The Experts below are selected from a list of 204 Experts worldwide ranked by ideXlab platform
Hans-jürgen Möller - One of the best experts on this subject based on the ideXlab platform.
-
Distinct seasonality of depressive episodes differentiates unipolar depressive patients with and without depressive mixed states.
Journal of affective disorders, 2005Co-Authors: Tetsuya Sato, Ronald Bottlender, Marcus Sievers, Hans-jürgen MöllerAbstract:Abstract Background The bipolar nature of unipolar depression with depressive mixed sates (DMX) needs further validation studies. The seasonality of depressive episodes is indicated to be different between unipolar and bipolar depressions. We therefore explored the seasonal pattern of depressive episodes in unipolar depressive patients with DMX. Methods The subjects were 958 consecutive depressive inpatients for a 6-year period. For defining DMX, previously validated operational criteria were used (2 or more of 8 manic or mania-related symptoms: flight of idea, Logorrhea, aggression, excessive social contact, increased drive, irritability, racing thoughts, and distractibility). Onsets of the index depressive episodes during each of the 12 calendar months were summed up over the 6-year for bipolar depressive patients ( N = 95), and unipolar depressive patients with ( N = 77) and without DMX ( N = 786) separately. An appropriate statistic was used for testing seasonality. Results A significant seasonal variation with a large peak in spring was recognized in unipolar depression without DMX, while both bipolar depression and unipolar depression with DMX had a significant fall peak. The monthly distribution of depressive episodes was significantly different between unipolar depression without DMX and other 2 diagnostic categories. Similar results were obtained in separate analyses for each gender. Limitations Further replication study using an epidemiological or outpatient sample is needed. Bipolar I and II patients were combined due to a small number of bipolar II patients in this sample. Conclusion Unipolar depression with DMX has a seasonal pattern similar to bipolar depression. The finding provides further evidence of the bipolar nature of unipolar depression with DMX.
-
Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder.
Journal of affective disorders, 2004Co-Authors: Ronald Bottlender, Tetsuya Sato, N. Kleindienst, Anton Strauß, Hans-jürgen MöllerAbstract:Background: Case observations imply that depressed patients with mixed features are of high risk for maniform switch during acute treatment. Methods: The medical records of 158 bipolar I depressives were examined with respect to mixed depressive features at admission, naturalistic medications, and maniform switch during inpatient treatment. Results: Besides pharmacological variables, the number of mixed depressive symptoms (flight of ideas, racing thoughts, Logorrhea, aggression, excessive social contact, increased drive, irritability, and distractibility) at admission was associated with a higher risk for, and the acceleration of, maniform switch during inpatient treatment. Limitations: This was a retrospective study in patients receiving naturalistic treatment. The cohort was hospital based and thus not representative of the full range of bipolar affective disorder. Conclusions: In line with recent studies, our results underline the factors inherent in subjects at a higher risk of switch. Investigation of the relationships between several inherent factors and their interactions with pharmacological treatments may be important in resolving the controversy surrounding antidepressant-induced mania. Further validation studies on mixed depression are warranted.
