GMS German Medical Science最新文献

{"title":"Matrix-producing metaplastic breast carcinoma - a rare tumor with heterologous elements.","authors":"Sharma Shruti,&nbsp;Fouzia Siraj","doi":"10.3205/000258","DOIUrl":"https://doi.org/10.3205/000258","url":null,"abstract":"<p><p>Metaplastic breast carcinomas are ductal carcinomas that undergo metaplasia into non-glandular growth patterns. They are very rare and account for less than 1% of all invasive breast carcinomas. Matrix-producing carcinoma is an extremely rare and aggressive subtype of metaplastic breast carcinoma that is characterized by a ductal carcinomatous component with direct transition to areas with cartilaginous/osseous differentiation without an intervening spindle cell element. It has a better prognosis than metaplastic carcinoma. Even though these tumors are composed of a mixture of infiltrating ductal carcinomas and areas of heterologous stroma, each of which behaves aggressively individually, these composite tumors have a better 5-year survival rate with rare nodal metastasis. Immunohistochemically, they are positive for keratin, epithelial membrane antigen and S100. The tumor, which is matrix-producing, is S100-reactive and nonreactive for cytokeratin. They are usually hormone receptor-negative. The average age of these patients is approximately 58 years. Since these tumors are usually triple-negative, chemotherapy after surgery is the mainstay of therapy, using either mastectomy or local excision. Our report highlights this rare entity in a 55-year-old female patient with matrix-producing metaplastic breast carcinoma. Its distinctive histological features and peculiar clinical behavior warrants clear knowledge about this unique entity.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"15 ","pages":"Doc17"},"PeriodicalIF":0.0,"publicationDate":"2017-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5727344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35668778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic alterations in benign prostatic hyperplasia patients.","authors":"Hanaa Mahmoud Mohamed,&nbsp;Magdy Sayed Aly,&nbsp;Tarek Dardeer Hussein","doi":"10.3205/000257","DOIUrl":"https://doi.org/10.3205/000257","url":null,"abstract":"<p><p><b>Background:</b> Benign prostate hyperplasia (BPH) is a classical age-related disease of the prostate, present in 20% of men at the age of 40 years with progression to 70% by the age of 60 years. BPH is associated with various lower urinary tract symptoms, which affect their day-to-day life. <b>Materials and methods:</b> Our objective was to evaluate the association between HER-2/neu, c-myc, p53, and clinicopathological variables in 45 patients diagnosed with benign prostatic hyperplasia using fluorescence in situ hybridization (FISH). The patients underwent transurethral prostate resection to address their primary urological problem. All patients were evaluated by use of a comprehensive medical history and rectal digital examination. The preoperative evaluation also included serum prostate specific antigen (PSA) measurement and ultrasonographic measurement of prostate volume. <b>Results:</b> The mean (± standard deviation) age of the 45 patients was 69.65 ± 8.97 years. The mean PSA value of the patients was 9.25 ± 5.12 ng/mL. The mean prostate volume was 65.46 ± 11.43 mL. Amplification of HER-2/neu was seen in 4/45 (8.9%) cases and amplification of c-myc was seen in 5 of 45 (11.1%) cases; both genes were not associated with adverse clinicopathological variables. Deletion of p53 was seen in 20/45 (44.4%) cases. p53 gene was significantly associated with a severe AUASI (American Urological Association Symptom Index) score. <b>Conclusion:</b> In this study, we discussed important genetic markers in benign prostatic hyperplasia patients which may, in the future, be used as markers for diagnosis and prognosis, as well as targets for therapeutic intervention.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"15 ","pages":"Doc16"},"PeriodicalIF":0.0,"publicationDate":"2017-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35650539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of medical education in Germany and the United States: from applying to medical school to the beginnings of residency.","authors":"Dmitry Zavlin,&nbsp;Kevin T Jubbal,&nbsp;Jonas G Noé,&nbsp;Bernd Gansbacher","doi":"10.3205/000256","DOIUrl":"https://doi.org/10.3205/000256","url":null,"abstract":"<p><p>Both Germany and the United States of America have a long tradition of science and medical excellence reaching back as far as the nineteenth century. The same tribute must be paid to the medical educational system in both countries. Despite significant initial