Psychiatrische Praxis最新文献

In order to provide an up-to-date overview on changes in population's mental health during the COVID-19 pandemic, a continuous literature review was conducted. Building on a rapid review, systematic and hand searches were conducted monthly until December 31, 2022. Studies were assessed for observation periods, risk of bias and outcomes. Trends in depressive symptoms in adults were summarized by vote counting. 102 publications were included from 62 studies in the adult population. Studies declined over the course of the pandemic. Overall, 37% of the studies and 56% of the publications can assess trends in the population reliably. Among evidence for changes in depressive symptoms deteriorations predominated at last. The heterogeneity of results published by the end of 2022 limits evidence syntheses. Evidence of deterioration requires further surveillance. A continuous review can indicate evidence gaps at an early stage.

Objective: To investigate variations in intended utilization in cases of an acute psychotic episode, an alcohol related or depressive disorder depending on different case characteristics.

Methods: A telephone survey with case vignettes was conducted (N=1,200). Vignettes varied in terms of urgency of symptoms, daytime, sex of the afflicted person and age/mental disorder. The respondents were asked to indicate whom they would contact first in the described case.

Results: Outpatient physicians were named most frequently as the first point of contact (61.1%) while only 6.5% of the respondents named emergency medicine including the medical on call service (8.1% in high urgency cases, i. e. emergencies that did not tolerate any delay). Intended utilization varied by urgency and age/mental illness.

Conclusion: More Information about the need to seek medical help immediately in cases of mental illnesses with high urgency should be provided.

This part of the AKtiV Study focuses on treatment satisfaction of patients and their relatives within Inpatient Equivalent Home Treatment (IEHT) and regular treatment. Stress of relatives and job satisfaction and workload of employees in IEHT is also considered. Relevant Parameters were collected via established as well as newly adapted questionnaires at the end of treatment. Patients and relatives in IEHT are significantly more satisfied. The stress experienced by relatives is reduced in both forms of treatment. Employees in IEHT are generally very satisfied, although there is no correlation with the satisfaction of relatives and patients. Known limitations of satisfaction surveys must be taken into account. In general these results encourage the expansion and continuous development of this new form of treatment in Germany.

Objectives: Due to insufficient empirical data on the occupational participation of people affected by severe mental illness receiving integration assistance, routine data from a community psychiatry service were evaluated.

Methods: Reference workers filled out a short questionnaire on different occupational and employment aspects of their clients from supported housing/floating outreach. In addition to descriptive and exploratory analyses, overall results from previous survey rounds were also evaluated.

Results: N=1418 individuals (M=47.6 years) could be included, of whom approximately 45% had no job, sheltered employment, or daytime service. This percentage has remained almost unchanged over the last decades.

Conclusion: Overall, there is an urgent need for action to improve occupational participation opportunities for people with mental illness and substance addiction.

Background: Evaluation of the practice of coercive treatment in Germany after the Constiutional Court's decision in 2011.

Methods: The documented emergency treatments (N=86) and judicially approved compulsory treatments (N=62) in 2015 and 2016 at 6 hospital locations in Baden-Württemberg were retrospectively analysed.

Results: Patients had an average of 8 previous psychiatric hospitalisations with a cumulative duration of 645 days on average and 87% had a psychotic disorder. 34% received subsequent compulsory treatment within one year. The median duration of compulsory treatment was 15 days. 92% of the patients were taking an antipsychotic at discharge, 45% received further treatment in a day hospital or a psychiatric outpatient clinic.

Conclusion: Coercive treatment affects a relatively small, chronically severely ill group of patients and is frequently recurrent among them. For considerable part, no consecutive treatment setting can be established after discharge.

Objective: The study examines how successful the participation of people with mental illness and family members is currently in the development of psychiatric guidelines.

Methods: Survey results of N=561 (Response 37%) guideline developers are analyzed.

Results: Involvement of affected individuals succeeds more often than that of family members (61% vs. 55%). 68% felt that this participation was central to successful guideline development. 51% perceived discrepancies between empirical evidence and experience perspective. 33-36% perceived a lack of appreciation of experience expertise, 37% an insufficient representation and 46% an inequality in consensus building. 45% did not see barriers effectively removed.

Conclusion: There remain challenges in the participation of people with mental illness and family members. There is an increasing awareness that their participation is central.

Objective: The influence of guideline recommendations and other factors on the utilization of psychosocial interventions in people with severe mental illness was examined.

Methods: Data from a cross-sectional study of 397 people with severe mental illness were analysed descriptively.

Results: Patients are less likely to receive therapies with a strong recommendation compared to other levels of recommendation. Various other factors are diffusely associated with utilization rates, but no ubiquitous predictors could be identified across all therapies.

Conclusion: Current practice in the use of psychosocial interventions does not follow guideline recommendation strength. Interventions with strong recommendations are probably not available across services. Consequently, routine practice is not able to follow guideline recommendations according to their strength. Other consistent predictors could not be identified.

Objective: The objective of the study was to investigate whether psychological distress increased in a German community sample from Saxony during the course of the Corona pandemic.

Methods: In 2017/2018 and 2022, N=289 participants (54.7% female) of the Saxon Longitudinal Study were interviewed about their psychological well-being using questionnaires (PHQ-4, SSS-8).

Results: There is a significant increase in complaints (anxiety, depression, psychological distress, physical complaints) compared to 2017/2018 to 2022 with effect sizes in the small and medium range (Cohens d=0.26-0.62).

Conclusion: Data collection was not due to the pandemic but was routine as part of an ongoing long-term study. The Covid-19 pandemic led to an increase in psychological distress and physical complaints in a Saxonian, age-homogeneous population sample.

Background: People with mental illness are more likely to be nicotine-dependent and they have a shorter life expectancy as a result of smoking. Although guidelines recommend smoking cessation support, this is rarely provided by psychiatric staff who often view the implementation of smoke-free policies critically.

Method: We undertook inductive thematic analysis of the free-text fields of a staff survey on smoking.

Results: Feedback on the topic was often emotional and related to the areas patient care, staff and the protection of non-smokers. Participants were often concerned that smoking cessation could worsen the patient's psychiatric condition or lead to aggressive behavior.

Conclusions: There is no scientific evidence for these concerns. It is important to counteract false assumptions by providing the appropriate training on smoking cessation.