Nervenarzt最新文献

{"title":"[Psychiatric consultation and liaison sevices in the emergency department].","authors":"Kathrin Nickel, Katharina Domschke, Dieter Ebert","doi":"10.1007/s00115-025-01823-9","DOIUrl":"https://doi.org/10.1007/s00115-025-01823-9","url":null,"abstract":"<p><p>In somatic emergency departments, the prevalence of psychiatric emergencies is high, ranging from 5-10%. The psychiatric consultation and liaison service plays a central role in the interdisciplinary care of emergency patients in somatic emergency departments. It addresses patients primarily with psychiatric disorders, organically caused psychiatric conditions and somatic illnesses with psychiatric comorbidities. While consultation activities involve advising other medical disciplines, consultation and liaison services enable continuous treatment of patients. Depending on the organization as a consultation or combined consultation and liaison service, the aim is to ensure efficient, targeted, safe and cost-effective evaluation of psychiatric symptoms and/or to screen as many patients as possible with psychiatric symptoms, facilitating access to psychiatric treatment. Psychiatric consultation and liaison services can furthermore support decisions regarding necessary somatic evaluations prior to psychiatric treatment. The \"SMART medical clearance form\" provides a standardized approach to somatic evaluations for patients with psychiatric symptoms in emergency departments. To improve psychiatric assessments of patients in somatic emergency departments, further standardization of the recommended somatic examinations and the evaluation of whether somatic symptoms can be associated with an underlying psychiatric disorder are needed. In addition, guidelines should establish which patients require a psychiatric consultation assessment in emergency departments.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804532","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":"Erratum zu: Zweitschrittverfahren in der antidepressiven Pharmakotherapie.","authors":"Marlene Krabs, Tom Bschor, Jonathan Henssler, Christopher Baethge","doi":"10.1007/s00115-025-01827-5","DOIUrl":"https://doi.org/10.1007/s00115-025-01827-5","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774634","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 COVID-19 pandemic in Germany: mental health trajectories, resilient and vulnerable groups].","authors":"J M Stoffers-Winterling, H F Wiegand, J Broll, S K Schäfer, K Adorjan, O Tüscher, K Lieb","doi":"10.1007/s00115-025-01824-8","DOIUrl":"https://doi.org/10.1007/s00115-025-01824-8","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has probably been the biggest health crisis of the twenty-first century to date. For many people it meant prolonged exposure to psychologically relevant stressors and simultaneously limited coping possibilities.</p><p><strong>Aim of the study: </strong>The aim of this review is to present a summary of the current state of knowledge on the course of mental health in Germany during the COVID-19 pandemic.</p><p><strong>Material and methods: </strong>Using longitudinal and repeated cross-sectional surveys, key findings are summarized and vulnerability and resilience factors are identified.</p><p><strong>Results: </strong>Large proportions of the German population reported at least temporary effects on their mental well-being in the sense of increased anxiety and depression symptoms as well as reduced life satisfaction, particularly among women, children and adolescents. At the same time, resilient courses were observed in most cases, i.e., most people managed to maintain their mental health during the pandemic. Vulnerability factors included female gender, younger age and financial difficulties. In contrast, a positive appraisal style, cognitive flexibility, social support, self-efficacy beliefs and, at a societal level, social cohesion and institutional trust were reported as important resilience factors.</p><p><strong>Discussion: </strong>The vulnerability and resilience factors identified offer concrete starting points for promoting pandemic preparedness.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781397","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":"[Mental health and mental healthcare as elements of pandemic and crisis preparedness].","authors":"Hauke Felix Wiegand, Kristina Adorjan, Jutta Stoffers-Winterling, Simone Scheithauer, Jochen Schmitt, Oliver Tüscher, Peter Falkai, Klaus Lieb","doi":"10.1007/s00115-025-01822-w","DOIUrl":"https://doi.org/10.1007/s00115-025-01822-w","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic was challenging in terms of the mental health of the population and the provision of mental health services.</p><p><strong>Aims of the study: </strong>To gain insights from the pandemic for an improved pandemic and crisis preparedness for the future.</p><p><strong>Material and methods: </strong>Recommendations are derived from the results of reviews on mental health and psychiatric psychotherapeutic care during the pandemic.</p><p><strong>Results: </strong>Large sections of the population proved to be resilient in terms of mental health. Populations at risk showed increased stress, particularly children, adolescents, women, people with low socioeconomic status, people in nursing homes and healthcare workers. People with long/post-COVID were also particularly affected. At the same time there were significant restrictions on the provision of psychiatric psychotherapeutic care, particularly in the inpatient sector. Insufficient current data on the mental health of the population and a lack of surveillance of service utilization, despite an existing data basis, made it difficult for timely detection of stress and care restrictions and an adequate response for crisis management. The rigid sectorization of the mental healthcare system often prevented alternative outpatient care.