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Sleep disturbances are frequent and multifaceted and have serious consequences. They play an important role within psychiatric symptoms and disorders. On the one hand they may appear as a symptom of a disorder, which may also be a diagnostic criterion, as for example in affective disorders, on the other hand they may be independent disorders or last but not least sequelae of psychiatric disorders or their pharmacological therapy, as with antidepressants or neuroleptics, which may cause or deteriorate nocturnal movement disorders. They may aggravate psychiatric disorders, perpetuate them or predict a disease onset, like in depressive or manic episodes. Also in organic sleep disorders, such as sleep-related breathing disorders or nocturnal movement disorders, increased anxiety or depression scores may be observed. Patients suffering from sleep disorders do not only experience impaired well-being, but also show deteriorations in cognition and performance, have a higher risk of accidents, are generally more prone to health problems, have a higher sickness absence rate, seek medical help more often and thus are also an important socioeconomic factor. This is why sleep disorders should be taken seriously and treated adequately.

Aim: Pupillometry is a non-invasive measurement technique based on the pupillary response to specific sensoric, mental and emotional variables. After topical application of a cholinergic antagonist (tropicamide) an increased pupillary dilatation response in Alzheimers s disease patients was described ("receptor test"). The aim of the present study was to evaluate the usefulness of the 0.01% tropicamide receptor test in differentiating types of dementia., Method: 425 patients (159 men, 266 women, mean age 75 years) of the Memory Clinic of the SMZ Ost Vienna, Austria were included in the study. 195 patients suffered from a dementia in Alzheimer's disease with late onset (ICD-10: F00.1), 42 from dementia in Alzheimer's disease with early onset (F00.0), 71 from vascular dementia (F01), 34 from Lewy-Body dementia (F03) and 83 from mixed dementia (F00.2). All patients were investigated by means of a computer-assisted pupillometer. The pupillary diameter of the left eye was measured 4 times (baseline=0 minutes, after 20, 40 and 60 minutes). 4 minutes after baseline one drop of 0.01% tropicamide solution was installed onto the left eye of the patients., Results: At baseline the pupillary diameter was largest in Lewy-Body dementia, smallest in vascular dementia. Significant differences were observed between vascular dementia and early-onset dementia in Alzheimer's disease as well as between Lewy-Body dementia and all other dementia syndromes (except dementia in Alzheimer's disease with early onset). The 0.01% tropicamide receptor test made it possible to differentiate early-onset dementia in Alzheimer's disease from vascular and mixed dementia., Conclusion: Utilizing pupillometry in combination with the 0.01% tropicamide receptor test allows to discriminate between different dementia types of, as demonstrated in our study.

In the treatment of snoring (SN) and sleep-related breathing disorders (SRBD), mandibular advancement devices (MAD) are of increasing importance. Their mode of action is based on the advancement of the mandible, thereby increasing various upper airway dimensions and thus airway patency and airflow during sleep. The aim of the present study was to investigate efficacy and tolerability of an individually fitted MAD on 11 patients (10 males, 1 female), mean age 57 years, using sleep laboratory methods in 3 subsequent nights (adaptation-, baseline-, treatment night). The MAD consists of 2 separate parts that attach to both dental arches. On occlusion the upper maxillary part with a protruding cone meets an inclined plane of the lower mandibulary part, thereby forcing the mandible to advance. 10 patients (6 with obstructive sleep apnea, 3 with obstructive hypopnea and 1 primary snorer) tolerated the MAD well; one patient (primary snorer) removed the MAD after 1 hour. Regarding the target variable, the snoring index (SI), confirmatory statistics demonstrated a significant improvement from 108 to 53/h sleep, though normalisation could not be achieved. Descriptive data analysis showed significant improvement of the apnea-hypopnea index (AHI) from 15 to 5.5/h and of the oxygen desaturation index (O2-DI) from 21 to 13/h sleep. Arousal variables and periodic leg movement index (PLMI) improved as well. Objective sleep efficiency and subjective sleep- and awakening quality remained unchanged. Thus, besides the good therapeutic efficacy (the medians of improvement of the SI, AI, AHI, O2-DI and PLMI were 37, 48, 53, 51 and 29%, respectively), acute acceptance of the MAD was also satisfactory. Last but not least our present study showed once more the necessity of an adaptation night, as from the first to the second sleep laboratory night respiratory indices deteriorated significantly.

