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Functional neuroanatomy in panic disorder:Status quo of the research

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World Journal of psychiatry 2017年第1期7卷 12-33页

作者： Thomas Sobanski Gerd Wagner Department of psychiatry Psychotherapyand Psychosomatic MedicineThueringen-Kliniken GmbH Psychiatric Brain and Body Research Group Jena Department of Psychiatry and PsychotherapyJena University Hospital

AIM To provide an overview of the current research in the functional neuroanatomy of panic *** Panic disorder(PD) is a frequent psychiatric disease. Gorman et al(1989; 2000) proposed a comprehensive neuroanatomical model of PD, which suggested that fear-and anxiety-related responses are mediated by a so-called "fear network" which is centered in the amygdala and includes the hippocampus, thalamus, hypothalamus, periaqueductal gray region, locus coeruleus and other brainstem sites. We performed a systematic search by the electronic database PubMed. Thereby, the main focus was laid on recent neurofunctional, neurostructural, and neurochemical studies(from the period between January 2012 and April 2016). Within this frame, special attention was given to the emerging field of imaging genetics. RESULTS We noted that many neuroimaging studies have reinforced the role of the "fear network" regions in the pathophysiology of panic disorder. However, recent functional studies suggest abnormal activation mainly in an extended fear network comprising brainstem, anterior and midcingulate cortex(ACC and MCC), insula, and lateral as well as medial parts of the prefrontal cortex. Interestingly, differences in the amygdala activation were not as consistently reported as one would predict from the hypothesis of Gorman et al(2000). Indeed, amygdala hyperactivation seems to strongly depend on stimuli and experimental paradigms, sample heterogeneity and size, as well as on limitations of neuroimaging techniques. Advanced neurochemical studies have substantiated the major role of serotonergic, noradrenergic and glutamatergic neurotransmission in the pathophysiology of PD. However, alterations of GABAergic function in PD are still a matter of debate and also their specificity remains questionable. A promising new research approach is "imaging genetics". Imaging genetic studies are designed to evaluate the impact of genetic variations(polymorphisms) on cerebral function in reg

关键词： Panic disorder Anterior cingulate cortex Amygdala Insula Functional magnetic resonance imaging Diffusion tensor imaging Voxel-based morphometry Imaging genetics Serotonin Noradrenaline

Treating Comorbid Insomnia in Older Adults via Cognitive-Behavioural Treatment, Bright Light and Exercise

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Health 2014年第10期6卷 960-968页

作者： K. Richter J. Myllymaeki S. Scharold-Schaefer I. Tomova R. Mayrer G. Niklewski clinic for psychiatry and psychotherapy Nuremberg Hospital Nuremberg Germany Psychotherapeutical Practice Weissenburg Germany Sozialstiftung Bamberg Clinic for Psychiatry Psychosomatic and Psychotherapy Clinic Bamberg Bamberg Germany

Background: Insomnia occurs frequently in older adults. The underlying factors for the disorder are physiological changes of the sleep-wake cycle, comorbid diseases and drug treatment. Cognitive behavioural therapy (CBT I) combined with light therapy and physical activity can be effective in the treatment of comorbid insomnia in older adults. Methods: Sixty-three (63) insomnia patients (47 female, 16 male) with an average age of 66.6 years participated in the program. Before and after the treatment, the participants completed questionnaires to assess their sleep quality (PSQI), day-time sleepiness (ESS), mood (BDI) and well-being (WHO-5-Index). In addition, they kept sleep diaries for six weeks. Results: Pre-post comparisons revealed a significant improvement in sleep latency and sleep quality, as well as a significant reduction of day-time sleepiness. In patients with both insomnia and depression, all depression scores improved slightly but significantly. Conclusions: Non-pharmacological combination treatment using CBT I, light therapy and physical activity seemed to be effective in older adults with comorbid insomnia and improve additionaly depressive symptoms.

关键词： Insomnia Non-Pharmacological Treatment Older Adults CBT Light Therapy Physical Activity

A crate of Pandora:do amyloids from bacteria promote Alzheimer’s disease?

