Die Bedeutung des Immunsystems in der Pathophysiologie von bipolaren Erkrankungen und Epilepsie ist ein aktueller Gegenstand der neuropsychoimmunologischen Forschung. Eine erhöhte Produktion von Zytokinen aufgrund von oxidativem Stress wurde dabei wiederholt als für die Pathophysiologie von Epilepsie und Bipolarer Störung relevant angesehen. In Hinblick auf Veränderungen der Zytokine Interleukin (IL)-1ß, IL-2, IL-4, IL-6 und Tumornekrosefaktor-alpha (TNF-α) wurden z. T. überlappende Ergebnisse bei beiden Erkrankungen beschrieben. Inwiefern diese Zytokine durch Stimmungsstabilisierer und Antiepileptika beeinflusst werden, wurde bisher jedoch nicht systematisch untersucht. In dieser Studie wurden systematisch in-vitro die Konzentrationen von IL-1ß, IL-2, IL-4, IL-6, IL-17, IL-22 und TNF-α im stimulierten Blut 14 gesunder Frauen mittels Vollblutverfahren (whole blood assay) nach Zugabe von Stimmungsstabilisierern bzw. Antiepileptika gemessen. Es wurden dabei die Stimmungsstabilisierer bzw. Antiepileptika Primidon, Carbamazepin, Levetiracetam, Lamotrigin, Valproat, Oxcarbazepin, Topiramat, Phenobarbital und Lithium untersucht. Die Ergebnisse lassen darauf schließen, dass der Mechanismus von erwünschter und unerwünschter anderer Wirkung von Stimmungsstabilisierern und Antiepileptika mit der Regulation von IL-1ß, IL-2, IL-22 und TNF-α in Zusammenhang stehen könnte. Getrennt nach den im Vollblutverfahren verwendeten Stimulanzien – Toxic-Shock-Syndrome-Toxin-1 (TSST-1) vs. monoklonaler Antikörper gegen das CD3-Oberflächenantigen (OKT3) in Kombination mit dem 5C3-Antikörper gegen CD40 (OKT3/CD40) – wurden die Ergebnisse in zwei unterschiedlichen Publikationen berichtet, die dieser Promotion zugrunde liegen.

Mood disorders are serious diseases. Nevertheless, their pathophysiology is not sufficiently clarified. Biological markers that would facilitate the diagnosis or successful prediction of pharmacotherapy are still being sought. The aim of the study was to find out whether mitochondrial functions are affected by antidepressants, mood stabilizers and depression. Our research is based on recent hypotheses of mood disorders, the advanced monoamine hypothesis, the neurotrophic hypothesis, and the mitochondrial dysfunction hypothesis. We assume that impaired function of mitochondria leads to neuronal damage and can be related to the origin of mood disorders. Effects of antidepressants and mood stabilizers on mitochondrial functions can be related to their therapeutic or side effects. In vitro effects of pharmacologically different antidepressants and mood stabilizers on the activities of mitochondrial enzymes were measured in mitochondria isolated from pig brains (in vitro model). Activity of monoamine oxidase (MAO) isoforms was determined radiochemically, activities of other mitochondrial enzymes were measured spectrophotometrically. Overall activity of the system of oxidative phosphorylation was measured electrochemically using high- resolution respirometry. Methods were modified to measure the same...

Psychopharmaca are a large group of drugs widely used not only in psychiatry. Their systemic administration affects both the main diagnosis and the organism as a whole. The subject of our experiments is the effect of psychopharmaca on the changes in mitochondrial functions, which is beneficial for understanding of molecular mechanisms of therapeutic and adverse effects of drugs. The aim of this thesis was to study the in vitro effects of selected drugs on the cell energy metabolism. Selected antipsychotics (chlorpromazine, levomepromazine, haloperidol, risperidone, ziprasidone, zotepine, aripiprazole, clozapine, olanzapine, and quetiapine), antidepressants (bupropion, fluoxetine, amitriptyline, imipramine) and mood stabilizers (lithium, valproate, valpromide, lamotrigine, carbamazepine) were tested. In vitro effects of selected psychopharmaca were measured on isolated pig brain mitochondria. The activities of citrate synthase (CS) and electron transport chain (ETC) complexes (I, II+III, IV) were measured spectrophotometrically. Drug-induced changes of mitochondrial respiration rates linked to complex I (supported by malate and pyruvate) and complex II (supported by succinate) were evaluated by high resolution respirometry. Complex I was significantly inhibited by lithium, carbamazepine, fluoxetine,...

