Co-occurring Addictive and Psychiatric Disorders, 2014
Although research and clinical interventions for patients with dual disorders have been described... more Although research and clinical interventions for patients with dual disorders have been described since as early as the 1980s, the day-to-day treatment of these patients remains problematic and challenging in many countries. Throughout this book, many approaches and possible pathways have been outlined. Based upon these experiences, some key points can be extracted in order to guide to future developments. (1) New diagnostic approaches are warranted when dealing with patients who have multiple problems, given the limitations of the current categorical systems. (2) Greater emphasis should be placed on secondary prevention and early intervention for children and adolescents at an increased risk of later-life dual disorders. (3) Mental, addiction, and somatic care systems can be integrated, adopting a patient-focused approach to care delivery. (4) Recovery should be taken into consideration when defining treatment intervention and outcome goals. (5) It is important to reduce societal risk factors, such as poverty and early childhood adversity. (6) More resources are needed to provide adequate mental health care in the various countries. The development of European guidance initiatives would provide benefits in many of these areas, making it possible to ensure a more harmonized standard of care for patients with dual disorders.
BACKGROUND There is a lack of studies on internet-based interventions in inpatient settings. This... more BACKGROUND There is a lack of studies on internet-based interventions in inpatient settings. This is especially true for studies of internet-based interventions in acute psychiatric inpatient care. Internet-based interventions in this specific setting may provide benefits such as patient empowerment and overall improved treatment outcomes. However, there may also be specific barriers to their implementation that are unique due to the complexity of acute psychiatric inpatient care. OBJECTIVE The aim of this study is to examine the feasibility and preliminary evidence for effectiveness of a web-based emotion regulation intervention provided as an add-on to acute psychiatric inpatient care. METHODS The goal is to randomly allocate 60 patients with a range of different diagnoses in a 1:1 ratio to either treatment as usual (TAU), which consists of acute psychiatric inpatient treatment, or to the intervention group, which will receive TAU plus access to a web-based intervention that focuses on reduction of emotion regulation difficulties and improvement of emotion regulation skills. The primary outcome is symptom severity, assessed with the short form of the Brief Symptom Inventory at baseline, after 4 weeks, after 8 weeks, and at hospital discharge. Secondary outcomes include 2 emotion regulation parameters, intervention use, usability, patient satisfaction, and reasons for patient loss to follow-up. RESULTS Participant recruitment started in August 2021 and as of March 2023 was ongoing. First publication of study results is expected in 2024. CONCLUSIONS This study protocol describes a study that intends to examine a web-based emotion regulation intervention in acute psychiatric inpatient care. The study will provide information on the feasibility of the intervention and possible effects on symptom severity and emotion regulation. The results will provide new insights on blended treatment, in this case the combination of a web-based intervention and face-to-face psychiatric treatment, in an understudied patient group and setting. CLINICALTRIAL ClinicalTrials.gov NCT04990674; https://clinicaltrials.gov/ct2/show/NCT04990674 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/47656
Suchterkrankungen, speziell Alkoholabhangigkeit, gehoren zu den haufigsten psychischen Erkrankung... more Suchterkrankungen, speziell Alkoholabhangigkeit, gehoren zu den haufigsten psychischen Erkrankungen uberhaupt. Die neurobiologischen Grundlagen, aber auch die wichtigsten neuropsychiatrischen Folgeschaden und Therapiemoglichkeiten sind gerade von der psychiatrischen Grundlagenforschung lange Zeit eher stiefmutterlich behandelt worden. In den letzten Jahren haben sich aber auch im deutschsprachigen Raum eine Vielzahl von klinisch und wissenschaftlich zum Teil hervorragenden Arbeitsgruppen etabliert, die das gesamte Gebiet der Suchtforschung deutlich vorangebracht haben. In diesem Heft werden ausgewahlte Beitrage eines Symposiums vorgestellt, das im Vorjahr im Rahmen