Alex Gamma
University of Zurich, Switzerland, Research, Department Member
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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... 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.
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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... 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.
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Research Interests: Cognitive Science, Bipolar Disorder, Family, Obsessive-Compulsive Disorder, Comorbidity, and 23 moreFamily history, Logistic Regression, Anxiety, Prospective studies, Humans, Major Depressive Disorder, Female, Male, Obsessive Compulsive Disorder, Cohort Study, Clinical Sciences, Prevalence, Social phobia, Spectrum, Questionnaires, Adult, Alcohol Abuse, ANXIETY, Anxiety Disorder, Cross Sectional Studies, Neurosciences, Substance-Related Disorders, and Psychiatric Status Rating Scales(Family history, Logistic Regression, Anxiety, Prospective studies, Humans, Major Depressive Disorder, Female, Male, Obsessive Compulsive Disorder, Cohort Study, Clinical Sciences, Prevalence, Social phobia, Spectrum, Questionnaires, Adult, Alcohol Abuse, ANXIETY, Anxiety Disorder, Cross Sectional Studies, Neurosciences, Substance-Related Disorders, and Psychiatric Status Rating Scales)
(Family history, Logistic Regression, Anxiety, Prospective studies, Humans, Major Depressive Disorder, Female, Male, Obsessive Compulsive Disorder, Cohort Study, Clinical Sciences, Prevalence, Social phobia, Spectrum, Questionnaires, Adult, Alcohol Abuse, ANXIETY, Anxiety Disorder, Cross Sectional Studies, Neurosciences, Substance-Related Disorders, and Psychiatric Status Rating Scales)
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ABSTRACT
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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... 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.
Abstract 1. Responds to comments by HJ Gijsman et al (see record 1999-11359-015) regarding the risks of long-term methylenedioxymethamphetamine (MDMA, or" Ecstasy")-produced serotonin reductions and the ethics of using... more
Abstract 1. Responds to comments by HJ Gijsman et al (see record 1999-11359-015) regarding the risks of long-term methylenedioxymethamphetamine (MDMA, or" Ecstasy")-produced serotonin reductions and the ethics of using single doses with healthy ...
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Obesity has become a major health problem with increasing prevalence. Given the limited availability of effective treatment of weight problems, the identification of potentially modifiable risk factors may lead to preventive approaches to... more
Obesity has become a major health problem with increasing prevalence. Given the limited availability of effective treatment of weight problems, the identification of potentially modifiable risk factors may lead to preventive approaches to obesity. The objective of this study was to test the hypothesis that short sleep duration is associated with obesity and weight gain during young adulthood. Prospective single-age cohort study of young adults. Information was derived from 4 interviews when participants were ages 27, 29, 34, and 40 years. Community setting. 496 young adults. Trained health professionals administered a semistructured interview for psychiatric and medical conditions and health habits. This study showed an association between short sleep duration and obesity (at age 27 years, odds ratio: 7.4, 95% confidence interval: 1.3-43.1) and a negative association between sleep duration and body mass index in young adults. These associations persisted after controlling for a vari...
Research Interests: Obesity, Biological Sciences, Prospective studies, Humans, Female, and 16 moreSleep disorders, Male, Duration, Young Adult, Sleep, Vigilance, Body Mass Index, Risk factors, Risk Factor, Adult, Time Factors, Risk Factors, Long Term, Cross Sectional Studies, Cohort Studies, and Severity of Illness Index
We assessed demographics, diagnoses, course, severity, impact and treatment of primary headache outpatients from records in the Headache and Pain Clinic, Neurological Department, Zürich University Hospital. All outpatients seen from 1996... more
We assessed demographics, diagnoses, course, severity, impact and treatment of primary headache outpatients from records in the Headache and Pain Clinic, Neurological Department, Zürich University Hospital. All outpatients seen from 1996 to 1998 for migraine, tension-type headache, and both, were included. Diagnoses, drug, physical and alternative treatments before and after referral were listed. Descriptive statistics were used for differences between the general population and this sample, the diagnoses, and treatments. The coexistence of migraine and tension-type headache, and the high frequencies of headache days would have excluded most migraine patients from typical drug trials: at best, only one third were eligible. The socioeconomic impact of combined and difficult syndromes calls for comprehensive management beyond simple treatment with instant relief drugs. The diagnostic and therapeutic practices of referring physicians exposed a deficit of information on headache, and a ...
