Nervenarzt最新文献_第7页

[Psychiatric consultation and liaison sevices in the emergency department]. [急诊科的精神病学咨询和联络服务]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2025-07-01 Epub Date: 2025-04-07 DOI: 10.1007/s00115-025-01823-9

Kathrin Nickel, Katharina Domschke, Dieter Ebert

{"title":"[Psychiatric consultation and liaison sevices in the emergency department].","authors":"Kathrin Nickel, Katharina Domschke, Dieter Ebert","doi":"10.1007/s00115-025-01823-9","DOIUrl":"10.1007/s00115-025-01823-9","url":null,"abstract":"In somatic emergency departments, the prevalence of psychiatric emergencies is high, ranging from 5-10%. The psychiatric consultation and liaison service plays a central role in the interdisciplinary care of emergency patients in somatic emergency departments. It addresses patients primarily with psychiatric disorders, organically caused psychiatric conditions and somatic illnesses with psychiatric comorbidities. While consultation activities involve advising other medical disciplines, consultation and liaison services enable continuous treatment of patients. Depending on the organization as a consultation or combined consultation and liaison service, the aim is to ensure efficient, targeted, safe and cost-effective evaluation of psychiatric symptoms and/or to screen as many patients as possible with psychiatric symptoms, facilitating access to psychiatric treatment. Psychiatric consultation and liaison services can furthermore support decisions regarding necessary somatic evaluations prior to psychiatric treatment. The \"SMART medical clearance form\" provides a standardized approach to somatic evaluations for patients with psychiatric symptoms in emergency departments. To improve psychiatric assessments of patients in somatic emergency departments, further standardization of the recommended somatic examinations and the evaluation of whether somatic symptoms can be associated with an underlying psychiatric disorder are needed. In addition, guidelines should establish which patients require a psychiatric consultation assessment in emergency departments.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"329-335"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804532","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}

引用次数: 0

[Psychiatric consultation-liaison services - primary psychiatric care in the general hospital]. [精神病学咨询-联络服务-综合医院的初级精神病学护理]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2025-07-01 Epub Date: 2025-07-07 DOI: 10.1007/s00115-025-01843-5

Albert Diefenbacher, Katharina Domschke

引用次数: 0

[Difficult doctor-patient interactions in the psychiatric consultation-liaison service: the use of attachment-based models]. [精神科咨询联络服务中困难的医患互动：基于依恋模型的使用]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2025-07-01 Epub Date: 2025-06-04 DOI: 10.1007/s00115-025-01844-4

Ronald Burian

{"title":"[Difficult doctor-patient interactions in the psychiatric consultation-liaison service: the use of attachment-based models].","authors":"Ronald Burian","doi":"10.1007/s00115-025-01844-4","DOIUrl":"10.1007/s00115-025-01844-4","url":null,"abstract":"Background: In the psychiatric consultation-liaison service (CL service) in hospitals a rapid classification of the interaction behavior of patients is often essential for a successful consultation.Objective: This article gives an abridged and practical overview of how models from the attachment theory can be meaningfully implemented in the CL service.Material and methods: Based on the relevant literature the foundations of attachment theory are briefly explained and appropriate recommendations for action for the construction of medical relationships are derived. A case study is used to illustrate this pragmatic approach.Results: According to the 4‑category model of Bartolomew and Horowitz a clear classification into 4 different attachment styles can be achieved in adulthood. Furthermore, the derived recommendations for action can be used in the CL service to adapt the construction of relationships.Discussion: Models from the attachment theory can be helpful to establish a functional physician-patient relationship. This is helpful for a successful contact in counselling and these models can also mediate the primary treating physician and contribute to positive medical outcomes.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"348-354"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217394","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}

引用次数: 0

[Drug-related problems in psychiatric consultation services]. [精神科谘询服务中的毒品相关问题]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2025-07-01 Epub Date: 2025-06-18 DOI: 10.1007/s00115-025-01831-9