similarities and cross-inspiration, the paths from enrolling in a medical university to graduating as a medical doctor in Germany and the US seem to have become much different. To fill a void in literature, the authors' objective therefore is to delineate both structures of medical education in an up-to-date review and examine their current differences and similarities. Recent medical publications, legal guidelines of governmental or official organizations, articles in media, as well as the authors' personal experiences are used as sources of this report. Tuition loans of over $200,000 are not uncommon for students in the US after graduating from medical schools, which are often private institutions. In Germany, however, the vast majority of medical universities are tax-funded and, for this reason, free of tuition. Significant differences and surprisingly multiple similarities exist between these two systems, despite one depending on government and the other on private organizations. Germany currently employs an integrated medical curriculum that typically begins right after high school and consists of a 2-year long pre-clinical segment teaching basic sciences and a 4-year clinical segment leading medical students to the practical aspects of medicine. On the other hand, the US education is a two-stage process. After successful completion of a Bachelor's degree in college, an American student goes through a 4-year medical program encompassing 2 years of basic science and 2 years of clinical training. In this review, we will address some of these similarities and major differences.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"15 ","pages":"Doc15"},"PeriodicalIF":0.0,"publicationDate":"2017-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5617919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35527314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous Lyme borreliosis: Guideline of the German Dermatology Society.","authors":"Heidelore Hofmann,&nbsp;Volker Fingerle,&nbsp;Klaus-Peter Hunfeld,&nbsp;Hans-Iko Huppertz,&nbsp;Andreas Krause,&nbsp;Sebastian Rauer,&nbsp;Bernhard Ruf","doi":"10.3205/000255","DOIUrl":"https://doi.org/10.3205/000255","url":null,"abstract":"<p><p>This guideline of the German Dermatology Society primarily focuses on the diagnosis and treatment of cutaneous manifestations of Lyme borreliosis. It has received consensus from 22 German medical societies and 2 German patient organisations. It is the first part of an AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.) interdisciplinary guideline: \"Lyme Borreliosis - Diagnosis and Treatment, development stage S3\". The guideline is directed at physicians in private practices and clinics who treat Lyme borreliosis. Objectives of this guideline are recommendations for confirming a clinical diagnosis, recommendations for a stage-related laboratory diagnosis (serological detection of IgM and IgG Borrelia antibodies using the 2-tiered ELISA/immunoblot process, sensible use of molecular diagnostic and culture procedures) and recommendations for the treatment of the localised, early-stage infection (erythema migrans, erythema chronicum migrans, and borrelial lymphocytoma), the disseminated early-stage infection (multiple erythemata migrantia, flu-like symptoms) and treatment of the late-stage infection (acrodermatitis chronica atrophicans with and without neurological manifestations). In addition, an information sheet for patients containing recommendations for the prevention of Lyme borreliosis is attached to the guideline.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"15 ","pages":"Doc14"},"PeriodicalIF":0.0,"publicationDate":"2017-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5588623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35441777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and trends of hospital treated pesticide poisonings in Germany 2000-2014.","authors":"Susanne Moebus,&nbsp;Wolfgang Boedeker","doi":"10.3205/000254","DOIUrl":"https://doi.org/10.3205/000254","url":null,"abstract":"<p><p><b>Objectives:</b> To analyze the occurrence, trends, and patterns of hospital treated pesticide poisonings in Germany <b>Methods:</b> Data from the German diagnoses statistics of hospital discharges are analyzed for the years 2000-2014. ICD code specific numbers of cases as well as rates per one million and case-fatality ratios are calculated. The number of fatal pesticides poisonings is compared to the official German causes-of-death statistics. <b>Results:</b> During 2000 and 2014 overall 2,871 pesticides poisonings were treated in hospitals with 191 cases per year on average. The rate per 1 million dropped from 2.74 in 2000 to 1.38 in 