des jahrlichen interdisziplinaren Suchtkongresses in Munchen, einer traditionell sehr gut besuchten Veranstaltung, gehalten wurden. In dem Beitrag von Dirk Wedekind und Ursula Havemann-Reinecke, Gottingen, geht es um die Grundlagen und Korrelate psychiatrischer Komorbiditat bei Suchterkrankungen, speziell dem serotonergen System. In dem Artikel wird deutlich, wie haufig psychische Erkrankungen, speziell Angststorungen, die Borderline-Storung oder depressive Erkrankungen bei Suchterkrankungen sind. Eine Vielzahl von Untersuchungen deuten dabei auf eine serotonerge Dysfunktion als mogliche gemeinsame Wurzel beider Storungen hin. Dem Ausgleich einer serotenergen Dysfunktion kommt daher nach Aussagen der Autoren auch eine grose Bedeutung fur die Therapie von Suchterkrankungen zu. Ein fur die Therapieforschung interessantes Modell ist die von Christina Zingg, Meiringen, dargestellte Selbstwirksamkeitserwartung, die grose Bedeutung fur den Behandlungserfolg hat. Selbstwirksamkeit ist ein guter Pradikator fur die Aufrechterhaltung einer Alkoholabstinenz, wie eigene Daten in dem Artikel verdeutlichen. Die zahlreichen zu dieser Frage publizierten Studien werden von ihr zusammenfassend dargestellt. In einem weiteren wichtigen Beitrag stellt Ulrich Preuss und MW Wong von der Universitat Halle die Bedeutung der Komorbiditat von bipolaren Storungen und Abhangigkeitserkrankungen in den Vordergrund. Diese ist besonders hoch und fur den Krankheitsverlauf wichtig. Der Aspekt der Komorbiditat von Suchterkrankungen, affektiven Storungen und Angsterkrankungen wird von Markus Lorscheider und Christof Fehr von der Universitatsklinik Mainz aufgegriffen. In dem Beitrag geht es um Behandlungskonzepte. Die zu dieser Frage publizierten Studien speziell mit Antidepressiva werden kritisch diskutiert. Die Autoren kommen zu dem Schluss, dass Serotonin-Wiederaufnahmehemmer im Vergleich zum Trizyklika in ihrer Wirksamkeit vielleicht unterlegen sind, wegen eines geringen Suizidrisikos, aber bevorzugt eingesetzt werden sollten. Im eigenen Beitrag geht es um das Thema psychotische Erkrankungen bei Alkoholabhangigkeit. Die Alkoholhalluzinose, die psychopathologisch der Schizophrenie ahnelt, ist ein von vielen Psychiatern eher vernachlassigtes, weil unbekanntes, dabei nicht seltenes Krankheitsbild. Stimmenhoren, Angst und Verfolgungsideen stehen ganz im Vordergrund. Differenzieren muss man die Alkoholhalluzinose von anderen drogeninduzierten Psychosen, aber auch Schizophrenie mit sekundarem Substanzmissbrauch. Es steht zu hoffen, dass das vorliegende Heft deutlich macht, dass Alkoholund Drogenabhangigkeit sehr viel mit psychischen Erkrankungen zu tun haben und thematisch in die Psychiatrie gehoren.
BACKGROUND There is a lack of studies on internet-based interventions in inpatient settings. This... more BACKGROUND There is a lack of studies on internet-based interventions in inpatient settings. This is especially true for studies of internet-based interventions in acute psychiatric inpatient care. Internet-based interventions in this specific setting may provide benefits such as patient empowerment and overall improved treatment outcomes. However, there may also be specific barriers to their implementation that are unique due to the complexity of acute psychiatric inpatient care. OBJECTIVE The aim of this study is to examine the feasibility and preliminary evidence for effectiveness of a web-based emotion regulation intervention provided as an add-on to acute psychiatric inpatient care. METHODS The goal is to randomly allocate 60 patients with a range of different diagnoses in a 1:1 ratio to either treatment as usual (TAU), which consists of acute psychiatric inpatient treatment, or to the intervention group, which will receive TAU plus access to a web-based intervention that focuses on reduction of emotion regulation difficulties and improvement of emotion regulation skills. The primary outcome is symptom severity, assessed with the short form of the Brief Symptom Inventory at baseline, after 4 weeks, after 8 weeks, and at hospital discharge. Secondary outcomes include 2 emotion regulation parameters, intervention use, usability, patient satisfaction, and reasons for patient loss to follow-up. RESULTS Participant recruitment started in August 2021 and as of March 2023 was ongoing. First publication of study results is expected in 2024. CONCLUSIONS This study protocol describes a study that intends to examine a web-based emotion regulation intervention in acute psychiatric inpatient care. The study will provide information on the feasibility of the intervention and possible effects on symptom severity and emotion regulation. The results will provide new insights on blended treatment, in this case the combination of a web-based intervention and face-to-face psychiatric treatment, in an understudied patient group and setting. CLINICALTRIAL ClinicalTrials.gov NCT04990674; https://clinicaltrials.gov/ct2/show/NCT04990674 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/47656
