Nervenarzt最新文献

{"title":"[Overlooked professionalism-Individual factors for success of peer support workers].","authors":"Daniela Schmidt, Imke Heuer, Madeleine Küsel, Guillermo Ruiz Perez, Sebastian von Peter","doi":"10.1007/s00115-024-01754-x","DOIUrl":"10.1007/s00115-024-01754-x","url":null,"abstract":"<p><strong>Background: </strong>The peer support worker is becoming increasingly more relevant also due to the new personnel regulations. Therefore, the question arises which individual conditions for success are available for the implementation of peer support workers.</p><p><strong>Method: </strong>This study is a subproject of ImpPeer-Psy5 study financed by Innovation Funds, which investigates the nationwide requirements for the implementation of peer support workers in care financed by health insurance funds (German Social Act V, SGB V). Using a comparative thematic analysis, 57 problem-oriented interviews with peer support workers (PSW), employees and users as well as a focus group based on this were examined. This study was predominantly implemented by a researcher who already had experience in psychiatry and crises.</p><p><strong>Results: </strong>From the perspective of the employees interviewed, sympathy and personality are the core factors for a successful implementation of peer support workers. In contrast, a professional coping with one's own crisis and recovery experience as well as diverse previous life and occupational experiences were prioritized by the PSWs.</p><p><strong>Conclusion: </strong>In order to effectively incorporate the impulse of peer support workers, a recognition of the professional identity of the PSWs is necessary. In particular, settings that separate the tasks between the professional groups in a less hierarchical manner and rely on building relationships, such as domestic treatment, are particularly suited for the implementation of PSWs.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"362-371"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584775","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":"[Legitimation and criticism of community psychiatry: concomitant phenomena and sequelae of a long-term model project].","authors":"Heiner Fangerau","doi":"10.1007/s00115-025-01851-5","DOIUrl":"https://doi.org/10.1007/s00115-025-01851-5","url":null,"abstract":"<p><p>This article describes the development and criticism of community psychiatry in Germany since the 1975 Inquiry Commission on Psychiatry as well as its precursors and reference points. While the inquiry called for fundamental reforms such as the establishment of community-based care structures, the concrete content and structural guidelines remained vague. This lack of clarity meant that community psychiatry was characterized less by central reforms than by a large number of regional model projects. With a view to the historical context, this project orientation is interpreted as an expression of a shift in focus since the 1980s towards self-help, civil society actors and the flexibilization of the social state. Although projectification has led to diversification and professionalization, it has also resulted in uncertainty, lack of sustainability and fragmentation of care. Community psychiatry is thus seen as a mirror of social and political change.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509177","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":"[Taxonomy of anxiety disorders in comparison of ICD‑10 and ICD‑11. German version].","authors":"Katharina Domschke, Peter Zwanzger","doi":"10.1007/s00115-025-01841-7","DOIUrl":"10.1007/s00115-025-01841-7","url":null,"abstract":"<p><p>With the introduction of the 11th revision of the World Health Organization International Statistical Classification of Diseases and Related Health Problems (ICD-11), structural and content-related adjustments to the diagnostic guidelines for anxiety disorders were made, which are presented in this review article. Previously classified as \"phobic disorders\" and \"other anxiety disorders\" within the group \"neurotic, stress-related, and somatoform disorders\", in ICD-11 \"anxiety- or fear-related disorders\" now constitute a separate group. The core diagnoses of agoraphobia, social anxiety disorder, specific phobia, panic disorder and generalized anxiety disorder are retained, with the modification that agoraphobia and panic disorder can now be diagnosed separately and comorbidly. Within the framework of the lifespan perspective, separation anxiety disorder and selective mutism have been moved to the group \"anxiety- or fear-related disorders\". The diagnosis \"mixed anxiety and depressive disorder\" is now classified as \"mixed depressive and anxiety disorder\" in the group \"affective disorders\". In accordance with the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‑5), it is possible to code isolated panic attacks in addition to other mental or somatic disorders. Overall, ICD-11 follows the DSM‑5 classification of anxiety- and fear-related disorders in many respects. Furthermore, the omission of subcategorizations and a precise minimum number of required symptoms simplify the diagnostic criteria. Future studies will need to address questions regarding the diagnostic accuracy, clinical practicability and further operationalization of the ICD-11 diagnostic criteria for anxiety- or fear-related disorders.