Fortschritte Der Neurologie Psychiatrie最新文献

{"title":"[Peer support for promoting mental health: A descriptive analysis of target groups and support content].","authors":"Jochen Mutschler, Ladina Pfyffer, Sebastian Fischer, Christian Lay, David Weis, Felicia Chantal Derendinger, Hans Schmied","doi":"10.1055/a-2860-8461","DOIUrl":"https://doi.org/10.1055/a-2860-8461","url":null,"abstract":"<p><strong>Aim of the study: </strong>Mental illnesses are on the rise both internationally and in Switzerland, pushing psychiatric care facilities to the limit of their capacity. As a result, there is a growing need for low-threshold psychosocial support that accompanies, stabilizes and supports those affected in their everyday lives. This is precisely where the \"Psycho-Social Services\" (PSD) project of the GLEICH UND ANDERS Schweiz foundation comes in. The aim of this study was to provide a descriptive, empirical analysis of the PSD project.</p><p><strong>Methodology: </strong>A descriptive analysis of the project was carried out for quality assurance purposes. The socio-demographic data of the participants and the concerns and stressful situations supported by peers were systematically recorded. In addition, the forms, content and focus of the peer support and the number of hours provided were quantitatively evaluated.</p><p><strong>Results: </strong>In the period from 2023 to the end of 2024, 102 people were supported (71.6% of whom were women). The age of the clients was between 16 and 75 years with a median of 44.0 years. The places of residence of the people receiving support were spread across the cantons of German-speaking Switzerland, with most people coming from the cantons of Lucerne (47 people) and Bern (21 people). The most common reasons for seeking support were depression (45.1%), followed by schizophrenia (11.8%), burnout (9.8%), eating disorders (8.8%) and attention deficit/hyperactivity disorder (ADHD) (8.8%). A total of 473.23 hours of peer work were carried out, with an average of 4.64 hours per person supported. The majority of people (57.8%) were supported for between 1 and 5 hours.</p><p><strong>Conclusion: </strong>The results show that peer support in the PSD project is primarily used by middle-aged women with depressive symptoms from the cantons of Lucerne and Bern, with short and targeted support sessions predominating. This underlines the need for low-threshold, time-limited support services and shows the potential of peer work and psychosocial services. At the same time, the regional focus points to the importance of further disseminating and publicizing such services in other cantons.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rare very late-onset neuromyelitis optica].","authors":"Maxim Maximov, Alberto Rodriguez Lago","doi":"10.1055/a-2878-1828","DOIUrl":"https://doi.org/10.1055/a-2878-1828","url":null,"abstract":"<p><strong>Background: </strong>Neuromyelitis optica (NMO) and its related forms, collectively referred to as neuromyelitis optica spectrum disorders (NMOSD), are rare but often severe autoimmune diseases of the central nervous system (CNS). NMOSD predominantly affects women, most commonly between the ages of 30 and 40 years. Aquaporin-4 antibodies (AQP4-IgG) are detectable in approximately 80% of patients with NMOSD.The cardinal clinical manifestations include transverse myelitis, optic neuritis (ON), as well as brainstem and diencephalic involvement.Most NMOSD cases follow a relapsing-remitting course without progression between relapses. NMOSD relapses are often severe and result in incomplete remission and permanent disability. Monophasic courses are rare.</p><p><strong>Methods: </strong>We report the case of an 86-year-old female patient who presented with subacute occipital headache and right leg hemiparesis, which progressed to tetraparesis.</p><p><strong>Results: </strong>Magnetic resonance imaging (MRI) revealed a longitudinally extensive transverse myelitis (LETM) from cervical vertebrae C1 to C5. Cerebrospinal fluid (CSF) analysis demonstrated mild pleocytosis, elevated protein levels, and the presence of oligoclonal bands. Aquaporin-4 antibody testing returned strongly positive, confirming the diagnosis of NMOSD. The disease was classified as very late-onset NMOSD (VLO-NMOSD). Treatment with high-dose intravenous methylprednisolone for five days resulted in symptom improvement. Approximately eleven weeks post-discharge, therapy with the anti-CD20 monoclonal antibody rituximab was initiated. The patient's condition remained stable under maintenance therapy, with no further relapses.</p><p><strong>Conclusions: </strong>NMOSD can manifest even in very advanced age, beyond 75 years. Given the patient's initial presentation with right leg hemiparesis, advanced age, and multiple vascular risk factors, NMOSD was not initially suspected. The accompanying occipital headaches often exhibit migraine-like characteristics.Treatment with intravenous methylprednisolone resulted in symptom improvement, and rituximab was well tolerated.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Intravenous Subnarcotic Ketamine Infusions for Treatment-Resistant Depression: Historical Development, Comparison with Esketamine Nasalspray, and Prospects].","authors":"Udo Bonnet, Norbert Scherbaum, Georg Juckel, Tom Bschor","doi":"10.1055/a-2846-4275","DOIUrl":"https://doi.org/10.1055/a-2846-4275","url":null,"abstract":"<p><strong>Introduction: </strong>Esketamine nasal spray (EN) has been approved in Germany since 2021 for the treatment of treatment-resistant depression (TRD). Historically, the development of EN resulted from the positive results of randomized clinical trials on the off-label use of subnarcotic ketamine infusions (SKI) for TRD. How effective, tolerable, and safe is off-label SKI compared to EN?