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[Doxazosin as an adjunct to trauma-focused cognitive behavioral therapy for the treatment of posttraumatic nightmares]. [Doxazosin作为以创伤为中心的认知行为疗法的辅助治疗创伤后噩梦]。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2026-02-09 DOI: 10.1007/s00115-026-01941-y
Nikola Schoofs, Philipp Trenkmann, Kristina Meyer, Kathlen Priebe, Felix Wülfing
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引用次数: 0
[Artificial intelligence in sychotherapy-Attitudes and competencies of medical and psychological psychotherapists]. [心理治疗中的人工智能——医学和心理心理治疗师的态度和能力]。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2026-02-09 DOI: 10.1007/s00115-026-01948-5
Marc Augustin, Annika Reitz, Jonathan Wirtz, Ahmed Hallawa, Guido Dartmann, Anke Schmeink

Background: Arificial Intelligence (AI) is increasingly becoming established in medicine, such as therapeutic chatbots in mental health. Despite this, knowledge about clinicians' views and skills is lacking. This study examines the attitudes toward AI and competencies of German physicians (ÄPT), psychotherapists (PPT) and psychotherapists in training (PiA) for the first time.

Method: Cross-sectional study with online survey (June-July 2025) of 335 participants, recruited through professional associations and chambers. Attitudes were assessed using the AIAS‑4 scale, competencies using the MAILS scale. Statistical analysis using ANCOVA with age as covariate (Bonferroni-corrected).

Results: All professional groups showed moderate AI literacy (M = 4.9-5.9/11), e.g. recognizing and evaluating the use of AI and moderately positive attitudes toward AI (AIAS-Total; M = 5.6-6.3/10). After controlling for age (ANCOVA), professional group effects emerged only for attitudes (p = 0.012), with physicians showing more positive attitudes than both psychologist groups (d = 0.40-0.49) but not for AI literacy (p = 0.267). There was a strong generational effect: younger participants demonstrated higher AI literacy (r = -0.28) and more positive attitudes (items 1-3: r = -0.12 to -0.17). Development competency for AI was almost nonexistent.

Conclusion: The competence of reflective use of AI appears primarily generation-dependent, not profession-specific. Age-adapted, cross-professional training programs are necessary to systematically integrate reflective competencies in education and continuing professional development.

背景:人工智能(AI)在医学领域的应用越来越广泛,例如心理健康领域的治疗性聊天机器人。尽管如此,关于临床医生的观点和技能的知识是缺乏的。本研究首次考察了德国医生(ÄPT)、心理治疗师(PPT)和在训心理治疗师(PiA)对人工智能的态度和能力。方法:横断面研究,在线调查(2025年6 - 7月)335名参与者,通过专业协会和商会招募。态度用AIAS - 4量表评估,能力用mail量表评估。统计分析采用ANCOVA,年龄为协变量(bonferroni校正)。结果:各专业组均表现出中等程度的人工智能素养(M = 4.9-5.9/11),如对人工智能使用的认识和评价,以及对人工智能的适度积极态度(M = 5.6-6.3/10)。在控制年龄(ANCOVA)后,专业群体效应只出现在态度上(p = 0.012),医生比两个心理学家组表现出更积极的态度(d = 0.40-0.49),但在人工智能素养方面没有(p = 0.267)。有很强的代际效应:年轻的参与者表现出更高的人工智能素养(r = -0.28)和更积极的态度(第1-3项:r = -0.12至-0.17)。人工智能的开发能力几乎不存在。结论:反思性使用人工智能的能力主要表现为世代依赖性,而非专业特异性。适应年龄的、跨专业的培训项目对于系统地整合教育和持续专业发展中的反思能力是必要的。
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引用次数: 0
[Vulnerability factors of depressive relapses and recurrences]. [抑郁症复发和复发的易感性因素]。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2026-02-05 DOI: 10.1007/s00115-026-01945-8
Lea Teutenberg, Tilo Kircher

Background: Depressive episodes are associated with a high risk of relapse and recurrence. A precise understanding of the risk factors for recurrence and relapse can prevent poor disease courses through the implementation of early and targeted interventions.

Objective: Description of the factors that increase the risk of recurrence and relapse in major depression.

Material and methods: Narrative literature review.

Results: Risk factors for depressive recurrence and relapse are primarily clinical factors, including the number of previous depressive episodes, a young age at first onset and existing residual symptoms. Environmental factors include childhood maltreatment and current stressors. Intrapsychic factors such as increased neuroticism or dysfunctional cognition also promote relapses and recurrences. Biological factors include functional and structural brain changes, immunological dysregulation and genetic predispositions.

