Clinical outcome in patients with obsessive-compulsive disorder after discontinuation of SRI treatment: results from a two-year follow-up.

Background: Combined treatment with serotonin-reuptake inhibitors (SRI) and cognitive-behavioral therapy (CBT) is a common therapy approach for obsessive-compulsive disorder (OCD). However, it is a matter of debate whether discontinuation of SRI after combined treatment leads to relapse.

Method: Seventy-four consecutively admitted patients suffering from OCD were included in the study.

Do periodic leg movements influence patients' perception of sleep quality?

Background And Purpose: Periodic leg movements in sleep (PLMS) are a common finding in various sleep disorders. Whether PLMS are an epiphenomenon or are causally related to the presence of sleep-wake disturbances is still being debated. We investigated the relationship of the occurrence of PLMS to patients' perception of sleep quality during a night of polysomnography in various sleep disorders.

Object alternation test--is it sensitive enough to detect cognitive dysfunction in obsessive-compulsive disorder?

A computerized version of the object alternation test (OAT) was employed in unmedicated obsessive-compulsive disorder (OCD) patients and matched healthy controls. OCD patients performed normally on the OAT but scored below controls on a task assessing visuo-spatial working memory. The results challenge the concept of the OAT as a sensitive instrument for orbitofrontal dysfunction in OCD.

Impact of sleep deprivation and subsequent recovery sleep on cortisol in unmedicated depressed patients.

Objective: One night of sleep deprivation induces a transient improvement in about 60% of depressed patients. Since depression is associated with abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis, the authors measured cortisol secretion before, during, and after therapeutic sleep deprivation for 1 night.

Method: Fifteen unmedicated depressed inpatients participated in a combined polysomnographic and endocrine study.

Neuropsychological performance in obsessive-compulsive disorder: a critical review.

There is growing evidence for neuropsychological dysfunction in obsessive-compulsive disorder (OCD) related to an underlying frontal lobe and/or basal ganglia dysfunction. The following paper is a systematical review of the existing literature on cognitive impairment in OCD patients. Fifty studies were surveyed with regard to methodological aspects and cognitive impairments found in OCD patients.

Sleep deprivation and antidepressant treatment.

The mood-improving effect of sleep deprivation (SD) in depression is even today still not fully understood. Despite the fact that mood and cognitive functions are lowered by prolonged sleep loss and despite convincing data that insomnia is a strong risk factor for subsequent depression,(1) acute SD for one night or even partial SD in the second half of the night improves mood in about 60% of depressed patients the day after.(2,3) In this respect, among alt types of antidepressant treatments, SD elicits the fastest results, faster even than electroconvulsive therapy.

Primary insomnia: a risk factor to develop depression?

Background: Chronic insomnia afflicts approximately 5-10% of the adult population in Western industrialized countries. Insomnia may be secondary, i.e.

Are there gender differences in objective and subjective sleep measures? A study of insomniacs and healthy controls.

It is well known that insomnia is more frequent in women than in men throughout all age groups. In this respect insomnia resembles other psychiatric disorders that occur more frequently in women such as anxiety and depressive disorders. Since insomnia is frequently a symptom of anxiety and depression, it remains an open question whether the comorbidity with psychiatric disorders fully explains the gender differences in the prevalence of insomnia or whether gender influences sleep independently from psychiatric conditions.

Nocturnal cortisol and melatonin secretion in primary insomnia.

The present study investigated evening and nocturnal serum cortisol and melatonin concentrations in patients with primary insomnia to test if this clinical condition is accompanied by an increase of cortisol secretion and a simultaneous decrease of nocturnal melatonin production. Ten drug-free patients (4 males, 6 females) with primary insomnia (mean age+/-S.D.

Effects of the neuropeptide substance P on sleep, mood, and neuroendocrine measures in healthy young men.

The neuropeptide substance P (SP) has been supposed to be involved in the etiopathology of affective disorders, mainly because of the finding of increased levels of SP in the cerebrospinal fluid of depressed patients and the preliminary evidence of antidepressant effects of SP-receptor antagonists in depressed patients. We investigated whether SP may induce changes of sleep, mood and neuroendocrine measures that are similar to those in depressed patients. In a double-blind, randomized cross-over design, 12 healthy young men were investigated in two blocks of three consecutive nights, in which SP or NaCl was intravenously infused during the third night.

Transient total sleep loss in cerebral Whipple's disease: a longitudinal study.

A case with transient, almost complete sleep loss caused by cerebral manifestation of Whipple's disease (WD) is presented. Cerebral WD is rare and in most cases occurs after gastrointestinal infection. In our case, a progressive and finally almost complete sleep loss was the initial and predominant symptom.

Periodic limb movements during sleep in alcohol dependent patients.

Complaints of sleep disturbances are common among alcohol dependent patients during subacute abstinence. Recovered patients may show persistent sleep abnormalities for months or even years. In the present study we studied the issue whether periodic limb movements in sleep and disturbances of nocturnal respiration are more frequent in alcohol dependent patients than healthy subjects and may be of predictive value for sustained abstinence vs.

The tryptophan depletion test: impact on sleep in primary insomnia - a pilot study.

The application of the tryptophan depletion test is based on the assumption that the decrease of plasma or serum tryptophan concentration following the ingestion of a tryptophan-free amino acid drink reflects a central nervous effect on serotonin metabolism. In the present study the impact of tryptophan depletion on polysomnographically recorded sleep in patients with primary insomnia was studied. Fifteen patients with primary insomnia slept for four nights in the sleep laboratory.

Neurobiological findings before and during successful lithium therapy of a patient with 48-hour rapid-cycling bipolar disorder.

48-hour rapid cycling is a very rare form of bipolar disorder, characterized by regular periodic changes of mood from one day to the other. We report on a patient who suffered from a 48-hour rapid cycling without a history of bipolar disorder before the abrupt onset of his rapid mood cycles. We present polysomnographic and neuroendocrine findings and the clinical course based on daily self-ratings of mood.

Sleep and sleep-wake manipulations in bipolar depression.

In the last 30 years, it has been convincingly demonstrated that sleep in major depression is characterized by disturbances of sleep continuity, a reduction of slow wave sleep, a disinhibition of REM sleep including a shortening of REM latency (i.e. the time between sleep onset and the occurrence of the first REM period) and an increase in REM density.

Fluoxetine and sleep EEG: effects of a single dose, subchronic treatment, and discontinuation in healthy subjects.

The goals of the current study were to evaluate whether a single dose of fluoxetine causes qualitatively different changes in sleep architecture and NREM sleep EEG than subchronic administration in healthy subjects and to determine degree and duration of such changes after the single dose and after discontinuation from subchronic administration. Our hypothesis was that subchronic intake should cause changes qualitatively different from the single dose and that such changes could be sufficiently long-lived to suggest the possibility of a dosing in intervals of several days. Ten healthy volunteers first took one single 60-mg dose of fluoxetine and a week later started to take a 40-mg dose every morning for three weeks.