-
Evaluating the inter-episode stability of depressive mixed states
Journal of affective disorders, 2004Co-Authors: Tetsuya Sato, Ronald Bottlender, Andreas Schröter, N. Kleindienst, Marcus Sievers, Hans-jürgen MöllerAbstract:Abstract Background : Depressive mixed state (DMX) is understudied, although this diagnostic concept may be of clinical and theoretical importance. Our goal was to provide preliminary evidence of the inter-episode stability of DMX. The inter-episode stability is known to be an important validator for establishing a distinct clinical entity. Methods : Out of depressive patients consecutively hospitalized at our institute, those who experienced two or more hospitalizations due to discrete depressive recurrences during a 6-year period were selected. All depressive episodes were directly observed and assessed using a standardized rating instrument in terms of eight intra-episode manic symptoms (flight of idea, Logorrhea, aggression, excessive social contact, increased drive, irritability, racing thoughts, and distractibility). Assessments for subsequent episodes were performed blindly to those for previous episodes within each patient. Results : The inter-episode stability of categorical DMX diagnoses and the number of intra-episode manic symptoms was moderate but significantly high. Approximately 50% of patients with DMX in the index episode obtained a DMX diagnosis in the second episode. Approximately 40% of the total variance of the number of intra-episode manic symptoms was explained by agreements across several depressive episodes. Depressive patients who experienced a diagnostic switch from unipolar to bipolar disorder had a higher frequency of DMX and a greater number of intra-episode manic symptoms in the index as well as subsequent episodes. Limitations : All consecutive patients were not followed up. Bipolar I and II patients were combined due to a small number of bipolar II patients in this sample. Conclusion : The inter-episode stability of DMX may not be so high as is required for establishing a distinct clinical entity. However, the findings strongly suggest that some depressive patients have a long-lasting liability to DMX. It is important to determine whether such a liability to DMX is mediated by affective temperaments, as was originally hypothesized by Akiskal [J. Clin. Psychopharmacol. 16 (1996) 4S–14S]. DMX may be a risk factor to the diagnostic switch from unipolar to bipolar disorder.
Ronald Bottlender - One of the best experts on this subject based on the ideXlab platform.
-
Distinct seasonality of depressive episodes differentiates unipolar depressive patients with and without depressive mixed states.
Journal of affective disorders, 2005Co-Authors: Tetsuya Sato, Ronald Bottlender, Marcus Sievers, Hans-jürgen MöllerAbstract:Abstract Background The bipolar nature of unipolar depression with depressive mixed sates (DMX) needs further validation studies. The seasonality of depressive episodes is indicated to be different between unipolar and bipolar depressions. We therefore explored the seasonal pattern of depressive episodes in unipolar depressive patients with DMX. Methods The subjects were 958 consecutive depressive inpatients for a 6-year period. For defining DMX, previously validated operational criteria were used (2 or more of 8 manic or mania-related symptoms: flight of idea, Logorrhea, aggression, excessive social contact, increased drive, irritability, racing thoughts, and distractibility). Onsets of the index depressive episodes during each of the 12 calendar months were summed up over the 6-year for bipolar depressive patients ( N = 95), and unipolar depressive patients with ( N = 77) and without DMX ( N = 786) separately. An appropriate statistic was used for testing seasonality. Results A significant seasonal variation with a large peak in spring was recognized in unipolar depression without DMX, while both bipolar depression and unipolar depression with DMX had a significant fall peak. The monthly distribution of depressive episodes was significantly different between unipolar depression without DMX and other 2 diagnostic categories. Similar results were obtained in separate analyses for each gender. Limitations Further replication study using an epidemiological or outpatient sample is needed. Bipolar I and II patients were combined due to a small number of bipolar II patients in this sample. Conclusion Unipolar depression with DMX has a seasonal pattern similar to bipolar depression. The finding provides further evidence of the bipolar nature of unipolar depression with DMX.
-
Brief report Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder
2004Co-Authors: Ronald Bottlender, Tetsuya Sato, N. KleindienstAbstract:Background: Case observations imply that depressed patients with mixed features are of high risk for maniform switch during acute treatment. Methods: The medical records of 158 bipolar I depressives were examined with respect to mixed depressive features at admission, naturalistic medications, and maniform switch during inpatient treatment. Results: Besides pharmacological variables, the number of mixed depressive symptoms (flight of ideas, racing thoughts, Logorrhea, aggression, excessive social contact, increased drive, irritability, and distractibility) at admission was associated with a higher risk for, and the acceleration of, maniform switch during inpatient treatment. Limitations: This was a retrospective study in patients receiving naturalistic treatment. The cohort was hospital based and thus not representative of the full range of bipolar affective disorder. Conclusions: In line with recent studies, our results underline the factors inherent in subjects at a higher risk of switch. Investigation of the relationships between several inherent factors and their interactions with pharmacological treatments may be important in resolving the controversy surrounding antidepressant-induced mania. Further validation studies on mixed depression are warranted. D 2004 Elsevier B.V. All rights reserved.
-
Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder.