Conclusion: In clinical practice the previous course of illness is the key predictor for individual risk prognosis. Therapeutic interventions should focus on achieving full remission of residual symptoms through combined pharmacological and psychotherapeutic treatment. The vulnerability to recurrence of depressive episodes is multifactorial and the indications for recurrence prevention should reflect this.

背景:抑郁发作与复发和复发的高风险相关。准确了解复发和复发的危险因素可以通过实施早期和有针对性的干预措施来预防不良病程。目的:探讨增加重性抑郁症复发和复发风险的因素。材料与方法:叙事文献综述。结果:抑郁症复发和复发的危险因素主要是临床因素,包括既往抑郁发作次数、首次发病年龄小和是否存在残留症状。环境因素包括童年虐待和当前的压力源。心理内因素,如神经质增加或认知功能障碍也会促进复发和复发。生物学因素包括脑功能和结构改变、免疫失调和遗传易感性。结论:在临床实践中,既往病程是个体危险预后的关键预测因素。治疗干预应侧重于通过药物和心理治疗相结合的治疗,使残余症状得到完全缓解。抑郁症复发的易感性是多因素的,预防复发的适应症应反映这一点。
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引用次数: 0
[The new S3 guideline on schizophrenia (living) 2025]. [新的S3指南精神分裂症(生活)2025]。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2026-02-02 DOI: 10.1007/s00115-026-01946-7
Theresa Halms, Wolfgang Gaebel, Stefan Leucht, Peter Falkai, Tania Lincoln, Andreas Bechdolf, Christoph U Correll, Stefanie J Schmidt, Martin Lambert, Thomas Wobrock, Alkomiet Hasan

Background: On 15 October 2025, the revised S3 guideline on schizophrenia (living) was published and transferred to the MAGICapp evidence ecosystem and will be updated annually in the future.

Objective: This narrative review summarizes essential innovations and explains their development.

Material and methods: New and revised recommendations and MAGICapp background information were extracted and summarized.

Results and conclusion: The guideline is now fully integrated into MAGICapp and annually updated. Key changes include a downgrading of the recommendation for antipsychotic monotherapy, a substantial expansion of guidance on adverse effect monitoring and management and a strengthened emphasis on evidence-based psychotherapeutic interventions, such as metacognitive training and systemic therapy. Additionally, 4 new recommendations (digital/technology-assisted interventions, mindfulness-based procedures, acceptance and commitment therapy [ACT], trauma-focussed therapy for post-traumatic stress disorder [PTSD]) were implemented and 12 were removed. All chapters were comprehensively revised.

背景:2025年10月15日,修订后的S3精神分裂症(生活)指南发布并转移到MAGICapp证据生态系统,未来将每年更新一次。目的:本文概述了重要的创新,并解释了它们的发展。材料和方法:提取和总结新的和修订的建议和MAGICapp背景信息。结果和结论:该指南现已完全纳入MAGICapp并每年更新。主要变化包括降低抗精神病药物单一疗法的推荐等级,大幅扩大不良反应监测和管理指导,并加强对基于证据的心理治疗干预措施的重视,如元认知训练和全身治疗。此外,实施了4项新建议(数字/技术辅助干预、基于正念的程序、接受和承诺疗法(ACT)、创伤后应激障碍(PTSD)的创伤聚焦疗法),删除了12项建议。所有章节都进行了全面修订。
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引用次数: 0
[Psychotherapy in inpatient psychiatry: from staffing levels to patient contact time]. [精神科住院病人的心理治疗:从人员配备水平到病人接触时间]。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2026-01-26 DOI: 10.1007/s00115-026-01939-6
Johannes Kornhuber, Manuel Maler, Timo Oberstein
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引用次数: 0
[Transition: challenges and recommendations for adolescents and young adults with schizophrenia]. [过渡:青少年和青年精神分裂症患者的挑战和建议]。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2026-01-20 DOI: 10.1007/s00115-025-01936-1
Benno Graf Schimmelmann, Alkomiet Hasan

Background: First acute episodes or severe recurrent courses of schizophrenia often occur in the age of transition, the transition between the pediatric psychiatric and the adult psychiatric care systems.

Objective: Examination of the challenges and recommendations for the transition of patients with schizophrenia.

Material and methods: A narrative review was carried out taking the current S3 guidelines of the Association of the Scientific Medical Societies in Germany (AWMF) on schizophrenia into consideration.

Results: The guideline-conform early detection and treatment of schizophrenia is already a challenge independent of the transition. Recommendations on the transition period for clinics and private service providers concern elements of the disorder itself, the structure of the healthcare system and specialized training and culture, and the concepts and financial compensation for treatment transitions.

Conclusion: The updated German S3 guidelines on schizophrenia published in 2025 include numerous recommendations for coordinated treatment in the transition phase but in most parts maintain the age cut-off at 18 years. For optimal care in the age for transition, access to specialized early detection and intervention centers is essential. An overlapping treatment during the transition phase and a bidirectional flexibility of age limits within healthcare systems appear to be beneficial in certain cases.

