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Author: Peter Brieger (39)


Mar
2018

In a previous single center study we found that a standardized drug treatment algorithm (ALGO) was more cost effective than treatment as usual (TAU) for inpatients with major depression. This report aimed to determine whether this promising initial finding could be replicated in a multicenter study.
Treatment costs were calculated for two time periods: the study period (from enrolment to exit from study) and time in hospital (from enrolment to hospital discharge) based on daily hospital charges.

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Sep
2017

Treatment algorithms are considered as key to improve outcomes by enhancing the quality of care. This is the first randomized controlled study to evaluate the clinical effect of algorithm-guided treatment in inpatients with major depressive disorder.
Inpatients, aged 18 to 70 years with major depressive disorder from 10 German psychiatric departments were randomized to 5 different treatment arms (from 2000 to 2005), 3 of which were standardized stepwise drug treatment algorithms (ALGO).

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Jun
2017

The objective of the present study was the application and comparison of common remission and recovery criteria between patients with the diagnosis of schizophrenia and major depressive disorder (MDD) under inclusion of other outcome parameters. Patients with schizophrenia and MDD who were treated as inpatients at the beginning of the study were examined within two naturalistic follow-up trials from admission to discharge of an inpatient treatment period and the one-year follow-up assessment. PANSS criteria of the Remission in Schizophrenia Working Group (RSWG) for schizophrenia and HAMD criteria of the ACNP Task Force in MDD for depressive patients as well as the Clinical Global Impression-Severity Scale (CGI-S) were applied as symptomatic outcome measures additionally to functional outcome parameters.

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Dec
1969

Remission is a common outcome of short-term trials and the main goal of acute and longterm treatment. The longitudinal stability of remission has rarely been investigated under naturalistic treatment conditions.
Naturalistic multisite follow-up study.

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Mar
2015

Approximately 20-30% of patients with Major depressive disorder (MDD) develop a chronic course of their disease. Chronic depression is associated with increased health care utilisation, hospitalisation and a higher disease burden. We identified clinical correlates and differences in treatment response of chronic MDD (cMDD) patients compared with non-chronic episodic depression in a huge sample of depressive inpatients.

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Nov
2012

To study effects of the implementation of joint-crisis plans (JCP) on health-care users and professionals.
The first 3 years of the implementation of JCP were followed with structured interviews with health-care users and professionals. Legal and administrative complications were documented.

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Sep
2011

Most predictor analyses search for single predictors or rely on data from randomized controlled trials. We aimed at detecting a set of clinical baseline variables for prediction of response and remission in 1014 naturalistically treated inpatients with major depressive episode treated for 53.62 ± 47.

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Nov
2010

Because of strict inclusion and exclusion criteria, results drawn from placebo-controlled randomized antidepressant efficacy trials may not be transferable to real-world patients.
This study was performed from March 2000 to September 2005 as a prospective, multicenter follow-up. Patients were recruited from February 2000 to June 2005.

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Aug
2010

The objective of this study was to explore the prevalence of anxious depression in an inpatient population, to describe its clinical and sociodemographic correlates, and to compare treatment outcomes between patients with anxious and nonanxious depression. Furthermore, the efficacy of algorithm-guided treatment versus treatment as usual in patients with anxious versus nonanxious depression was evaluated.
Data were collected on 429 inpatients with the diagnosis of a depressive episode (according to ICD-10) and a score of ≥ or = 15 on the 21-item Hamilton Depression Rating Scale (HDRS-21).

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Nov
2010

Remission and response were suggested as the most relevant outcome criteria for the treatment of depression. There is still marked uncertainty as to what cut-offs should be used on current depression rating scales. The goal of the present study was to compare the validity of different HAMD, MADRS and BDI cut-offs for response and remission.

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Jan
2010


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Feb
2010

This study examined the transcultural robustness of a screening instrument for hypomania, the Hypomania Checklist-32, first revised version (HCL-32 R1). It was carried out in 2606 patients from twelve countries in five geographic regions (Northern, Southern and Eastern Europe, South America and East Asia). In addition, GAMIAN Europe contributed data from its members.

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May
2010

Due to strict exclusion criteria the generalizability of randomized controlled trials appears to be limited. Therefore, outcomes of naturalistically treated depressive inpatients with respect to depression mean scores, response and remission rates were evaluated. This was a multicenter trial, conducted in 12 psychiatric hospitals in Germany with a follow-up period of 4years.

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Apr
2009

The purpose of this paper is to demonstrate similarities and differences between bipolar I patients with and without mood-incongruent symptoms (MIS) over a long period of time, independently of longitudinal syndromatic constellations.
The Halle bipolarity longitudinal study (HABILOS) prospectively investigates 182 patients meeting the DSM-IV criteria for bipolar I disorders over a long period of time (x;- = 16.84 years).

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Jun
2009

Delayed onset of efficacy of antidepressants and a high proportion of depressed patients being poor or non-responders to antidepressants are well known clinical challenges. Therefore, it seems to be necessary to identify predictors for response and - even more important - for remission. It has been suggested that reduction of depressive symptoms at an early stage of antidepressant treatment may predict treatment outcome.

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Jul
2009

To assess the longitudinal effectiveness of a comprehensive vocational rehabilitation program in Germany.
In a non-randomized open study, 106 participants of two comprehensive rehabilitation programs were prospectively and multidimensionally compared to a control group (n = 75) at program termination and at a 9 months follow-up. Primary outcome was employment status at 9 months follow-up, secondary outcome parameters were changes in symptoms (Positive and Negative Syndrome Scale), subjective well-being (WHOQOL-Bref), and level of functioning (Level of Functioning Scale) during the study.