Introduction: In individuals with alcohol use disorder (AUD), the brain areas underlying cue-indu... more Introduction: In individuals with alcohol use disorder (AUD), the brain areas underlying cue-induced reactions (e.g., cingulum, striatum, thalamus) and altered activation of these regions have been identified by functional neuroimaging. Neuronal responses to a complex alcohol-related context are yet to investigate. To better understand contextual effects as well as the interplay of cue-induced neural reactions and context exposure, the present study implemented an imagination procedure during functional magnetic resonance imaging (fMRI). Methods: Thirteen patients with AUD and 13 healthy controls completed two rounds of a cue-reactivity paradigm inside an MRI scanner. Two individualized imagination tasks were conducted before each of the two cue reactivity tasks. A 2 (group) × 2 (imagination) × 2 (picture-type) analysis of variance (ANOVA) was performed. Results: The ANOVA revealed a main effect for imagination with higher activation in bilateral thalamus and right caudate nucleus and an interaction effect between imagination and group in right thalamus and left caudate nucleus, due to the patient group reacting stronger during alcohol-related imagination. These structures are involved in relaying sensory information and habit learning. No main or interaction effects of picture type were observed. Conclusions: These results support the view that context effects alter the neural responses in thalamus and nucleus caudatus in patients with AUD, and that imagination tasks are suited to incorporate contextual influences in neurophysiological research designs. Future research needs to investigate whether the failure to observe a picture-type effect was due to limited statistical power and omission to individualize picture set, or whether an imagination procedure interferes with the evocation of picture-type effects.
When individuals vote, decide on what to wear or what to eat, they do not do so in a societal vac... more When individuals vote, decide on what to wear or what to eat, they do not do so in a societal vacuum; rather, their actions are influenced and affected by society’s values, trends, commercials, and campaigns. From our daily experience, it seems plausible that social and cognitive processes are intertwined. However, in the area of natural recovery research, decisional processes of
Despite the progress made in the field of allergy-immunology in recent years, there are a group o... more Despite the progress made in the field of allergy-immunology in recent years, there are a group of diseases that the allergist-immunologist may be called on to manage in which their precise etiologies have not been identified but that appear to be initiated or exacerbated by allergic mechanisms. Attention deficit hyperactivity disorder (ADHD), chronic fatigue syndrome (CFS), and fibromyalgia (FM) fall into this category of disorders. Although the precise etiology of ADHD still remains unknown, the most prevalent theory is that it represents a neurobiologically based developmental disability leading to inadequate production of the neurotransmitter dopamine. In patients with CFS, there appears to be a fundamental dysfunction of the neuroendocrine-immunological system with deficiencies of immunological and neurological function, which, together with chronic viral infection, may lead to a sequence of events responsible for the symptoms of this disorder. FM appears to be a variant of CFS with a predominance of hypothalamic pituitary axis dysfunction. The disorder is characterized by chronic widespread pain and the finding of 11/18 tender points on examination. Now, there is emerging evidence to suggest that adverse reactions to foods or food components also may be associated with behavioral disturbances that may play a role in each of these disorders. An understanding of the interactive responses involved in the neuroendocrine-immunological network is essential for a comprehension of the pathophysiology of ADHD, CFS, and FM and the role of allergies appears to be an important triggering event in each of the disorders.
