AMISULPRIDE AS AN AUGMENTATION AGENT IN TREATMENT RESISTANT DEPRESSION: A CASE SERIES AND REVIEW OF THE LITERATURE

Amisulpride (AMS) in low dosage has been used effectively for treatment of dysthymia. Yet there is a dearth of reports on its use as an augmentation agent in therapy-resistant depression. We deal with this issue presenting case reports and a review of the literature. The addition of 50 mg amisulpride (AMS) to antidepressant therapy in seven patients with depression at different stages of treatment resistance, one of them a case of recurrent brief depression, is described in this report. Augmentation with AMS led to a profound improvement in psychopathology in most patients. The only side effects were elevation of prolactin levels and occasional weight gain. In most cases, improvement occurred early, after only 1-2 weeks of treatment. In some patients, reduction or cessation of AMS led to an immediate and intense recurrence of depressive symptoms that resembled a withdrawal syndrome. Further investigations into the clinical utility and the mode of action of AMS as an augmentation agent are warranted

TEN YEAR OUTCOME OF TARDIVE DYSKINESIA DURING CONTINUOUS TREATMENT WITH FIRST GENERATION ANTIPSYCHOTICS

Objective: The aim of this study is to determine the course of tardive dyskinesia (TD) during continuous medication with first generation antipsychotics. Subjects and methods: Patients of a psychiatric nursing home were assessed for TD by means of the AIMS on two occasions ten years apart. Results: Out of 10 patients who met criteria for TD at baseline the global judgement of severity of the AIMS improved in 5, worsened in 4 and remained unchanged in one patient. The mean sum score of the AIMS slightly increased from 5.5 to 6.3. No patient developed movements that incapacitated him in his daily activities. Conclusion: In concordance with the available literature these findings support the view that under continuous treatment with antipsychotics there is an equal chance for improvement as for deterioration. Progressive worsening to severe forms of TD was not observed

TEN YEAR OUTCOME OF TARDIVE DYSKINESIA DURING CONTINUOUS TREATMENT WITH FIRST GENERATION ANTIPSYCHOTICS

Objective: The aim of this study is to determine the course of tardive dyskinesia (TD) during continuous medication with first generation antipsychotics. Subjects and methods: Patients of a psychiatric nursing home were assessed for TD by means of the AIMS on two occasions ten years apart. Results: Out of 10 patients who met criteria for TD at baseline the global judgement of severity of the AIMS improved in 5, worsened in 4 and remained unchanged in one patient. The mean sum score of the AIMS slightly increased from 5.5 to 6.3. No patient developed movements that incapacitated him in his daily activities. Conclusion: In concordance with the available literature these findings support the view that under continuous treatment with antipsychotics there is an equal chance for improvement as for deterioration. Progressive worsening to severe forms of TD was not observed

DIE DIAGNOSE "SCHIZOPHRENIE": VERGANGENHEIT, GEGENWART UND ZUKUNFT

Schizophrenia is one of the most important diseases in psychiatry. The diagnostic criteria, first formulated more than 100 years ago, have since undergone multiple changes. While the disease was originally named "dementia praecox" by Emil Kraepelin, the term "schizophrenia" was coined by Eugen Bleuler soon afterwards. DSM-III changed diagnostic criteria dramatically in 1980, relying especially on Kurt Schneider\u27s first rank criteria. These changes were also incorporated into ICD-10. Diagnosis of schizophrenia thus became much more reliable. Yet there remain many problems to be solved: the demarcation towards other psychotic disorders remains arbitrary; the diagnosis is based on multiple, quite different symptoms, enabling two patients being diagnosed with schizophrenia without sharing a single symptom, yet further important symptoms (e.g. cognitive impairments) are not even covered by present diagnostic criteria; until now it was not possible to formulate diagnostic criteria reflecting underlying biological processes or to find a reliable biological marker. These methodological uncertainties are in stark contrast to the persistence of the stigma which accompanies schizophrenia despite all efforts. For the forthcoming publication of DSM-5 and ICD-11 further revisions of diagnostic criteria of schizophrenia are to be expected.Schizophrenie ist eine der wichtigsten psychiatrischen Erkrankungen. Die seit mehr als 100 Jahren bestehende Konzeption ist immer wieder modifiziert worden. Ausgehend von der ursprünglichen Beschreibung als "Dementia präcox" durch Kraepelin erfolge schon kurz darauf die Prägung des noch heute verwendeten Namens "Schizophrenie" durch Eugen Bleuler. 1980 brachte das DSM-III eine wesentliche Neuformulierung der diagnostischen Kriterien, wobei man sich inhaltlich stark auf die Symptome 1. Ranges nach Kurt Schneider orientierte. Diese Änderungen wurden auch im ICD-10 übernommen. Die Diagnose Schizophrenie ist damit wesentlich reliabler geworden. Allerdings bleiben viele Probleme bestehen: Die Abgrenzung zu anderen psychotischen Störungen ist diffus, die diagnoserelevanten Symptome sind äußerst vielfältig, ohne dass alle wichtigen Symptome überhaupt erfasst wären (wie z.B. kognitive Störungen), es gibt keine verlässlichen biologischen Marker. Diese methodischen Unsicherheiten steht ein sehr fest fundiertes Stigma in der Öffentlichkeit gegenüber. Anlässlich der Vorarbeiten für DSM-5 und ICD-11 werden nun neuerlich Veränderungen der diagnostischen Kriterien diskutiert

