Nervenarzt最新文献

{"title":"OMW: Psychische Gesundheit in Krisenzeiten.","authors":"Andreas Meyer-Lindenberg","doi":"10.1007/s00115-024-01771-w","DOIUrl":"https://doi.org/10.1007/s00115-024-01771-w","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":"95 11","pages":"979"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548601","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 Basel model of principle-oriented clinical ethics consultation 2.0 : An introduction for psychiatry].","authors":"Jan Schürmann, Charlotte Wetterauer, Anna Lisa Westermair, Manuel Trachsel","doi":"10.1007/s00115-024-01710-9","DOIUrl":"10.1007/s00115-024-01710-9","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of clinical ethics counselling in medicine in terms of satisfaction of the participants, support of ethical decision-making, perceived impact on clinical care, moral competence and quality of communication is now empirically well validated. In psychiatry, more and more institutions have structures for clinical ethics consultation as well; however, there is still a lack of evaluative accompanying research on the benefits and differential indications of the various forms and models of clinical ethics counselling in psychiatry.</p><p><strong>Aim of the work: </strong>The article presents the principles and the step by step application of the principle-oriented clinical ethics consultation according to the Basel model 2.0.</p><p><strong>Material and methods: </strong>The article is based on material and procedures developed at the Clinical Ethics Unit of the University Hospital Basel and the University Psychiatric Clinics Basel for the principle-oriented clinical ethics consultation according to the Basel model 2.0.</p><p><strong>Results and discussion: </strong>Principle-oriented clinical ethics consultation according to the Basel model 2.0 is suitable for dealing with moral issues and conflicts in psychiatric practice and for their ethical reflection; however, further evaluative accompanying research is needed on the benefits and differential indications of this and other models of clinical ethics support in psychiatry.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"1033-1042"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11525241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731573","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":"[Guideline-recommended standardized instruments in multiple sclerosis : A comparative content analysis based on the International Classification of Functioning, Disability and Health (ICF)].","authors":"Jasmin Bolte, Elise-Marie Dilger, Anna Levke Brütt","doi":"10.1007/s00115-024-01752-z","DOIUrl":"https://doi.org/10.1007/s00115-024-01752-z","url":null,"abstract":"<p><strong>Background: </strong>Guidelines serve as practice-based decision support and recommend the use of standardized instruments to measure functional capacity in individuals with multiple sclerosis (MS). However, the extent to which a person's functioning is captured by these instruments is unclear.</p><p><strong>Objectives: </strong>The aim of this study is to link the content of the MS disease guideline with the International Classification of Functioning, Disability and Health (ICF) in order to capture the distribution of the content on the functional domains and contextual factors and to uncover existing gaps.</p><p><strong>Materials and methods: </strong>Instruments of the S2k guideline \"Diagnosis and therapy of multiple sclerosis, neuromyelitis optica spectrum diseases and MOG-IgG-associated diseases\", which were available free of charge in German or English and designed for adult people, were included. The instruments were classified into their meaningful concepts (meaningful concepts = MCs) and subsequently coded using standardized ICF rules by two raters.</p><p><strong>Results: </strong>The 23 included instruments contained 351 items and 718 MCs. Of these, 663 MCs could be linked to the ICF according to the coding rules. Of these, 51% (340 MCs) related to body functions, 44% (291 MCs) to the activity and participation component, and 5% (32 MCs) to environmental factors. The most frequently coded chapter was mobility (d4) with 201 MCs. Interrater agreement was k = 0.79.</p><p><strong>Discussion: </strong>The linking of the guideline-recommended instruments to the ICF shows that the instruments cover different themes. The area of environmental factors is underrepresented. The ICF linkage reveals a broad spectrum of functioning covered by the guideline-recommended instruments and facilitates the selection of appropriate instruments for the affected persons.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548597","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":"[Self-help offers for people with severe mental illness: who uses which format?]","authors":"Daniel Richter, Johanna Breilmann, Thomas Becker, Andreas Allgöwer, Reinhold Kilian, Alkomiet Hasan, Peter Falkai, Klemens Ajayi, Theresa Halms, Peter Brieger, Karel Frasch, Stephan Heres, Markus Jäger, Andreas Küthmann, Albert Putzhammer, Steffi G Riedel-Heller, Bertram Schneeweiß, Michael Schwarz, Markus Kösters, Uta Gühne","doi":"10.1007/s00115-024-01749-8","DOIUrl":"https://doi.org/10.1007/s00115-024-01749-8","url":null,"abstract":"<p><strong>Background: </strong>Self-help can play an important supplementary role in the treatment of people with severe mental illness; however, little is known about the utilization of the various approaches.