Subjects participating in magnetic resonance imaging (MRI) examinations regularly report anxiety and stress related reactions. This may result in impaired data quality and premature termination of scans. Moreover, cognitive functions and neural substrates can be altered by stress. While prior studies investigated pre–post scan differences in stress reactions only, the present study provides an in-depth analysis of mood changes and hormonal fluctuations during the time course of a typical fMRI session. Thirty-nine subjects participated in the study. Subjective mood, salivary alpha-amylase (sAA) and cortisol were assessed at six time points during the lab visit. Associations between hormonal data and neural correlates of a visual detection task were observed using a region of interest approach applied to the thalamic region. Mood and hormonal levels changed significantly during the experiment. Subjects were most nervous immediately after entering the scanner. SAA was significantly elevated after MRI preparation. A subgroup of n = 5 (12.8%) subjects showed pronounced cortisol responses exceeding 2.5 nmol/l. Preliminary fMRI data revealed an association between sAA levels and left thalamic activity during the first half of the experiment that disappeared during the second half. No significant correlation between cortisol and thalamic activity was observed. Results indicate that an fMRI experiment may elicit subjective and neuroendocrine stress reactions that can influence functional activation patterns.

Hintergrund: Nach der deutschen Wiedervereinigung beschäftigte sich eine Reihe von Studien mit der psychischen Befindlichkeit der Menschen in Ost- und Westdeutschland. Die vorliegende Untersuchung stellt eine Replikation der Studie von Basten et al. [Psychische Beschwerden und körperliche Gesundheit im vereinten Deutschland: Eine Ost-West-Vergleichsuntersuchung an einer studentischen Stichprobe. Verhaltenstherapie 1994;4:90–95] 10 Jahre nach der Originaluntersuchung dar. Diese wurde 1991/1992 durchgeführt und untersuchte Unterschiede in der Depressivität, Angst, Somatisierung sowie im berichteten Essverhalten zwischen Studentinnen in Dresden und Marburg. Probanden und Methode: Von Oktober 2001 bis April 2002 wurden die psychischen Beschwerden und das Essverhalten bei Dresdner und Marburger Studenten untersucht. In die vorliegende Arbeit gingen Daten von 221 Studentinnen ein. Es wurden dieselben standardisierten Erhebungsinstrumente wie in der Originaluntersuchung eingesetzt. Ergebnisse: Im Unterschied zu der Originalstudie konnte keine höhere Depressivität bei der westdeutschen Stichprobe nachgewiesen werden. Stattdessen gaben ostdeutsche Studentinnen signifikant mehr Angstsymptome an als westdeutsche. Daneben gab es Hinweise auf einen stärker ausgeprägten Schlankheitswunsch der Ostdeutschen. Insgesamt wiesen die ostdeutschen Studentinnen in allen Verfahren höhere Mittelwerte auf als 10 Jahre vorher. Diskussion: Die Studie bestätigt vorliegende Ergebnisse, wonach nur geringe Unterschiede in der psychischen Befindlichkeit in Ost- und Westdeutschland bestehen. Allerdings sind in den letzten 10 Jahren Veränderungen geschehen, die aufgrund fehlender Längsschnittstudien nicht eruiert wurden. Die höhere Ausprägung der Angstsymptomatik der ostdeutschen Studentinnen wird als ein Sozialisationsergebnis interpretiert. / Background: After the German unification, several studies have focused on differences in the psychological health of people in East and West Germany. The current study is a replication of the Basten et al. study [Psychological wellbeing and health in a unified Germany: An East-West-comparison of two student samples. Verhaltenstherapie 1994;4:90–95] 10 years after the original research of 1991/1992. It investigated differences in depression, anxiety and bodily symptoms as well as problematic eating behaviour in female university students in Dresden (East Germany) and Marburg (West Germany). Subjects and Methods: From October 2001 to April 2002, we investigated psychological symptoms and eating behaviour in students of the universities of Dresden and Marburg. The current report includes data of 221 female students. We used the same standardized measures as had been used in the original research. Results: In contrast to the original study, students from West Germany did no