Non-Standard Errors

In statistics, samples are drawn from a population in a data-generating process (DGP). Standard errors measure the uncertainty in estimates of population parameters. In science, evidence is generated to test hypotheses in an evidence-generating process (EGP). We claim that EGP variation across researchers adds uncertainty: Non-standard errors (NSEs). We study NSEs by letting 164 teams test the same hypotheses on the same data. NSEs turn out to be sizable, but smaller for better reproducible or higher rated research. Adding peer-review stages reduces NSEs. We further find that this type of uncertainty is underestimated by participants

DIE DIAGNOSE "SCHIZOPHRENIE": VERGANGENHEIT, GEGENWART UND ZUKUNFT

Schizophrenia is one of the most important diseases in psychiatry. The diagnostic criteria, first formulated more than 100 years ago, have since undergone multiple changes. While the disease was originally named "dementia praecox" by Emil Kraepelin, the term "schizophrenia" was coined by Eugen Bleuler soon afterwards. DSM-III changed diagnostic criteria dramatically in 1980, relying especially on Kurt Schneider\u27s first rank criteria. These changes were also incorporated into ICD-10. Diagnosis of schizophrenia thus became much more reliable. Yet there remain many problems to be solved: the demarcation towards other psychotic disorders remains arbitrary; the diagnosis is based on multiple, quite different symptoms, enabling two patients being diagnosed with schizophrenia without sharing a single symptom, yet further important symptoms (e.g. cognitive impairments) are not even covered by present diagnostic criteria; until now it was not possible to formulate diagnostic criteria reflecting underlying biological processes or to find a reliable biological marker. These methodological uncertainties are in stark contrast to the persistence of the stigma which accompanies schizophrenia despite all efforts. For the forthcoming publication of DSM-5 and ICD-11 further revisions of diagnostic criteria of schizophrenia are to be expected.Schizophrenie ist eine der wichtigsten psychiatrischen Erkrankungen. Die seit mehr als 100 Jahren bestehende Konzeption ist immer wieder modifiziert worden. Ausgehend von der ursprünglichen Beschreibung als "Dementia präcox" durch Kraepelin erfolge schon kurz darauf die Prägung des noch heute verwendeten Namens "Schizophrenie" durch Eugen Bleuler. 1980 brachte das DSM-III eine wesentliche Neuformulierung der diagnostischen Kriterien, wobei man sich inhaltlich stark auf die Symptome 1. Ranges nach Kurt Schneider orientierte. Diese Änderungen wurden auch im ICD-10 übernommen. Die Diagnose Schizophrenie ist damit wesentlich reliabler geworden. Allerdings bleiben viele Probleme bestehen: Die Abgrenzung zu anderen psychotischen Störungen ist diffus, die diagnoserelevanten Symptome sind äußerst vielfältig, ohne dass alle wichtigen Symptome überhaupt erfasst wären (wie z.B. kognitive Störungen), es gibt keine verlässlichen biologischen Marker. Diese methodischen Unsicherheiten steht ein sehr fest fundiertes Stigma in der Öffentlichkeit gegenüber. Anlässlich der Vorarbeiten für DSM-5 und ICD-11 werden nun neuerlich Veränderungen der diagnostischen Kriterien diskutiert