2014. On average 5% of pesticides poisonings were fatal, this percentage also approximately halved from 2000 to 2014. The majority of pesticide poisonings occurred in men. In both sexes about 70% of all pesticide poisonings occurred below 55 years and one third of patients were younger than 25 years. With respect to fatal poisonings men shared almost 80% of incidents and more than 70% of cases occurred above 55 years of age. There is poor agreement between the different data sources studied. On average only 24% of the fatal pesticide poisoning in the mortality statistics were seen in the diagnoses statistics of hospital discharges. <b>Conclusions:</b> This study shows that the decrease of pesticide poisonings in Germany applies to fatal and non-fatal incidents. There seems to be a decrease also in the case fatality ratio which might point to positive preventive effects by reducing the availability of toxic pesticides. Fatal pesticides poisonings prevails in elder men while non-fatal pesticide poisoning more often affects the younger population. These different patterns should be addressed when improving preventive strategies. The discrepancy between the different data bases with respect to fatal poisoning might be explained by intoxications not admitted to a hospital. However, the difference seems rather high and calls for a deeper investigation. The ICD version 10 does not provide codes allowing for pesticide-specific analyzes of poisonings. The new ICD version 11 therefore should be adjusted to the needs of monitoring of pesticide poisonings.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"15 ","pages":"Doc13"},"PeriodicalIF":0.0,"publicationDate":"2017-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35463476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral rhabdoid meningioma mimicking glioma: an unusual occurrence.","authors":"Varsha Dalal,&nbsp;Fouzia Siraj,&nbsp;Manveen Kaur,&nbsp;K B Shankar,&nbsp;Avninder Singh","doi":"10.3205/000253","DOIUrl":"https://doi.org/10.3205/000253","url":null,"abstract":"<p><p>Rhabdoid meningioma is an infrequent variant of meningioma, introduced for the first time in the 2000 World Health Organization's classification of tumors of the nervous system. Owing to its aggressive clinical course and high proliferative index, it has been classified as a grade III neoplasm. We describe a fifty-year-old male with headache, weakness of limbs, and altered sensorium. CT showed hetero-dense enhancing mass lesions in both right and left parietal areas raising suspicion of high grade glioma. Histopathologic and immunohistochemical examination revealed a tumor with features of rhabdoid meningioma. A review of literature did not reveal any bilateral occurrence of this tumor.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"15 ","pages":"Doc12"},"PeriodicalIF":0.0,"publicationDate":"2017-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35463475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Water-filtered infrared-A (wIRA) overcomes swallowing disorders and hypersalivation - a case report.","authors":"Gerd Hoffmann","doi":"10.3205/000252","DOIUrl":"https://doi.org/10.3205/000252","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Case description:&lt;/b&gt; A patient with a Barrett oesophageal carcinoma and a resection of the oesophagus with gastric pull-up developed swallowing disorders 6 years and 2 months after the operation. Within 1 year and 7 months two recurrences of the tumor at the anastomosis were found and treated with combined chemoradiotherapy or chemotherapy respectively. 7 years and 9 months after the operation local tumor masses and destruction were present with no ability to orally drink or eat (full feeding by jejunal PEG tube): quality of life was poor, as saliva and mucus were very viscous (pulling filaments) and could not be swallowed and had to be spat out throughout the day and night resulting in short periods of sleep (awaking from the necessity to spit out). In total the situation was interpreted more as a problem related to a feeling of choking (with food or fluid) in the sense of a functional dysphagia rather than as a swallowing disorder from a structural stenosis. At that time acetylcysteine (2 times 200 mg per day, given via the PEG tube) and irradiation with water-filtered infrared-A (wIRA), a special form of heat radiation, of the ventral part of the neck and the thorax were added to the therapy. Within 1 day with acetylcysteine saliva and mucus became less viscous. Within 2 days with wIRA (one day with 4 to 5 hours with irradiation with wIRA at home) salivation decreased markedly and quality of life clearly improved: For the first time the patient slept without