Nervenarzt最新文献

{"title":"[The challenge of drugs: a dynamic situation requires evidence-based interventions].","authors":"Falk Kiefer","doi":"10.1007/s00115-024-01724-3","DOIUrl":"10.1007/s00115-024-01724-3","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":"95 9","pages":"779-780"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127167","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":"[Sexual abuse in the area of responsibility of the Protestant Church: some results from a subproject of the ForuM study].","authors":"Harald Dreßing, Dieter Dölling, Elke Voss, Leonie Scharmann, Andreas Hoell","doi":"10.1007/s00115-024-01670-0","DOIUrl":"10.1007/s00115-024-01670-0","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"868-870"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873902","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":"[Individual placement and support in mental health services: evaluation of routine clinical data using a retrospective chart review].","authors":"Dorothea Jäckel, Karolina Leopold, Andreas Bechdolf","doi":"10.1007/s00115-024-01706-5","DOIUrl":"10.1007/s00115-024-01706-5","url":null,"abstract":"<p><strong>Background: </strong>People with severe mental illnesses are often excluded from working life and would like support to (re)enter the general labor market as part of the psychiatric treatment. Individual placement and support (IPS) is an effective method of finding and retaining work in the general labor market. The aim of the study was to determine the integration rates of IPS into the general labor market in acute and postacute psychiatric settings, identifying patient, setting and program characteristics associated with (re)entering work.</p><p><strong>Method: </strong>A retrospective chart review (RCR) of routine clinical data between 2016 and 2021 was carried out. The IPS program adherence was rated using the IPS fidelity scale.</p><p><strong>Results: </strong>A total of 375 patients participated in the IPS with at least 4 appointments. The (re)integration rate into the general labor market was 51.7%. A shorter time period to the last working day, diagnosis of F1, F2, F3 (vs. F4), change of treatment setting and IPS in the psychiatric institute outpatient department (PIA), IPS fidelity and the number of IPS coaching sessions were positively correlated with (re)integration into work.</p><p><strong>Conclusion: </strong>The implementation of IPS in clinical mental healthcare is possible and leads to high integration rates in the open labor market. An early start of IPS during the clinical treatment can promote social inclusion.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"839-844"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635540","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":"[Mentally ill people with means-tested benefits at the job center : Diagnosis spectrum and care-First results from the LIPSY project].","authors":"M Koschig, F Hußenöder, I Conrad, M Alberti, K Gatzsche, L Bieler, K Stengler, S G Riedel-Heller","doi":"10.1007/s00115-024-01723-4","DOIUrl":"10.1007/s00115-024-01723-4","url":null,"abstract":"<p><strong>Background: </strong>Although people receiving means-tested benefits are regularly taken care of at the job center, little is known about their mental health situation and mental health care.</p><p><strong>Objective: </strong>The aim of the study was to describe the diagnostic spectrum and the functional status as well as the mental health care utilization of individuals with mental illnesses who are receiving means-tested benefits.</p><p><strong>Methods: </strong>Mentally ill people with means-tested benefits were recruited at the job center as part of the \"Leipzig Individual Placement and Support for Mentally Ill People\" (LIPSY) project, where they were initially diagnosed according to ICD-10 and included in the project if they had a mental disorder. Mental healthcare utilization was recorded. In the present study, data from n = 583 consecutively included persons were analyzed descriptively and by multivariate statistics.</p><p><strong>Results: </strong>Of the study participants 60.7% (n = 583; 51.5% female; average age 36 years; unemployed for an average of 4.8 years) suffered from affective disorders, followed by neurotic, stress and somatoform disorders (42.5%). With a mean global assessment of functioning (GAF) value of 49.4 (SD 7.7), there was on average a serious impairment. Nearly half of the subjects (48.5%) had never received psychotherapeutic, psychiatric or neurological treatment in the 6 months prior to inclusion in the project.</p><p><strong>Discussion: </strong>It could be shown that there is a broad spectrum of mental disorders with substantial functional impairment. The data suggest that this group is significantly undertreated and difficult to reach.