Background There is a high prevalence of depression in patients with rheumatic disorders. Especially, in rheumatoid arthritis, it is one of the most prevalent co-morbidities with 16% to 38%. Vitamin D (VD) deficiency is one of the known risk factors for depressive disorders. On the other hand, a VD deficiency has often been detected in rheumatic diseases. A possible correlation between these two co-morbidities has not been investigated so far in patients with early arthritis (EA). Objectives The aim of this study was to examine the association between VD deficiency and depression and/or anxiety disorders in patients who have presented themselves for the first time in the EA clinic. Methods Patients with a suspected EA (at least one swollen joint without previous trauma or joint infection with a symptom duration of 6 weeks to 12 months) received a screening date within five work days. The VD status (25-hydroxy-VD3) was obtained during the first EA clinic consultation. In addition, each patient completed questionnaires on the disease history, as well as evaluated self-assessment questionnaires including the health assessment questionnaire (HAQ) and the Hospital Anxiety and Depression Scale (HADS). The hereby-obtained results of disease activity, VD-status and HADS-scores were investigated. In the observation period from June 2012 to March 2015, 75 patients fulfilled the inclusion criteria of completed results and questionnaires as well as a disease duration of less than 12 months. Results The mean age of this EA cohort was 51.7±16.9 years (♀ 65.3%, mean disease duration: 4.0±3.0 months). The prevalence of VD deficiency (<75 nmol/l) was 73.3%. 48.0% of EA patients showed a positive global distress score (≥13). The mean HADS global distress score in VD sufficient patients was 10.2±8.6 vs 13.3±6.9 in deficient patients. The observed difference was not statistically significant. There was neither an association between gender, age and VD status nor was there any difference in the laboratory parameters (e.g. C-reactive protein, rheumatic factor, anti citrullinated peptide, hemoglobine) or assessment of functional status (e.g. HAQ, disease activity score by 28 joints). Conclusions The prevalence of VD deficiency is higher in EA patients with 73% than in the general German population (vs. 60%). The prevalence of positive distress with 50% is also higher. Interestingly, no association of deficient VD levels and positive distress in the HADS was detected in our examined EA cohort. This might be explained by the early stage of disease, but further studies are necessary to evaluate this new insight. References Dougados, M., et al., Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis, 2014. 73(1): p. 62–8. Linseisen J, Bechthold A, Bischoff-Ferrari HA et al. Vitamin D und Prävention ausgewählter chronischer Krankheiten – Stellungnahme. In: V. DGfEe, ed. Bonn 2011. Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, Saag KG, et al. Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women9s Health Study. Arthritis Rheum. 2004;50(1):72–7. Disclosure of Interest None declared