Norbert Scherbaum, Udo Bonnet

{"title":"[Drug-related problems in psychiatric consultation services].","authors":"Norbert Scherbaum, Udo Bonnet","doi":"10.1007/s00115-025-01831-9","DOIUrl":"10.1007/s00115-025-01831-9","url":null,"abstract":"Background: The use of psychoactive substances is associated with the risk of somatic complications requiring treatment. Psychiatric consultations can be requested in this context.Aim: Description of physical and psychological complications of acute and chronic use of various drugs (except alcohol and benzodiazepines), and the procedure for consultations.Materials: Narrative literature review.Results: Severe physical and psychological complications of drug use can also occur with sporadic use. New psychoactive substances (NPS) in particular are known to have severe side effects compared to plant-based drugs with similar effects. Sporadic drug use, harmful use, and dependence must be differentiated diagnostically. Somatic complications of chronic use usually occur with dependent use, especially with intravenous drug administration. Depending on the individual case, recommendations for abstinence, safer use, or motivational interventions to take up a subsequent support program should be made. This requires precise knowledge of the local treatment network for drug users. Medication is used to alleviate withdrawal symptoms symptomatically. Potential complications must be taken into account during withdrawal treatment, e.g. withdrawal delirium and seizures in the case of GABA-ergic drugs. Maintenance treatment is the therapy of choice for opioid addicts.Conclusion: Addiction psychiatry consultations should not only offer help in the management of current clinical problems, but should also show those affected the possibilities of further care and treatment.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"336-341"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327535","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}

引用次数: 0

[Genetic diagnostics of mental health disorders in adulthood]. [成年期精神疾病的基因诊断]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2025-07-01 Epub Date: 2024-09-24 DOI: 10.1007/s00115-024-01737-y

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

{"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":"10.1007/s00115-024-01737-y","url":null,"abstract":"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.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"386-395"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254155/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Delirium in psychiatric consultation services]. [精神科咨询服务中的谵妄]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2025-07-01 Epub Date: 2025-05-30 DOI: 10.1007/s00115-025-01836-4

Eike Ahlers

{"title":"[Delirium in psychiatric consultation services].","authors":"Eike Ahlers","doi":"10.1007/s00115-025-01836-4","DOIUrl":"10.1007/s00115-025-01836-4","url":null,"abstract":"Background: Inquiries about delirium are a very common request in psychiatric consultation and liaison services (CL).Objectives: What practical procedures can be derived from current recommendations?Methods: Evaluation of current guidelines and literature recommendations, as well as of the experiences in interdisciplinary planning of delirium management at various hospitals and of comments of participants in the author's workshops.Results: Delirium is seen as a major burden in the treatment of seriously ill patients across all medical disciplines. There are national and international medical guideline recommendations that unanimously recommend institutional delirium management, which follows a standardized approach for the respective department to minimize risk and prevent delirium. Cognitive deficits can follow delirium, especially in old age. Pathophysiological models can support the indication for treatment. Nonpharmacological techniques are effective; pharmacological steps should be carefully considered. Communication with those affected and their relatives and the transition upon discharge or transfer should be explicitly included.Conclusions: The CL can support steps and department-specific optimization of multiprofessional and delirium management, especially differential psychopharmacotherapy. Further efforts in the implementation of effective delirium management are also possible institutionally in order to improve the prognosis and quality of life of those affected.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"342-347"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188361","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}

引用次数: 0

[Update on obsessive-compulsive and related disorders]. [强迫症及相关疾病的最新进展]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2025-07-01 Epub Date: 2025-06-27 DOI: 10.1007/s00115-025-01845-3

Dominique Endres, Juan C Baldermann, Miriam A Schiele, Lena Jelinek, Katharina Domschke, Ulrich Voderholzer

