Nervenarzt最新文献

Work and employment have a long tradition in psychiatric psychotherapeutic treatment and are of great importance for the rehabilitation process of the people affected. Education as an essential component of promotion of rehabilitation and participation was initially given less consideration in this context, although its importance for young people is very high, particularly in connection with incipient mental illnesses.. Based on the available scientific evidence and against the background of the current health and sociopolitical challenges in Germany, opportunities for the occupational integration of people with mental illnesses are highlighted. Oriented to the sociolegal situation, some successfully implemented regional models are described as examples and the necessary implications for their nationwide transfer to the standard care context are addressed. In a future care system rehabilitation and participation support should be closely interlinked, harmonized and coordinated and form part of a regional care obligation to ensure that the treatment and participation needs of people with severe mental illness are met.

Background: In the medical world women have taken on a steadily increasing role over the last decades and are now numerically superior to men in many specialized fields. In this context psychiatry is no exception. As cinematics always reflect social developments, this fact raises the question of whether the representation of female psychiatrists in films and series takes this trend into account.

Methods: Film productions presenting female psychiatrist characters were systematically identified by means of a targeted search in relevant databases and a supplementary literature search. In addition, pertinent film examples up to the twenty-first century were analyzed.

Objective: The focus is on research questions relevant to social, medical and film history: Does the image of screen psychiatrists correspond to reality? Are stereotypes served or initiated? How does the portrayal differ from the male counterpart?

Results and conclusion: The exemplary examination of 18 films and 1 series reveals the early emergence of a gender-specific character cliché which is still influential today: the female psychiatrist as an empathic, sensitive and emotionally active doctor who can make a successful career by virtue of these character traits but who is also emotionally and socially marginalized as a result. A chronologically structured analysis not only reveals social contexts of this stereotype but also shows mechanisms of media transmission. Reflecting on this distorted image in professional settings can help to recognize and specifically address media-induced reservations in patients.

Major depressive disorder (MDD) and bipolar disorder (BD) are prevalent and disabling psychiatric disorders, often following a chronic and relapsing course. The Collaborative Research Centre 393 (SFB/TRR 393), funded by the German Research Foundation (DFG), aims to identify trajectories and symptom changes in MDD and BD, with a focus on cognitive-emotional mechanisms and their neurobiological underpinnings.Our research initiative seeks to (1) identify individual trajectories of recurrences and remissions in affective disorder (AD), (2) determine cognitive-emotional mechanisms and neurobiological correlates of acute symptom changes, and (3) probe mechanism-based interventions.These goals will be pursued through a threefold approach: (1) Continuous mobile assessment in a prospective cohort: We will combine in-depth clinical characterization with multilevel neuroimaging, biobanking, and -omics analyses in 1500 AD patients and healthy participants over a 2-year follow-up (German Mental Health Cohort, GEMCO) at three time points. Participants will be drawn from existing DFG FOR 2107 and BMBF Early-BipoLife cohorts (Domain A). (2) Identification of key cognitive-emotional mechanisms: We will study emotion regulation, expectation, social cognition, and cognitive-behavioural rhythms, and their neurobiological correlates mediating symptom changes, using parallel human studies and animal experiments (Domain B). (3) Targeted interventions: We will probe key cognitive-emotional mechanisms in relation to recurrences and remissions (Domain C).Over a 12-year period, we will elucidate environmental, psychosocial, and (neuro)biological predictors of illness course; cognitive-emotional and neurobehavioural mechanisms underlying real-life recurrences and remissions; and targeted, mechanism-based interventions.

Aim: From a public health perspective, the provision of information on low-risk consumption is highly relevant for behavior with addictive potential and negative health, psychological or social consequences. This article provides an overview of the effectiveness and benefits of such recommendations for alcohol, cannabis, gambling and gaming.

Methods: An overview based on a narrative review.

Results: The recommendation for alcohol consumption limits can no longer be upheld on the basis of current evidence. Instead, abstinence is recommended. In the case of cannabis, it is currently not possible to determine thresholds for the frequency and quantity of use with regard to consequential harms. Current recommendations, therefore, relate to "safer use". With respect to gambling, initial but not yet reliable empirical data are available. Thresholds of varying consumption dimensions, such as the involvement in different forms of gambling, the regularity or duration of gambling as well as the amount of money spent, must be taken into account. There are no evidence-based consumption recommendations for gaming. Furthermore, a consideration of the media content that goes beyond pure usage time is essential before any recommendations can be derived. Overall, the effectiveness of recommendations depends on the perception and acceptance of the population.

Conclusion: Recommendations for consumption are based on the available evidence and must be continuously reviewed and adapted, as can be seen from the example of alcohol consumption. Behavioral recommendations must be communicated in a suitable form so that they are understood without bias and are accepted by the general population.

Background: Digital technologies open up new opportunities in the treatment of mental health disorders. Internet-based and mobile telephone-based interventions (IMIs), in particular, have proven to be effective, cost-efficient and accessible approaches to improving the care of people with mental disorders. In Germany digital health applications (DiGAs) that are reimbursed by all public health insurances are gaining increasing importance in routine clinical practice.

Objective: This article provides a narrative review of the evidence and challenges related to DiGAs for depression in the German healthcare system. The approved DiGAs are presented and key studies, developments and perspectives for future research and care concepts are discussed.

Material and methods: This study is based on a narrative review of the relevant literature. The focus is on evidence-based DiGAs approved by the Federal Institute for Drugs and Medical Devices (BfArM) for the treatment of depression and their integration into routine care as well as acceptance by patients and clinicians.

Results: Internet-based cognitive behavioral therapy (iCBT) in particular, demonstrate a small to medium effect strength for depression, comparable to face-to-face therapy (Hedge's g = 0.43). Guided and blended care approaches appear to provide advantages with respect to the evidence and care; however, the utilization of DiGAs remains low, considering the large number of affected individuals, which is attributable to factors, such as limited awareness, complex access routes and prescription processes and data privacy concerns.

Conclusion: Despite promising evidence, the integration of DiGAs into existing healthcare systems remains challenging. Future research efforts should focus on the long-term effectiveness, personalization of digital solutions and hybrid care models to enhance acceptance and utilization.