Background The depression is with an average of 16% to 38% one of the most prevalent co-morbidities in rheumatoid arthritis (RA) as well as heart diseases or diabetes mellitus. Few studies investigate the clinical relevance of psychiatric disorders in an early disease stage of the RA and as if they may affect future outcomes in chronicity process. Objectives The aim was to evaluate the prevalence rates of depression and anxiety in an early arthritis (EA) cohort and the distribution across diagnosis groups and gender. Furthermore, we wanted to investigate whether certain disease parameters of an EA show differences between patients (pts) with normal scores versus (vs) pts with high scores in depression and anxiety to construe strategies for everyday practice by gathering such diseases at an early stage. Methods In a prospective cross-sectional survey, 176 pts with EA answered the Hospital Anxiety and Depression Scale (HADS). The suspicion of an EA was defined by at least one fluid joint and a disease duration from six weeks to maximum 12 months. We compared the standardized clinical routine assessment with disease activity score 28 (and clinical investigation of 68 joints), visual analogue scale (VAS) for pain and disability according the health assessment questionnaire (HAQ) with results of HADS in different diagnostic groups. Results The mean age of EA cohort was 50.4±16.1 years (♀ 69.3%, mean disease duration: 4.2±3.4 months). Pts assigned to the following groups: “Rheumatic diseases” (RD, n=108) with subgroups “Rheumatoid Arthritis” (RA, n=55) and “Non-rheumatoid arthritis” (NRA, n=53) and “Non-rheumatic diseases” (NRD, n=68). We found a positive global distress in 47.7% of EA pts. The score in RD group was 50.9% vs 42.6% in NRD group. In RA pts it was 49.1% vs 52.8% in NRA pts. The HADS average was as similar in all groups and if compared to gender. We found out that a positive distress score accompanied with significantly higher means of the tender joint count-68 (TJC, p=0.032), the VAS for pain (p<0.000) and HAQ (p<0.000). RA pts with positive distress score showed higher rates in HAQ (p=0.004) and pain-VAS (p=0.001). NRD pts with positive distress scores had also significant higher means of pain-VAS (p=0.033). Only the NRA group didn9t show statistically significant differences. Conclusions There is an extremely high point prevalence, with almost 50%, of anxiety and depression for EA pts. If EA pts had positive HADS, three established standardized EA measurement instruments (HAQ, VAS for pain, TJC68) showed significantly higher average as if they had negative scores. To improve the treat-to-target concepts in clinical practice with a particular focus on comorbidities, further studies are required. The importance of early psychiatric-psychological interventions in the early stages of RA disease is unclear. References Dougados, M., et al., Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis, 2014. 73(1): p. 62–8 Matcham, F., et al., The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford), 2013. 52(12): p. 2136–48. Disclosure of Interest None declared

Unsere ursprüngliche Quelle infraroter (IR) Strahlung ist die Sonne. Im Laufe seiner Geschichte legte sich der Mensch eigene thermische Strahler zu, Feuer, erhitzte Steine, Ofen, Sauna, IR-Therapiegeräte, wie auch preisgünstige IR-Bestrahlungskabinen für den Hausgebrauch. Die Erhöhung der Haut- bzw. Körpertemperatur ist ein sehr altes und ungemein erfolgreiches prophylaktisches und therapeutisches Prinzip. Der technische Fortschritt eröffnete neue Anwendungsgebiete – von Fitness und Wellness bis zur Behandlung von Krebs, Vergiftungen und Erkrankungen des Bewegungsapparats. Der Spektralbereich infraroter Strahlung umfasst Wellenlängen elektromagnetischer Strahlung zwischen 780 nm und 1 mm. Unterteilt wird in die Teilbereiche IR-A (0,78 – 1,40 μm), IR-B (1,40 – 3,00 μm) und IR-C (3,00 μm – 1 mm). Nach dem Planck’schen Gesetz ändert sich die Quantenenergie der Photonen von 1,59 eV bei der Wellenlänge 0,78 μm bis 0,12 eV bei 1,0 mm, sowie 0,89 eV bei der Wellenlänge 1,4 μm, die die Teilbereiche IR-A und IR-B teilt. Diskutiert werden Wellenlängenabhängigkeiten von Absorption und Streuung, Eindringtiefe und Wärmetransport und -verteilung, Besonderheiten des wassergefilterten Infrarot-A (wIRA) und eine Klassifikation der Ganzkörperhyperthermie mit wIRA.

Our aboriginal source of infrared (IR) radiation is the sun. In the course of history, mankind got its own thermic radiators like fire, heated stones, ovens, sauna, therapeutic IR equipment, and inexpensive IR boxes for domestic use. Rising the temperature of skin or body is a very old and efficient prophylactic and therapeutic principle. Technological progress discloses new fields of application, from fitness and wellness to the treatment of malignant diseases, poisoning, rheumatic diseases and diseases of the musculoskeletal system.The spectral range of IR covers wavelengths of electromagnetic radiation between 780 nm and 1.0 mm. It is divided into the sub-ranges IR-A (0.78-1.40 mu m), IR-B (1.40-3.00 mu m) and IR-C (3.00 mu m-1.0 mm). Following Planck's law, the quantum energy of photons varies from 1.59eV at the wavelength 0.78 mu m to 0.12 eV at 1.0 mm and 0.89 eV at the wavelength 1.4 mu m, which is dividing the domains IR-A and IR-B. Furthermore, wavelength dependence of absorption and dispersion, depth of penetration, transport and distribution of heat, characteristics of water-filtered IR-A radiation and the classification of whole body-hyperthermia using wIRA are discussed.