Hintergrund: Wahrend eine Reihe von Studien zeigen konnte, dass Personen mit einer Aufmerksamkeit... more Hintergrund: Wahrend eine Reihe von Studien zeigen konnte, dass Personen mit einer Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung (ADHS) eine relativ hohe Pravalenz von Storungen durch Substanzkonsum aufweisen, wurden kaum prospektive Langsschnittstudien zur Initialisierung bzw. Eskalation von Substanzkonsum durchgefuhrt. Diese Kohortenstudie untersucht den pradiktiven Wert von ADHS Symptomen fur den Verlauf von Substanzkonsum in einer reprasentativen Stichprobe junger Schweizer Manner. Methode: In der „Cohort Study on Substance Use Risk Factors“ (C-SURF) wurden 5’103 Manner im Alter von 20 Jahren mit dem Screening Instrument „ADHS self-report scale“ (ASRS-v1.1) zu ADHS Symptomen sowie mit verschiedenen Fragebogen zu Storungen des Sozialverhaltens und zu Substanzkonsum befragt (Baseline) und 15 Monate spater nachuntersucht (Nachbefragung). Verglichen wurden Manner, deren Screening positiv fur ADHS ausfiel (ADHS+), mit Mannern mit negativem ADHS Screening (ADHS-) einerseits zum Zeitpunkt der Baseline in Bezug auf den Suchtmittelkonsum und andererseits in Bezug auf dessen Veranderungen in der Nachbefragung, wobei der Einfluss der Sozialverhaltensstorung statistisch kontrolliert wurde. Ergebnisse: Zum Zeitpunkt der Baseline wiesen die 215 (4.2%) Manner der ADHD+ Gruppe eine betrachtlich hohere Pravalenz und Frequenz von Substanzkonsum bzw. von Storungen durch Alkohol, Nikotin und Cannabis auf als die 4‘880 Manner der ADHS- Gruppe. Von Baseline zur Nachbefragung blieb in beiden Gruppen der Alkohol- und Nikotinkonsum konstant, wahrend der Cannabiskonsum zunahm. Die ADHS+ Gruppe begann ausser Alkohol signifikant haufiger mit dem Konsum weiterer Substanzen, einschliesslich nicht verschriebenem Methylphenidat. Schlussfolgerungen: Junge Manner mit ADHS Symptomen wiesen nicht nur ein hoheres Risiko zu kontinuierlichem schwereren Suchtmittelkonsum im Vergleich zur ADHS- Gruppe auf, sondern verfugten im Verlauf von 15 Monaten auch uber ein hoheres Risiko mit dem Konsum von Drogen und nicht verschriebenen Medikamenten zu beginnen und zwar unabhangig von einer zusatzlichen Sozialverhaltensstorung. Aus Praventionsperspektive konnte bei jungen Mannern das Erkennen und Behandeln von ADHS Symptomen eine Fruhpravention zur Risikoverringerung von Drogen- und Medikamentenkonsum sein.
Co-occurring Addictive and Psychiatric Disorders, 2014
Although research and clinical interventions for patients with dual disorders have been described... more Although research and clinical interventions for patients with dual disorders have been described since as early as the 1980s, the day-to-day treatment of these patients remains problematic and challenging in many countries. Throughout this book, many approaches and possible pathways have been outlined. Based upon these experiences, some key points can be extracted in order to guide to future developments. (1) New diagnostic approaches are warranted when dealing with patients who have multiple problems, given the limitations of the current categorical systems. (2) Greater emphasis should be placed on secondary prevention and early intervention for children and adolescents at an increased risk of later-life dual disorders. (3) Mental, addiction, and somatic care systems can be integrated, adopting a patient-focused approach to care delivery. (4) Recovery should be taken into consideration when defining treatment intervention and outcome goals. (5) It is important to reduce societal risk factors, such as poverty and early childhood adversity. (6) More resources are needed to provide adequate mental health care in the various countries. The development of European guidance initiatives would provide benefits in many of these areas, making it possible to ensure a more harmonized standard of care for patients with dual disorders.
