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Schwarzmeier H, Kleint NI, Wittchen HU, Ströhle A, Hamm AO, Lueken U. Characterizing the nature of emotional-associative learning deficits in panic disorder: An fMRI study on fear conditioning, extinction training and recall. Eur Neuropsychopharmacol 2019; 29:306-318. [PMID: 30497840 DOI: 10.1016/j.euroneuro.2018.11.1108] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/22/2022]
Abstract
Emotional-associative learning represents a translational model for the development, maintenance and treatment of anxiety disorders such as panic disorder (PD). The exact nature of the underlying fear learning and extinction deficits however, remains under debate. Using a three-day paradigm to separate the distinct learning and consolidation processes, we aimed to gain insights into the neurofunctional substrates of altered fear conditioning, extinction training and recall in PD. In contrast to studies employing one-session fear conditioning paradigms, a differential fear conditioning and delayed extinction task was conducted for the purpose of disentangling neural networks involved in fear acquisition, extinction training and recall of extinction memories. Using functional magnetic resonance imaging (fMRI), quality-controlled datasets from 10 patients with PD and 10 healthy controls were available from three consecutive days (day 1: acquisition; day 2: extinction training; day 3: extinction recall) with neutral faces serving as CSs and an aversive auditory stimulus (panic scream) as US. PD patients showed heightened fear circuitry (e.g. right amygdala and left insula) activation during early acquisition and prolonged activation in the right insula, left inferior frontal operculum and left inferior frontal gyrus during extinction recall compared to healthy controls. Stronger neural activation in structures conferring defensive reactivity during early acquisition and extinction recall may indicate the accelerated acquisition of conditioned responses, while extinction recall may be attenuated as a function of PD pathophysiology. Future studies should investigate the predictive value of experimental measures of extinction recall for clinical relapse.
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Affiliation(s)
- H Schwarzmeier
- Center of Mental Health, Dept. of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Margarete-Höppel-Platz 1, D-97080 Würzburg, Germany.
| | - N I Kleint
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - H U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Clinical Psychology & Psychotherapy RG, Department of Psychiatry & Psychotherapy, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - A Ströhle
- Dept. of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Berlin, Germany
| | - A O Hamm
- Dept. of Physiological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald , Germany
| | - U Lueken
- Center of Mental Health, Dept. of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Margarete-Höppel-Platz 1, D-97080 Würzburg, Germany; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Dept. of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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Esser P, Glaesmer H, Wittchen HU, Faller H, Koch U, Härter M, Schulz H, Wegscheider K, Weis J, Mehnert A. Posttraumatische Belastungsstörung bei Krebspatienten: Ergebnisse einer epidemiologischen Studie aus Deutschland. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- P Esser
- Universitätsmedizin Leipzig, Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | - H Glaesmer
- Universitätsmedizin Leipzig, Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | | | | | | | | | | | | | | | - A Mehnert
- Universitätsmedizin Leipzig, Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
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Fengler S, Roeske S, Heber I, Reetz K, Schulz JB, Riedel O, Wittchen HU, Storch A, Linse K, Baudrexel S, Hilker R, Mollenhauer B, Witt K, Schmidt N, Balzer-Geldsetzer M, Dams J, Dodel R, Gräber S, Pilotto A, Petrelli A, Fünkele S, Kassubek J, Kalbe E. Verbal memory declines more in female patients with Parkinson's disease: the importance of gender-corrected normative data. Psychol Med 2016; 46:2275-2286. [PMID: 27193073 DOI: 10.1017/s0033291716000908] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Data on gender-specific profiles of cognitive functions in patients with Parkinson's disease (PD) are rare and inconsistent, and possible disease-confounding factors have been insufficiently considered. METHOD The LANDSCAPE study on cognition in PD enrolled 656 PD patients (267 without cognitive impairment, 66% male; 292 with mild cognitive impairment, 69% male; 97 with PD dementia, 69% male). Raw values and age-, education-, and gender-corrected Z scores of a neuropsychological test battery (CERAD-Plus) were compared between genders. Motor symptoms, disease duration, l-dopa equivalent daily dose, depression - and additionally age and education for the raw value analysis - were taken as covariates. RESULTS Raw-score analysis replicated results of previous studies in that female PD patients were superior in verbal memory (word list learning, p = 0.02; recall, p = 0.03), while men outperformed women in visuoconstruction (p = 0.002) and figural memory (p = 0.005). In contrast, gender-corrected Z scores showed that men were superior in verbal memory (word list learning, p = 0.02; recall, p = 0.02; recognition, p = 0.04), while no difference was found for visuospatial tests. This picture could be observed both in the overall analysis of PD patients as well as in a differentiated group analysis. CONCLUSIONS Normative data corrected for gender and other sociodemographic variables are relevant, since they may elucidate a markedly different cognitive profile compared to raw scores. Our study also suggests that verbal memory decline is stronger in women than in men with PD. Future studies are needed to replicate these findings, examine the progression of gender-specific cognitive decline in PD and define different underlying mechanisms of this dysfunction.
