Marius K. Nickel

Background: Suicide attempts by adolescents continue to be a major public health problem. The purpose of this study was to examine the difference in the family functioning and sociopsychopathological risk factor relationship between female bulimic adolescents with suicidal ideation only, and those who attempted suicide.Methods: A group of 211 patients were observed for 12 months. Data from 63 subjects (SUG [suicide group], age 17.2 ± 1.3 years) who had attempted suicide were then compared with 148 (control group, age 18.1 ± 1.5 years) who had expressed suicidal ideation but did not follow through.Results: Those in the suicide attempt group had been exposed more frequently to physical/sexual violence in childhood. As adults they either lived alone or were dissatisfied with their partnership. The frequency of borderline personality disorders and depressive disorders in this group was significant. Psychosomatic symptoms, disturbed coenesthesia, substance abuse, social impairment and interference with their perception of their own life circumstances, as well as their job performance, often preceded the suicide attempt. Nine genuine risk factors that occurred significantly more often in the SUG were calculated out of all the stress factors using stepwise logistic regression: ‘as a child I was even hit with a stick or whip’, ‘I had no set orientation in life’, ‘I had a feeling of loneliness despite family and friends’, ‘I could not relax’, ‘incapable of dealing with the public’, ‘I do not like to be touched’, ‘parents have psychiatric disorders’, ‘misuse of stimulants’, and ‘as a child I felt lonely’ (odds ratio, 10.56–1.90).Conclusion: Adverse family experiences and multiple sociopsychopathological factors may increase the risk of suicide in female bulimic adolescents.

Background: Asthma is a serious medical problem in pregnancy and is often associated with stress, anger and poor quality of life.The aim of this study was to determine the efficacy of progressive muscle relaxation (PMR) on change in blood pressure, lung parameters, heart rate, anger and health-related quality of life in pregnant women with bronchial asthma. Methods: We treated a sample of 64 pregnant women with bronchial asthma from the local population in an 8-week randomized, prospective, controlled trial. Thirty-two were selected for PMR, and 32 received a placebo intervention. The systolic blood pressure, forced expiratory volume in the first second, peak expiratory flow and heart rate were tested, and the State-Trait Anger Expression Inventory and Health Survey (SF-36) were employed. Results: According to the intend-to-treat principle, a significant reduction in systolic blood pressure and a significant increase in both forced expiratory volume in the first second and peak expiratory flow were observed after PMR. The heart rate showed a significant increase in the coefficient of variation, root mean square of successive differences and high frequency ranges, in addition to a significant reduction in low and middle frequency ranges. A significant reduction on three of five State-Trait Anger Expression Inventory scales, and a significant increase on seven of eight SF-36 scales were observed. Conclusions: PMR appears to be an effective method to improve blood pressure, lung parameters and heart rate, and to decrease anger levels, thus enhancing health-related quality of life in pregnant women with bronchial asthma.

The effectiveness of cabergoline in 50 men with psychogenic erectile dysfunction was investigated in a 4-month, randomized, placebo-controlled, double-blind study with validated psychological tests, and prolactin, follicle-stimulating hormone, luteinizing hormone and testosterone serum levels. Cabergoline treatment was well-tolerated and resulted in normalization of hormone levels in most cases. In the cabergoline-treated group, significant interactions between prolactin and testosterone serum concentrations were observed. Erectile function improved significantly. Sexual desire, orgasmic function, and the patient's and his partner's sexual satisfaction were also enhanced. Cabergoline may be an effective and safe alternative agent for men with psychogenic ED.

Objective: To determine the influence of brief strategic family therapy (BSFT) on salivary cortisol, anger, and health-related quality of life (QoL) in adolescent boys with bullying behaviour. Method: We selected a sample of 72 boys demonstrating bullying behaviour from the general population and treated 36 with BSFT for 12 weeks. The other 36 boys formed the control group. Primary outcome measures were salivary cortisol concentration 15 to 30 minutes after awakening and changes on the subscales of the State-Trait Anger Expression Inventory (STAXI) and the Health Survey (SF-36). Results: After 12 weeks' treatment, we observed a significant reduction in bullying behaviour in the BSFT group ( P = 0.017) and in the mean values (according to the intent-to-treat principle) for salivary cortisol concentration ( P < 0.001). The BSFT group also showed significantly greater change on the STAXI subscales State-Anger ( P < 0.001), Trait-Anger ( P < 0.001), Anger-Out ( P < 0.001), and Anger-Control ( P < 0.001). Treatment with BSFT also resulted in significant improvement on the SF-36 subscales for Vitality ( P < 0.001), Social Functioning ( P < 0.001), Role-Emotional ( P < 0.001), and Mental Health ( P < 0.001). Conclusions: BSFT effectively influenced bullying behaviour, salivary cortisol concentration, anger, and health-related QoL in adolescent bullying boys.

