Top PDF Prevalence and Assessment of Excessive Daytime Sleepiness in Diabetic and Obese Patients.

Prevalence and Assessment of Excessive Daytime Sleepiness in Diabetic and Obese Patients.

Prevalence and Assessment of Excessive Daytime Sleepiness in Diabetic and Obese Patients.

Prevalence and Assessment of Excessive Daytime Sleepiness in Diabetic and Obese Patients 20 Pittsburgh sleep quality index (PSQI) was used to check the sleep habits of diabetic patient during the past month. The situations in the questionnaire were classified as during the past month how often had they taken medicine to help them sleep, wake up in the middle of the night or early morning, cannot get to sleep within 30 minutes, have to get up to use the bathroom, had bad dreams, have pain. For each of the questions of the questionnaire, response was classified as “never”, “once a week” and “more than once a week”. Individuals with a score of six or more were considered poor sleepers. Patient counselling to improve the quality and quantity of sleep were also given.
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Excessive Daytime Sleepiness and Hypertension in Cameroonian Adult Population

Excessive Daytime Sleepiness and Hypertension in Cameroonian Adult Population

In this large population-based study in a sub-Saharan African country, we found no independent association between excessive daytime sleepiness and hypertension. In hypertensive subjects, Sudanese ethnicity, residence in Bandjoun or Douala and obesity are factors independently associated with EDS. Thus, EDS should be systematically evaluated for in hypertensive and obese subjects in order to identify the cause as this will permit optimal management of these patients. In addition, other studies should examine the reasons for a higher prevalence of EDS in Sudanese hypertensive patients and also in those living in West and Littoral region of Cameroon. The reduction of body mass index should also allow a reduction of burden of EDS in hypertensive subjects.
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Prevalence and determinants of excessive daytime sleepiness in hypertensive patients: a cross-sectional study in Douala, Cameroon

Prevalence and determinants of excessive daytime sleepiness in hypertensive patients: a cross-sectional study in Douala, Cameroon

This study has demonstrated that a high proportion of hypertensive patients suffer from EDS. This was signi fi - cant in patients with diabetes mellitus: in snorers, in obese patients and in patients with uncontrolled BP. Patients who feel very dizzy during the day should consult their physician for screening while health per- sonnel involved in the management of hypertensive patients should screen EDS and consider weight loss in positive patients. Health-related organisations and policy- makers should promote programmes of sensitisation on EDS as well as encourage the purchase of sleep diagnos- tic tools in our context. Researchers should use this study as baseline for further studies on sleep related dis- orders in hypertensive patients in sub-Saharan Africa.
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An association between liraglutide treatment and reduction in excessive daytime sleepiness in obese subjects with type 2 diabetes

An association between liraglutide treatment and reduction in excessive daytime sleepiness in obese subjects with type 2 diabetes

In this context, an important perspective to consider is whether sleep/wake patterns could be partly modulated by food intake, especially with a high-fat dietary intake. Findings from several studies conducted in animal models demonstrated that high-fat diet and weight gain were associated with impaired sleep patterns, with more sleep time during the animals’ subjective day [27–29]; Wells et al. explored in a small group of adult volunteers ( n = 16) the effects of a meal on objective and subjective measures of daytime sleepiness, showing that regular in- gestion of fat-rich meals and significant excess of nutri- ents can predict EDS and poor quality of nocturnal sleep [30]. Clinical data showed reduced food intake, en- hanced satiety and subsequent reductions in body weight were achieved upon the administration of GLP-1ra in patients with type 2 diabetes [31] and non-diabetic adults [32]. Interestingly, in a small study conducted with 20 obese and type-2 diabetic Japanese subjects, short-term treatment with liraglutide effectively reduced visceral fat adiposity, appetite and the urge for fat intake [33]. Collectively, we could contemplate that GLP-1ra liraglutide could improve EDS not only as a result of weight reduction, but also by decreasing appetite and re- ducing fat intake.
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Excessive Daytime Sleepiness in Children and Adolescents across the Weight Spectrum

