NEUROPSYCHIATRIE最新文献

Background: The study examines the extent to which certain target dimensions of the UN CRPD are implemented in the work-related aftercare services of a provider of vocational rehabilitation in Austria and how the implementation affects the subjective perception of the participants.

Methods: To answer the research questions, survey data from clients of work-related psychosocial aftercare services in Austria were evaluated over a period of 10 years (2013 to 2022; n = 2133).

Results: The results show that > 90 % of the survey participants consider various aspects of the CRPD to be fulfilled by the use of services, but that the degree of implementation of the UN CRPD differs depending on the type of service.

Conclusions: The study emphasises the central role of work in the psychosocial aftercare context and its importance for the implementation of certain goals of the UN CRPD as well as for the subjective perception of health.

Exposure and response prevention therapy in virtual reality (VERP) for patients with obsessive-compulsive disorder (OCD) has been investigated primarily for its effectiveness. This study evaluated an important research gap, the negative and positive side effects of VERP and its safety. Eighty outpatients with contamination- or checking-related OCD were randomized to two conditions: VERP (six weekly sessions) or care as usual (CAU). Assessments were conducted at baseline (t0), 6 weeks after t0 (t1), and 3 months after t1 (t2). General side effects (Negative and Positive Side Effects Questionnaire; NPSE) and those specific to virtual reality (VERP-Specific Side Effects Questionnaire; VEQ) were assessed at t1. Cybersickness (Simulator Sickness Questionnaire; SSQ) was assessed before and after each session. The safety evaluation involved assessing the worsening of OC-symptoms (Reliable Change Index of the Yale-Brown Obsessive-Compulsive Scale; Y‑BOCS) from t0 to t1 and serious adverse events during the intervention. Results indicated no significant clinical symptom deterioration in the VERP group and no adverse events. In total, 47% of participants in both groups experienced at least one side effect, with significantly fewer reported in the VERP than in the CAU group (p < 0.001). Concerning VERP-specific side effects, at least one side effect was found in 55% of the patients. The SSQ total score did not significantly change from before to after the VERP sessions (p = 0.098, Cohen's d = 0.297). In conclusion, VERP was safe and demonstrated few side effects, highlighting its potential as a well-tolerated and safe intervention for patients with OCD.

Background: Although diagnostic markers in cerebrospinal fluid (CSF) have become a rapidly growing research field, they have not as yet been investigated in relation to capacities that are of interest to geriatric psychiatry and neuropsychology, such as financial capacity. The aim of this study was to assess whether CSF biomarkers can predict financial capacity in patients with a diagnosis of major neurocognitive disorder due to Alzheimer's disease (AD).

Methods: Participants were examined with a number of neuropsychological tests, with an emphasis on the Mini-Mental State Examination (MMSE), the Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS) and CSF tests.

Results: Amyloid β peptide 1-42 (Aβ42), total tau, and phosphorylated tau were not found to predict financial capacity performance in AD, but MMSE shows a strong positive correlation with LCPLTAS.

Conclusions: These preliminary findings indicate that complex cognitive functions, such as financial capacity, may not be directly linked to CSF concentrations of the abovementioned biomarkers. Further studies with larger numbers of patients will be required to assess the reproducibility of these findings and to determine whether this approach can assist not only in diagnosis but also in neuropsychological assessment.

The WHO describes suicides as a worldwide phenomenon and serious problem for public health, calling for strategies across sectors for suicide prevention. In 2017, the creation of a suicide database has begun in Carinthia which means that there is detailed data about suicides from 2018 up to now for this federal Austrian state.Aim of the study was to characterise all suicides based on the available information from the suicide database Carinthia. The data of 525 suicides from 2018 till 2022 (78% male, 1/3 from the age of 65 up) were subjected to descriptive analysis and cluster analysis.About 80% of suicides happened without prior notice and often in public places (43%). Almost half of the suicides involved a mental disorder and 1/3 involved a sudden change in behaviour. The analysis revealed five clusters which are characterised as follows: "relationship issues, alcohol problems, mentally ill, announced, younger age" (N = 150), "old and sick" (N = 149), "withdrawal, mentally ill, younger age, public place" (N = 135), "unannounced, alone at home, higher age" (N = 56), and "the unidentified" (N = 35). For most of the suicides, multiple stressors and illnesses were surveyed which were identified as risk factors and warning signals. For a smaller number, many factors are unknown, and the suicides occur unannounced and unexpectedly.Several specific suicide prevention strategies could be introduced based on this data, which has also been incorporated into international studies.