Daytime tiredness and daytime sleepiness are frequent complaints occurring in 29% and 14% of the Austrian population. Epidemiological studies demonstrate a high comorbidity between nonorganic hypersomnia and mental disorders. Especially comorbidity with affective disorders increases steadily from the general population over primary to tertiary care settings. Diagnostic criteria of nonorganic hypersomnia have been described in the International Classification of Diseases (ICD-10). Nonorganic hypersomnia can be primary or associated with a number of psychiatric disorders such as reaction to severe stress or adjustment disorders, affective disorders, other functional disorders, tolerance to or withdrawal of CNS-stimulating substances and chronic use of CNS-sedating substances. Diagnostic procedures comprise case history and symptom evaluation, sleep-specific and supplementary investigations. Concerning the latter, this article will focus on sleep questionnaires, vigilance and psychological tests as well as CNS investigations. Therapy of nonorganic hypersomnia rests on 3 pillars: psychological, somatic and pharmacological treatment. In view of the wide variety of psychiatric causes, resulting in a number of therapeutic options, it seems desirable that apart from subjective clinical assessment also objective methods be used in diagnosis and treatment. On the neurophysiological level objective measures can be obtained by means of EEG mapping during the day and polysomnography at night. Different mental disorder patients show different brain activity patterns as compared with normal controls and different classes of psychotropic substances cause different changes in neurophysiological variables. The fact that the changes in electrophysiological brain activity caused by mental disorders are exactly opposite to those induced by the psychotropic drugs used for their treatment suggests a key-lock principle in the diagnosis and treatment of nonorganic hypersomnia.

In addition to their 40-hour working week (Mon-Fri, 8 a.m.-4 p.m.) residents at the emergency department of the General Hospital of Vienna have to do approximately six 24-hour duties. The reasons for conducting the present field study were physicians' complaints about tiring night duties. 11 residents (4 women, 7 men; aged between 28 and 43 years, x = 33.5 +/- 4.9 years; working at the emergency department for 4-50 months, x = 31 +/- 20 months) were tested on an ordinary working day at 9 a.m. and midnight. Self-rating concerning sleep duration, perception of stress and workload on the days of the investigations were found to be representative of other prolonged duties. Subjects reported a usual nocturnal sleep duration of only 6-7 hours. Stress was regarded as moderate by most of the volunteers. Blood pressure and pulse rates did not show diurnal changes. Generally, residents felt significantly (p < 0.01) less awake at night than in the morning, but reported only slight vegetative and somatic stress reactions or annoyances as assessed by the Fahrenberg self-rating scale. Interindividual differences were found; residents who had been working at the emergency department for a longer period experienced a more pronounced impairment. Further studies are required in order to objectify a nocturnal decrease in vigilance (by means of computer-assisted EEG) and to evaluate potential performance deficits (by means of psychometric tests).

There is evidence that daytime tiredness is caused by apnea/hypopnea with oxygen desaturation and/or by sleep fragmentation due to arousals. The aim of this study was to investigate objective and subjective sleep and awakening quality and daytime vigilance--objectified by midmorning mapping of vigilance-controlled EEG (V-EEG)--in sleep apnea patients (N: 18), as compared with age- and sex-matched normal controls (N: 18) as well as to correlate nocturnal respiratory distress and arousals to daytime brain function. Statistical analyses demonstrated a deterioration in subjective and objective sleep and awakening quality in apnea patients. Midmorning V-EEG mapping in apnea patients exhibited less total power, more delta and theta, less alpha and beta activity, as well as a slower dominant frequency and centroid of the total activity compared to controls, which suggests a vigilance decrement. The Spearman rank correlation between 6 polysomnographically registered respiratory variables and 36 diurnal quantitative EEG measures demonstrated the following: the higher the apnea, apnea-hypopnea, snoring and desaturation indices and the lower the minimum and average low oxygen saturation, the more pronounced was diurnal tiredness. Eleven arousal measures based on ASDA criteria showed the following significant correlations: the higher the nocturnal arousal index and the more arousals due to hypopneas, the greater was daytime tiredness. On the other hand, the greater the average frequency change during arousals and the more spontaneous arousals, the better was daytime vigilance. Our findings show that, in contrast to the lengthy Multiple Sleep Latency (MSLT) and Maintenance of Wakefulness (MWT) tests which evaluate sleep pressure under resting conditions conducive to sleep, V-EEG mapping provides a brief objective measure of a sleep apnea patient's daytime tiredness under conditions of wakefulness more appropriate to reflect the patient's everyday life.