Objective: This study was carried out to examine sociopsychopathological predictors of prospective observed suicide attempts in bulimic women purging type without comorbid major depression (BNG) at the time of study entry and in woman with major depression without comorbid eating disorder at the time of study entry (MDG).Methods: Data from 28 BNG (age 23.5 ± 3.6) and 126 MDG women (age 33.4 ± 5.1) who had attempted suicide during 12 months' monitoring were compared.Results: A univariate comparison of the two groups revealed various differences. Analysis of risk factors for suicide attempts using stepwise logistic regression was conducted separately for each group. The derived logistic models showed that patients from the BNG group had a history of higher incidence of sexual abuse in childhood, as well as abuse of laxatives and illicit drugs; they also lacked orientation in life, felt lonely despite family and friends, tended to direct their anger outward, and were unable to relax.Conclusions: Sociopsychopathological risk factors for suicide attempts in the BNG and MDG appear to vary. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006

Objective The aim of the current study was to test the influence of topiramate on behavior, body weight, and health‐related quality of life (HRQOL) in bulimic patients. Method Thirty patients with bulimia nervosa were treated with topiramate in a 10‐week randomized, double‐blind, placebo‐controlled study. The subjects were randomly assigned to receive topiramate (topiramate group [TG]; n = 30) or a placebo (control group [CG]; n = 30). Primary outcome measures were changes in the frequency of binging/purging, in body weight, and on the SF‐36 Health Survey (SF‐36) scales. Results In comparison to the CG group (according to the intent‐to‐treat principle), significant changes in the frequency of binging/purging (a > 50% reduction: TG, n = 11 [36.7%]; CG, n = 1 [3.3%]; p < .001), body weight (difference in weight loss between the two groups: 3.8 kg, 95% confidence interval [CI] = −5.4 to −2.1; p < .001), and SF‐36 (all ps < .001) could be seen. All patients tolerated topiramate well. Conclusion Topiramate appears to safe and effective in influencing the frequency of binging/purging, body weight, and HRQOL in bulimic patients. © 2005 by Wiley Periodicals, Inc.

Background: Many girls bully others. They are conspicuous because of their risk-taking behavior, increased anger, problematic interpersonal relationships and poor quality of life. Our aim was to determine the efficacy of brief strategic family therapy (BSFT) for bullying-related behavior, anger reduction, improvement of interpersonal relationships, and improvement of health-related quality of life in girls who bully, and to find out whether their expressive aggression correlates with their distinctive psychological features. Methods: 40 bullying girls were recruited from the general population: 20 were randomly selected for 3 months of BSFT. Follow-up took place 12 months after the therapy had ended. The results of treatment were examined using the Adolescents’ Risk-taking Behavior Scale (ARBS), the State-Trait Anger Expression Inventory (STAXI), the Inventory of Interpersonal Problems (IIP-D), and the SF-36 Health Survey (SF-36). Results: In comparison with the control group (CG) (according to the intent-to-treat principle), bullying behavior in the BSFT group was reduced (BSFT-G from n = 20 to n = 6; CG from n = 20 to n = 18, p = 0.05) and statistically significant changes in all risk-taking behaviors (ARBS), on most STAXI, IIP-D, and SF-36 scales were observed after BSFT. The reduction in expressive aggression (Anger-Out scale of the STAXI) correlated with the reduction on several scales of the ARBS, IIP-D, and SF-36. Follow-up a year later showed relatively stable events. Conclusions: Our findings suggest that bullying girls suffer from psychological and social problems which may be reduced by the use of BSFT. Expressive aggression in girls appears to correlate with several types of risk-taking behavior and interpersonal problems, as well as with health-related quality of life.

Background and aims: The purpose of this study was to assess the effect of antidepressant therapy on changes in instrumental activities of dailyliving disability in elderly female patients with musculoskeletal pain in a controlled study comparing active drugs with a placebo. Methods: In an 8-week double-blind, placebo-controlled outpatient trial, 30 female patients (response rate 90.0%) between 70 and 79 were examined. They all had a history of clinically evident musculoskeletal pain, were afflicted with depressive symptoms, and could independently bathe, walk, dress, and transfer (e.g., from a chair) inside the house. The study was performed using the Center for Epidemiological Studies Depression Scale (CES-D), and Instrumental Activities of Daily Living (IADL). Results: Compared with the placebo-group, significant changes in the CES-D (pConclusion: Treatment of depressive symptoms may be efficacious in reducing IADL disability in elderly female patients afflicted with musculoskeletal pain.