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Neural Regeneration Research 2021年第5期16卷 988-989页

作者： Vu Thu Thuy Nguyen Kristina Endres Department of psychiatry and psychotherapy University Medical Center Johannes Gutenberg-University MainzMainzGermany

Incidence for microbes as drivers of Alzheimer’s disease(AD)pathology:AD is the predominant neurodegenerative disease within the *** 50 million patients suffer from dementia currently world-wide and an estimated tripling of numbers within the next 30 years is *** one to maximally five percent of all cases of AD are based on mutations in the amyloid precursor protein(APP)gene or within the presenilin genes(PS1/PS2)and therefore are called familial(FAD).The majority of cases has to be designated as sporadic,which frankly only means that the origin of these cases is still enigmatic.

关键词： amyloid Alzheimer pathology

Suicidal behavior-advances in clinical and neurobiological research and improvement of prevention strategies

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World Journal of psychiatry 2022年第9期12卷 1115-1126页

作者： Thomas Sobanski Gregor Peikert Ulrich W Kastner Gerd Wagner Department of psychiatry Psychotherapyand Psychosomatic MedicineTHUERINGEN-Kliniken GmbHSaalfeld 07318Germany Network for Suicide Prevention in Thuringia(NeST) Jena 07743Germany Department of psychiatry and psychotherapy University Hospital JenaJena 07743Germany Department of psychiatry and psychotherapy Helios Fachkliniken HildburghausenHildburghausen 98646Germany

Suicide is the 14^(th)leading cause of death *** is responsible for 1%-5%of all *** article highlights the latest developments in universal,selective,and indicated prevention *** universal suicide prevention,current research has shown that strategies such as restricting access to lethal means(e.g.,control of analgesics and hot-spots for suicide by jumping)and school-based awareness programs are most *** selective prevention,substantial progress can be expected in psychological screening methods for suicidal *** measurement of implicit cognition proved to be more valid in predicting future suicide attempts than classic clinical *** developments are smartphone-based interventions and realtime monitoring of suicidal *** effort has been made to establish valid neurobiological screening methods(e.g.,genetic and epigenetic risk factors for suicide,hypothalamic-pituitary-adrenal axis)without yielding a major ***,multiple biomarkers rather than a single one are necessary to identify individuals at *** regard to indicated prevention in form of psychopharmacological treatment,recent pharmacoepidemiological studies and meta-analyses have supported a protective role of antidepressants,lithium,and ***,the data concerning a specific anti-suicidal effect of these drugs are currently not *** results exist for ketamine in reducing suicidal ideation,independently of its antidepressant *** psychotherapy,recent findings suggest that psychotherapeutic interventions specifically designed to prevent suicide re-attempts are most ***,cognitive behavioral therapy and psychodynamic therapy approaches proved to decrease the number of suicide re-attempts significantly.

关键词： Antidepressants Biomarkers Cognitive behavioral therapy Ketamine Prevention Suicide

Influence of mental stress on platelet bioactivity

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World Journal of psychiatry 2012年第6期2卷 134-147页

作者： Pia Koudouovoh-Tripp Barbara Sperner-Unterweger clinic for Biological psychiatry Department of Psychiatry and PsychotherapyInnsbruck Medical UniversityAnichstrasse 356020 InnsbruckAustria clinic for General psychiatry Department of Psychiatry and PsychotherapyInnsbruck Medical UniversityAnichstrasse 356020 InnsbruckAustria

It is well established that various mental stress conditions contribute, or at least influence, underlying pathophysiological mechanisms in somatic, as well as in psychiatric disorders; blood platelets are supposed to represent a possible link in this respect. The anculeated platelets are the smallest corpuscular elements circulating in the human blood. They display different serotonergic markers which seem to reflect the central nervous serotonin metabolism. They are known as main effectors in haematological processes but recent research highlights their role in the innate and adaptive immune system. Platelets are containing a multitude of pro-inflammatory and immune-modulatory bioactive compounds in their granules and are expressing immune-competent surface markers. Research gives hint that platelets activation and reactivity is increased by mental stress. This leads to enhanced cross talk with the immune system via paracrine secretion, receptor interaction and formation of platelet leucocyteaggregates. Recently it has been demonstrated that the immune system can have a remarkable impact in the development of psychiatric disorders. Thereforeplatelets represent an interesting research area in psychiatry and their role as a possible biomarker has been investigated. We review the influence of mental stress on what is termed platelet bioactivity in this article, which subsumes the mainly immune-modulatory activity of platelets in healthy volunteers, elderly persons with chronic care-giving strain, patients with cardiovascular diseases who are prone to psychosocial stress, as well as in patients with posttraumatic stress disorder. Research data suggest that stress enhances platelet activity, reactivity and immune-modulatory capacities.

