NEUROPSYCHIATRIE最新文献

{"title":"[Gulliver travels into psychosis-inspired by Dean Swift's own experience].","authors":"Hans Förstl","doi":"10.1007/s40211-025-00554-2","DOIUrl":"10.1007/s40211-025-00554-2","url":null,"abstract":"<p><strong>Background: </strong>Jonathan Swift (1667-1745) had long been interested in mental disease, which he also (ab)used for satirical purposes. He characterized various forms of madness in 1704, was elected governor of Bedlam in 1714, and in 1731 decided to dedicate his fortune to the founding of a first lunatic asylum in Ireland.</p><p><strong>Objective: </strong>To identify and consider the nature of neuropsychiatric features described in Gulliver's Travels.</p><p><strong>Material & methods: </strong>Literary works by and biographies of Jonathan Swift were examined together with the pertinent medical and historical specialist literature.</p><p><strong>Results: </strong>Gulliver's Travels, primarily a political satire, was published 300 years ago. The adventures of the restless naval surgeon Lemuel Gulliver on various remote islands can be understood as a journey into psychosis with characteristic motor, sensory and cognitive features. After his return home an autistic Gulliver refuses contact with his own species, the Yahoo-like humans, including his family and prefers the company of horses. Seamen and lunatic inpatients apparently shared a number of environmental risk factors and features of scorbutic nostalgia.</p><p><strong>Conclusion: </strong>Caution is advised when making a retrospective diagnosis, even with a fictional character like Lemuel Gulliver. If there were no hints at relevant organic causes-primarily hypovitaminoses-, one might suggest that Swift/Gulliver reported a number of characteristic symptoms of schizophrenia long before they were described in the medical literature.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"141-151"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349089","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":"M Höger-Weinmüller","doi":"10.1007/s40211-026-00589-z","DOIUrl":"10.1007/s40211-026-00589-z","url":null,"abstract":"","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"168-169"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680378","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":"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":"120-128"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303177","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":"Patients with anorexia nervosa perceive higher emotional connectedness to their parents than bulimia nervosa patients independent of objective family factors.","authors":"Elias Fischer, Noah Lensch, Günter Reich, Thomas Meyer","doi":"10.1007/s40211-025-00558-y","DOIUrl":"10.1007/s40211-025-00558-y","url":null,"abstract":"<p><strong>Background: </strong>Psychological constructs of individual autonomy (IA) and emotional connectedness (EC) differ between patients with anorexia nervosa (AN) and bulimia nervosa (BN); however, it is unclear whether objective family factors modulate these associations.</p><p><strong>Methods: </strong>In a cohort of 445 participants from the FamFINED study (FAMily Factors INvolved in Eating Disorders) with eating disorders (EDs) diagnosed as AN (n = 232) or BN (n = 213), we assessed objective psychosocial family factors as well as the IA and EC constructs using the self-rated Subjective Family Image Test (SFIT) questionnaire.</p><p><strong>Results: </strong>While the two ED entities did not differ with respect to IA in univariate analysis (p = 0.355), patients diagnosed with AN had higher perceived EC than participants with BN, as assessed by a lower score for the difference between the actual and desired family image (16.0 ± 15.8 vs. 21.6 ± 17.6, p < 0.001). In a regression model adjusted for age, body-mass index, living in parental home, and parental separation, we found that the EC score used as the dependent variable differed significantly between the two ED entities (expβ = 4.8, 95% confidence interval = 0.54-9.11, p = 0.028). In contrast, no association was observed between IA and ED diagnoses using the same set of confounders (p = 0.717).</p><p><strong>Conclusion: </strong>The higher perceived EC in AN patients compared to those diagnosed with BN indicates more intense feelings of family solidarity, regardless of objective family factors.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"113-119"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606625","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":"bericht aus dem ögkjp-vorstand.","authors":"A Karwautz","doi":"10.1007/s40211-026-00590-6","DOIUrl":"https://doi.org/10.1007/s40211-026-00590-6","url":null,"abstract":"","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":"40 3","pages":"165-167"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889001","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":"Case report of S-ketamine as treatment option for suicidal ideation and treatment-resistant depression in adolescents with early-onset psychosis.","authors":"Nicolas Schmelzle, Katrin Neubacher, Paul L Plener, Christian Scharinger","doi":"10.1007/s40211-026-00587-1","DOIUrl":"https://doi.org/10.1007/s40211-026-00587-1","url":null,"abstract":"<p><strong>Background: </strong>Depressive symptoms and suicidality are highly prevalent in adolescents with early-onset psychosis (EOP) and often remain refractory to standard treatment. While S‑ketamine is an established treatment for treatment-resistant depression in adults (TRD), its use in primary psychotic disorders remains scarce due to risk of exacerbation of psychotic symptoms.