Refine
Year of publication
Document Type
- Doctoral Thesis (67)
- Article (45)
Has Fulltext
- yes (112)
Is part of the Bibliography
- no (112)
Keywords
- - (37)
- Depression (14)
- Psychiatrie (9)
- Zwangsstörung (7)
- Alexithymia (5)
- Alexithymie (5)
- Epidemiologie (5)
- Adipositas (4)
- SHIP (4)
- Sekundärkrankheit (4)
- Trauma (4)
- depression (4)
- Brain-derived neurotrophic factor (3)
- Childhood trauma (3)
- Cortisol (3)
- Lebensqualität (3)
- OCD (3)
- PTSD (3)
- Posttraumatisches Stresssyndrom (3)
- Psychopathologie (3)
- Resilienz (3)
- Schizophrenie (3)
- Stereotypes (3)
- Vitamin D (3)
- obesity (3)
- Alkohol (2)
- Alkoholabhängigkeit (2)
- Angst (2)
- Anxiety (2)
- Childhood abuse (2)
- Cortical thickness (2)
- DDR (2)
- Dissoziation (2)
- Dissoziation <Psychologie> (2)
- Epigenetik (2)
- FGF21 (2)
- Familienstudie (2)
- Fettsucht (2)
- Genetik (2)
- Germany (2)
- Inanspruchnahme (2)
- Inanspruchnahme von Hilfe (2)
- Individualization (2)
- Kognition (2)
- Komorbidität (2)
- Kosegregation (2)
- Obesity (2)
- Obsessive-compulsive disorder (2)
- Patienten (2)
- Posttraumatic stress disorder (2)
- Posttraumatische Belastungsstörung (2)
- Resilience (2)
- SADS-LA-IV (2)
- Selbstmord (2)
- Self-stigma (2)
- Soziale Unterstützung (2)
- Statistik (2)
- Substance use disorders (2)
- Sucht (2)
- Wahrnehmungsstörung (2)
- childhood maltreatment (2)
- comorbidity (2)
- heavy user (2)
- high-fat diet (2)
- intelligence (2)
- machine learning (2)
- magnetic resonance imaging (2)
- mental health (2)
- metabolic syndrome (2)
- microbiome (2)
- non-alcoholic fatty liver disease (2)
- obsessive compulsive disorder (2)
- posttraumatic stress disorder (2)
- trauma (2)
- 1999-2009 (1)
- AMDP-System (1)
- Adverse consequences (1)
- Affekt (1)
- Akute Intoxikation (1)
- Alcohol Dependence (1)
- Alcohol dependence (1)
- Allgemeinbevölkerung (1)
- Alter (1)
- Altersangst (1)
- Alterschirurgie (1)
- Alterspsychiatrie (1)
- Alterspsychologie (1)
- Alzheimer's disease (1)
- Alzheimer’s disease (1)
- Ambiguous Loss (1)
- Anorexia nervosa (1)
- Appetitlosigkeit (1)
- Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie (1)
- Attitudes (1)
- Ausdauer (1)
- BDI <Test> (1)
- BISCWIT (1)
- Basisemotionen (1)
- Beck Depression-Inventory II (1)
- Beck Depressionsinventar II (1)
- Bibliotherapie (1)
- Biomarker (1)
- Body-Mass-Index (1)
- Borderline personality disorder (1)
- Boundary Ambiguity (1)
- Bulimie (1)
- Burnout-Syndrom (1)
- COVID-19 (1)
- Centrality (1)
- Charakteristika (1)
- Children (1)
- Children of impaired parents (1)
- Citalopram (1)
- Classification of Poetry Literature (1)
- Clinimetrics (1)
- Cognitive Control (1)
- Comorbidity (1)
- Connectivity (1)
- Correlation networks (1)
- Cortex (1)
- DSM-IV (1)
- Darstellung (1)
- Datenerhebung (1)
- Delinquenz (1)
- Depressive symptoms (1)
- Depressivität (1)
- Disease management (1)
- Dissociation (1)
- Dissociative Disorders [epidemiology] (1)
- Dopamin (1)
- Doppeldiagnose (1)
- Droge (1)
- Dysfunktionale Kognitionen (1)
- ECG (1)
- Early-onset (1)
- Effectiveness of telemedicine treatment (1)
- Efficacy (1)
- Einsamkeit (1)
- Elterlicher Stress (1)
- Elternschaft (1)
- Emotionale Intelligenz (1)
- Entwicklungskrise (1)
- Entwicklungspsychologie (1)
- Epidemiology (1)
- Erkennen (1)
- Essstörung (1)
- Evaluation (1)
- FDS (1)
- Facelift (1)
- Fachkräfte akquirieren (1)
- Facial Emotion Recognition (1)
- Familial transmission pathways (1)
- Five-Phase-Rule (1)
- Flüchtlinge (1)
- Fragebogen (1)
- Frau (1)
- FreeSurfer (1)