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499003","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":"[Youth mental health: early detection and early intervention of mental disorders].","authors":"Peter J Uhlhaas, Andreas Bechdolf, Kerstin Konrad, Nikolaos Koutsouleris, Eva Meisenzahl, Andreas Meyer-Lindenberg, Ulrich Reininghaus, Christoph U Correll","doi":"10.1007/s00115-025-01847-1","DOIUrl":"https://doi.org/10.1007/s00115-025-01847-1","url":null,"abstract":"<p><strong>Background: </strong>Mental diseases occur particularly frequently between the ages of 12 and 25 years, with important implications for the pathogenesis, diagnosis and treatment.</p><p><strong>Objective: </strong>Against this background this article outlines a youth mental health paradigm which prioritizes the early detection, early intervention and prevention of mental disorders, e.g., psychoses, bipolar disorders and personality disorders in adolescence.</p><p><strong>Material and methods: </strong>The first part of the article summarizes the findings for sensitive phases during brain development, which indicate the elevated plasticity of neural circuits during youth that can be used for preventive interventions. The interactions between risk and resilience factors and ongoing brain development are an essential reason for the frequent occurrence of mental disorders between 12-25 years. Furthermore, innovative diagnostic approaches, such as clinical staging models, are proposed that are a prerequisite for early detection and early intervention. In this context, low-threshold service modelss and age-appropriate interventions, such as digital approaches, are necessary to improve access to care in youths.</p><p><strong>Discussion: </strong>Taken together, a \"youth mental health\" paradigm could significantly enhance mental health in young people and initiate a shift towards the prevention of severe mental disorders.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486710","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":"[Genetically informed treatment in psychiatry: new dynamics through APOE and antibody treatment of Alzheimer's disease].","authors":"Daniel J Müller, Christine M Freitag, Urs Heilbronner, Markus M Nöthen, Robert Perneczky, Marcella Rietschel, Eva C Schulte, Jürgen Deckert","doi":"10.1007/s00115-025-01839-1","DOIUrl":"https://doi.org/10.1007/s00115-025-01839-1","url":null,"abstract":"<p><p>The European Medicines Agency has recommended testing for the ApoE-genotype prior to treatment of Alzheimer's disease with Lecanemab. The drug approval is limited to patients who are not homozygous for the ApoE epsilon 4 allele. This is to reduce the risk of undesired adverse effects in the patients treated with Lecanemab. With this recommendation for the first time a psychiatric therapy will be genetically informed.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477579","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":"[A case study-On the relationship between medication and secret police practice in the state security prison hospital in Berlin-Hohenschönhausen].","authors":"Tillmann Wickert, Kathleen Haack, Felicitas Söhner, Ekkehardt Kumbier","doi":"10.1007/s00115-025-01849-z","DOIUrl":"https://doi.org/10.1007/s00115-025-01849-z","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286946","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":"[Benefits and risks of gabapentinoids in geriatric psychiatry].","authors":"Maximilian Gahr","doi":"10.1007/s00115-025-01850-6","DOIUrl":"https://doi.org/10.1007/s00115-025-01850-6","url":null,"abstract":"<p><strong>Background: </strong>Gabapentinoids (gabapentin, pregabalin) are increasingly being prescribed and frequently in off-label indications. This applies also to older people.</p><p><strong>Objective: </strong>This article provides a current overview regarding the pharmacology, safety and tolerability and efficacy of gabapentinoids in psychogeriatric indications, particularly behavioral and psychological symptoms of dementia (BPSD).</p><p><strong>Material and methods: </strong>A selective literature search was carried out in the databases PubMed and ScienceDirect using the search terms \"gabapentin\", \"pregabalin\", \"dementia\" and \"elderly\".</p><p><strong>Results: </strong>The precise mechanism of action of the gabapentinoids is unclear but is based on inhibition of the α2δ subunits of presynaptic voltage-gated calcium channels. Rapid onset of action, principally good tolerability, negligible hepatic metabolization, low interaction potential and efficacy in relevant comorbid disorders such as epilepsy, neuropathic pain syndrome and anxiety disorders can be beneficial in gerontopsychiatric patients; however, in older patients there is an increased risk of falls and fractures, respiratory depression and pneumonia, cognitive and functional impairments and possibly atrial fibrillation. Regarding BPSD only one randomized controlled trial (RCT, pregabalin), systematic reviews and case series/case reports are available, predominantly reporting good efficacy and tolerability of gabapentinoids. In addition, a positive RCT (pregabalin) concerning generalized anxiety disorder (GAD) in older patients exists.