interruption and without the need for sleep-inducing medication. After 5 days with wIRA the patient could eat his first soft dumpling although drinking of fluids was still not possible. After 2½ weeks with wIRA the patient could eat his first minced schnitzel (escalope). Following the commencement of wIRA (with typically approximately 90-150 minutes irradiation with wIRA per day) the patient had 8 months with good quality of life with only small amounts of liquid saliva and mucus and without the necessity to spit out. During this period the patient was able to sleep during the night. &lt;b&gt;Discussion:&lt;/b&gt; The main physiological effects of water-filtered infrared-A (wIRA) are: wIRA increases tissue temperature, tissue oxygen partial pressure and tissue perfusion markedly. The five main clinical effects of wIRA are: wIRA decreases pain, inflammation and exudation/hypersecretion, and promotes infection defense and regeneration, all in a cross-indication manner. Therefore there is a wide range of indications for wIRA. The effects of wIRA are based on both its thermal effects (relying on transfer of heat energy) and thermic effects (temperature-dependent effects, occurring together with temperature changes) as well as on non-thermal and temperature-independent effects like direct effects on cells, cell structures or cell substances. &lt;b&gt;Conclusion:&lt;/b&gt; Besides in a variety of other indications for wIRA, in cases of swallowing disorders (functional dysphagia) and hypersalivation or hyperse","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"15 ","pages":"Doc11"},"PeriodicalIF":0.0,"publicationDate":"2017-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35398395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality indicators in intensive care medicine for Germany - third edition 2017.","authors":"Oliver Kumpf,&nbsp;Jan-Peter Braun,&nbsp;Alexander Brinkmann,&nbsp;Hanswerner Bause,&nbsp;Martin Bellgardt,&nbsp;Frank Bloos,&nbsp;Rolf Dubb,&nbsp;Clemens Greim,&nbsp;Arnold Kaltwasser,&nbsp;Gernot Marx,&nbsp;Reimer Riessen,&nbsp;Claudia Spies,&nbsp;Jörg Weimann,&nbsp;Gabriele Wöbker,&nbsp;Elke Muhl,&nbsp;Christian Waydhas","doi":"10.3205/000251","DOIUrl":"https://doi.org/10.3205/000251","url":null,"abstract":"<p><p>Quality improvement in medicine is depending on measurement of relevant quality indicators. The quality indicators for intensive care medicine of the German Interdisciplinary Society of Intensive Care Medicine (DIVI) from the year 2013 underwent a scheduled evaluation after three years. There were major changes in several indicators but also some indicators were changed only minimally. The focus on treatment processes like <i>ward rounds</i>, <i>management of analgesia and sedation</i>, <i>mechanical ventilation</i> and <i>weaning</i>, as well as the number of 10 indicators were not changed. Most topics remained except for <i>early mobilization</i> which was introduced instead of <i>hypothermia following resuscitation</i>. <i>Infection prevention</i> was added as an outcome indicator. These quality indicators are used in the peer review in intensive care, a method endorsed by the DIVI. A validity period of three years is planned for the quality indicators.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"15 ","pages":"Doc10"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/000251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35307588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real life pharmaceutical treatment patterns for adult patients with focal epilepsy in Germany: a longitudinal and cross-sectional analysis of recently approved anti-epileptic drugs.","authors":"Antje Groth,&nbsp;Thomas Wilke,&nbsp;Simon Borghs,&nbsp;Patrick Gille,&nbsp;Lars Joeres","doi":"10.3205/000250","DOIUrl":"https://doi.org/10.3205/000250","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objectives&lt;/b&gt;: The aim of this study was to investigate the antiepileptic drug (AED) treatment of adults suffering from focal epilepsies (FE) in Germany. Of special interest was the number and percentage of the patients 16 years and older receiving no treatment with an AED, treatment with one AED (monotherapy), treatment with more than one AED, and treatment with a novel AED. The definition for \"novel\" was newly approved at the time of market entry since 2006 (last 10 years): eslicarbazepine (ESL), lacosamide (LCM), perampanel (PER), and retigabine (RTG). &lt;b&gt;Methods:&lt;/b&gt; The analysis was based on a claims data set covering the years 2007 to 2014, provided by AOK PLUS, a German statutory health insurance. Two patient samples were defined: (1) prevalent patients suffering from FE (at least one in- or outpatient