</p><p><strong>Case presentation: </strong>We present the case of a 16-year-old male with schizophrenia (ICD-10: F20.9) and chronic suicidality. Despite achieving remission of positive symptoms with amisulpride, severe depressive symptoms including suicidality persisted. Following the initiation of off-label intranasal S‑ketamine (titrated to 84 mg) at age 17 and 11 months, the patient showed a rapid clinical response. The Montgomery-Åsberg Depression Rating Scale (MADRS) score decreased by 50% within 3 weeks, accompanied by a significant reduction in the Positive and Negative Syndrome Scale (PANSS)-positive symptoms subscale score (from 22 to 10) and the PANSS-negative symptoms subscale score (from 33 to 17). Notably, no exacerbation of remitted positive symptoms occurred, and sustained functional recovery was achieved.</p><p><strong>Conclusion: </strong>This case suggests that intranasal S‑ketamine may be a safe and effective augmentation strategy for TRD and suicidality in stable adolescent early-onset psychosis, highlighting the need for further research in this high-risk population.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819859","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":"Basic symptoms of psychosis-from historical foundations to current evidence.","authors":"Frauke Schultze-Lutter, Christian Theisen, Tri Kurniati Ambarini, Marius Wrulich","doi":"10.1007/s40211-026-00588-0","DOIUrl":"https://doi.org/10.1007/s40211-026-00588-0","url":null,"abstract":"<p><strong>Purpose: </strong>Psychoses are among the most debilitating mental disorders, making early detection a major public health priority. In extension of the ultra-high-risk (UHR) approach, which was developed to identify an imminent risk of psychosis, the basic symptom (BS) approach aims for the earliest possible detection of the developing disorder; it is increasingly used worldwide. Basic symptoms are subtle, self-perceived disturbances affecting various domains, such as cognition, perception, affect, and drive, that precede and scaffold the development of attenuated and frank psychotic symptoms.</p><p><strong>Methods and results: </strong>This narrative review outlines historical foundations, phenomenology, and assessment instruments for BSs. It summarizes empirical findings on their predictive value for subsequent psychosis and their specificity for psychotic disorders across all age groups. Furthermore, developmental aspects and neurobiological findings are highlighted that support one of the core assumptions of the BS concept, namely, that BSs represent the most immediate phenomenological manifestation of the cerebral alterations underlying the development of psychosis. Finally, evidence for the broader clinical significance of BSs beyond psychosis prediction is discussed, indicating that BSs as a whole are useful for both multi- and differential-diagnostic purposes.</p><p><strong>Conclusion: </strong>Overall, the reviewed findings underline the value of BSs for advancing neurobiological research on the etiopathology of psychoses and for developing individualized prediction models and targeted early interventions.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799157","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":"Efficacy of metacognitive therapies in first-episode psychosis: a systematic review.","authors":"Claudia Requejo, Naomi Naides, Maria Lamarca, Marina Peniza-Soriano, Susana Ochoa","doi":"10.1007/s40211-026-00585-3","DOIUrl":"https://doi.org/10.1007/s40211-026-00585-3","url":null,"abstract":"<p><strong>Purpose: </strong>Metacognitive interventions have emerged as promising therapeutic approaches for individuals experiencing a first episode of psychosis (FEP), given the relationship between metacognitive deficits, reduced cognitive insight, and symptom persistence. This systematic review synthesizes the available evidence on the effectiveness of metacognitive therapies in adults with FEP, focusing on their impact on cognitive insight, psychotic symptoms, and global functioning.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, PsycINFO, Web of Science, and Scopus following PRISMA guidelines, with prior registration in PROSPERO (CRD420261281443). Studies published between 2014 and 2025 were included if they applied metacognitive interventions to adult FEP samples and evaluated changes in psychotic symptomatology and/or cognitive insight using validated instruments. Methodological quality was assessed using the Mixed Methods Appraisal Tool.