfassung Manische Patienten weisen in reizarmen Situationen häufig massive, mit der Elekt... more Zusammenfassung Manische Patienten weisen in reizarmen Situationen häufig massive, mit der Elektroenzephalographie nachweisbare Vigilanzabfällen bis hin zu „micro sleeps“ innerhalb der ersten Minute auf (Labilität der Vigilanzregulation). Postuliert wird, dass die manische Symptomatik durch Schaffung einer reizintensiven Umwelt der Vigilanzstabilisierung dient. Es werden theoretische Argumente und empirische Belege präsentiert, nach denen nicht nur die Symptomatik bei Manie, sondern auch bei Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung
Journal of Psychiatry Neuroscience Jpn, Jul 1, 2007
ObjectiveSerotonergic dysfunction is considered to be involved in the pathophysiology of borderli... more ObjectiveSerotonergic dysfunction is considered to be involved in the pathophysiology of borderline personality disorder (BPD). The aim of this study was to investigate serotonin transporter availability in patients with BPD as a marker of the central serotonergic system.MethodsEight unmedicated patients with BPD and 9 healthy control subjects received single photon emission computed tomography (SPECT) 4 hours after injection of 185 MBq [I-123] ADAM (2-([2-([dimethylamino]methyl)phenyl]thio)). As a measure of brain serotonin transporter (SERT) availability, ratios of specific-to-nonspecific [I-123] ADAM binding for the brainstem and hypothalamus were calculated with an occipital reference. Levels of impulsiveness and depressive symptoms were assessed with the Barratt Impulsiveness Scale and the Beck Depression Inventory.ResultsMean specific-to-nonspecific ratios showed a 43% higher brainstem and a 12% higher hypothalamus ADAM binding in patients, compared with control subjects. We found significant correlations of ADAM binding with both age and impulsiveness but not depression. Associations of BIS scores with ADAM binding remained significant after controlling for age and depression (r = 0.69, p < 0.01).ConclusionThe study provides evidence of a serotonergic dysfunction in patients with BPD and suggests a serotonergic component in the pathophysiology of the disorder. SERT binding reflected the level of impulsiveness as a common feature in BPD.ObjectifOn considère que le dysfonctionnement sérotoninergique joue un rôle dans la pathophysiologie du trouble de personnalité limite (TPL). Cette étude visait à étudier, chez les patients atteints d'un TPL, la disponibilité du transporteur de la sérotonine comme marqueur du système sérotoninergique central.MéthodesHuit patients atteints d'un TPL qui ne prenaient pas de médicament et neuf sujets témoins en bonne santé ont été soumis à une tomographie d'émission monophotonique (TEM) 4 heures après avoir reçu par injection 185 MBq [I-123] d'ADAM (2-([2-([dimethylamino]methyl)phenyl]thio)). Pour mesurer la disponibilité du transporteur de la sérotonine dans le cerveau (SERT), on a calculé des ratios de fixation spécifique:non spécifique [I-123] d'ADAM dans le tronc cérébral et l'hypothalamus en utilisant un point de référence occipital. On a évalué les niveaux d'impulsivité et de symptômes dépressifs au moyen de l'échelle d'impulsivité de Barratt (EIB) et du questionnaire de dépression de Beck.RésultatsLes ratios de fixation spécifique:non spécifique moyens ont montré que la fixation de l'ADAM était plus élevée de 43 % dans le tronc cérébral et de 12 % dans l'hypothalamus chez les patients comparativement aux sujets témoins. Nous avons constaté des liens importants entre la fixation de l'ADAM et à la fois l'âge et l'impulsivité, mais non la dépression. Les liens entre les résultats de l'EIB et la fixation de l'ADAM sont demeurés importants compte tenu de l'âge et de la dépression (r = 0,69, p < 0,01).ConclusionL'étude présente des preuves de dysfonctionnement sérotoninergique chez les patients atteints de TPL et indique la présence d'un élément sérotoninergique dans la pathophysiologie du trouble. La fixation du SERT reflète le niveau d'impulsivité, caractéristique très commune dans les cas de TPL.
... Eine Kombination aus Pharmako-und Psychotherapie ist hingegen bei minD nicht zu favorisieren,... more ... Eine Kombination aus Pharmako-und Psychotherapie ist hingegen bei minD nicht zu favorisieren, denn selbst bei akuter und rezidivprophylaktischer Behandlung der ma-joren Depression war deren Überlegenheit ... 18. Fergusson DM, Horwood LJ, Ridder EM, Beautrais AL. ...
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