Background The prevalence of Vitamin D deficiency in northern countries such as Germany is as high as 60% [1]. Vitamin D deficiency is usually defined as 25(OH)D3 levels lower than 50 nmol/l. Insufficiency already starts at levels under 75 nmol/l, which consequentially leads to still more severe figures considering the population’s supply status [2]. Since Vitamin D is not only essential for calcium hemostasis, but has recently also been detected to play a role in the prevention of autoimmune diseases, carcinogenesis and psychiatric disorders, such as major depression and seasonal affective disorder, a solution for improving the Vitamin D supply is strongly needed. Objectives UV radiation is necessary for 90% of the body’s Vitamin D production and is not sufficiently available in Europe during the winter months [3]. Therefore, it was our aim to examine the effect of an artificial UV stimulation on Vitamin D status and mood of young women. Methods 20 healthy young women, aged 20-30 (Ø 22,95), were exposed to 3 sessions (on day 1, 3 and 5) of UV-B radiation during one week in winter. The irradiation dose was increased from 80 J/m2 on day 1 to 150 J/m2 on day 5 for Fitzpatrick skintype I, and from 100 J/m2 to 187,5 J/m2 for skintypes II and III. All doses applied were below the minimal erythema dose (MED), usually defined as 250 J/m2. Before (day 1) and after (day 7) the radiation week blood samples for 25(OH)D3 and 1,25(OH)2D3 determination were taken, and the subjects were asked to answer the mood questionnaire “Beck Depression Inventory” (BDI). The BDI was also assessed by additional 24 female, healthy controls before and after a week of negligible sun exposure. 4 and 6 weeks later, on day 36 and 50, further blood samples for Vitamin D detection were retained. Results Both Vitamin D metabolites increased considerably after the 3 UV-sessions: 25(OH)D3 rose from its 54,4 nmol/l (SD: 24,1 nmol/l) baseline level to 68,3 nmol/l (SD 18,2 nmol/l) on day 7 (p <0,001), as did 1,25(OH)2D3 from 130,9 pmol/l (SD 35,8 pmol/l) to 157,1 pmol/l (SD 49,8 pmol/l) (p= 0,009). Moreover, we detected still significantly higher 25(OH)D3 levels than at baseline 4 and 6 weeks after UV exposure (p <0,001 and. p= 0,044). Interestingly, the BDI also showed an improvement of more than 35%, from a score of 3,95 (SD 2,14) to 2,55 (SD 2,54) (p= 0,003) and correlated with both, 25(OH)D3 (-0,436; p= 0,005) and 1,25(OH)2D3 (-0,42; p= 0,007). There was no such improvement in the UV-unexposed controls, whose BDI scores did not differ on day 1 and 7. Conclusions 3 suberythemal UV-B stimulations increase Vitamin D levels and also considerably improve the mood of healthy young women. After further studies with an expanded spectrum of subjects, this method presents one possible solution to the difficult Vitamin D supply situation and can also have a preventive impact on the increasing number of mood disorders. Its application would be especially eligible for diseases such as rheumatoid arthritis, where patients suffer from seriously decreased Vitamin D levels and also have a high prevalence for the co-morbidity of depression. References DGE 2011 Holick MF. Vitamin D deficiency. Nengl j med 2007;357:3. Webb AR. Who, what, where and when-influences on cutaneous vitamin D synthesis. Prog Biophys Mol Biol. 2006 Sep;92(1):17-25. Disclosure of Interest None Declared