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Affiliation(s)
- S Fengler
- Department of Medical Psychology,University Hospital Cologne,Germany
| | - S Roeske
- Department of Neurology,University Hospital Bonn, and German Center for Neurodegenerative Diseases (DZNE),Bonn,Germany
| | - I Heber
- Department of Neurology,Medical Faculty,RWTH Aachen University,Germany
| | - K Reetz
- Department of Neurology,Medical Faculty,RWTH Aachen University,Germany
| | - J B Schulz
- Department of Neurology,Medical Faculty,RWTH Aachen University,Germany
| | - O Riedel
- Leibniz-Institute of Prevention Research and Epidemiology,Department of Clinical Epidemiology,Bremen,Germany
| | - H U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden,Germany
| | - A Storch
- Division of Neurodegenerative Diseases,Department of Neurology,Technische Universität Dresden,Germany
| | - K Linse
- Division of Neurodegenerative Diseases,Department of Neurology,Technische Universität Dresden,Germany
| | - S Baudrexel
- Department of Neurology,J.W. Goethe University,Frankfurt/Main,Germany
| | - R Hilker
- Department of Neurology,J.W. Goethe University,Frankfurt/Main,Germany
| | - B Mollenhauer
- Department of Neuropathology,University Medical Center Goettingen,Germany
| | - K Witt
- Department of Neurology,Christian Albrechts University,Kiel,Germany
| | - N Schmidt
- Department of Neurology,Christian Albrechts University,Kiel,Germany
| | | | - J Dams
- Department of Neurology,Philipps University Marburg,Germany
| | - R Dodel
- Department of Neurology,Philipps University Marburg,Germany
| | - S Gräber
- Department of Neurodegenerative Diseases,Hertie Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases (DZNE), University Tübingen, and German Center for Neurodegenerative Diseases, Tübingen,Germany
| | - A Pilotto
- Department of Neurodegenerative Diseases,Hertie Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases (DZNE), University Tübingen, and German Center for Neurodegenerative Diseases, Tübingen,Germany
| | - A Petrelli
- Institute of Gerontology & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Vechta,Germany
| | - S Fünkele
- Department of Neurology,University of Ulm,Germany
| | - J Kassubek
- Department of Neurology,University of Ulm,Germany
| | - E Kalbe
- Department of Medical Psychology,University Hospital Cologne,Germany
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Trautmann S, Schönfeld S, Behrendt S, Höfler M, Zimmermann P, Wittchen HU. Substance use and substance use disorders in recently deployed and never deployed soldiers. Drug Alcohol Depend 2014; 134:128-135. [PMID: 24210162 DOI: 10.1016/j.drugalcdep.2013.09.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 09/19/2013] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Military studies investigating the prevalence of substance use (SU) and substance use disorders (SUD) and the relation between SU and mental disorders often lack a comprehensive assessment of SU, SUD and mental disorders and comparable groups of deployed and non-deployed personnel. There is also limited data regarding SU and SUD in the German military to date. METHODS Cross-sectional examination of n=1483 soldiers recently deployed in Afghanistan and 889 never deployed soldiers using a fully-standardized diagnostic interview (MI-CIDI) including a comprehensive substance section. RESULTS Across both groups, 12-months prevalence of DSM-IV alcohol use disorders was 3.1%, 36.9% reported binge drinking, 13.9% heavy drinking, 1.3% illegal drug use. 55.1% were regular smokers, 10.9% nicotine dependent. Although recently deployed soldiers revealed slightly higher rates in some measures, there were no significant differences to the never deployed regarding SU und SUD except that recently deployed soldiers smoked more cigarettes per day. The association of SU with mental mental disorders was substantially different though, revealing significant associations between SU and mental disorders only among recently deployed soldiers. CONCLUSIONS We do not find remarkable differences in the prevalence of SU and SUD between recently deployed and never deployed soldiers. Especially binge drinking and regular smoking were prevalent across both samples indicating needs for improved interventions. The finding that SU and mental disorders are only associated in recently deployed soldiers might have implications for improved screening and prevention and suggests that deployment might promote different pathways and mechanisms involved in the evolution of SU and mental disorders.
