Josef Schwitzer

Carbamazepine in the prophylaxis of mood disorders.

Alternatives to lithium are desirable in the prophylaxis of affective disorders, especially in patients who are intolerant of or do not respond to that drug. In the past few years the anticonvulsant carbamazepine has been in the foreground of discussion. Twenty-four patients with affective disorders (17 unipolar depressed, six bipolar, and one unipolar manic) were included in a comparative trial of lithium and carbamazepine; 12 had been pretreated with lithium without a satisfactory effect. All patients received carbamazepine (four received it in combination with lithium) over a mean time span of 20.2 months. Eighty percent of the patients improved with carbamazepine treatment. Side effects were infrequent.

Tardive Dyskinesia Prevalence Rates During a Ten-year Follow-up

We followed up patients in the State Psychiatric Hospital Mauer-Öhling, Mauer-Öhling, Austria, who had been examined in 1982 to determine the prevalence of tardive dyskinesia (TD). Of the 861 patients examined in 1982, 270 were still in hospital 10 years later. Only these patients were included in our study. The SKAUB (Skala für abnorme unwillkürliche Bewegungen, i.e., The German version of the Abnormal Involuntary Movement Scale) was used to quantify the occurrence of TD. The prevalence rate of TD was 3.7% in 1982 and 12.7% in 1992. The 1992 prevalence rate in patients who had not shown TD symptoms in 1982 was 11.4%. The major risk factor for TD was advanced age.

The Role of Carbamazepine in the Prophylaxis of Unipolar Depression

The prophylaxis of unipolar depression is still a controversial subject. Some authors prefer lithium, others maintenance treatment with antidepressants. The role of carbamazepine remains unclear. Few patients have been described in the literature, and most are lithium nonresponders or rapid cyclers. In an open-label naturalistic study, 15 patients suffering from unipolar depression (DSM-III, 296.2, 296.3) and receiving long-term prophylaxis with carbamazepine were followed for 5 years. Four had been pretreated with lithium without satisfactory effects, 11 were prophylaxis naive. The mean time span patients received carbamazepine was 49.5 months. 73% of the patients gained substantial profit from carbamazepine. Side effects were infrequent.

Information transmission defect identified and localized in language learning impaired children by means of electrophysiology.

Children with language processing deficits have various learning impairments and poor scholastic performance. In 3-10% of all children a specific language processing deficit can be identified by the Sound Connecting Sub-Test of the Illinois Test of Psycholinguistic-Abilities (SC-ITPA). These children among which we drew our index group (AS-Group) suffer from the disability to recognize isolated sounds as parts of words. Following linguistic terminology this is known as an auditory sequential sound processing deficit (ASSPD) Eighteen children (AS-Group) and 21 controls (C-Group) were subjected to mapped P300 evoked potential analyses of cortical response to acoustic stimulation in the oddball paradigm. The data presented here show that there exists significant relation between the P300 amplitude reduction and ASSPD. The P300 amplitude decrease measured in the AS-Group is due to a reduced information transmission in accordance with Johnsons Triarchic Model of the P300 Amplitude. The cerebral structures involved in poor language processing are localized at the left temporo-parietal cortex. This supports the hypothesis that the underlying neuronal defect of ASSPD is localized in the language center and not in the auditory pathway. The P300 amplitude may serve as electrophysiological tool to identify ASSPD and to quantify the degree of improvement in the course of specific therapy.

About epidemiology of suicidal behavior: An investigation in the health-service district of Brixen

OBJECTIVE Aim of this investigation is to find out how many parasuicids as well as suicides are commited and which epidemiological characteristics (sex, age, substance addictions, relationships, job, life-events and suicide attempts in past) show people who commit suicide, and people who commiting parasuicide. After that we try to find variables predicting a suicide or variables what show a vulnerability to commit suicide. METHODS Clinicans assess patients who commit parasuicide by the WHO-Parasuicide-Monitoring-Questionnaire and suicide victims by interview with the bereaved. Afterwards, data are assimilated and aggregated. RESULTS In this period a mean of 37 (SD = 7.78) parasuicides and 6.32 (SD = 3.79) suicides happened yearly. The sample shows different characteristics in age, sex, life-events in the run-up to the action, job situation and parasuicide(s) in past. No differences were found between relationship and substance abuse/addiction and regarding both types of suicidal behavior. CONCLUSION The incidence concerning suicide is slightly lower; the incidence with regard to parasuicide is lower than in other samples. Demographic variables show that people commiting suicide differ from those who commit parasuicide.ZusammenfassungAnliegenGegenstand dieser Untersuchung ist es, Aussagen über die Häufigkeit des Parasuizids im Gesundheitsbezirk Brixen und über die Verteilung soziodemographischer Merkmale (Lebensalter, Geschlecht, Abhängigkeitserkrankungen, Partnerschaften, Life-events, Beschäftigung, Suizidversuche in der Vergangenheit) bei Personen, die Suizide bzw. Parasuizide begehen, zu treffen. Geprüft werden soll darüber hinaus, anhand welcher Merkmale am ehesten ein Suizid vorausgesagt bzw. eine diesbezügliche Gefährdung festgestellt werden kann.MethodeBei Personen, die einen Suizidversuch begangen hatten, wurde vom Kliniker der WHO-Parasuizid-Monitoring-Fragebogen ausgefüllt, bei Suizidopfern die Hinterbliebenen befragt. Anschließend wurden die Daten aggregiert bzw. assimiliert.ErgebnisseIm Erhebungszeitraum kam es jährlich zu durchschnittlich 37 Parasuiziden (SD = 7,78) und 6,32 Suiziden (SD = 3,79). Die beiden Stichproben unterscheiden sich hinsichtlich Lebensalter, Geschlecht, Life-events im Vorfeld, Beschäftigung und Parasuizide in der Vergangenheit. Keine Unterschiede konnten hinsichtlich der Merkmale Partnerschaft und Substanzabhängigkeit/-missbrauch errechnet werden.SchlussfolgerungenDie Inzidenz für die Suizide kann etwas niedriger eingestuft werden und die Inzidenz für die Parasuizide als niedriger eingestuft werden als in anderen Stichproben. Es lassen sich demographische Variablen finden, hinsichtlich derer sich Personen, die einen Suizid begehen, von Personen, die einen Parasuizid begehen, unterscheiden.SummaryObjectiveAim of this investigation is to find out how many parasuicids as well as suicides are commited and which epidemiological characteristics (sex, age, substance addictions, relationships, job, life-events and suicide attempts in past) show people who commit suicide, and people who commiting parasuicide. After that we try to find variables predicting a suicide or variables what show a vulnerability to commit suicide.MethodsClinicans assess patients who commit parasuicide by the WHO-Parasuicide-Monitoring-Questionnaire and suicide victims by interview with the bereaved. Afterwards, data are assimilated and aggregated.ResultsIn this period a mean of 37 (SD = 7.78) parasuicides and 6.32 (SD = 3.79) suicides happened yearly. The sample shows different characteristics in age, sex, life-events in the run-up to the action, job situation and parasuicide(s) in past. No differences were found between relationship and substance abuse/addiction and regarding both types of suicidal behavior.ConclusionThe incidence concerning suicide is slightly lower; the incidence with regard to parasuicide is lower than in other samples. Demographic variables show that people commiting suicide differ from those who commit parasuicide.

