Fortschritte Der Neurologie Psychiatrie最新文献

{"title":"[Medical evaluation of Parkinson's disease as an occupational disease].","authors":"Jens D Rollnik","doi":"10.1055/a-2791-7896","DOIUrl":"https://doi.org/10.1055/a-2791-7896","url":null,"abstract":"<p><p>Since 2023, a new occupational disease (OD), \"Parkinson's syndrome caused by pesticides\", can be recognized by the statutory accident insurance system in Germany. For a patient to be recognized as suffering from this disease, an expert medical assessment must confirm the presence of a \"primary Parkinson's syndrome\", and Parkinsonism must not be secondary to another underlying condition. In addition, there must be evidence of occupational exposure to pesticides, specifically fungicides, insecticides, or herbicides, on at least 100 working days within one functional group (insecticides, herbicides, or fungicides). This article provides guidance for accurate diagnosis and discusses differential diagnostic considerations that must be taken into account during the medical assessment.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226154","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":"[Suizide prevention in Italy and Germany: An overview].","authors":"Giancarlo Giupponi, Andreas Conca, Paraskevi Mavrogiorgou, Georg Juckel","doi":"10.1055/a-2791-7446","DOIUrl":"https://doi.org/10.1055/a-2791-7446","url":null,"abstract":"<p><p>Suicide prevention is highly relevant both individually and socially. In this study, the psychiatric care models in Italy and Germanyin suicide prevention are compared as part of a literature analysis. Suicide rates are significantly lower in Italy than in Germany. This could be due to different historical and, cultural and possibly also climatic characteristics, but in Italy, following the Basaglia reform, social inclusion, community-based care and respect for individual rights play a particularly important role. This care model also shows that open, almost coercion-free psychiatry may be more successful with regard to the important outcome factor of suicide. Italy, on the other hand, can learn from the central, more pronounced coordination of suicide prevention programs, but also from the dense medical care network in Germany with rapid, above all psychopharmacological as well as psychotherapeutical intervention options. The integration of both approaches would probably be most successful.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194441","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":"[Foreign body ingestions in mental disorders: What do we know and what should we do?]","authors":"Maximilian Gahr, Karl Mischke, Stephan Kanzler, Markus Alexander Kölle, Florian Seemüller, Alkomiet Hasan","doi":"10.1055/a-2778-7790","DOIUrl":"https://doi.org/10.1055/a-2778-7790","url":null,"abstract":"<p><p>Foreign body ingestion (FBI) in mental disorders is a common and often highly challenging healthcare problem. While international guidelines exist for the acute gastroenterological care of adults with FBI, the data available in the psychiatric context is very limited in terms of both quantity and quality. FBI occurs in almost all mental disorders, but is probably most common in patients with borderline personality disorder. Sharp and pointed objects, particularly large (>2.5 cm in diameter) or long (>6 cm) objects, as well as batteries, especially button cells, but also magnets, are associated with the greatest risk of FBI-related complications. Nevertheless, approximately 80% of all ingested objects are excreted in the feces without complications after 5 to 6 days. Acute psychiatric care for FBI should include a medical history regarding the type and number of foreign bodies ingested, the time of ingestion, and a physical examination focusing on general condition, abdomen, respiratory system, and vital signs. Not every ingested object needs to be removed endoscopically, which is why knowledge of gastroenterological guideline recommendations is also necessary in a psychiatric setting. In cases of repeated FBI, interdisciplinary discussions should be held to address general and case-related aspects of acute care. Standards for communication and interaction between the team and the patient should be defined with the aim of avoiding reinforcement of the patient's dysfunctional behavior. In addition, supervision and intervision should be carried out. A clinical ethics committee should be involved in particularly complex cases. For ethical, medical, and liability reasons, it cannot be recommended to refrain from endoscopy in all cases of repeated FBI. In individual cases, however, after weighing the benefits and risks and reaching an interdisciplinary consensus, gastroscopy may be delayed or avoided in order to reduce dysfunctional reinforcement and the risk of adverse effects and complications. If disorder-specific psychotherapy (e.g., DBT, MBT) is not available or feasible, important elements of treatment include defining the further course of action in a therapy contract, conducting situation analyses, and contingency management. The aspects mentioned should be documented in an acute treatment plan that has been agreed upon by an interdisciplinary team and communicated to the patient.