Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Skip to main content
    Although EU member states are obligated to take special account of the situation of particularly vulnerable refugees, appropriate and specific measures to detect affected asylum seekers are not yet available. This study tries to pave the... more
    Although EU member states are obligated to take special account of the situation of particularly vulnerable refugees, appropriate and specific measures to detect affected asylum seekers are not yet available. This study tries to pave the way for the implementation of an adequate instrument which at the same time assesses these needs of suffering people whilst responding to the need for mental health assessments specifically designed for refugees. This was done by testing the implementation of a screening method (Refugee Health Screener RHS-15) for trauma related mental health problems in refugees. Two refugee samples in Germany (differing in arrival time: 126 applicants for asylum residing in the initial reception center and 116 living in long term communal accommodations) were assessed with the culturally sensitive Refugee Health Screener (RHS-15) to detect the incidence of mental health problems amongst them. Test fairness, reasonableness, susceptibility, transparency, acceptance,...
    Although EU member states are obligated to take special account of the situation of particularly vulnerable refugees, appropriate and specific measures to detect affected asylum seekers are not yet available. This study tries to pave the... more
    Although EU member states are obligated to take special account of the situation of particularly vulnerable refugees, appropriate and specific measures to detect affected asylum seekers are not yet available. This study tries to pave the way for the implementation of an adequate instrument which at the same time assesses these needs of suffering people whilst responding to the need for mental health assessments specifically designed for refugees. This was done by testing the implementation of a screening method (Refugee Health Screener RHS-15) for trauma related mental health problems in refugees. Two refugee samples in Germany (differing in arrival time: 126 applicants for asylum residing in the initial reception center and 116 living in long term communal accommodations) were assessed with the culturally sensitive Refugee Health Screener (RHS-15) to detect the incidence of mental health problems amongst them. Test fairness, reasonableness, susceptibility, transparency, acceptance,...
    Neurocognitive deficits that persist despite antidepressive treatment and affect social and vocational functioning are well documented in major depressive disorder. Cognitive training approaches have proven successful in ameliorating... more
    Neurocognitive deficits that persist despite antidepressive treatment and affect social and vocational functioning are well documented in major depressive disorder. Cognitive training approaches have proven successful in ameliorating these deficits in other psychiatric groups, but very few studies have been conducted in unipolar depressive patients by now. In contrast to previous studies solely including outpatients, effects of a cognitive remediation intervention on neurocognitive functioning of depressed inpatients were assessed by the present study. A randomized controlled trial was carried out with 46 depressed inpatients of a psychiatric hospital. Patients were randomly assigned to either a control group that received standard drug and non-drug (cognitive behavioural, occupational, sports, relaxation and music therapy) antidepressive treatment or a remediation group that additionally received 12 sessions of cognitive training for a total of 4 weeks (three sessions per week). An...
    Neurocognitive deficits that persist despite antidepressive treatment and affect social and vocational functioning are well documented in major depressive disorder. Cognitive training approaches have proven successful in ameliorating... more
    Neurocognitive deficits that persist despite antidepressive treatment and affect social and vocational functioning are well documented in major depressive disorder. Cognitive training approaches have proven successful in ameliorating these deficits in other psychiatric groups, but very few studies have been conducted in unipolar depressive patients by now. In contrast to previous studies solely including outpatients, effects of a cognitive remediation intervention on neurocognitive functioning of depressed inpatients were assessed by the present study. A randomized controlled trial was carried out with 46 depressed inpatients of a psychiatric hospital. Patients were randomly assigned to either a control group that received standard drug and non-drug (cognitive behavioural, occupational, sports, relaxation and music therapy) antidepressive treatment or a remediation group that additionally received 12 sessions of cognitive training for a total of 4 weeks (three sessions per week). An...
    Much recent research has shown an association between mood disorders and an altered emotion perception. However, these studies were conducted mainly with stimuli such as faces. This is the first study to examine possible differences in... more
    Much recent research has shown an association between mood disorders and an altered emotion perception. However, these studies were conducted mainly with stimuli such as faces. This is the first study to examine possible differences in how people with major depressive disorder (MDD) and healthy controls perceive emotions expressed via body movements. Thirty patients with MDD and thirty healthy controls observed the video scenes of human interactions conveyed by point-light displays (PLDs). They rated the depicted emotions and judged their confidence in their rating. Results showed that patients with MDD rated the depicted interactions more negatively than healthy controls. They also rated interactions with negative emotionality as being more intense and were more confident in their ratings. It is concluded that patients with MDD exhibit an altered emotion perception compared to healthy controls when rating emotions expressed via body movements depicted in PLDs.
