Nervenarzt最新文献

{"title":"[Sociodemographic and clinical data among GHB patients-an observational study].","authors":"Julia Martin, Peter Neu","doi":"10.1007/s00115-025-01838-2","DOIUrl":"https://doi.org/10.1007/s00115-025-01838-2","url":null,"abstract":"<p><strong>Background: </strong>Due to its anxiolytic and stimulating effects gammahydroxybutyrate (gamma-hydroxybutyric acid, GHB) has gained popularity among drug users. The rate of dangerous intoxications and withdrawal syndromes is very high.</p><p><strong>Objective: </strong>This study was conducted to gain knowledge about the sociodemographic background of GHB users and their motives of consumption. Furthermore, we intended to collect data about the clinical course of withdrawal treatment, its risks, and complications.</p><p><strong>Methods: </strong>A group of 34 patients who had been consecutively admitted to our hospital for withdrawal treatment was asked for informed consent. The participants fullfilled a semiquantative questionnaire giving information about their socioeconomic background and their history of addictive disease. We also collected clinical data about the course and complications of the withdrawal treatment in our clinic. All patients received treatment as usual.</p><p><strong>Results: </strong>Most of the participants were male, well educated, and rather young (mean age 34). Very few had children of their own or lived in a partnership. None of them had a history of criminal activities. There were prior contacts with other drugs, especially amphetamines. During detoxification, the rate of withdrawal delirium was very high (40%).</p><p><strong>Conclusion: </strong>In order to improve our treatment and prevention of GHB addictive disease, we need to learn more about the patient groups who are at risk of becoming addicted to GHB. It is further crucial to develop clinical treatment standards to reduce the high rates of delirium and premature treatment interruption.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188362","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":"[Delirium in psychiatric consultation services].","authors":"Eike Ahlers","doi":"10.1007/s00115-025-01836-4","DOIUrl":"https://doi.org/10.1007/s00115-025-01836-4","url":null,"abstract":"<p><strong>Background: </strong>Inquiries about delirium are a very common request in psychiatric consultation and liaison services (CL).</p><p><strong>Objectives: </strong>What practical procedures can be derived from current recommendations?</p><p><strong>Methods: </strong>Evaluation of current guidelines and literature recommendations, as well as of the experiences in interdisciplinary planning of delirium management at various hospitals and of comments of participants in the author's workshops.</p><p><strong>Results: </strong>Delirium is seen as a major burden in the treatment of seriously ill patients across all medical disciplines. There are national and international medical guideline recommendations that unanimously recommend institutional delirium management, which follows a standardized approach for the respective department to minimize risk and prevent delirium. Cognitive deficits can follow delirium, especially in old age. Pathophysiological models can support the indication for treatment. Nonpharmacological techniques are effective; pharmacological steps should be carefully considered. Communication with those affected and their relatives and the transition upon discharge or transfer should be explicitly included.</p><p><strong>Conclusions: </strong>The CL can support steps and department-specific optimization of multiprofessional and delirium management, especially differential psychopharmacotherapy. Further efforts in the implementation of effective delirium management are also possible institutionally in order to improve the prognosis and quality of life of those affected.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188361","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":"Anorexia nervosa-an update.","authors":"Ulrich Voderholzer, Silke Naab, Ulrich Cuntz, Sandra Schlegl","doi":"10.1007/s00115-025-01820-y","DOIUrl":"https://doi.org/10.1007/s00115-025-01820-y","url":null,"abstract":"<p><p>Anorexia nervosa (AN) is a severe psychiatric disorder with the highest mortality rate among eating disorders. It predominantly affects adolescents and young adults, with a significant increase in prevalence among adolescents observed since the coronavirus disease 2019 (COVID-19) pandemic. It is frequently associated with other psychiatric disorders, such as depression, anxiety and obsessive-compulsive disorders as well as numerous physical complications. An early diagnosis and treatment are associated with better outcomes. The treatment of choice for AN includes cognitive behavioral therapy and family-based therapy for children and adolescents. Innovative treatment approaches, such as home treatment and technology-based interventions, have shown promising preliminary results. With the exception of moderate evidence supporting the use of olanzapine regarding weight gain, there is currently no evidence for the efficacy of psychopharmacotherapy in AN. Future research should focus on prevention, early detection and intervention, relapse prevention, personalized treatment approaches, management of comorbid disorders, long-term studies and the influence of psychosocial factors.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162694","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":"[Needs of people with severe mental illness].","authors":"Johanna Breilmann, Andreas Allgöwer, Reinhold Kilian, Uta Gühne, Steffi G Riedel-Heller, Alkomiet Hasan, Thomas Becker, Peter Falkai, Klemens Ajayi, Peter Brieger, Karel Frasch, Theresa Halms, Stephan Heres, Markus Jäger, Andreas Küthmann, Albert Putzhammer, Bertram Schneeweiß, Michael Schwarz, Markus Kösters","doi":"10.1007/s00115-025-01835-5","DOIUrl":"https://doi.org/10.1007/s00115-025-01835-5","url":null,"abstract":"<p><strong>Background: </strong>Due to illness-related functional limitations, a significant proportion of individuals with severe mental illness are dependent on external assistance to navigate their daily lives and achieve an optimal level of independence and wellbeing.</p><p><strong>Objectives: </strong>The present study sought to investigate the needs, the coverage of needs and the influencing factors among people with severe mental illness in Germany.</p><p><strong>Methods: </strong>The study included patients diagnosed with severe mental illness. The met and unmet needs, as well as the potential influencing factors, were collected using Camberwell Assessment of Need (CAN) and Client Sociodemographic and Service Receipt Inventory (CSSRI) and subsequently analysed descriptively and exploratively.