Alex Gamma | University of Zurich, Switzerland (original) (raw)

Papers by Alex Gamma

European Archives of Psychiatry and Clinical Neuroscience, 2007

Several recent studies have found an association between conduct problems and bipolar disorder in... more Several recent studies have found an association between conduct problems and bipolar disorder in adolescents. However, prospective studies are rare and most do not apply multivariable analysis strategies to control for important variables (e.g. socio-demographics). The aim of this study was to test the association between certain conduct problems and bipolar disorders. The sample consisted of 591 adolescents (male and female) representative for 2,600 persons from the Canton of Zurich in Switzerland. Data were prospectively collected through an interviewing procedure, with the first screening taking place at the age of 19-20. The incidence rate was computed using sampling weights, and risk factors of bipolar II disorder were estimated using a multivariable logistic regression model. The 9-year incidence rate of bipolar II disorder in the canton of Zurich was 8.4% (n = 65). Adolescents and children showing behavior such as repeated running away from home and physical fighting were 2.6-3.5 times more likely to experience a bipolar II disorder than those with no indication of conduct problems. Sensitivity analysis showed that the conduct problems were not the result of low socio-economic status.

Bmc Psychiatry, May 16, 2014

Neuropsychopharmacology, Oct 31, 1998

3,4-methylenedioxymethamphetamine (MDMA, “Ecstasy”) is a recreational drug reported to produce a ... more 3,4-methylenedioxymethamphetamine (MDMA, “Ecstasy”) is a recreational drug reported to produce a different psychological profile than that of classic hallucinogens and stimulants. It has, therefore, been tentatively classified into a novel pharmacological class termed entactogens. This double-blind placebo-controlled study examined the effects of a typical recreational dose of MDMA (1.7 mg/kg) in 13 MDMA-naı̈ve healthy volunteers. MDMA produced an affective state of enhanced mood, well-being, and increased emotional sensitiveness, little anxiety, but no hallucinations or panic reactions. Mild depersonalization and derealization phenomena occurred together with moderate thought disorder, first signs of loss of body control, and alterations in the meaning of percepts. Subjects also displayed changes in the sense of space and time, heightened sensory awareness, and increased psychomotor drive. MDMA did not impair selective attention as measured by the Stroop test. MDMA increased blood pressure moderately, with the exception of one subject who showed a transient hypertensive reaction. This severe increase in blood pressure indicates that the hypertensive effects of MDMA, even at recreational doses, should not be underestimated, particularly in subjects with latent cardiovascular problems. Most frequent acute somatic complaints during the MDMA challenge were jaw clenching, lack of appetite, impaired gait, and restless legs. Adverse sequelae during the following 24 hours included lack of energy and appetite, feelings of restlessness, insomnia, jaw clenching, occasional difficulty concentrating, and brooding. The present findings are consistent with the hypothesis that MDMA produces a different psychological profile than classic hallucinogens or psychostimulants.

Int J Psychiatr Clin Pract, 2007

Background. Recent preclinical research suggests that lithium, clozapine, and possibly even antid... more Background. Recent preclinical research suggests that lithium, clozapine, and possibly even antidepressants, have neurotrophic and neuroprotective properties. However, it remains unclear whether their long-term use can prevent the development of dementia or attenuate its severity in patients with major mood disorders. Method. Subjects included patients with bipolar disorder (N=220) and major depressive disorder (N=186) admitted between 1959 and 1963 and followed from 1965 to 1985. The presence of dementia was assessed clinically using ICD-9 criteria, and functioning was determined with the Global Assessment Schedule (GAS). Long-term medication with lithium, clozapine and antidepressants was documented. Results. In the total sample, the occurrence of dementia correlated only with age. In a restricted analysis of the 88 patients with dementia, age became non-significant and lithium showed a trend to an inverse correlation with the severity of dementia. In the subgroup of bipolar demented patients, both lithium and clozapine medication were inversely related to the severity of dementia. Conclusions. The results are consistent with an attenuating effect of lithium and possibly clozapine on the development of severe dementia. Limitations. The sample of patients with dementia was small and the results are based on a naturalistic study. Dementia was only assessed once, without the use of cognitive measures.

Data Revues 09249338 002300s2 08001247, Apr 1, 2008

Eur Arch Psychiat Clin Neuros, 2005

■ Abstract Objective To determine the prevalence and clinical characteristics of comorbid obsessi... more ■ Abstract Objective To determine the prevalence and clinical characteristics of comorbid obsessive compulsive disorders and syndromes (OCD/OCS), compared with pure OCD/OCS among adults in the community. Method Data were drawn from the Zurich Study, a longitudinal cohort study of 591 adults in the canton of Zurich. Comorbid OCD/OCS was compared with pure OCD/OCS groups in terms of distress, impairment, family history, suicide behavior and treatment using multivariable logistic regression analyses. Results OCD was significantly comorbid with bipolar I/II and minor bipolar disorders, anxiety states (GAD, repeated panic attacks) and social phobia, whereas there was no clear association between OCD and major depressive disorder or phobias other than social phobia. Results suggest that comorbid OCD/OCS is common among adults in the community, with the majority of those with OCD/OCS having at least one comorbid mood or anxiety disorder with a prevalence of 7.4 % compared to 4.8 % of remaining OCD/OCS. Comorbidity of OCD/OCS and anxiety states was more common among women (85.6 %) and comorbidity with bipolar spectrum was more common among men (69.6 %). Comorbid OCD/OCS was associated with significantly higher levels of treatment seeking, impairment, distress and suicidality compared with pure OCD/OCS. Comorbidity with bipolar disorders significantly increased the risk for alcohol abuse/dependence. Conclusions Comorbidity of OCD/OCS with bipolar disorder and bipolar spectrum disorders is common and very probably explains the association between OCD and depression found in other studies. The early recognition of bipolar/cyclothymic OCD/OCS may help to prevent the abuse of/dependence on alcohol.

Statistical Software Components, Feb 28, 2005

Eur Neuropsychopharmacol, 2001

Statistical Software Components, 2009

Http Dx Doi Org 10 1080 02791072 2002 10399951, Sep 6, 2011

Eur Neuropsychopharmacol, 2000

Psychological Medicine, 2007

Neurology Psychiatry and Brain Research

ABSTRACT

Nordic Journal of Psychiatry

Schizophrenie — Zukunftsperspektiven in Klinik und Forschung, 2010

Die Schizophrenie, ursprünglich (1896) als Dementia praecox beschrieben und 1911 von Eugen Bleule... more Die Schizophrenie, ursprünglich (1896) als Dementia praecox beschrieben und 1911 von Eugen Bleuler als Schizophrenie benannt, ist nach heutigem Kenntnisstand eine seltene Erkrankung, die weniger als 1% der Bevölkerung betrifft. Wir diagnostizieren die Schizophrenie im klinischen Alltag anhand bestimmter operationalisierter Kriterien. Die Diagnose soll nicht nur Auskunft über Art und Verlauf der Erkrankung geben, sondern auch handlungsleitend für die Therapie sein. Aus klinischer Sicht stellt sich deshalb bei jedem einzelnen Patienten die Frage, ob es sich um einen „Fall“ handelt oder nicht.