Nervenarzt最新文献

{"title":"[Genetic diagnostics of mental health disorders in adulthood].","authors":"Laura L Kilarski, Isabelle Claus, Elisabeth B Binder, Franziska Degenhardt, Katharina Domschke, Andreas J Forstner, Hans J Grabe, Urs Heilbronner, Daniel Müller, Markus M Nöthen, Franziska Radtke, Marcella Rietschel, Thomas G Schulze, Fabian Streit, Ludger Tebartz van Elst, Oliver Tüscher, Jürgen Deckert, Eva C Schulte","doi":"10.1007/s00115-024-01737-y","DOIUrl":"https://doi.org/10.1007/s00115-024-01737-y","url":null,"abstract":"<p><p>This review article provides insights into the role of genetic diagnostics in adult mental health disorders. The importance of genetic factors in the development of mental illnesses, from rare genetic syndromes to common complex genetic disorders, is described. Current clinical characteristics that may warrant a genetic diagnostic work-up are highlighted, including intellectual disability, autism spectrum disorders and severe psychiatric conditions with specific comorbidities, such as organ malformations or epilepsy. The review discusses when genetic diagnostics are recommended according to current guidelines as well as situations where they might be considered even in the absence of explicit guideline recommendations. This is followed by an overview of the procedures and the currently used diagnostic methods. Current limitations and possible developments in the field of genetic diagnostics in psychiatry are discussed, including the fact that, for many mental health conditions, genetic testing is not yet part of standard clinical practice; however, in summary genetic causes should be considered more frequently in certain clinical constellations, and genetic diagnostics and counselling should be offered where appropriate.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308928","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":"[Life style drug laughing gas (nitrous oxide, N₂O) and the dependency criteria according to ICD-10].","authors":"Dominik Diesing, Peter Neu","doi":"10.1007/s00115-024-01736-z","DOIUrl":"https://doi.org/10.1007/s00115-024-01736-z","url":null,"abstract":"<p><strong>Objective: </strong>The increasing popularity of nitrous oxide (N₂O) as a recreational drug raises questions about its potential for dependency. This narrative review examines the dependency risk of N₂O using the ICD-10 criteria for substance use disorders and evaluates the current literature.</p><p><strong>Material and methods: </strong>A comprehensive literature search until April 2024 was conducted to identify publications addressing N₂O consumption in the context of dependency criteria. The results were analyzed based on the ICD-10 criteria.</p><p><strong>Results: </strong>Studies showed mixed results regarding craving and loss of control among N₂O users. There is evidence of neglect of other interests and potential tolerance development, while data on withdrawal symptoms are limited. Persistent consumption despite harmful consequences has been described but objective diagnostic methods to determine consumption intensity are lacking.</p><p><strong>Discussion: </strong>The data on the dependency potential of N₂O are inconsistent. The discussion on its classification as an addictive substance remains controversial; however, the clinical indications suggest a possible risk of dependency, especially with excessive consumption.</p><p><strong>Conclusion: </strong>Nitrous oxide is currently primarily regarded as a substance of abuse with the potential to foster psychological dependence, manifesting particularly through loss of control and neglect; however, the criteria for physical dependence, such as the occurrence of withdrawal syndromes and the development of tolerance, have not yet been convincingly documented. Further research is needed to better understand the dependency potential of N₂O and develop appropriate preventive and therapeutic measures.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299591","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":"[Fatigue and sensorimotor instability : Neurologically controlled conversion of post-COVID-19 patients].","authors":"Thomas Urban, Fritjof Reinhardt, Peter Lohse, Stefan G Spitzer, Luise Rasche, Heinz Reichmann","doi":"10.1007/s00115-024-01732-3","DOIUrl":"https://doi.org/10.1007/s00115-024-01732-3","url":null,"abstract":"<p><strong>Background: </strong>For the treatment of the symptoms of post-COVID-19 syndrome, no causal therapy is currently widely recommended according to evidence-based criteria. The overarching goal of the intervention study over a 3-year period (Q1-2021-Q4-2023) was to evaluate the changes in the key symptoms of fatigue and sensorimotor instability through individualized stress-controlled training therapy and through intensified cognitive behavioral therapy.</p><p><strong>Material and methods: </strong>In the 3‑year period 407 vaccinated nucleocapsid positive patients were treated at the Post-COVID-19 Center Lausitz (Senftenberg). In 78 (around 19%) fatigue/immunometabolic depression and sensorimotor instability were identified as the leading syndromes. The evaluation of the individualized stress-controlled training therapy was based on the specific post-COVID-19 syndrome and motor fatigue parameters. The secondary psychosomatic syndrome was assessed using cognitive fatigue parameters and cognitive behavioral therapy instruments. The investigation of -parameters influencing behavior took place in Q2-2023-Q4-2023 with a guide-supported qualitative interview among the participants.</p><p><strong>Results: </strong>The post-COVID-19 key symptoms \"fatigue,\" \"sensorimotor instability,\" \"neuropsychiatric symptoms,\" \"cardiac/autonomic dysfunction,\" and \"pain\" improved significantly in the overall cohort and in the gender-specific analysis. A deterioration occurred in \"secondary psychosomatic symptoms\". A therapeutic effect was demonstrated for all motor fatigue parameters for the entire cohort using the Cohen's d value. An intensification of cognitive behavioral therapy achieved positive effects through an increasing development of the patients' own activity and their self-control using persuasion and gamification.