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Affiliation(s)
- S Trautmann
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany.
| | - S Schönfeld
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - S Behrendt
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - P Zimmermann
- "Center of Military Mental Health" (Zentrum für Psychiatrie und Psychotraumatologie am Bundeswehrkrankenhaus), 10115 Berlin, Germany
| | - H U Wittchen
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
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Wittchen HU, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jönsson B, Olesen J, Allgulander C, Alonso J, Faravelli C, Fratiglioni L, Jennum P, Lieb R, Maercker A, van Os J, Preisig M, Salvador-Carulla L, Simon R, Steinhausen HC. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 2011; 21:655-79. [PMID: 21896369 DOI: 10.1016/j.euroneuro.2011.07.018] [Citation(s) in RCA: 2201] [Impact Index Per Article: 169.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIMS To provide 12-month prevalence and disability burden estimates of a broad range of mental and neurological disorders in the European Union (EU) and to compare these findings to previous estimates. Referring to our previous 2005 review, improved up-to-date data for the enlarged EU on a broader range of disorders than previously covered are needed for basic, clinical and public health research and policy decisions and to inform about the estimated number of persons affected in the EU. METHOD Stepwise multi-method approach, consisting of systematic literature reviews, reanalyses of existing data sets, national surveys and expert consultations. Studies and data from all member states of the European Union (EU-27) plus Switzerland, Iceland and Norway were included. Supplementary information about neurological disorders is provided, although methodological constraints prohibited the derivation of overall prevalence estimates for mental and neurological disorders. Disease burden was measured by disability adjusted life years (DALY). RESULTS Prevalence: It is estimated that each year 38.2% of the EU population suffers from a mental disorder. Adjusted for age and comorbidity, this corresponds to 164.8million persons affected. Compared to 2005 (27.4%) this higher estimate is entirely due to the inclusion of 14 new disorders also covering childhood/adolescence as well as the elderly. The estimated higher number of persons affected (2011: 165m vs. 2005: 82m) is due to coverage of childhood and old age populations, new disorders and of new EU membership states. The most frequent disorders are anxiety disorders (14.0%), insomnia (7.0%), major depression (6.9%), somatoform (6.3%), alcohol and drug dependence (>4%), ADHD (5%) in the young, and dementia (1-30%, depending on age). Except for substance use disorders and mental retardation, there were no substantial cultural or country variations. Although many sources, including national health insurance programs, reveal increases in sick leave, early retirement and treatment rates due to mental disorders, rates in the community have not increased with a few exceptions (i.e. dementia). There were also no consistent indications of improvements with regard to low treatment rates, delayed treatment provision and grossly inadequate treatment. Disability: Disorders of the brain and mental disorders in particular, contribute 26.6% of the total all cause burden, thus a greater proportion as compared to other regions of the world. The rank order of the most disabling diseases differs markedly by gender and age group; overall, the four most disabling single conditions were: depression, dementias, alcohol use disorders and stroke. CONCLUSION In every year over a third of the total EU population suffers from mental disorders. The true size of "disorders of the brain" including neurological disorders is even considerably larger. Disorders of the brain are the largest contributor to the all cause morbidity burden as measured by DALY in the EU. No indications for increasing overall rates of mental disorders were found nor of improved care and treatment since 2005; less than one third of all cases receive any treatment, suggesting a considerable level of unmet needs. We conclude that the true size and burden of disorders of the brain in the EU was significantly underestimated in the past. Concerted priority action is needed at all levels, including substantially increased funding for basic, clinical and public health research in order to identify better strategies for improved prevention and treatment for disorders of the brain as the core health challenge of the 21st century.
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Affiliation(s)
- H U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.
