Fortschritte Der Neurologie Psychiatrie最新文献

{"title":"[Emerging suicidal ideation in a bipolar patient after taking pregabalin: a case report].","authors":"Christine Wagner, Augusto Montecino","doi":"10.1055/a-2374-2182","DOIUrl":"10.1055/a-2374-2182","url":null,"abstract":"<p><p>Bipolar disorder is a severe mental illness and often occurs with comorbidities like anxiety or alcohol abuse. Thus pregabalin could be a promising drug. We present a case report of a 37-year-old woman with bipolar II disorder suffering from a depressive episode with features of anxiety and increased alcohol consumption. The patient was started on quetiapine as monotherapy. After a few days of add-on pregabalin, we observed suicidal ideations and self-harming behaviour, although expression of anxiety as well as alcohol consumption showed a decrease. When we stopped pregabalin and increased the dosage of quetiapine, suicidal behaviour almost disappeared. In the relevant literature, there is disagreement on the use of pregabalin. On the one hand, pregabalin is described as a safe and well-tolerated drug, and on the other hand, there are also concerns about the suicidal effect of anticonvulsants. In conclusion, we recommend the cautious use of pregabalin and other anticonvulsant drugs in patients with affective disorder. There could be a promising effect on the comorbidities but the effect on mood remains still unclear.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"53-56"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105985","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>Objective: </strong>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>Methods: </strong>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>Results: </strong>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>Conclusions: </strong>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":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-16","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":"[The 'Tabes Syphilis Controversy' : A Dispute About the Cause of Tabes Dorsalis and Progressive Paralysis at the End of the 19th Century].","authors":"Holger Steinberg","doi":"10.1055/a-1972-3201","DOIUrl":"10.1055/a-1972-3201","url":null,"abstract":"<p><p>For some years now, the incidence of syphilis and neuroluetic clinical pictures has been increasing. As a result, tabes dorsalis and progressive paralysis are once again gaining relevance in neurology. In the last two decades of the 19th century, there was a heated debate in German neurology about the understanding of the aetiology of these conditions, the so-called 'tabes syphilis controversy'. In 1879, Wilhelm Erb had called on the German neurological community in a much-noticed lecture to finally tackle the problem to unequivocally identify the cause of tabes dorsalis. Mainly on the basis of disease statistics he himself postulated a previous syphilitic infection as of key importance. Answering this question was urgent, because the proportion of patients in psychiatric institutions suffering from progressive paralysis, to which tabes was seen in close parallel, was rapidly increasing. The Berlin neurologists Carl Westphal, Ernst Julius Remak, Martin Bernhardt and Ernst Victor von Leyden regarded Erb's thesis as a gauntlet. They saw the causes of tabes and progressive paralysis in social impoverishment such as damp and cold living conditions, in physically one-sided work overloads or in the hardships of soldiers in the army. They assumed that traumatic tabes was caused by concussions or bruises. The Leipzig neurologist Paul Julius Möbius was the first to state between 1890 and 1897 that the only cause of tabes and progressive paralysis was a previous syphilitic infection. He consistently ruled out all other aetiological theories. Above all, bacteriological and microbiological research in the following years proved Möbius right. Thus 40 years after Erb's lecture, in addition to diagnostic, specific therapeutic approaches could be developed and applied.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"494-501"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10485139","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":"[About compulsion, syphilis and more].","authors":"Heinz Reichmann","doi":"10.1055/a-2417-1997","DOIUrl":"https://doi.org/10.1055/a-2417-1997","url":null,"abstract":"","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"92 12","pages":"492-493"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779797","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":"[Obsessive-compulsive Disorder: Exposure Treatment and special Features of concentrated Treatment].","authors":"Amir H Yassari, Maren Schäfer, Bjarne K A Hansen, Lena Jelinek","doi":"10.1055/a-2338-3555","DOIUrl":"https://doi.org/10.1055/a-2338-3555","url":null,"abstract":"<p><p>Obsessive-compulsive disorder (OCD) is often associated with great suffering for both the affected individual as well as their relatives. The treatment of choice for OCD is cognitive behavioural therapy (CBT) with exposure and response prevention. Exposurebased treatment is offered in a concentrated, high-frequency format over four consecutive days in the Bergen 4-Day Treatment (B4DT). This article presents the procedure and effectiveness of this concentrated exposure treatment.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"92 12","pages":"509-524"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779798","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":"[Synergies Instead of Rivalries - Expert Opinion on the Misunderstood Roles of Continuous Intrajejunal Levodopa Therapy and Deep Brain Stimulation in the Treatment of Parkinson̓s Disease].","authors":"Nils Schröter, Wolfgang H Jost, Michel Rijntjes, Volker Coenen, Sergiu Groppa, Bastian Sajonz","doi":"10.1055/a-2238-1641","DOIUrl":"10.1055/a-2238-1641","url":null,"abstract":"<p><p>In the therapy of Parkinson̓s disease, both the intrajejunal administration of Levodopa/Carbidopa Intestinal Gel (LCIG) and, more recently, Levodopa/Carbidopa/Entacapone Intestinal Gel (LECIG), as well as deep brain stimulation (DBS), are employed. These approaches differ significantly in their efficacy and side effect profiles, as well as the timing of their use. Yet, the initiation of therapy for both methods is often simultaneously considered when patients have reached an advanced stage of the disease. From the authors' perspective, however, patients may reach the milestones for the indication of one of these respective treatments at different points in the course of the disease. Individual disease progression plays a pivotal role in this regard. The concept that all patients become candidates for a specific treatment at a predefined time appears erroneous to the authors. In the context of this review, therefore, the therapeutic modalities are presented in terms of their efficacy for different symptoms, the notion of simultaneous timing of their initiation is questioned, and an individualized therapy evaluation is derived, with a focus on quality of life and participation.