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Showing PubMed Articles 1–25 of 287 from Der Nervenarzt
Understanding the term burnout in psychiatry and psychotherapy.
BACKGROUND: Currently there is much debate about the concept of burnout and its use as a diagnostic entity. The aim of the present survey was to present the view of mental health professionals towards the concept of burnout. METHODS: A total of 300 mental health professionals were surveyed using a structured questionnaire. RESULTS: The majority of participants see burnout as a state of exhaustion which constitutes a risk factor for later developing a mental disorder. Participants reported that from their po...
Teriflunomide for treatment of multiple sclerosis.
Interferon beta and glatiramer acetate are still considered to be the first-line therapeutics for treatment of relapsing forms of multiple sclerosis (MS). The use of new compounds, such as natalizumab or fingolimod, is restricted to severe forms of relapsing MS or cases refractory to first-line treatment owing to substance-specific risk-benefit considerations. Teriflunomide is a new compound which has recently been approved as a first-line treatment of relapsing forms of MS in the USA and Australia. It is c...
Schizophrenia - a disorder in its own right? : Results from 25 years of the ABC study.
BACKGROUND: The ABC schizophrenia study conducted by the same team over 25 years initially aimed at illuminating the onset, prodromal stage and sex differences in age at first hospitalization in schizophrenia. New hypotheses were systematically generated from the results achieved. METHODS: A population-based sample of 276 first admission cases (232 first episodes, age 12-59 years), including a subsample of 130 first admissions (115 first episodes), were assessed to study prodromal stage, first illness episo...
FEES in the stroke unit : Recommendations for implementation in the clinical routine.
Dysphagia occurs in about 50 % of patients with acute stroke, is strongly related to early complications, such as aspiration pneumonia and is a major cause of increased morbidity and mortality in acute stroke. Flexible endoscopic evaluation of swallowing (FEES) has proven to be an easy to use, non-invasive tool for assessment of dysphagia in acute stroke, significantly adding accuracy to the clinical evaluation of dysphagia. With respect to the growing use of FEES in German stroke units this article summar...
Stressful war experiences can cause posttraumatic stress disorder (PTSD) in survivors. To what extent were the soldiers and young women of World War II affected by PTSD symptoms over the course of their lives? Do these men and women differ in the traumatic experiences and PTSD symptom severity? To investigate these questions 52 male and 20 female Germans aged 81-95 years were recruited through newspaper advertisements and notices and interviewed regarding war experiences and PTSD symptoms. Of the men 2 % a...
Lump sum payment system in psychiatry and psychosomatics : Concomitant research - quo vadis?
The new lump sum payment scheme for psychiatric and psychosomatic services is coming into force in 2013. This constitutes another step on the way to performance-based financial compensation of inpatient and day hospital treatment in psychiatric and psychosomatic hospitals in Germany. This fundamental change needs to be accompanied by scientific evaluation with regards to its effects. This article reflects on the legal foundations of such evaluations and the current progress of preparation. Furthermore, own...
Vascular factors in the pathogenesis of Alzheimer's disease.
According to the amyloid hypothesis of Alzheimer's disease (AD), the amyloid β (Aβ) peptide, as the primary neurotoxic species, plays a key role in the pathogenesis of the disease. However, many lines of recent evidence also point towards a major importance of early cerebrovascular dysfunction at least for the most common form of the disease, sporadic AD. In the preclinical course not only neuronal but also vascular damage frequently occurs. Cerebral hypoperfusion, blood-brain barrier dysfunction and vasc...
Reangiography after perimesencephalic subarachnoid hemorrhage.
BACKGROUND: This study aimed to determine the value of digital subtraction angiography (DSA) for the detection of causative vascular lesions in patients with perimesencephalic subarachnoid hemorrhage (SAH) after initially negative noninvasive and invasive neurovascular imaging, such as computed tomography angiography (CTA), DSA and magnetic resonance angiography (MRA). MATERIALS AND METHODS: We analyzed the value of repeated DSA for the detection of causative vascular lesions in 750 patients presenting to o...
Interferon-β1b in multiple sclerosis therapy : More than 20 years clinical experience.
The introduction of interferon-β1b in 1993 in the USA and 2 years later in Europe made it possible for the first time to alter the course of the disease in patients with relapsing-remitting multiple sclerosis (MS). Subsequently, interferon-β1b was approved for the treatment of patients with active secondary progressive MS (1999) and early relapsing-remitting MS following a first demyelinating event (clinically isolated syndrome, CIS) (2006). Here we provide an overview of the clinical experience gathered...