Purpose: Perinatal mental illness (PMI) is one of the major health problems during pregnancy and one year after birth (the perinatal period), with robust evidence of its potentially detrimental effects on the parent's and child's health. Many countries have prioritised perinatal and infant mental health care (PIMHC). In Austria, it is currently unknown how many services are available in which region. The paper aims to map the current PIMHC landscape.

Methods: Using publicly accessible sources, such as health reports or organisation websites and supplementary information from experts, we collected data on eight characteristics of services to prevent, early identify, treat or support parents with a PMI. We extracted the information into tables, narratively summarised the results and presented a geographical visualisation of service availability.

Results: While there is currently no standardised nationwide systematic screening for PMI in place, there are a variety of services to support and treat parents with a PMI of different severity in Austria. However, there are large regional variations and gaps in care, particularly regarding specialised PIMHC and trained staff, leading to unequal access. PIMHC primarily addresses mothers and involves many, mostly public, providers and funding sources.

Conclusion: There is an urgent need to reduce the regional disparities regarding specialised PIMHC, ensuring adequate referrals and treatment and reducing inequalities in access to care. The results also call for a national strategy and defined political, administrative and service provider responsibilities based on international evidence-based recommendations. Investing in the training of staff and defined care pathways seems warranted.

Purpose: Social challenges are common in patients with eating disorders (ED). The presence of autistic characteristics often exacerbates social difficulties within this group, potentially affecting treatment outcomes. This study investigates the communication preferences, challenges, dislikes, and support needs of patients with ED, both with and without autistic traits, using a communication passport in a national inpatient ED service.

Methods: An explorative qualitative analysis of 38 completed communication passports was conducted to investigate patients' communication preferences, sensory needs, struggles and dislikes, and areas of support required, paying particular attention to the distinct needs of patients with high levels of autistic traits.

Results: The communication passport provided valuable insights into patients' communication preferences, sensory sensitivities, challenges, and support needed. Patients also used the passports to share information about their strengths, personal identity, and life beyond the hospital.

Conclusion: The communication passport fosters a deeper understanding of patients' needs and may support clinicians in care planning and communication strategies tailored to each patient's needs. Regular evaluation and updates are warranted to ensure its usability and accessibility by the wider care team.

Background: Pain is a multidimensional and subjective experience, and its perception is influenced by sensory, emotional, and behavioral factors. This work aims to evaluate the influence of depression and anxiety in the quantitative and qualitative assessment of chronic pain.

Methods: This is a cross-sectional study carried out at the Multidisciplinary Pain Center of the Clinical Hospital of the Federal University of Minas Gerais. A total of 103 patients were interviewed and evaluated using the following instruments: McGill Questionnaire, visual numerical scale, Hospital Anxiety and Depression Scale and the Medical Outcomes Study SF-36.

Results: The affective, sensory and miscellaneous categories of anxious patients were higher than the nonanxious population (p < 0.05). In the depressed population, the "affective" category was higher than the nondepressed population (p < 0.05). Regarding the anxious and depressed population, the affective, sensory and miscellaneous categories were superior to the nonanxious and nondepressed population (p < 0.05).

Discussion: Depression and anxiety are the most common psychiatric disorders in the population with chronic pain, with a prevalence of 30-40%. In the presence of anxiety and depression, a worse qualitative evaluation was observed. The higher the scores obtained in the assessment of these two mental disorders, the higher the pain index found, and the higher pain index correlates with a lower quality of life.

Conclusion: The presence of anxiety and depression altered the qualitative assessment of pain, making it more unpleasant. The pain index correlated with quality of life without, however, being related to pain intensity.

The sharp rise in the number of predominantly natal female adolescents experiencing gender dysphoria and seeking treatment in specialized clinics has sparked a contentious and polarized debate among both the scientific community and the public sphere. Few explanations have been offered for these recent developments. One proposal that has generated considerable attention is the notion of "rapid-onset" gender dysphoria, which is assumed to apply to a subset of adolescents and young adults. First introduced by Lisa Littman in a 2018 study of parental reports, it describes a subset of youth, primarily natal females, with no childhood indicators of gender dysphoria but with a sudden emergence of gender dysphoria symptoms during puberty or after its completion. For them, identifying as transgender is assumed to serve as a maladaptive coping mechanism for underlying mental health issues and is linked to social influences from peer groups and through social media. The purpose of this article is to analyze this theory and its associated hypotheses against the existing evidence base and to discuss its potential implications for future research and the advancement of treatment paradigms.