背景:精神分裂症的首次急性发作或严重复发往往发生在过渡年龄,即儿童精神病学和成人精神病学护理系统之间的过渡。目的:探讨精神分裂症患者转型面临的挑战和建议。材料和方法:考虑到德国科学医学学会协会(AWMF)关于精神分裂症的现行S3指南,进行了一项叙述性综述。结果:符合指南的精神分裂症早期发现和治疗已经是一个独立转型的挑战。关于诊所和私人服务提供者过渡期的建议涉及疾病本身的因素,保健系统的结构和专门培训和文化,以及治疗过渡的概念和经济补偿。结论:更新后的德国S3精神分裂症指南于2025年出版,其中包括许多关于过渡阶段协调治疗的建议,但大多数部分仍将年龄限制在18岁。为了在过渡年龄获得最佳护理,进入专门的早期检测和干预中心是必不可少的。在某些情况下,过渡阶段的重叠治疗和医疗保健系统内年龄限制的双向灵活性似乎是有益的。
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引用次数: 0
[Obituary Prof. Dr. med. habil. Klaus Ernst : 25 February 1936 in Rostock-6 November 2025 in Rostock]. [讣告]habil博士教授。克劳斯·恩斯特:1936年2月25日,罗斯托克[2025年11月6日,罗斯托克]。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2026-01-09 DOI: 10.1007/s00115-025-01938-z
Michael Seidel, Ekkehardt Kumbier, Sabine Herpertz
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引用次数: 0
[Sex and gender sensitivity in psychiatry and psychotherapy]. [精神病学和心理治疗中的性和性别敏感性]。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2026-01-15 DOI: 10.1007/s00115-025-01935-2
Birgit Derntl, Ute Habel
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引用次数: 0
[Sex and gender differences in posttraumatic stress disorder: current evidence on etiology, trajectory and treatment]. [创伤后应激障碍的性别差异:目前的病因、发展轨迹和治疗证据]。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-10-06 DOI: 10.1007/s00115-025-01907-6
Stephanie Haering, Caroline Meyer, Christine Knaevelsrud, Sinha Engel

Background: Sex and gender differences in mental disorders are widespread. Posttraumatic stress disorder (PTSD) is one of the mental disorders with the largest prevalence differences between women and men.

Aim of the paper and methods: This narrative review article highlights the current scientific evidence on sex and gender differences in the development, diagnostics and treatment of PTSD.

Results: Although men more frequently experience traumatic events women have a twofold to threefold higher risk of developing PTSD and experience more severe PTSD symptoms than men. The increased vulnerability of women is not yet fully understood and can be attributed to a combination of biological and psychosocial factors. Despite the higher risk, women and female-specific risk factors are underrepresented in relevant research, a gender data gap exists. Men are more likely to experience accidental and weapon-related trauma and women are more likely to be exposed to sexual violence. While women more frequently suffer from comorbid anxiety and affective disorders, PTSD in men occurs more frequently in combination with substance abuse. Men with PTSD are less likely to seek psychotherapeutic help than women and benefit less from evidence-based trauma-focused interventions.

Discussion: The differential consideration of biological and psychosocial factors is crucial to understanding sex and gender differences in PTSD. Sex and gender-sensitive approaches in diagnostics and treatment as well as the consideration of sex/gender beyond binary classifications can help to close knowledge gaps and enable more targeted care.

背景:精神障碍的性别差异是普遍存在的。创伤后应激障碍(PTSD)是男女患病率差异最大的精神障碍之一。本文的目的和方法:这篇叙述性综述文章重点介绍了目前关于创伤后应激障碍的发展、诊断和治疗中性别和性别差异的科学证据。结果:尽管男性更频繁地经历创伤性事件,但女性患创伤后应激障碍的风险比男性高两到三倍,并且经历更严重的创伤后应激障碍症状。妇女的脆弱性增加尚未得到充分了解,这可归因于生物和社会心理因素的综合作用。尽管风险较高,但在相关研究中,女性和女性特有的风险因素的代表性不足,但存在性别数据差距。男性更有可能经历意外和与武器有关的创伤,而女性更有可能遭受性暴力。虽然女性更常患有共病性焦虑和情感障碍,但男性PTSD更常与药物滥用相结合。与女性相比,患有创伤后应激障碍的男性较少寻求心理治疗帮助,也较少从循证的创伤干预中获益。讨论:对生理和社会心理因素的不同考虑对于理解PTSD的性别差异至关重要。在诊断和治疗中采用对性别和性别敏感的方法,以及在二元分类之外考虑性别/性别,有助于缩小知识差距,实现更有针对性的护理。
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引用次数: 0
[Needs of people with severe mental illness]. [严重精神疾病患者的需要]。
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-19 DOI: 10.1007/s00115-025-01835-5
Johanna Breilmann, Andreas Allgöwer, Reinhold Kilian, Uta Gühne, Steffi G Riedel-Heller, Alkomiet Hasan, Thomas Becker, Peter Falkai, Klemens Ajayi, Peter Brieger, Karel Frasch, Theresa Halms, Stephan Heres, Markus Jäger, Andreas Küthmann, Albert Putzhammer, Bertram Schneeweiß, Michael Schwarz, Markus Kösters