Excessive Daytime Sleepiness in Children and Adolescents across the Weight Spectrum

There are several limitations to this study. First and foremost, this study was done using data from a population referred to a sleep clinic and as such does not represent the general population of children and adolescents. However, this can be viewed positively as this is the population sleep specialists deal with. The findings of this study support the notion that sleep specialists should employ higher levels of suspicion for the presence of EDS when presented with overweight and obese children. While it may be thought that using a clinic based population would tend to magnify the outcome, which is probably correct one can take the attitude that the point at which this becomes critical is in the assessment of children presenting at a sleep clinic. In this setting the issue of discerning likely diagnosis and the utility of a sleep assessment is crucial. In this situation an awareness of factors that might influence sleepiness and when a test to measure sleepiness is being contemplated ( with cost implications as well) and awareness of factors that make unappreciated ( from the patients perspective) sleepiness more likely is helpful in making clinical decisions. It would be a separate exercise to evaluate contributors to
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Armodafinil in the treatment of excessive sleepiness

Armodafinil in the treatment of excessive sleepiness

is a comparatively new medication, it has not yet been incorpo- rated into AASM guidelines for the treatment of ES associated with treated OSA. Stimulants, such as amphetamines, reverse the daytime somnolence seen in some patients on CPAP therapy; however, these agents carry a potential risk for abuse and cardiovascular sequelae and further evidence is required before they can be recommended in this indication. 33,36

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Running title: Impact of narcolepsy Key words: Narcolepsy, Excessive Daytime Sleepiness, Qualitative, Social Context, Invisible

Running title: Impact of narcolepsy Key words: Narcolepsy, Excessive Daytime Sleepiness, Qualitative, Social Context, Invisible

The success of these intervention strategies is variable and research findings indicate that the clinical symptoms of narcolepsy have a profound negative effect on the quality of life of those diagnosed as narcoleptic, engulfing most aspects of daily functioning. It seems that narcoleptic patients experience a higher rate of work, home and driving accidents, greater unemployment, lower job satisfaction and performance and lower educational outcomes than their non-narcoleptic counterparts (Broughton, Ghaneem, Hishikawa, Sugita et al., 1983). It is not uncommon for people living with the disorder to be labeled as lazy or irresponsible in work and school settings or seen as emotionally unstable (Alaia, 1992; Douglas 1998; Kales, Soldatos, Bixler, Caldwell et a.l, 1982). Issues regarding interpersonal relationships and psychological well-being in narcoleptic patients are also well documented with problem areas including sexual dysfunction, depression, low levels of self esteem, anxiety, social and emotional withdrawal, poor psychosocial adjustment and irritability (Broughton, 1992; Bruck, 2001; Cohen, Ferrans, & Smith, 1992).
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Excessive daytime sleepiness and falls among older men and women: cross-sectional examination of a population-based sample

Excessive daytime sleepiness and falls among older men and women: cross-sectional examination of a population-based sample

Over one-tenth of older men and women sampled in this study report EDS (16 % and 13.6 %, respectively), which is comparable to population-based prevalence we have cited previously [1], but higher than that cited by others [9]. Healthy, independent community-dwelling older adults often report lower rates of EDS than those who reside within aged-care facilities [30]. This may in part be attributed to typically higher levels of physical functioning and greater levels of independence among these individuals [31], as well as lower overall rates of peripheral factors often associated with EDS, such as dis- ease comorbidity [32] and increased rates of polypharmacy [33]. We further report an overall fall prevalence for both men and women that is comparable to [34], but lower than some [35] of the previous research assessing falls among healthy, community-dwelling adults. Higher rates of falls are often observed among older adults living within aged care or assisted living facilities compared to those living within the community [36, 37]. Indeed, individuals living in long-term institutionalised care have as much as a three- fold increased risk of reporting a fall, and a 10-25 % increased risk of sustaining injuries such as a fracture or laceration as a direct result of a fall [38]. Falls are often considered independent determinants of functional decline and worse disability outcomes among older community- dwelling adults [39]; and are often cited as the primary contributing factor for later admission to institutionalised care [38]. Community-based prevention strategies are therefore pivotal in the reduction of nursing home admissions among at-risk individuals.
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Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis

Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis

Numerous studies in the general population have demon- strated that poor or reduced amounts of nocturnal sleep and excessive daytime sleepiness adversely affect a variety of quality of life and functional health status indicators [15,46-50]. Both problems have also recently been associ- ated with cardiovascular disease [46-49], the most com- mon cause of death in the HD population [42]. However, although sleep disorders and excessive daytime sleepiness [51] are very prevalent in the HD population, limited information is available with regard to the extent to which these problems affect life quality. Previous reports suggest that poor subjective sleep[52,53] and sleep-related breathing disorders [54] have adverse effects, but the scope of these studies with regard to sleep measures is lim- ited. Thus, we examined how quality of life is related to both subjective and objective measures of nocturnal sleep and daytime sleepiness in a sample of stable HD patients. Perhaps the most important finding of this study is that selected indicators of poor nocturnal sleep and increased daytime sleepiness are associated with reduced quality of life. Sleep complaints that characterize insomnia [52,55], including difficulty initiating sleep, early morning awak- enings, and feeling unrefreshed in the morning, are partic- ularly important. A recent study by Williams et al. [52], also noted that complaints of insomnia were associated with pain, depression, and decreased physical functioning. These findings suggest that the assessment and treatment of insomnia-related complaints should be included in any overall plan of care designed to optimize quality of life as well as other important clinical out- comes. Numerous pharmacological and/or cognitive behavioral techniques are efficacious for treatment of insomnia but controlled clinical trials designed to evalu- ate their effectiveness in HD patients remain to be con- ducted [56-59].
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Modafinil in the treatment of excessive sleepiness

Modafinil in the treatment of excessive sleepiness

usefulness (Arand et al 2005). While these tests do not appear to adequately discriminate between patients with sleep disorders and control subjects due in part to fl oor (MSLT) and ceiling (MWT) effects and to large standard deviations (Arand et al 2005), they effectively monitor changes caused by interventions that alter sleepiness or alertness (Arand et al 2005). The MSLT in particular appears to be sensitive to changes in sleepiness across the 24-hour day and following long-term sleep debt or extension (Seidel et al 1984; Roehrs et al 1996). In addition, sleep latencies have been shown to refl ect circadian changes in studies that simulated night shift conditions (Arand et al 2005), suggesting responses occur as expected when sleep cycles are reversed (eg, for night shift workers). Whether establishing a diagnosis or evaluating a response to treatment, sleep latency test fi ndings should be interpreted within the context of other available medical information and testing (Arand et al 2005).
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An assessment of sleep quality and daytime sleepiness in hemodialysis patients: a cross-sectional study from Palestine

An assessment of sleep quality and daytime sleepiness in hemodialysis patients: a cross-sectional study from Palestine

Hemodialysis patients’ life quality can be impacted by many factors (Wang et al. 2016). Such factors include poor sleep quality, which was reported in many studies as a common problem among hemodialysis patients (HDP) and that it predicts their life quality in general, and their mortality risk (Wang et al. 2016). HDP, espe- cially those with ESRD, may suffer physical, mental, and social consequences that can be the direct result of their ESRD, the therapy-related adverse effects on their qual- ity of life, the lifestyle changes that come along with, or any number of these factors combined. In Palestine, HD centers were run by the Palestinian Ministry of Health, which suffers from under-staffing in all fields due to economic and political instabilities (World Health Organization 2012; Zyoud et al. 2014). Therefore, we expect that patients undergoing hemodialysis in Palestine may not receive adequate attention regarding sleep disorders by experts, to avoid any health complica- tions. There are many tools available for the assessment of sleep quality and related sleep problems. Of these, two particular tests that are commonly and reliably used for that purpose: the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) which as- sess the quality of sleep and the excessive daytime sleepiness, respectively (Beaudreau et al. 2012).
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A Prader-Willi Syndrome Patient with Excessive Daytime Sleepiness (EDS) and Narcoleptic Symptoms: A Case Report

