Nervenarzt最新文献

{"title":"[Psychotherapy in inpatient psychiatry: from staffing levels to patient contact time].","authors":"Johannes Kornhuber, Manuel Maler, Timo Oberstein","doi":"10.1007/s00115-026-01939-6","DOIUrl":"10.1007/s00115-026-01939-6","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"494-496"},"PeriodicalIF":1.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047333","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":"[Psychotherapy for aggression in personality disorders: a mechanism-based perspective].","authors":"Corinne Neukel, Sophie Hauschild, Sabine C Herpertz","doi":"10.1007/s00115-026-02008-8","DOIUrl":"https://doi.org/10.1007/s00115-026-02008-8","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867639","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 S3 guideline on dementia (living guideline)-What is new?]","authors":"Frank Jessen, Lara Bohr, Richard Dodel","doi":"10.1007/s00115-026-02004-y","DOIUrl":"https://doi.org/10.1007/s00115-026-02004-y","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841860","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":"[What is psychotherapy? An interdisciplinary proposal for a definition].","authors":"Sabine C Herpertz, Jan Philipp Klein, Julia Asbrand, Luisa Baumgärtner, Ulrike Dinger, Christoph Flückiger, Nina Heinrichs, Tania M Lincoln, Silke Lipinski, Wolfgang Lutz, Bernhard Strauss, Svenja Taubner, Oliver Vorthmann, Winfried Rief","doi":"10.1007/s00115-026-02006-w","DOIUrl":"https://doi.org/10.1007/s00115-026-02006-w","url":null,"abstract":"<p><p>The definition of psychotherapy has wide-ranging implications for research and clinical care as well as for legal issues, as set out in the German psychotherapy guidelines. It can determine which services are covered by health insurance and who is authorized to provide the services. In light of the ongoing debate regarding the evidence base of psychotherapy, a group of experts from various professional disciplines with different theoretical and methodological backgrounds and focusing on different age groups, has worked together with individuals with personal experience of psychotherapy and young clinicians to engage in a discussion process aimed at arriving at a contemporary definition of psychotherapy. This incorporates the current body of empirical evidence, enables innovative developments towards a transtheoretical, transdiagnostic and personalized psychotherapy and places the needs of patients at the center. Our literature review leads to a definition of psychotherapy comprising four aspects: treatment modality or \"tools\" (treatment modality)? How does the treatment work (proposed mechanisms of action, assumptions about causal and evidence-based processes)? Who receives psychotherapy (target group)? Who provides psychotherapy (provider)? Our proposed definition is not bound to specific treatment theories and orientations but aims to promote the evidence-based provision of psychotherapy within the German healthcare system and in accordance with the legal framework.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800630","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":"[AKuT outpatient clinic: cross-sectoral crisis intervention for borderline personality disorder and trauma-related disorders at the Central Institute of Mental Health in Mannheim].","authors":"Florian Bähner, Cornelia Vogelpohl, Verena Geyer, Albert Fuchs, Andreas Meyer-Lindenberg, Christian Schmahl, Frank Enning","doi":"10.1007/s00115-026-02007-9","DOIUrl":"https://doi.org/10.1007/s00115-026-02007-9","url":null,"abstract":"<p><strong>Background: </strong>Patients with borderline personality disorder or trauma-related disorders often experience psychosocial crises. Due to a lack of promptly available outpatient treatment options, acute care is often provided in a psychiatric emergency department or an inpatient setting. This impedes treatment continuity and fosters hospitalization.</p><p><strong>Objective: </strong>Development and implementation of a hospital-wide treatment concept for crisis intervention at the Central Institute of Mental Health (CIMH) in Mannheim that overcomes sectoral boundaries.</p><p><strong>Material and methods: </strong>Presentation of the new patient care concept, which reflects typical clinical challenges during treatment of acute crises. Description of the relation to a treatment model with three pathways, central principles underlying treatment and interfaces with other services.