Psychiatrische Praxis最新文献

Objective: The bejective was to determine health literacy (HL) and care aspects of those affected by Long-COVID.

Method: 407 patients with Long-COVID and long-term neuropsychiatric symptoms were interviewed in the LIFE study center. In addition to descriptive analyses, regression models were calculated to examine the relationships between health literacy (HLS-EU-Q16) and various aspects of care (RehaQ-N1).

Results: The results show that 35.8% had problematic and 17.9% had inadequate HL. The majority of subjective needs were unmet and 47.7% of those affected were dissatisfied with the therapy they received.

Discussion: Among those affected by Long-COVID, subjective HL is rather reduced. The healthcare system appears to be unprepared for these patients, which is reflected in unmet needs and low treatment satisfaction. This was even more pronounced among those exhibiting lower HL.

Aim of the study: Peer Support Workers (PW) were asked about stressors and resources and how stressful or relieving they perceived them to be.

Method: Questionnaire-based survey RESULTS: 175 PW were included in the data analysis and identified stressors and resources in their daily work. Psychological security and autonomy are the most frequently mentioned resources, while role clarity is the least frequently mentioned. Autonomy can also be more of a burden than a resource, especially in combination with a lack of role clarity. PW rarely feel stigmatized by their colleagues. However, when they do, they find it very stressful. Relevant stressors were uncertainty about decisions made, problems with the team culture, or perceived inadequate role fulfillment by the team.

Conclusions: The lack of clarity about work processes and the roles of all participants is a significant stressor, despite the availability of relevant resources.

This retrospective follow-up study over one year (after discharge from the index treatment), compares the effects of inpatient-equivalent home treatment (IEHT) and regular psychiatric treatment using subjective and objective quality indicators. Using a 1:1 matching of cohorts (diagnosis, age, gender, number of previous treatments and severity of illness), 732 IEHT patients were assigned to a comparison group. Outcome data was taken from the routine data of the clinic database and the in-house basic documentation. In the subjective quality measure, patients and practitioners in regular psychiatric treatment reported a significantly higher improvement in condition. In terms of the objective quality measure, the number of further inpatient treatment days in the observation period, the two groups did not differ significantly, which can be interpreted as encouragement for the use of this new, increasingly established form of treatment.

Objective: After WW II, Holocaust survivors often faced negative assessments by German psychiatrists when claiming compensation for psychological damage, a fact that was met with criticism. This study examines how as a result the prevailing doctrine on trauma sequelae underwent a transformation.

Methods: Academic contributions in German language from 1946 to 1969 are analyzed for their para-digmatic views on the etiology of mental disorders after war and Nazi persecution.

Results: Only a new generation of psychiatrists was able to develop more adequate psychotraumatological concepts by using anthropological and occasionally psychoanalytic theoretical elements. At the same time this also questioned the medically oriented concept of illness in psychiatry.

Conclusion: Less the persistence of anti-Semitic sentiments but rather internal scientific reasons such as an unevidenced dogmatism obstructed the the advancement of science.

Background: The predicted prevalence of people with dementia (PWD) in Germany has risen to 1.8 million since 2010. In the near future, we will see the approval of antibody therapies. The study aims to demonstrate the recent anti-dementia medication prescriptions and diagnosis prevalence.

Methods: Data from 357 general practitioner (GP) and 71 specialist practices (SP) (1.1 Mio. patients) were analyzed to demonstrate the prevalence of dementia diagnoses and anti-dementia drug prescriptions between 2010 and 2021.

Results: The diagnosis prevalence of PWD (Alzheimer's dementia) remained relatively constant in GP practices at 1.0-1.3% (0.19-0.21%). Among SP, the prevalence increased from 4.9% (2.8%) to 5.9% (3.6%). The anti-dementia prescription rate decreased in GP (from 0.14% to 0.10%) and increased in SP practices (from 2.1% to 2.4%).

Discussion: The diagnosis and prescription rate, especially in GP practices, remained below the prevalence forecasts and the expected prescriptions.

Aim: Inpatient-Equivalent Home Treatment (IEHT) for mental health is new in Germany and therefore requires quality development. A best practice model (BPM) for IEHT is being developed from a service user perspective.

Methods: 1. Collection and organization of evidence (literature review; n=55 interviews with service users), 2. qualitative analysis and formulation of criteria; 3. consensus and grouping of criteria (Delphi process).

Results: 58 Best practice criteria were developed in 8 groups: 1. Information, access and crisis management; 2. Treatment framework, end of treatment and continuity; 3. Scheduling, organization of contacts and flexibility; 4. Practical support and activation; 5. Treatment and therapy services; 6. Treatment team and staff; 7. Relatives, caregivers and community; and 8. Privacy and behavior in the home environment.

Conclusion: The BPM provides initial guidance for a user-centered assessment of the implementation of IEHT.

Background: Psychotherapy is going digital. The study investigated the usage behavior and acceptance of digital psychotherapy interventions among outpatient psychotherapists and patients.

Method: 269 therapists and 157 patients answered questions in an online survey on the use and satisfaction of digital psychotherapy interventions (video therapy, apps, VR, sensor-based psychotherapy), affinity for technology, acceptance of technology, digital therapy relationship.

Results: All participants were satisfied with video therapy, stated that they used apps, VR, etc. less. Patients were more open, more tech-savvy and felt more competent in their use compared to therapists. Psychotherapists rated the digital therapeutic relationship better than patients.

Discussion: The use of digital technologies in psychotherapy is not yet established in outpatient care. Measures to promote acceptance are necessary to break down barriers.

Objective: There is evidence suggesting that climate change, coupled with an increase in the frequency and severity of heatwaves, affects mental health. The aim of this study was to investigate potential associations between high temperature and the utilization of an emergency department (ED) by individuals with psychiatric disorders.

Methods: A retrospective analysis of all psychiatric emergency patients from 2015 to 2022 (N=15478) was conducted and compared with local temperature data.

Results: Particularly during heatwaves, more psychiatric emergency patients presented to the ED.

Conclusion: Beyond the results identified during heatwaves, our extensive analysis of the examined ED revealed no additional significant effects of heat on psychiatric emergencies. This contradicts findings from other studies. Other systemic influences, such as the utilization of the ED during the Covid-19 pandemic, could have modified the results.

Objective: To examine the specific scope of practice of community mental health nurses (CMHNs) across CMHN roles and care contexts.

Methods: Systematic literature searches in CINAHL, PubMed/Medline, Google and Google Scholar, supplemented by a search of various publishers' databases. Data were analyzed and synthesized using the framework analysis method.

Results: This paper identifies two role profiles in CMHN practice that describe distinct functions in the outpatient care of people with mental illness: (A) Primary Care CMHN and (B) Specialized Care CMHN. For each role profile, contextual factors and specific role content are described and analyzed for similarities and differences.

Conclusions: The described role profiles can serve as a template for the development of curricula in the field of CMHN. It is important to consider the national context as well as the current and future need for psychosocial care.