longer exhibit higher depression scores. Instead, students from East Germany showed significantly increased anxiety symptoms. Furthermore, there was a trend towards a higher drive for thinness in East German students. In all, students from Dresden showed higher mean values in all measures than 10 years before. Discussion: This study corroborates results that there are only minor differences in psychological health between people in East and West Germany. However, our findings point out that during the past decade subtle changes might have occurred which have not been detected through lack of longitudinal investigations. The higher level of anxiety in East German students could be a result of socialisation. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Hot och våld på akutmottagning har visat sig vara ett växande problem världen över. Akutsjuksköterskor arbetar i en arbetsmiljö som inte bedöms vara acceptabel. Syftet var att utforska tillgänglig litteratur gällande hur akutsjuksköterskans vårdarbete påverkas av hot och våld på akutmottagning. Metoden valdes för att besvara studiens syfte var, en systematisk och integrativ litteraturstudie. Datainsamlingen bestod av 17 vetenskapliga artiklar, 11 av dessa var kvalitativa och sex var kvantitativa. Det insamlade materialet kategoriseras enligt två kategorier och sex subkategorier. Kategorierna som valdes var ett vårdmöte som inverkar på hälsa och faktorer som påverkar akutsjuksköterskans vårdarbete. Valda subkategorier var identifiera riskfaktorer vid patientnära arbete, identifiera anledningar till våldsbejakande beteende, utsättas för otillfredsställande bemötande, identifiera stöd från ledning, bristfällig kunskap och utbildning och påverkas av otillräcklig vårdmiljö. Resultatet visade att akutsjuksköterskor drabbas av hot och våld dagligen och samtliga anser att deras hälsa påverkas negativt. Det framkom att få drabbade anmäler händelsen till sjukhusledningen. Samtliga menade att utbildning saknades och efter insatt utbildning upplevdes en förbättring i akutsjuksköterskors konflikthantering vilket ökade välbefinnandet och självförtroendet. Författarna har förhoppningar att den här systematiska och integrativa litteraturstudien används på akutmottagningar i undervisande syfte för att förbättra akutsjuksköterskors arbetsmiljö, mående samt patientens vårdmiljö. Att anmäla hot och våld, förbättrad kommunikation och utbildning i konflikthantering minskar risken för att akutsjuksköterskor utsätts i lika hög utsträckning. / Threats and violence in emergency rooms have proven to be a growing problem world-wide. Emergency nurses work in a work environment that is not considered acceptable. The purpose was to explore available literature regarding how the emergency nurse's care work is affected by threats and violence in the emergency department. The method chosen to answer the study's purpose was a systematic and integrative literature study. The data collection consisted of 17 scientific articles, 11 of which were qualitative and six were quantitative. The collected material is categorized according to two categories and six sub-categories. Categories that were chosen were a care meeting that affects health and factors that affect the emergency nurse's care work. Selected subcategories were identifying risk factors in work close to patients, identifying reasons for violent behavior, being ex-posed to unsatisfactory treatment, identifying support from management, lack of knowledge and education and being affected by an inadequate care environment. The results showed that emergency nurses are affected by threats and violence on a daily basis, all of whom believe that their health is negatively affected. It emerged that few victims reported the incident to the hospital management. All felt that there was a lack of training and after training, there was an improvement in the emergency management of emergency nurses, which increased well-being and self-confidence. The authors hope that this systematic and integrative literature study will be used in emergency rooms for teaching purposes to improve the emergency nurses' work environment, mood and patient care environment. Reporting threats and violence, improved communication and training in conflict management reduces the risk of emergency nurses being exposed to the same extent.