diagnosis of FE and at least one prescription of an AED), and (2) incident FE patients (first in- or outpatient diagnosis of FE without any previous diagnoses/AED prescriptions in the preceding 6 months). Patient observation started at date of first observed inpatient or outpatient focal epilepsy diagnosis within the analyzed period. Each patient was classified as a \"no AED therapy\", \"AED monotherapy\" or \"more than one AED therapy\". Patients were analyzed by number and type of concomitantly prescribed AEDs in yearly tranches (no, one, two, three, four, more than four AEDs; novel versus non-novel AEDs). &lt;b&gt;Results:&lt;/b&gt; A total of 34,422 patients diagnosed with FE aged 16 year or older (mean age 59.6 years, 48.7% female) were identified. The mean follow-up period was 1,891 days (5.2 years) since first confirmed diagnosis. The percentage of prevalent patients diagnosed with FE who received one AED (monotherapy) was stable overall and ranged between a minimum of 66.2% (2007) and a maximum of 68.9% (2010). The percentage of patients who received two AEDs ranged from 23.6% (2012) to 25.8% (2007). The remaining patients received therapies with three (6.0% in 2010 to 6.7% in 2007), four (1.0% in 2010 to 1.2% in 2009) or more than four AEDs (0.1% in 2014 to 0.3% in 2013). Between 8.1%-16.6% (2007; 2014) of the patients received no AED therapy in the observed period. In the first year after the diagnosis of FE (incident patients), 9.7% of patients didn't receive any AED therapy. Of those treated with at least one AED, 80.0% received one AED (monotherapy) only, 17.0% received therapy with two AEDs, 2.6% with three AEDs, 0.3% with four AEDs, and 0.1% with &gt;4 AEDs during the respective observation time window and remained stable throughout the four-year follow-up period. Of prevalent patients with a diagnosis of FE, 1,889 (5.5%) received at least one prescription of a novel AED during the observation period; 98.6% of these patients received the novel AED in combination with at least one other AED. Of those patients, 269 (14.2%) received &gt;1 novel AED. The analysis of the patients receiving novel AEDs by the time from the first confirmed diagnosi","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"15 ","pages":"Doc09"},"PeriodicalIF":0.0,"publicationDate":"2017-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/000250","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35108357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions for reducing self-stigma in people with mental illnesses: a systematic review of randomized controlled trials.","authors":"Roland Brian Büchter, Melanie Messer","doi":"10.3205/000248","DOIUrl":"10.3205/000248","url":null,"abstract":"<p><p><b>Background:</b> Self-stigma occurs when people with mental illnesses internalize negative stereotypes and prejudices about their condition. It can reduce help-seeking behaviour and treatment adherence. The effectiveness of interventions aimed at reducing self-stigma in people with mental illness is systematically reviewed. Results are discussed in the context of a logic model of the broader social context of mental illness stigma. <b>Methods:</b> Medline, Embase, PsycINFO, ERIC, and CENTRAL were searched for randomized controlled trials in November 2013. Studies were assessed with the Cochrane risk of bias tool. <b>Results:</b> Five trials were eligible for inclusion, four of which provided data for statistical analyses. Four studies had a high risk of bias. The quality of evidence was very low for each set of interventions and outcomes. The interventions studied included various group based anti-stigma interventions and an anti-stigma booklet. The intensity and fidelity of most interventions was high. Two studies were considered to be sufficiently homogeneous to be pooled for the outcome self-stigma. The meta-analysis did not find a statistically significant effect (SMD [95% CI] at 3 months: -0.26 [-0.64, 0.12], I²=0%, n=108). None of the individual studies found sustainable effects on other outcomes, including recovery, help-seeking behaviour and self-stigma. <b>Conclusions:</b> The effectiveness of interventions against self-stigma is uncertain. Previous studies lacked statistical power, used questionable outcome measures and had a high risk of bias. Future studies should be based on robust methods and consider practical implications regarding intervention development (relevance, implementability, and placement in routine services).</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"15 ","pages":"Doc07"},"PeriodicalIF":0.0,"publicationDate":"2017-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34988440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}