Nervenarzt最新文献

{"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}

{"title":"[Access to electroconvulsive therapy for people lacking decision making capacity and as nonvoluntary treatment : Expert consensus and statement of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN)].","authors":"David Zilles-Wegner, Jakov Gather, Alkomiet Hasan, Jürgen L Müller, Thomas Pollmächer, Alfred Simon, Tilman Steinert, Alexander Sartorius","doi":"10.1007/s00115-025-01816-8","DOIUrl":"https://doi.org/10.1007/s00115-025-01816-8","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) is a clinically well-established, evidence-based procedure for the treatment of particularly severe or treatment-resistant psychiatric and neuropsychiatric disorders. A considerable number of patients who require ECT are unable to provide informed consent due to their medical condition. Both international and national studies show that restrictive laws and legal rulings can hinder or even prevent the use of ECT in patients lacking the capacity to provide informed consent or in cases of nonvoluntary treatment (coercive treatment). Patients with indications for ECT who lack the capacity to consent constitute a vulnerable group, often with no viable alternative therapy available. The decision to administer ECT to individuals lacking the capacity to consent, particularly as a nonvoluntary treatment, is highly complex in terms of legal and medical ethics aspects because depending on the circumstances, both administering and withholding ECT can profoundly impact the patient's fundamental rights. The available evidence shows that patients initially treated against their will exhibit good overall response rates, with equally high retrospective and prospective approval for therapy compared to patients who initially consented to treatment.Together with the medical ethics considerations the authors conclude that the use of ECT should adhere to the same ethical and normative standards as all other medical interventions. This also applies to cases involving involuntary treatment. Adopting a more restrictive approach to ECT compared to other medical measures is neither medically nor ethically justified. Structural and legal barriers restricting access to necessary treatment for patients with severe and potentially life-threatening conditions should be critically reviewed and, when possible and necessary, removed.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558493","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":"[Glucagon-like peptide-1 receptor agonists: a new pharmacological treatment option for psychiatric illnesses?]","authors":"Hubertus Himmerich","doi":"10.1007/s00115-025-01813-x","DOIUrl":"https://doi.org/10.1007/s00115-025-01813-x","url":null,"abstract":"<p><p>Albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, orforglipron and semaglutide are glucagon-like peptide‑1 (GLP-1) receptor agonists. Tirzepatide targets not only GLP‑1 but also glucose-dependent insulinotropic peptide (GIP) receptors and retatrutide is a triple GLP‑1, GIP and glucagon receptor agonist. The GLP‑1 receptor agonists increase insulin release but suppress glucagon release. They slow down the emptying of the stomach and thus prevent blood sugar spikes. They reduce appetite and food intake. In the brain GLP‑1 receptor agonists lead to a better glycemic control and they appear to have anti-inflammatory and neuroprotective effects. It has been reported that GLP‑1 receptor agonists reduce oxidative stress and apoptosis, lower the risk of ischemia and promote neurogenesis. The GLP‑1 receptor agonists can also influence dopaminergic signal transduction in the nucleus accumbens. Therefore, they could modify the effect of cocaine, alcohol and nicotine. Preliminary investigations provide indications of the therapeutic benefits of GLP‑1 receptor agonists for people with dementia, eating disorders, psychopharmacologically induced weight gain, depression, anxiety and substance use disorders. Typical accompanying adverse reactions are gastrointestinal side effects, such as nausea, vomiting, diarrhea, eructation and gastroesophageal reflux. More severe side effects include pancreatitis, allergic reactions, renal function disorders and possibly an increased risk of thyroid cancer.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558459","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":"[Attention deficit hyperactivity disorder (ADHD) treatment in old age - It is never too late for ADHD].","authors":"Svenja Wudy, Nicole Mauche, Jue Huang, Maria Strauß","doi":"10.1007/s00115-025-01807-9","DOIUrl":"https://doi.org/10.1007/s00115-025-01807-9","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558495","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":"[Development of outpatient psychotherapeutic care in Saxony].","authors":"Lilly Rüthrich, Tina Haase, Lorenz Harst, Markus Kösters","doi":"10.1007/s00115-025-01805-x","DOIUrl":"https://doi.org/10.1007/s00115-025-01805-x","url":null,"abstract":"<p><strong>Background: </strong>The care of mentally ill people should be carried out in a timely, needs-based and community-based manner. The structure of the outpatient care is a cornerstone in achieving this goal. Against this background, this study presents the development of psychotherapeutic care in Saxony.</p><p><strong>Methods: </strong>Data on outpatient psychotherapy between 2014 and 2023 from the medical register of the Saxony Association of Statutory Health Insurance Physicians were retrospectively evaluated and mapped using geodata analyses. Publicly available data from the Saxony geodatabase were used to analyze distances between local districts in Saxony and the private practices.</p><p><strong>Results: </strong>The number of psychotherapists in private practice increased between 2014 and 2023, particularly in rural regions. The number of psychotherapists for adults increased from 761 to 1224. In 2023 all psychotherapeutic practices for adults were within 20 km of all districts in Saxony so that the provision of care improved with respect to the spatial coverage. In contrast, the availability of pediatric and adolescent psychotherapists and specialists in the child and adolescent sector as well as for adults has improved only slightly.</p><p><strong>Discussion: </strong>The number of practices for psychotherapy has improved in urban and rural areas; however, there is a lack of data to reliably assess the coverage of needs. An analysis of the need for psychotherapeutic treatment is therefore urgently required.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558457","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}