Nervenarzt最新文献

{"title":"[Suicidal ideation with instrumental components at inpatient psychiatric admission or discharge: clinical, ethical and judicial implications and recommendations for action].","authors":"D Schwerthöffer, B Schäfer, U Zimmermann","doi":"10.1007/s00115-026-01990-3","DOIUrl":"https://doi.org/10.1007/s00115-026-01990-3","url":null,"abstract":"<p><strong>Background: </strong>The treatment of patients who report suicidal ideation if they are not admitted as inpatients or discharged from inpatient treatment, raises clinical, judicial and ethical concerns.</p><p><strong>Methods: </strong>Ethical discussion based on a case study and practical recommendations for action based on clinical, ethical and judicial aspects and selective literature search.</p><p><strong>Results and conclusion: </strong>Suicidal statements of patients can have instrumental components. Suicidal ideation with instrumental components (Swic) can be associated with impulsive actions. Even though risk assessment in Swic may not be reliably achievable, there are clinical indicators for assessing the instrumental components of suicidal ideation. A differentiated ethical analysis can broaden the clinical perspective in treating patients with Swic. Communication with patients with Swic should be empathetic, clear and transparent and must be linked with concrete offers of support. The documentation of the treatment for patients with Swic who are not admitted for inpatient treatment or discharged from inpatient care should at least include: diagnostic assessment, consideration of alternatives, offered support and communication with the patient. In addition to inpatient treatment, there are numerous partial inpatient or outpatient support options for patients with Swic.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594294","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":"[When AI is involved in making decisions. Ethical considerations on shared decision-making in psychotherapeutic-psychiatric treatment].","authors":"Eva Kuhn, Laura Fässler, Florian Funer","doi":"10.1007/s00115-026-01992-1","DOIUrl":"https://doi.org/10.1007/s00115-026-01992-1","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is on the rise in the treatment of persons with psychiatric disorders. It can integrate diverse data points, analyze patterns and thereby generate clinically relevant insights that can influence the shared decision-making (SDM) process between patient and practitioner.</p><p><strong>Objective: </strong>This article aims to examine how AI can influence the SDM process in psychiatric and psychotherapeutic care. Furthermore, ethical and clinical considerations relevant to an appropriate and justified implementation are addressed.</p><p><strong>Methods: </strong>The potential effects on SDM are analyzed with an adapted process model which is expanded by the dimensions of relational autonomy and epistemic justice, using three exemplary clinical applications.</p><p><strong>Results: </strong>The use of AI has the potential to support patients in reflecting on and validating their own experiences by providing additional information; however, the use of such tools can influence the patient-practitioner relationship. This is particularly important if algorithmic assessments undermine the patients' self-reports or shift responsibilities in the decision-making process.</p><p><strong>Discussion: </strong>Whether AI supports or hinders SDM seems to depend on its embedment in the treatment context. When results are transparently communicated, interpreted within the participant-practitioner alliance and considered as a part of the participatory decision-making process, AI can be implemented in a clinically and ethically responsible and beneficial manner.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413543","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":"[Experienced stigmatization within the somatic healthcare system : A survey of people with diagnoses of severe mental illnesses].","authors":"Naomi Jiménez, Michael Strunz, Frank Jacobi","doi":"10.1007/s00115-026-01993-0","DOIUrl":"https://doi.org/10.1007/s00115-026-01993-0","url":null,"abstract":"<p><strong>Background and objective: </strong>Individuals with severe mental illness (SMI) suffer from poorer somatic health and increased mortality compared to the general population. As experiences of stigmatization can have a negative impact on physical health, this study aims to determine how often people with SMI experience stigmatization in the somatic healthcare system in Germany.</p><p><strong>Methods: </strong>Online survey to measure experiences of stigmatization according to the Mental Illness Stigma Framework (MISF) of people with vs. without SMI.</p><p><strong>Results: </strong>People with SMI report significantly more instances of stigmatization across the three subscales, discrimination, stereotyping and prejudice and, within these situations, they also report experiencing stigmatization more frequently.</p><p><strong>Conclusion: </strong>People with SMI experience significantly more discrimination in the somatic healthcare system due to their diagnosis. This study points to the need for antistigmatization measures in somatic healthcare and offers ideas for future research.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413612","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 increasing problem of the nonmedical use of medical cannabis].","authors":"N Scherbaum, U Bonnet, K Müller-Vahl","doi":"10.1007/s00115-026-01995-y","DOIUrl":"10.1007/s00115-026-01995-y","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413583","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":"[Psychotropic drug research in Germany: challenges of early benefit assessment and precision psychiatry].","authors":"Gerhard Gründer, Holger Bielen, Karl Broich, Silke Lipinski, Waltraud Rinke, Anne Röseler, Maximilian Schuier, Christoph von der Goltz, Marcus Weiland, Andreas Meyer-Lindenberg, Andreas Reif","doi":"10.1007/s00115-026-01991-2","DOIUrl":"https://doi.org/10.1007/s00115-026-01991-2","url":null,"abstract":"<p><strong>Background: </strong>The path to more precise and innovative psychotropic drugs is arduous and lengthy due to the complexity of mental illnesses and high regulatory hurdles. Nevertheless, several drugs have been developed and approved in the USA and the EU in recent years; however, not all of them were able to prevail in the benefit assessment in Germany. In order to exchange ideas about new precision medicine approaches as well as problems in the development and market access of psychotropic drugs and their possible solutions, the German Society of Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) in cooperation with the House of Pharma & Healthcare hosted the round table on the future of psychotropic drug research in Frankfurt on 24 August 2023. Participants from clinical care, academic research, the pharmaceutical industry and patient representatives came together.