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Huntington's disease (HD) is an autosomal dominant inherited disease, which leads to motor, cognitive and psychiatric symptoms. The diagnosis can be confirmed by genetic testing for extended CAG repeats in the Huntingtin gene. Mental and behavioral symptoms are common in HD and can appear several years before the onset of motor symptoms. The psychiatric symptoms include apathy, depression, anxiety, obsessive-compulsive symptoms and, in some cases, psychoses and aggression. These are currently restricted to symptomatic treatment as disease-modifying treatment approaches are still under investigation. The current clinical practice is based on expert opinions as well as experience with the treatment of similar symptoms in other neurological and mental health diseases. This article provides an overview of the complex psychiatric manifestations of HD, the diagnostic options and the established pharmacological and nonpharmacological treatment approaches.

Background: People with severe mental illnesses are often excluded from working life and would like support to (re)enter the general labor market as part of the psychiatric treatment. Individual placement and support (IPS) is an effective method of finding and retaining work in the general labor market. The aim of the study was to determine the integration rates of IPS into the general labor market in acute and postacute psychiatric settings, identifying patient, setting and program characteristics associated with (re)entering work.

Method: A retrospective chart review (RCR) of routine clinical data between 2016 and 2021 was carried out. The IPS program adherence was rated using the IPS fidelity scale.

Results: A total of 375 patients participated in the IPS with at least 4 appointments. The (re)integration rate into the general labor market was 51.7%. A shorter time period to the last working day, diagnosis of F1, F2, F3 (vs. F4), change of treatment setting and IPS in the psychiatric institute outpatient department (PIA), IPS fidelity and the number of IPS coaching sessions were positively correlated with (re)integration into work.

Conclusion: The implementation of IPS in clinical mental healthcare is possible and leads to high integration rates in the open labor market. An early start of IPS during the clinical treatment can promote social inclusion.

Background: Although people receiving means-tested benefits are regularly taken care of at the job center, little is known about their mental health situation and mental health care.

Objective: The aim of the study was to describe the diagnostic spectrum and the functional status as well as the mental health care utilization of individuals with mental illnesses who are receiving means-tested benefits.

Methods: Mentally ill people with means-tested benefits were recruited at the job center as part of the "Leipzig Individual Placement and Support for Mentally Ill People" (LIPSY) project, where they were initially diagnosed according to ICD-10 and included in the project if they had a mental disorder. Mental healthcare utilization was recorded. In the present study, data from n = 583 consecutively included persons were analyzed descriptively and by multivariate statistics.

Results: Of the study participants 60.7% (n = 583; 51.5% female; average age 36 years; unemployed for an average of 4.8 years) suffered from affective disorders, followed by neurotic, stress and somatoform disorders (42.5%). With a mean global assessment of functioning (GAF) value of 49.4 (SD 7.7), there was on average a serious impairment. Nearly half of the subjects (48.5%) had never received psychotherapeutic, psychiatric or neurological treatment in the 6 months prior to inclusion in the project.

Discussion: It could be shown that there is a broad spectrum of mental disorders with substantial functional impairment. The data suggest that this group is significantly undertreated and difficult to reach.

Background: In Germany 1.5-2.75 million children live in families affected by substance use disorders. Substance abuse can impact on family interactions in many ways. If a dependent parental drug use continues over a longer period of time, this can have pronounced psychological and social consequences for the (co)affected children. Nevertheless, family-focused treatment approaches are not yet widely used in the context of addiction treatment.

Aim: This review article aims to provide an overview of the prevalence of parenthood among dependent drug users in Germany, the impact of dependent drug use on families and family-focused treatment approaches.

Methods and results: Recording parenthood is particularly difficult in the case of dependent drug users as they often do not openly discuss it with their therapists because of the fear of consequences from youth welfare services. In order to change this, a structured recording of parenthood by the treatment providers is required. This is the prerequisite for being able to offer family-focused treatment to those affected. In Germany, three evidence-based therapy programs are available for this purpose: SHIFT, SHIFT Plus and MAMADAM. Additionally, a number of programs developed in the Anglo-American region can also be used. In contrast, the evidence for web-based programs is much weaker.