The aims of the studies were to assess body image perceptions, the role of stress and other possible associated psychopathologies within a non-clinical sample. The prevalence of body image concern is increasing and is widely considered as secondary to evolving socio-cultural trends. Negative self-perceptions about body image can be manifest as measurable indicators of physiological stress, or even psychopathology. This thesis describes two quantitative studies into the role and relevance of various causative factors in the development of negative body image in cohorts of volunteers drawn from the general population of the University of Bradford in West Yorkshire, UK. In Study One, subjects (n=360) completed a self-directed questionnaire that psychometrically measured satisfaction/dissatisfaction with personal appearance, queried which external sources influenced those opinions, and correlated these with demographic information. In particular, we sought to examine how a subject¿s opinion about their personal appearance varied with age, gender, ethnicity, mental health, relationship status, sexual orientation and Body Mass Index (BMI). Subjective views regarding personal appearance were determined by answers given to specific body image questions that revealed a subject¿s day-to-day appearance concerns, all preoccupations, and the extent to which these concerns resulted in distress, all social impairment. Overall, the results demonstrated that BMI values were positively correlated with personal appearance concerns. High BMI values correlated with greater dissatisfaction with personal appearance. Self ratings of appearance values were negatively correlated with BMI scores. Subjects who gave themselves high appearance ratings were relatively unaffected by media influence with regard to their image, compared to subjects rating themselves less attractive. These latter subjects also showed higher peer pressure scores in terms of both the amount of time they compared themselves to peers, and the degree to which peer comparisons affected their self-appearance ratings. Based on responses to the body image questions specifically, the entire cohort of subjects were categorised into principal clusters: those largely unaffected by any body image concerns; and those profoundly distressed by their self assessed body image. Perhaps the most interesting aspect of these findings is that the scores for this latter (n=17) group of subjects on the body image questions revealed a degree of personal distress this is almost identical to the scores expected from those people diagnosed with body dysmorphic disorder (BDD). Collectively, these results suggest that high BMI values in subjects negatively impact on self-appearance ratings, render subjects more prone to media messages that portray body image ideals, and elicit frequent comparisons with peers to validate self-image concerns. Furthermore, severely affected subjects with high BMI scores may show similar psychopathology to that of BDD sufferers. In Study Two, a small cohort of subjects (n=60) were given questionnaires and were interviewed to further investigate self-appearance ratings and mood/depressive traits. The body image questions used in Study One to assess image concerns and the magnitude of distress were repeated in Study Two. Mood and depressive state were measured using the validated Beck¿s Depression Inventory (BDI). In parallel, subjects completed the Derriford Appearance Scale 59 (DAS 59), which is a valid psychometric indication of an individual's perception of their appearance as ¿normal¿ or ¿disfigured¿, and used as a tool by plastic surgeons to inform decisions regarding the necessity for surgery to correct an individual's appearance. Physiological markers were recorded before and after exposure of subjects to a physical and a psychological stressor: these were saliva concentrations of cortisol and sIgA (an immune marker), blood glucose and blood pressure. The results of Study Two revealed no changes in scores for any of the physiological measures following stressors. BDI scores for most subjects fell within normal ranges, although females scored higher than males, but not at a pathological level. Those subjects with a history of mental illness or those who reported feeling a high degree of stress on a daily basis, or those who expressed greater self-appearance concerns, all had significantly elevated BDI values. Perhaps the most intriguing finding from Study Two, as in Study One, was that subjects again tended to fall within specific categories for body image concerns: those unaffected or minimally affected by body image concerns, and those (n=6) greatly and deleteriously affected by body image concerns. This subsection of subjects also scored very high on the DAS 59 for disfigurement. On the basis of these findings it would seem that body image concerns may be severe enough for some individuals for them to perceive themselves as actually being disfigured, or that the DAS 59 (a widely used assessment tool in plastic surgery), may not be entirely appropriate for assessment of an individual's need for surgery because it cannot distinguish between those genuinely disfigured and those merely expressing severe body image concerns.