    Chronic low back pain (CLBP) is a serious health problem in industrialised countries and the efficacy of current treatment options is unsatisfying. The present study examines the effects of a combined intervention that utilizes visual... more
    Chronic low back pain (CLBP) is a serious health problem in industrialised countries and the efficacy of current treatment options is unsatisfying. The present study examines the effects of a combined intervention that utilizes visual feedback, motion and sensory discrimination training in CLBP patients. Thirty patients of an outpatient orthopaedic rehabilitation unit were randomly assigned to either feedback or control group. In addition to standard treatment, patients of the feedback group received 6 feedback sessions where they watched the image of their back during a brief 2-point discrimination training and, after that, while they were tilting their pelvis up and down on the left and right side using their lumbar musculus multifidus solely. The control group received 6 sessions consisting of 2 units of physiotherapy, relaxation training and movement training (walking) each.RESULTS: A significant effect on self-reported pain and sensory discrimination threshold could be found fo...
    We tried to show the attitude of the environment towards the epileptic patient with special consideration of teachers and the mother of the epileptic child. specific problems of the epileptic patient like frequency of convulsions,... more
    We tried to show the attitude of the environment towards the epileptic patient with special consideration of teachers and the mother of the epileptic child. specific problems of the epileptic patient like frequency of convulsions, psychiatric manifestations and the disease process itself were viewed in relationship to the ability to work and the position in school. We looked in addition into legal problems like fitness to drive, delinquency and insurance problems.
    BackgroundSchizophrenia out-patients have deficits in affective theory of mind (ToM) but also on more basal levels of social cognition, such as the processing of neutral and emotional expressions. These deficits are associated with... more
    BackgroundSchizophrenia out-patients have deficits in affective theory of mind (ToM) but also on more basal levels of social cognition, such as the processing of neutral and emotional expressions. These deficits are associated with changes in brain activation in the amygdala and the superior temporal sulcus (STS). However, until now there have been no studies that examined these different levels of social cognition and their neurobiological underpinnings in patients within one design.MethodSixteen medicated schizophrenia out-patients and 16 matched healthy controls were studied with functional magnetic resonance imaging (fMRI) during a social cognition task that allows the investigation of affective ToM (aToM), emotion recognition and the processing of neutral facial expressions.ResultsPatients showed a deficit in emotion recognition and a more prominent deficit in aToM. The performance in aToM and in emotion recognition was correlated in the control group but not in the schizophren...
    Long-standing processes of deinstitutionalization often display processes of selection that result in groups of patients with marked disability profiles left in hospital. According to the literature socially deviant and unacceptable... more
    Long-standing processes of deinstitutionalization often display processes of selection that result in groups of patients with marked disability profiles left in hospital. According to the literature socially deviant and unacceptable behaviour are a main obstacle to living in the community. Therefore, a group of "remnant" chronic schizophrenic patients was analysed by means of a latent class analysis with indicators of social behaviour and compliance. Three different subgroups were found, one of which had an extremely poor level of adaptation. However, prognosis of staff with regard to patients' ability to live outside the psychiatric hospital, and the rates of patients being moved into the community in the course of subsequent deinstitutionalization were not different among the three groups. Characteristics of "most-difficult-to-place patients' " as discussed in the literature are called into question on the basis of the results of this study.
    Deinstitutionalization (DI) of most of the chronic long-stay patients has taken place in the last decades in Germany. However, a... more
    Deinstitutionalization (DI) of most of the chronic long-stay patients has taken place in the last decades in Germany. However, a "residual" group of patients often remains in psychiatric hospitals, with an ongoing controversy on an appropriate type of their care (community based vs. hospital). Clinical, functional and social characteristics of such schizophrenic patients still residing in the long-stay wards in the German state of Hesse after decades of DI are presented. The n = 266 patients investigated displayed a marked degree of negative symptoms and moderate positive symptoms but, however, severe social disabilities. In addition, the patients were very dependent in daily living, had an extremely impoverished social network and leisure activities. The findings contribute to the research on "difficult-to-place" patients described in the literature.
