The editors of
have decided in 2016 to prepare special issues regularly in order provide our readers volumes of the journal with a thematic focus 1. The first such special issue is dedicated to the ...field of child and adolescent psychopharmacology. Many young patients are treated with psychotherapeutic, but also pharmacotherapeutic, methods worldwide. Most of our psychopharmacological agents are not approved by the federal institutions for persons under 18 years old. However, severe mental illnesses like schizophrenia, depression, anxiety, ADHD, and bipolar disorder frequently require pharmacological treatments in children and adolescents. We also see a wide range of rather unspecific emotional and behavioral disturbances up to excitation crises or suicidal acts in this young population, so that we see the necessity for standardized and valid psychopharmacological treatment regimens based on meta-analyses, randomized controlled trials, and guidelines 2. Child and adolescent psychiatry is unfortunately far away from this; industry-supported research is rare in this area, but also not all child and adolescent psychiatrists see the importance of psychopharmacological treatment and trust specific psychotherapy, psychoeducation, and educational strategies. These are all extremely important treatments, but one can/should think that psychopharmacotherapy is an important addition and often a cornerstone for the other treatments.
The foundation of a German Society of Biological Psychiatry (DGBP) was initiated at the Second World Congress of Biological Psychiatry of the WFSBP in Barcelona in 1978. Its mission was and is to ...promote interdisciplinary research on the biology of mental disorders and to translate results of biological research into clinical practice. During the presidency of Peter Falkai, its tasks were defined to improve the quality and support of biologically oriented research in Germany by the DFG (Deutsche Forschungsgemeinschaft; German Research Foundation), BMBF (Bundesministerium für Bildung und Forschung) and EU (European Union), to promote young researchers doing biologically oriented research, to improve on the diagnosis and therapy of mental disorders and to advise policy makers by taking part in legal processes. The DGBP has been a corporate member of the WFSBP from its beginning, became a cooperative member of the DGPPN (Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde), later of the German Brain Council, and fostered relationships with other scientific societies. Over the past 45 years, more than twenty congresses were held in Germany and neighboring countries. Emerging from the pandemic, the DGBP is ready to continue its mission to promote interdisciplinary research on the biology of mental disorders with a focus on the development of young scientists and to translate results of biological research into clinical practice, with regard to pharmacotherapy in close cooperation with the Arbeitsgemeinschaft Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP). In this sense, this article also aims to stimulate the cooperation of the society with other national and international partners and to foster new relationships with young scientists and professionals interested in the aims and goals of the DGBP.
Treating legally committed patients on open, instead of locked wards is controversially discussed and the affected stakeholders (patients, mental health professionals) have ambiguous views on the ...benefits and disadvantages. The study aims to assess the opinions and values of relevant stakeholders with regard to the requirements for implementing open wards in psychiatric hospitals.
Semi-structured interviews were conducted with 15 psychiatrists, 15 psychiatric nurses and 15 patients, and were analyzed using qualitative content analysis.
The interviewees identified conceptual, personnel and spatial requirements necessary for an open door policy. Observation and door watch concepts are judged to be essential for open wards, and patients appreciate the therapeutic value they hold. However, nurses find the door watch problematic. All groups suggest seclusion or small locked divisions as a possible way of handling agitated patients. All stakeholders agree that such concepts can only succeed if sufficient, qualified staff is available. They also agree that freedom of movement is a key element in the management of acutely ill patients, which can be achieved with an open door policy. Finally, the interviewees suggested removing the door from direct view to prevent absconding.
For psychiatric institutions seeking to implement (partially) open wards, the present results may have high practical relevance. The stakeholders' suggestions also illustrate that fundamental clinical changes depend on resource investments which - at least at a certain point - might not be feasible for individual psychiatric institutions but presumably require initiatives on the level of mental health care providers or policy makers.
Inhalative loxapine which will come onto the market shortly, is an important new alternative medication for the treatment of agitation, restlessness and tension in patients with schizophrenia and ...bipolar disorders. The possibility of inhaled administration provides an advantage for patients and staff in certain acute situations. In patients with obstructive lung diseases there is a danger concerning bronchospasms. The resulting safety regulations limit the easy and broad usage of inhaled loxapine slightly but these can be easily realized within hospitals. In view of the rapid onset antiagitation effect and the easy handling of inhaled loxapine, this might be a rather minor problem.