</p><p><strong>Research question: </strong>What initiatives are necessary in the field of psychiatry research and regulation in order to successfully develop psychotropic drugs in Germany and to be able to introduce them into care?</p><p><strong>Material and method: </strong>The article represents a synthesis of the lecture and discussion contributions of the 1‑day event.</p><p><strong>Results: </strong>Current challenges are due to the fact that the biological mechanisms of mental illnesses are complex and heterogeneous and are insufficiently mapped by the current diagnostic entities. The benefit assessment of a preparation by the Federal Joint Committee (G-BA) often fails if an appropriate comparator therapy (zVT) cannot be reasonably selected or tested in a study. Platform studies (APT), which test the efficacy of several preparations at the same time with a control arm, can speed up the approval process and are meaningful. Consultations by the G‑BA in advance should be binding. The integration of empirical expertise can significantly enrich psychotropic drug research.</p><p><strong>Conclusion: </strong>Continuous dialogue between authorities, economy, science, politics and representatives of those affected is needed to promote the development and approval of psychotropic drugs and thus improve the quality of life of patients.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399615","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 and the WHO: patients and professionals deserve expertise and facts, not ideology.","authors":"David Zilles-Wegner, Alexander Sartorius","doi":"10.1007/s00115-025-01891-x","DOIUrl":"10.1007/s00115-025-01891-x","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"397-399"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976654","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":"[Dextromethorphan-bupropion for the treatment of agitation in Alzheimer's disease].","authors":"Michael Paulzen","doi":"10.1007/s00115-026-01984-1","DOIUrl":"10.1007/s00115-026-01984-1","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"411-414"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206694","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":"[Acute aortic dissection (Stanford A) in temporal association with electroconvulsive therapy].","authors":"Daniel Ehmke, Christian Stierle, Thomas Eckey, Holger Jahn","doi":"10.1007/s00115-026-01975-2","DOIUrl":"10.1007/s00115-026-01975-2","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"407-410"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786883","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":"[Neuropsychiatric manifestations of sex chromosome aberrations-Clinical and therapeutic aspects of neuropsychiatric care].","authors":"Heiko Paland, Alexandra Philipsen, Eva C Schulte","doi":"10.1007/s00115-026-01977-0","DOIUrl":"10.1007/s00115-026-01977-0","url":null,"abstract":"<p><strong>Background: </strong>Sex chromosome aberrations affect approximately 1.5 per 1000 individuals, although somatically inconspicuous phenotypes can remain undetected. Even when diagnosed, the elevated risk of neuropsychiatric manifestations needs to be specifically addressed in psychiatric care.</p><p><strong>Methods: </strong>This narrative review analyzes the current literature on neuropsychiatric manifestations of sex chromosome syndromes, focusing on the four most common forms (Klinefelter, Turner, XYY and triple‑X syndromes).</p><p><strong>Results: </strong>Sex chromosome aberrations show characteristic neuropsychiatric manifestations. Frequent psychiatric manifestations include attention deficit hyperactivity disorder, autism spectrum disorders, anxiety disorders, affective and psychotic disorders. Cognitive impairments affect the majority of individuals and are manifested in speech developmental disorders, executive dysfunctions or visuospatial deficits. Severe intellectual impairments are rare (< 5-10%).</p><p><strong>Conclusion: </strong>Heightened clinical attention to neuropsychiatric manifestations of sex chromosome aberrations facilitates earlier diagnosis and access to developmental, psycho(pharmaco)logical and endocrinological treatment approaches to improve the quality of life and social participation of those affected.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"326-338"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145190","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":"[The cannabinoid hyperemesis syndrome-A narrative review].","authors":"Udo Bonnet","doi":"10.1007/s00115-025-01864-0","DOIUrl":"10.1007/s00115-025-01864-0","url":null,"abstract":"<p><strong>Background: </strong>Until 25 years ago cyclic vomiting attacks under the chronic influence of cannabis were virtually unknown. Following the legalization of non-medical cannabis in North America and the associated increase in cannabis use, including high-potency strains, the number of patients there with cannabis-related cyclic vomiting is increasing. The ROME-IV criteria now define cannabis-induced cyclic vomiting as cannabinoid hyperemesis syndrome (CHS). This review aims to provide information about CHS, as an increase in cases is also to be expected in Germany following legalization.</p><p><strong>Method: </strong>Selective review article.</p><p><strong>Results: </strong>The CHS is most frequently registered in emergency departments. A clear differentiation between CHS and cyclic vomiting syndrome (CVS), in which one third of those affected also regularly use cannabis, is only possible by establishing full remission during a 6-12 month cannabis abstinence. Therefore, mixed forms of CVS and CHS are initially seen in emergency departments (suspected CHS), also with hidden life-threatening abdominal comorbidities. Severe vomiting can also lead to serious complications. The commonly used antiemetics often do not help. Hot showers and baths as well as i.m. haloperidol (5 mg) can provide acute relief from severe vomiting. Rubbing the abdomen with 0.075-0.1% capsaicin cream also has an antiemetic effect but less quickly.</p><p><strong>Discussion: </strong>In ROME-IV the CHS is nosologically considered a special variant of CVS. In particular, it is a specific cannabis-related, often severe physical disorder. As healing can only be achieved through sustained cannabis abstinence, suspected CHS in emergency departments is an interdisciplinary challenge for gastroenterology, neuropsychiatry and the addiction support system.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"377-381"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676346","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}