    To compare the impact of sertindole and haloperidol on cognitive function in patients suffering from schizophrenia. In a 12 week trial, of the 40 patients randomised to treatment, 34 (17 sertindole and 17 haloperidol) were included in the... more
    To compare the impact of sertindole and haloperidol on cognitive function in patients suffering from schizophrenia. In a 12 week trial, of the 40 patients randomised to treatment, 34 (17 sertindole and 17 haloperidol) were included in the analysis set. Cognitive sub-processes were investigated with the Reaction Time Decomposition (RTD) method and the Wisconsin Card Sorting Test (WCST), at baseline, Week 4 and Week 12. In executive function, i.e. set shifting tasks, sertindole reversed cognitive deficits significantly more than haloperidol. It was demonstrated that this atypical drug improved cognitive processing independently of motor function. Patients receiving sertindole markedly improved on the RTD task at Week 4 and continued to improve (although at a slower rate) at Week 12, those patients receiving haloperidol showed marked impairment at Week 4 with partial recovery by Week 12. The study demonstrated two distinct processes of action on cognition between sertindole and haloperidol and the marked beneficial effects of sertindole, particularly in parameters that are regarded as schizophrenia-related cognitive disturbances.
    Background: Executive functions, which are neuroanatomically associated with the frontal lobe, are known to be impaired in schizophrenia. It is, however, still unclear whether the underlying functional disturbance is due to a hyper- or a... more
    Background: Executive functions, which are neuroanatomically associated with the frontal lobe, are known to be impaired in schizophrenia. It is, however, still unclear whether the underlying functional disturbance is due to a hyper- or a hypoactivation of the dorsolateral prefrontal cortex (DLPFC) or neither. Methods: To address this question, we examined the brain activation of 21 schizophrenic patients on atypical antipsychotic medication and 21 healthy control subjects during a mental maze task by means of fMRI. Results: We found no significant overall difference in cerebral activation between the groups, but differences in the change in DLPFC activation from the first to the second half of the experiment. In the maze compared to the control task, there was a decrease in activation in the DLPFC in the patients and an almost significant increase in the controls. The change in activation in the patient group correlated with a change in subjective sleepiness, while the increase in a...
    ✓ Nine cases with temporal fossa arachnoid cysts were diagnosed by computerized tomography (CT). Five patients also had subdural hematomas, three of them following head trauma. When the hematoma was chronic and of equal hypodensity with... more
    ✓ Nine cases with temporal fossa arachnoid cysts were diagnosed by computerized tomography (CT). Five patients also had subdural hematomas, three of them following head trauma. When the hematoma was chronic and of equal hypodensity with the cyst, a clear-cut differentiation was not possible from the CT scan. The presence of a subdural hematoma could only be suggested by thickened arachnoid structures crossing the hypodense area, indicating the wall between cyst and hematoma. The cyst could often be diagnosed by bulging of the skull bone and a temporal lobe defect. Differences in density between cyst and hematoma, such as in subacute subdural hematoma, delineated both entities. Typical examples are demonstrated. Treatment consisted of evacuation of the hematoma and excision of the cyst in all cases.
    EEG Brain Mapping offers a promising approach to study complex pattern of brain function. However, traditional usage of this method was focussed mainly on isolated details of the whole specter. The present study was, therefore, aimed at... more
    EEG Brain Mapping offers a promising approach to study complex pattern of brain function. However, traditional usage of this method was focussed mainly on isolated details of the whole specter. The present study was, therefore, aimed at the simultaneous observation of all available parameters. Discriminant analysis was used to distinguish between 4 groups of patients suffering from either schizophrenia (acute/off drugs; improved/on drugs) or depression (acute/off drugs; improved/on drugs) and healthy volunteers, each group with n = 10. The multivariate pattern of 50 topographical spectral variables brought about correct group classification of 49 out of 50 probands. Results suggest that more complex statistical paradigms that take advantage of all available parameters add to an integrative explantation of psychophysiological mechanisms in mental illness. EEG-Brain-Mapping stellt eine vielversprechende Methode zur Untersuchung komplexer Hirnfunktionsmuster dar. Herkommliche Forschungsarbeiten konzentrierten sich jedoch zumeist auf die Untersuchung von Detailaspekten. Die vorliegende Studie hatte daher die Zielsetzung, alle verfugbaren Parameter einer simultanen Betrachtung zu unterziehen. Mit Hilfe einer Diskriminanzanalyse sollte eine Vorhersage der Gruppenzugehorigkeit der schizophrenen Patienten (je 10 akut/unbehandelt-UNMED und gebessert/behandelt-MED), der depressiven Patienten (je 10 akut/unbehandelt-UNMED und gebessert/behandelt- MED) und der 10 gesunden Kontrollpersonen erreicht werden. Das multivariate Muster von 50 topographischen und frequenzbezogenen Variablen erbrachte bei 49 der 50 Probanden eine korrekte Gruppenklassifikation. Die Ergebnisse dieser Studie zeigen, das komplexe statistische Verfahren, welche das Zusammenspiel aller verfugbaren Meswerte berucksichtigen, einen wesentlichen Beitrag zur integrativen Betrachtung der psychophysiologischen Mechanismen bei psychiatrischen Krankheiten darstellen.