Mémoire de maîtrise présenté en vue de l'obtention de la maîtrise en psychologie (M. Sc) / L'humeur, en tant qu’élément central dans notre perception du monde, englobe diverses émotions et affecte grandement le bien-être mental et physiologique. Une régulation efficace de l'humeur est vitale pour un fonctionnement quotidien normal et tout dérèglement peut mener à des troubles psychologiques majeurs comme la dépression. Au niveau cérébral, le système de récompense, en particulier le cortex préfrontal dorsolatéral gauche (CPFdl) et ses projections dopaminergiques, joue un rôle central dans la régulation de l'humeur et du plaisir. De nombreuses recherches montrent maintenant que l’écoute de la musique influence notre humeur, en agissant sur le système de récompense. En outre, la stimulation magnétique transcrânienne répétitive excitatrice (SMTr) ciblant le CPFdl gauche a donné des résultats prometteurs en modifiant l'humeur et l'activité du système de récompense, ainsi qu'en modulant le plaisir perçu et la motivation pendant l'écoute de la musique en augmentant l'excitabilité et la plasticité corticales. Cependant, les études existantes sur l'impact de la SMTr sur l'humeur des personnes en bonne santé aboutissent à des résultats contradictoires, et l'effet conjoint de la SMTr et de la musique sur l'humeur reste inexploré. Cette étude vise donc à déterminer si la SMTr excitatrice peut augmenter les effets de la musique sur l'humeur chez des volontaires sains. Plus précisément, nous souhaitons valider l'impact de la musique, de la SMTr et de leur application combinée sur l'humeur des participants. Vingt-quatre participants ont suivi quatre sessions expérimentales, comprenant soit la SMTr seule, l’écoute de la musique seule, la SMTr associée à l’écoute de la musique, ou les conditions placebo/sham. L'humeur des participants a été évaluée à l'aide d'un questionnaire sur l'humeur et d'enregistrements de l'activité électrodermale (EDA) avant et après les stimuli. Les résultats ont révélé une amélioration significative de l'humeur générale et de l'humeur positive, ainsi qu'une diminution significative de l'humeur négative au cours de la séance de musique seule, ce qui indique l'efficacité de la musique en tant qu'intervention pour améliorer l'humeur. À l'inverse, la séance de SMTr seule a entraîné une diminution de l'humeur positive et une augmentation de l'humeur négative, ce qui suggère un effet négatif potentiel de la SMTr sur l'humeur. . Dans la session SMTr + musique, on a observé une tendance à l'amélioration de l'humeur, ce que nous interprétons comme le fait que l'application de la SMTr sur le CPFdl gauche a entrainé une baisse de l'humeur, tandis que l'écoute de la musique contrecarrait cet effet en induisant une humeur positive et en réduisant l'humeur négative.En conclusion, les résultats de cette étude soulignent le potentiel de la musique en tant qu'intervention visant à améliorer l'humeur. En outre, les résultats suggèrent que la SMTr excitatrice ciblant le CPFdl gauche peut entraîner une baisse de l'humeur. Il est nécessaire de poursuivre les recherches dans ce domaine, notamment en explorant d'autres combinaisons de stimuli, telles que la SMTr excitatrice sur le CPFdl droit associée à la musique, afin de mieux comprendre les mécanismes sous-jacents et d'optimiser l'utilisation de ces interventions pour la régulation de l'humeur. Ces recherches supplémentaires permettront de mieux comprendre la modulation de l'humeur et d'améliorer l'efficacité des interventions dans ce domaine. / Mood, as a central element in our perception of the world, encompasses a variety of emotions and greatly affects mental and physiological well-being. Effective mood regulation is vital for normal daily functioning, and any disruption can lead to major psychological disorders such as depression. At the cerebral level, the reward system, in particular, the left dorsolateral prefrontal cortex (DLPFC) and its dopaminergic projections, plays a central role in regulating mood and pleasure. A large body of research now shows that listening to music influences our mood, by affecting the reward system. In addition, excitatory repetitive transcranial magnetic stimulation (rTMS) targeting the left DLPFC has shown promising results in altering mood and the reward system activity, as well as modulating perceived pleasure and motivation during music listening by increasing cortical excitability and plasticity. However, existing studies on the impact of rTMS on mood in healthy individuals yield conflicting results, and the joint effect of rTMS and music on mood remains unexplored. This study aims to determine whether excitatory rTMS can enhance the effects of music on mood in healthy volunteers. More specifically, we aim to validate the impact of music, rTMS, and their combined application on participants' mood. Twenty-four participants completed four experimental sessions, comprising either rTMS alone, listening to music alone, rTMS + music, or placebo/sham conditions. Participants' mood was assessed using a mood questionnaire and electrodermal activity (EDA) recordings before and after the stimuli. Results revealed a significant improvement in overall mood and positive mood, as well as a significant decrease in negative mood during the music-only session, indicating the effectiveness of music as a mood-enhancing intervention. Conversely, the rTMS session alone resulted in a decrease in positive mood and an increase in negative mood, suggesting a potential negative effect of rTMS on mood. In rTMS + music session, there was a trend in mood improvement, which we interpret as meaning that applying rTMS to the left DLPFC resulted in a decrease in the mood while listening to music counteracted this effect by inducing positive mood and reducing negative mood. In conclusion, the results of this study underline the potential of music as a mood-enhancing intervention. In addition, the results suggest that excitatory rTMS targeting the left DLPFC may lead to a decrease in mood. Further research in this area is necessary, including exploring alternative combinations of stimuli, such as excitatory rTMS on the right DLPFC in conjunction with music to better understand the underlying mechanisms and optimize the use of these interventions for mood regulation. This additional research will contribute to a more comprehensive understanding of mood modulation and enhance the effectiveness of interventions in this field.