Hypersomnia (excessive sleepiness) accompanies many diseases. 14% of the total Austrian population regularly have problems staying awake during the day or are prone to taking spontaneous naps. Hypersomnia is a symptom of the sleep apnea syndrome, which is a risk factor for cerebrovascular disorders. Daytime sleepiness is also a characteristic symptom of narcolepsy, idiopathic hypersomnia, episodic hypersomnia, and many more neurological or psychiatric disorders; it can also be drug induced. Involvement of brain structures which are essential for the regulation of the sleep wake cycle as a result of neurological disorders can likewise lead to hypersomnia. Symptomatic treatment is necessary when treatment of the causal factors is not possible or no improvement has been achieved.

The hypnogenic effects of melatonin are well documented in human pharmacological studies in normal volunteers after daytime parenteral and oral administration of pharmacological, supraphysiological and physiological doses. The findings after evening administration are not so unequivocal. From the clinical point of view, melatonin proved effective in double-blind, placebo-controlled trials in 2 types of sleep disorder: 1) as a chronobiotic in circadian rhythm sleep disorders such as jet lag-syndrome, shift-worker sleep disorder, delayed sleep phase syndrome and non-24-hour sleep-wake disorder; 2) as a hypnotic for insomnia in elderly patients with a relative melatonin deficit. Interactions with other psychotropic drugs are described and a potential indication in polymorbid patients with concomitant insomnia and sleep-related breathing disorders is suggested. More controlled studies are necessary on the effects, therapeutic efficacy and tolerability of melatonin in the treatment of the many different sleep disorders.

Between 1992, the year in which the Sleep Out-Patient Clinic at the Department of Psychiatry, University of Vienna, Allgemeines Krankenhaus (General Hospital) Vienna, was established, and 1996, 817 patients (58% females, average age 52 years; 42% males, average age 48 years) were treated for sleep disorder. According to the International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization (WHO), 70% of the patients presented with a non-organic sleep disorder and 30% with an organic sleep disorder as main diagnosis. Non-organic insomnia was by far the most frequently diagnosed sleep disorder (48%), while within the organic sleep disorders sleep apnea was dominant (12%). In regard to the additional non-organic (mental disorder) diagnoses rounding off the clinical picture, neurotic, stress related, and somatoform disorders were the most common (41%), followed by affective disorders (31%) and mental and behavioural disorders due to intake of psychoactive substances, e.g. alcohol, drugs (15%). Additional organic diagnoses related to sleep disorders involved primarily endocrine disorders such as adipositas (23%), followed by cardiovascular disorders (19%), and primary snoring (17%). The sleep out-patient clinic has at its disposal a supportive diagnostic armamentarium such as all-night sleep polysomnography, 24-hour polysomnography, the Multiple Sleep Latency Test, EEG and EEG-mapping in the affiliated sleep laboratory, the evaluation of event-related potentials (P300) and actometry in the psychophysiological laboratory, as well as psychological and psychophysiological tests in the clinical psychodiagnostic laboratory, in order to determine the right treatment or preventive measures for the individual patients.

Recently a new, precise and economical method for measuring central nervous activation in psychopathological groups was presented. By means of this procedure, the ¿psychopharmacological pupillary oscillations hypothesis¿ after administration of the nootropic compound bifemelane (CAS 90293-01-9) was examined in oder to assess pharmacologically induced changes in central activation. Before calculating the Fourier analysis, blinks have to be identified and eliminated by means of a new technique, which is called ¿smoothing¿. After application of bifemelane, a marked improvement of symptoms caused by cerebro-vascular disorders was reported. 18 subjects (7 females and 11 males), aged between 60 and 80 years, with a neurological and psychic age-adequate state, from whom a written, informed consent was obtained, participated voluntarily in the study. A placebo-controlled and double-blind design were administered in an interval of 8 days in cross-over design. The study, which also included measurement of noopsychic and thymopsychic changes, was carried out before and in the 2nd, 4th, 6th and 8th hour after application of the substances. In the slow frequency band, after application of bifemelane, an increase of activation (higher amplitudes) could be observed, which lasted from the 2nd to the 4th hour. However, differences between bifemelane and placebo did not reach the level of statistical significance. In faster frequencies, a reduction of the height of the amplitudes was found. Regarding the total spectrum, in the 2nd hour a moderate increase of activation could be demonstrated.