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Wittchen H, Mühlig S, Riedel O. Kontrolliertes und unkontrolliertes allergisches Asthma in der fachärztlichen Routineversorgung - Ergebnisse einer bundesweiten klinisch-epidemiologischen Studie in Deutschland. Pneumologie 2011. [DOI: 10.1055/s-0031-1272152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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van der Werf M, Thewissen V, Dominguez MD, Lieb R, Wittchen H, van Os J. Adolescent development of psychosis as an outcome of hearing impairment: a 10-year longitudinal study. Psychol Med 2011; 41:477-485. [PMID: 21272386 DOI: 10.1017/s0033291710000978] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND It has long been acknowledged that hearing impairment may increase the risk for psychotic experiences. Recent work suggests that young people in particular may be at risk, indicating a possible developmental mechanism. METHOD The hypothesis that individuals exposed to hearing impairment in early adolescence would display the highest risk for psychotic symptoms was examined in a prospective cohort study of a population sample of originally 3021 adolescents and young adults aged 14-24 years at baseline, in Munich, Germany (Early Developmental Stages of Psychopathology Study). The expression of psychosis was assessed at multiple time points over a period of up to 10 years, using a diagnostic interview (Munich Composite International Diagnostic Interview; CIDI) administered by clinical psychologists. RESULTS Hearing impairment was associated with CIDI psychotic symptoms [odds ratio (OR) 2.04, 95% confidence interval (CI) 1.10-3.81], particularly more severe psychotic symptoms (OR 5.66, 95% CI 1.64-19.49). The association between hearing impairment and CIDI psychotic symptoms was much stronger in the youngest group aged 14-17 years at baseline (OR 3.28, 95% CI 1.54-7.01) than in the older group aged 18-24 years at baseline (OR 0.82, 95% CI 0.24-2.84). CONCLUSIONS The finding of an age-specific association between hearing impairment and psychotic experiences suggests that disruption of development at a critical adolescent phase, in interaction with other personal and social vulnerabilities, may increase the risk for psychotic symptoms.
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Affiliation(s)
- M van der Werf
- Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON Graduate School of Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.
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Schneider HJ, Klotsche J, Wittchen HU, Stalla GK, Kann P, Kreitschmann-Andermahr I, Wallaschofski H. Effects of growth hormone replacement on estimated cardiovascular risk and predictors of risk reduction in patients with growth hormone deficiency: results from the German KIMS cohort. Exp Clin Endocrinol Diabetes 2010. [DOI: 10.1055/s-0030-1267021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tijssen MJA, Van Os J, Wittchen HU, Lieb R, Beesdo K, Wichers M. Risk factors predicting onset and persistence of subthreshold expression of bipolar psychopathology among youth from the community. Acta Psychiatr Scand 2010; 122:255-66. [PMID: 20199490 DOI: 10.1111/j.1600-0447.2010.01539.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine factors increasing the risk for onset and persistence of subthreshold mania and depression. METHOD In a prospective cohort community study, the association between risk factors [a family history of mood disorders, trauma, substance use, attention-deficit/hyperactivity disorder (ADHD) and temperamental/personality traits] and onset of manic/depressive symptoms was determined in 705 adolescents. The interaction between baseline risk factors and baseline symptoms in predicting 8-year follow-up symptoms was used to model the impact of risk factors on persistence. RESULTS Onset of manic symptoms was associated with cannabis use and novelty seeking (NS), but NS predicted a transitory course. Onset of depressive symptoms was associated with a family history of depression. ADHD and harm avoidance (HA) were associated with persistence of depressive symptoms, while trauma and a family history of depression predicted a transitory course. CONCLUSION Different risk factors may operate during onset and persistence of subthreshold mania and depression. The differential associations found for mania and depression dimensions suggest partly different underlying mechanisms.
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Affiliation(s)
- M J A Tijssen
- Department of Psychiatry, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, the Netherlands
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Dimopoulou C, Sievers C, Wittchen HU, Pieper L, Klotsche J, Roemmler J, Schopohl J, Schneider HJ, Stalla GK. Adverse anthropometric risk profile in biochemically controlled acromegalic patients: comparison with an age- and gender-matched primary care population. Pituitary 2010; 13:207-14. [PMID: 20131100 PMCID: PMC2913005 DOI: 10.1007/s11102-010-0218-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
GH and IGF-1 play an important role in the regulation of metabolism and body composition. In patients with uncontrolled acromegaly, cardiovascular morbidity and mortality are increased but are supposed to be normalised after biochemical control is achieved. We aimed at comparing body composition and the cardiovascular risk profile in patients with controlled acromegaly and controls. A cross-sectional study. We evaluated anthropometric parameters (height, weight, body mass index (BMI), waist and hip circumference, waist to height ratio) and, additionally, cardiovascular risk biomarkers (fasting plasma glucose, HbA1c, triglycerides, total cholesterol, HDL, LDL, and lipoprotein (a), in 81 acromegalic patients (58% cured) compared to 320 age- and gender-matched controls (ratio 1:4), sampled from the primary care patient cohort DETECT. The whole group of 81 acromegalic patients presented with significantly higher anthropometric parameters, such as weight, BMI, waist and hip circumference, but with more favourable cardiovascular risk biomarkers, such as fasting plasma glucose, total cholesterol, triglycerides and HDL levels, in comparison to their respective controls. Biochemically controlled acromegalic patients again showed significantly higher measurements of obesity, mainly visceral adiposity, than age- and gender-matched control patients (BMI 29.5 +/- 5.9 vs. 27.3 +/- 5.8 kg/m(2); P = 0.020; waist circumference 100.9 +/- 16.8 vs. 94.8 +/- 15.5 cm; P = 0.031; hip circumference 110.7 +/- 9.9 vs. 105.0 +/- 11.7 cm; P = 0.001). No differences in the classical cardiovascular biomarkers were detected except for fasting plasma glucose and triglycerides. This effect could not be attributed to a higher prevalence of type 2 diabetes mellitus in the acromegalic patient group, since stratified analyses between the subgroup of patients with acromegaly and controls, both with type 2 diabetes mellitus, revealed that there were no significant differences in the anthropometric measurements. Biochemically cured acromegalic patients pertain an adverse anthropometric risk profile, mainly because of elevated adiposity measurements, such as BMI, waist and hip circumference, compared to an age- and gender-matched primary care population.