Zur Epidemiologie suizidalen Verhaltens: Eine Untersuchung im Gesundheitsbezirk Brixen

OBJECTIVE Aim of this investigation is to find out how many parasuicids as well as suicides are commited and which epidemiological characteristics (sex, age, substance addictions, relationships, job, life-events and suicide attempts in past) show people who commit suicide, and people who commiting parasuicide. After that we try to find variables predicting a suicide or variables what show a vulnerability to commit suicide. METHODS Clinicans assess patients who commit parasuicide by the WHO-Parasuicide-Monitoring-Questionnaire and suicide victims by interview with the bereaved. Afterwards, data are assimilated and aggregated. RESULTS In this period a mean of 37 (SD = 7.78) parasuicides and 6.32 (SD = 3.79) suicides happened yearly. The sample shows different characteristics in age, sex, life-events in the run-up to the action, job situation and parasuicide(s) in past. No differences were found between relationship and substance abuse/addiction and regarding both types of suicidal behavior. CONCLUSION The incidence concerning suicide is slightly lower; the incidence with regard to parasuicide is lower than in other samples. Demographic variables show that people commiting suicide differ from those who commit parasuicide.ZusammenfassungAnliegenGegenstand dieser Untersuchung ist es, Aussagen über die Häufigkeit des Parasuizids im Gesundheitsbezirk Brixen und über die Verteilung soziodemographischer Merkmale (Lebensalter, Geschlecht, Abhängigkeitserkrankungen, Partnerschaften, Life-events, Beschäftigung, Suizidversuche in der Vergangenheit) bei Personen, die Suizide bzw. Parasuizide begehen, zu treffen. Geprüft werden soll darüber hinaus, anhand welcher Merkmale am ehesten ein Suizid vorausgesagt bzw. eine diesbezügliche Gefährdung festgestellt werden kann.MethodeBei Personen, die einen Suizidversuch begangen hatten, wurde vom Kliniker der WHO-Parasuizid-Monitoring-Fragebogen ausgefüllt, bei Suizidopfern die Hinterbliebenen befragt. Anschließend wurden die Daten aggregiert bzw. assimiliert.ErgebnisseIm Erhebungszeitraum kam es jährlich zu durchschnittlich 37 Parasuiziden (SD = 7,78) und 6,32 Suiziden (SD = 3,79). Die beiden Stichproben unterscheiden sich hinsichtlich Lebensalter, Geschlecht, Life-events im Vorfeld, Beschäftigung und Parasuizide in der Vergangenheit. Keine Unterschiede konnten hinsichtlich der Merkmale Partnerschaft und Substanzabhängigkeit/-missbrauch errechnet werden.SchlussfolgerungenDie Inzidenz für die Suizide kann etwas niedriger eingestuft werden und die Inzidenz für die Parasuizide als niedriger eingestuft werden als in anderen Stichproben. Es lassen sich demographische Variablen finden, hinsichtlich derer sich Personen, die einen Suizid begehen, von Personen, die einen Parasuizid begehen, unterscheiden.SummaryObjectiveAim of this investigation is to find out how many parasuicids as well as suicides are commited and which epidemiological characteristics (sex, age, substance addictions, relationships, job, life-events and suicide attempts in past) show people who commit suicide, and people who commiting parasuicide. After that we try to find variables predicting a suicide or variables what show a vulnerability to commit suicide.MethodsClinicans assess patients who commit parasuicide by the WHO-Parasuicide-Monitoring-Questionnaire and suicide victims by interview with the bereaved. Afterwards, data are assimilated and aggregated.ResultsIn this period a mean of 37 (SD = 7.78) parasuicides and 6.32 (SD = 3.79) suicides happened yearly. The sample shows different characteristics in age, sex, life-events in the run-up to the action, job situation and parasuicide(s) in past. No differences were found between relationship and substance abuse/addiction and regarding both types of suicidal behavior.ConclusionThe incidence concerning suicide is slightly lower; the incidence with regard to parasuicide is lower than in other samples. Demographic variables show that people commiting suicide differ from those who commit parasuicide.