The application of homeopathic treatment quickly becomes a matter of ideological confrontation; however, homeopathy is steadily gaining in sympathy in the population. Although the possible ...effectiveness and the modes of action are currently not scientifically elucidated and the study situation regarding homeopathic treatment in psychiatry is still manageable, there is a whole series of positive evidence for the effects of homeopathic remedies for mental disorders, such as depression, anxiety disorders and addiction. The most important studies are presented and the most important arguments are weighed up with respect to the pros and cons. It is clear that homoeopathic remedies can only be used as an add-on and not alone. These remedies belong in the hands of physicians experienced in homeopathic and psychiatric psychopharmacology. It would be advisable to at least try out homeopathy for the well-being of the patient not only in the case of very mild disorders but also in severe chronic cases, since due to the generally good tolerability, no avoidable disadvantage should result.
Highlights • Higher GM-volume in the supplementary motor area in high class athletes. • Higher gray matter volume in hippocampus/parahippocampus in endurance sport athletes. • No alterations in ...hippocampal regions in martial artists.
•Validation of the motivational phase of the IMV model in a high-risk sample.•Mediation of defeat via entrapment (as well as internal and external entrapment) on suicidal ideation.•Interaction of ...thwarted belongingness and perceived burdensomeness as motivational moderator.
The Integrated Motivational–Volitional (IMV) model of suicidal behavior proposes in its motivational phase that perceptions of defeat and entrapment (total, internal and external entrapment) lead to the development of suicidal ideation and that thwarted belongingness and perceived burdensomeness moderate this process. The aim of this study was to test the motivational phase of the IMV model cross-sectionally in a German sample of psychiatric inpatients.
A total of 308 psychiatric inpatients (53% female) aged 18 to 81 years (M = 36.92, SD = 14.30) were included in the study and investigated within 14 days after psychiatric admission due to suicide attempt (53%) or acute suicidal crisis (47%). Statistical analyses included a mediation analysis and moderation analyses.
Results demonstrate a simple mediation of defeat via entrapment (total, internal and external entrapment) on suicidal ideation. The interaction between thwarted belongingness and perceived burdensomeness was confirmed as a motivational moderator.
Limiting factors of the present study are the cross-sectional design and the retrospective assessment of suicidal ideation.
The main assumptions of the motivational phase of the IMV model could empirically be confirmed. Perceptions of defeat, internal and external entrapment, thwarted belongingness, and perceived burdensomeness should be taken into account with regard to prevention, risk assessment and interventions of suicidal ideation and attempts. However, future investigations based on prospective data are warranted.
Ayurveda is a traditional Indian system of medicine that is more than 3000 years old, consisting mostly of a specific diet, oily infusions mainly in the area of the head, enemas, medicinal plants and ...yoga. It is based on a naturopathic and anthropological belief in association with the hinduistic religion. Ayurveda has been practiced very successfully in India but so far it has only been insufficiently appreciated by western medicine, especially psychiatry. An exception is Scharfetter from Zürich who wrote a review article on this topic in 1976. Nevertheless, it is probable that particularly the immunological mechanisms of psychotic and affective disorders can be influenced by the application of ayurvedic methods; however, the empirical data source, particularly with respect to randomized controlled trials and meta-analyses regarding psychiatric disorder symptoms is limited. Even if Ayurveda is applied in a highly individualized manner, this should be rapidly improved for further evidential assessment. First positive experiences in the neuropsychiatric field in Germany are already available.
The COVID-19 pandemic poses significant challenges in psychiatric hospitals, particularly in the context of the treatment of people under involuntary commitment. The question arises at various points ...in the procedure for and process of involuntary commitment whether procedural modifications or further restrictive measures are necessary to minimise the spread of COVID-19 and protect all people involved from infection.
In the light of current developments in Germany, this article examines under which conditions changes in the treatment of people under involuntary commitment are ethically justified in view of the COVID-19 pandemic. Among others, we discuss ethical arguments for and against involuntary commitments with reference to COVID-19, the use of different coercive interventions, the introduction of video hearings, an increased use of video surveillance and interventions based on the German Infection Protection Act.
We argue that strict hygiene concepts, the provision of sufficient personal protective equipment and frequent testing for COVID-19 should be the central strategies to ensure the best possible protection against infection. Any further restrictions of the liberty of people under involuntary commitment require a sound ethical justification based on the criteria of suitability, necessity and proportionality. A strict compliance with these criteria and the continued oversight by external and independent control mechanisms are important to prevent ethically unjustified restrictions and discrimination against people with the diagnosis of a mental disorder during the COVID-19 pandemic.
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