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194462","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":"[Myasthenic syndromes: retrospective analysis of two patient cohorts].","authors":"Felix Maximilian Xaver Lorenz, Benedikt Schoser","doi":"10.1055/a-2777-1902","DOIUrl":"https://doi.org/10.1055/a-2777-1902","url":null,"abstract":"<p><p>Myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) are rare autoimmune-mediated neuromuscular diseases characterized by muscle weakness. Although various treatment options are available for MG, a subset of patients may be considered treatment-refractory, with differing definitions of this status present in the scientific literature. This monocentric, retrospective cohort study investigated 200 patients with MG and 15 patients with LEMS. Data on clinical characteristics, antibody status, treatment response, and concomitant diseases were collected. MG patients who received at least three different immunosuppressants during their disease history were categorized as treatment-refractory. Statistical analyses were conducted using SPSS.11.5% of MG patients (n=23) were classified as treatment-refractory. According to the MGFA classification, these patients were more likely to exhibit severe disease, have a higher prevalence of MuSK antibodies, and experience increased cardiovascular comorbidities. The results indicate that patients in the treatment-refractory group exhibited severe disease progression more frequently according to the MGFA classification and required escalation therapies more often. However, a standardized definition of therapy-refractory MG is not yet available.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103467","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":"[From stroke via swollen joints to M. Whipple: case report from neurological rehabilitation and review of literature].","authors":"Hilke Weichert, Ina Kötter, Oliver Pade","doi":"10.1055/a-2662-1621","DOIUrl":"10.1055/a-2662-1621","url":null,"abstract":"<p><p>Whipple's disease is a rare systemic disease caused by a chronic infection with Tropheryma whipplei, which can often only be diagnosed years after the first symptoms appear. The symptoms are varied and sometimes unspecific. In addition to cachexia, recurrent joint swelling and abdominal complaints, neurological symptoms with dementia, myoclonus and motor neuron disease also occur. In the reported case, symptoms such as joint swelling and spasms of the legs occurred during neurological rehabilitation following a paramedian pons infarction. The close collaboration between the neurological rehabilitation physicians and rheumatology colleagues made it possible to diagnose Whipple's disease. Guideline-compliant treatment with ceftriaxone followed by sulfamethoxazole-trimethoprim was initiated. This improved the joint effusions and, surprisingly, also the spasms of the legs within a few days.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"52-55"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948294","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":"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":"34-40"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","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":"[Digital therapeutics in Neurology].","authors":"Matthias Guth","doi":"10.1055/a-2655-2462","DOIUrl":"10.1055/a-2655-2462","url":null,"abstract":"<p><p>Since 2020 physicians and psychotherapist in Germany can prescribe digital interventions. The interventions have to meet safety and data privacy requirements and must prove their effectiveness. Eight interventions are available in the field of neurology: Two for multiple sclerosis (elevida, levidex), three for insomnia (HelloBetter Schlafen, somnio, somnovia), one for aphasia (neolexon Aphasie), one for mild cognitive impairment (NeuroNation MED), and one for migraine headache prophylaxis (sinCephalea - Migräneprophylaxe). In Germany, digital interventions can be prescribed to outpatients and as a post-hospital treatment.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"94 1-02","pages":"56-70"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984687","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 Impact of Antidepressants on COVID-19 and Post-Acute COVID-19 Syndrome: A Scoping-Review Update].","authors":"Udo Bonnet, Georg Juckel","doi":"10.1055/a-2374-2218","DOIUrl":"10.1055/a-2374-2218","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Introduction Preclinically, fluvoxamine and other antidepressants (AD) exerted antiviral and anti-inflammatory properties also against SARS-COV-2. Therfore, It makes sense to test the clinical effect of AD against COVID-19 and Long COVID.