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Background: Atypical depression (AD) is a subtype of unipolar depression characterized by mood reactivity, hypersomnia, hyperphagia and interpersonal sensitivity. The concept of immunometabolic depression (IMD) describes a subgroup with additional metabolic and inflammatory abnormalities, such as obesity, insulin resistance and elevated C‑reactive protein (CRP) levels.

Objective: To summarize current evidence on AD, its overlap with immunometabolic mechanisms and therapeutic implications.

Material and methods: Narrative review based on a PubMed search using the terms "atypical depression" and "immunometabolic depression" (IMD), supplemented by relevant review articles.

Results: Atypical depressive syndromes are associated with increased systemic inflammation and metabolic dysregulation. There is evidence suggesting specific efficacy of bupropion and monoamine oxidase (MAO) inhibitors, although overall evidence remains limited. In patients with immunometabolic abnormalities (e.g., elevated C-reactive protein), anti-inflammatory agents (e.g., infliximab) and metabolically active medications (e.g., oral antidiabetic drugs) are discussed as potential treatment options; however, statins have not shown consistent antidepressant effects to date. Physical activity and dietary interventions appear additionally beneficial.

Discussion: The concept of IMD could enable stratified treatment approaches in the future. At present the evidence is inconclusive and no specifically approved treatment is available. Moreover, frequent fluctuation between atypical and melancholic syndromes complicates clinical differentiation.

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.

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.

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.

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.

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.