{"title":"Recorded spontaneous seizure prior to electroconvulsive therapy after etomidate induction in a patient treated with bupropion: a case report.","authors":"Evelyn Romina Pircher Nöckler, Laurin Mauracher, Lukas Gasteiger, Imrich Blasko","doi":"10.1007/s40211-025-00553-3","DOIUrl":"https://doi.org/10.1007/s40211-025-00553-3","url":null,"abstract":"<p><strong>Background: </strong>Electroconvulsive therapy (ECT) is a widely used and effective treatment for refractory depression. Patients hospitalized for ECT regularly take antidepressants or adjuvant antipsychotics, both can influence the quality of seizures. Adaptation of the seizure threshold during an ECT series necessitates adjustments in treatment parameters to ensure adequate seizure quality.</p><p><strong>Methods: </strong>We report the case of a 46-year-old man with treatment-resistant depression treated with bupropion and ECT, who developed a spontaneous seizure after first-time etomidate anesthesia induction, as previously induced seizures under thiopental were considered insufficient. Serendipitously, an electroencephalogram (EEG) of the seizure was recorded.</p><p><strong>Results: </strong>The characteristics of the EEG captured after this spontaneous seizure were similar to those of regular ECT seizures under thiopental anesthesia in this patient. After returning to thiopental anesthesia, the remaining ECT course was unremarkable, and the patient's depressive symptoms improved partially.</p><p><strong>Conclusion: </strong>Accordingly, the use of etomidate as an anesthesia induction agent for ECT in patients who are concomitantly using bupropion needs to be cautiously considered. The case of a documented etomidate-induced seizure could indicate the relatively benign course of such events.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NEUROPSYCHIATRIEPub Date : 2025-10-07DOI: 10.1007/s40211-025-00551-5
U Volpe, R Ramalho, W Gaebel
{"title":"Risks of digitalization in mental health care.","authors":"U Volpe, R Ramalho, W Gaebel","doi":"10.1007/s40211-025-00551-5","DOIUrl":"https://doi.org/10.1007/s40211-025-00551-5","url":null,"abstract":"<p><p>The digitalization of mental health care has ushered in transformative possibilities for enhancing access, diagnosis, and treatment through technologically enabled tools and platforms. However, this evolution presents substantial risks that warrant careful consideration. This paper critically examines the psychological, ethical, cultural, and clinical challenges embedded in digital mental health practices. Key concerns include diminished clinical oversight, compromised patient data security, algorithmic bias in diagnostic and therapeutic algorithms, and the erosion of traditional therapeutic relationships. Cultural disparities in digital literacy and engagement further complicate equitable care delivery. Through a multidisciplinary lens, the paper explores how these risks may impact both care outcomes and professional standards. To bridge the gap between innovation and responsible practice, a table of best practices is provided to support clinicians and developers in ethically integrating digital tools into psychiatric settings. These recommendations aim to uphold patient autonomy, strengthen clinician accountability, and preserve the humanistic foundation of mental health care. Ultimately, the paper advocates for a balanced and cautious approach to digitalization-one that embraces opportunity without compromising clinical integrity.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NEUROPSYCHIATRIEPub Date : 2025-09-18DOI: 10.1007/s40211-025-00550-6
Rupa Sanadi, Ranga Rao, Claudia Klier, Nabagata Das, Prabha S Chandra
{"title":"Optimal care for mother and baby in severe postpartum mental illness.","authors":"Rupa Sanadi, Ranga Rao, Claudia Klier, Nabagata Das, Prabha S Chandra","doi":"10.1007/s40211-025-00550-6","DOIUrl":"https://doi.org/10.1007/s40211-025-00550-6","url":null,"abstract":"<p><strong>Background: </strong>Severe postpartum mental illnesses (PPSMI), including postpartum psychosis, bipolar disorder, and major depression, affect approximately 1-2 per 1000 deliveries and can lead to serious consequences including suicide, infanticide, and long-term disruptions in the mother-infant relationship. In many low-resource settings, the absence of specialized mother-baby units (MBUs) necessitates alternate models of care.</p><p><strong>Methods: </strong>This narrative review synthesizes current evidence and clinical guidelines on managing PPMI in outpatient and inpatient settings. Key focus areas include rational psychopharmacology, indications for electroconvulsive therapy (ECT), identification of organic conditions, psychosocial interventions, and family involvement, particularly in low- and middle-income countries (LMICs).</p><p><strong>Results: </strong>Effective management of PPSMI requires timely diagnosis, individualized medication plans compatible with breastfeeding, and consideration of conditions such as autoimmune encephalitis or cerebral venous thrombosis in atypical presentations. ECT is a valuable, often underutilized, option. Multidisciplinary teams play a key role in psychiatric evaluation, pharmacological and nonpharmacological treatment. Family engagement, telepsychosocial support, caregiver education, safety planning and community-based care are essential in the absence of MBUs.</p><p><strong>Conclusion: </strong>A multidisciplinary, biopsychosocial approach adapted to local resources is vital for managing PPSMI. Strengthening perinatal mental health services and policies can improve maternal outcomes and ensure safer environments for both mother and infant.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NEUROPSYCHIATRIEPub Date : 2025-09-18DOI: 10.1007/s40211-025-00543-5
