[The introduction of antipsychotics in the neurological psychiatric hospital of the University of Leipzig and their effects on other forms of therapy, the length of stay and transferrals]. / Die Einführung der Antipsychotika an der Neurologisch-Psychiatrischen Klinik der Universität Leipzig und ihre Auswirkungen auf andere Therapieformen sowie auf die Verweildauern und Verlegungen.

AIM: The impacts of the introduction of antipsychotics on psychiatric care in a clinic were investigated for the first time, specifically in the Neurological and Psychiatric Clinic of the University of Leipzig from 1946 to 1965. RESEARCH QUESTIONS: When and which antipsychotics were first used, to what extent and how did this affect the use of traditional forms of therapy? MATERIAL AND METHODS: According to psychopathological criteria, 306 cases were selected from the database of patient records from the hospital archive and systematically reviewed with respect to the research question. RESULTS: The use of antipsychotics began in 1953 and subsequently with increasing frequency and duration. Traditional therapies and antipsychotics were frequently used in combination. In particular, the use of antipsychotics and electroconvulsive therapy represented the new basic therapy. A decrease in the length of hospitalization could not be demonstrated. From 1955, however, fewer transfers to the provincial hospitals were necessary and more patients could be discharged into domestic life as "improved". Beginning in 1961, for the first time a discharge medication was mentioned and evidence of outpatient therapies including electric shock therapies were recorded. CONCLUSION: Evidence of facilitation of mental rehabilitation through the use of antipsychotics cannot be directly confirmed; however, it appears that the administration beyond a time-limited treatment has contributed to this development and also to the establishment of outpatient facilities. Thus, both a watershed in the psychiatric treatment and a change for the patients themselves could be identified.

Association of the X-chromosomal genes TIMP1 and IL9R with rheumatoid arthritis.

OBJECTIVE: Rheumatoid arthritis (RA) is an inflammatory joint disease with features of an autoimmune disease with female predominance. Candidate genes located on the X-chromosome were selected for a family trio-based association study. METHODS: A total of 1452 individuals belonging to 3 different sample sets were genotyped for 16 single-nucleotide polymorphisms (SNP) in 7 genes. The first 2 sets consisted of 100 family trios, each of French Caucasian origin, and the third of 284 additional family trios of European Caucasian origin. Subgroups were analyzed according to sex of patient and presence of anti-cyclic citrullinated peptide (anti-CCP) autoantibodies. RESULTS: Four SNP were associated with RA in the first sample set and were genotyped in the second set. In combined analysis of sets 1 and 2, evidence remained for association of 3 SNP in the genes UBA1, TIMP1, and IL9R. These were again genotyped in the third sample set. Two SNP were associated with RA in the joint analysis of all samples: rs6520278 (TIMP1) was associated with RA in general (p = 0.035) and rs3093457 (IL9R) with anti-CCP-positive RA patients (p = 0.037) and male RA patients (p = 0.010). A comparison of the results with data from whole-genome association studies further supports an association of RA with TIMPL The sex-specific association of rs3093457 (IL9R) was supported by the observation that men homozygous for rs3093457-CC are at a significantly higher risk to develop RA than women (risk ratio male/female = 2.98; p = 0.048). CONCLUSION: We provide evidence for an association of at least 2 X-chromosomal genes with RA: TIMP1 (rs6520278) and IL9R (rs3093457).