</p><p><strong>Results: </strong>A total of 15 studies met the inclusion criteria. Overall, metacognitive interventions demonstrated consistent improvements in cognitive insight, notably increased self-reflectivity, and reduced overconfidence. Findings regarding psychotic symptom reduction were heterogeneous, although several studies reported significant improvements. Additional benefits were observed in neurocognitive domains, whereas results concerning social cognition were mixed. Interventions varied substantially in duration, format, and intensity, with most being delivered individually.</p><p><strong>Conclusion: </strong>The available evidence suggests that metacognitive therapies constitute a promising treatment option for individuals with FEP, showing robust effects on cognitive insight and potential benefits for clinical and functional outcomes. Nonetheless, further high-quality research, particularly comparative trials and long-term follow-up studies, is needed to consolidate these findings and clarify their applicability across diverse clinical settings.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608487","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":"Psychedelics in treatment-resistant depression: a comprehensive review of mechanisms, clinical evidence, and recommendations.","authors":"Cielo A Estela-Fernandez, Reem Mohamed Yousif Elsheikh, Dal Bianco Beatrice, Abdullah A Alhendal, Chinonso Irene Ewe, Sebastian Y Montesinos, Jocelyn Wensel, Anushka Prakash Mishra, Asma Ahmed Yousif, Hossam Tharwat Ali","doi":"10.1007/s40211-026-00584-4","DOIUrl":"https://doi.org/10.1007/s40211-026-00584-4","url":null,"abstract":"<p><strong>Purpose: </strong>Major depressive disorder (MDD) is a heterogeneous, debilitating disorder. A distinct subgroup within the MDD spectrum is identified to have treatment-resistant depression (TRD). There is an impetus to find alternative treatments for TRD to reduce disease burden and improve quality of life. Psychedelics have been used in the treatment of various psychiatric disorders since the 1950s, with potential benefits in TRD.</p><p><strong>Methods: </strong>Aiming to summarize the evidence of using psychedelics for TRD by exploring mechanisms and potential benefits, we conducted a literature search on different psychedelics with their mechanisms from clinical and preclinical evidence.</p><p><strong>Results: </strong>Psychedelics have been examined in many preclinical studies for efficacy and mechanisms with fewer clinical studies on patients with TRD. Besides serotonergic agonism, glutamate surge and monoamine release, psychedelics promote neuroplasticity, corticolimbic function, and epigenetic changes. Psilocybin, ketamine, and esketamine are the most researched agents of psychedelics in the context of TRD. Psilocybin-assisted therapy has been shown to induce short-term improvement in symptoms that can persist for weeks and months, with some meta-analyses consolidating such findings. Ketamine, as an atypical psychedelic, in many clinical trials of intravenous, subcutaneous, and oral forms, had rapid and robust effects in reducing depressive symptoms and relapses without decreasing cognitive function. Similarly, esketamine induced early and clinically meaningful improvements in function and productivity. Ayahuasca also showed fast and sustained effects with higher remission rates and good safety.</p><p><strong>Conclusion: </strong>Psychedelics have significant potential in TRD with superior mechanisms over traditional antidepressants. Despite the encouraging findings of the existing studies, large, well-designed studies are needed to extend their use as part of standard recommendations.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353962","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":"[Reduction and discontinuation of antipsychotics and antidepressants: Comparative assessment by outpatient psychiatrists].","authors":"Thomas Koch, Sebastian von Peter, Stefan Weinmann, Guillermo Ruiz-Pérez","doi":"10.1007/s40211-026-00583-5","DOIUrl":"https://doi.org/10.1007/s40211-026-00583-5","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate physicians' perspectives on the tapering and discontinuation (R&D) of antidepressants (AD) and antipsychotics (AP).</p><p><strong>Methods: </strong>In ten systematic interviews and a focus group with outpatient psychiatrists from Berlin and Brandenburg, differences in assessments, counseling practices, and decision-making patterns were recorded and subsequently with MAXQDA inductively evaluated.</p><p><strong>Results: </strong>R&D is initiated more frequently in AD because depressed patients are considered more insightful and adherent to treatment. In contrast, psychiatrists perceive the risk of relapse and the consequences of discontinuing AP to be higher, leading to more reluctance to initiate R&A. Structural barriers, unclear guidelines, and a lack of non-pharmacological alternatives make R&A difficult, particularly in cases of psychosis.</p><p><strong>Conclusion: </strong>More participatory R&D practices require clear guidelines, knowledge transfer, and improved psychosocial care services-especially for patients with psychosis.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273376","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}