Psychiatrische Praxis最新文献

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.

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.

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.

Objective: The qualitative study aims to explore reasons and occations for concealment in male participants with depression.

Methods: Five focus groups with 16 men were analysed via Qualitative Content Analysis.

Results: Four motives of concealment have been explored: 1. continuity of professional career, 2. Ensure acceptance and social belonging, 3. control over social identity, 4. avoiding loads of personal environment. Participants differentiate from stereotypes of hegemonic male gender norms. However, participants connect to hegemonic male gender norms when attributing professional success with vigour and assertiveness.

Conclusion: Results confirm the presence of hegemonic male gender norms particularly on the job. As a consequence, men with depressiopn replicate self- and social stigma if they fail to comply with hegemonic male gender roles. Workplace interventions that react to discrimination of mental health problems may be beneficial for men with depression.

Objective: The aim is to analyze pandemic-related effects on everyday life and psychosocial health in the understudied vulnerable group of cognitively impaired elderly people living at home.

Methods: Structured telephone interviews in 2020 (n+=+141) and 2021 (n+=+107) were used to survey over-65s with cognitive impairment (MMSE Ø 23.4). The results from the 2021 survey presented here reflect experiences and attitudes, effects on daily life and health care, and psychosocial burdens and resources. Longitudinal analysis of selected indicators of burden is provided for n+=+66.

Results: Even in the face of increasing concerns and moderate impacts on everyday life and health care, overall psychosocial health is proving to be good and largely stable over time.

Conclusion: Respondents have high levels of personal and social resources, and their coping with limitations is characterized by acceptance and willingness to adapt.

The study describes developments and local models of psychiatric rehabilitation in the GDR and the USSR. After the Second World War patient care was focused on hospitals. The Rodewisch Theses and the Brandenburg Theses as well as the "Conception to improve the patient care for mentally ill people after 1980" were important suggestions. The GDR primary literature review shows that soviet concepts were often received. The principles of stages, continuity and sectorization set the stage for success here and there. Transition units such as psychoneurological dispensaries, the occupational/protected workshops and assisted residences, therapeutic clubs, day and night hospitals were created. The occupational therapy was intended to facilitate the transition into the normal working. As a consequence, during the 1970s and 1980s in the GDR a high level of employment of mentally ill people in the economy could be achieved.

People with mental illness often have complex social problems. Up to now, there has been no systematised/standardised recording of social assistance needs in acute psychiatric care. One reason for this is the lack of adequate instruments and the increasing workload. The review analyses established needs assessment instruments with regard to their suitability for addressing the question. It becomes clear that these instruments are insufficiently suitable for a structured assessment of the need for psychosocial support. This results in the need for the development of a short and standardised instrument for the assessment of psychosocial support needs, which can be used as part of multiprofessional diagnostics within psychiatric care.