    This review addresses practical clinical issues related to the use of ziprasidone in the treatment of schizophrenia using information from clinical trials, unpublished data,... more
    This review addresses practical clinical issues related to the use of ziprasidone in the treatment of schizophrenia using information from clinical trials, unpublished data, manufacturer's information, and input from an expert faculty of European psychiatrists with extensive experience of the use of ziprasidone, both in clinical trials and in everyday clinical practice. A Medline search of published data (1998 - 2010) was carried out, together with a review of unpublished data and manufacturer's information. In addition, expert opinion was sought from psychiatrists with extensive experience of ziprasidone in the treatment of schizophrenia in clinical settings across Europe. This review has been undertaken to determine how the information from clinical trials can be optimally translated into…
    Psychiatric services providing care for patients and their families confronted with a first psychotic episode need to be sensitive towards patients’ and families’ preferences. Ten patients, ten family members and ten professional... more
    Psychiatric services providing care for patients and their families confronted with a first psychotic episode need to be sensitive towards patients’ and families’ preferences. Ten patients, ten family members and ten professional caregivers composed a list of 42 preferences in the treatment for a first psychotic episode. In total 99 patients, 100 family members and 263 professional caregivers evaluated these preferences, thus producing an order of priorities. There appears to be considerable agreement among the groups of respondents regarding their top ten priorities, especially concerning information on diagnosis and medication. However, we found important differences between groups of respondents. The results suggest that in psychiatric services great attention should be given to psycho-education and early outpatient intervention.
    Impaired cognitive function is both a feature of schizophrenia and a side effect of conventional neuroleptics. Maze tests were used to determine the effects on cognition of conventional dopamine antagonist neuroleptics (haloperidol and... more
    Impaired cognitive function is both a feature of schizophrenia and a side effect of conventional neuroleptics. Maze tests were used to determine the effects on cognition of conventional dopamine antagonist neuroleptics (haloperidol and fluphenazine) and the newer serotonin-dopamine antagonist antipsychotics (risperidone and clozapine). Patients on clozapine or risperidone showed better performance on the maze tasks than untreated patients or patients taking conventional neuroleptics. In particular, patients treated with risperidone or clozapine were better able to maintain motor coordination while they focused on the more complex "frontal" maze tasks which required sequencing and planning. In view of the restrictions on the use of clozapine, it is suggested that risperidone should be more widely used in schizophrenia because it preserves cognitive function better than conventional neuroleptics and is therefore likely to allow patients to have better insight into their illness and to have better long-term quality of life expectations.
    Cognitive deficits are a core symptom in schizophrenia, but until now controlled efficacy studies of cognitive training methods have shown inconclusive results. This study examined the effects of c...
    BackgroundThe effectiveness of anti-psychotic drugs against positive psychotic symptoms has been demonstrated in many studies, but their effects on quality of life have yet to be clarified. The impact of different neuroleptic therapies on... more
    BackgroundThe effectiveness of anti-psychotic drugs against positive psychotic symptoms has been demonstrated in many studies, but their effects on quality of life have yet to be clarified. The impact of different neuroleptic therapies on the subjective quality of life of schizophrenic patients is evaluated in a cross-sectional open study.MethodDuring a four-month period a standardised quality of life interview for schizophrenic patients was applied on day 10 after admission; 33 patients on atypical neuroleptics (AAP) were compared with 31 matched patients on conventional neuroleptics (CAP).ResultsThe AAP group had significantly higher scores in general quality of life as well as in different life domains: physical well-being, social life and everyday life. In separate comparisons of the AAP group, patients on clozapine and risperidone were found to have a higher quality of life score than patients on CAP or zotepine.ConclusionsThe pharmacological profile of clozapine and risperidon...
    Healthy aging is accompanied by working memory-related functional cerebral changes. Depending on performance accuracy and the level of working memory demands, older adults show task-related patterns of either increased or decreased... more
    Healthy aging is accompanied by working memory-related functional cerebral changes. Depending on performance accuracy and the level of working memory demands, older adults show task-related patterns of either increased or decreased activation compared to younger adults. Controversies remain concerning the interpretation of these changes and whether they already manifest in earlier decades of life. To address these issues, functional magnetic resonance imaging (fMRI) was used to examine brain activation during spatial working memory retrieval in 45 healthy individuals between 20 and 68 years of age. Participants performed a modified version of the Corsi Block-Tapping test (CBT). The CBT requires the storage and subsequent reproduction of spatial target sequences and allows modulating working memory load by a variation of sequence length. Results revealed that activation intensity at the lowest CBT load level increased with increasing age and positively correlated with the number of e...