Discussion: In order to establish family-focused treatment approaches for drug-using parents across the board, long-term, secure funding is required. The necessary framework conditions must be created at a political level.

The first 4-6 weeks after childbirth are defined as the onset time for postpartum depression (PPD). Despite this known time frame there are significant gaps in the identification and treatment of PPD. The risk for postpartum depression (RiPoD) study investigated specific risk factors and predictors of postpartum psychological adjustment processes and the results are presented within the framework of a state of the art review of research. The dynamic neuroplastic changes in the maternal brain during pregnancy and the postpartum period appear to be closely linked to peripartum hormone fluctuations, which jointly influence the development of postpartum mood disorders. Hormonal risk factors such as baby blues and premenstrual syndrome have been found to have a bearing on PPD. The combination of these two factors predicts the risk of PPD with 83% sensitivity within the first week postpartum. Follow-up digital monitoring of symptom development in the first 6 weeks postpartum has enabled an accurate identification of women with PPD. Understanding the interaction between hormone fluctuations, neuroplasticity and psychiatric disorders should be an important target for future research. Early identification and diagnosis of PPD can be easily integrated into the clinical routine and everyday life.

Background: More than a decade ago disulfiram lost its approval for use in Germany. Nonetheless, a considerable number of psychiatric hospital outpatient departments as well as practicing physicians continue to prescribe it. These professionals have formed the "Network for Alcohol Aversive Pharmacotherapy" (NAP) to maintain a high quality of this treatment approach.

Objective: To describe the current use of disulfiram with respect to patient numbers and characteristics, side effects, and use of concomitant multimodal treatment forms.

Material and methods: Since 2019 the NAP has conducted an annual retrospective survey among its members regarding the aforementioned parameters.

Results: From 2019 to 2023 a total of 1579 treatment cases were described by 33 centers, 152 patients reported a total of 241 drinking events, 26 of them resulting in hospitalization but none causing complications or permanent harm. The most frequent side effects, in descending order, were unpleasant body odor (2.5%), fatigue, male sexual dysfunction, mildly elevated liver enzymes, allergic skin reactions and polyneuropathy (0.8%). More than one quarter of the patients suffered from comorbid depression, and approximately 5% from ADHD, borderline or other personality disorders, trauma-related disorders and anxiety disorders, respectively. Of the patients 33% were treated with antidepressants and 12% with sedating antipsychotics. Various forms of concomitant group therapy were offered to 66% of the patients.

Conclusion: Treatment with disulfiram is legally possible, generally well-tolerated and safe. It is offered in most treatment centers as part of a comprehensive treatment plan that includes multimodal treatment of comorbid psychiatric disorders.

The aim of this study was to differentiate between types of bipolar disorders and the associated features using explorative analysis. The focus was particularly on the role of bipolar 1 and bipolar 2 disorders as well as the influence of prophylactic interventions for relapse in a randomized, controlled treatment study. A total of 274 of the 305 originally included persons could be investigated in the study. Patients participated in either cognitive behavioral group therapy (SEKT) or supportive, patient-centered group therapy (FEST). Treatment took place over 4 days separated by a 1-month interval (equivalent to 16 double hours). Depressive and manic symptoms were assessed using the longitudinal interval follow-up evaluation (LIFE). The symptoms were retrospectively assessed for the previous 6 months, with respect to each week before and after the intervention phase and for 6‑month and 12-month follow-ups. The results show that the effects of both group therapies were comparable; however, there were statistically significant differences in a multivariate proportional hazards model for the factors bipolar 1 and 2 as well as the interaction of therapy with bipolar 1 and 2. In particular, bipolar 2 patients benefited significantly less from the SEKT intervention than from the FEST intervention. There were three clusters identified that separated bipolar 1 (SEKT, no comorbidity, predominantly no recurrences, younger patients), from bipolar 2 (FEST, no comorbidity, at least 1 often 2 recurrences, older patients) and from a heterogeneous group (SEKT and FEST, comorbidity). The distinction between bipolar 1 and bipolar 2 disorder is important and has so far not received sufficient attention. Bipolar 2 disorders generally have a worse course and respond particularly poorly to cognitive behavioral therapy (SEKT). An open, unstructured, supportive, patient-centered psychotherapy (FEST) is generally effective.