</p><p><strong>Objective: </strong>This study describes the use of various self-help options by patients with severe mental illness and examines potential predictors.</p><p><strong>Material and methods: </strong>As part of the observational cross-sectional study on patients with severe mental illness (IMPPETUS, N = 397), trained staff collected sociodemographic, illness-associated and treatment-associated data between March 2019 and September 2019. Binary logistic regression was used to analyze a possible association with the use of self-help.</p><p><strong>Results: </strong>The participants most frequently reported using self-help literature (n = 170; 45.5%) followed by self-help groups (n = 130; 33.2%), electronic mental health applications (n = 56; 15.5%) and self-management approaches (n = 54; 14.8%). Trialogue seminars (n = 36; 9.9%) were the least used by the participants. The utilization of the various approaches is influenced by sociodemographic and disease-related characteristics (age, education, marital status, migration background, age at onset of initial mental health problems, psychosocial functioning level) but not by factors associated with treatment.</p><p><strong>Conclusion: </strong>The potential of self-help is not being fully utilized in the sample investigated. The reported use of self-help approaches by the participants ranged between 10% and 46%. The various formats address specific target groups. More targeted information must be provided about the various options and the use of self-help in routine treatment must be actively fostered in order to increase the utilization of self-help.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511800","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":"[Long-term courses of major depressive disorder : Characteristics, risk factors and the definitional challenge of treatment response].","authors":"Rebecca Paetow, Thomas Frodl","doi":"10.1007/s00115-024-01756-9","DOIUrl":"https://doi.org/10.1007/s00115-024-01756-9","url":null,"abstract":"<p><strong>Background: </strong>The definition of long-term courses of depression is heterogeneous. Chronic and treatment-resistant courses, in particular, represent a high-cost factor and greatly reduce the quality of life. Based on the pharmacotherapeutic treatment-resistant depression (TRD), more and more systemic approaches are becoming important.</p><p><strong>Objective: </strong>This narrative review provides an overview of the long-term course of depressive disorders, including various definitions and influencing factors. In addition, an overview of biomarker research on treatment response with a focus on neuroimaging is presented.</p><p><strong>Material and methods: </strong>A selective literature search was conducted in PubMed and Google Scholar for a narrative review. Particular attention was given to larger cohort studies, systematic reviews, meta-analyses and studies on the prediction of treatment response.</p><p><strong>Results: </strong>Chronic and treatment-resistant courses mean a relevant reduction in the quality of life and increased health risks. The assessment of treatment response is a definitional challenge: An alternative to TRD is the systemically oriented difficult to treat depression (DTD). The focus is thus moving away from symptom reduction towards controlling the level of functioning. Biomarker research for treatment response offers potential but currently mainly serves to gain theoretical knowledge.</p><p><strong>Conclusion: </strong>Recording the long-term course of depressive illnesses is important, but also complex. Clinical interventions should therefore include a continuous monitoring and the focus on maintaining the quality of life.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479158","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":"[Post-COVID-19 condition-Clinical phenotyping in practice].","authors":"Karen Humkamp, Ana Sofia Costa, Kathrin Reetz, Julia Walders","doi":"10.1007/s00115-024-01753-y","DOIUrl":"https://doi.org/10.1007/s00115-024-01753-y","url":null,"abstract":"<p><strong>Background: </strong>The high number and clinical heterogeneity of neurological impairments in patients with a post-COVID-19 condition (PCC) poses a challenge for outpatient care.</p><p><strong>Objective: </strong>Our aim was to evaluate the applicability of the proposed subtypes according to the guidelines \"Long/Post-COVID\" (30 May 2024) and their phenotyping using clinical and neuropsychological findings from our post-COVID outpatient clinic.</p><p><strong>Methods: </strong>The evaluation was based on cross-sectional neurological and psychological test examinations of the patients, which were carried out using standardized questionnaires and test batteries. In addition, a detailed anamnesis of the current symptoms and a retrospective survey of the acute symptoms up to 4 weeks after the confirmed infection was conducted. The subtypes were classified according to the abovementioned guidelines based on the medical history and selected patient questionnaires, to which we added a 5th subtype with reference to the previous guidelines \"Long/Post-COVID\" (as of 5 March 2023).