关键词： Mental stress Caregiving strain Posttraumatic stress disorder Cardiovascular disease Serotonin Platelet activation Platelet bioactivity

Effects of age and sex on clinical high-risk for psychosis in the community

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World Journal of psychiatry 2020年第5期10卷 101-124页

作者： Frauke Schultze-Lutter Benno G Schimmelmann Rahel Fluckiger Chantal Michel Department of psychiatry and psychotherapy Medical FacultyHeinrich-Heine UniversityDüsseldorf 40692Germany University Hospital of Child and Adolescent psychiatry and psychotherapy University of BernBern 3000Switzerland University Hospital of Child and Adolescent psychiatry University Hospital Hamburg-EppendorfHamburg 20246Germany

BACKGROUND Recent reports of both heightened prevalence rates and limited clinical relevance of clinical high-risk(CHR)criteria and their relevant symptoms in children and adolescents indicate an important role of neurodevelopment in the early detection of ***,sex effects in CHR symptoms have been reported,though studies were *** sex also impacts on neurodevelopment,we expected that sex might have an additional contribution to age in the prevalence and clinical relevance of CHR symptoms and *** To investigate age and sex effects on CHR criteria and symptoms and their association with psychosocial impairment and mental *** In this cross-sectional cohort study,n=29168-to 40-year-olds,randomly drawn from the population register of the Swiss canton Bern,were assessed in semistructured interviews by phone or face-to-face for CHR symptoms and criteria using the Structured Interview for Psychosis-Risk Syndromes and the Schizophrenia Proneness Instrument in its child and youth,and adult version,***,social and occupational functioning and DSM-IV axis I disorders were *** and interaction effects of age and sex on CHR symptoms and criteria,and interaction effects of age,sex,and CHR symptoms and criteria on presentation of functional impairment and of non-psychotic disorder were investigated using logistic regression *** Altogether,542(18.6%)participants reported any CHR symptom;of these,261(9.0%)participants reported any one of the 11 criteria relevant cognitive and perceptual basic symptoms,and 381(13.1%)any one of the five attenuated or transient psychotic symptoms(attenuated psychotic symptoms/brief intermittent psychotic symptoms).Fewer participants met any one of the CHR criteria(n=82,2.8%)or any one of the three recently recommended CHR criteria(n=38,1.3%).Both age and sex were significantly(P<0.05)associated with CHR symptoms and criteria,mostly by younger age and female se

关键词： Psychosis clinical high-risk Attenuated psychotic symptoms Basic symptoms Community Age Sex Interview assessment Prevalence

clinical high-risk criteria of psychosis in 8–17-year-old community subjects and inpatients not suspected of developing psychosis

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World Journal of psychiatry 2022年第3期12卷 425-449页

作者： Frauke Schultze-Lutter Petra Walger Maurizia Franscini Nina Traber-Walker Naweed Osman Helene Walger Benno G Schimmelmann Rahel Flückiger Chantal Michel Department of psychiatry and psychotherapy Medical FacultyHeinrich-Heine UniversityDüsseldorf 40629North-Rhine WestphaliaGermany Department of Psychology Faculty of PsychologyAirlangga UniversitySurabaya 60286Indonesia University Hospital of Child and Adolescent psychiatry and psychotherapy University of BernBern 3000Switzerland Department of Child and Adolescent psychiatry and psychotherapy University of ZürichZürich 8032Germany Department of psychiatry and psychotherapy Ludwig-Maximilian-UniversityMunich 80336BavariaGermany University Hospital of Child and Adolescent psychiatry University Hospital Hamburg-EppendorfHamburg 20246Germany