Journal of affective disorders, 2004Co-Authors: Ronald Bottlender, Tetsuya Sato, N. Kleindienst, Anton Strauß, Hans-jürgen MöllerAbstract:Background: Case observations imply that depressed patients with mixed features are of high risk for maniform switch during acute treatment. Methods: The medical records of 158 bipolar I depressives were examined with respect to mixed depressive features at admission, naturalistic medications, and maniform switch during inpatient treatment. Results: Besides pharmacological variables, the number of mixed depressive symptoms (flight of ideas, racing thoughts, Logorrhea, aggression, excessive social contact, increased drive, irritability, and distractibility) at admission was associated with a higher risk for, and the acceleration of, maniform switch during inpatient treatment. Limitations: This was a retrospective study in patients receiving naturalistic treatment. The cohort was hospital based and thus not representative of the full range of bipolar affective disorder. Conclusions: In line with recent studies, our results underline the factors inherent in subjects at a higher risk of switch. Investigation of the relationships between several inherent factors and their interactions with pharmacological treatments may be important in resolving the controversy surrounding antidepressant-induced mania. Further validation studies on mixed depression are warranted.
-
Evaluating the inter-episode stability of depressive mixed states
Journal of affective disorders, 2004Co-Authors: Tetsuya Sato, Ronald Bottlender, Andreas Schröter, N. Kleindienst, Marcus Sievers, Hans-jürgen MöllerAbstract:Abstract Background : Depressive mixed state (DMX) is understudied, although this diagnostic concept may be of clinical and theoretical importance. Our goal was to provide preliminary evidence of the inter-episode stability of DMX. The inter-episode stability is known to be an important validator for establishing a distinct clinical entity. Methods : Out of depressive patients consecutively hospitalized at our institute, those who experienced two or more hospitalizations due to discrete depressive recurrences during a 6-year period were selected. All depressive episodes were directly observed and assessed using a standardized rating instrument in terms of eight intra-episode manic symptoms (flight of idea, Logorrhea, aggression, excessive social contact, increased drive, irritability, racing thoughts, and distractibility). Assessments for subsequent episodes were performed blindly to those for previous episodes within each patient. Results : The inter-episode stability of categorical DMX diagnoses and the number of intra-episode manic symptoms was moderate but significantly high. Approximately 50% of patients with DMX in the index episode obtained a DMX diagnosis in the second episode. Approximately 40% of the total variance of the number of intra-episode manic symptoms was explained by agreements across several depressive episodes. Depressive patients who experienced a diagnostic switch from unipolar to bipolar disorder had a higher frequency of DMX and a greater number of intra-episode manic symptoms in the index as well as subsequent episodes. Limitations : All consecutive patients were not followed up. Bipolar I and II patients were combined due to a small number of bipolar II patients in this sample. Conclusion : The inter-episode stability of DMX may not be so high as is required for establishing a distinct clinical entity. However, the findings strongly suggest that some depressive patients have a long-lasting liability to DMX. It is important to determine whether such a liability to DMX is mediated by affective temperaments, as was originally hypothesized by Akiskal [J. Clin. Psychopharmacol. 16 (1996) 4S–14S]. DMX may be a risk factor to the diagnostic switch from unipolar to bipolar disorder.
-
Frequency of manic symptoms during a depressive episode and unipolar 'depressive mixed state' as bipolar spectrum.
Acta psychiatrica Scandinavica, 2003Co-Authors: T. Sato, Ronald Bottlender, Andreas Schröter, H.-j. MöllerAbstract:Objective: To report the frequency of intra-episode manic symptoms in depressive episodes, and to evaluate unipolar depressive mixed state (DMS) as bipolar spectrum. Method: A total of 958 (863 unipolar, 25 bipolar II, and 70 bipolar I) depressive in-patients were assessed in terms of manic symptoms at admission, and several clinical variables using standardized methods. Results: The frequency of manic symptoms (flight of idea, Logorrhea, aggression, excessive social contact, increased drive, irritability, racing thoughts, and distractibility) was significantly higher in bipolar depressives than in unipolar depressives. Unipolar depressives with DMS – defined as having two or more manic symptoms – had more similarities to bipolar depressives than to other unipolar depressives in clinical variables such as onset age, family history of bipolar disorder, and possibly suicidality. Conclusion: Depressive mixed state is frequent, particular in bipolar depressives. Unipolar depressives with DMS may be better classified into bipolar spectrum.