</p><p><strong>Results: </strong>A total of 157 patients were included between August 2020 and March 2022. The presentation was at a median of 9.4 months (interquartile range, IQR = 5.3) after infection, with a mean age of 49.9 years (IQR = 17.2) and more women (68%) presenting, with a total hospitalization rate of 26%. Subtype 1 (postintensive care syndrome) showed the highest proportion of men, highest body mass index (BMI) scores and the highest rates of subjective complaints of word-finding difficulties (70%). Subtype 2 (secondary diseases) was dominated by cognitive impairment and had the highest depression scores. Subtype 3 (fatigue and exercise-induced insufficiency) was the most common, had the most symptoms and most severe subjective fatigue and the largest proportion of women. Subtype 4 (exacerbation) mainly showed affective symptoms. Subtype 5 (complaints without relevance to everyday life) had the lowest scores for depression, fatigue and BMI. Neurological and psychological conditions were frequently pre-existing in all groups.</p><p><strong>Discussion: </strong>The management of PCC can be improved at various levels. A standardized subtype classification enables early individually tailored treatment concepts. Patients at risk should be identified at the primary care level and informed about risk factors and prevention strategies. Regular monitoring of cardiovascular risk factors and physical activity are essential for PCC treatment. In the case of cognitive deficits and concurrent affective symptoms, psychotherapeutic support and drug treatment with selective serotonin reuptake inhibitors (SSRI) should be provided at an early stage.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373362","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 healthcare in South Tyrol].","authors":"Gerd Schaller, Roger Pycha, Andreas Conca, Tilman Steinert","doi":"10.1007/s00115-024-01755-w","DOIUrl":"https://doi.org/10.1007/s00115-024-01755-w","url":null,"abstract":"<p><p>Mental healthcare in South Tyrol, as everywhere in Italy, is still characterized by Law 180, which came into force in 1978 under the leadership of Franco Basaglia and Bruno Orsini. The Ministry of Health subsequently set a target number of beds of 10/100,000 inhabitants. Unlike in other parts of Italy, private clinics play a minimal role in South Tyrol. The \"Psychiatric Services\" are part of the state healthcare system responsible for all citizens and are also responsible for compulsory outpatient care. According to the concept of community care, also due to the small number of inpatient beds, a great deal of care is provided on an outpatient basis. Coercive measures can only be used in the case of an illness requiring urgent treatment that the patient refuses, without recourse to endangering circumstances (self-endangerment or danger to a third party). Inpatient hospitalization is only possible if treatment also takes place and the principle of \"outpatient before inpatient\" also applies in this context, i.e., coercive treatment can only take place as an inpatient if it cannot be carried out as an outpatient. Forensic psychiatry has very few places and mentally ill offenders are often in prison or occupy beds in general psychiatric wards. Compared to Germany there are fewer beds available but staffing levels are better, particularly for nursing. In relation to the number of inhabitants, compulsory treatment is more frequent than in Germany, whereas involuntary hospitalization and physical restraint are much rarer (only possible in Italy by court order).</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373361","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":"Mitteilungen der DGPPN 10/2024.","authors":"","doi":"10.1007/s00115-024-01751-0","DOIUrl":"10.1007/s00115-024-01751-0","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":"95 10","pages":"957-960"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331119","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":"[Inflammatory causes of stroke-Diagnostics and treatment].","authors":"Antje Schmidt-Pogoda, Frederike A Straeten, Carolin Beuker, Nils Werring, Jens Minnerup","doi":"10.1007/s00115-024-01711-8","DOIUrl":"10.1007/s00115-024-01711-8","url":null,"abstract":"<p><p>Inflammatory causes of stroke are frequent and often pose diagnostic and therapeutic challenges due to the scarcity of randomized trials and the absence of clear guideline recommendations for many scenarios. Following the publication of the recommendations of the European Stroke Organization on primary angiitis of the central nervous system (PACNS) last year, the German Neurological Society (DGN) has issued very clear guidelines this year on the diagnostics and treatment of PACNS and updated the recommendations for systemic vasculitides; however, stroke often occurs not only as a result of primary vascular inflammation but also as a complication of another organ infection. Approximately 5% of all patients with sepsis, ca. 20% of patients with bacterial meningitis and up to 40% of patients with bacterial endocarditis suffer from a stroke as a complication. This article summarizes the key characteristics of these inflammatory causes of stroke and particularly focuses on the current recommendations for diagnostic and therapeutic management.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"909-919"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11427622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856989","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":"[Neuroimmunology without limits].","authors":"Sven G Meuth","doi":"10.1007/s00115-024-01700-x","DOIUrl":"10.1007/s00115-024-01700-x","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":"95 10","pages":"889-893"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11427606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331117","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}