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"845-852"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894734","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":"[Assessment of university psychiatry and psychotherapy in Germany: Responsibilities and challenges : Position paper of the Lehrstuhlinhaber für Psychiatrie und Psychotherapie e. V. (LIPPs) in Germany].","authors":"P Falkai, T Frodl, H J Grabe, R Rupprecht, A Philipsen","doi":"10.1007/s00115-024-01688-4","DOIUrl":"10.1007/s00115-024-01688-4","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"853-860"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433227","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":"[Family-focused treatment approaches for drug-addicted parents].","authors":"Anne Koopmann, Ulrich S Zimmermann, Diana Moesgen","doi":"10.1007/s00115-024-01692-8","DOIUrl":"10.1007/s00115-024-01692-8","url":null,"abstract":"<p><strong>Background: </strong>In Germany 1.5-2.75 million children live in families affected by substance use disorders. Substance abuse can impact on family interactions in many ways. If a dependent parental drug use continues over a longer period of time, this can have pronounced psychological and social consequences for the (co)affected children. Nevertheless, family-focused treatment approaches are not yet widely used in the context of addiction treatment.</p><p><strong>Aim: </strong>This review article aims to provide an overview of the prevalence of parenthood among dependent drug users in Germany, the impact of dependent drug use on families and family-focused treatment approaches.</p><p><strong>Methods and results: </strong>Recording parenthood is particularly difficult in the case of dependent drug users as they often do not openly discuss it with their therapists because of the fear of consequences from youth welfare services. In order to change this, a structured recording of parenthood by the treatment providers is required. This is the prerequisite for being able to offer family-focused treatment to those affected. In Germany, three evidence-based therapy programs are available for this purpose: SHIFT, SHIFT Plus and MAMADAM. Additionally, a number of programs developed in the Anglo-American region can also be used. In contrast, the evidence for web-based programs is much weaker.</p><p><strong>Discussion: </strong>In order to establish family-focused treatment approaches for drug-using parents across the board, long-term, secure funding is required. The necessary framework conditions must be created at a political level.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"830-835"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460320","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":"[Prediction and timely identification of postpartum depression: results of the longitudinal RiPoD study in the context of the literature].","authors":"Susanne Nehls, Juergen Dukart, Christian Enzensberger, Elmar Stickeler, Simon B Eickhoff, Natalia Chechko","doi":"10.1007/s00115-024-01726-1","DOIUrl":"https://doi.org/10.1007/s00115-024-01726-1","url":null,"abstract":"<p><p>The first 4-6 weeks after childbirth are defined as the onset time for postpartum depression (PPD). Despite this known time frame there are significant gaps in the identification and treatment of PPD. The risk for postpartum depression (RiPoD) study investigated specific risk factors and predictors of postpartum psychological adjustment processes and the results are presented within the framework of a state of the art review of research. The dynamic neuroplastic changes in the maternal brain during pregnancy and the postpartum period appear to be closely linked to peripartum hormone fluctuations, which jointly influence the development of postpartum mood disorders. Hormonal risk factors such as baby blues and premenstrual syndrome have been found to have a bearing on PPD. The combination of these two factors predicts the risk of PPD with 83% sensitivity within the first week postpartum. Follow-up digital monitoring of symptom development in the first 6 weeks postpartum has enabled an accurate identification of women with PPD. Understanding the interaction between hormone fluctuations, neuroplasticity and psychiatric disorders should be an important target for future research. Early identification and diagnosis of PPD can be easily integrated into the clinical routine and everyday life.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057088","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":"[Patient and quality characteristics in the treatment with disulfiram (Antabus) in the German \"Network for Alcohol Aversive Pharmacotherapy\"].","authors":"Ulrich S Zimmermann, Clemens Plickert, Christel Lüdecke, Markus Stuppe, Christian Rosenbeiger, Yvonne Krisam, Tobias Link, Jean Keller, Gero Bühler, Deborah Scholz-Hehn, Ursula Havemann-Reinecke, Dirk Wedekind, Mathias Luderer, Maik Spreer","doi":"10.1007/s00115-024-01714-5","DOIUrl":"https://doi.org/10.1007/s00115-024-01714-5","url":null,"abstract":"<p><strong>Background: </strong>More than a decade ago disulfiram lost its approval for use in Germany. Nonetheless, a considerable number of psychiatric hospital outpatient departments as well as practicing physicians continue to prescribe it. These professionals have formed the \"Network for Alcohol Aversive Pharmacotherapy\" (NAP) to maintain a high quality of this treatment approach.</p><p><strong>Objective: </strong>To describe the current use of disulfiram with respect to patient numbers and characteristics, side effects, and use of concomitant multimodal treatment forms.</p><p><strong>Material and methods: </strong>Since 2019 the NAP has conducted an annual retrospective survey among its members regarding the aforementioned parameters.