Psychiatrische Praxis最新文献

Objective: People with mental illness should live independently in the community. This study analyzed the housing situation and the use and need of psychiatric housing facilities of people with severe mental illness.

Methods: Data from a cross-sectional study with 397 people with severe mental illness from two Bavarian districts were used and analyzed descriptively.

Results: 70% of the patients live independently. 6% use supported housing or residential care. 25% of the participants have housing needs, but 39% of them do not receive adequate help. Most of the patients are familiar with supported housing or residential care and find these helpful.

Conclusion: Most patients live in a housing situation that meets the social norm. However, some patients have an unresolved housing problem. The use of supported housing or residential care is helpful, but is rarely used.

Child abuse increases the risk of adult mental health problems. Limited research explores the association of early institutional childhood care in the GDR with experienced childhood abuse and mediates anxiety and depression in adulthood. The sample includes N=1743 individuals born in the GDR (1949-1983). In multi-group path analyses (stratified men/women), we analysed the influence of pre-school care as a predictor and experienced child abuse (CTS) as a mediator variable for anxiety (GAD-7) and depression (PHQ-9) in adulthood. There are no direct effects of pre-school care on anxiety and depression. Childhood trauma significantly affected current mental health (women β=0.253-0.610; men β=0.092-0.439). Analyses suggest no link between early institutional care and childhood abuse. Considering other contextual factors in childcare is crucial for establishing population-wide prevention strategies for child safety.

Objective: Day centres for people with mental disabilities are widespread. Nevertheless, there are only a few studies on their utilisation and effectiveness. This study examines what an ideal day centre should look like from the perspective of the users.

Methods: Six guided focus groups were conducted with 4-8 users each. The discussions were transcribed verbatim and analysed using qualitative content analysis.

Results: 36 participants (67% women, aged 20-62 years). The day centres fulfilled 5 functions: Improving mental health, experiencing community, maintaining daily structure, meaningful occupation and building up workability. The results revealed important aspects of organisation, current and desired activities and support.

Conclusion: Day centres are seen as an elementary component of intermediate mental health care. Users have clear ideas about how day centres can support their social and occupational rehabilitation.

This study presents first descriptive statistics on the usage behavior relating to discounted tickets for public transportation as part of an initiative of the German Federal Government in 2022. During a three-month period, 103 psychiatric outpatients of the University Clinic - Charité Berlin provided self-reported data by completing a survey. In general results suggested a high usage rate of the so-called "9-Euro-ticket" of 89,3%. Due to its purchase, 37,9% (N=39) of the participants felt motivated to explore unknown places. Furthermore, approximately one third of the sample (34,9%; n=36) reported an increase of social contacts as a result of their ticket usage. A higher influence of costs on participants' activity levels was associated with an increase in main symptoms. Higher age was correlated with a decrease of patients' core symptoms due to their activity. Results indicate a high usage of reduced-price tickets for subsidized public transport by the patients concerned.

Objective: Identification of interventions to prevent coercive measures in the event of escalating crisis situations in an inpatient acute psychiatric treatment context.

Methods: Content analysis of 98 joint crisis plans (JCP) using frequency analysis (secondary data analysis).

Results: In over half of the joint crisis plans, withdrawal to a low-stimulation environment (64.3%), a conversation (62.2%), and a walk (57.1%) were agreed upon as intervention for escalating crisis situations. A significant difference (p=0.020) was found in relation to the intake of (on-demand) medication, which was determined exclusively by males.

Conclusions: The results provide potentially helpful suggestions for escalating crisis situations and gender-specific findings with regard to the agreed interventions.

Objective: Identification of predictors that contribute to explaining regional variance of involuntary admission (IA) in Switzerland.

Methods: Multiple regression analysis including potential predictors and regional rates of IA at the level of utilisation-based care regions.

Results: Authorisation to issue involuntary admission, assistance/guardianship, outpatient consultation rate in psychiatric practices, hospitalisation rate and urbanisation are significantly related to regional variation in IA rates.

Conclusion: Restrictive regulation of the authority to issue IA and voluntary outpatient psychosocial and administrative support measures can contribute to a reduction in the rates of IA.

Objective: Peer support workers (=PSW) are expected to change the culture of a care facility. It is examined whether and how they can implement such a change mandate.

Methods: The material is based on two sub-studies of the ImpPeer-Psy5 study, investigating the implementation of PSW in the German psychiatric care system. Data from 57 problem-centered interviews and two focus groups were analyzed using a thematic analysis.

Results: PSW need courage, also as their impulses for change are often insufficiently received. This can lead to the reproduction of exclusion and to the PSWs' adaption to the attitudes of the teams.

Conclusions: To facilitate the implementation of the PSWs' change mandate, power relations and structural discrimination should be reflected, exchange spaces and a culture of critique should be established, and enough time be allowed for the implementation of PSW.

Objectives: Despite high demand, culturally adapted therapies for Arabic speaking refugee patients with depression are rare. Aim of the study was to culturally adapt and evaluate the group treatment Metacognitive Training for Depression (D-MCT) for them.

Methods: The cultural adaptation of the D-MCT included translation and surface adaptation as well as an expert discussion. The comprehensibility, acceptance and feasibility of the outpatient culturally adapted D-MCT (CA-D-MCT) were then tested in an uncontrolled pilot study with n=11 refugee patients.

Results: The experts rated 83% of the translations and 78% of the illustrations as unproblematic in terms of equivalence. The acceptability and feasibility of the eight modules were predominantly positive.

Conclusions: From the patients' perspective, the adapted training shows a high acceptance and comprehensibility for culturally sensitive, interpreter-supported implementation.