</p><p><strong>Discussion: </strong>The national mental health surveillance should be continued and further developed. Structures should be provided for the time-sensitive consolidation of data and the multiprofessional generation of recommendations in order to be able to detect and respond to challenges due to bottlenecks in the provision of care and stress in risk groups. Flexible, cross-sectoral mental healthcare should be made possible throughout Germany.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765592","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":"[Managing suicidal patients in general practices : A qualitative study on barriers and facilitating factors].","authors":"Constantin Brand, Carolin Haas, Tobias Dreischulte, Peter Falkai, Jochen Gensichen, Karoline Lukaschek","doi":"10.1007/s00115-025-01826-6","DOIUrl":"https://doi.org/10.1007/s00115-025-01826-6","url":null,"abstract":"<p><strong>Background: </strong>Patients with suicidal intent often visit their general practitioner (GP) before attempting suicide; however, GPs may struggle to address suicidality and recognize warning signs. This qualitative study explores GPs' experiences in managing suicidal patients, identifying key challenges and facilitating factors.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 21 GPs. The interviews were transcribed and analyzed using Kuckartz's qualitative content analysis.</p><p><strong>Results: </strong>The GPs strive to balance professional detachment with empathy when addressing suicidal ideation, despite time constraints. They refine their communication skills through peer exchange and self-directed learning. The need for practice-oriented training and improved professional networks was strongly emphasized.</p><p><strong>Conclusion: </strong>Effective suicide prevention requires strong interpersonal skills and sensitive decision making. To effectively fulfil their role, GPs need both organizational and emotional support.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755551","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 evolution of the concept of neuroses in Emil Kraepelin's textbooks].","authors":"Clara Fuhrmann, Holger Steinberg","doi":"10.1007/s00115-025-01821-x","DOIUrl":"https://doi.org/10.1007/s00115-025-01821-x","url":null,"abstract":"<p><strong>Background: </strong>The German psychiatrist Emil Kraepelin (1856-1926) developed a nosology of mental illnesses, the main features of which are still valid today, particularly in the form of the differentiation between the affective and schizophrenic forms. However, little is known about his work on neuroses.</p><p><strong>Objective: </strong>What development did Kraepelin's concept of neurosis undergo, especially with respect to its etiological theories, symptom complexes, basic characteristics and thus also included or excluded disorders? Which influencing factors played a decisive role in each case?</p><p><strong>Material and methods: </strong>All neurosis-specific chapters of the 1st to 8th editions of Kraepelin's psychiatry textbook published between 1883 and 1915 were analyzed, compared and examined for changes and their motivations for change.</p><p><strong>Results: </strong>The neurosis concept established in the 2nd edition is retained in its basic features until the 6th edition. In the 7th edition Kraepelin breaks with his original conception due to a lack of selectivity and only retains one subgroup: the \"psychogenic neuroses\". This was continued in the 8th edition under the name of \"psychogenic disorders\" and expanded to include new disorders.</p><p><strong>Conclusion: </strong>Both social and professional neurological influencing factors can be identified for the development of Kraepelin's concept of neuroses.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665024","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 Adult Separation Anxiety Questionnaire (ASA-27): reliability of the German translation, factor structure, and concurrent validity with anxiety sensitivity and agoraphobic cognition.","authors":"Patrik D Seuling, Michael G Gottschalk, Melanie Vietz, Ulrike Lueken, Tina B Lonsdorf, Udo Dannlowski, Paul Pauli, Jürgen Deckert, Stefano Pini, Vijaya Manicavasagar, Katharina Domschke, Miriam A Schiele","doi":"10.1007/s00115-025-01806-w","DOIUrl":"https://doi.org/10.1007/s00115-025-01806-w","url":null,"abstract":"<p><strong>Background: </strong>Separation anxiety disorder (SEPAD) is characterized by pronounced fear or anxiety concerning separation from attachment figures. Despite its high lifetime prevalence, adult SEPAD often remains undetected due to a lack of diagnostic tools in multiple languages. The Adult Separation Anxiety Questionnaire (ASA-27) is a key instrument for assessing symptoms of SEPAD in adults. However, no validated German version is available.</p><p><strong>Objectives: </strong>This study addressed the translation and validation of the ASA-27 in a German-speaking population to introduce the first German questionnaire assessing SEPAD.</p><p><strong>Materials and methods: </strong>A consecutive forward and backward translation was conducted. Reliability and validity of the German ASA-27 against several established anxiety-related psychometric scores were assessed in a large sample of 1520 healthy participants.</p><p><strong>Results: </strong>Results revealed robust internal consistency (Cronbach's α = 0.87) and a factor structure explaining 49.7% of variations in answers. Concurrent validity was confirmed through significant correlations with established anxiety measures. Younger age and female sex were positively correlated with ASA-27 scores.</p><p><strong>Conclusion: </strong>The German ASA-27 constitutes a promising diagnostic tool for adult SEPAD with sound psychometric properties and a coherent factor structure, offering a structured and reliable assessment of SEPAD and its dimensional evaluation in German-speaking populations.