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Background: Adverse childhood experiences (ACE) are a risk factor for an unfavorable lifestyle, mental disorders and cardiometabolic diseases. However, the mechanisms through which these risks are mediated have not been conclusively investigated.

Research question: Is there a connection between ACE and cardiovascular health in adults with congenital heart disease (ACHD)?

Methods: A total of 609 ACHD were included. Sociodemographic parameters, ACE (Childhood Trauma Questionnaire, CTQ), depressive symptoms (Hospital Anxiety and Depression Scale, HADS) and physical activity were assessed. Patients underwent a full cardiological examination including the measurement of epicardial adipose tissue (EAT) using echocardiography. Bootstrapped mediation analyses were performed with ACE as the predictor, depressive symptoms and physical activity as mediators and EAT as the dependent variable.

Results: The CTQ sum score showed a significant indirect effect on EAT, which was serially mediated by depressive symptoms and physical activity (CTQ → HADS-D → Exercise → EAT; a*d*b2 = 0.0171, 95% confidence interval, CI 0.0080, 0.0285). Comparable significant effects were found for the individual CTQ domains (emotional/physical neglect, emotional/physical abuse, sexual trauma).

Discussion: We show that ACE are associated with increased depressive symptoms, which in turn lead to reduced physical activity and increased EAT, a risk marker for cardiac events. Our findings point to a key mechanism through which ACE impair cardiovascular health and highlight several targets for primary and secondary preventive interventions within a multimodal treatment approach for ACHD.

Background: Own experiences of crises and treatment (ECT) are widespread among staff in psychiatric and psychosocial settings. The present subproject of the ECT research project, investigating how staff of psychiatric institutions in Berlin and Brandenburg are affected, addresses the questions of what significance these employees attach to the ECT in patient-related work and how they feel about disclosing these experiences.

Material and methods: In an explorative cross-sectional online survey, 182 mental health professionals were asked about the disclosure of the ECTs in the work context. The data were analyzed descriptively and analytically.

Results: The existence of ECT is predominantly rated positively by the staff surveyed and is seen as influential for their work and useful for patients. The disclosure of these experiences was assessed as neutral to negative and rarely practiced.

Discussion: Staff are reluctant to disclose their ECT. Based on the literature on the topic of peer and recovery counselling, it can be assumed that ECT could bring more benefits in patient-related work through reflective disclosure.

Mental health is significantly influenced by social, cultural and gender-specific factors. The article highlights the relevance of sex/gender in the psychotherapeutic practice and shows how stereotypic expectations can distort both diagnosis and treatment. Using substance use disorders and eating disorders as examples, it demonstrates how deeply societal norms influence psychological distress. Concepts such as doing gender, intersectionality and feminist psychotherapy provide valuable perspectives for discrimination-sensitive care. They enable clinicians to reflect on structural inequalities and to recognize individual life realities in a more nuanced way. The article advocates for a stronger integration of sex/gender aspects into training, diagnostics and treatment to make psychotherapeutic approaches more equitable and effective. A concluding session offers practical recommendations for clinicians on how to incoporate sex/gender-sensitive approaches into the clinical routine.

In the pharmacological treatment of mental disorders, gender-specific aspects are often ignored and guidelines also barely consider these aspects; however, male and female can react very differently to medications due to differences in pharmacokinetics and pharmacodynamics. This article provides an overview of gender-specific differences with a focus on the pharmacokinetics of psychotropic drugs. Furthermore, (life) phase-dependent differences are addressed considering the menstruation effect, the influence of oral contraceptives, pregnancy and menopause-related physiological alterations. Therapeutic drug monitoring (TDM) is a clinical instrument that can provide valuable contributions due to changing pharmacokinetics in order to optimize the efficacy and safety of pharmacotherapy in various phases of life.

This article explores the impact of gender roles on the development, course, and treatment of alcohol use disorders. Epidemiological data reveal significant gender differences in prevalence, patterns of use, and comorbidities related to alcohol dependence. These differences are not solely biologically determined but also reflect the social construction of gender and culturally specific role expectations. Traditional masculinity norms are associated with increased alcohol consumption, reduced help-seeking behavior, and greater propensity for violence, while women are more likely to experience internalizing mental illnes and societal stigma. LGBTIQ* individuals are particularly vulnerable due to minority stress and structural barriers. This article advocates for gender-sensitive addiction care that addresses psychosocial stressors, trauma, and systemic inequalities. It emphasizes the need to critically examine rigid gender roles, which may exacerbate problems and hinder effective treatment.

The European Medicines Agency has recommended testing for the ApoE-genotype prior to treatment of Alzheimer's disease with Lecanemab. The drug approval is limited to patients who are not homozygous for the ApoE epsilon 4 allele. This is to reduce the risk of undesired adverse effects in the patients treated with Lecanemab. With this recommendation for the first time a psychiatric therapy will be genetically informed.