Sleep apnea and snoring are widely discussed as risk factors for internal and neurological diseases. The prevalence of snoring in an Austrian population survey is about 27.2% (males 36.5%, females 18.9%), and that of apnea (respectively irregularity and/or cessation of breathing) about 8.5% (31% of all snorers). Clinical symptoms like naps, daytime sleepiness, unquiet sleep, hypertonia, headache in the morning and psychological symptoms may be characteristics of sleep apnea. They should lead to further diagnosis and removal of this risk factor for ischemic heart disease and stroke.

For the diagnosis of sleep disorders, 3 different standardized classification systems are available: the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R/DSM-IV) and the International Classification of Sleep Disorders (ICSD). These 3 classification schemata were comparatively evaluated in 50 sleep-disturbed patients who were admitted within 1 year to a non-specialized sleep laboratory for diagnostic evaluation and treatment. 17 female and 33 male sleep-disturbed patients, aged 54 +/- 12 years, were recorded polysomnographically in 3 subsequent nights (adaptation night, baseline/diagnosis night, treatment night) for measuring objective sleep quality. The subjective sleep quality as well as the subjective and objective awakening quality was assessed by means of rating scales, as well as psychometric and psychophysiological test battery. During the day, EEG, EEG-mapping, psychodiagnostic tests as well as, in many cases, pulmonary function, otolaryngological, CT, MRT and pharyngometric investigations were carried out. Psychic disorders were the leading cause for sleep problems in all 3 classification systems. Based on the ICD-10, the most frequent diagnosis was non-organic insomnia (46%), followed by sleep apnea (18%) and other organic sleep disorders (14%). Based on the DSM-III-R, 46% of the patients were diagnosed as insomnias based on another mental disorder, 38% as organic hypersomnias and 14% as parasomnias. Based on the ICSD Classification, sleep disorders associated with anxiety disorders were leading (30%), followed by sleep disorders based on affective disorders (16%), obstructive snoring (14%), primary snoring (8%) and sleep disorders based on neurological disorders (6%). While the broader ICD-10 and DSM-III-R diagnoses are syndrome-etiologically oriented and may be easily utilized by the practicing physician, the more narrowly defined, extensive, pathogenetically oriented polysomnographic features including ICSD diagnoses are suited better for the specialist.

While the changes in pupillary size during wakefulness and drowsiness are easy to understand, the origin of pupillary oscillations is quite mysterious. Waves of spontaneous pupillary constriction and dilation accompany periods of increasing sleepiness and spontaneous arousal. Lowenstein et al. (1963) demonstrated that in the dark, the pupils of young normal alert subjects show waves of dilatation and contraction lasting from about 4 to 40 s and measuring up to 0.5 mm. Furthermore, superimposed fast and very extensive oscillations were observed. The first described oscillations seemed to reflect central nervous activation. Therefore we analysed pupillary oscillations during the recording period of static pupillometry (described by the authors in 1992) which lasted for 25.6 s. Before calculating the Fourier analysis, blinks have to be identified and eliminated by means of a new technique which is called "smoothing". Using the Fourier analysis, the spectrum was divided into 5 frequency bands (0.0-0.2; 0.21-0.4; 0.41-0.60; 0.61-0.8; 0.81-1 Hz). We were also interested in the total spectrum. In order to demonstrate utilisation of the new technique, 146 male and female depressed patients (ICD-Diagnosis 296.1, 296.3, 296.1, 296.3 + 300, respectively, 300.4, 301.1, 296.1, 296.3 + 290, respectively), aged between 18 and 45 years, were investigated by means of pupillometry, followed by analysis of pupillary oscillations. The whole group of depressive patients who received antidepressive medication was compared with 64 healthy subjects of similar age to demonstrate differences in the frequency bands.(ABSTRACT TRUNCATED AT 250 WORDS)

Unlabelled: Epidemiologic data on sleep disturbances in Austria were collected for the first time in March/April 1993 in a representative inquiry (, Sample: n = 1000, 471 males, 529 females). 26% of the subjects reported sleep disturbances which were mostly chronic (21% had suffered from sleep disturbance for more than one year). The incidence of sleep disturbances increased with age, namely 13% in 14-30 year-old subjects, 22% in 31-50 year-old ones and 41% in subjects over 50. 7% suffered from disturbances in sleep initiation, i.e., they had a sleep latency of over 30 minutes. 19% of them had difficulties in getting to sleep at least once a week. Disturbances in maintaining sleep were reported by 28% of subjects, 56% of them needing longer than one hour to get back to sleep. 30% suffered from daytime sleepiness, 43% of the subjects were impaired by their sleep disturbances in some way, but only 34% had consulted their doctor.