    Deficits in social functioning are a core symptom of schizophrenia and an important criterion for evaluating the success of treatment. However, there is little agreement regarding its measurement. A common, often cited instrument for... more
    Deficits in social functioning are a core symptom of schizophrenia and an important criterion for evaluating the success of treatment. However, there is little agreement regarding its measurement. A common, often cited instrument for assessing self-reported social functioning is the Social Functioning Scale (SFS). The study aimed to investigate the reliability and validity of the German translation. 101 patients suffering from schizophrenia (SZ) and 101 matched controls (C) (60 male / 41 female, 35.8 years in both groups) completed the German version. In addition, demographic, clinical, and functional data were collected. Internal consistency was investigated calculating Cronbach's alpha for SFS full scale (α: .81) and all subscales (α: .59-.88). Significant bivariate correlation coefficients were found between all subscales as well as between all subscales and full scale (p <.01). For the total sample, principal component analysis gave evidence to prefer a single-factor solu...
    During the last few years, the working group ‘Psychophysiology’ of the Association for Methodology and Documentation in Psychiatry (AMDP) discussed the possibility of the establishment of defined EEG modules in psychiatry. It was the aim... more
    During the last few years, the working group ‘Psychophysiology’ of the Association for Methodology and Documentation in Psychiatry (AMDP) discussed the possibility of the establishment of defined EEG modules in psychiatry. It was the aim to create a common data pool in order to be able to have access to larger data sets. The installation of such a common data
    ABSTRACT
    Aging comes along with reduced gray matter (GM) volume in several cerebral areas and with cognitive performance decline in different cognitive domains. Moreover, regional GM volume is linked to specific cognitive sub processes in older... more
    Aging comes along with reduced gray matter (GM) volume in several cerebral areas and with cognitive performance decline in different cognitive domains. Moreover, regional GM volume is linked to specific cognitive sub processes in older adults. However, it remains unclear which regional changes in older individuals are directly associated with decreased cognitive performance. Moreover, most of the studies on this topic focused on hippocampal and prefrontal brain regions and their relation to memory and executive functioning. Interestingly, there are only a few studies that reported an association between striatal brain volume and cognitive performance. This is insofar surprising that striatal structures are (1) highly affected by age and (2) involved in different neural circuits that serve intact cognition. To address these issues, voxel-based morphometry (VBM) was used to analyze GM volume in 18 younger and 18 older adults. Moreover, several neuropsychological tests from different n...
    Research Interests:
    Within cognitive neuroscience, in nearly every experimental setting, subjects are presented with stimuli that appear at either constant or variable points in time, referred to as interstimulus intervals (ISIs). These temporal patterns... more
    Within cognitive neuroscience, in nearly every experimental setting, subjects are presented with stimuli that appear at either constant or variable points in time, referred to as interstimulus intervals (ISIs). These temporal patterns differ in the degree to which an exact stimulus onset may be predicted. We investigated whether this experimental feature affects brain and behavior, and whether the impact is modulated by the cognitive demands of a task. Subjects (N=26) were assessed via fMRI while solving three different tasks under either temporally predictable (constant ISI) or unpredictable (variable ISI) conditions. The tasks differed with regard to demands on working memory and response uncertainty. Compared to constant ISIs, variable (i.e., less predictable) ISIs led to a general increase in reaction time and in right amygdala activation. Depending on the cognitive demands required by the specific task, the left amygdala, the parietal cortex, the supplementary motor area, and the dorsolateral prefrontal cortex were engaged as well. The results indicate that the temporal structure in a stimulus sequence affects both overt and covert behaviors. Implicit temporal uncertainty increases activation in several brain regions depending on cognitive demands. Thus, an often-overlooked basic design feature, the application of constant or variable ISIs, may contribute to heterogeneity in cognitive neuroscience findings.
    Since clinical and biochemical observations point to much overlap between depression and aggression, both characterised by intolerance to frustration, a questionnaire was developed to test if different patterns of depressive and... more
    Since clinical and biochemical observations point to much overlap between depression and aggression, both characterised by intolerance to frustration, a questionnaire was developed to test if different patterns of depressive and aggressive reactions elicited by exposure to negative events and deprivation from expected positive ones in human and nonhuman conditions, respectively, would result in specific response patterns in depressive and aggressive persons. The questionnaire was tested for internal consistency in a pilot healthy sample and for correlations of responses with the personality factors of Aggression and Depression in 60 abstinent male alcoholics. Aggressive and depressive responses were highly correlated across all stimulus conditions, and not specifically but rather equally associated with the personality factors of Aggression and Depression, confirming the close association between these dimensions.

    And 40 more