Georg Schönbeck

The tridimensional personality model : Influencing variables in a sample of detoxified alcohol dependents

C.R. Cloninger proposed a biosocial model for personality, linking personality traits to patterns of responses to various external stimuli, including alcohol. The Tridimensional Personality Questionnaire (TPQ) was administered in a multicenter study to detoxified alcohol-dependent patients (N = 521). The objectives of the study were to evaluate (1) the expression of the three personality dimensions, novelty-seeking (NS), harm avoidance (HA), and reward dependence (RD), of the TPQ in this sample, and (2) the influence of different variables on these personality dimensions. The following variables were selected for a multiple and a stepwise regression analysis: sex, family history for major psychiatric disorders, marital status, occupation, age at study enrollment, age of onset of alcoholism, serum cholesterol level, intake of neuroleptics or benzodiazepines for detoxification, and severity of depression and anxiety. In comparison to Austrian normative data, both sexes of detoxified alcohol addicts scored higher in HA. The variables examined explain 23% of the variance of NS and 35% of HA. Only one variable, namely age of onset, is significantly influencing NS (19% explained variance). HA is significantly influenced by three variables: anxiety state, anxiety trait, and sex (32% explained variance). RD is not influenced by any of the variables examined.

Rapid Psychotherapeutic Effects of Anesthesia with Isoflurane (ES Narcotherapy) in Treatment-Refractory Depressed Patients

Treatment-refractory depressed patients who objected to electroconvulsive therapy (ECT) were given a series of anesthesias with isoflurane (Forane), a modern and established inhalation anesthetic. According to our hypothesis to be tested, the brief period of electrocerebral silence (ES), which can be observed shortly after the grand mal seizure in ECT, may be in itself a crucial biological determinant for the therapeutic effects of ECT. Isoflurane is the only drug known to effect an ES in the EEG in nontoxic concentrations, which does not result in adverse effects on any body organ including the brain; no seizure activity can be observed. Eleven depressed patients received a total of 36 anesthesias with isoflurane (ES narcotherapy). Rapid antidepressant effects were observed in 9 patients (p less than 0.0001). Effects were reproducible and lasted up to several weeks. No adverse effects of anesthesia were noticed.

The TSH-response to TRH: A possible predictor of outcome to antidepressant and neuroleptic treatment.

This study was designed to investigate the possible common patterns of neuroendocrine mechanisms, which may be involved in the therapeutic effects of antidepressant drugs in depressive and of neuroleptic drugs in schizophrenic patients. Sixty-three depressed women (major depressive disorder) and 21 paranoid-hallucinatory women have been studied while on antidepressant (clomipramine) or neuroleptic (haloperidol) treatment, respectively. The neuroendocrine test (TRH-test) was performed at weekly intervals. The change of TSH-response to TRH during treatment, i.e. the treatment associated normalization of a former blunted TSH-response, can tentatively be regarded as a predictor of outcome for depressive and paranoid-hallucinatory patients to their respective drug treatments. Antidepressant and neuroleptic drugs appear to involve the normalization of the TSH-response in their therapeutic effects in that proportion of patients (40%) which showed a blunted TSH-response at admission.

Biperiden and Haloperidol Plasma Levels and Extrapyramidal Side Effects in Schizophrenic Patients

Anticholinergic drugs such as biperiden are used for the treatment of extrapyramidal side effects (EPS) induced by neuroleptics such as haloperidol. The effects of biperiden and haloperidol plasma levels on EPS were studied in 29 chronically ill schizophrenics. The results show relationships between biperiden dose and biperiden plasma levels (BPL), and between BPL and haloperidol plasma levels (HPL). Neither BPL nor HPL seem to influence EPS.

The tridimensional personality questionnaire as a predictor of relapse in detoxified alcohol dependents

Personality traits have been found as strong predictors for treatment response in different psychiatric disorders. We administered the Tridimensional Personality Questionnaire, which measures the three personality dimensions: novelty seeking, harm avoidance (HA), and reward dependence, as introduced by Cloninger in a multicenter study (1 1 centers in the United Kingdom, Eire, Switzerland, and Austria) with detoxified alcohol-dependent patients (n = 521). The objective of this study was to evaluate a possible predictive value of these three dimensions on relapse over 1 -year follow up. A logistic regression analysis showed that novelty seeking is a strong predictor for relapse in detoxified male alcoholics (p = O.OOO7; p values adjusted for treatment), but not in females. In both sexes, HA and reward dependence were of no predictive value. However, we found a trend for significance of HA for predicting “early” relapse (4 weeks) in females (p = 0.074). Our results show that Tridimensional Personality Questionnaire personality traits have direct clinical applications for prediction of relapse in detoxified alcohol dependents and indicate

The Blunted TSH Response to TRH — What Does It Tell Us? Biological Monitoring During Psychopharmacological Treatment

The past two decades have witnessed an intensive search for a biological substrate in “functional” psychiatric disorders. Psychoneuroendocrinology has offered a fertile field for such investigations, as the perturbations in hormone levels may reflect certain important CNS processes (Langer et al. 1985). Of the several endocrine systems studied, the pituitary-thyroid subsystem has produced certain significant observations which point to applications in clinical practice. Interest in the pituitary-thyroid subsystem seems to have its origins in the reported association between thyroid dysfunction and psychiatric conditions (for review see Loosen and Prange 1984). An impetus to research into the thyroid subsystem applicable to psychiatric disorders was given by the observation that one of the hormones — thyrotropin-releasing hormone (TRH), which regulates the thyroid subsystem — is secreted by hypothalamus (Prange et al. 1987).

Neuroendokrine Studien zur therapeutischen Wirkung von Antidepressiva und Neuroleptika — Das Konzept der entaktivierenden Wirkung

Seit der Entdeckung der Neuroleptika (Chlorpromazin; Delay et al. [4]) und Antidepressiva (Imipramin; Kuhn [9]) werden diese Pharmaka weltweit — wenn auch nicht immer erfolgreich — in der psychiatrischen Therapie angewendet. Viele Analogpraparate der „Originale“ sind seither synthetisch hergestellt worden, z. T. mit vergleichbarem psychopharmakologischem Profil. Obwohl heute die allgemeine Wirksamkeit dieser Medikamente erwiesen ist, bleibt ungeklart, warum trotz adaquater Indikation und Therapie einige Patienten therapieresistent sind.