Research Interests: Adolescent, Comorbidity, High Frequency, Humans, Child, and 18 moreComplementary Therapies, Switzerland, The, Differential Diagnosis, Aged, Middle Aged, Questionnaires, Adult, Sex Factors, Retrospective Studies, Age Factors, Tension-Type Headache, General Population, Analgesics, Age of Onset, Marital Status, Clinical Trials as Topic, and Child preschool
The study measured the accuracy of the Italian version of the Hypomania Checklist (HCL-32) for self-assessment as a screening instrument for bipolar disorder (BPD) in a psychiatric setting and compared results with a previous study,... more
The study measured the accuracy of the Italian version of the Hypomania Checklist (HCL-32) for self-assessment as a screening instrument for bipolar disorder (BPD) in a psychiatric setting and compared results with a previous study, carried out in a comparable sample and in the same setting, using the Mood Disorder Questionnaire (MDQ). 123 consecutive subjects attending a psychiatric division were screened for BPD using the Italian translation of the HCL-32, and diagnostically interviewed with the SCID by physicians. The sample of the previous study using the MDQ consisted of 154 subjects. On the basis of the SCID: 26 received a diagnosis of bipolar/schizoaffective disorder, 57 were diagnosed as having at least another psychiatric disorder in Axis-I, whilst 40 were unaffected by any type of psychiatric disorder. Comparing the bipolar with all other patients the HCL-32 showed a good accuracy: cut-off 8: sensitivity 0.92-specificity 0.48; cut-off 10: sensitivity 0.88-specificity 0.54;...
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Research Interests: Epidemiology, Depression, Public Health, Comorbidity, Biological Sciences, and 18 moreProspective studies, Humans, Major Depressive Disorder, Chronic Disease, Female, Male, Young Adult, Sleep, Follow-up studies, Incidence, Periodicity, Prevalence, Adult, Time Factors, Disease Progression, Cross Sectional Studies, Cohort Studies, and Severity of Illness Index
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... more
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. Exploratory and confirmatory factor analyses were used to examine the transregional stability of the measurement properties of the HCL-32 R1, including the influence of sex and age as covariates. Across cultures, a two-factor structure was confirmed: the first factor (F1) reflected the more positive aspects of hypomania (being more active, elated, self-confident, and cogni-tively enhanced); the second factor (F2) reflected the more negative aspects (being irritable, impulsive, careless, more substance use). The measurement properties of the HCL-32 R1 were largely invariant across cultures. Only few items showed transcul...
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... Event-related brain potentials in boys at risk for alcoholism. Science 225, 14931496. ... (1994) came to the conclusion that positive P3 findings in FHP individuals were most consistently found in studies using difficult visual ERP... more
... Event-related brain potentials in boys at risk for alcoholism. Science 225, 14931496. ... (1994) came to the conclusion that positive P3 findings in FHP individuals were most consistently found in studies using difficult visual ERP tasks. ...
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Introd Bipolar Recurrent brief depression as an indicator of severe mood disorders Jules Angst,Alex Gamma, Valadeta Ajdacic, Dominique Eich, Lukas ... By weighting the two strata, it is possible to extrapolate to a representative group of... more
Introd Bipolar Recurrent brief depression as an indicator of severe mood disorders Jules Angst,Alex Gamma, Valadeta Ajdacic, Dominique Eich, Lukas ... By weighting the two strata, it is possible to extrapolate to a representative group of 2599 persons of the general population of ...