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651675","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":"[Binge Eating Disorder-State of the art].","authors":"Katrin Giel, Stephan Zipfel, Kathrin Schag","doi":"10.1007/s00115-025-01818-6","DOIUrl":"https://doi.org/10.1007/s00115-025-01818-6","url":null,"abstract":"<p><strong>Background: </strong>Eating disorders are complex mental disorders the prevalence of which has continued to increase, particularly since the coronavirus pandemic. Binge Eating Disorder has been newly included as a diagnosis in the Diagnostic and Statistical Manual of Mental disorders 5 (DSM-5) and the International Classification of Diseases 11th revision (ICD-11).</p><p><strong>Aim of the work: </strong>We present a state of the art overview of diagnostic criteria, psychopathology, differential diagnostics, epidemiology, comorbidities, developmental and maintenance factors, treatment and care situation of binge eating disorder.</p><p><strong>Material and methods: </strong>A narrative review is provided.</p><p><strong>Results: </strong>Binge eating disorder is characterized by recurrent binge eating with loss of control. It is the most common eating disorder in the general population and is often associated with overweight or obesity. Neurobiological models see changes in the areas of emotion regulation, reward processing and impulse control as etiological contributions to binge eating disorder. Psychotherapy is the treatment of choice for binge eating disorder, which often goes undetected and untreated. A reason for this is the experienced or feared stigmatization, shame and feelings of guilt of those affected.</p><p><strong>Discussion: </strong>As the diagnosis of a binge eating disorder influences the choice of treatment and the prognosis of both the eating disorder and a potentially comorbid obesity, active clarification of the eating behavior and a possible eating disorder in the context of motivational interviewing is essential.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651672","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":"[Psychiatric professionals' own crisis and treatment experiences-impact and coping strategies].","authors":"Anna Brieger, Angel Ponew, Christian Lust, Sven Speerforck, Stefan Stützle, Sebastian von Peter","doi":"10.1007/s00115-025-01815-9","DOIUrl":"https://doi.org/10.1007/s00115-025-01815-9","url":null,"abstract":"<p><strong>Background: </strong>Own experiences of crises and treatment (ECT) are widespread among staff in psychiatric and psychosocial settings. The present subproject of the ECT research project, investigating how staff of psychiatric institutions in Berlin and Brandenburg are affected, addresses the questions of what significance these employees attach to the ECT in patient-related work and how they feel about disclosing these experiences.</p><p><strong>Material and methods: </strong>In an explorative cross-sectional online survey, 182 mental health professionals were asked about the disclosure of the ECTs in the work context. The data were analyzed descriptively and analytically.</p><p><strong>Results: </strong>The existence of ECT is predominantly rated positively by the staff surveyed and is seen as influential for their work and useful for patients. The disclosure of these experiences was assessed as neutral to negative and rarely practiced.</p><p><strong>Discussion: </strong>Staff are reluctant to disclose their ECT. Based on the literature on the topic of peer and recovery counselling, it can be assumed that ECT could bring more benefits in patient-related work through reflective disclosure.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634874","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":"[Utilization of mental health services in Germany during the first year of the COVID-19 pandemic-Systematic review and meta-analysis].","authors":"Antranik Erdekian, Miriam Glock, Sophia Huetter, Mike Rueb, Dirk Riedinger, Jutta Stoffers-Winterling, Saskia Lindner, Fabian Baum, Lars P Hölzel, Oliver Tüscher, Klaus Lieb, Kristina Adorjan, Hauke Felix Wiegand","doi":"10.1007/s00115-025-01812-y","DOIUrl":"https://doi.org/10.1007/s00115-025-01812-y","url":null,"abstract":"<p><strong>Background: </strong>During the coronavirus disease 2019 (COVID-19) pandemic studies showed indications of changes in the utilization of inpatient, outpatient and emergency mental healthcare services; however, the level of observation and representativeness of these studies were heterogeneous.</p><p><strong>Objectives: </strong>Changes in the utilization of psychiatric and psychotherapeutic care in the first year of the COVID-19 pandemic were classified through a systematic literature search, evaluation of the quality and observational levels as well as a meta-analysis of the effects.</p><p><strong>Material and methods: </strong>A systematic search was carried out in PubMed, PsycInfo and Embase until June 2023 and a follow-up search in PubMed up to and including October 2024. Data were assigned to the periods first lockdown phase, between lockdown phases, second lockdown phase and entire pandemic year 2020.</p><p><strong>Results: </strong>A total of 17 studies were included. There were reductions in the number of inpatient admissions for the first lockdown phase of relative risk, RR 0.74, 95% confidence interval CI 0.70-0.79, I² 95.5%, t² 0.0053 and for the second lockdown phase of RR 0.78, 95% CI 0.75-0.81, I² 97.1%, t² 0.0058. Only studies with a low observational level were found for psychiatric emergency care and only two studies with different indicators for outpatient utilization. There were no clear changes in the prescription of psychotropic drugs.</p><p><strong>Conclusion: </strong>In the first year of the COVID-19 pandemic utilization of mental healthcare services was reduced, especially for the inpatient sector. The effects of these significant restrictions are unclear. We therefore propose a mental healthcare surveillance that could promptly record such changes and possible consequences.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574469","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}