Tetsuya Sato - One of the best experts on this subject based on the ideXlab platform.
-
Distinct seasonality of depressive episodes differentiates unipolar depressive patients with and without depressive mixed states.
Journal of affective disorders, 2005Co-Authors: Tetsuya Sato, Ronald Bottlender, Marcus Sievers, Hans-jürgen MöllerAbstract:Abstract Background The bipolar nature of unipolar depression with depressive mixed sates (DMX) needs further validation studies. The seasonality of depressive episodes is indicated to be different between unipolar and bipolar depressions. We therefore explored the seasonal pattern of depressive episodes in unipolar depressive patients with DMX. Methods The subjects were 958 consecutive depressive inpatients for a 6-year period. For defining DMX, previously validated operational criteria were used (2 or more of 8 manic or mania-related symptoms: flight of idea, Logorrhea, aggression, excessive social contact, increased drive, irritability, racing thoughts, and distractibility). Onsets of the index depressive episodes during each of the 12 calendar months were summed up over the 6-year for bipolar depressive patients ( N = 95), and unipolar depressive patients with ( N = 77) and without DMX ( N = 786) separately. An appropriate statistic was used for testing seasonality. Results A significant seasonal variation with a large peak in spring was recognized in unipolar depression without DMX, while both bipolar depression and unipolar depression with DMX had a significant fall peak. The monthly distribution of depressive episodes was significantly different between unipolar depression without DMX and other 2 diagnostic categories. Similar results were obtained in separate analyses for each gender. Limitations Further replication study using an epidemiological or outpatient sample is needed. Bipolar I and II patients were combined due to a small number of bipolar II patients in this sample. Conclusion Unipolar depression with DMX has a seasonal pattern similar to bipolar depression. The finding provides further evidence of the bipolar nature of unipolar depression with DMX.
-
Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder.
Journal of affective disorders, 2004Co-Authors: Ronald Bottlender, Tetsuya Sato, N. Kleindienst, Anton Strauß, Hans-jürgen MöllerAbstract:Background: Case observations imply that depressed patients with mixed features are of high risk for maniform switch during acute treatment. Methods: The medical records of 158 bipolar I depressives were examined with respect to mixed depressive features at admission, naturalistic medications, and maniform switch during inpatient treatment. Results: Besides pharmacological variables, the number of mixed depressive symptoms (flight of ideas, racing thoughts, Logorrhea, aggression, excessive social contact, increased drive, irritability, and distractibility) at admission was associated with a higher risk for, and the acceleration of, maniform switch during inpatient treatment. Limitations: This was a retrospective study in patients receiving naturalistic treatment. The cohort was hospital based and thus not representative of the full range of bipolar affective disorder. Conclusions: In line with recent studies, our results underline the factors inherent in subjects at a higher risk of switch. Investigation of the relationships between several inherent factors and their interactions with pharmacological treatments may be important in resolving the controversy surrounding antidepressant-induced mania. Further validation studies on mixed depression are warranted.
-
Brief report Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder
2004Co-Authors: Ronald Bottlender, Tetsuya Sato, N. KleindienstAbstract:Background: Case observations imply that depressed patients with mixed features are of high risk for maniform switch during acute treatment. Methods: The medical records of 158 bipolar I depressives were examined with respect to mixed depressive features at admission, naturalistic medications, and maniform switch during inpatient treatment. Results: Besides pharmacological variables, the number of mixed depressive symptoms (flight of ideas, racing thoughts, Logorrhea, aggression, excessive social contact, increased drive, irritability, and distractibility) at admission was associated with a higher risk for, and the acceleration of, maniform switch during inpatient treatment. Limitations: This was a retrospective study in patients receiving naturalistic treatment. The cohort was hospital based and thus not representative of the full range of bipolar affective disorder. Conclusions: In line with recent studies, our results underline the factors inherent in subjects at a higher risk of switch. Investigation of the relationships between several inherent factors and their interactions with pharmacological treatments may be important in resolving the controversy surrounding antidepressant-induced mania. Further validation studies on mixed depression are warranted. D 2004 Elsevier B.V. All rights reserved.
