Validation of the motivational phase of the integrated motivational-volitional model of suicidal behavior in a German high-risk sample.

BACKGROUND: The Integrated Motivational-Volitional (IMV) model of suicidal behavior proposes in its motivational phase that perceptions of defeat and entrapment (total, internal and external entrapment) lead to the development of suicidal ideation and that thwarted belongingness and perceived burdensomeness moderate this process. The aim of this study was to test the motivational phase of the IMV model cross-sectionally in a German sample of psychiatric inpatients. METHODS: A total of 308 psychiatric inpatients (53% female) aged 18 to 81 years (M = 36.92, SD = 14.30) were included in the study and investigated within 14 days after psychiatric admission due to suicide attempt (53%) or acute suicidal crisis (47%). Statistical analyses included a mediation analysis and moderation analyses. RESULTS: Results demonstrate a simple mediation of defeat via entrapment (total, internal and external entrapment) on suicidal ideation. The interaction between thwarted belongingness and perceived burdensomeness was confirmed as a motivational moderator. LIMITATIONS: Limiting factors of the present study are the cross-sectional design and the retrospective assessment of suicidal ideation. CONCLUSION: The main assumptions of the motivational phase of the IMV model could empirically be confirmed. Perceptions of defeat, internal and external entrapment, thwarted belongingness, and perceived burdensomeness should be taken into account with regard to prevention, risk assessment and interventions of suicidal ideation and attempts. However, future investigations based on prospective data are warranted.

The role of childhood abuse for suicidality in the context of the interpersonal theory of suicide: An investigation in German psychiatric inpatients with depression.

BACKGROUND: Several studies provide evidence for a relationship between childhood abuse and suicidality across the lifespan. To examine this association in the context of the Interpersonal Psychological Theory of Suicide (IPTS), we investigated whether its constructs thwarted belongingness, perceived burdensomeness and capability for suicide are potential mediators. METHODS: Eighty-four German psychiatric inpatients with unipolar depression (M = 37.6 years, 69% female) and current or lifetime suicidal ideation were included. For the assessment we used the Childhood Trauma Screener (CTS), the Rasch-based Screening for Depression (DESC-I), the Interpersonal Needs Questionnaire (INQ), the German Capability for Suicide Questionnaire (GCSQ), the Beck Scale for Suicide Ideation (BSS) and the Suicide Behaviors Questionnaire-Revised (SBQ-R). Simple and multiple mediator analyses were applied. RESULTS: Most patients (70%) had experienced childhood abuse. Emotional abuse showed an indirect association with suicidal ideation via thwarted belongingness and perceived burdensomeness, whereas physical and sexual abuse were indirectly related to suicide risk via capability for suicide. LIMITATIONS: The small sample size and the cross-sectional design are limiting factors of the present study. CONCLUSIONS: Childhood abuse is a common experience of inpatients with unipolar depression. This study showed its indirect effects on suicidal ideation and risk for suicide, mediated by the constructs of the IPTS. Further research should investigate this issue in other populations and clinicians should be aware of the devastating effects of childhood abuse.

[Etiology of torsio uteri in cattle: a review]. / Atiologische Aspekte der Torsio uteri beim Rind: Eine Ubersicht.

An overview about various observed phenomena, assumptions, and relations concerning the development of uterine torsion in cattle is presented. Furthermore, contradictory observations and old ideas are relativated and more accurate interpretations are given. It is known that the fetus himself is moving what is considered a reason for a torsion of the uterus. Intrauterine movements of the fetus are physiologic, and therefore other factors for uterine torsions are likely to be involved. A very plausible explanation for the selective occurrence of uterine torsion in cattle seems to be decreased amniotic fluid in relation to the size of fetus and uterus, because other influences can also be observed in all or at least in a high number of other animals. Destabilizing factors concerning the uterus (tonus decreased, uterus outside bursa supraomentalis) increase the possibility of developing a torsio uteri but are not compelling for the torsio uteri.

The effect of rank order on feed intake and growth of fattening pigs.

On the basis of 120 fattening pigs, classified in 6 groups of 20 animals each, the rank order was determined and its influence on the feed intake behaviour as well as on the fattening progress was studied. The results show that with respect to the total length of stay at the trough and to the time per visit to the feeding station the dominant barrows stayed significantly longer at the feeding place than their subordinate pen mates. Additionally, they showed a higher weight at the end of the fattening period and a higher weight gain per day of fattening. As to the frequency of the visits to the feeding station there was no significant difference between high-ranking and low-ranking animals during the period of observation.

Rating of isolated disseminated tumor cells in bone marrow in comparison with other factors of prognosis in breast carcinoma.