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Affiliation(s)
- C Dimopoulou
- Max Planck Institute of Psychiatry, Department of Endocrinology, Munich, Germany.
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Von Reichmann H, Deuschl G, Riedel O, Spottke A, Förstl H, Henn F, Heuser I, Oertel W, Riederer P, Trenkwalder C, Dodel R, Wittchen HU. [The German Study on the Epidemiology of Parkinson's Disease with Dementia (GEPAD): more than Parkinson]. MMW Fortschr Med 2010; 152 Suppl 1:1-6. [PMID: 20942300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED It is unknown, how frequently Parkinson's disease (PD) is complicated by dementia, depression and other neuropsychiatric conditions. An epidemiologic characterisation of the situation in specialised neurologic settings is lacking. The Geman Study on the Epidemiology of Parkinson's Disease with Dementia (GEPAD) isa national representative epidemiological study of n=1449 PD patients in n=315 office-based neurological settings, designed to estimate the prevalence of dementia, depression and other neuropsychiatric conditions in patients with PD of all stages by using standardized clinical assessments. RESULTS 28.6% met DSM-IV criteria for dementia. 33.6% met criteria for depression and 61% additionally had other clinically significant psychopathological syndromes. Only 29.4% had no neuropsychiatric conditions. GEPAD reveals for the first time comprehensively that the neuropsychiatric burden of PD patients in all stages and even early stages is considerable, posing challenging questions for research and clinical management.
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Affiliation(s)
- H Von Reichmann
- Klinik für Neurologie, Medizinische Fakultät Carl Gustav Carus Dresden
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Gloster AT, Wittchen HU, Einsle F, Höfler M, Lang T, Helbig-Lang S, Fydrich T, Fehm L, Hamm AO, Richter J, Alpers GW, Gerlach AL, Ströhle A, Kircher T, Deckert J, Zwanzger P, Arolt V. Mechanism of action in CBT (MAC): methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia. Eur Arch Psychiatry Clin Neurosci 2009; 259 Suppl 2:S155-66. [PMID: 19876674 DOI: 10.1007/s00406-009-0065-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.
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Affiliation(s)
- A T Gloster
- Dresden University of Technology, Dresden, Germany
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Wittchen HU, Barth A, Kotlarski B, Riedel O, Deuschl G, Dodel R, Falkai P, Förstl H, Hüll M, Reichmann H, Maier W, Teipel S. IDEA – eine epidemiologische Untersuchung ungedeckter Bedürfnisse und Hindernisse bei der Behandlung von Alzheimer Demenz. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Brückl T, Lieb R, Pfister H, Wittchen HU, Holsboer F, Ising M, Zimmermann P. Polymorphisms in the serotonin receptor 2A gene (HTR2A), parenting styles and the risk of depression in young adulthood: results from a family study. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bach JP, Riedel O, Klotsche J, Spottke A, Wittchen HU, Dodel R. Care of PD patients with dementia in office-based neurologists: a national Survey (GEPAD study). Akt Neurol 2009. [DOI: 10.1055/s-0029-1238718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pieper L, Ziemssen T, Kern S, Thurau C, Wittchen HU. Allgemeine und psychopathologische Belastungsfaktoren bei MS-Patienten und ihren pflegenden Angehörigen: Design und Methodik der MS Ceragiver Burden Studie. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zimmermann P, Brückl T, Pfister H, Lieb R, Wittchen HU, Holsboer F, Ising M, Binder EB, Uhr M, Nocon A. The interplay of variations in the FKBP5 gene and adverse life events in predicting the first onset of depression during a ten-year follow-up. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Indlekofer F, Piechatzek M, Daamen M, Glasmacher C, Lieb R, Pfister H, Tucha O, Lange KW, Wittchen HU, Schütz CG. Reduced memory and attention performance in a population-based sample of young adults with a moderate lifetime use of cannabis, ecstasy and alcohol. J Psychopharmacol 2009; 23:495-509. [PMID: 18635709 DOI: 10.1177/0269881108091076] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Regular use of illegal drugs is suspected to cause cognitive impairments. Two substances have received heightened attention: 3,4-methylenedioxymethamphetamine (MDMA or 'ecstasy') and delta-9-tetrahydrocannabinol (THC or 'cannabis'). Preclinical evidence, as well as human studies examining regular ecstasy consumers, indicated that ecstasy use may have negative effects on learning, verbal memory and complex attentional functions. Cannabis has also been linked to symptoms of inattention and deficits in learning and memory. Most of the published studies in this field of research recruited participants by means of newspaper advertisements or by using word-of-mouth strategies. Because participants were usually aware that their drug use was critical to the research design, this awareness may have caused selection bias or created expectation effects. Focussing on attention and memory, this study aimed to assess cognitive functioning in a community-based representative sample that was derived from a large-scale epidemiological study. Available data concerning drug use history allowed sampling of subjects with varying degrees of lifetime drug experiences. Cognitive functioning was examined in 284 young participants, between 22 and 34 years. In general, their lifetime drug experience was moderate. Participants completed a neuropsychological test battery, including measures for verbal learning, memory and various attentional functions. Linear regression analysis was performed to investigate the relationship between cognitive functioning and lifetime experience of drug use. Ecstasy and cannabis use were significantly related to poorer episodic memory function in a dose-related manner. For attentional measures, decrements of small effect sizes were found. Error measures in tonic and phasic alertness tasks, selective attention task and vigilance showed small but significant effects, suggesting a stronger tendency to experience lapses of attention. No indication for differences in reaction time was found. The results are consistent with decrements of memory and attentional performance described in previous studies. These effects are relatively small; however, it must be kept in mind that this study focussed on assessing young adults with moderate drug use from a population-based study.
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Affiliation(s)
- F Indlekofer
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
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Nobis S, Einsle F, Dekoy MC, Kotlarski B, Joraschky P, Wittchen HU. Der Einfluss der Komorbidität auf die Versorgungswege von Patienten mit Panikstörung und Agoraphobie–Eine qualitative Untersuchung zu Gründen unterschiedlichen Inanspruchnahmeverhaltens. Psychother Psychosom Med Psychol 2009. [DOI: 10.1055/s-0029-1208250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
OBJECTIVE The estimated prevalence of acromegaly is 40-125 per million. The diagnosis of acromegaly is often delayed due to deficits in recognizing the signs of the disease. It is not known how many subjects with increased IGF-1 levels have acromegaly. We aimed to assess the prevalence of acromegaly in primary care by screening for elevated IGF-1 levels. DESIGN A cross-sectional, epidemiological study (the DETECT study). Patients A total of 6773 unselected adult primary care patients were included. MEASUREMENTS We measured IGF-1 in all patients and recommended further endocrine evaluation in all patients with elevated IGF-1 levels (> 2 age-dependent SDS). RESULTS Of 125 patients with elevated IGF-1 levels, 76 patients had indeterminate results and acromegaly could be excluded in 42 patients. One patient had known florid acromegaly. Two patients had newly diagnosed acromegaly and pituitary adenomas. Four patients had biochemical acromegaly but refused further diagnostics. This corresponds to a prevalence of 1034 per million patients. CONCLUSIONS Our study shows a high prevalence of undiagnosed acromegaly in primary care. These results imply that acromegaly is underdiagnosed and stress the importance of detecting acromegaly.
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Affiliation(s)
- H J Schneider
- Medizinische Klinik - Innenstadt, Ludwig-Maximilian-University, Munich, Germany.