-
Evaluating the inter-episode stability of depressive mixed states
Journal of affective disorders, 2004Co-Authors: Tetsuya Sato, Ronald Bottlender, Andreas Schröter, N. Kleindienst, Marcus Sievers, Hans-jürgen MöllerAbstract:Abstract Background : Depressive mixed state (DMX) is understudied, although this diagnostic concept may be of clinical and theoretical importance. Our goal was to provide preliminary evidence of the inter-episode stability of DMX. The inter-episode stability is known to be an important validator for establishing a distinct clinical entity. Methods : Out of depressive patients consecutively hospitalized at our institute, those who experienced two or more hospitalizations due to discrete depressive recurrences during a 6-year period were selected. All depressive episodes were directly observed and assessed using a standardized rating instrument in terms of eight intra-episode manic symptoms (flight of idea, Logorrhea, aggression, excessive social contact, increased drive, irritability, racing thoughts, and distractibility). Assessments for subsequent episodes were performed blindly to those for previous episodes within each patient. Results : The inter-episode stability of categorical DMX diagnoses and the number of intra-episode manic symptoms was moderate but significantly high. Approximately 50% of patients with DMX in the index episode obtained a DMX diagnosis in the second episode. Approximately 40% of the total variance of the number of intra-episode manic symptoms was explained by agreements across several depressive episodes. Depressive patients who experienced a diagnostic switch from unipolar to bipolar disorder had a higher frequency of DMX and a greater number of intra-episode manic symptoms in the index as well as subsequent episodes. Limitations : All consecutive patients were not followed up. Bipolar I and II patients were combined due to a small number of bipolar II patients in this sample. Conclusion : The inter-episode stability of DMX may not be so high as is required for establishing a distinct clinical entity. However, the findings strongly suggest that some depressive patients have a long-lasting liability to DMX. It is important to determine whether such a liability to DMX is mediated by affective temperaments, as was originally hypothesized by Akiskal [J. Clin. Psychopharmacol. 16 (1996) 4S–14S]. DMX may be a risk factor to the diagnostic switch from unipolar to bipolar disorder.
N. Kleindienst - One of the best experts on this subject based on the ideXlab platform.
-
Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder.
Journal of affective disorders, 2004Co-Authors: Ronald Bottlender, Tetsuya Sato, N. Kleindienst, Anton Strauß, Hans-jürgen MöllerAbstract:Background: Case observations imply that depressed patients with mixed features are of high risk for maniform switch during acute treatment. Methods: The medical records of 158 bipolar I depressives were examined with respect to mixed depressive features at admission, naturalistic medications, and maniform switch during inpatient treatment. Results: Besides pharmacological variables, the number of mixed depressive symptoms (flight of ideas, racing thoughts, Logorrhea, aggression, excessive social contact, increased drive, irritability, and distractibility) at admission was associated with a higher risk for, and the acceleration of, maniform switch during inpatient treatment. Limitations: This was a retrospective study in patients receiving naturalistic treatment. The cohort was hospital based and thus not representative of the full range of bipolar affective disorder. Conclusions: In line with recent studies, our results underline the factors inherent in subjects at a higher risk of switch. Investigation of the relationships between several inherent factors and their interactions with pharmacological treatments may be important in resolving the controversy surrounding antidepressant-induced mania. Further validation studies on mixed depression are warranted.
