Alpha-synuclein levels in blood plasma decline with healthy aging.

There is unequivocal evidence that alpha-synuclein plays a pivotal pathophysiological role in neurodegenerative diseases, and in particular in synucleinopathies. These disorders present with a variable extent of cognitive impairment and alpha-synuclein is being explored as a biomarker in CSF, blood serum and plasma. Considering key events of aging that include proteostasis, alpha-synuclein may not only be useful as a marker for differential diagnosis but also for aging per se.

Altered serum IgG levels to α-synuclein in dementia with Lewy bodies and Alzheimer's disease.

Natural self-reactive antibodies in the peripheral blood may play a considerable role in the control of potentially toxic proteins that may otherwise accumulate in the aging brain. The significance of serum antibodies reactive against α-synuclein is not well known. We explored serum IgG levels to monomeric α-synuclein in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) with a novel and validated highly sensitive ELISA assay.

Negative symptoms of schizophrenia as primary target of cognitive behavioral therapy: results of the randomized clinical TONES study.

Clinical studies on cognitive behavioral therapy (CBT) that include schizophrenia patients primarily on the basis of negative symptoms are uncommon. However, those studies are necessary to assess the efficacy of CBT on negative symptoms. This article first gives an overview of CBT on negative symptoms and discusses the methodological problems of selecting an adequate control group.

Cognitive behavioural therapy versus supportive therapy for persistent positive symptoms in psychotic disorders: the POSITIVE Study, a multicenter, prospective, single-blind, randomised controlled clinical trial.

Background: It has been demonstrated that cognitive behavioural therapy (CBT) has a moderate effect on symptom reduction and on general well being of patients suffering from psychosis. However, questions regarding the specific efficacy of CBT, the treatment safety, the cost-effectiveness, and the moderators and mediators of treatment effects are still a major issue. The major objective of this trial is to investigate whether CBT is specifically efficacious in reducing positive symptoms when compared with non-specific supportive therapy (ST) which does not implement CBT-techniques but provides comparable therapeutic attention.

Implementation of a manual-based training of humor abilities in patients with depression: a pilot study.

Humor and laughter can positively influence mood, promote optimism and lead to a change of perspective. Six patients with major depression participated in a group training program specifically designed to enhance humor abilities. After 8 weeks of training, short-term mood improvement was observed and the patients considered themselves more capable of using humor as a coping strategy.

Does the cognitive dispute of psychotic symptoms do harm to the therapeutic alliance?

We examined whether the cognitive dispute of psychotic symptoms has a negative impact on the course of the therapeutic alliance. Sixty-seven patients with persistent psychotic symptoms received either cognitive behavioral therapy (CBT) or supportive therapy. Questionnaire-based alliance ratings were repeatedly obtained throughout the course of therapy.

Quality and correlates of specific self-esteem at the beginning stabilisation phase of schizophrenia.

In view of the potential importance of self-esteem in schizophrenia, there is a considerable lack of knowledge about the characteristics of specific self-esteem. The literature suggests that the experience of the self might be particularly destabilised in the transition phase between acute and remission points of the illness. Thus, the present study aims at examining the quality and correlates of different self-concepts at the beginning stabilisation phase of schizophrenia.

Cognitive behavioural treatment of negative symptoms in schizophrenia patients: study design of the TONES study, feasibility and safety of treatment.

Currently, there are no convincing treatment strategies for negative symptoms of schizophrenia. On this background, we are conducting the treatment of negative symptoms (TONES) study which addresses the question whether cognitive behavioural therapy (CBT) is efficacious for the reduction of negative symptoms in schizophrenia. The present paper aims at presenting the design of the clinical trial of the study as well as the treatment concept.

A cluster-randomized effectiveness trial of smoking cessation modified for at-risk smoker subgroups.

A. Batra, S.E.

[Research into the feasibility of cognitive behavioural therapy in the treatment of psychotic disorders].

Psychotherapy in psychotic disorders is a rare condition and is confronted with much scepticism. On the background of intensive research - in particular in Great Britain, sufficient empirical evidence is available from randomised clinical trials to recommend Cognitive Behavioural Treatment for routine care. However, many research questions are open.

[Acceptance of smoke-free policy in a psychiatric department by in-patients and staff].

The high smoking prevalence among psychiatric patients and staff in psychiatric hospitals explains the difficulties in accompanying efforts for the introduction of regulations for a smoke-free environment. Prior to the establishment of regulations for a smoke-free psychiatric department at the University Hospital, Dept. of Psychiatry and Psychotherapy in Tubingen, a democratic process was initiated.

The influence of baseline symptoms and insight on the therapeutic alliance early in the treatment of schizophrenia.

Background: The consistent association between therapeutic alliance and outcome underlines the importance of identifying factors which predict the development of a positive alliance. However, only few studies have examined the association between pretreatment characteristics and alliance formation in patients with schizophrenia.

Objective: The study examined whether symptoms and insight would predict the therapeutic alliance in psychotherapy of schizophrenia.

Increase of visceral fat and adrenal gland volume in women with depression: preliminary results of a morphometric MRI study.