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Scharnagl H, Stojakovic T, Pittrow D, Pieber L, Boehler S, Ruf G, Maerz W, Wittchen H. ASSOCIATION OF N-TERMINAL PRO-B-TYPE NATRIURETIC PEPTIDE WITH CARDIOVASCULAR RISK FACTORS: RESULTS FROM THE DETECT STUDY. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70478-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pieper L, Eichler T, Klotsche J, Depta A, Pittrow D, Huppertz E, Stridde E, Wittchen HU. Prospektive Betrachtung des Zusammenhangs zwischen Typ-2-Diabetes und Depression: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pieper L, Pittrow D, Klotsche J, Eichler T, Huppertz E, Stridde E, Wittchen HU. Das metabolische Syndrom als Prädiktor für Typ-2-Diabetes und Koronarer Herzerkrankung: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pieper L, Huppertz E, Klotsche J, Eichler T, Pittrow D, Stridde E, Wittchen HU. Auswirkungen einer DMP-Registrierung auf den 12-Monats-Krankheitsverlauf bei Patienten mit Typ-2-Diabetes: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wittchen HU, Bühringer G, Rehm J. Effekte der langfristigen Substitution – Wie können wir den Verlauf und Interventionseffekte untersuchen? Suchttherapie 2007. [DOI: 10.1055/s-2007-1032320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sievers C, Dimopoulou C, Pfister H, Lieb R, Steffin B, Roemmler J, Schopohl J, Mueller M, Schneider HJ, Ising M, Wittchen HU, Stalla GK. A shifted psychopathological risk profile in acromegalic patients? Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-990445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sievers C, Dimopoulou C, Pfister H, Lieb R, Steffin B, Roemmler J, Schopohl J, Schneider HJ, Ising M, Wittchen HU, Saemann PG, Czisch M, Wendl A, Zihl J, Stalla GK. Acromegalic patients: more depressed, without panic? The 'endocrine psychosyndrome' of acromegaly revised. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nocon A, Brückl T, Zimmermann P, Lieb R, Wittchen HU. Specific vulnerability and risk factors for the onset of panic disorder, agoraphobia and other phobias. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schreier A, Wittchen HU, Hoefler M, Lieb R. Maternal psychopathology – a risk factor for affective, anxiety and substance use disorders in offspring? Results from a prospective-longitudinal community study. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schreier A, Wittchen HU, Hoefler M, Lieb R. Maternal psychopathology – a risk factor for affective, anxiety and substance use disorders in offspring? Results from a prospective-longitudinal community study. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schneider HJ, Klotsche J, Lehnert H, Sievers C, Wittchen HU, Stalla GK. Associations of age-dependent IGF-1 standard deviation scores to cardiovascular diseases and risk factors: A cross-sectional study in 6,282 primary care patients. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rabung S, Harfst T, Kawski S, Koch U, Wittchen HU, Schulz H. Hamburger Module zur Erfassung allgemeiner Aspekte psychosozialer Gesundheit für die therapeutische Praxis (HEALTH) – Ein neues Selbstbeurteilungsinstrument zur multidimensionalen Erfassung psychosozialer Gesundheit. Psychother Psychosom Med Psychol 2007. [DOI: 10.1055/s-2007-970696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pieper L, Klotsche J, Eichler T, Pittrow D, Böhler S, Stridde E, Huppertz E, Lehnert H, Wittchen HU. Depression und Typ 2 Diabetes – Prävalenz und Patientencharakteristik: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Stridde E, Pieper L, Huppertz E, Klotsche J, Eichler T, Lehnert H, Wittchen HU. Prävalenz des metabolischen Syndroms in der primärärztlichen Versorgung: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pieper L, Klotsche J, Eichler T, Pittrow D, Böhler S, Stridde E, Huppertz E, Lehnert H, Wittchen HU. Gesundheitsbezogene Lebensqualität und Nutzwerte bei Typ 2 Diabetikern in der primärärztlichen Versorgung: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dirmaier J, Watzke B, Koch U, Wittchen HU, Schulz H. Depression und Typ 2 Diabetes bei Hausarztpatienten: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Huppertz E, Pieper L, Klotsche J, Eichler T, Pittrow D, Böhler S, Stridde E, Lehnert H, Wittchen HU. Blutzucker (HbA1c) und andere Risikofaktoren bei Typ 2 Diabetikern in der primärärztlichen Versorgung: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pittrow D, Pieper L, Klotsche J, Eichler T, Huppertz E, Stridde E, Lehnert H, Wittchen HU. Mikro- und makrovaskuläre Folgeerkrankungen bei Typ 2 Diabetikern in der primärärztlichen Versorgung: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wittchen HU. Zentrale Ergebnisse der COBRA-Studie (Cost-benefit and risk appraisal of substitution treatment. An epidemiological study in routine care). Suchttherapie 2006. [DOI: 10.1055/s-2006-959122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Böhler S, Pittrow D, Pieper L, Klotsche J, Huppertz E, Stridde E, Jacobi F, Glaesmer H, Lehnert H, Wittchen HU. Diabetes mellitus in der primärärztlichen Versorgung: Häufigkeit von mikro- und makrovaskulären Komplikationen – Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-944040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wittchen HU, Pieper L, Glaesmer H, Böhler S, Pittrow D, Klotsche J, Jacobi