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Mar
2008

The study examined whether a measure of learning potential is prospectively related to the success of a vocational rehabilitation program for patients with severe mental illness in Germany.
At rehabilitation intake (November 2002 to January 2004), 41 persons with schizophrenia or schizoaffective disorders completed a test-train-test version of the Wisconsin Card Sorting Test as a measure of learning potential. Research participants were classified as high scorers, learners, or nonlearners.

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Jul
2007

Spouses of patients with depression have an elevated risk to develop an affective disorder themselves. We evaluate whether a group intervention program for spouses of patients with depression does improve participants' depressive and anxiety symptoms.
66 spouses participated in a six months intervention with 12 group sessions.

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Apr
2008

The longitudinal course of bipolar I disorders is often characterized by a polymorphism, which means that different kinds of episodes develop during the illness. This study investigated the characteristics, similarities and differences of the long-term course of bipolar I patients regarding the dominance of various kinds of episodes.
One hundred eighty-two (182) patients with DSM-IV bipolar I disorder were longitudinally investigated (approximately 17 years duration of the illness) with standardized instruments.

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Dec
2007

Personality and temperament are supposed to have an impact on the clinical expression and course of an affective disorder. There is some indication, that mixed episodes result from an admixture of inverse temperamental factors to a manic syndrome. In a preliminary report [Brieger, P.

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Jan
2007

A new group intervention program has been assessed, rating its ability to increase the quality of life in partners of patients suffering under depression. Over a period of six months 66 subjects participated in an intervention group for a total of twelve sessions. The control group consisted of 50 persons, and quality of life was assessed with the WHOQOL-BREF.

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Jul
2006

Vocational rehabilitation aims to improve work performance. Few studies have examined the course of work performance during vocational rehabilitation. It remains unclear whether all subjects profit equally from rehabilitation programs regarding improvement of work performance.

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Apr
2007

Various subjective and objective criteria are used to assess outcome in bipolar disorder. In this study, we explored to what extent they reflect distinct categories and whether underlying dimensions can be identified.
One-hundred and twenty-one subjects with at least three episodes of bipolar I disorder (DSM-IV) were assessed on average 4.

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Apr
2006

To determine the conditional factors underlying a premature termination of vocational rehabilitation programs.
123 rehabilitation participants were assessed prospectively regarding sociodemographic and psychopathological variables, level of functioning, subjective health, intellectual and work capacity.
23 persons terminated rehabilitation prematurely.

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Sep
2005

Persons with severe mental illnesses often need additional vocational rehabilitation in order to gain or regain an adequate capability to work. The objective of this paper is the assessment of work capability and its development throughout the rehabilitation process, as well as clarification of its correlating variables, and predictors.
We present data obtained at two different points in time (at rehabilitation program intake and at the six month mark of being in the program) from a sample of 117 rehabilitants.

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Mar
2005

The purpose of the study was to evaluate the psychometric properties of the German version of the TEMPS-A questionnaire. Besides the reliability of the temperament scales, validity was the focus of interest. Therefore, the relationship between the TEMPS-A and the well-established personality questionnaire NEO-FFI, whose factors show theoretical overlap with temperaments, was investigated.

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Sep
2004

To assess subjective quality of life (QOL) of subjects with unipolar depressive and bipolar affective disorders.
153 consecutive psychiatric in-patients were assessed with standardized interviews. Prior to discharge QOL was assessed with WHOQOL-bref.

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May
2004

Little is known concerning the frequency of disability payments due to depressive and bipolar affective disorders in Germany.
177 consecutive psychiatric in-patients were assessed with standardized interviews concerning diagnosis (SCID-I, DSM-IV) and illness history. To compare unipolar depressive and bipolar affective patients, a survival analysis was calculated.

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Apr
2004

Although both DSM-IV and ICD-10 define schizoaffective mixed states, they have not received much attention-neither in the clinical nor in research context. We present preliminary results of a prospective study of bipolar affective (n = 100) and bipolar schizoaffective (n = 177) patients. 25% of the bipolar affective and 32% of the bipolar schizoaffective patients had at least one (schizo)mixed episode during the illness course.

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May
2003

This article describes and analyses the availability of outpatient, inpatient and community-based psychiatric care in Saxony-Anhalt, one of the federal states in the eastern part of Germany. The European Services Mapping Schedule was used to classify 365 institutions. Outpatient care was provided by an average of four private practice psychiatrists per 100,000 inhabitants, which is low when compared to the German average.

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May
2003

One expression of the complex relationship between personality and affective disorder is the comorbidity of personality disorders (PDs) with affective disorders. In a sample of 117 patients with unipolar and 60 with bipolar affective disorders, we assessed DSM-III-R PDs with the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) and compared them with personality factors as obtained by the five-factor model (FFM-NEO Five-Factor Inventory). Fifty-one percent of the unipolar and 38% of the bipolar disorders fulfilled criteria for a comorbid PD.

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Jan
2003

Temperament is an important factor in affective illness. There is some indication that mixed episodes result from an admixture of inverse temperamental factors (e.g.

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May
2002

To describe consequences of the presence of a comorbid personality disorder (PD) in inpatients with a major depressive disorder (MDD) on variables connected to course and outcome of the unipolar affective illness, 117 inpatients with a major depressive episode were assessed at various times during inpatient treatment. Trait markers (including personality and PDs) were obtained toward the end of the treatment, when acute psychopathology had largely remitted. Fifty-one percent of all patients fulfilled the criteria for a DSM-III-R PD, 15% met the criteria for two or more PDs, and 18% fulfilled the criteria for at least one cluster A or B PD.

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