Psychiatrische Praxis最新文献

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.

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.

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: 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.

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.

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.