Psychiatrische Praxis最新文献

Background: Since the amendments to the Baden-Württemberg Psychiatric Assistance Act, psychiatric patients who are treated involuntarily can be admitted to open wards. As a result, a comprehensive research project was carried out to implement an open-door policy. This work evaluates the attitudes of patients and therapeutic teams.

Methods: Over the course of a year, 8 focus groups with 6 to 11 participants were conducted with patients and staff before and at the end of the intervention phase and analyzed qualitatively.

Results: The concept of open doors was received positively. The staff raised safety concerns whereas on the patient side the door status seemed to be of limited relevance regarding the experience of autonomy or stigmatization.

Discussion: The elaboration of conflict issues allows a further development of specific concepts towards the implementation of open doors on psychiatric acute wards.

Background: Since 2017 physicians in Germany can prescribe cannabis based medicines or medical cannabis with subsequent funding by the statutory health insurance system.

Methods: Physicians prescribing cannabinoid drugs were legally required to take part in a survey conducted by the Federal Institute for Drugs and Medical Devices. This study analyses data from 16.809 case reports that were collected from 30.3.2017 to 31.12.2021.

Results: There were 5582 cases documenting the use of cannabinoid drugs in psychiatric disorders. More than half of the prescriptions were Dronabinol. 80% of the treatments concerned somatoform disorders. Most of the treatments for other psychiatric disorders also targeted pain. Doctors reported a positive effect on symptoms in at least 75% of the cases.

Discussion: Most patients with psychiatric disorders received cannabinoid drugs for pain. The evidence from randomized controlled clinical trials for the use of cannabinoid drugs in psychiatric indications is weak.

Aim: This article is part of the EKB-study which explores lived crisis and treatment experiences of mental health professionals in Berlin and Brandenburg. It addresses the disclosure of mental health workers' lived experiences in their workplace.

Method: An online survey was conducted among 182 mental health professionals, containing questions on disclosure of lived experiences. Data were analyzed descriptively and analytically.

Results: Participants reported disclosure mainly to supervisors and affiliated colleagues. Experiences were mostly positive, with severe negative exceptions. Central motives against disclosure were fear of vulnerability, fear of compromising professional identity, and shame.

Conclusions: Disclosure of lived crisis experiences is not always the proper strategy for mental health professionals. Disclosure may be a means of reducing public and internalized stigma.

The study explores the common effort of social psychiatrists in Eastern and Western Germany to help people suffering from mental health issues to gain more self-determination and social participation and to make mental health care more humane from the 1960s onwards. At the same time, it provides a contrastive analysis of the social psychiatric concepts developed by the psychiatrists Karl Peter Kisker, Klaus Weise and the philosopher Achim Thom. A thorough analysis of literature reveals differences in the theoretical approaches in the East and West. Kisker, who was a representative of the West German social psychiatric movement, had a phenomenological-anthropological background. By contrast, Weise and Thom even though following the same subject orientation, established a socialist social psychiatry clearly integrating Marxist views into their concept. This contrastive also elaborates common viewpoints in understanding the social dimensions of mental health conditions in the two concepts.

Against the background of the discussion about a comprehensive regional mental health care service, the essay discusses the possibility of a comprehensive, transparent and meaningful evaluation. Proposals for how structures, processes, and outcomes may be assessed are presented. We argue for collecting data that are transparent and actionable on all levels of care organisations. The suggested evaluation would be innovative, meaningful for individual patients, services, health care organisations and whole regions, and thus a way for a data-driven ongoing quality improvement.

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.

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.

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.