BACKGROUND There is a lack of studies on internet-based interventions in inpatient settings. This... more BACKGROUND There is a lack of studies on internet-based interventions in inpatient settings. This is especially true for studies of internet-based interventions in acute psychiatric inpatient care. Internet-based interventions in this specific setting may provide benefits such as patient empowerment and overall improved treatment outcomes. However, there may also be specific barriers to their implementation that are unique due to the complexity of acute psychiatric inpatient care. OBJECTIVE The aim of this study is to examine the feasibility and preliminary evidence for effectiveness of a web-based emotion regulation intervention provided as an add-on to acute psychiatric inpatient care. METHODS The goal is to randomly allocate 60 patients with a range of different diagnoses in a 1:1 ratio to either treatment as usual (TAU), which consists of acute psychiatric inpatient treatment, or to the intervention group, which will receive TAU plus access to a web-based intervention that focuses on reduction of emotion regulation difficulties and improvement of emotion regulation skills. The primary outcome is symptom severity, assessed with the short form of the Brief Symptom Inventory at baseline, after 4 weeks, after 8 weeks, and at hospital discharge. Secondary outcomes include 2 emotion regulation parameters, intervention use, usability, patient satisfaction, and reasons for patient loss to follow-up. RESULTS Participant recruitment started in August 2021 and as of March 2023 was ongoing. First publication of study results is expected in 2024. CONCLUSIONS This study protocol describes a study that intends to examine a web-based emotion regulation intervention in acute psychiatric inpatient care. The study will provide information on the feasibility of the intervention and possible effects on symptom severity and emotion regulation. The results will provide new insights on blended treatment, in this case the combination of a web-based intervention and face-to-face psychiatric treatment, in an understudied patient group and setting. CLINICALTRIAL ClinicalTrials.gov NCT04990674; https://clinicaltrials.gov/ct2/show/NCT04990674 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/47656
Suchterkrankungen, speziell Alkoholabhangigkeit, gehoren zu den haufigsten psychischen Erkrankung... more Suchterkrankungen, speziell Alkoholabhangigkeit, gehoren zu den haufigsten psychischen Erkrankungen uberhaupt. Die neurobiologischen Grundlagen, aber auch die wichtigsten neuropsychiatrischen Folgeschaden und Therapiemoglichkeiten sind gerade von der psychiatrischen Grundlagenforschung lange Zeit eher stiefmutterlich behandelt worden. In den letzten Jahren haben sich aber auch im deutschsprachigen Raum eine Vielzahl von klinisch und wissenschaftlich zum Teil hervorragenden Arbeitsgruppen etabliert, die das gesamte Gebiet der Suchtforschung deutlich vorangebracht haben. In diesem Heft werden ausgewahlte Beitrage eines Symposiums vorgestellt, das im Vorjahr im Rahmen des jahrlichen interdisziplinaren Suchtkongresses in Munchen, einer traditionell sehr gut besuchten Veranstaltung, gehalten wurden. In dem Beitrag von Dirk Wedekind und Ursula Havemann-Reinecke, Gottingen, geht es um die Grundlagen und Korrelate psychiatrischer Komorbiditat bei Suchterkrankungen, speziell dem serotonergen System. In dem Artikel wird deutlich, wie haufig psychische Erkrankungen, speziell Angststorungen, die Borderline-Storung oder depressive Erkrankungen bei Suchterkrankungen sind. Eine Vielzahl von Untersuchungen deuten dabei auf eine serotonerge Dysfunktion als mogliche gemeinsame Wurzel beider Storungen hin. Dem Ausgleich einer serotenergen Dysfunktion kommt daher nach Aussagen der Autoren auch eine grose Bedeutung fur die Therapie von Suchterkrankungen zu. Ein fur die Therapieforschung interessantes Modell ist die von Christina Zingg, Meiringen, dargestellte Selbstwirksamkeitserwartung, die grose Bedeutung fur den Behandlungserfolg hat. Selbstwirksamkeit ist ein guter Pradikator fur die Aufrechterhaltung einer Alkoholabstinenz, wie eigene Daten in dem Artikel verdeutlichen. Die zahlreichen zu dieser Frage publizierten Studien werden von ihr zusammenfassend dargestellt. In einem weiteren wichtigen Beitrag stellt Ulrich Preuss und MW Wong von der Universitat Halle die Bedeutung der Komorbiditat von bipolaren Storungen und Abhangigkeitserkrankungen in den Vordergrund. Diese ist besonders hoch und fur den Krankheitsverlauf wichtig. Der Aspekt der Komorbiditat von Suchterkrankungen, affektiven Storungen und Angsterkrankungen wird von Markus Lorscheider und Christof Fehr von der Universitatsklinik Mainz aufgegriffen. In dem Beitrag geht es um Behandlungskonzepte. Die zu dieser Frage publizierten Studien speziell mit Antidepressiva werden kritisch diskutiert. Die Autoren kommen zu dem Schluss, dass Serotonin-Wiederaufnahmehemmer im Vergleich zum Trizyklika in ihrer Wirksamkeit vielleicht unterlegen sind, wegen eines geringen Suizidrisikos, aber bevorzugt eingesetzt werden sollten. Im eigenen Beitrag geht es um das Thema psychotische Erkrankungen bei Alkoholabhangigkeit. Die Alkoholhalluzinose, die psychopathologisch der Schizophrenie ahnelt, ist ein von vielen Psychiatern eher vernachlassigtes, weil unbekanntes, dabei nicht seltenes Krankheitsbild. Stimmenhoren, Angst und Verfolgungsideen stehen ganz im Vordergrund. Differenzieren muss man die Alkoholhalluzinose von anderen drogeninduzierten Psychosen, aber auch Schizophrenie mit sekundarem Substanzmissbrauch. Es steht zu hoffen, dass das vorliegende Heft deutlich macht, dass Alkoholund Drogenabhangigkeit sehr viel mit psychischen Erkrankungen zu tun haben und thematisch in die Psychiatrie gehoren.