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"502-508"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139722263","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":"[Ethical challenges of telepsychiatry].","authors":"Julien Willms, Alice Sader, Georg Juckel, Paraskevi Mavrogiorgou, Marco Kramer","doi":"10.1055/a-2452-8558","DOIUrl":"https://doi.org/10.1055/a-2452-8558","url":null,"abstract":"<p><p>Telepsychiatry is shifting the focus of psychiatry and psychotherapy from personal interaction and relationship building to communication with technological mediators in the form of telecommunication, virtual reality (VR), social robots or artificial intelligence (AI). This article discusses the opportunities and risks of new technologies in psychiatric treatment, taking into account the principles of medical ethics. Telepsychiatric treatments can promote self-determination in the home environment as opposed to institutionalisation but carry the risk of uncontrolled data sharing. They harbour risks of potential harm such as social isolation, negative effects on the doctor-patient relationship and long-term changes in patient behaviour through, for example, VR. In terms of justice, demographic and psychopathological factors could result in unequal access to telepsychiatry, with questionable sustainability effects. The anonymity of telepsychiatry threatens alienation, while moral considerations cannot be replaced by AI for the time being. It is obligatory to carefully weigh up the benefits and risks of telepsychiatry, but especially in rural areas they could optimise care.Precisely because of ethical concerns, further intensive research is necessary to weigh up the risks and benefits. The development of telepsychiatric systems requires transdisciplinary co-operation. At a societal level, the significance of technologies as a supplement or replacement for the doctor-patient relationship needs to be discussed.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617214","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":"[Telemedicine for mental disorders: Presentation and initial results of a telephone-based care approach].","authors":"Georg Bornemann","doi":"10.1055/a-2439-3965","DOIUrl":"https://doi.org/10.1055/a-2439-3965","url":null,"abstract":"<p><strong>Objective: </strong>A telephone-based health program for people with depressive and anxiety disorders as well as stress, already implemented in the standard care of a private health insurance company, as well as the initial evaluation results will be presented.</p><p><strong>Methods: </strong>The program, based on several months of telephone support for patients from medical professionals, focuses on teaching psychoeducational content, behavioral therapy techniques, and emotional support. In the current program, the German version of the DASS 21 questionnaire was used, which detects distress in the dimensions of depression, anxiety and stress as well as overall psychological stress. The demographic data and the questionnaire results of all participants from the first eleven months of the program, who completed questionnaires at two time points, are presented. The reductions in the DASS 21 (sub)scores after five months of coaching were defined as the primary endpoints. The basis for calculation was the t-test for dependent samples (α=0.05).</p><p><strong>Results: </strong>Two completed questionnaires were available from 86 of 199 participants (43.2%). The population was on average 49.5 years old and predominantly female (61.6%). In total, coaching lasted 170 (SD=58) days and 200 (81) minutes. On average, these minutes were distributed over 5.6 (1.9) calls. At baseline, there were increased scores in all subcategories (depression: 7.13 [4.99]; anxiety: 4.49 [4.07]; stress: 9.85 [4.16]; total: 21.47 [11.54]). After five months, a reduction in each parameter was measured (depression: - 2.14 [3.99], Cohen's d=0.54; anxiety: - 1.65 [3.36], d=0.49; stress: - 2.24 [4.81], d=0.47; total: - 6.03 [10.70]; d=0.56; p < 0.001 for each). Broken down by severity of stress at the start of care, several subcategories showed an increase in score reduction with increasing severity, with medium to large effect sizes.</p><p><strong>Conclusion: </strong>The telephone program described is promising as an accompanying approach to treatment of mental illness. Due to the pre-post study design, the results presented do not allow a final statement to be made about the effectiveness of the program. However, based on the significant improvements in psychological stress shown over the course of the program, including relevant effect sizes, a further evaluation of this setting under controlled conditions is recommended.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617215","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":"[Understanding and assessing the antidepressant drug-associated risk of bleeding].","authors":"Johanna Seifert, Gabriel Eckermann, Johannes Heck, Stefan Bleich, Dominik Dabbert, Renate Grohmann, Sermin Toto","doi":"10.1055/a-2089-3490","DOIUrl":"10.1055/a-2089-3490","url":null,"abstract":"<p><p>Antidepressants, in particular selective serotonin reuptake inhibitors (SSRIs), are the most commonly prescribed psychopharmacological drug group. Thus, a precise knowledge of the expected adverse drug reactions is indispensable. The increased risk of bleeding events is well documented, especially in patients treated with SSRIs. However, many other antidepressant drug groups have also been implicated in increasing the risk of bleeding. In the following review, the thrombocytic serotonin system and the respective targets of the different antidepressants are explained. Subsequently, the available literature on bleeding under the respective antidepressant classes or individual substances is presented, using data from meta-analyses whenever possible. In addition to the risk of bleeding in general, individual bleeding entities are also considered, such as gastrointestinal and cerebral hemorrhages. Finally, the effects of other drugs that increase the risk of bleeding (i. e., nonsteroidal anti-inflammatory drugs, platelet aggregation inhibitors and anticoagulants) in combination with antidepressant drugs are discussed. The information presented here is meant to guide practitioner's decision making regarding an appropriate antidepressant pharmacotherapy based on the patient's individual risk constellation.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"458-467"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9697137","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":"Molekulare Biomarker bei neuroinflammatorischen Erkrankungen.","authors":"Louisa Müller-Miny, Jan Lünemann","doi":"10.1055/a-2335-0149","DOIUrl":"https://doi.org/10.1055/a-2335-0149","url":null,"abstract":"","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"92 11","pages":"468-481"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603903","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}