Expression, identification and experience of emotions in mental diseases : An overview.
Several studies in clinical neuroscience have focused on the analysis of expression of emotions, identification of emotions and experience of emotions. These empirical studies produced certain insights into emotional competency in different mental diseases, most of them in schizophrenia. The current article gives a description of the scientific data about alterations in emotional competency in several mental diseases (e.g. schizophrenia, depression, bipolar and borderline diseases) and links the data, if po...
Surveillance in the group of schizophrenia : Key to understanding the etiology.
Narcissistic personality disorder.
Narcissism is a multifaceted term which encompasses traits of normal personality as well as a specific personality disorder. While much research has been concerned with narcissism as a trait there are only few empirical studies available on narcissistic personality disorder (NPS). The current diagnostic of NPS according to DSM-IV-TR focuses on grandiose type narcissism whereas vulnerable narcissism, which has been described by clinicians and researchers has not yet been recognised. Psychotherapy of narcissi...
Multimodal complex treatment in advanced multiple sclerosis.
Mental distress in primary care patients : German patients compared with patients of Turkish origin.
BACKGROUND: In Germany empirical research on the (mental) health of immigrants is still insufficiently investigated. METHODS: The symptom severity of depressiveness (Beck Depression Inventory, BDI) and of somatoform complaints (Screening for Somatoform Symptoms, SOMS-2) were measured in 254 Turkish and 164 German patients in primary care. RESULTS: Turkish patients showed a higher age-adjusted severity of depressive and somatoform symptomatology compared with German patients. The most pronounced depressive s...
Psychiatry with open doors : Part 2: Therapeutic challenges.
In the previous part of the issue we argued that opening the doors of acute psychiatric inpatient wards is actually one of the anchor points on the way to an innovative psychiatry. It focuses on the patient's personality in a sense that this is taken as seriously as the psychiatric disorder itself. Patients and relatives should be enabled to participate in treatment decisions as they should experience that treatment teams are concerned about reliance, liability and security in therapeutic relationships in a...
Video game and internet addiction : The current state of research.
The use of interactive screen media is widespread and for some users leads to pathological symptoms that are phenomenologically similar to signs of addictive disorders. Addictive use of computer games and other Internet applications, such as social media can be distinguished. In the past standard criteria to classify this new disorder were lacking. In DSM-5, nine criteria are proposed for diagnosing Internet gaming disorder. The focus is currently on video games as most studies have been done in this field....
Psychiatry with open doors : Part 1: Rational for an open door for acute psychiatry.
Despite the reform efforts of the last decades modern acute psychiatry still stands between conflicting priorities in everyday practice. The protection of patient autonomy might conflict with a regulatory mandate of psychiatry in societal contexts and the necessity of coercive measures and involuntary treatment might become problematic with respect to presumed but contentious interests of the patient. The conflicts particularly concern questions of involuntary commitment, door closing, coercive and isolatio...
Combination of two depot antipsychotic drugs.
Extensive coherent clinical, psychopathological, neurobiological and genetic similarities with substance-related addictions justify the forthcoming classification of gambling addiction under the new category "Substance Use and Addictive Disorders" in the DSM-5. Thus, gambling addiction can be regarded as the prototype of behavioral addiction. In general it should be kept in mind that isolated gambling forms are associated with varying addictive potential due to specific situational and structural game chara...
Abnormal tau lesions (e.g., pretangles, neuropil threads, and neurofibrillary tangles) that develop in a few types of nerve cells in the central nervous system are essential to the pathogenesis of Alzheimer's disease. Pretangles begin to occur in puberty and even during early childhood in the locus coeruleus. Evolutionally speaking, the propensity to develop tau lesions may be related to late developing and maturing nerve cell types in the human brain.
Paraneoplastic neurological syndromes.
Paraneoplastic neurological syndromes (PNS) are very rare, remote effects of malignancies. Well-characterised antibodies against intracellular neuronal antigens are well-known in association with distinct tumors and with classical and non-classical syndromes. In this review article the current aspects of classification, pathophysiology, underlying tumors, antineuronal autoantibodies and diagnostic and therapeutic aspects of syndromes affecting the central nervous system are summarized.
Spinal prodromal phase of anti-NMDA receptor encephalitis.