</p><p><strong>Results: </strong>Disorder-specific treatment strategies from dialectical behavior therapy (DBT) enable a focused, low-threshold crisis intervention and foster the transition to disorder-specific psychotherapy. A central structure is the cross-sectoral outpatient clinic for crisis intervention and therapy commitment (AKuT outpatient clinic) that serves as an interface between inpatient crisis treatment in acute psychiatry and disorder-specific treatment offers in the department of psychosomatic medicine. This establishes a continuum of care from crisis intervention to disorder-specific psychotherapy.</p><p><strong>Conclusion: </strong>Challenges during implementation in an acute psychiatric hospital and possible effects on treatment continuity and hospitalization are critically discussed.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800597","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":"[Treatment of posttraumatic stress disorder-The updated S3 guidelines].","authors":"Ingo Schäfer, Thomas Ehring, Ulrich Frommberger, Britta Jacobsen, Christine Knaevelsrud, Astrid Lampe, Kirsten Lehmann, Cosima Leithner, Andreas Maercker, Paul Plener, Rita Rosner, Bianca Schreyer, Carsten Spitzer","doi":"10.1007/s00115-026-02003-z","DOIUrl":"https://doi.org/10.1007/s00115-026-02003-z","url":null,"abstract":"<p><p>The S3 guidelines on posttraumatic stress disorder (PTSD) have been updated and expanded under the leadership of the German-speaking Society for Psychotraumatology (DeGPT). Given the high prevalence of trauma exposure, traumatic experiences should be assessed during all clinical evaluations and history taking. Trauma-focused psychotherapy remains the first-line treatment and should also be offered in cases of complex PTSD (cPTSD) with comorbid disorders, in older people, refugees and individuals with mild to moderate intellectual disabilities. Strong evidence is now available for a broader range of interventions, particularly cognitive behavioral therapy (CBT). Trauma-focused interventions can be delivered online and at higher intensity (several sessions per week). For children and adolescents, trauma-focused CBT also remains the treatment of choice. Pharmacotherapy is the second-line treatment and is not recommended for children or adolescents. Benzodiazepines and Z‑drugs should generally be avoided. Among adjuvant forms of treatment the strongest evidence is available for exercise and physical activity. An important treatment principle involves the establishment of trauma-informed basic principles (trauma-informed care) as a standard approach in institutions of the healthcare system.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766642","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":"Nachruf auf Prof. em. Dr. med. Dr. h.c. mult. Jules Angst : 11.12.1926–15.05.2026.","authors":"Martin Preisig, Michael Bauer, Erich Seifritz","doi":"10.1007/s00115-026-02010-0","DOIUrl":"10.1007/s00115-026-02010-0","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702669","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":"[Modular psychotherapy-Toward personalized psychotherapy].","authors":"Katja I Seitz, Sabine C Herpertz","doi":"10.1007/s00115-026-02009-7","DOIUrl":"https://doi.org/10.1007/s00115-026-02009-7","url":null,"abstract":"<p><p>Globally, nearly 1 billion people are affected by mental disorders. Psychotherapy, despite its demonstrated efficacy, often shows only limited effects. Current estimates suggest that fewer than half of the patients achieve a clinically relevant symptom reduction. Against this background, innovative psychotherapeutic approaches are gaining importance, particularly personalized treatments, such as modular psychotherapy. Modular psychotherapy refers to treatment programs composed of distinct, functionally defined units (so-called modules) that are independently effective and can be flexibly combined in variable sequences within a systematic treatment algorithm. Initial efficacy studies, such as the MATCH study in children and adolescents, showed superior effects of modular psychotherapy compared to standard treatments, although current evidence is heterogeneous. Current developments of modular psychotherapy, such as the MeMoPsy studies conducted within the German Center for Mental Health (DZPG), integrate digital phenotyping, algorithm-based decision processes, and transdiagnostic mechanisms of change. Overall, modular psychotherapy represents an innovative approach to sustainably enhance the effectiveness of psychotherapeutic treatments via personalization.