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;On May 20, 2024, this systematic scoping review in PUBMED identified 1016 articles related to AD and COVID-19, Long COVID and SARS-COV-2. These included 10 retrospective \"large scale\" studies (&gt; 20000 chart reviews), 8 prospective clinical trials (plus 4 regarding Long COVID), 11 placebo-controlled randomized (RCT) (plus 2 regarding Long COVID) and 15 meta-analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;COVID-19: Retrospective studies with cohorts taking AD primarily for psychiatric comorbidities or chronic pain conditions directly prior to SARS-COV-2 infection described that this substance class (most studied: Selective Serotonin Re-Uptake Inhibitors (SSRI) and Selective Serotonin Noradrenaline Re-Uptake Inhibitors (SSNRI)) were associated with (i) significantly fewer SARS-COV-2 infections and (ii) a milder course of COVID-19 (\"COVID-19 protection\"). Ten of the 11 RCTs found regarding COVID-19 tested fluvoxamine, as this old AD appeared suitable as a prophylactic agent against severe COVID-19, taking into account its in vitro potency against the progression of intracellular sepsis cascades. Therefore, most (12 out of 15) meta-analyses also referred to fluvoxamine. They found (iii) a significant (40-70% reduction) in mortality, intubation and hospitalization rates when fluvoxamine was used as an add-on to standard therapy for mild to moderate COVID-19. When this AD was used in the early stages of the disease, it was more successful than when it was given later in advanced, severe COVID-19 (e.g. severe pneumonia, final sepsis stages). A dose dependency was observed: 2x50 mg fluvoxamine over 15 days was less effective than 2x100 or even 3x100 mg with an adverse event profile still at the placebo level. Direct comparisons with drugs approved for COVID-19 do not yet exist. A first indirect meta-analytical comparison showed an advantage of paxlovid or molnupiravir versus fluvoxamine against the development of severe COVID-19: risk reduction of 95% (I2 = N/A, but only one study) or 78% (I2=0) versus 5+-5% (I2=48). However, an add-on of fluvoxamine was still significantly more efficacious than symptom-oriented standard therapy alone. Long COVID: A common Long COVID phenotype with dominant anxiety and depression symptoms, which responds to AD, relaxation therapy and/or psychotherapy, has now been identified. Casuistics report positive effects of AD on fatigue, cognitive and autonomic dysfunctions. A first large prospective open-label RCT has just shown significantly more favourable courses, less viral load and less pro-inflammatory cytokines in the treatment of mild to moderate COVID-19 with fluvoxamine versus standard treatment, also with regard to the subsequent development of neuropsyc","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"14-33"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307477","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":"[Ofatumumab in the treatment of multiple sclerosis - A summary of preclinical and clinical data].","authors":"Juliane Klehmet, Tobias Bopp","doi":"10.1055/a-2365-0966","DOIUrl":"10.1055/a-2365-0966","url":null,"abstract":"<p><strong>Background: </strong>  B-cell targeted therapies are highly effective in multiple sclerosis (MS). Most of these therapies are administered intravenously at long intervals. Ofatumumab, an anti-CD20 antibody that is administered subcutaneously at low doses on a monthly basis due to its high affinity to the target structure, became available for the treatment of MS in 2021.</p><p><strong>Methods: </strong>  An overview of practice-relevant immunological and clinical data on ofatumumab is provided.</p><p><strong>Results: </strong>  The high affinity of ofatumumab to the target structure allows low dose and low volume administration, with the release and absorption profile after subcutaneous application allowing for high concentrations in the lymph nodes and gradual depletion of B-cells. Rapid onset of action is achieved as well as B-cell repletion within a few months in case of discontinuation of therapy. Long-term data show stable IgG levels over up to four years and high efficacy with respect to relapse rate, progression, and cognition. According to current study data, the effect compared to teriflunomide is greater the earlier therapy is initiated. Ofatumumab has a specific B-cell depletion pattern. CD20 expressing B-cell progenitor cells in the bone marrow are preserved and therefore also the inducibility and differentiation of plasma cells. The formation of a humoral immunological memory is therefore possible. Four-year study data showed no abnormalities in the rate of severe infections or malignancies.</p><p><strong>Conclusions: </strong>  Ofatumumab is an innovative B-cell targeted therapy. It is highly effective with a good safety and tolerability profile, well controllable and maintains immunocompetence against pathogens.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"41-51"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12803776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Brain and Mental Health Go Hand in Hand: A Look Back at a Year of Intensive Collaboration].","authors":"Jens Kuhn, Peter Falkai","doi":"10.1055/a-2731-9023","DOIUrl":"https://doi.org/10.1055/a-2731-9023","url":null,"abstract":"","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"94 1-02","pages":"12-13"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984667","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}