Background In the European population of northern climes poses the deficiency of vitamin D (vitD) a frequent problem, especially in autumn and winter1,2. On the other hand it is difficult to supply a necessary dose of vitD in a diet1. The substitution in case of deficiency of vitD occurs principally orally3. Objectives The aim of this pilot project was to investigate, if 1) an UV-B-stimulus and 2) a diet rich in vitD have an influence on vitD level in autumn and winter months. Methods 20 healthy female subjects (age: 21-25 years, UV skin types: I - III ) received 3 whole body irradiation with an solar simulated UV-B-stimulus on 3, not successive days, within one week in winter 2011/2012. The dose of the UV-B-stimulus came to 40%, 60% and 75% of the minimal erythema dose (MED) according to UV skin type classification. The level of vitD-metabolites, 25-hydroxy-vitD (25-OH-vitD) and 1.25-Dihydroxy-vitD (1.25-diOH-vitD) were measured on day (d) 1, 8, 36 and 50 (before the irradiation, 3 d, 4 and 6 weeks after the irradiation). A questionnaire including food examples rich of vitD has been enquired on d1. Results The level of both vitD-metabolites increased significantly on d8 (25-OH-vitD - p<0,001 and 1.25-diOH-vitD – p=0,009). On d36 and d50 the level of 25-OH-vitD was also higher than baseline level ( p < 0,001 on d36, p = 0,043 on d50). There was no correlation between a diet rich in vitD and the beginning level of 25-OH-vitD (k=0,17). Conclusions Calculated whole body UV-B-irradiation resulted in a significant and long-lasting increase of the level of vitD. A correlation between a diet rich in vitD and the beginning level of 25-OH-vitD couldn’t be shown. It is necessary to investigate if UV-B-stimulus could be used as an alternative to an oral substitution in case of deficiency of vitD. References Referenzwerte für die Nährstoffzufuhr. Vitamin D. Deutsche Gesellschaft für Ernährung (DGE), 1. Auflage, 4. korrigierter Nachdruck 2012 Webb AR, Engelsen O, Calculated ultraviolet exposure levels for a healthy vitamin D status. Photochem Photobiol, 2006;821:697-703 Chandra P, Wolfenden LL, Ziegler TR et al Treatment of vitamin D deficiency with UV light in patients with malabsorption syndromes: a case series. Photodermatol Photoimmunol Photomed 2007;5:179-185 Disclosure of Interest None Declared

We compared horizontal saccadic eye movements in patients with dementia (n=18), and age-matched patients with major depression (n=18) or healthy controls (n=18). Cognitive functions were evaluated using Mini-Mental-State-Examination (MMSE) and ADAS-cog. Results: Saccadic latency and number of saccadic intrusions were significantly (p< 0.001) higher in patients with dementia relative to healthy controls and depressed patients. There were significant correlations between MMSE total score and latency (r = -0.78, p< 0.01) or number of saccadic intrusions (r = -0.80, p< 0.001) in the demential group. In addition, both saccadic parameters were significantly associated with ADAS-cog total score of patients with dementia, whereas the subscale “orientation” showed the strongest correlation with latency (r = 0.71, p< 0.01) and intrusions (r = 0.74, p< 0.01). There were no significant differences in saccadic eye movements between healthy controls and patients with major depression as a whole, or a subgroup of depressed patients with the worst cognitive performance (n=9). Conclusions: It seems that disturbances in horizontal saccadic eye movements in patients with dementia are related to the degree of cognitive deficits in these patients. On the other hand, the lack of alterations in horizontal saccadic eye movements in depressed patients despite poor cognitive performance indicates different mechanism.

Aims:The aim was to determine the relation between characteristics of [123I]-ADAM binding to serotonin transporters (SERT) in several brain regions to different symptoms in patients diagnosed with major depressive disorder (MDD) and to analyze data for males and females separately. Differences of [123I]-ADAM binding in patients before and after treatment with Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant Citalopram were assessed.Method:12 non medicated patients (5 females and 7 males) diagnosed with MDD were examined by SPECT with specific Serotonin transporter radioligand [123I]-ADAM before and after treatment with SSRI Citalopram. We administered the dose of 10 mg Citalopram per day intravenously at first day, followed by a 6 days period of oral application. After 7 days of treatment patients were examined for second time with SPECT. The relationships between [123I]-ADAM binding and different aspects of major depression represented by HAMD items, assessed twice by Hamilton Depression-Scale (HAMD) once at baseline and second after treatment period, were evaluated.Results:We found significant correlations with significant gender differences between singular sub items of HAMD and indices of [123I]-ADAM binding in midbrain before and after treatment. These findings points to the need of data analysis separately in males and females. No correlations between HAMD total scores at baseline and indices were found.Conclusion:SERT availability for 123-ADAM binding in the midbrain in drug naives as well as in treated patients with major depression disorder seems to be related to intensity of sub items in the HAMD and the outcome of treatment.