-
Brief report Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder
2004Co-Authors: Ronald Bottlender, Tetsuya Sato, N. KleindienstAbstract:Background: Case observations imply that depressed patients with mixed features are of high risk for maniform switch during acute treatment. Methods: The medical records of 158 bipolar I depressives were examined with respect to mixed depressive features at admission, naturalistic medications, and maniform switch during inpatient treatment. Results: Besides pharmacological variables, the number of mixed depressive symptoms (flight of ideas, racing thoughts, Logorrhea, aggression, excessive social contact, increased drive, irritability, and distractibility) at admission was associated with a higher risk for, and the acceleration of, maniform switch during inpatient treatment. Limitations: This was a retrospective study in patients receiving naturalistic treatment. The cohort was hospital based and thus not representative of the full range of bipolar affective disorder. Conclusions: In line with recent studies, our results underline the factors inherent in subjects at a higher risk of switch. Investigation of the relationships between several inherent factors and their interactions with pharmacological treatments may be important in resolving the controversy surrounding antidepressant-induced mania. Further validation studies on mixed depression are warranted. D 2004 Elsevier B.V. All rights reserved.
-
Evaluating the inter-episode stability of depressive mixed states
Journal of affective disorders, 2004Co-Authors: Tetsuya Sato, Ronald Bottlender, Andreas Schröter, N. Kleindienst, Marcus Sievers, Hans-jürgen MöllerAbstract:Abstract Background : Depressive mixed state (DMX) is understudied, although this diagnostic concept may be of clinical and theoretical importance. Our goal was to provide preliminary evidence of the inter-episode stability of DMX. The inter-episode stability is known to be an important validator for establishing a distinct clinical entity. Methods : Out of depressive patients consecutively hospitalized at our institute, those who experienced two or more hospitalizations due to discrete depressive recurrences during a 6-year period were selected. All depressive episodes were directly observed and assessed using a standardized rating instrument in terms of eight intra-episode manic symptoms (flight of idea, Logorrhea, aggression, excessive social contact, increased drive, irritability, racing thoughts, and distractibility). Assessments for subsequent episodes were performed blindly to those for previous episodes within each patient. Results : The inter-episode stability of categorical DMX diagnoses and the number of intra-episode manic symptoms was moderate but significantly high. Approximately 50% of patients with DMX in the index episode obtained a DMX diagnosis in the second episode. Approximately 40% of the total variance of the number of intra-episode manic symptoms was explained by agreements across several depressive episodes. Depressive patients who experienced a diagnostic switch from unipolar to bipolar disorder had a higher frequency of DMX and a greater number of intra-episode manic symptoms in the index as well as subsequent episodes. Limitations : All consecutive patients were not followed up. Bipolar I and II patients were combined due to a small number of bipolar II patients in this sample. Conclusion : The inter-episode stability of DMX may not be so high as is required for establishing a distinct clinical entity. However, the findings strongly suggest that some depressive patients have a long-lasting liability to DMX. It is important to determine whether such a liability to DMX is mediated by affective temperaments, as was originally hypothesized by Akiskal [J. Clin. Psychopharmacol. 16 (1996) 4S–14S]. DMX may be a risk factor to the diagnostic switch from unipolar to bipolar disorder.
Alfred H.t. Pang - One of the best experts on this subject based on the ideXlab platform.
-
Psychopathology of catatonic speech disorders and the dilemma of catatonia: a selective review
The Australian and New Zealand journal of psychiatry, 1995Co-Authors: Gabor S. Ungvari, Erica White, Alfred H.t. PangAbstract:Objective: Over the past decade there has been an upsurge of interest in the prevalence, nosological position, treatment response and pathophysiology of catatonia. However, the psychopathology of catatonia has received only scant attention. Once the hallmark of catatonia, speech disorders - particularly logorrhoea, verbigeration and echolalia - seem to have been neglected in modern literature. The aims of the present paper are to outline the conceptual history of catatonic speech disorders and to follow their development in contemporary clinical research.Method: The English-language psychiatric literature for the last 60 years on logorrhoea, verbigeration and echolalia was searched through Medline and cross-referencing. Kahlbaum, Wernicke, Jaspers, Kraepelin, Bleuler, Kleist and Leonhard' s oft cited classical texts supplemented the search.Results: In contrast to classical psychopathological sources, very few recent papers were found on catatonic speech disorders. Current clinical research failed to incor...
