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66. Factors related to age at depression onset: the role of SLC6A4 methylation, sex, exposure to stressful life events and personality in a sample of inpatients suffering from major depression.

Author

Sanwald, Simon, Widenhorn-Müller, Katharina, Schönfeldt-Lecuona, Carlos, GenEmo Research Group, Connemann, Bernhard J., Gahr, Maximilian, Kammer, Thomas, Montag, Christian, and Kiefer, Markus

Subjects
SADNESS, LIFE change events, MENTAL depression, AGE of onset, METHYLATION, PERSONALITY
Abstract

Background: An early onset of depression is associated with higher chronicity and disability, more stressful life events (SLEs), higher negative emotionality as described by the primary emotion SADNESS and more severe depressive symptomatology compared to depression onset later in life. Additionally, methylation of the serotonin transporter gene (SLC6A4) is associated with SLEs and depressive symptoms. Methods: We investigated the relation of SLEs, SLC6A4 methylation in peripheral blood, the primary emotions SADNESS and SEEKING (measured by the Affective Neuroscience Personality Scales) as well as depressive symptom severity to age at depression onset in a sample of N = 146 inpatients suffering from major depression. Results: Depressed women showed higher SADNESS (t (91.05) = − 3.17, p = 0.028, d = − 0.57) and higher SLC6A4 methylation (t (88.79) = − 2.95, p = 0.02, d = − 0.55) compared to men. There were associations between SLEs, primary emotions and depression severity, which partly differed between women and men. The Akaike information criterion (AIC) indicated the selection of a model including sex, SLEs, SEEKING and SADNESS for the prediction of age at depression onset. SLC6A4 methylation was not related to depression severity, age at depression onset or SLEs in the entire group, but positively related to depression severity in women. Conclusions: Taken together, we provide further evidence that age at depression onset is associated with SLEs, personality and depression severity. However, we found no associations between age at onset and SLC6A4 methylation. The joint investigation of variables originating in biology, psychology and psychiatry could make an important contribution to understanding the development of depressive disorders by elucidating potential subtypes of depression. [ABSTRACT FROM AUTHOR]

Published
2021
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68. Treatment of the Neuroleptic Malignant Syndrome in International Therapy Guidelines: A Comparative Analysis.

Author

Schönfeldt-Lecuona, Carlos, Kuhlwilm, Lilli, Cronemeyer, Maximilian, Neu, Peter, Connemann, Bernhard J., Gahr, Maximilian, Sartorius, Alexander, and Mühlbauer, Viktoria

Subjects
NEUROLEPTIC malignant syndrome, ELECTROCONVULSIVE therapy, AMISULPRIDE, MEDICAL societies, COMPARATIVE studies, GUIDELINES
Abstract

Introduction The neuroleptic malignant syndrome (NMS) is a potentially life-threatening condition associated to the use of antipsychotics. Since it requires rapid and efficient medical care, high-quality treatment guidelines should be available. In this article, we analyzed and compared different international therapy guidelines for the treatment of schizophrenia, in which NMS treatment recommendations might be contained. Methods We performed an Internet-based search for schizophrenia guidelines via the website of the respective medical society. Guidelines in English, French, Italian, and German from countries whose medical care meets high standards were selected for further analysis and comparison of the NMS treatment recommendations (if present), and their underlying evidence. Results The NMS is mentioned in 12 of 14 guidelines. Only 9 report concrete therapy recommendations (benzodiazepines/dantrolene/bromocriptine/amantadine/intensive care and/or electroconvulsive therapy (ECT)), however, with high heterogeneity. Only 5 guidelines included all possible drug therapy options and ECT, but with differing combination strategies, dosages, application forms, and combinability of options. The level of evidence of the different recommendations was estimated as low. Discussion One-third of the selected guidelines do not report any NMS therapy recommendations. Most guidelines mentioning the NMS do not provide therapy recommendations that include all relevant treatment options. The results show a very high heterogeneity, and the recommendations and statements are of low-evidence levels. The lack of knowledge about the NMS and its treatment may delay the onset of therapy, impair the quality of treatment, and lead to a worse outcome or death. [ABSTRACT FROM AUTHOR]

Published
2020
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80. Update Opipramol

Author

Gahr, Maximilian, additional, Hiemke, Christoph, additional, and Connemann, Bernhard, additional

Published
2017
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84. Comparison of International Therapy Guidelines with Regard to the Treatment of Malignant Catatonia.

Author

Schönfeldt-Lecuona, Carlos, Cronemeyer, Maximilian, Hiesener, Lilli, Connemann, Bernhard J., Gahr, Maximilian, Sartorius, Alexander, and Mühlbauer, Viktoria

Subjects
CATATONIA, ELECTROCONVULSIVE therapy, GUIDELINES, MEDICAL care, RARE diseases
Abstract

Objective Malignant catatonia (MC) is an extremely rare, life-threatening disorder. It is characterized by catatonic symptoms accompanied by autonomic instability, hyperthermia, and changes in laboratory values. In many cases, MC is not recognized as such. Evidence-based guidelines are essential to ensure quality of treatment, but what do current national and international guidelines recommend? Method Online search for international guidelines from English-, French-, Italian-, and German-speaking countries whose medical care meets high standards addressing the treatment of MC. These were analyzed and compared regarding statements on MC, recommendations, and strength of scientific evidence. Results Fifteen of the identified guidelines were included. Only 5 of 15 comment on the treatment of MC. As for other rare diseases, no detailed recommendations are available. Suggested therapies are limited to benzodiazepines and electroconvulsive therapy. Levels of evidence and grades of recommendation are predominantly low. Conclusion Many international guidelines do not mention MC. It is not possible to derive a clear algorithm for the treatment of MC from most current guidelines. A thorough update of most guidelines appears to be necessary. Lack of awareness and knowledge of MC among physicians and medical professionals might lead to inadequate or delayed care, worsened outcome, or death. [ABSTRACT FROM AUTHOR]

Published
2020
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87. Correspondence (letter to the editor): Prophylactic Role of Aspirin

Author

Connemann, Bernhard J

Subjects
Barrett Esophagus, Esophageal Neoplasms, Correspondence, Humans, Adenocarcinoma
Abstract

Esophageal adenocarcinoma has attracted more attention among gastroenterologists recently because of its rapidly rising incidence in Western countries. Many new epidemiological findings have been published, and there have been numerous technical advances in diagnostic procedures and in multimodal treatment based on the staging of the disease.In this paper, we selectively review the literature on esophageal adenocarcinoma, also considering the evidence-based recommendations contained in the guidelines of the German Society for Digestive and Metabolic Diseases (Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten, DGVS) as well as the latest data from our own research team.here have been major recent advances in the diagnosis and treatment of esophageal adenocarcinoma. New refinements in endoscopic techniques now make endoscopic treatment possible for early esophageal carcinoma. New surgical techniques and new strategies of neoadjuvant chemotherapy have lowered the morbidity and improved the outcome of patients with locally advanced disease. Molecular therapies, too, have shown promising initial results.

Published
2012

95. Better Risk Assessment for Individual Substances

Author

Freudenmann, Roland W., primary, Freudenmann, Ninja, additional, Zurowski, Bartosz, additional, Schönfeldt-Lecuona, Carlos, additional, Connemann, Bernhard J., additional, Gahr, Maximilian, additional, and Freudenmann, Roland, additional

Published
2015
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