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Background: The peer support worker is becoming increasingly more relevant also due to the new personnel regulations. Therefore, the question arises which individual conditions for success are available for the implementation of peer support workers.

Method: This study is a subproject of ImpPeer-Psy5 study financed by Innovation Funds, which investigates the nationwide requirements for the implementation of peer support workers in care financed by health insurance funds (German Social Act V, SGB V). Using a comparative thematic analysis, 57 problem-oriented interviews with peer support workers (PSW), employees and users as well as a focus group based on this were examined. This study was predominantly implemented by a researcher who already had experience in psychiatry and crises.

Results: From the perspective of the employees interviewed, sympathy and personality are the core factors for a successful implementation of peer support workers. In contrast, a professional coping with one's own crisis and recovery experience as well as diverse previous life and occupational experiences were prioritized by the PSWs.

Conclusion: In order to effectively incorporate the impulse of peer support workers, a recognition of the professional identity of the PSWs is necessary. In particular, settings that separate the tasks between the professional groups in a less hierarchical manner and rely on building relationships, such as domestic treatment, are particularly suited for the implementation of PSWs.

Critical alterations in the brain and psyche are often triggered by critical points and feedback effects in closely networked systems. Such crises can occur in the form of neurological disorders, such as epilepsy or mental disorders, such as bipolar disorder and depression. A central mechanism is the excitation-inhibition (EI) balance in the brain, which is responsible for an optimal processing of information. Disruptions in this balance can lead to pathological conditions. The concept of attractors, which represent the stable conditions in neuronal networks, helps to explain the consolidation of memories, behavioral patterns and mental states. These attractor states can be triggered by external stimuli and may become anchored in pathological contexts. Advances in measurement technologies and methods of artificial intelligence enable a deeper analysis of neuronal dynamics and open up new pathways for targeted therapeutic interventions for the treatment of mental disorders.

Background: Psychotherapeutic interventions play a crucial role in alleviating psychological distress and promoting resilience during personal and global crises.

Objective: What general principles are relevant for psychotherapeutic crisis interventions in acute psychiatry? What contributes to an in-depth understanding of individual reactions to the course of crises? When do global crises translate into personal crises? How can global crises be integrated into the psychotherapeutic process?

Material and methods: Selected results from the scientific literature on psychiatric psychotherapeutic crisis interventions in acute psychiatry are reviewed and summarized.

Results: Although the evidence for specific crisis intervention strategies in acute psychiatry is limited, general principles for psychotherapeutic crisis interventions can be derived.

Conclusion: Understanding early relational experiences based on psychodynamic or learning theory processes influences the application of further crisis intervention techniques and their impact on affected individuals.

Objective: Social media facilitate the distribution of conspiracy theories. It is uncertain whether indeed the number of myths and also the number of those who appropriate myths has increased. Conspiracy theories have so far essentially been the subject of sociological and psychosociological research showing a general disposition to become infected irrespective of the topic of a myth. Are there specific psychopathological risk factors for becoming infected by conspiracy myths? Are there effective therapeutic or preventive measures?

Methods: A systematic search was carried out in PubMed using the query "conspir*[title] AND review" followed by manual selection and appraisal only of publications addressing conspiracy theories in general, i.e. not limited to specific myths, with a focus on systematic reviews and meta-analyses. Moreover, the publications identified were manually screened for further meta-analyses.

Results: The search resulted in 166 hits. The available evidence is essentially based on studies using questionnaires, which can clarify only associations but not causalities. The evidence suggests that the strongest correlates of conspiratorial ideation pertain to low cognitive abilities, nonanalytic style of thought resulting in reduced balancing of probabilities before deciding, feelings of loss of control, paranoia, schizotypy and the dark triad (narcissism, Machiavellianism, authoritarianism).

Conclusion: Specific psychological characteristics are risk factors for conspiratorial ideation. Current research approaches are unsuitable to clarify whether psychiatric disorders are overrepresented. Sociodemographic risk factors include male gender, low level of education, low income, social isolation and are non-specific. Group processes promote, again presumably nonspecifically, conspiracy theories thus contributing to social polarization. The genetic basis and neurobiological mechanisms are unknown. Conspiracy theories were and are used as an instrument of political contention. The enlightened democratic social contract requires free, unbiased thinking. Consequently, the risk factors identified so far facilitate conspiratorial ideation and question the very fundaments of the social contract by impairing unbiased evaluation and decision making. Therefore, prevention is warranted. .

Global polycrises comprise the synchronous or consecutive occurrence of various crises, with no intervening phases of stability, e.g., coronavirus disease 2019 (COVID-19) pandemic, inflation, war and climate crisis. This poses challenges for both society as a whole and its individual members. Polycrises are associated with enormous psychological stress, especially for vulnerable groups. Polycrises also impair social interaction, which can trigger or intensify subjectively stressful loneliness. The aim of this narrative review is to show how loneliness affects social behavior in times of global polycrises and what the consequences are. Loneliness is associated with both mental and physical morbidity and mortality as well as being a significant barrier to recovery. Studies have shown that there is a mutual detrimental influence between mental illness and loneliness. The social behavior of chronically lonely people is characterized by a negative cognitive bias, hypervigilance in the social context and a dysregulated oxytocin system. Furthermore, the quality and quantity of these relationships are significantly impaired. The social consequences of loneliness are, for example, a decrease in social engagement and low voting participation. The phenomenon of loneliness clearly shows that crises can exacerbate latent problems and bring them to the surface; however, crises should also be seen as an opportunity to openly and constructively address shame-laden topics such as loneliness in public discourse and in psychotherapeutic settings.

Background: Ethical case discussions in psychiatric hospitals are particularly useful when a moral conflict between respect for the patient's autonomy and well-being becomes apparent when considering the legitimacy of coercive treatment. To date, there is hardly any data on the procedure and the results of such case discussions. We therefore present data from a large psychiatric clinic.

Aim of the study: We retrospectively analyzed ethical case discussions prior to compulsory medication in a quantitative and qualitative manner.

Methods: The study analyzed the protocols of all ethical case discussions over a 2-year period. They used the method of principle-based ethical case discussion. The qualitative analysis of selected cases was supplemented by reference to case records.

Results: An advance care directive was not available in any of the cases, so that the presumed will was used generally to assess the autonomy perspective. It proved quite complex to address danger to third parties when assessing the beneficence and nonmaleficence perspective. In 5 out of 35 consultations, the compulsory medication was not recommended from an ethical perspective.

Discussion: Ethical case discussions enable a holistic individual examination of moral obligations. They contribute to well-founded decisions and can help to reduce the frequency of coercive medications, suggesting routine use of ethics counselling.