BACKGROUND There is a lack of studies on internet-based interventions in inpatient settings. This... more BACKGROUND There is a lack of studies on internet-based interventions in inpatient settings. This is especially true for studies of internet-based interventions in acute psychiatric inpatient care. Internet-based interventions in this specific setting may provide benefits such as patient empowerment and overall improved treatment outcomes. However, there may also be specific barriers to their implementation that are unique due to the complexity of acute psychiatric inpatient care. OBJECTIVE The aim of this study is to examine the feasibility and preliminary evidence for effectiveness of a web-based emotion regulation intervention provided as an add-on to acute psychiatric inpatient care. METHODS The goal is to randomly allocate 60 patients with a range of different diagnoses in a 1:1 ratio to either treatment as usual (TAU), which consists of acute psychiatric inpatient treatment, or to the intervention group, which will receive TAU plus access to a web-based intervention that focuses on reduction of emotion regulation difficulties and improvement of emotion regulation skills. The primary outcome is symptom severity, assessed with the short form of the Brief Symptom Inventory at baseline, after 4 weeks, after 8 weeks, and at hospital discharge. Secondary outcomes include 2 emotion regulation parameters, intervention use, usability, patient satisfaction, and reasons for patient loss to follow-up. RESULTS Participant recruitment started in August 2021 and as of March 2023 was ongoing. First publication of study results is expected in 2024. CONCLUSIONS This study protocol describes a study that intends to examine a web-based emotion regulation intervention in acute psychiatric inpatient care. The study will provide information on the feasibility of the intervention and possible effects on symptom severity and emotion regulation. The results will provide new insights on blended treatment, in this case the combination of a web-based intervention and face-to-face psychiatric treatment, in an understudied patient group and setting. CLINICALTRIAL ClinicalTrials.gov NCT04990674; https://clinicaltrials.gov/ct2/show/NCT04990674 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/47656
Introduction: In individuals with alcohol use disorder (AUD), the brain areas underlying cue-indu... more Introduction: In individuals with alcohol use disorder (AUD), the brain areas underlying cue-induced reactions (e.g., cingulum, striatum, thalamus) and altered activation of these regions have been identified by functional neuroimaging. Neuronal responses to a complex alcohol-related context are yet to investigate. To better understand contextual effects as well as the interplay of cue-induced neural reactions and context exposure, the present study implemented an imagination procedure during functional magnetic resonance imaging (fMRI). Methods: Thirteen patients with AUD and 13 healthy controls completed two rounds of a cue-reactivity paradigm inside an MRI scanner. Two individualized imagination tasks were conducted before each of the two cue reactivity tasks. A 2 (group) × 2 (imagination) × 2 (picture-type) analysis of variance (ANOVA) was performed. Results: The ANOVA revealed a main effect for imagination with higher activation in bilateral thalamus and right caudate nucleus and an interaction effect between imagination and group in right thalamus and left caudate nucleus, due to the patient group reacting stronger during alcohol-related imagination. These structures are involved in relaying sensory information and habit learning. No main or interaction effects of picture type were observed. Conclusions: These results support the view that context effects alter the neural responses in thalamus and nucleus caudatus in patients with AUD, and that imagination tasks are suited to incorporate contextual influences in neurophysiological research designs. Future research needs to investigate whether the failure to observe a picture-type effect was due to limited statistical power and omission to individualize picture set, or whether an imagination procedure interferes with the evocation of picture-type effects.