- Frühkindliche Lebensereignisse (1)
- Fünf-Phasen-Regel (1)
- GENOS (1)
- Gehirn (1)
- General Population (1)
- General population (1)
- Gerichtliche Psychiatrie (1)
- Gerontopsychologie (1)
- Geschlechtsunterschied (1)
- Gesichtererkennung (1)
- Gesundheitswesen (1)
- Gewaltkriminalität (1)
- Glucocorticoid receptor (1)
- Gruppentherapie (1)
- Handlungsüberwachung (1)
- Health behavior (1)
- Heavy User (1)
- Helplessness (1)
- Herzinfarkt (1)
- Herzinfarktpatient (1)
- Herzinsuffizienz (1)
- High Utiliser (1)
- Hinterbliebene (1)
- Hippocampus (1)
- Hirnrinde (1)
- Hospitalisierung (1)
- Hospitals (1)
- IIP-D (1)
- Impulsivität (1)
- Inhibition (1)
- Intelligenz (1)
- Intensivstation (1)
- Internalisierung gewichtsbezogener Stigmatisierung (1)
- Internet (1)
- Item-Response-Theorie (IRT) (1)
- Jugendliche Mütter (1)
- Kernspintomografie (1)
- Kinder (1)
- Kinder psychisch kranker Eltern (1)
- Kindersoldat1 (1)
- Kindesmisshandlung (1)
- Kindheitstrauma (1)
- Kindheitstraumatisierung (1)
- Kindliche Traumata (1)
- Kognitive Kontrolle (1)
- Komplexe Posttraumatische Belastungsstörung (1)
- Komplizierte Trauer (1)
- Konversion <Psychologie> (1)
- Koronare Herzkrankheit (1)
- Krankheitskonzept (1)
- Krankheitsverhalten (1)
- Kriegskinder (1)
- Kriegsverlust (1)
- Krise der Lebensmitte (1)
- Kritische Lebensereignisse (1)
- Kultur (1)
- Langstrafenvollzug (1)
- Late-onset (1)
- Lebensbedingungen (1)
- Lebensereignis (1)
- Left-heart catheter examination (1)
- Linksherzkatheteruntersuchung (1)
- Luftwaffenhelfer (1)
- MSCEIT (1)
- Magnetische Stimulation (1)
- Mann (1)
- Maßregelvollzug (1)
- Mecklenburg-Vorpommern (1)
- Mediation analysis (1)
- Medikamentenadhärenz (1)
- Mental Disorders [epidemiology] (1)
- Mental Pain Questionnaire (1)
- Mental pain (1)
- Messgenauigkeit (1)
- Metabolisches Syndrom (1)
- Metabolom (1)
- Metabolomics (1)
- Migrant (1)
- Mimik (1)
- Missing in Action (1)
- Monitoring (1)
- Mother-child disagreement (1)
- Motivation (1)
- Motorik (1)
- Myocardial infarction (1)
- Myokardinfarkt (1)
- NEO-FFI (1)
- NMR metabolomics (1)
- NR3C1 (1)
- Narzissmus (1)
- Neuroleptika (1)
- Neurologie (1)
- Neuronen-spezifische Enolase (1)
- Onkologie (1)
- Online Befragung (1)
- Orale Kontrazeptiva (1)
- Oxytozinrezeptor-Gen (1)
- PHQ-9 (1)
- Parenting (1)
- Pathological gambling (1)
- Patient-reported outcomes (1)
- Performance Monitoring (1)
- Personalisierte Psychotherapie (1)
- Persönlichkeitsentwicklung (1)
- Persönlichkeitsstörung (1)
- Pflegepraktikum (1)
- Phobie (1)
- Phänomene (1)
- Plastische Chirurgie (1)
- Poetry Group Sessions (1)
- Poetry Gruppensitzungen (1)
- Poetry Therapie (1)
- Poetry Therapy (1)
- Poetry- Literaturbewertungskritierien (1)
- Poetry- Literaturklassifizierung (1)
- Polymorphismus (1)
- Posttraumatisches Belastungsstörung (1)
- Praxisbasierte Studien (1)
- Praxisorientierte Forschung (1)
- Precision Mental Health Care (1)
- Printmedien (1)
- Prolonged Grief (1)
- Psychiatric Comorbidity (1)
- Psychiatrische Erkrankungen (1)
- Psychiatrische Institutsambulanz (1)
- Psychiatry (1)
- Psychische Belastung (1)
- Psychisches Trauma (1)
- Psychometrics Questionnaires (1)
- Psychopathology (1)
- Psychosomatik (1)
- RMSSD (1)
- Recurrent depression (1)
- Reliabilität (1)
- SCI <Test> (1)
- SCID-II (1)
- SCL-90-R <Deutsche Version> (1)
- SKID-II (1)
- SMS (1)
- SOC (1)
- STAI (1)
- Schönheitsoperation (1)
- Selbstlenkungsfähigkeit (1)
- Selbstmordgefährdung (1)
- Selbststigmatisierung (1)
- Selbstwert (1)
- Selbstwertbestätigungs-Intervention (1)