A Prader-Willi Syndrome Patient with Excessive Daytime Sleepiness (EDS) and Narcoleptic Symptoms: A Case Report

A variety of night-time sleep architecture disturbances are also reported in PWS. The most commonly observed dysfunction is a decreased REM sleep latency and the presence of sleep onset REM (SOREM) periods [9]. Other abnormalities include reduced percentage REM sleep, fragmented REM sleep, and decreased NREM sleep instability [4]. Studies specific to pediatric PWS patients show a tendency for increased stage I sleep and decreased REM latency. The PSG testing over the course of 6 years in our patient illustrates many of these findings. The patient also had a family history of EDS, which may contribute to her significant sleep
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A Prader-Willi Syndrome Patient with Excessive Daytime Sleepiness (EDS) and Narcoleptic Symptoms: A Case Report

A Prader-Willi Syndrome Patient with Excessive Daytime Sleepiness (EDS) and Narcoleptic Symptoms: A Case Report

PWS patient, and the effectiveness of long-term modafinil use for the treatment of EDS in a young female with PWS over the course of three years. EDS is a common symptom of PWS, affecting between 70 and 85% of PWS individuals [4]. Caregivers often report increased sleepiness in both children and adults with PWS; individuals with PWS also self-report higher levels of EDS compared to other intellectually disabled groups [6]. EDS is also objectively demonstrated through abnormal MSLT results in PWS patients. A collection of studies reviewed by Maas et al. reported severe sleepiness (MSLT score <5 minutes) in 40-50% of adults with PWS and moderate to severe sleepiness (MSLT score <10 minutes) in 70-100% [2,7]. A combination of obesity, craniofacial abnormalities, sleep apnea and abnormalities of sleep structure are proposed contributing factors related to their daytime hypersomnia [4]. Sleep difficulties can functionally impair attention and behaviour and overall cognitive status and school functioning [1]. Our patient was initially noted to nap for 2 to 3 hours each day and sleep for 12 hours during the night. These sleep periods are relatively long compared to age-matched peers; the average sleep duration for 8 year olds is 10.6 ± 0.6 h per 24 h period [8]. A MSLT test performed at age 6 revealed severe pathological sleepiness,with a MSLT score of less than 5 minutes. Generally, prepubertal children have mean sleep latencies greater than 15 minutes [8]. Additionally, the two SOREMs found on our patients’ MSLT are typical features of both narcolepsy and PWS [4].
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Relationship between poor quality sleep, excessive daytime sleepiness and low academic performance in medical students

Relationship between poor quality sleep, excessive daytime sleepiness and low academic performance in medical students

Purpose: Poor quality of sleep and excessive daytime sleepiness affect cognitive ability and have a negative impact on the academic performance of medical students. This study aims to determine the prevalence of excessive daytime sleepiness, sleep quality and psychological distress as well as assess their association with low academic performance in this population. Participants and methods: A cross-sectional study was conducted among 457 medical students from the Faculty of Medicine and Pharmacy of Rabat, Morocco, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth Sleepiness Scale to determine the quality of sleep and excessive daytime sleepiness, respectively. Sociodemographic variables and psychological distress (Kessler Psychological Distress Scale) were also measured. Multivariate linear regression was performed in order to evaluate the link between low academic performance and sleep quality after adjusting for other covariates.
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Excessive daytime sleepiness and adherence to antihypertensive medications among Blacks: analysis of the counseling African Americans to control hypertension (CAATCH) trial

