H. Beckmann

Dexamethasone Suppression Test Combined with Total Sleep Deprivation in Depressed Patients

The effect of one nights total sleep deprivation (SD) on the dexamethasone suppression test (DST) was studied in groups of endogenously and nonendogenously depressed patients who were diagnosed according to different research classification systems. The DST was normal (less than 5 micrograms/dl) before and after SD in the group of nonendogenously depressed patients. Deterioration, no change or only slight clinical response in single items occurred. In the group of endogenous depressives 8 out of 11 were baseline nonsuppressors (greater than 5 micrograms/dl). After SD a large variability of cortisol nonsuppression was found in this group. Clinical response occurred in the majority of these patients but was more favorable in those who had a trend for normalization of DST. Clinical diagnosis as well as DST seem to have a therapy-predictive value for one nights total SD in patients with affective disorders.

Low platelet MAO activity and schizophrenia: sex differences

The authors compared platelet monoamine oxidase activity in schizophrenic patients and normal controls. A significant reductkm in the enzyme activity was found in the male schizophrenic patients but not in the females. No differences were detected among the subgroups of schizophrenia. Sources of bias and the possible mechanism for the findings are discussed.

A possible association between HLA B-27 and vulnerability to schizophrenia

Abstract The frequency of HLA B-27 has been found to be increased in schizophrenic patients, especially in those with a positive family history of schizophrenia. In the present study, psychiatrically healthy arthropathic patients bearing HLA B-27 were found to have significantly higher P scores as compared to arthropathic patients without this antigen. Psychoticism could be seen as a trait of the personality at high-risk for schizophrenia. Thus, the present finding suggests an association between HLA B-27 and the genetic vulnerability to some forms of schizophrenia.

CSF Studies in Schizophrenia: A Multidimensional Approach

The aim of the present study was the simultaneous investigation of different neuronal systems in a group of schizophrenic patients and healthy controls in order to investigate their possible role in the disease, their interrelationship, and the effects of neuroleptic drugs upon their function. We have investigated the brain metabolism through the determination of the concentrations of hormones, neurotransmitters, and their major metabolites in the cerebrospinal fluid (CSF).

Trazodone and amitriptyline in treatment of depressed inpatients: a double-blind study

Trazodone (TZ), a new generation antidepressant and amitriptyline (AMT) were administered in a double-blind controlled study to 43 depressed inpatients. The Hamilton Depression Rating Scale (HAM-D), the AMDP-system and the Bf-s self-rating questionnaire were used for documentation of psychopathological changes and autonomic side effects. The Newcastle-Scale for definition of a neurotic and an endogenous subgroup of depression was retrospectively applied. No significant improvement was noticed on the Bf-s self-rating questionnaire in the TZ group as compared to the AMT group (p less than 0.001). The global HAM-D score decreased significantly in the TZ group (p less than 0.05) as well as in the AMT group difference (p less than 0.01) emerged during the trial in favour of AMT. Core symptoms of depression were significantly improved in the AMT group but not in the TZ group: depressed mood (p less than 0.001), psychic anxiety (p less than 0.001) and retardation (p less than 0.05). TZ was faster actin than AMT in controlling agitation. Results of this clinical study demonstrate TZ to have sedative and some anxiolytic properties but only negligible antidepressant efficacy.

The anticholinergic biperiden in depressive disorders

In an open study the cholinolytic biperiden was administered to 10 severely depressed inpatients in an average dose of 12 mg per day for 30 days. Patients were classified according to the International Classification of Diseases, the research Diagnostic Criteria and the Newcastle Scale. A significant improvement was demonstrated in the global score of the Hamilton Depression Scale (p less than 0.001). Especially the factors retardation (p less than 0.001) and agitation (p less than 0.001) and the items depressed mood (p less than 0.001), initial insomnia (p less than 0.05), work and interest (p less than 0.001) and gastrointestinal symptoms (p less than 0.001) could favorably be influenced. Nevertheless, biperiden treatment had to be discontinued after three weeks in two patients because of a paranoid syndrome in one case and symptoms of inner restlessness and disturbances of vital feelings in the other case. There was a positive correlation between the clinical response and the cortisol non-suppressability to dexamethasone prior to the study (p less than 0.03). These results taken together with other findings from the literature suggest that cholinergic mechanisms may have an important impact on the pathogenesis of certain forms of depression.