Norman Sartorius
{"title":"The future of psychiatry.","authors":"Norman Sartorius","doi":"10.1007/s40211-025-00543-5","DOIUrl":"https://doi.org/10.1007/s40211-025-00543-5","url":null,"abstract":"<p><p>The future of psychiatry depends upon the development of knowledge about the functioning of the brain and the human body, on the changes to the world in which we live, and on the impact of major socioeconomic trends such as urbanization. This article describes the impact of these trends on mental health and health programs and lists what should be done to reduce mental health problems and improve the future of psychiatry.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NEUROPSYCHIATRIEPub Date : 2025-09-17DOI: 10.1007/s40211-025-00552-4
Lukas Roell, Isabel Maurus, Andrea Schmitt, Peter Falkai
{"title":"Physical exercise therapy in schizophrenia spectrum disorders: current evidence and treatment recommendations.","authors":"Lukas Roell, Isabel Maurus, Andrea Schmitt, Peter Falkai","doi":"10.1007/s40211-025-00552-4","DOIUrl":"https://doi.org/10.1007/s40211-025-00552-4","url":null,"abstract":"<p><p>Physical exercise has been proposed as an adjunctive treatment for schizophrenia spectrum disorders, with meta-analyses showing benefits for positive, negative, and total symptom severity, as well as cognition and daily functioning, although effects on physical health remain minimal. This narrative review summarizes current evidence, discusses the underlying mechanisms, and offers recommendations for implementing exercise therapy in clinical practice.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NEUROPSYCHIATRIEPub Date : 2025-09-01Epub Date: 2025-07-29DOI: 10.1007/s40211-025-00535-5
Carina S Bichler, Linda K Rausch, Jana Unterholzner, Martin Kopp, Barbara Sperner-Unterweger, Katharina Hüfner
{"title":"[Physical activity in psychiatry: a practical guide for clinicians on patient communication about physical activity, exercise, and sport].","authors":"Carina S Bichler, Linda K Rausch, Jana Unterholzner, Martin Kopp, Barbara Sperner-Unterweger, Katharina Hüfner","doi":"10.1007/s40211-025-00535-5","DOIUrl":"10.1007/s40211-025-00535-5","url":null,"abstract":"<p><p>Mental disorders are often associated with a significantly reduced level of physical activity, leading to inactivity rates of 40-86%. This is concerning, as physical activity not only has well-documented positive effects on physical health but also represents an evidence-based, cost-effective, and low-risk treatment option for psychiatric disorders. However, exercise remains insufficiently integrated into psychiatric care, partly due to barriers among healthcare providers and patients. The most common barriers reported by patients include fatigue, uncertainty, and financial constraints, while lack of time plays a less significant role.This review examines the scientific evidence supporting exercise as a therapeutic intervention - \"Exercise is Medicine®\" - for psychiatric disorders and highlights its effectiveness across a wide range of conditions, from anxiety disorders to obsessive-compulsive disorders. Furthermore, it explores the \"knowledge-action gap\" between existing research and clinical implementation, providing practical recommendations based on Motivational Interviewing techniques. In addition to distinguishing between the concepts of physical activity, exercise, sport, and exercise therapy, this article presents recommendations for physical activity, behavior change techniques, a structured counseling guide, and an informational flyer for patients.The aim of this article is to establish exercise as an integral component of psychiatric treatment and facilitate its implementation in clinical practice. By integrating physical activity, not only can quality of life and mental health be improved, but health disparities can also be reduced. This article offers evidence-based recommendations and practical strategies for promoting physical activity in psychiatric care.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"133-143"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733762","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}
NEUROPSYCHIATRIEPub Date : 2025-09-01Epub Date: 2025-07-28DOI: 10.1007/s40211-025-00538-2
Dimitri Chubinidze, Catherine Perry, Kate Tchanturia