</p><p><strong>Methods: </strong>Narrativ review. Selective literature search in PubMed for clinical studies comparing SKI and EN for TRD. International guidelines for depression and the cost-effectiveness of SKI and EN in inpatient treatment were also considered.</p><p><strong>Results: </strong>Randomized direct comparative studies between EN and SKI are currently lacking. There is solid circumstantial evidence for the equivalence of acute treatment of TRD with SKI (usually 0.5 mg/kg body weight intravenously over 40-45 minutes) or EN (usually 56 or 84 mg per dose) in terms of effectiveness, safety, and tolerability: 9 meta-analyses (2 network meta-analyses) and 7 real-world studies (1 prospective, 6 retrospective comparative studies). SKI and subanesthetic esketamine infusions were also equivalent. A similar picture is emerging for serial treatment. Favorable tolerability and safety data have been available for EN for over 5 years (for serial SKI no such long-term observations). The USA and Canada have included off-label SKI as an alternative to approved EN in their guidelines for add-on treatment of TRD. For the German healthcare system, inpatient add-on treatment with SKI is about 2.3 to 3.8 times cheaper than with EN.</p><p><strong>Discussion and conclusion: </strong>Based on the above evidence, we estimate that there is currently low to moderate confidence according to GRADE for assuming the equivalence in effectiveness, tolerability, and safety of add-on treatment of TRD with SKI or EN. A more accurate assessment will be possible in 2030 at the earliest, when the results of an ongoing direct comparative clinical study are available. When updating the guidelines, we recommend checking whether the off-label add-on SKI can be provisionally placed at the same level as the add-on EN in the TRD treatment algorithm, as is the case in the USA and Canada. We hereby also encourage (i) health insurance companies to cover the costs of add-on SKI and (ii) the German authorities to review the off-label prescribability of SKI for TRD by the Joint Federal Committee (GB-A).</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Profiling involuntarily hospitalized patients according to risk to themselves and/or risk to others].","authors":"Franziska Abelein, Sophia Kabuya-Mulamba, Uwe Enders, Mathias Zink","doi":"10.1055/a-2878-1904","DOIUrl":"https://doi.org/10.1055/a-2878-1904","url":null,"abstract":"<p><strong>Objectives: </strong>Emergency situations can lead to immediate admissions according to mental health act. It has never been investigated within the scope of the Bavarian Mental Health Act, which differences might be associated with specific risk constellations. We therefore grouped patients according to admission due to a risk to themselves, a risk to others, or a combination of both and analysed epidemiological and clinical properties.</p><p><strong>Methodology: </strong>We used case-based, pseudonymized data from the large hospital in Ansbach and described differences in terms of age, gender, diagnoses, coercive measures, and mode of discharge.</p><p><strong>Results: </strong>2,153 involuntary admissions accounted for 16.8% of all inpatient cases (n=12,787) from 2021 to 2023. Self-harm was significantly more frequently associated with alcohol addiction, depressive episodes, acute stress reactions, and personality disorders, and more often resulted in discharge the following day. Risk to others was, at the same average age, more frequently associated with male gender, diagnoses within the addiction spectrum involving cannabinoids and stimulants, as well as within the spectrum of schizophrenic psychoses and manic episodes. Coercive measures and prolonged involuntary hospitalizations occurred more frequently. The group with a combination of self-harm and harm to others was used as a means of validating the comparison between the two groups.</p><p><strong>Conclusions: </strong>These distinct characteristics enable specific preventive and therapeutic measures to be implemented both before admission, as well as during, and after inpatient treatment. The results of the pseudonymized analysis confirm the added value of moving away from strictly anonymized data collection at the Bavarian state level.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The pioneers Schwerin and Brandenburg-Görden in the development of alcohol use disorder therapy in the GDR].","authors":"Nadja Pontzen, Holger Steinberg","doi":"10.1055/a-2452-8376","DOIUrl":"10.1055/a-2452-8376","url":null,"abstract":"<p><strong>Abstract: </strong>OBJECTIVE: The aim of this study was to provide insights into the addiction therapy concepts applied at the clinics of Hugo von Keyserlingk in Schwerin and Hubertus Windischmann in Brandenburg and to enable an understanding of the specific problems in this subsector of psychiatric care in the GDR.</p><p><strong>Abstract: </strong>METHODS: Works published primarily in the GDR were identified, analyzed and contextualized, with expert interviews with von Keyserlingk and Windischmann complementing the findings.</p><p><strong>Abstract: </strong>RESULTS: Initially limited approaches to alcoholism treatment after the Second World War gradually developed into more complex and diverse structures. Thus, from the 1960s on, von Keyserlingk established an addiction clinic, while Windischmann established an addiction treatment center in Brandenburg with various therapeutic options.</p><p><strong>Abstract: </strong>CONCLUSIONS: Von Keyserlingk's and Windischmann's contributions play a significant role in the development of therapeutic concepts. The study shows that they played a pioneering role in alcohol patient care in the GDR.