</p><p><strong>Results: </strong>From 2019 to 2023 a total of 1579 treatment cases were described by 33 centers, 152 patients reported a total of 241 drinking events, 26 of them resulting in hospitalization but none causing complications or permanent harm. The most frequent side effects, in descending order, were unpleasant body odor (2.5%), fatigue, male sexual dysfunction, mildly elevated liver enzymes, allergic skin reactions and polyneuropathy (0.8%). More than one quarter of the patients suffered from comorbid depression, and approximately 5% from ADHD, borderline or other personality disorders, trauma-related disorders and anxiety disorders, respectively. Of the patients 33% were treated with antidepressants and 12% with sedating antipsychotics. Various forms of concomitant group therapy were offered to 66% of the patients.</p><p><strong>Conclusion: </strong>Treatment with disulfiram is legally possible, generally well-tolerated and safe. It is offered in most treatment centers as part of a comprehensive treatment plan that includes multimodal treatment of comorbid psychiatric disorders.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019335","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":"[Relapse prevention of bipolar disorders: an explorative cluster analytical approach in a randomized controlled psychotherapy study].","authors":"Martin Hautzinger","doi":"10.1007/s00115-024-01720-7","DOIUrl":"https://doi.org/10.1007/s00115-024-01720-7","url":null,"abstract":"<p><p>The aim of this study was to differentiate between types of bipolar disorders and the associated features using explorative analysis. The focus was particularly on the role of bipolar 1 and bipolar 2 disorders as well as the influence of prophylactic interventions for relapse in a randomized, controlled treatment study. A total of 274 of the 305 originally included persons could be investigated in the study. Patients participated in either cognitive behavioral group therapy (SEKT) or supportive, patient-centered group therapy (FEST). Treatment took place over 4 days separated by a 1-month interval (equivalent to 16 double hours). Depressive and manic symptoms were assessed using the longitudinal interval follow-up evaluation (LIFE). The symptoms were retrospectively assessed for the previous 6 months, with respect to each week before and after the intervention phase and for 6‑month and 12-month follow-ups. The results show that the effects of both group therapies were comparable; however, there were statistically significant differences in a multivariate proportional hazards model for the factors bipolar 1 and 2 as well as the interaction of therapy with bipolar 1 and 2. In particular, bipolar 2 patients benefited significantly less from the SEKT intervention than from the FEST intervention. There were three clusters identified that separated bipolar 1 (SEKT, no comorbidity, predominantly no recurrences, younger patients), from bipolar 2 (FEST, no comorbidity, at least 1 often 2 recurrences, older patients) and from a heterogeneous group (SEKT and FEST, comorbidity). The distinction between bipolar 1 and bipolar 2 disorder is important and has so far not received sufficient attention. Bipolar 2 disorders generally have a worse course and respond particularly poorly to cognitive behavioral therapy (SEKT). An open, unstructured, supportive, patient-centered psychotherapy (FEST) is generally effective.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019336","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":"[Electroconvulsive therapy in people with intellectual disability].","authors":"M Guhra, S H Kreisel, D Zilles-Wegner, A Sartorius, T Sappok, N Freundlieb","doi":"10.1007/s00115-024-01713-6","DOIUrl":"https://doi.org/10.1007/s00115-024-01713-6","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) is a highly effective treatment option for severe mental illness. Although people with intellectual disability (ID) have similar prevalence rates of mental disorders in comparison to the general population their access to ECT remains challenging. A systematic literature review was carried out on treatment with ECT in patients with ID and a case report on a patient with ID who underwent ECT is presented, to highlight a typical clinical routine. A total of 100 articles with 208 different case reports were retrieved. In summary, the results underline the effectiveness of ECT in people with ID, with side effects comparable to those in the general population. The ECT is effective in the treatment of severe affective and psychotic disorders and particularly in people with catatonia. The use of ECT can improve the patient's mental health and quality of life and is often a life-saving treatment option. The prophylaxis of relapses should be included as early as possible in the planning process. Providing an easy access to ECT treatment for people with ID is corroborated by its effectiveness and is in line with the right to equal treatment in accordance with article 25 of the United Nations Convention on the Rights of Persons with Disabilities.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141614","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}