When individuals vote, decide on what to wear or what to eat, they do not do so in a societal vac... more When individuals vote, decide on what to wear or what to eat, they do not do so in a societal vacuum; rather, their actions are influenced and affected by society’s values, trends, commercials, and campaigns. From our daily experience, it seems plausible that social and cognitive processes are intertwined. However, in the area of natural recovery research, decisional processes of
Despite the progress made in the field of allergy-immunology in recent years, there are a group o... more Despite the progress made in the field of allergy-immunology in recent years, there are a group of diseases that the allergist-immunologist may be called on to manage in which their precise etiologies have not been identified but that appear to be initiated or exacerbated by allergic mechanisms. Attention deficit hyperactivity disorder (ADHD), chronic fatigue syndrome (CFS), and fibromyalgia (FM) fall into this category of disorders. Although the precise etiology of ADHD still remains unknown, the most prevalent theory is that it represents a neurobiologically based developmental disability leading to inadequate production of the neurotransmitter dopamine. In patients with CFS, there appears to be a fundamental dysfunction of the neuroendocrine-immunological system with deficiencies of immunological and neurological function, which, together with chronic viral infection, may lead to a sequence of events responsible for the symptoms of this disorder. FM appears to be a variant of CFS with a predominance of hypothalamic pituitary axis dysfunction. The disorder is characterized by chronic widespread pain and the finding of 11/18 tender points on examination. Now, there is emerging evidence to suggest that adverse reactions to foods or food components also may be associated with behavioral disturbances that may play a role in each of these disorders. An understanding of the interactive responses involved in the neuroendocrine-immunological network is essential for a comprehension of the pathophysiology of ADHD, CFS, and FM and the role of allergies appears to be an important triggering event in each of the disorders.
Hintergrund: Wahrend eine Reihe von Studien zeigen konnte, dass Personen mit einer Aufmerksamkeit... more Hintergrund: Wahrend eine Reihe von Studien zeigen konnte, dass Personen mit einer Aufmerksamkeitsdefizit-/Hyperaktivitatsstorung (ADHS) eine relativ hohe Pravalenz von Storungen durch Substanzkonsum aufweisen, wurden kaum prospektive Langsschnittstudien zur Initialisierung bzw. Eskalation von Substanzkonsum durchgefuhrt. Diese Kohortenstudie untersucht den pradiktiven Wert von ADHS Symptomen fur den Verlauf von Substanzkonsum in einer reprasentativen Stichprobe junger Schweizer Manner. Methode: In der „Cohort Study on Substance Use Risk Factors“ (C-SURF) wurden 5’103 Manner im Alter von 20 Jahren mit dem Screening Instrument „ADHS self-report scale“ (ASRS-v1.1) zu ADHS Symptomen sowie mit verschiedenen Fragebogen zu Storungen des Sozialverhaltens und zu Substanzkonsum befragt (Baseline) und 15 Monate spater nachuntersucht (Nachbefragung). Verglichen wurden Manner, deren Screening positiv fur ADHS ausfiel (ADHS+), mit Mannern mit negativem ADHS Screening (ADHS-) einerseits zum Zeitpunkt der Baseline in Bezug auf den Suchtmittelkonsum und andererseits in Bezug auf dessen Veranderungen in der Nachbefragung, wobei der Einfluss der Sozialverhaltensstorung statistisch kontrolliert wurde. Ergebnisse: Zum Zeitpunkt der Baseline wiesen die 215 (4.2%) Manner der ADHD+ Gruppe eine betrachtlich hohere Pravalenz und Frequenz von Substanzkonsum bzw. von Storungen durch Alkohol, Nikotin und Cannabis auf als die 4‘880 Manner der ADHS- Gruppe. Von Baseline zur Nachbefragung blieb in beiden Gruppen der Alkohol- und Nikotinkonsum konstant, wahrend der Cannabiskonsum zunahm. Die ADHS+ Gruppe begann ausser Alkohol signifikant haufiger mit dem Konsum weiterer Substanzen, einschliesslich nicht verschriebenem Methylphenidat. Schlussfolgerungen: Junge Manner mit ADHS Symptomen wiesen nicht nur ein hoheres Risiko zu kontinuierlichem schwereren Suchtmittelkonsum im Vergleich zur ADHS- Gruppe auf, sondern verfugten im Verlauf von 15 Monaten auch uber ein hoheres Risiko mit dem Konsum von Drogen und nicht verschriebenen Medikamenten zu beginnen und zwar unabhangig von einer zusatzlichen Sozialverhaltensstorung. Aus Praventionsperspektive konnte bei jungen Mannern das Erkennen und Behandeln von ADHS Symptomen eine Fruhpravention zur Risikoverringerung von Drogen- und Medikamentenkonsum sein.
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