{"title":"Artificial intelligence-assisted visual elicitation in anorexia nervosa : Qualitative case studies.","authors":"Dimitri Chubinidze, Catherine Perry, Kate Tchanturia","doi":"10.1007/s40211-025-00538-2","DOIUrl":"10.1007/s40211-025-00538-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored the feasibility and therapeutic potential of combining artificial intelligence (AI)-assisted visual elicitation with sensory-attuned guided reflection to support emotional expression and engagement in individuals with anorexia nervosa (AN).</p><p><strong>Methods: </strong>We conducted a two-session, therapist-led intervention with two adults with restrictive AN. In session 1, we guided participants to reflect on emotionally challenging experiences using metaphor and sensory language cues. We translated these narratives into prompts for DALL·E (v3; OpenAI, San Francisco, CA, USA), an AI image-generation tool. In session 2, participants selected from curated images to reflect on and deepen their exploration of emotional experiences. We analysed the data using reflexive thematic analysis and performed a cross-case synthesis.</p><p><strong>Results: </strong>Visual metaphors helped to externalise and communicate emotions, evoke embodied responses and refine affective descriptions. The co-creative process fostered therapeutic engagement and a greater sense of agency in both participants.</p><p><strong>Conclusion: </strong>AI-assisted visual elicitation, integrated into a structured therapeutic process, may offer an additional benefit to talking therapy for individuals with AN. By enabling visual expression, this approach could support emotional insight and communication in populations with emotion labelling and regulation differences.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"144-154"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733763","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}
NEUROPSYCHIATRIEPub Date : 2025-09-01DOI: 10.1007/s40211-025-00542-6
Jonathan Campion, Afzal Javed
{"title":"Public mental health: a WPA priority and key opportunity to address implementation failure.","authors":"Jonathan Campion, Afzal Javed","doi":"10.1007/s40211-025-00542-6","DOIUrl":"https://doi.org/10.1007/s40211-025-00542-6","url":null,"abstract":"<p><p>Mental health conditions (MHCs) account for a large proportion of global disease burden and result in broad impacts and associated economic costs. Despite the existence of effective public mental health (PMH) interventions, only a minority of individuals with MHCs receive treatment, far fewer receive interventions to prevent associated impacts, and there is negligible coverage of interventions to prevent MHCs or promote mental wellbeing and resilience. This implementation failure results in population-scale preventable suffering, broad impacts and associated economic costs, which are far greater in low- and middle-income countries. The gap also breaches the right to health and statutory legislation in some countries. The World Psychiatric Association has prioritised PMH and highlighted how a set of coordinated actions can improve PMH implementation, including by effectively making the PMH case, PMH practice, PMH training and improved population knowledge, settings-based and integrated approaches, digital technology, maximising existing resources, use of interventions with a large population impact, a rights approach and legislation, and implementation-focused research. Improved implementation results in broad population impacts, achievement of policy objectives across sectors and sustainable reduction in the impact of MHCs and promotion of population wellbeing. The associated economic benefits make PMH a key part of sustainable economic development.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NEUROPSYCHIATRIEPub Date : 2025-09-01Epub Date: 2025-07-22DOI: 10.1007/s40211-025-00534-6
Maximilian Wolfmeir, Julia Burits
{"title":"Acute psychosis in variegate porphyria: a case report.","authors":"Maximilian Wolfmeir, Julia Burits","doi":"10.1007/s40211-025-00534-6","DOIUrl":"10.1007/s40211-025-00534-6","url":null,"abstract":"<p><strong>Background: </strong>Variegate porphyria (VP) is a rare metabolic disorder resulting in a deficiency of the heme synthesis pathway. Patients typically present with photosensitive skin lesions, hypertension, abdominal pain, and heterogeneous neuropsychiatric symptoms, including psychosis.</p><p><strong>Methods: </strong>We report a case of porphyria-associated psychosis in a female patient with VP and no prior psychiatric history. Additionally, we highlight the hypothesized underlying pathophysiological mechanisms contributing to neuropsychiatric symptoms in VP.</p><p><strong>Results: </strong>Although VP is a rare cause of psychosis, its pathophysiological mechanisms are of significant interest, as they further support the plausibility of current prevailing hypotheses on the development of psychosis.</p><p><strong>Conclusion: </strong>Management of VP requires care in specialized centers. Avoiding triggers, such as stress, fasting, and certain medications, is crucial for preventing disease flare-ups.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"155-158"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NEUROPSYCHIATRIEPub Date : 2025-09-01DOI: 10.1007/s40211-025-00547-1
A Karwautz
{"title":"bericht aus dem ögkjp-vorstand.","authors":"A Karwautz","doi":"10.1007/s40211-025-00547-1","DOIUrl":"https://doi.org/10.1007/s40211-025-00547-1","url":null,"abstract":"","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":"39 3","pages":"161-163"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}