NEUROPSYCHIATRIE最新文献

{"title":"[Lithium and its impact on renal function. Recommendations for practice, especially for older patients].","authors":"Christian Jagsch, Gerhard Wirnsberger, Christian Simhandl","doi":"10.1007/s40211-025-00532-8","DOIUrl":"https://doi.org/10.1007/s40211-025-00532-8","url":null,"abstract":"<p><strong>Purpose and research question of the review: </strong>Despite its substantial therapeutic efficacy-particularly in the acute treatment and relapse prevention of bipolar affective disorders-lithium is associated with a broad spectrum of side effects, among which potential nephrotoxicity represents one of the most significant long-term risks. In clinical practice, particularly in the treatment of older adults, physicians are often faced with the question of whether lithium therapy can or should be continued, or whether initiation is feasible, given comorbid somatic illnesses, polypharmacy, or reduced glomerular filtration rate (GFR). The aim of this review is to provide practical, evidence-based recommendations for clinical decision-making.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed, Web of Science, and Google Scholar, focusing on the treatment of patients with bipolar and unipolar affective disorders with lithium and its potential effects on renal function, particularly in the context of long-term therapy and aging. A case report is included to illustrate clinical application.</p><p><strong>Results and conclusions: </strong>Lithium remains a cornerstone in the pharmacological treatment of bipolar and unipolar affective disorders, despite its known nephrotoxic potential. Optimizing the balance between therapeutic benefit and potential renal risks necessitates close monitoring and individualized treatment adjustments. The risk of lithium-induced nephropathy increases with the duration of therapy, patient age, and the frequency of episodes of lithium toxicity or overdose. Current guidelines recommend maintaining serum lithium levels within a range of 0,6-0,8 mmol/L. In older patients with good treatment response, target levels at the lower end of the therapeutic window (0,4-0,6 mmol/L) are advised. Lithium therapy should be monitored at regular intervals, including laboratory testing and 12-hour serum level checks every three months, or every 8-10 weeks in elderly patients. If GFR falls below 30 ml/min/1,73 m², nephrology consultation is warranted, and the continuation of lithium treatment should be critically re-evaluated. In patients with a GFR below 45 ml/min/1,73 m², initiation of lithium therapy in old age is not recommended. Decisions regarding the discontinuation or initiation of lithium therapy should always be made on an individual and interdisciplinary basis, carefully weighing the therapeutic benefit against the risk of affective relapse and the potential for progressive renal impairment.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508794","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}

{"title":"Psychopathological symptom severity and parent-child age differences in patients with eating disorders.","authors":"Lina Schmauch, Emma Josephine Michel, Günter Reich, Thomas Meyer","doi":"10.1007/s40211-025-00528-4","DOIUrl":"https://doi.org/10.1007/s40211-025-00528-4","url":null,"abstract":"<p><strong>Background: </strong>Although family factors affecting the development of eating disorders (EDs) have been extensively studied, it is unknown whether the age gaps between the parents and their affected child have an impact on the overall psychopathological symptom severity.</p><p><strong>Methods: </strong>In a cohort of 510 consecutive study participants diagnosed with an ED and treated between 1991 and 2017, we examined the associations between parent-patient age gaps and scores from the self-report Global Severity Index (GSI), which measures overall psychopathological distress and symptom severity of the nine psychopathological themes of the Symptom Checklist-90-Revised (SCL-90-R).</p><p><strong>Results: </strong>In univariate analysis, the GSI scores correlated significantly and negatively between the ED-affected child and the age gap to both the mother (r = -0.119, p = 0.007) and the father (r = -0.108, p = 0.017). Regression models adjusted for body mass index, living in the parental home, and the education level of the patient as clinically relevant confounders confirmed the significant relationship between the overall psychological distress and the age difference to the mother (exp(β) = -0.091, 95% confidence interval [CI] = -0.022-0.000, p = 0.049). In addition, using the same set of confounders, there was a trend toward an association between GSI scores and the paternal age difference to the ED-diagnosed patients (exp(β) = -0.086, 95% CI = -0.018-0.000, p = 0.063).</p><p><strong>Conclusion: </strong>The symptom severity is more pronounced in cases of a smaller age gap between the parents and their ED-affected child. In multivariate analysis, a significant association was found between a higher self-rated symptom severity and a smaller maternal age difference to the patient. Future studies should thoroughly investigate the influence of parents' age on their offspring's EDs in search of potential underlying mechanisms.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303177","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}

{"title":"bericht aus dem ögkjp-vorstand.","authors":"Andreas Karwautz","doi":"10.1007/s40211-025-00531-9","DOIUrl":"https://doi.org/10.1007/s40211-025-00531-9","url":null,"abstract":"","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":"39 2","pages":"102-104"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209775","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}

{"title":"bericht aus dem ögpp-vorstand.","authors":"Goedl-Fleischhacker U","doi":"10.1007/s40211-025-00530-w","DOIUrl":"https://doi.org/10.1007/s40211-025-00530-w","url":null,"abstract":"","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":"39 2","pages":"100-101"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209776","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}