In a single blind study the antiepileptic effects and safety of vigabatrin--a new anticonvulsant drug selectively inhibiting GABA-transaminase--was investigated in therapy resistant epilepsy, along with its central effects objectivated by mapping of EEG and event-related potentials (ERP). In addition to their current antiepileptic therapy, 10 patients with complex partial seizures (CP) (4 male, 6 female), aged between 22 and 57 years received placebo for 1 month, subsequently 2 g vigabatrin for 2 months and thereafter a titrated optimal dosage vigabatrin for another 2 months. Clinical investigations were carried out at the afore-mentioned periods, neurophysiological ones pre and post 2 months vigabatrin. After 2 months vigabatrin, 5 out of 10 patients had a 50% or greater decrease in CP frequency, after another 2 months 7 out of 10. The median number of CP per months decreased from 5.5 to 3.75 (p < 0.05) to 2.0 (p < 0.01), respectively. No clinically relevant side effects and laboratory changes were noted. EEG mapping showed decreased fast alpha and slow beta power and increased delta-theta frequency variability, reflecting most likely a decreased CP disposition. ERP mapping showed slightly increased N1 and P2 as well as reduced P300 amplitudes. Unchanged P300 latency indicated no delayed stimulus evaluation time after vigabatrin therapy.

Sleep disturbances are an important health problem; about 20-33% of the population suffer from hyposomnias (lack of sleep). Hyposomnias often accompany neurological disorders (head traumas, chronic cephalea, pain, cerebrovascular and neuromuscular disorders, M. Parkinson, and dementia). Slow wave sleep decreases, arousals increase, and sleep is fragmented; these types of hyposomnias are treated by treatment of the basic neurological disease. Some sleep disturbances (e.g. sleep apneas) are a risk factor for cerebrovascular disorders.

In a double-blind, placebo-controlled study, the relationships between blood levels and pharmacodynamics of zotepine were investigated in 15 healthy subjects. They received randomized at weekly intervals single oral doses of 25, 50 and 100 mg zotepine and 50 mg clozapin as reference substance. Blood sampling for zotepine and prolactin plasma levels, quantitative EEG analyses, psychometry and tolerability measures were carried out at the hours 0, 1, 2, 4, 6 and 8. There was a dose-dependent increase in zotepine plasma levels with a tmax between 2-4 hours post-drug and cmax: 6.9, 14.8 and 19.6 ng/ml for the 3 doses, respectively and a slow decline thereafter. Prolactin levels also rose dose dependently, peaking in the 4th hour. Regression and correlation analyses demonstrated: the higher the zotepine plasma levels, the more delta/theta, the less alpha activity and the slower the centroid in the spectral analysed EEG and the more decrease in reaction time performance, numerical memory and CFF in psychometry. Neurophysiological changes started at 8 ng/ml, psychometric ones at 9 ng/ml. Our pharmacodynamic findings suggested zotepine to be a sedative broad-band neuroleptic, which was also reflected in the side effects.

Concrete cross-sectional studies of the organic brain syndrome, carried out periodically, attempt to establish for the parameters evaluation of substrate damage--and different noopsychopathological rating-scales for the measurement of brain capacity impairment. Beyond the level of the purely correlative-statistical point of view of the relationship between parameter and score changes, demanding for a quantitative model which could provide not only a description, but also an explanation for such a relationship. The fact that there can only be a question here of a "quantitative causality" embracing non-specificity of toxic substances and relative to acute and chronic diffuse organic brain syndromes. It results, that quantitative causality meets the requirements of an exponential function model and that one can validate such models through correlative-statistical methods. This has already been carried out by Ball and Taylor.

In connection with clinical drug trials we compared the ECG-recordings during application of two different antidepressants. Tandamine (AY 23946) is a tricyclic drug with main effects on the norepinephrine reuptake, Fluvoxamine (DU 23 000) a nontricyclic antidepressant with a selective effect on the serotonin reuptake. No differences were observed regarding both frequency and patterns of the repolarisation disturbances. Thus, it appears that the chemical structure of the drug is not responsible for the "typical" form of the repolarisation disturbances. We further hypothesize that toxic effects and regulatory mechanisms of the cardiovascular system, caused by changes in norepinephrine and 5-hydroxytryptamine levels may be responsible for the areforementioned ECG aberrations.