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Research Interests: Algorithms, General Practice, Psychometrics, Adolescent, Humans, and 21 moreMajor Depressive Disorder, Female, Personality Disorder, Male, Depressive Disorder, Differential Diagnosis, Risk factors, Recurrence, General Health, Aged, Middle Aged, Adult, Disease Progression, Risk Factors, Suicide Attempt, Attempted Suicide, Affective Disorder, Drug treatment, False Negative, Diagnostic Criteria, and Randomized Controlled Trials as Topic(Major Depressive Disorder, Female, Personality Disorder, Male, Depressive Disorder, Differential Diagnosis, Risk factors, Recurrence, General Health, Aged, Middle Aged, Adult, Disease Progression, Risk Factors, Suicide Attempt, Attempted Suicide, Affective Disorder, Drug treatment, False Negative, Diagnostic Criteria, and Randomized Controlled Trials as Topic)
(Major Depressive Disorder, Female, Personality Disorder, Male, Depressive Disorder, Differential Diagnosis, Risk factors, Recurrence, General Health, Aged, Middle Aged, Adult, Disease Progression, Risk Factors, Suicide Attempt, Attempted Suicide, Affective Disorder, Drug treatment, False Negative, Diagnostic Criteria, and Randomized Controlled Trials as Topic)
Research Interests: Education, Nutrition, Depression, Metabolism, Obesity, and 18 moreChild Development, Asthma, Humans, Female, Male, Young Adult, Switzerland, Pediatric, Body Mass Index, Adult, Cross Section, Critical Period, Fat, Body Weight, Depressive Symptoms, Weight Gain, Confidence Interval, and Factorization Method
Research Interests: Epidemiology, Schizophrenia, Bipolar Disorder, Humans, Substance Abuse, and 16 moreFemale, Male, Obsessive Compulsive Disorder, Young Adult, Mental Disorders, Common Mental Disorders, Risk factors, Middle Aged, Adult, Retrospective Studies, Psychotic Disorders, Risk Factors, Logistic Models, Area Under Curve, Cohort Studies, and Psychiatric Status Rating Scales
Background: Bipolar disorders (BP) are frequently diagnosed and treated as pure depression initially; accurate diagnosis often being delayed by 8 to 10 years. In prospective studies, the presence of hypomanic symptoms in adolescence is... more
Background: Bipolar disorders (BP) are frequently diagnosed and treated as pure depression initially; accurate diagnosis often being delayed by 8 to 10 years. In prospective studies, the presence of hypomanic symptoms in adolescence is strongly predictive of later bipolar disorders. As such, an instrument for self-assessment of hypomanic symptoms might increase the detection of suspected and of manifest, but under-treated, cases of bipolar disorders. Methods: The multi-lingual hypomania checklist (HCL-32) has been developed and is being tested internationally. This preliminary paper reports the performance of the scale in distinguishing individuals with BP (N=266) from those with major depressive disorder (MDD; N=160). The samples were adult psychiatry patients recruited in Italy (N=186) and Sweden (N=240). Results: The samples reported similar clinical profiles and the structure for the HCL-32 demonstrated two main factors identified as bactive/elatedQ hypomania and brisk-taking/ir...
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To investigate continuity and change of self-reported physical and psychological complaints in young adults over a period of 20 years. The Zurich Study--a long-term panel survey in psychiatric epidemiology--is based on a stratified sample... more
To investigate continuity and change of self-reported physical and psychological complaints in young adults over a period of 20 years. The Zurich Study--a long-term panel survey in psychiatric epidemiology--is based on a stratified sample of 591 subjects born in 1958 (women) and 1959 (men). The sample strata combine SCL-90-R high-scorers and low-scorers in a 2:1 ratio. Up to now, the Zurich Study has included six interviews between 1979 and 1999, i.e. 20 years of life in young adults. We analysed the longitudinal frequency data of a variety of physical and psychological complaints, as well as information about subjective suffering and use of professional help. The analyses utilised on the McNemar's test, the Q-test and Markov chain models. Sleep disorders, depression, menstruation, backache, headache, stomach and bowel complaints yielded cumulative prevalence rates of 80% or higher. Physical and psychological complaints systematically differ with respect to the change patterns between 1979 and 1999. Moreover, strong differences were found in view of subjective suffering and use of professional help. Even though many self-reported physical and psychological complaints are very common in young adulthood, the underlying dynamics and the implications largely differ. It seems to be crucial whether respondents use somatic glasses or psychological lenses.