Objective: Depression is often accompanied by increased visceral adipose tissue (VAT), stress, enlarged adrenal glands, and an increased risk of cardiovascular disease. VAT turn-over is regulated by adrenal stress hormones such as cortisol. Aim of this study was to investigate the relationship between the adrenal volume as a marker for long-term stress and the volume fractions of several body fat compartments in healthy and depressive women.

Collaboration in outpatient antipsychotic drug treatment: analysis of potentially influencing factors.

Knowledge of factors relevant for medication adherence and patient collaboration is still limited. Our study aims at exploring the contribution of a variety of factors to collaboration in outpatients with schizophrenia and schizoaffective disorder. We obtained self-rated and observer-rated data from 108 outpatients during an interview 6 months after hospital discharge.

Development and validation of a cluster-based classification system to facilitate treatment tailoring.

Aims: The objectives of this study were to replicate smoker profiles identified in Batra et al. (in press) and to develop a cluster-based classification system to categorize new cases into smoker profiles so that an appropriate tailored intervention could be applied.

Methods: Participants were smokers in southwest Germany who sought treatment for smoking cessation.

Short-term treatment with risperidone or haloperidol in first-episode schizophrenia: 8-week results of a randomized controlled trial within the German Research Network on Schizophrenia.

Patients with first-episode schizophrenia appear to respond to lower doses of neuroleptics, and to be more sensitive to developing extrapyramidal side-effects. The authors therefore compared in such patients the efficacy and extrapyramidal tolerability of comparatively low dosages of the atypical neuroleptic risperidone and of the conventional neuroleptic haloperidol. Risperidone was hypothesized to have better extrapyramidal tolerability and efficacy in treating negative symptoms.

Depression during an acute episode of schizophrenia or schizophreniform disorder and its impact on treatment response.

The aim of the present study was to examine the relevance of depressive symptoms during an acute schizophrenic episode for the prediction of treatment response. Two hundred inpatients who fulfilled DSM-IV criteria for schizophrenia or schizophreniform disorders were assessed at hospital admission and after 6 weeks of inpatient treatment using the Positive and Negative Syndrome Scale (PANSS) and the Hamilton Rating Scale for Depression (HAM-D). Depressive symptoms showed positive correlations with both positive and negative symptoms at admission and after 6 weeks, and decreased during 6 weeks of treatment.

Autoantibody reactivity in serum of patients with major depression, schizophrenia and healthy controls.

The present study assessed 25 patients with unipolar major depression and 34 patients with schizophrenia along with 50 healthy, non-psychiatric controls for the presence of serum antinuclear (ANA), smooth muscle (SMA), anti-endothelial (AEA), anti-sarcolemma (ASA), thyroid gland (TGA) and parietal cell (PCA) antibodies. In the group of patients with major depression, the frequency of elevated ANA, TGA and PCA was significantly higher than in the control group. In addition, the group of patients with schizophrenia significantly more often showed increased levels of ANA and SMA than the control group of healthy volunteers.

Prediction of community outcome in schizophrenia 1 year after discharge from inpatient treatment.

This longitudinal study aimed at identifying predictors of community outcome from a broad range of neuropsychological, clinical psychopathologic, sociodemographic, and treatment related factors. N = 96 schizophrenia patients were assessed both at baseline during inpatient treatment and 1 year after discharge from hospital (follow-up). At follow-up functional outcome was measured by the Global Assessment of Functioning Scale (GAF) and the Social Adjustment Scale II (SAS II).

Multidimensional smoker profiles and their prediction of smoking following a pharmacobehavioral intervention.

The objective of this observational study was to identify multidimensional smoker profiles to aid the development of future tailored treatments for different smoker subtypes. Based on findings in the literature, it was hypothesized that smokers reporting higher levels of novelty seeking/hyperactivity, depressivity, and nicotine dependence would evince greater odds of postintervention smoking than smokers reporting lower symptom levels across these dimensions. Adult regular smokers (N=165) in southwest Germany completed self-report questionnaires assessing psychological and smoking variables and received a pharmacobehavioral intervention.

Epilepsy in an elderly patient caused by Hashimoto's encephalopathy.

Late-onset seizures are frequently caused by cerebrovascular disease, head trauma, degenerative disorders or CNS tumors. In one-third of cases, the etiology remains obscure. In only 60-70% of adult-onset epilepsy is antiepileptic drug treatment successful.

[Longer-term effects of inpatient vocational and ergotherapeutic measures on the vocational integration of patients with schizophrenia].

Objective: Unemployment rates are high in people with schizophrenia, so that considerable importance is attached to measures to improve their ability to work and their vocational integration.

Methods: In a study of the German Research Network on Schizophrenia the long-term effects of four-week vocational and ergotherapeutic measures on in-patients were investigated. The target criteria were the vocational integration, level of general functioning (Global Assessment of Functioning Scale) and psychopathology (Positive and Negative Syndrome Scale).

Significant impact of MTHFR C677T polymorphism on plasma homovanillic acid (HVA) levels among alcohol-dependent patients.

The enzyme 5,10-methylenetetrahydrofolate reductase (MTHFR) synthesizes 5-methyltetrahydrofolate. It plays a critical role in homocysteine metabolism. A high impact of MTHFR C677T polymorphism on plasma homocysteine levels has been observed among alcoholics.