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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.

Background: The climate crisis is increasingly leading to negative consequences for mental health and is of growing importance for psychiatric and psychotherapeutic care.

Objective: The effects of the climate crisis on mental health and its significance for psychiatric and psychotherapeutic care are presented. Recommendations for sustainability in psychiatric and psychotherapeutic practice are provided.

Material and methods: A narrative review of the literature was conducted for this article.

Results: The climate crisis has direct, indirect and intersectional negative effects on mental health. Sustainable and preventive recommendations for the practice include promoting health literacy, faster access to psychotherapy and online counselling, supporting social networks, promoting employment and reducing poverty, homelessness and social isolation. It is recommended to increase the proportion of outpatient care and to streamline administrative processes. The use of disposable products should be minimized and the application of instrumental diagnostics and materials should be optimized according to guidelines. Digital interventions should be considered more frequently in the clinical practice and sustainable facility management should be improved. Access to green spaces for the general population and patients should be facilitated.

Conclusion: Due to the negative impact of the climate crisis on mental health, sustainability should be promoted in psychiatric and psychotherapeutic care.

Climate change is the greatest global health threat of the twenty-first century. Greenhouse gas emissions and the resulting rise in average temperatures are directly linked to heatwaves, droughts, water and food shortages, extreme weather events, rising sea levels and migration movements as well as the loss of biodiversity and the alteration and degradation of ecosystems as we know them. Current estimates suggest that societies need to show much greater efforts to ensure that the global average temperature does not rise by more than 1.5 °C by 2029. Not only climate change but also other man-made factors, such as noise, light, particulate matter and plastics are threatening the health of the planet and therefore inevitably human health as well, both physical and mental health. Poorer planetary health also has an impact on human mental health. This article extends the DGPPN 2023 position paper on climate change and mental health to include the concept of planetary health. In particular, the normative dimension of the Canmore Declaration on Planetary Health, the concept of transdisciplinarity and specific calls for action are presented with their relevance to psychiatry, psychotherapy and mental health and the associations are graphically illustrated.

Personality psychology subdivides the narcissism of healthy persons into the grandiose and the vulnerable types (2 factor model), which can be further described in a more differentiated way with the three personality factors extroversion, intolerance/antagonism and neuroticism (3 factor model). The grandiose and the vulnerable types of narcissism can also be found in narcissistically disturbed patients. The narcissistic personality disorder (NPD), which in DSM‑5 is exclusively characterized by the grandiose features also shows vulnerable features; however, these are hidden behind the grandiose features. Grandiose narcissism is relatively rare in the clinical routine. So far vulnerable narcissism could not be diagnosed in DSM‑5 or ICD-10; however, in the future this will be demonstrable in ICD-11 by the dimensional concept of personality disorder even if it does not exist as an official diagnosis in ICD-11.

Background: Clinical ethics consultants support mental health professionals in identifying and analyzing moral problems in clinical practice.

Objective: Presentation of key ethical concepts and normative theories that are relevant for clinical ethics consultation in mental healthcare.

Material and methods: Conceptual and ethical analyses.

Results: After distinguishing between morality, ethics and law, moral problems are differentiated from other types of problems encountered in clinical practice. Subsequently, key ethical concepts and the concept of moral distress are clarified. In relation to the normative framework a distinction is made between philosophical ethical theories and medical ethical theories, such as principlism and the ethics of care. Finally, justification tests for ethical decision-making in situations of danger to self or others based on the harm principle and soft paternalism are proposed.

Conclusion: Knowledge of key ethical concepts and normative theories is important for the identification and analysis of moral problems in mental healthcare and should be given greater weight in the training of clinical ethics consultants.