BACKGROUND: Despite the use of radical loco-regional therapeutic methods and although conventional methods of diagnosis give no indication of metastases at the time of operation, distant metastases develop in approximately 50 percent of the carcinoma patients within 5 years. While with the R0 resection of solid tumors local relapses are mainly a matter of concern for the operating surgeon, distant metastases can be traced back to systemic dissemination of tumor cells at the time of operation. AIMS: The goal of our prospective six year continuous study is to compare the rating of the IDT BM with established prognosis factors and to reach conclusions for the practice. METHODS: A prospective study is represented in which 197 patients suffering from breast carcinoma were analyzed for prognostic relevance of detected isolated disseminated tumor cells in the bone marrow (IDT BM). The patients were operated between 1993-1997 and subsequently observed until 1999. The monoclonal antibodies CK II and A45-B/B3 were used with the immuno-cytochemical standard method for detecting IDT BM. For the purpose of cell cultivation, the cells were marked with the HEA 125 antibody and separated by means of magnetic cell sorting (MACS). In this investigation, only the presence of isolated disseminated tumor cells detected by the RESULTS: A45-B/B3 antibody proved to be an independent prognostic factor for survival time. The risk of an earlier death increased with the detection of IDT BM at least by a factor of two. The detection of IDT BM also represented an independent prognostic factor for the time until advancement of the tumor. The risk of an earlier relapse of the tumor increased with the detection of disseminated tumor cells in the bone marrow containing the A45-B/B3 antibody by at least a factor of four. CONCLUSION: A generally acknowledged standardization of the method is desirable. Due to the importance of the independent prognostic IDT BM factor, this method of ascertaining the pathological stage should be established at institutions of higher learning.

Detection of cytokeratin-positive cells in bone marrow in breast cancer and colorectal carcinoma in comparison with other factors of prognosis.

A prospective study is presented in which 293 patients suffering from breast cancer and colorectal carcinoma were analyzed for prognostic relevance of detected isolated disseminated tumor cells in bone marrow (IDTBM). The patients underwent surgery in the period from 1995 to 1997 and remained under observation until 1999. The monoclonal antibody A 45-B/B3 was used in the standard immuno-cytochemical method for detecting IDTBM, which represented an independent prognostic factor for survival time in patients with breast cancer or colorectal cancer. In breast cancer, when IDTBM were detected, the survival period was reduced by at least half. When disseminated tumor cells containing the A45-B/B3 antibody were detected in bone marrow, the risk of an earlier relapse of the tumor increased at least fourfold. In colorectal cancer, detection of IDTBM reduced survival time by a factor of 1.2-4.3. The risk of earlier relapse increased when disseminated tumor cells containing the A45-B/B3 antibody were detected in bone marrow by 2.8-8.1. Therefore, the use of IDTBM as an independent prognostic factor would provide an important method for determining the pathological stage of various cancers. Standardization of this technique into a generally accepted method would be especially desirable in treatment of patients with breast or colorectal cancer.

[Immunocytochemical detection of cytokeratin positive cells in human bone marrow of gastric and colorectal cancer patients]. / Cytokeratinpositive Zellen im Knochenmark bei Patienten mit gastralen und colorectalen Carcinomen: Korrelation mit konventionellen Prognosekriterien und dem klinischen Verlauf.

We looked for disseminated tumour cells postoperatively in the bone marrow of 22 patients with gastric cancer and of 26 patients with colorectal cancer. On an average the follow-up was 6.5 months in the gastric cancer group and 9 months in the colorectal cancer group. In 27% of the gastric cancer group and in 30% of the colorectal cancer group follow-up aspirates were obtained. Micrometastases were detected in 96% of colorectal cancer patients and in 77% of gastric cancer patients. Both, postoperative and follow-up aspirations showed clear differences in the number of ck+ cells between the iliac crest sides. The majority of cells formed clusters from 2 to about 200 cells. In both groups no significant correlation was found between the number of tumour cells detected and the established risk factors (stage, tumour extension, lymph node involvement, distant metastasis) or the disease-free survival. In the gastric cancer group higher numbers of ck+ cells were seen in the low tumor stages I and II, as compared to stage III and IV. Besides, in this group significantly more ck+ cells were detected in younger patients (age under 63,5) than in the older group over 63,5 years. Colorectal cancer patients did not show this correlation. In follow-up aspirations the number of ck+ cells of the colorectal and also the gastric cancer group showed a tendency of rise in relapse and of fall in disease-free survival. There was a tendency of higher rates of ck+ cells in the colorectal cancer group when compared to gastric cancer patients.