Background: Due to illness-related functional limitations, a significant proportion of individuals with severe mental illness are dependent on external assistance to navigate their daily lives and achieve an optimal level of independence and wellbeing.

Objectives: The present study sought to investigate the needs, the coverage of needs and the influencing factors among people with severe mental illness in Germany.

Methods: The study included patients diagnosed with severe mental illness. The met and unmet needs, as well as the potential influencing factors, were collected using Camberwell Assessment of Need (CAN) and Client Sociodemographic and Service Receipt Inventory (CSSRI) and subsequently analysed descriptively and exploratively.

Results: The mean number of reported needs was 6.4, with an average of 40.6% of these needs being met. The vast majority of patients (98%) require professional support, which is, from their perspective, inadequate (9-86% depending on the area concerned). Additionally, many patients also receive support from relatives (7-57% depending on the area concerned). The diagnosis, age, functioning, household income, and housing situation have an influence on the number and coverage of needs.

Conclusions: The findings indicate that patients have diverse and complex needs, which are not fully met. Notably, the support provided by professional services is perceived as inadequate.

背景:由于疾病相关的功能限制,很大一部分患有严重精神疾病的个体依赖外部援助来导航他们的日常生活,并达到最佳水平的独立性和幸福感。目的:调查德国重度精神疾病患者的心理需求、心理需求的覆盖范围及其影响因素。方法:研究对象为诊断为严重精神疾病的患者。使用Camberwell需求评估(CAN)和客户社会人口和服务接收量表(CSSRI)收集已满足和未满足的需求以及潜在的影响因素,并随后进行描述性和探索性分析。结果:报告需求的平均数量为6.4个,平均有40.6%的需求得到满足。绝大多数患者(98%)需要专业支持,从他们的角度来看,这是不足的(9-86%,取决于相关地区)。此外,许多患者还得到亲属的支持(7-57%,取决于有关地区)。诊断、年龄、功能、家庭收入和住房状况对需求的数量和覆盖范围有影响。结论:研究结果表明,患者的需求是多样而复杂的,并没有得到充分满足。值得注意的是,专业服务提供的支助被认为是不够的。
{"title":"[Needs of people with severe mental illness].","authors":"Johanna Breilmann, Andreas Allgöwer, Reinhold Kilian, Uta Gühne, Steffi G Riedel-Heller, Alkomiet Hasan, Thomas Becker, Peter Falkai, Klemens Ajayi, Peter Brieger, Karel Frasch, Theresa Halms, Stephan Heres, Markus Jäger, Andreas Küthmann, Albert Putzhammer, Bertram Schneeweiß, Michael Schwarz, Markus Kösters","doi":"10.1007/s00115-025-01835-5","DOIUrl":"10.1007/s00115-025-01835-5","url":null,"abstract":"<p><strong>Background: </strong>Due to illness-related functional limitations, a significant proportion of individuals with severe mental illness are dependent on external assistance to navigate their daily lives and achieve an optimal level of independence and wellbeing.</p><p><strong>Objectives: </strong>The present study sought to investigate the needs, the coverage of needs and the influencing factors among people with severe mental illness in Germany.</p><p><strong>Methods: </strong>The study included patients diagnosed with severe mental illness. The met and unmet needs, as well as the potential influencing factors, were collected using Camberwell Assessment of Need (CAN) and Client Sociodemographic and Service Receipt Inventory (CSSRI) and subsequently analysed descriptively and exploratively.</p><p><strong>Results: </strong>The mean number of reported needs was 6.4, with an average of 40.6% of these needs being met. The vast majority of patients (98%) require professional support, which is, from their perspective, inadequate (9-86% depending on the area concerned). Additionally, many patients also receive support from relatives (7-57% depending on the area concerned). The diagnosis, age, functioning, household income, and housing situation have an influence on the number and coverage of needs.</p><p><strong>Conclusions: </strong>The findings indicate that patients have diverse and complex needs, which are not fully met. Notably, the support provided by professional services is perceived as inadequate.</p>","PeriodicalId":49770,"journal":{"name":"Nervenarzt","volume":" ","pages":"74-81"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12808281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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