Excessive daytime sleepiness and adherence to antihypertensive medications among Blacks: analysis of the counseling African Americans to control hypertension (CAATCH) trial

either case, this must be done in a culturally and linguistically appropriate manner when targeting minority communities. Second, overall management of hypertension should include newly identified comorbid conditions including sleep-related problems and not solely the traditional conditions like diabe- tes and chronic kidney disease. Third, behavioral interven- tions that seek to address adherence status should include adherence to both prescribed sleep and hypertension regi- mens. Finally, studies may also wish to look at mechanistic factors that may be common to both daytime sleepiness and adherence, such as stress, especially in low-income com- munities such as the ones sampled in this study. 37
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Atopic Dermatitis and Excessive Daytime Sleepiness: Analysis of Data from 8362 Adult Subjects in a Sub-Saharan Africa Country

Atopic Dermatitis and Excessive Daytime Sleepiness: Analysis of Data from 8362 Adult Subjects in a Sub-Saharan Africa Country

Abstract: Sleep disorders in patients with atopic dermatitis (AD) are common and can have a negative impact on the quality of life of the affected subjects. Very little data are available on the association between AD and excessive daytime sleepiness (EDS) in adults. The objective of this study was to compare the prevalence of EDS in subjects with AD and those without AD, and to investigate the determinants of EDS in adults with AD. In this cross-sectional population-based study conducted from 2015 to 2018 in Cameroon, adult subjects aged at least 19 years were included by multi-level stratified random sampling. AD was defined as the presence of a chronic itchy dermatitis evolving intermittently over a period of at least 6 months and electively affecting certain areas (fronts of the elbows, back of the knees, front of the ankles, under the buttocks, around the neck, around the eyes or ears) during the last 12 months preceding the survey. EDS was defined by an Epworth score≥10. Logistic regression was used to investigate the independent association between EDS and AD. A difference was considered significant if p<0.05. A total of 8362 subjects (55.2% women) with median age (25 th -75 th percentiles) of 39 (27-54) years were included. There were 217 subjects (2.6%) with AD and 1022 subjects (12.2%) with EDS. The prevalence of EDS was higher in subjects with AD than in those without AD (22.1% vs. 12%, p<0.001). In multivariate analysis integrating potential confounders (area of recruitment, age, education level, body mass index, association with other allergic diseases), AD remained independently associated with EDS with an adjusted odds ratio (95% CI) of 2.18 (1.54-3.08). No independent associated factors to EDS were found in subjects with AD. There is an independent association between EDS and AD, and nearly one quarter of patients with AD has EDS in this setting. It is necessary to consider the systematic evaluation of EDS in subjects with AD to optimize their management.
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Construct Validation and Reliability Assessment of Tamil Version of Epworth Sleepiness Scale to Evaluate Daytime Sleepiness among Adolescents in Rural Puducherry, South India.

Construct Validation and Reliability Assessment of Tamil Version of Epworth Sleepiness Scale to Evaluate Daytime Sleepiness among Adolescents in Rural Puducherry, South India.

Initially, translation of English version of the ESS questionnaire into Tamil was done by two bilingual literary language experts. They had no prior knowledge regarding the purpose, content, or interpretation of the questionnaire. Then, back translation of Tamil version into English was carried out by two different bilingual language experts. After which, comparison of the English back‑translated version with the original English form of ESS was done. It was found to concur in accordance with the original version. Language and grammatical errors in the translated Tamil version were corrected. Then, Tamil version was pilot tested among subsample of adolescents (n = 15) for the assessment of difficulty in understanding the questions and final corrections in language and grammatical errors. Based on feedback during pilot testing, finer modifications were made and final Tamil version of ESS was obtained.
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Excessive daytime sleepiness, metabolic syndrome, and obstructive sleep apnea: two independent large cross-sectional studies and one interventional study

Excessive daytime sleepiness, metabolic syndrome, and obstructive sleep apnea: two independent large cross-sectional studies and one interventional study