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702618","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":"[Neuromodulation as the fourth pillar in the treatment of depression : A position paper of the German Center for Mental Health].","authors":"Sarah Kayser, Beatrix Barth, Malek Bajbouj, Ann-Christine Ehlis, Martin F Gerchen, Ahmed A Karim, Joan Koti, Nils B Kroemer, Fritz-Georg Lehnhardt, Thomas Nickl-Jockschat, Michael A Nitsche, Marie-Luise Otte, Christian Plewnia, Alexander Sartorius, Stefan R Schweinberger, Julia Siodmiak, Surjo R Soekadar, Giovanni Vardiero, Ulrike Vogelmann, Tino Zaehle, Ulf Ziemann, David Zilles-Wegner, Alireza Gharabaghi, Andreas Fallgatter","doi":"10.1007/s00115-026-01999-8","DOIUrl":"10.1007/s00115-026-01999-8","url":null,"abstract":"<p><strong>Background: </strong>Depressive disorders are associated with a high burden of disease; a substantial proportion of patients show insufficient response despite guideline-based pharmacotherapy and psychotherapy, particularly in treatment-resistant depression (TRD). Neuromodulation has become established as a fourth pillar in the treatment of depression and includes electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), vagus nerve stimulation (VNS), transcranial electrical stimulation (tES), magnetic seizure therapy (MST), deep brain stimulation (DBS) and neurofeedback (NF). Despite partly well-established efficacy, these interventions remain insufficiently integrated into routine clinical care. The aim of this paper is to summarize the current evidence and to analyze key barriers to implementation.</p><p><strong>Material and methods: </strong>Narrative review of clinical studies, meta-analyses, and care data on efficacy, safety and cognitive tolerability.</p><p><strong>Results: </strong>The strongest evidence for both acute and maintenance treatment of severe depressive disorders is for ECT; rTMS is effective and cognitively well tolerated and VNS can represent an additive long-term option in TRD. For tES, small and heterogeneous effects have been reported, MST and DBS remain experimental and for NF consistent evidence of efficacy is lacking. Key barriers include partly heterogeneous protocols, insufficient funding structures, particularly in the outpatient setting and the absence of standardized qualification requirements.</p><p><strong>Conclusion: </strong>Neuromodulation should be systematically integrated into staged-care models. Standardized protocols and registry-based research are needed to enable the structured and sustainable implementation of neuromodulatory interventions in clinical care.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680652","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 aspects of commercially available products containing cannabidiol].","authors":"Maximilian Gahr","doi":"10.1007/s00115-026-01998-9","DOIUrl":"https://doi.org/10.1007/s00115-026-01998-9","url":null,"abstract":"<p><strong>Background: </strong>Cannabidiol (CBD) has gained sustained public, medical, and scientific attention in recent years. The prevalence of use of commercially available products containing CBD (CPC) is correspondingly high.</p><p><strong>Objectives: </strong>Overview of the benefits and risks of CPC, taking into account certain aspects related to CBD as a pharmaceutical active ingredient.</p><p><strong>Materials and methods: </strong>Selective literature search in the PubMed database.</p><p><strong>Results: </strong>Currently, only one primarily CBD-containing drug is approved in Germany (Epidyolex®). CBD demonstrates good safety and tolerability. Elevated transaminases, sedation, decreased appetite, diarrhea, sleep disturbances, infections, and weight loss are possible side effects. CBD modulates the endocannabinoid system and interacts with numerous other molecular targets. CBD is metabolized via CYP2C19, CYP3A4, and UGT. The potential for pharmacokinetic interactions with CBD has not been well studied, but is theoretically high. The potential for abuse of CBD is negligible when administered orally, but should be investigated more thoroughly for inhalation and higher-dose use. Studies have found significant discrepancies between the stated and actual CBD content in many CPC; THC was frequently detected. There is no evidence supporting the health benefits typically claimed by manufacturers for ≤ 4.3 mg of oral CBD/kg/day, but there are indications of significant hepatotoxicity at ≥ 4.3 mg of oralCBD/kg/day.</p><p><strong>Conclusion: </strong>There is no robust evidence of health benefits associated with CPC. However, given the levels of exposure, product deficiencies, and the EFSA safety concerns, it must be assumed that there are relevant health risks (particularly hepatotoxicity) associated with the use of CPC.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671199","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}