{"title":"[\"Assisted Suicide\"-A Case Report on Assisted Suicide in the Context of Mental Illnesses].","authors":"Cornelia Marion Diendorfer, Dominik Ivkic, Valentin Popper, Matthäus Willeit, Christoph Kraus","doi":"10.1007/s40211-025-00523-9","DOIUrl":"10.1007/s40211-025-00523-9","url":null,"abstract":"<p><p>Since January 2022, assisted suicide has also been legal in Austria under certain legally specified conditions. According to the Constitutional Court, the previous legislation did not align with the \"right to self-determination\" and was therefore declared unconstitutional [1]. In contrast, countries such as the Netherlands, Belgium, and Switzerland have had a less restrictive legislation on assisted suicide for a longer period of time. The requirement for submitting a request for assisted suicide is that the patient suffers from a terminal illness and that both their decision-making capacity and free will are ensured [1]. This case report of a 47-year-old patient, who suffered from recurrent depressive disorder with a current severe episode and, after two previous suicide attempts, chose assisted suicide in Switzerland, aims to highlight the ethical and legal challenges associated with assisted suicide for psychiatric patients and to emphasize the need for careful consideration between autonomy and the duty of protection.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"87-94"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665054","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":"kultur im kontext.","authors":"Höger-Weinmüller Maria","doi":"10.1007/s40211-025-00529-3","DOIUrl":"10.1007/s40211-025-00529-3","url":null,"abstract":"","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"105-106"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112281","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}

{"title":"Kritische Anmerkungen zum Artikel von Altendorfer-Kling.","authors":"Bärbel Hellstern","doi":"10.1007/s40211-025-00525-7","DOIUrl":"10.1007/s40211-025-00525-7","url":null,"abstract":"","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"95-96"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129195","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}

{"title":"[Neuropsychiatry position statement to points of criticism concerning the scientific paper Violence in conduct- and custody proceedings : A case of child endangerment in the familycourt. Where are efficient child protection measures?]","authors":"Ulrike Altendorfer-Kling","doi":"10.1007/s40211-025-00526-6","DOIUrl":"10.1007/s40211-025-00526-6","url":null,"abstract":"","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"97-99"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129242","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}

{"title":"[Implementation of the UN Convention on the Rights of Persons with Disabilities in work rehabilitation offers].","authors":"Martin Böhm, Barbara Stiglbauer","doi":"10.1007/s40211-025-00517-7","DOIUrl":"10.1007/s40211-025-00517-7","url":null,"abstract":"<p><strong>Background: </strong>The study examines the extent to which certain target dimensions of the UN CRPD are implemented in the work-related aftercare services of a provider of vocational rehabilitation in Austria and how the implementation affects the subjective perception of the participants.</p><p><strong>Methods: </strong>To answer the research questions, survey data from clients of work-related psychosocial aftercare services in Austria were evaluated over a period of 10 years (2013 to 2022; n = 2133).</p><p><strong>Results: </strong>The results show that > 90 % of the survey participants consider various aspects of the CRPD to be fulfilled by the use of services, but that the degree of implementation of the UN CRPD differs depending on the type of service.</p><p><strong>Conclusions: </strong>The study emphasises the central role of work in the psychosocial aftercare context and its importance for the implementation of certain goals of the UN CRPD as well as for the subjective perception of health.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"72-78"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516968","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}

{"title":"Examining the safety and side effects of exposure therapy in virtual reality for patients with obsessive-compulsive disorder.","authors":"Luzie Lohse, Lara Rolvien, Swantje Borsutzky, Simone Kühn, Franziska Miegel, Lena Jelinek","doi":"10.1007/s40211-025-00518-6","DOIUrl":"10.1007/s40211-025-00518-6","url":null,"abstract":"<p><p>Exposure and response prevention therapy in virtual reality (VERP) for patients with obsessive-compulsive disorder (OCD) has been investigated primarily for its effectiveness. This study evaluated an important research gap, the negative and positive side effects of VERP and its safety. Eighty outpatients with contamination- or checking-related OCD were randomized to two conditions: VERP (six weekly sessions) or care as usual (CAU). Assessments were conducted at baseline (t0), 6 weeks after t0 (t1), and 3 months after t1 (t2). General side effects (Negative and Positive Side Effects Questionnaire; NPSE) and those specific to virtual reality (VERP-Specific Side Effects Questionnaire; VEQ) were assessed at t1. Cybersickness (Simulator Sickness Questionnaire; SSQ) was assessed before and after each session. The safety evaluation involved assessing the worsening of OC-symptoms (Reliable Change Index of the Yale-Brown Obsessive-Compulsive Scale; Y‑BOCS) from t0 to t1 and serious adverse events during the intervention. Results indicated no significant clinical symptom deterioration in the VERP group and no adverse events. In total, 47% of participants in both groups experienced at least one side effect, with significantly fewer reported in the VERP than in the CAU group (p < 0.001). Concerning VERP-specific side effects, at least one side effect was found in 55% of the patients. The SSQ total score did not significantly change from before to after the VERP sessions (p = 0.098, Cohen's d = 0.297). In conclusion, VERP was safe and demonstrated few side effects, highlighting its potential as a well-tolerated and safe intervention for patients with OCD.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"55-67"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674716","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}