{"title":"[Update on obsessive-compulsive and related disorders].","authors":"Dominique Endres, Juan C Baldermann, Miriam A Schiele, Lena Jelinek, Katharina Domschke, Ulrich Voderholzer","doi":"10.1007/s00115-025-01845-3","DOIUrl":"10.1007/s00115-025-01845-3","url":null,"abstract":"Obsessive-compulsive disorders (OCD) are common and have high treatment resistance rates. The rationale of this CME article is to provide an update on OCD in adulthood. First, recent study results on the etiopathogenesis of OCD and its correlates are summarized and the clinical manifestations and current classification criteria are presented. Insight specifiers were added in the ICD-11 criteria and the classification into subtypes and the time criterion were removed; instead, the criteria now require the symptoms to be time-consuming (e.g., lasting > 1 h/day). In addition, a separate category for obsessive-compulsive and related disorders has been introduced. Frequent mental comorbidities, which are present in approximately 70-90% of cases and differential diagnostic considerations are summarized. The current state with respect to the diagnostic work-up and secondary (e.g., autoimmune) obsessive-compulsive syndromes is outlined. In terms of treatment options, disorder-specific cognitive behavioral therapy with exposure and response prevention has demonstrated high effect sizes. Novel approaches and formats include concentrated short-term or internet-based interventions. Pharmacotherapy is primarily carried out with serotonin reuptake inhibitors (SSRIs or clomipramine). Atypical antipsychotic drugs can be used for augmentation. Glutamate modulators are currently being investigated in clinical trials. Brain stimulation techniques, including noninvasive repetitive transcranial magnetic stimulation and invasive bilateral deep brain stimulation, are therapeutic options in cases of treatment resistance. Finally, a short summary delineates other OCD-related disorders. New diagnostic and treatment options to reduce the treatment resistance rates seem promising.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"403-415"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509178","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}

引用次数: 0

[Mentally ill citizens as victims of violation of physical integrity and extermination under the NS regime based on the example of a German city]. [根据德国城市的例子，精神病公民是新国家政权侵犯人身安全和灭绝行为的受害者]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2025-07-01 Epub Date: 2024-09-26 DOI: 10.1007/s00115-024-01745-y

Beatrice Rose, Jörg-Stefan Schulz, Eckhard Sundermann, Paraskevi Mavrogiorgou, Georg Juckel

{"title":"[Mentally ill citizens as victims of violation of physical integrity and extermination under the NS regime based on the example of a German city].","authors":"Beatrice Rose, Jörg-Stefan Schulz, Eckhard Sundermann, Paraskevi Mavrogiorgou, Georg Juckel","doi":"10.1007/s00115-024-01745-y","DOIUrl":"10.1007/s00115-024-01745-y","url":null,"abstract":"Background: Even 90 years after the National Socialist seizure of power and the beginning of the darkest chapter of German psychiatric history, examination of the medical historical past retains great relevance as an ongoing medical responsibility. The interventions in the lives of mentally ill people by the National Socialist regime are a firmly established part of medical historical research; however, little is known about how specific regions proceeded with affected citizens.Objective: The aim of this study was therefore to identify transfer routes of the \"euthanasia\" transports and places of death of the victims from Bochum as well as their patient characteristics.Materials and methods: During the timeframe studied, inpatient care for mentally ill patients from the Westphalia region was provided in seven provincial institutions. There was no psychiatric clinic in Bochum at the time, so patients were distributed among these institutions. The investigation was based on the transfer lists of the Westphalian provincial institutions to the killing sites.Results and conclusion: A total of 366 Bochum citizens affected by \"euthanasia\" transfers were identified. The transport lists were verified by admission and departure books, death lists, and patient files. The hereditary health files of the city archive were used to examine the relocated Bochum patients to determine whether they were victims of forced sterilization.","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"372-381"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331114","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}

引用次数: 0

Mitteilungen der DGPPN 07/2025. “DGPPN 07/2025”。

IF 0.9 4区医学

Nervenarzt Pub Date : 2025-07-01 DOI: 10.1007/s00115-025-01852-4

引用次数: 0

[Mental healthcare in South Tyrol]. [南蒂罗尔的心理保健]。

IF 0.9 4区医学

Nervenarzt Pub Date : 2025-07-01 Epub Date: 2024-10-04 DOI: 10.1007/s00115-024-01755-w

Gerd Schaller, Roger Pycha, Andreas Conca, Tilman Steinert

{"title":"[Mental healthcare in South Tyrol].","authors":"Gerd Schaller, Roger Pycha, Andreas Conca, Tilman Steinert","doi":"10.1007/s00115-024-01755-w","DOIUrl":"10.1007/s00115-024-01755-w","url":null,"abstract":"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).","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"355-361"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","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}

引用次数: 0