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299590","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":"[Risk for post-injection syndrome after administration of olanzapine depot : Findings of real-world data evaluation at a psychiatric university hospital with a full-range care mandate].","authors":"Wolfgang Strube, Elias Wagner, Andreas Gartenmaier, Antje Grünemeyer, Klaus Peter Schmelzer, Alkomiet Hasan","doi":"10.1007/s00115-024-01733-2","DOIUrl":"10.1007/s00115-024-01733-2","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299593","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":"https://doi.org/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":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-16","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":"Erratum zu: Psychedelika und Dissoziativa in der Psychiatrie: Herausforderungen in der Behandlung.","authors":"Johannes Jungwirth, Francesco Bavato, Boris B Quednow","doi":"10.1007/s00115-024-01744-z","DOIUrl":"https://doi.org/10.1007/s00115-024-01744-z","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127165","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":"[Stimulants : Current insights into the principles, diagnostics and treatment].","authors":"Patrick Bach, Manuel Stenger, Karen D Ersche","doi":"10.1007/s00115-024-01687-5","DOIUrl":"10.1007/s00115-024-01687-5","url":null,"abstract":"<p><strong>Background: </strong>Consumption of stimulant drugs, a heterogeneous group of addictive substances, has significantly increased in recent years with rising numbers of stimulant-associated intoxication and deaths.</p><p><strong>Objective: </strong>To provide an overview of recent scientific evidence of the diagnosis and treatment of stimulant use disorders.</p><p><strong>Material and methods: </strong>A literature review of the neuropathology, clinical presentation, diagnostic criteria and evidence-based treatment for stimulant use disorders.</p><p><strong>Results: </strong>The chronic use of stimulant drugs is associated with significant physical (e.g., hypertension, tachycardia and dyspnoea) and psychological harm (e.g., dependence, psychotic disorders and affective disorders). Despite major advances in the research of the neuropathology of stimulant use disorder and the refinement of diagnostic criteria, the disorder still presents a challenge, not least because of the lack of effective treatments. There are currently no approved pharmacotherapeutic interventions for stimulant use disorder and meta-analyses show that the efficacy of behavioural interventions is low to moderate, similar to cognitive behavioural treatment.</p><p><strong>Conclusion: </strong>Despite growing insights into the neuropathology associated with stimulant use disorder, treatment remains a challenge. The lack of effective interventions makes it difficult to give clear recommendations for the clinical practice. Further scientific research is thus warranted.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"797-802"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312065","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":"[Kratom-From natural remedy to addictive drug and back].","authors":"Christian P Müller, Yuting Yang, Darshan Singh, Bernd Lenz, Elisabeth Müller","doi":"10.1007/s00115-024-01721-6","DOIUrl":"10.1007/s00115-024-01721-6","url":null,"abstract":"<p><strong>Background: </strong>Kratom/ketum is a psychoactive herbal preparation that has been used for a long time as a remedy and performance-enhancing substance in Southeast Asia. The advancement of globalization is making kratom increasingly more available in the western world, where it is becoming increasingly more used.</p><p><strong>Objective: </strong>The current research on kratom and its ingredients is presented.</p><p><strong>Material and methods: </strong>An overview of the use and effects of kratom is exemplary given on the basis of reports. The instrumentalization of the drug and its consequences up to the development of addiction are discussed.</p><p><strong>Results: </strong>Consumption is accompanied by several instrumentalizeable effects so that kratom is used as a therapeutic substance in the self-management of pain, anxiety and depression as well as other substance addictions. Another benefit comes from the performance-enhancing effects on physical work and in a social context. Consumption is usually well controlled, rarely escalates and has few and mostly mild aversive side effects. The danger arises from consumption particularly when there is an escalation of the dose and from mixed consumption with other psychoactive substances. The main alkaloid mitragynine and the more potent 7‑hydroxy-mitragynine are considered mainly responsible for the effect. Both have a complex pharmacology that involves partial µ‑opioid receptor agonism.</p><p><strong>Discussion: </strong>Epidemiological, clinical and neurochemical studies have shown that kratom only has a limited addictive drug profile, which might suggest a medical use as a remedy or substitute in addiction treatment.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"824-829"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861441","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":"[Challenges in the treatment of opioid dependence].","authors":"Andreas Heinz, Stefan Gutwinski, Michael Krausz, Gernot Ernst, Marc Vogel, Norbert Scherbaum","doi":"10.1007/s00115-024-01691-9","DOIUrl":"10.1007/s00115-024-01691-9","url":null,"abstract":"<p><strong>Background: </strong>The number of persons using opioids has increased worldwide in the last decade, particularly the use of opioid analgesics in North America and Africa. In Germany, the prevalence of heroin addiction has remained relatively stable.</p><p><strong>Method: </strong>Narrative review of the literature.</p><p><strong>Results: </strong>Opioid-assisted maintenance treatment (OMT) with the established substances methadone, levomethadone, slow-release morphine and buprenorphine is recommended as the first-line treatment for heroin dependence. The OMT reduces the use of heroin, mortality and individual suffering and improves the quality of life and physical health. A diamorphine and heroine-assisted treatment is an option for people who do not benefit from conventional OMT. An alternative to the use of diamorphine could be treatment with hydromorphone hydrochloride. The regulations on carrying out maintenance treatment in the Controlled Substances Prescription Act and the guidelines of the Federal Medical Association in Germany have been loosened based on the experiences of the COVID-19 pandemic, for example with respect to take-home prescriptions. There is an ongoing intensive discussion on how to deal with the decreasing number of outpatient clinics offering OMT.</p><p><strong>Conclusion: </strong>The first-line treatment for opioid addiction is opioid-assisted substitution treatment, including diamorphine and heroin-assisted treatment. Long-acting depot medications and implants still play a subordinate role.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"811-817"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617498","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: is work good for your health?]","authors":"Steffi G Riedel-Heller","doi":"10.1007/s00115-024-01717-2","DOIUrl":"10.1007/s00115-024-01717-2","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":"95 9","pages":"836-838"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127166","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}