Aim:The aim of this study was to investigate the efficacy of blue light emitting diode units in suppression of melatonin secretion and to evaluate whether a single exposure can improve well being in healthy males and females (20/30) and in 15 women with premenstrual syndrome.Methods:All study participants were of morning-type with a regular sleep schedule. On control day 1, the subjects were kept under dim illumination (< 10 lx) from 19:00 to 22:30. On day 2, after 1.5h in dim light, the subjects were exposed for 60 min to blue light (12.15 μM/cm², TurboLite, Germany) following by 30 min dim light. Blood samples were collected every 30 min for melatonin assay. Zerssen's complaints scale was used to assess mental und physical well-being at 19:00 (pre-test) and at 22:30 (post-test) after dim illumination or blue light exposure. In addition a visual analogue scale (VAS) for sleepiness was applied.Results:Overall, blue light improved significantly mental and physical complaints from pre-test to post-test (reduction in sum score of the Zerssen's complaints scale by in average 30%) and reduced sleepiness, as measured by the VAS. There were gender-related differences, as well as differences related to the menstrual phase in females. Blue light reduced but not suppressed the gradual increase of melatonin in plasma with time mostly pronounced in the follicular phase.Conclusion:A single exposition with blue light of low radiant flux density, as applied in our study, seems to be helpful in reducing mental and physical distress.

Introduction: Central serotonergic pathways may play an important role in the etiology of anorexia nervosa (AN). Although platelet monoamine oxidase activity (MAO-B) has been proposed as an index of cerebral serotonin activity, studies in patients with AN are scarce.Methods: Platelet MAO-B activity was determined in 59 acutely underweight AN patients (acAN, aged 14-29 years, BMI=15.2 +/- 1.4), 35 weight-recovered AN patients (recAN, aged 15-29, BMI=20.8 +/- 2.2) and 59 healthy control women (HCW, aged 14-26, BMI=21.6 +/- 2.1). Plasma leptin served as an indicator of malnutrition. Results were compared by ANCOVA controlling for confounding variables.Results: Platelet MAO-B activity in acAN patients (5.2 +/- 1.4 nmol/10(9)plt x 15 min) was similar to HCW (5.5 +/- 1.9) but significantly lower in recAN patients (4.4 +/- 1.5). BMI and leptin showed a significant negative correlation with MAO-B activity in AN patients, but not in HCW.Discussion: Our results highlight the importance of malnutrition for the interpretation of abnormalities in neurotransmitter systems in AN. Whether low MAO-B activity in weight-recovered AN patients indicates a premorbid trait or a secondary change due to recovery remains to be elucidated.

Hintergrund: Serotonin (5HT) hat peripher eine Schlüsselstellung in der Regulation gastrointestinaler Funktionen (Motilität, Sekretion, Sensitivität) und ist an der Genese von Reizdarmsymptomen beteiligt. Beim Reizdarm (RDS) besteht eine hohe Koinzidenz mit Angst und Depression; die Modulation dieser Affekte durch 5HT ist nachgewiesen. Im gesamten Organismus findet sich ein identischer Serotonintransporter (SERT); die Bestimmung von 5HT-Parametern am Thrombozyten gibt Aufschluss über Veränderungen des 5HT-Metabolismus in beiden Bereichen.