Research Interests: Psychology, Cognitive Science, Epidemiology, Mental Health, Young Adulthood, and 22 moreTreatment, Public Health, Markov-chain model, Humans, Female, Male, Young Adult, Social Environment, Incidence, Health Status, Self Evaluation, Clinical Sciences, Prevalence, Middle Aged, Questionnaires, Longitudinal Studies, Adult, Longitudinal Study, Study design, Sleep Disorder, Subjective Experience, and Cumulant(Treatment, Public Health, Markov-chain model, Humans, Female, Male, Young Adult, Social Environment, Incidence, Health Status, Self Evaluation, Clinical Sciences, Prevalence, Middle Aged, Questionnaires, Longitudinal Studies, Adult, Longitudinal Study, Study design, Sleep Disorder, Subjective Experience, and Cumulant)
(Treatment, Public Health, Markov-chain model, Humans, Female, Male, Young Adult, Social Environment, Incidence, Health Status, Self Evaluation, Clinical Sciences, Prevalence, Middle Aged, Questionnaires, Longitudinal Studies, Adult, Longitudinal Study, Study design, Sleep Disorder, Subjective Experience, and Cumulant)
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Research Interests: Epidemiology, Community-Based Mental Health Services, Schizophrenia, Treatment Outcome, Public Health, and 11 moreProspective studies, Humans, Female, Male, Adult, Psychotic Disorders, Life Span, Community Based Mental Health Services, General Population, Cohort Studies, and Severity of Illness Index
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Research Interests: Psychology, Depression, Obesity, Eating Disorders, Psychopathology, and 17 morePsychological Medicine, Prospective studies, Humans, Aggression, Psychological, Female, Male, Depressive Disorder, Incidence, Body Mass Index, Risk factors, Adult, Public health systems and services research, Risk Factors, Neurosciences, Prospective Study, and Cohort Studies
This study questions the 6-month duration criterion for generalized anxiety disorder (GAD) used in DSM-III-R and DSM-IV. In adults from age 20/21 to 40/41 in the prospective Zurich Cohort Study, four groups of generalized anxiety... more
This study questions the 6-month duration criterion for generalized anxiety disorder (GAD) used in DSM-III-R and DSM-IV. In adults from age 20/21 to 40/41 in the prospective Zurich Cohort Study, four groups of generalized anxiety syndromes defined by varying duration (2 weeks, 1 month, 3 months and 6 months) were compared. Applying DSM-III (1979-1999) and DSM-III-R (1986-1999) criteria, there were no significant differences between the four groups in terms of family history of anxiety, work impairment, distress, treatment rates or co-morbidity with major depressive episodes (MDEs), bipolar disorder or suicide attempts. Only social impairment related to the length of episodes. The 6-month criterion of DSM-III-R and DSM-IV GAD would preclude this diagnosis in about half of the subjects treated for generalized anxiety syndromes. In this epidemiological sample, the 6-month duration criterion for GAD could not be confirmed as clinically meaningful. GAD syndromes of varying duration form a continuum with comparable clinical relevance.
Research Interests: Psychology, Demography, Epidemiology, Anxiety Disorders, Public Health, and 14 morePsychological Medicine, Humans, Age, Psychological, Female, Male, Prevalence, Adult, Public health systems and services research, Time Factors, Reproducibility of Results, Neurosciences, Cohort Studies, and Severity of Illness Index
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Research Interests: Engineering, Physics, Chemistry, Psychometrics, Altered States of Consciousness, and 19 moreBiology, Consciousness, Medicine, Multidisciplinary, Humans, Female, Confirmatory factor analysis, Male, Ketamine, Cluster Analysis, Psychometric Properties, Structural Equation Model, Experimental Study, PLoS one, Rating Scale, Questionnaires, Theoretical Models, Adult, and Reproducibility of Results(Biology, Consciousness, Medicine, Multidisciplinary, Humans, Female, Confirmatory factor analysis, Male, Ketamine, Cluster Analysis, Psychometric Properties, Structural Equation Model, Experimental Study, PLoS one, Rating Scale, Questionnaires, Theoretical Models, Adult, and Reproducibility of Results)
(Biology, Consciousness, Medicine, Multidisciplinary, Humans, Female, Confirmatory factor analysis, Male, Ketamine, Cluster Analysis, Psychometric Properties, Structural Equation Model, Experimental Study, PLoS one, Rating Scale, Questionnaires, Theoretical Models, Adult, and Reproducibility of Results)