</p><p><strong>Results: </strong>The mean number of reported needs was 6.4, with an average of 40.6% of these needs being met. The vast majority of patients (98%) require professional support, which is, from their perspective, inadequate (9-86% depending on the area concerned). Additionally, many patients also receive support from relatives (7-57% depending on the area concerned). The diagnosis, age, functioning, household income, and housing situation have an influence on the number and coverage of needs.</p><p><strong>Conclusions: </strong>The findings indicate that patients have diverse and complex needs, which are not fully met. Notably, the support provided by professional services is perceived as inadequate.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095468","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":"[Current opioid consumption among younger patients : A comparison between the years 2019 and 2023 in a large addiction clinic in Hamburg].","authors":"Mandy Roy, Peter Strate","doi":"10.1007/s00115-025-01833-7","DOIUrl":"https://doi.org/10.1007/s00115-025-01833-7","url":null,"abstract":"<p><strong>Background: </strong>It remains unclear whether an opioid crisis similar to that in the United States can be expected in Germany. In September 2024, the federal government stated that it does not see any danger of this occurring in the country. Nevertheless, the number of drug-related deaths in 2023 reached an all-time high of 2227 victims, with opioids involved in 1626 of those cases. For a more comprehensive assessment, information from additional settings may be helpful.</p><p><strong>Objectives: </strong>This study aimed to analyze the quantitative development of inpatient treatment cases of younger patients with opioid addiction from a large addiction clinic in Hamburg, as well as their consumption patterns.</p><p><strong>Materials and methods: </strong>Based on data stored in electronic patient records, a comparison was made of the relative proportions of inpatient patients treated for opioid addiction in the age groups \"18-30 years\" vs. \"≥ 31 years\" between the years 2019 and 2023 using chi-square tests. Additionally, the substances consumed were analyzed.</p><p><strong>Results: </strong>A significant increase in the relative proportion of young opioid-dependent patients was observed, rising from 17.2% in 2019 to 27.5% in 2023 (p < 0.001). Heroin remained the most commonly consumed substance, consistently inhaled or taken nasally. The use of oxycodone increased significantly. Additionally, a significant increase in pregabalin consumption was noted.</p><p><strong>Conclusions: </strong>Although the collected data may not be representative of Germany as a whole, our study suggests a growing issue with opioid addiction. Possible causes may include psychological stress, potentially influenced by the aftermath of the COVID-19 pandemic. The results highlight the need for more comprehensive treatment options and preventive measures.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086939","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":"[Factors influencing hospital readmission rates in alcohol use disorder].","authors":"Anne Koopmann, Sabine Hoffmann, Alisa Riegler, Jaspar Cordes, Falk Kiefer","doi":"10.1007/s00115-024-01738-x","DOIUrl":"10.1007/s00115-024-01738-x","url":null,"abstract":"<p><strong>Background: </strong>According to data from the Federal Statistical Office, the diagnosis of alcohol use disorder (AUD) (F 10) is the second most common main diagnosis for hospital treatment. Those affected by this disorder are often repeatedly hospitalized at short intervals due to relapses; however, little is known about the factors that influence readmission rates after initial treatment.</p><p><strong>Aim of the study: </strong>The aim of this retrospective analysis is to analyze the effects of treatment type (qualified withdrawal treatment (QE) versus physical detoxification) and discharge mode on the probability of readmission in alcohol-dependent patients after inpatient treatment.</p><p><strong>Material and methods: </strong>Data from 981 male and female alcohol-dependent patients who completed either qualified withdrawal treatment (QE) (68% men; mean age 47.6 years) or inpatient detoxification (74% men; mean age 48.0 years) were analyzed. Predictors of regular discharge were determined separately for both types of treatment using stepwise logistic regression.</p><p><strong>Results: </strong>Patients who had completed a qualified withdrawal treatment were significantly more likely to be regularly discharged. Regular completion of the qualified withdrawal treatment (QE) led to a relative reduction in the readmission rate of 25.64% within 1 year compared to a physical detoxification.</p><p><strong>Conclusion: </strong>In order to prevent readmission and chronic courses of alcohol use disorder (AUD), qualified withdrawal treatment should always be recommended to affected patients instead of physical detoxification. Aktuelle Daten des Statistischen Bundesamtes für das Jahr 2022 zeigen, dass die Diagnose \"Psychische und Verhaltensstörungen durch Alkohol (F 10.X)\" die zweithäufigste Hauptdiagnose bei Krankenhausbehandlungen darstellt [13]. Im Gesundheitssystem entstehen durch dieses Erkrankungsbild und seine somatischen und psychischen Folgeerkrankungen jährlich ca. 10 Mrd. € direkte Kosten [13]. Dieser Sachverhalt wird dadurch kontrastiert, dass die Krankenkassen die qualifizierte Entzugsbehandlung (QE) als leitliniengerechte Goldstandardtherapie [4] wiederholt infrage stellen [10].</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"278-283"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299589","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":"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":"272-277"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058948/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Antipsychotic drugs beyond the dopamine D₂ blockade-Xanomeline-trospium as beacon of hope?]","authors":"Michael Paulzen, Jens Kuhn","doi":"10.1007/s00115-025-01830-w","DOIUrl":"https://doi.org/10.1007/s00115-025-01830-w","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":"96 3","pages":"304-308"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065146","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":"[Introduction to the topic: what have we learnt about the impact of the COVID-19 pandemic on mental health and care of mentally ill people in the preparation for future pandemics?]","authors":"Klaus Lieb, Frank Schneider","doi":"10.1007/s00115-025-01825-7","DOIUrl":"https://doi.org/10.1007/s00115-025-01825-7","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":"96 3","pages":"255-256"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042471","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":"10.1007/s00115-025-01827-5","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"323"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058933/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}