Background: In 2002, blue-light-sensitive retinal ganglion cell photoreceptors have been discovered by Berson et al. Blue light seems to be very effective in suppression of melatonin (mel) secretion. The aim of this study was to compare the efficacy of blue light emitting diode units with broad spectrum white light in suppression of mel secretion and well-being in healthy subjects. Methods: Secretion profiles of mel were studied in blood plasma of 30 healthy morning-type subjects (15m/15f) in three consecutive days. The subjects were kept under dim illumination (<10lx) from 19:00 to 22:30 (control day 1). On day 2 and 3, after 1,5h in dim light, the subjects were exposed for 60min (20:30–21:30) to white light (250lx) or blue light (12,15µW/cm2), respectively. Sleepiness and well-being were self-rated before and after each session. Results: In all subjects, 5lx (photopic) or 116lx (scotopic) illuminance of monochromatic blue light was sufficient to suppress mel secretion within 60min. The effect was greater when compared to 250lx white light. There were gender-related differences. Whereas white light was without any effects on sleepiness and well-being, blue light caused in 30% of investigated subjects a significant activation and reduction in sleepiness. Conclusion: Further examination of more subjects seems to be important to characterize different effects of blue and white light, as well as differences between males and females.

Hitzewallungen und Schweißausbrüche zählen zu den häufigsten Symptomen im vegetativ-vasomotorischen Erscheinungsbild des postmenopausalen Hormonmangels. Allerdings leidet eine große Anzahl von Wechseljahrespatientinnen zusätzlich unter psychischen Symptomen wie depressiven Verstimmungen, Antriebslosigkeit oder Nervosität. Methoden: In einer doppelblinden, randomisierten klinischen Studie über 16 Wochen wurde geprüft, ob die Einnahme einer fixen Kombination aus Traubensilberkerze und Johanniskraut signifikant und klinisch relevant wirksamer als Placebo ist. 301 Frauen, die unter klimakterischen Beschwerden mit einer ausgeprägten psychischen Symptomatik litten, wurden entweder mit Placebo oder mit täglich 2u2 Filmtabletten Remifemin® plus und anschließend für die restlichen acht Wochen mit der halben Dosis behandelt. Die klimakterischen Beschwerden wurden anhand der Menopause Rating Scale (MRS), die psychischen Beschwerden anhand der Hamilton Depression Scale 17 (HAMD-17) bewertet. Ergebnisse: Der Mittelwert der Gruppendifferenz des MRS-Gesamtscores fiel um 50 % unter Verum gegenüber 20 % unter Placebo (p < 0,001, Prä-Post-Vergleich). Auch der Prä-Post-Vergleich des HAMD-17-Gesamtscores zeigte eine signifikante (p < 0,001) Gruppendifferenz von 5,5 Punkten (95 %-Konfidenzintervall = 4,6-6,5 Punkte) bzw. 29,1 Prozentpunkten zugunsten der Verummedikation. Schlussfolgerung: Es konnte gezeigt werden, dass die 16-wöchige Einnahme der fixen Kombination von Traubensilberkerze und Johanniskraut hinsichtlich der Reduktion klimakterischer Beschwerden und besonders zur Behandlung von deren psychischer Komponente eine wirksame und gleichzeitig sichere therapeutische Möglichkeit darstellt.

Objective The aim was to determine whether characteristics of [123I]-ADAM binding in the midbrain, frontal lobe and cerebellum are related to different aspects of major depression (expressed by the HAMD items) and to analyse this relationship in samples of males and females separately. Material and Methods 28 nonmedicated patients with major depression (12 females and 16 males) were examined by [123I]-ADAM SPECT. Relationships between indices of [123I]-ADAM binding and different aspects of major depression were analyzed. The effect of confounding factors, as gender and age was examined. Results 1. The mean [123I]-ADAM binding ratios of midbrain-to-cerebellum in males and females were very similar. Counts measured in the midbrain and cerebellum were non-significantly higher in females than in males. Counts measured in the frontal lobe were significantly higher in females The findings were not affected by the age. 2. In the whole group of patients, there was no correlation between HAMD total score and the indices of the [123I]-ADAM binding in the regions of interest. We observed significant correlations between some of the HAMD items and these binding indices. There where gender-related differences in the correlation between ADAM binding and some psychopathological aspects of major depression. Some significant correlations in the whole group of patients were caused by females. This findings point to the need of a careful data analysis, separately for males and females.