A double-blind, placebo-controlled pharmaco-EEG and psychometric study was carried out to investigate the encephalotropic and psychotropic properties of a metabolically active hemoderivate (Actovegin) in 10 elderly subjects with a mean age of 65 years, and to form hypotheses about its therapeutic efficacy. They received randomized and in weekly intervals single oral doses of 6 dragées (drg.) Actovegin, 9 drg. Actovegin as well as placebo. Computer-assisted spectral analysis of the EEG demonstrated an increase of alpha- and beta-activities, an acceleration of the alpha-centroid as well as of the centroid of the total activity after Actovegin as compared with placebo, while slow activities tended to decrease--specifically in the 4th and 6th hour. These neurophysiological alterations indicate an improvement in vigilance of the elderly subjects, which was reflected in the psychometric tests. The latter demonstrated in the multivariate analysis a significant superiority of Actovegin over placebo. Actovegin induced--especially after 6 drg.--an increase in critical flicker frequency, prolongation of the after-effect as evaluated by means of the Archimedean spiral, shortening of reaction time as well as cognitive improvement in the Pauli-Test. In the autonomic nervous system, the widening of the pupillary diameter and the increase in skin conductance suggested also an activation at the ANS level. Our controlled investigations demonstrate that Actovegin--even after oral administration--may produce neurophysiological and clinical effects.

In a double-blind placebo-controlled study 100 mg zotepine (neuroleptic) were administered to 15 young healthy volunteers; another 15 volunteers received 200 mg moclobemide (Ro 11-1163) (MAO-inhibitor). At the certain days of investigation the light-evoked pupillary reactions were recorded prior to and 2, 4, 6, and 8 h after medication. Using the dynamic pupillometric method it was possible to differentiate between zotepine and moclobemide in view of autonomous activation.

In 3 sleep-laboratory studies the effects of nocturnal traffic noise on the sleep of young (1st study: mean age 25 years, n = 10) and elderly (2nd study: mean age 62 years, n = 10) healthy subjects as well as adaptation phenomena (3rd study: one week in young volunteers, n = 10) were investigated. Objective sleep quality was evaluated for baseline- and traffic noise-conditions by means of somnopolygraphic all-night recordings between 22:30 ("lights out") and 6:00 ("buzzer") in the sleep-laboratory. In the morning sleep- and awakening quality were measured by a self-rating scale and psychometric and psychophysiological tests. Traffic noise, presented by a loudspeaker throughout the night with an intensity of 68 to 83 dB (A) (L eq = 75.6 dB [A]), caused a lengthening of sleep latency and intermittent wakefulness as well as a reduction of total sleep time and sleep efficiency as compared to baseline. Concerning sleep architecture, traffic noise led to an increase of light sleep, while deep sleep and, more pronounced, REM sleep were shortened. Although we found these changes in both generations, they reached the level of significance in young subjects only. The objective results were reflected in a significant deterioration of subjective sleep- and awakening quality after traffic noise. Objective awakening quality was unaffected . In the course of a one-week nocturnal traffic noise, we observed an increase of S 4 and a decrease of S 3. The last 3 nights revealed a significant improvement in subjective sleep quality, suggesting adaptive phenomena.(ABSTRACT TRUNCATED AT 250 WORDS)

The habituation of the electrodermal reaction (EDR) is one of the most used variables among psychophysiological indicators in investigations in men. In our department a specific computer assisted technique for measuring habituation, mean amplitude, area underneath the line and "emotional reflection" was developed. 15 acoustic stimuli (500 Hz tone at 72 db intensity lasting for 500 msec) are presented to the patient. The habituation criterion is reached when there are no reactions to 3 consecutive stimuli. Since the first reports in 1981 AIDS has become an expanding major public health problem. Therefore the aim of our investigation was to study electrodermal activity in AIDS-patients, especially the habituation of the EDR. 37 addicted AIDS-patients participated in the study voluntarily and were compared to 30 drug addicted HIV-negative patients, 30 homosexual AIDS-patients and 20 healthy normals. Furthermore the patients were divided according to the stages of their disease. The drug addicted AIDS-patient group habituated earlier than the addicted HIV-negative group, the healthy normals, and the homosexual patients. The drug dependent AIDS-patients were more psychovegetatively suppressed. As compared to the healthy normals and addicted HIV-negative patients the homosexual AIDS-patients differed in emotional reflection; they showed a higher degree of excitement, while in drug dependent AIDS-patients a lower emotional reflection was found. Concerning emotional intensity similar results were obtained. Differences in the mean amplitudes reached the level of statistical significance between homosexual AIDS-patients and the healthy normals and addicted HIV-negative patients respectively. Within as well as between both groups differences concerning stage III and IV could be observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Variables measured during static and dynamic pupillometry were factor-analyzed. Following factors were obtained regardless whether investigations were carried out in normals or in psychiatric patients: A static factor, a dynamic factor, a stimulus-specific factor and a restitution-dependent factor. Evaluation of reliability in normals demonstrated a high reliability for the static variables of pupillometry.