F, Stalla GK, Schneider HJ, Lehnert H. Body Mass Index und abdominelle Fettleibigkeit bei diabetischen und nichtdiabetischen Hausarztpatienten: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pieper L, Pittrow D, Böhler S, Stridde E, Huppertz E, Klotsche J, Jacobi F, Glaesmer H, Lehnert H, Wittchen HU. Prävalenz und Therapie des Diabetes mellitus in der primärärztlichen Versorgung: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-944067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pittrow D, Glaesmer H, Pieper L, Huppertz E, Stridde E, Klotsche J, Böhler S, Jacobi F, Lehnert H, Wittchen HU. Werden Frauen mit Diabetes mellitus anders versorgt als Männer? – Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lehnert H, März W, Stalla GK, Zeiher AM, Silber S, Koch U, Pittrow D, Böhler S, Pieper L, Klotsche J, Wittchen HU. Diabetes mellitus in der primärärztlichen Versorgung: Ergebnisse der DETECT-Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-944063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pittrow D, Huppertz E, Pieper L, Böhler S, Stridde E, Klotsche J, Jacobi F, Glaesmer H, Lehnert H, Wittchen HU. Diabetes mellitus in der primärärztlichen Versorgung: HbA1c-Werte in Abhängigkeit von Geschlecht, Alter und Diabetesdauer – Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wittchen HU, Pieper L, Haffner S, Balkau B, Després JP, Van Gaal L. Die IDEA (International Day for the Evaluation of Abdominal obesity) Studie: Weltweite Prävalenz der abdominellen Fettleibigkeit und ihr Status als kardio-metabolischer Marker. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Apelt SM, Bernert B, Siegert J, Wittchen HU. COBRA – Substitution in der Routineversorgung: HIV-HCV-Koinfektionsraten. Suchttherapie 2005. [DOI: 10.1055/s-2005-923746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schreier A, Höfler M, Wittchen HU, Lieb R. Does parental rearing behavior play a role in the familial transmission of anxiety and affective disorders? Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
A literature search, in addition to expert survey, was performed to estimate the size and burden of panic disorder in the European Union (EU). Epidemiologic data from EU countries were critically reviewed to determine the consistency of prevalence estimates across studies and to identify the most pressing questions for future research. A comprehensive literature search focusing on epidemiological studies in community and clinical settings in European countries since 1980 was conducted (Medline, Web of Science, Psychinfo). Only studies using established diagnostic instruments on the basis of DSM-III-R or DSM-IV, or ICD-10 were considered. Thirteen studies from a total of 14 countries were identified. Epidemiological findings are relatively consistent across the EU. The 12-month prevalence of panic disorder and agoraphobia without history of panic were estimated to be 1.8% (0.7-2.2) and 1.3% (0.7-2.0) respectively across studies. Rates are twice as high in females and age of first onset for both disorders is in adolescence or early adulthood. In addition to comorbidity with agoraphobia, panic disorder is strongly associated with other anxiety disorders, and a wide range of somatoform, affective and substance use disorders. Even subclinical forms of panic disorder (i.e., panic attacks) are associated with substantial distress, psychiatric comorbidity and functional impairment. In general health primary care settings, there appears to be substantial underdiagnosis and undertreatment of panic disorder. Moreover, panic disorder and agoraphobia are poorly recognized and rarely treated in mental health settings, despite high health care utilization rates and substantial long-term disability.
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Affiliation(s)
- R D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA.
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Abstract
OBJECTIVE It has been suggested that influences operating early in life may affect the risk of postpubertal psychosis outcomes. This hypothesis was tested using a broad outcome of psychotic symptoms expressed in adolescence (prevalence: 15.6%). METHOD Findings are based on a longitudinal, population-based cohort study of 963 adolescents aged 15-20 years and their parents in the area of Munich, Germany. Trained psychologists assessed adolescents with the Munich-Composite International Diagnostic Interview. Independently, direct diagnostic interviews were conducted with the parents. RESULTS A range of medical complications of pregnancy and delivery, including lower birth weight, were not associated with the psychosis outcome. However, a number of maternal health behaviours and experiences did show associations, independent of confounders. CONCLUSION Not maternally reported medical complications of pregnancy and delivery, but maternal prenatal health behaviours predicted expression of psychosis along a continuum in adolescence. This effect may either be direct or constitute a proxy for later postnatal maternal behaviours associated with psychosis risk in the offspring.
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Affiliation(s)
- J Spauwen
- Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, 6200 MD Maastricht, The Netherlands
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