</p><p><strong>Conclusion: </strong>Currently, sufficient evidence for a recommendation on gabapentinoids for the treatment of BPSD (or other off-label indications in geriatric psychiatry) or GAD in older patients is not available. In the case of insufficient efficacy of nonpharmacological interventions and substances with better evidence, gabapentinoids can be considered for the treatment of BPSD and GAD in older patients, particularly when the specific characteristics of gabapentinoids can be beneficial in a particular case; however, the specific risks should be considered.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276462","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":"[Galactorrhea with euprolactinemia under SSRI treatment].","authors":"J Schreiber, R Demann, M Paulzen, R Savundararajan, J Kuhn","doi":"10.1007/s00115-025-01848-0","DOIUrl":"https://doi.org/10.1007/s00115-025-01848-0","url":null,"abstract":"","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276463","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":"Exploring the potential of ChatGPT as a digital advisor in acute psychiatric crises: a feasibility study.","authors":"Lubomir Barabas, Michal Novotny, Dennis Jung, Thomas Müller, Nicolas Nagysomkuti Mertse","doi":"10.1007/s00115-025-01837-3","DOIUrl":"https://doi.org/10.1007/s00115-025-01837-3","url":null,"abstract":"<p><strong>Background: </strong>This exploratory study tested ChatGPT as a digital advisor chatbot for German-speaking individuals in acute psychiatric crises. Additionally, the attitudes of young physicians and psychologists towards the use of large language models (LLMs) in healthcare were investigated.</p><p><strong>Methods: </strong>In total, 20 resident physicians and psychologists simulated patients in three clinical scenarios (depression, psychosis, adjustment disorder) and interacted with ChatGPT. They evaluated the chatbot's performance regarding overall experience, pleasantness, appropriateness of the responses, realism, and helpfulness. Before and after the intervention, their attitudes towards such a chatbot were assessed. Finally, they assessed 12 statements about the future of LLMs in healthcare and provided open feedback on the chat experience.</p><p><strong>Results: </strong>ChatGPT received predominantly positive ratings (over 8/10 points) for overall experience, helpfulness, pleasantness, and appropriateness, while realism was rated slightly lower at 7/10 points. The appropriateness of the responses varied significantly between the scenarios, with lower ratings for the psychosis scenario. Open feedback confirmed the limited suitability of ChatGPT for psychosis patients. Overall, 70% or more of the participants agreed that LLMs will become increasingly important in everyday life and healthcare, and that an LLM-based chatbot would be a modern tool for low-threshold access to initial psychiatric aid. However, the high number of neutral responses across all 12 items (20-45%) indicates uncertainty regarding the actual benefits and risks.</p><p><strong>Conclusion: </strong>The performance of ChatGPT was rated positively overall by the participants. Significant practical and methodological limitations remain, however, highlighting the need for further research including real patients for a gradual, carefully monitored integration of LLMs into mental healthcare.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235744","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":"[A survey on security services in psychiatric hospitals].","authors":"Sabine Müller, Sylvia Claus, Matthias Koller, Jürgen Müller, Brigitte Richter, Dorothea Sauter, Stephan Schieting, Tilman Steinert, Thomas Pollmächer","doi":"10.1007/s00115-025-01840-8","DOIUrl":"https://doi.org/10.1007/s00115-025-01840-8","url":null,"abstract":"<p><strong>Background: </strong>Psychiatric clinics use security services to varying degrees and for different tasks; however, empirical data on this do not yet exist.</p><p><strong>Objective: </strong>The aim of the study was to obtain an overview of the frequency, type and extent of the use of security services in psychiatric hospitals in Germany.</p><p><strong>Material and methods: </strong>An online questionnaire developed with the participation of a patient organization was sent to 266 chief physicians of psychiatric clinics.</p><p><strong>Results: </strong>Of the questionnaires 108 were completed in full (response rate: 40.6%). Security services are deployed in 46% of the participating clinics. In 82% of these clinics the security service personnel are employed by external service providers. Security services are most frequently used in outdoor areas of the hospital grounds (70%), followed by the central emergency department (42%) and the general psychiatric wards (38%). Security services are most often used to secure the site (74%); however, they are also used close to patients, e.g., in medical emergency situations, for monitoring/1:1 care during coercive measures and during admission or therapeutic consultations.</p><p><strong>Discussion: </strong>Security services are frequently deployed in psychiatric clinics. The deployment close to patients can be legally problematic. Little is known about the actual benefits of using security services and further research is needed in this area.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235743","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}