The effect of the nootropic drug, piridoxilate on normal and on exogenously (by traffic noise) disturbed sleep and awakening quality was investigated in a double-blind placebo-controlled study. 10 elderly subjects with a mean age of 62 years spent 13 nights in the sleep laboratory: 2 adaptation nights, 1 baseline night, 3 drug nights (placebo, 300 and 600 mg piridoxilate), as well as 2 drug nights with nocturnal traffic noise (placebo and 600 mg piridoxilate) and the subsequent wash-out nights. Polysomnographic recordings (including EEG, EMG and EOG) were carried out between 10:30 p.m. and 6.00 a.m. Traffic noise was pre-recorded at a busy Viennese street and presented continuously by a loudspeaker with a sound pressure level at the ear of between 68 and 83 dB (A) [mean 75.6 dB (A)]. In the morning the subjects completed a sleep questionnaire for the subjective evaluation of their quality of sleep and awakening. Thereafter objective awakening quality was measured by a psychometric test battery. Piridoxilate did not induce any significant changes in objective and subjective sleep variables. Nocturnal traffic noise produced a decrease in total sleep time and sleep efficiency, an increase in wakefulness and drowsiness (stage 1), as well as a decrease in REM and deep sleep stages, the last-mentioned being of statistical significance. Subjectively, the elderly subjects reported a deterioration in sleep quality due to traffic noise, an increase in middle and late insomnia, as well as a deterioration in awakening quality (dizziness, tiredness, headaches). Piridoxilate did not ameliorate these sleep disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)

The measurement of rigidity and perseveration respectively gets increasing importance in clinical psychodiagnostics. Recently we have developed a computer-assisted technique which allows to get information about inadequate persisting in psychic processes and behaviour within shortest time and to differentiate between psychopathological groups. 257 patients of both sexes who came for elucidation of their disorders to the department of clinical psychodiagnostics were investigated. The most significant differences between the groups were found in redundance of second degree (the patient has to press 10 buttons indiscriminately according to the beat of a metronom--standard condition) and in personal speed (the patient has to press 10 buttons as fast as possible--speed condition). Furthermore the psychopathological groups were ranged in the particular variables of rigidity according to their mean values and their average ranges the schizophrenics and effective psychoses were characterized by a high tendency of perseveration while the neurotics, patients with organic brain syndrome and alcohol and drug dependents showed more flexibility.

Microprocessor-assisted pupillometry was used in this psychophysiological study to investigate the pupillary diameter (static pupillometry) and visual-evoked pupillary reactions (dynamic pupillometry) in psychosomatic patients (duodenal ulcers, ulcerative colitis, cardiac phobia, anorexia nervosa, bronchial asthma) as compared with age-and sex-matched normal controls. Statistical analyses including multivariate methods demonstrated interesting differences between psychosomatic patients and normal controls, as well as between various subtypes of psychosomatic disorders and elucidated also the influence of a 6 weeks' course of psychotherapy. The data give valuable clues to symptom/syndrome-specific psychophysiological reaction types, which may be of considerable relevance for the characterization of psychosomatic diseases.

The present paper presents several new psychophysiological test methods and measures, which have been developed by the authors for utilization in the field of psychopathology and psychopharmacology. The main advantage of these new techniques seems to lie in the fact, that control and evaluation procedures are microprocessor-assisted which ensures objectivity, reliability and validity. The multidimensionality, e.g. the possibility to concomitantly evaluate several variables at the same time, and the economics, e.g. the short time effort involved in completing the tests, are further advantages. By means of the newly developed techniques several sensitive measures may be obtained which are of great value in the diagnostic process as well as in the assessment of drug effects in clinical psychopharmacology.