- Self-affirmation (1)
- Sexual- und Gewaltstraftäter (1)
- Short Message Service (1)
- Soziale Inklusion (1)
- Sozialgeschichte (1)
- Sport (1)
- Stigma (1)
- Stigmatisierung (1)
- Stoffwechselkrankheit (1)
- Strafanstalt (1)
- Stralsund (1)
- Stress (1)
- Stressfaktoren (1)
- Study of Health im Pomerania (1)
- Study of Health in Pomerania (1)
- TAS-20 (1)
- TAS-26 (1)
- TCI <Persönlichkeitstest> (1)
- TNFα (1)
- Telemedicine (1)
- Telemedizin (1)
- Telephone-based therapy (1)
- Testgütekriterium (1)
- Time trend study (1)
- Tourette Syndrom (1)
- Tourette Syndrome (1)
- Tourette-Syndrom (1)
- Toxikologie (1)
- Transkranielle magnetische Stimulation (1)
- Transmission (1)
- Trauma <Motiv> (1)
- Traumatische Genese (1)
- Traumatisierung (1)
- Treatment utilization (1)
- Trend (1)
- Trendstudie (1)
- Unbehandlete psychische Erkrankungen (1)
- Uneindeutiger Verlust (1)
- Urine diagnostics (1)
- Ursache (1)
- Ursachenvorstellungen (1)
- Validierung (1)
- Verbal memory (1)
- Vergiftung (1)
- Verlaufsbeobachtung (1)
- Verlust (1)
- Vermisster (1)
- Versorgungsforschung (1)
- Vertriebene (1)
- Vitamin-D-Gruppe (1)
- Vorpommern <Nord> (1)
- Weltkrieg <1939-1945> (1)
- Wiedervereinigung (1)
- Wunschmedizin (1)
- Y-BOCS (1)
- Zersetzungsmaßnahmen (1)
- Zwang (1)
- Zwangsgedanken (1)
- Zwangshandlung (1)
- Zwangsneurose (1)
- Zweiter Weltkrieg (1)
- abuse (1)
- acute intoxication (1)
- adolescents (1)
- affect (1)
- affective disorders (1)
- albuminuria (1)
- alpha diversity (1)
- attentive immobility (freezing) (1)
- bacterial community (1)
- behavioral characteristics (1)
- behavioral inhibition (1)
- behaviorale Inhibition (1)
- behaviour (1)
- benzoate metabolism (1)
- berufliche Entwicklung (1)
- berufliche Spezialisierung (1)
- berufliche Ziele (1)
- biomarker (1)
- bipolar disorder (1)
- body mass index (1)
- cardiovascular diseas (1)
- caregiver (1)
- causal beliefs (1)
- causality (1)
- children (1)
- chronic pain (1)
- chronotypes (1)
- cognitive behavioral therapy (1)
- cognitive inhibition (1)
- comorbid disorders (1)
- complex problem solving (CPS) (1)
- computer-based testing (1)
- control diet (1)
- coping skills (1)
- cosegregation (1)
- cross-cultural psychology (1)
- dementia (1)
- depresion (1)
- developmental origins of health and disease (1)
- diabetes mellitus (1)
- diet-induced obesity (1)
- dietary change (1)
- directed acyclic graphs (1)
- dissociation (1)
- drug overdose (1)
- early experience (1)
- early-life adversity (1)
- eating behavior (1)
- eating disorder (1)
- ecological momentary assessment (1)
- effectiveness (1)
- empathy (1)
- exekutive Funktion (1)
- extinction (1)
- family (1)
- family study (1)
- fear bradycardia (1)
- fear conditioning (1)
- feature selection (1)
- figural matrices (1)
- food cravings (1)
- frühkindliche Traumatisierung (1)
- gender (1)
- general population-based cohort (1)
- genome-wide association study (1)
- glomerular filtration rate (1)
- glucose metabolism (1)
- health care system (1)
- heart rate variability (HRV) (1)
- high fat diet (1)
- high utiliser (1)
- historische Entwicklung (1)
- host-microbe interactions (1)
- idiographic models (1)
- immune system (1)
- impulsivity (1)
- individualized medicine (1)
- internistische Intensivstation (1)
- interpersonal problems (1)
- intoxication trends (1)
- item banking (1)
- item response theory (IRT) (1)
- kognitive Inhibition (1)
- kognitive Verhaltenstherapie (1)
- large cohort data (1)
- lifetime prevalence (1)
- liver inflammation (1)
