Psychiatrische Praxis最新文献

Background: The treatment of addicted offenders detained under § 64 of the German Criminal Code can be terminated prematurely. There is an extensive literature on predictors of such premature termination concerned with factors established before treatment.

Objective: The aim of this paper is to present predictors of premature termination that become apparent during the course of therapy.

Methods: We conducted a systematic literature search and included 16 publications.

Results: Patients and therapists rated impulsivity/aggressiveness, substance use relapses and a lack of patient-therapist relationship as negative predictors. Both groups assessed as beneficial the presence of motivation and a positive social network.

Conclusion: To prevent early treatment termination a positive patient-therapist relationship, motivation and working through incidents during therapy is essential.

Objective: To establish the effectiveness of Individual Placement and Support (IPS) to integrate people with mental illness into the general labor market, controlled comparisons with usual rehabilitative practice in terms of employment rates and cost-effectiveness are needed.

Methods: 20 IPS participants with psychoses (primarily schizophrenia spectrum disorders) were compared with 20 controls who were offered usual rehabilitative practices in adjacent counties (rehabilitation as usual, RAU) over 18 months.

Results: IPS was significantly superior to RAU on all job-related criteria with moderate to high effect sizes, with no differences in absenteeism, hospital days, or dropout rates. IPS was significantly superior to RAU on cost-effectiveness.

Conclusion: This study provides evidence that IPS is an effective and cost-efficient addition to existing vocational rehabilitation services for people with psychoses.

Objective: To examine sociodemographic and clinical characteristics of persons hospitalized in five psychiatric hospitals from regions with different structural characteristics compared with persons hospitalized voluntarily.

Methods: Descriptive analyses of routine data on approximately 57000 cases of 33000 patients treated for a primary ICD-10 psychiatric diagnosis at one of the participating hospitals from 2016 to 2019.

Results: Admission rates, length of stay, rates of further coercive measures, sociodemographic and clinical characteristics of the affected persons differ between the different regions.

Conclusion: There are considerable regional differences between regulations and implementation of the admission procedures and the sample. Causal relationships between regional specifics and the results cannot be inferred.

Aim: Risky alcohol consumption increases the risk of dementia for people with mild cognitive impairment (MCI). The aim of this study is to assess alcohol consumption in people with MCI.

Methods: Socio-demographics, 12-month prevalence, 30-d prevalence, prevalence of risky consumption (>10 g/20 g/d pure alcohol for women/men) and binge drinking (≥50 g pure alcohol on one occasion) were recorded in 270 people (≥60 years) with MCI from the German RCT "Brainfit-Nutrition" in 2022.

Results: Approximately half of the people with MCI (50.8%) drink at least once a week. About one fifth (17.0%) of participants met the criterion for binge drinking; every third woman (34.8%) and every fifth man (18.6%) crossed the line to risky consumption in the last 30 d.

Discussion: Generally, people with MCI show similar consumption prevalence as the 65+German general population. However, the prevalence of risky consumption in women with MCI is significantly higher.

A risk of suicide in the course of a psychiatric disorder will often be answered with an admission for inpatient psychiatric treatment, resulting in a high potential of suicidal behavior on the ward. Despite extensive safety precautions and therapeutic interventions, suicides still occur within psychiatric hospitals. Such incidents, known as inpatient suicides, are rare but significant, necessitating further examination. We present the case of a 91-year-old suicidal male patient, who committed suicide on an open ward on a Sunday morning by blocking his nostrils with cotton and tissue and breathing into a pillow, leading to death by asphyxia. The case report aims to draw attention to the possibility of this extraordinary method of suicide, demonstrating that a suicide can be accomplished in a psychiatric hospital even without the use of prohibited dangerous objects.

Objectives: Our study investigates how psychotherapists implement and assess the newly introduced elements of the structural reform of the psychotherapy guideline in Germany.

Methods: We asked psychotherapists about their experiences with the structural reform in semi-structured interviews. The data was analysed using qualitative content analysis.

Results: A total of 37 h of audio material from 41 psychotherapists were available. The interviews showed that acute treatment and relapse prevention are welcomed by psychotherapists. However, due to lack of appointment capacity as well as conceptual barriers, these are rarely used. Concerning psychotherapeutic assessment consultations, the opinions were heterogeneous.

Conclusion: Individual aspects of the new care elements are assessed positively. However, these can only be implemented to a limited extent and are not sufficient to significantly improve the strained supply situation.