Bixler et al. showed that EDS was more strongly associ- ated with metabolic factors than with OSA [25]. However, other studies have shown different results. One study found that daytime sleepiness was associated with noctur- nal sleep disturbance, but not OSA and markers of MetS, in severely obese subjects [26]. However, elsewhere, EDS did not affect the relationship between OSA and meta- bolic variables [10]. Symptoms of EDS were not associated with sympathetic nervous system activation or arterial stiffness in non-severe OSA [27]. Furthermore, no rela- tionship was found between EDS and stroke risk, and only weak associations were found between EDS and risk of cardiovascular and coronary heart disease [28]. MetS is an independent risk factor for pre-cardiovascular disease (CVD) and CVD; EDS may not be associated with MetS, a view consistent with our findings.
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An association between unrecognized gastroesophageal reflux disease and excessive daytime sleepiness in Taiwanese subjects suspected to have liver disease: a pilot study

An association between unrecognized gastroesophageal reflux disease and excessive daytime sleepiness in Taiwanese subjects suspected to have liver disease: a pilot study

A relationship between GERD and daytime somno- lence has been described in other studies. For example, Demeter et al. [4] reported that the severity of GERD as assessed by panendoscopy and characterized by the Savary-Miller classification correlated positively with the degree of daytime somnolence as assessed by the ESS. Specifically, mild somnolence was observed in 29% of GERD 0 patients, 39% of GERD I patients, and 46% of GERD II patients; however 77% of GERD III patients suffered from significant somnolence. Guda et al. [25], who evaluated 385 consecutive subjects at an outpatient clinic for sleep disorders, reported that those with a diagnosis of GERD had significantly higher ESS scores than those diagnosed without GERD. Furthermore, Chen et al. [26] reported that patients with nighttime heartburn complain of significantly greater subjective sleep impairment as determined by the Pittsburgh Sleep Quality Index as compared to those without nighttime heartburn. However, it should be noted that Suurna et al. [27] observed no differences between patients with and without nighttime heartburn in any objective sleep parameter during an overnight polysomnographic study.
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Depression in narcolepsy A comparative analysis of depression severity and daytime sleepiness in patients with narcolepsy and idiopathic hypersomnia

Depression in narcolepsy A comparative analysis of depression severity and daytime sleepiness in patients with narcolepsy and idiopathic hypersomnia

I would like to thank Prof. Jürgen Zulley, Prof. Gorän Hajak and Dr. Peter Geisler for the great opportunity to take part in the sleep lab in Regensburg and to develop my dissertation there. I appreciate the valuable advice of Prof. Zulley in all aspects of the project presented in this dissertation. I am especially in debt to Dr. Geisler, because he supported every step of my research. His deep interest in narcolepsy and hypersomnia stimulated my own curiosity in this theme. And as he said, narcolepsy is an illness that affects people throughout life, but also people doing research in narcolepsy maintain the interest on this fascinating illness throughout life. Furthermore, he is responsible for gaining the enthusiasm from the German association of narcolepsy to participate on this project. Dr. Geisler has supported unselfishly this association for more than 20 years. I would also like to thank all the people working at the sleep lab for the warm human atmosphere that I felt from the first day, even without knowledge of the German language. Therefore, this dissertation means for me not only a large process of learning about sleep research but also the personal wisdom to live in a foreign country with a different culture. Employees working at the sleep lab received me in a friendly atmosphere that facilitated the adaptation process. Hence, I want to express special gratitude for Drs. Roland Popp, Tatjana Crönlein, Christiane Hirn and more at the end Christoph Pieh. I am in debt to Ms. Sabine Weigl, Ulla Götz, Karin Völlner, Annette Suttner and Karin Berger. And also I am thankful to Ms. Maria Wiechmann, Michaela Christl, Josefa Gawarkiewicz and Nina Effhauser. Moreover, inside the hospital, there were other individuals who have further been protagonists of this process, to whom I would also like to express my gratitude. They are Simone Hauser, Günter Gürlach and although no longer with us, Claudia Lübbers. I would like to express my gratitude to Drs. Eckl and Kühnl who helped me in the city of Regensburg to contact most of the patients with depression.
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