BACKGROUND In children and adolescents compared to adults,clinical high-risk of psychosis(CHR)criteria and symptoms are more prevalent but less psychosis-predictive and less clinically *** on high rates of non-converters to psychosis,especially in children and adolescents,it was suggested that CHR criteria were:(1)Pluripotential;(2)A transdiagnostic risk factor;and(3)Simply a severity marker of mental disorders rather than specifically *** any of these three alternative explanatory models were true,their prevalence should differ between persons with and without mental disorders,and their severity should be associated with functional impairment as a measure of *** To compare the prevalence and severity of CHR criteria/symptoms in children and adolescents of the community and *** In the mainly cross-sectional examinations,8–17-year-old community subjects(n=233)randomly chosen from the population register of the Swiss Canton Bern,and inpatients(n=306)with primary diagnosis of attention-deficit/hyperactivity disorder(n=86),eating disorder(n=97),anxiety including obsessive–compulsive disorder(n=94),or autism spectrum disorder(n=29),not clinically suspected to develop psychosis,were examined for CHR symptoms/*** items of the Structured Interview for Psychosis-Risk Syndromes(SIPS)were used to assess the symptomatic ultra-high-risk criteria,and the Schizophrenia Proneness Instrument,Child and Youth version(SPI-CY)was used to assess the 14 basic symptoms relevant to basic symptom *** examined group differences in frequency and severity of CHR symptoms/criteria usingχ^(2) tests and nonparametric tests with Cramer’s V and Rosenthal’s r as effect sizes,and their association with functioning using correlation *** The 7.3%prevalence rate of CHR criteria in community subjects did not differ significantly from the 9.5%rate in *** and severity of CHR criteria never differed bet

关键词： Psychotic disorders Risk assessment Minors Community Inpatients Psychosocial functioning

An Investigation of the Secular Acceleration of Psychiatric Disorders

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Open Journal of psychiatry 2015年第1期5卷 121-127页

作者： Sebastian Lemke Sunka De Vries psychiatry and psychotherapy clinic of Jena University Hospital Germany Ubbo Emmius clinic East Friesia Hospital Germany

Secular acceleration, for example an increase in height in groups of people over a period of time of more than a century, is a unique, perhaps “ecological” event. In the study presented here, historical patient files from the Jena Psychiatric clinic were evaluated in relation to the problem of acceleration. A first sampling of 119 patient files for the years 1880-1890 revealed that, for children and adolescents up until the end of their twentieth year of life, the average age at the time of their first admission was 17 years. Compared to this, the first admission of a second sample of 132 patient records for the years 1985-1987 revealed a clearly younger average age at first admission of 11 years. This difference in age was found to be statistically significant. The heights of 14-year-old subjects from the city of Jena for the years 1880 to 1975 obtained from the literature showed a documented increase in height of almost 20 cm. The results of our investigation revealed that, in addition to physical acceleration, there was also an advancement of pathological mental processes in the course of a period of 100 years.

关键词： Acceleration Secular

Apolipoprotein A1,the neglected relative of Apolipoprotein E and its potential role in Alzheimer’s disease

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Neural Regeneration Research 2021年第11期16卷 2141-2148页

作者： Kristina Endres Department of psychiatry and psychotherapy University Medical Center of the Johannes Gutenberg-University MainzUntere Zahlbacher Str.855131 MainzGermany

Lipoproteins are multi-molecule assemblies with the primary function of transportation and processing of lipophilic substances within aqueous bodily fluids(blood,cerebrospinal fluid).Nevertheless,they also exert other physiological functions such as immune *** particular,neurons are both sensitive to uncontrolled responses of the immune system and highly dependent on a controlled and sufficient supply of *** this reason,the role of certain lipoproteins and their protein-component(apolipoproteins,Apo’s)in neurological diseases is ***,for example,is well-accepted as one of the major risk factors for sporadic Alzheimer’s disease with a protective allele variant(ε2)and a risk-causing allele variant(ε4).ApoA1,the major protein component of high-density lipoproteins,is responsible for transportation of excess cholesterol from peripheral tissues to the *** protein is synthesized in the liver and intestine but also can enter the brain via the choroid plexus and thereby might have an impact on brain lipid *** review focuses on the role of ApoA1 in Alzheimer’s disease and discusses whether its role within this neurodegenerative disorder is specific or represents a general neuroprotective mechanism.

关键词： Aβ ApoA1 cholesterol high-density lipoproteins lipids lipoprotein neurodegeneration senile plaque