- loneliness (1)
- longitudinal cohort study (1)
- low-grade inflammation (1)
- measurement error (1)
- measurement precision (1)
- mechanisms of change (1)
- mediatation (1)
- medical education & training (1)
- medical emergency departement (1)
- mental illness (1)
- metabolomics (1)
- miRNS (1)
- mobile health (1)
- multidisciplinary pain treatment (1)
- naturalistic (1)
- neglect (1)
- neuronen-spezifische Enolase (1)
- night shift work (1)
- oral microbiome (1)
- oxytocin receptor gene (1)
- parental stress (1)
- passive sensing (1)
- persistent depressive disorder (1)
- personality development (1)
- personality disorders (1)
- personality traits (1)
- personalized medicine (1)
- personalized psychotherapy (1)
- phenotyping (1)
- poisoning (1)
- politisch Verfolgter (1)
- politische Verfolgung (1)
- population-based imaging (1)
- posttraumatisches Stresssyndrom (1)
- practice-based studies (1)
- practice-oriented research (1)
- pre-symptomatic Alzheimer’s disease marker (1)
- precision mental healthcare (1)
- prediabetes (1)
- prediction modelling (1)
- problem solving (1)
- psychiatric (1)
- psychisch Kranker (1)
- psychische Faktoren (1)
- psychotherapy (1)
- qualitative research (1)
- radiomics (1)
- regional differences (1)
- reliability (1)
- resilience (1)
- rs56149945 (1)
- schizophrenia (1)
- secondary trauma (1)
- sekundäre Traumatisierung (1)
- sex (1)
- single nucleotide polymorphism (1)
- sleep macro-architecture (1)
- slow-wave sleep (1)
- social cognition (1)
- social distance (1)
- social support (1)
- soziale Lage (1)
- soziale Unterstützung (1)
- spezifische Phobie (1)
- startle potentiation (1)
- stationäre Psychotherapie (1)
- steroids (1)
- stigma (1)
- substance abuse (1)
- suicidal behaviour (1)
- systematic review (1)
- teenage mothers (1)
- temporal characteristic (1)
- test development (1)
- test equating (1)
- time restricted feeding (1)
- time-lagged (1)
- time-restricted feeding (1)
- transcutaneous vagus nerve stimulation (1)
- transgenerational transmission (1)
- transgenerationale Übertragung (1)
- treadmill (1)
- treadmill exercise (1)
- urine normalization (1)
- use of welfare (1)
- whole-body magnetic resonance imaging (1)
- women’s’ health (1)
- Äquivalenz – Obsessive Compulsive Drinking Scale (OCDS) – Visuelle Analogskala (VAS) – Craving – Alkohol (1)
- Ärzte (1)
- Ästhetik (1)
- β-klotho (1)
Institute
- Klinik für Psychiatrie und Psychotherapie (112) (remove)
Publisher
- S. Karger AG (16)
- Frontiers Media S.A. (12)
- MDPI (7)
- Springer Nature (3)
- Hogrefe Verlag (2)
- British Medical Journal Publishing Group (1)
- John Wiley & Sons, Ltd (1)
- SAGE Publications (1)
- Wiley (1)
Das AMDP-Modul zu Dissoziation und Konversion (AMDP-DK) stellt eine Checkliste zur ökonomischen Erfassung dissoziativer und konversiver Phänomene dar, welche die Lücke zwischen reinen Selbstbeurteilungsverfahren und zeitaufwendigen strukturierten Interviews mit ihren jewei-ligen Nachteilen schließt. Das Verfahren umfasst operationalisierte 30 Merkmale, die entsprechend den AMDP-Algorhithmen bewertet werden, und die sich theoriegeleitet in die Subskalen Dissoziation (15 Items), Konversion (9 Items) und eine „formale“ Beurteilungsebene (6 Items), die assoziierte Merkmale abbildet, gliedert. In einer Stichprobe stationärer psychiatrischer Patienten (N = 73) fanden sich die erfassten Phänomene in sehr heterogener Häufigkeit und Ausprägung. Das AMDP-DK und seine Subskalen zeigten gute Werte für die innere Konsistenz (Cron-bachs ? zwischen 0,76 und 0,85). Faktoranalytisch konnte die theoriegeleitete Subskalenbildung größtenteils repliziert werden. Die konvergente und divergente Validität waren befriedigend bis gut, und die Checkliste zeigte im Gruppenvergleich eine gute Diskriminationsfähigkeit zwischen hoch- und niedrigdissoziativen Patienten. Die Befunde werden hinsichtlich der psychometrischen Güte und der Bedeutung für die Modellbildung zu Dissoziation und Konversion diskutiert.