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"228-234"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Institutional and patient-related factors influencing the frequency of restraint in a general psychiatric acute care unit].","authors":"Miriam Paetzold, Kathrin Kuhr, Fritz-Georg Lehnhardt","doi":"10.1055/a-2365-0878","DOIUrl":"10.1055/a-2365-0878","url":null,"abstract":"<p><strong>Abstract: </strong>OBJECTIVE: Valid knowledge about risk stratification is essential for the development of preventive approaches to reduce restraints.</p><p><strong>Abstract: </strong>METHODS:   This retrospective, monocentric study examined all 248 restraining measures used on 79 patients of a university psychiatric department in 2015. Eight institutional and seven patient-related factors were statistically calculated using logistic regression analysis and matched pairs.</p><p><strong>Abstract: </strong>RESULTS: A statistically significant increased probability of fixation was found in connection with a lower number of nurses per patient, a higher number of patients admitted by law, lower professional experience of nurses and in the nursing late shift as well as when admission occurred via emergency medical service.</p><p><strong>Abstract: </strong>CONCLUSION: Based on the results, possible preventive organizational measures are elaborated and preconditions for a prospective evaluation of the complex factors influencing coercive measures are discussed.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"221-227"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correction: The pioneers Schwerin and Brandenburg-Görden in the development of alcohol use disorder therapy in the GDR].","authors":"Nadja Pontzen, Holger Steinberg","doi":"10.1055/a-2503-2447","DOIUrl":"10.1055/a-2503-2447","url":null,"abstract":"","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"e1"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chronic vestibular syndromes: Correct diagnosis and treatment].","authors":"Sandra Becker-Bense, Marianne Dieterich","doi":"10.1055/a-2650-3095","DOIUrl":"10.1055/a-2650-3095","url":null,"abstract":"<p><strong>Abstract: </strong>Chronic dizziness is defined as dizziness or vertigo symptoms that are continuously present for more than 3 months. Typical complaints include persistent to-and-fro vertigo accompanied by postural imbalance and gait unsteadiness with an increased risk of falling. Patients often experience inadequate or inappropriate medical care despite being significantly impaired in their daily lives. Common vestibular causes include persistent peripheral vestibular disorders (such as bilateral vestibulopathy or incompletely compensated unilateral vestibulopathy), central vestibular syndromes (e. g., downbeat nystagmus with or without evidence of ataxia, dementia syndromes with cognitive-motor disorders), as well as non-organic functional disorders. A systematic medical history and a thorough clinical neurological examination - paying particular attention to the vestibular, oculomotor, cerebellar, sensory, and extrapyramidal systems, as well as cognitive function - are key to establishing the correct differential diagnosis. Even long-standing syndromes can often still be positively influenced by targeted physiotherapy, psychotherapy, or medication, leading to an improved quality of life for patients. This article provides a hands-on overview of the clinical characteristics of the most important organic and non-organic vestibular disorders underlying chronic dizziness as a primary symptom, as well as their specific effective treatment approaches.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"94 6","pages":"235-255"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Lithium: A \"Never‑Ending Story\" - Now for Dementia Prevention?]","authors":"Jens Kuhn, Joachim Klosterkötter","doi":"10.1055/a-2853-2760","DOIUrl":"https://doi.org/10.1055/a-2853-2760","url":null,"abstract":"","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"94 6","pages":"218-220"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cardiovascular adverse drug reactions related to psychotropic drugs: an evaluation of data of summaries of product characteristics].","authors":"Maximilian Gahr, Karl Mischke, Michael Paulzen, Lena Diefenbach","doi":"10.1055/a-2866-8844","DOIUrl":"10.1055/a-2866-8844","url":null,"abstract":"<p><strong>Background: </strong>The use of numerous psychotropic drugs is associated with a significant risk of cardiovascular adverse drug reactions (cvADR).</p><p><strong>Aim of the study: </strong>Systematic presentation and discussion of substance-specific risks of different cvADR.</p><p><strong>Materials and methods: </strong>Evaluation of the regulatory data from summaries of products characteristics (SmPC) of the psychotropic drugs most frequently prescribed in Germany in 2023 with regard to the risk of cvADR.</p><p><strong>Results: </strong>A total of 92 SmPC were examined, and within the indication groups, n=27 antidepressants, n=22 antipsychotics, n=4 mood stabilizers, n=12 hypnotics, n=9 sedatives and anxiolytics, n=6 drugs for the treatment of addiction disorders, n=5 psychostimulants, and n=7 antidementia drugs. The risk of cvADR was lowest for mood stabilizers, hypnotics, sedatives, and anxiolytics, and low for drugs used to treat addiction disorders, stimulants, and antidementia drugs, while antidepressants and antipsychotics were associated with the highest risk.</p><p><strong>Conclusion: </strong>The results found here, based on regulatory data, largely correspond with clinical experience and the available evidence from clinical studies. When using psychotropic drugs, especially antidepressants and antipsychotics, cvADR should be systematically taken into account and regularly monitored clinically.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}