This study investigates the diachronic shift of revised card texts in the tabletop collectible card game ‘Magic: The Gathering’.  The lexicogrammatical patterns found are compared to theories on comprehension and learning, and to the development of the game. To answer how the texts have changed, a sample of twenty cards with old and revised texts has been analysed according to systemic functional linguistics. The metafunctions used for the SFL analysis are interpersonal, ideational and textual. Additionally, a descriptive analysis has been conducted to answer how the changes in the linguistic metafunctions relate to comprehension and development. The analysis shows that there are general patterns within all the investigated metafunctions, which correspond to research on learning, language development and notions on text cohesion. Furthermore, the findings correlate to the game development and functions in the gameplay. While the sample size is limited in comparison to all available cards in the game, the diachronic shifts are distributed over a variety of card types matching the available cards overall, and with the initial interconnections found it is assumed that the patterns are generalisable. Further research could explore the findings in relation to general games development, games as a source of learning or genre and discourses.

Environ 300 millions de personnes dans le monde souffrent de dépression et environ 30% vont développer une dépression réfractaire. Une dépression est réfractaire quand deux traitements antidépresseurs ou plus échouent à améliorer la condition d’un patient. La stimulation magnétique transcrânienne (TMS) est un traitement sécuritaire et efficace de la dépression réfractaire. Son efficacité et sa tolérabilité ont été largement prouvées grâce à des études randomisées, des méta-analyses et des revues de littérature. Toutefois, jusqu’à présent, le traitement de la dépression réfractaire avec la TMS demeure sous-étudié avec des données en pratique clinique réelle. Pour répondre à cette lacune, nous avons conduit une analyse rétrospective des dossiers médicaux de patients dépressifs réfractaires ayant suivi un traitement de TMS à l’Unité de Neuromodulation Psychiatrique (UNP) du Centre Hospitalier de l’Université de Montréal (CHUM) entre janvier 2012 et mai 2022. Nous avons examiné l’efficacité et la tolérabilité de la TMS pour ces patients. De façon secondaire, nous avons vérifié si des caractéristiques cliniques des patients avant leur traitement de TMS pouvaient être associées avec l’amélioration de leurs symptômes dépressifs à la suite du traitement de TMS. Nous avons également vérifié si nos résultats étaient semblables à ceux retrouvés dans la littérature scientifique. Cette étude offrirait aux cliniciens une perspective réaliste de l’efficacité et de la tolérabilité de la TMS à une clinique de troisième ligne. / Around 300 million people worldwide suffer from depression and around 30% will develop treatment-resistant depression (TRD). Depression is treatment-resistant when two or more antidepressant treatments fail to improve a patient’s condition. Transcranial magnetic stimulation (TMS) is a safe and effective treatment for TRD. Its efficacy and tolerability have been widely demonstrated through randomized studies, meta-analyses, and literature reviews. However, to date, the treatment of TRD with TMS remains under-studied with evidence in real-world clinical practice. To address this gap, we conducted a retrospective chart review of TRD patients who had undergone TMS therapy at the Psychiatric Neuromodulation Unit (UNP) of the University of Montreal Hospital Center (CHUM) between January 2012 and May 2022. We examined the efficacy and tolerability of TMS for these patients. As a secondary measure, we examined whether baseline clinical characteristics of patients could be associated with the improvement of their depressive symptoms following TMS treatment. We also examined whether our results were similar to those found in the scientific literature. This study would provide clinicians with a realistic perspective on the efficacy and tolerability of TMS at a third-line clinic.