Background: Morningness-eveningness, also termed „chronotype“, is an individual characteristic that refers to the time-of-day-dependent preference of sleep and activity. These chronotypes are attributed to differences in the circadian clock. This study examined whether the chronotypes differ in the onset timing of melatonin secretion (mel-on), as well as in the slope up of mel secretion and in platelet 5HT concentration. Methods: Secretion profiles of mel were studied in blood samples of 50 entrained, healthy subjects (20 males/30 females, aged 18–35 years) with a regular sleep schedule. The subjects underwent a constant routine with dim light (<10 lux) between 19:00h and 22:30h. Additionally, mel concentration in the morning at 9:00h and platelet 5HT content were analysed. Results: Based on the original criteria of the Horne and Ostberg Morningness/Eveningness Questionnaire, the sample included 8 evening (E) types, 27 nether types and 15 morning (M) types. The individual time intervals between the dim light onset (19:00h) and mel-on were very variable, being very short in M-types (30min) and very long in E-types (>180min). Moreover, M-type and E-type subjects were significantly different in the slope up of mel concentration, as well as in their platelet-5HT concentration. Conclusion: The phenotype variability of morningness/eveningness in healthy subjects seems to be associated with a predisposition to very early or very late initiation of mel production and secretion.

Hintergrund: Patienten (Pat.) mit symptomatischer Fruktosemalabsorption (FM) imponieren klinisch oft ähnlich einem Diarrhöe-prädominantem Reizdarmsyndrom (RDS). Frühere Untersuchungen zeigten bei Pat. mit FM erniedrigte Konzentrationen von Tryptophan (Trpt) im Blut. Trpt ist als direkte Vorstufe essentiell für die Synthese von Serotonin (5HT). 5HT hat eine Schlüsselstellung in der Regulation verschiedener GI-Funktionen, wie Motilität, Sekretion und Sensitivität. Es gibt zahlreiche Hinweise darauf, dass Störungen des 5HT-Metabolismus an der Genese funktioneller GI-Erkrankungen beteiligt sind. Da der 5HT-Transporter (SERT) in allen Regionen des Körpers identisch ist, dienen Untersuchungen an Thrombozyten (Thr.) seit langem als Modellobjekt zur Identifizierung genereller Veränderungen des 5HT-Stoffwechsels.

In 2003/2004 wurde eine randomisierte, plazebokontrollierte Doppelblindstudie mit 301 Frauen im Alter von 45–60 Jahren (mittleres Alter=52,1 Jahre) mit entsprechendem Beschwerdebild in Berlin durchgeführt. Das untersuchte Präparat enthält einen isopropanolischen Extrakt aus Cimicifuga racemosa (iCR) sowie einen ethanolischen Extrakt aus Hypericum perforatum. In den ersten 8 Wochen nahmen die Patientinnen täglich 2u2 Tabletten, dann für weitere 8 Wochen 2u1 Tablette ein. Ziel/Untersuchungsparameter waren primär die Menopause Rating Scale (MRS I) und sekundär die Hamilton-Depressionsskala-17 (HAMD-17).

We studied the midbrain SERT availability in patients with major depression and assessed the relation of SERT occupancy by citalopram to the treatment response. 21 non-medicated patients with major depression and 13 healthy controls were examined by [123I]-ADAM SPECT. The midbrain SERT availability (SERT V3″) was calculated using individual MRI scans. In 13/21 patients SPECT was repeated 7 days after oral medication with citalopram (10 mg/day). We found no significant difference in the mean midbrain SERT availability between the studied patients with major depression and healthy controls (0.86 ± 0.27 vs. 0.71 ± 0.44, p = 0.069). The mean SERT occupancy accounted to 61%. The degree of SERT blockade by citalopram did not correlate with the reduction in HAMD total score. Treatment with low-dosed citalopram caused individually variable occupancy of the midbrain-SERT and a rapid clinical improvement in 54% of the investigated patients.