Zusammenfassung Ziel: Krankheitskonzepte von Doppeldiagnose-Patienten (DD) wurden untersucht und mit denen von Schizophrenie- und Suchtpatienten verglichen. Methodik: Mit 66 Patienten (nschiz=22, ndd=25, nsubst=19) wurden problemzentrierte Interviews geführt, die Tonbandaufnahmen wurden transkribiert und inhaltsanalytisch ausgewertet. Ergebnisse: Lebensgeschichtliche Faktoren, v.a. psychosoziale Belastungen, wurden in allen Gruppen präferiert. DD-Patienten gaben häufig an, dass die Psychose durch Drogen bedingt sei/aufrechterhalten werde. Schlussfolgerung: Die vielfältigen Krankheitskonzepte von DD-Patienten sollten exploriert, die Therapie individuell gestaltet werden.
The relationship between Alzheimer's-related brain atrophy patterns and sleep macro-architecture
(2022)
Introduction
Sleep is increasingly recognized as a major risk factor for neurodegenerative disorders such as Alzheimer's disease (AD).
Methods
Using an magnetic resonance imaging (MRI)–based AD score based on clinical data from the Alzheimer's Disease Neuroimaging Initiative 1 (ADNI1) case-control cohort, we investigated the associations between polysomnography-based sleep macro-architecture and AD-related brain atrophy patterns in 712 pre-symptomatic, healthy subjects from the population-based Study of Health in Pomerania.
Results
We identified a robust inverse association between slow-wave sleep and the AD marker (estimate: −0.019; 95% confidence interval: −0.03 to −0.0076; false discovery rate [FDR] = 0.0041), as well as with gray matter (GM) thicknesses in typical individual cortical AD-signature regions. No effects were identified regarding rapid eye movement or non–rapid eye movement (NREM) stage 2 sleep, and NREM stage 1 was positively associated with GM thickness, mainly in the prefrontal cortical regions.
Discussion
There is a cross-sectional relationship between AD-related neurodegenerative patterns and the proportion of sleep spent in slow-wave sleep.
Childhood abuse was inconsistently related to whole-brain cortical thickness in former studies. However, both childhood abuse and cortical thickness have been associated with depressive symptoms. We hypothesised that childhood abuse moderates the association between depressive symptoms and cortical thickness. In 1551 individuals of the general population, associations between whole-brain cortical thickness and the interaction of childhood abuse (emotional, physical, and sexual) and depressive symptoms were analysed using an ANCOVA. Linear regression analyses were used to estimate the same effect on the cortical thickness of 34 separate regions (Desikan-Killiany-atlas). A significant interaction effect of childhood abuse and depressive symptoms was observed for whole-brain cortical thickness (F(2, 1534) = 5.28, p = 0.007). A thinner cortex was associated with depressive symptoms in abused (t value = 2.78, p = 0.025) but not in non-abused participants (t value = − 1.50, p = 0.224). Focussing on non-depressed participants, a thicker whole-brain cortex was found in abused compared to non-abused participants (t value = − 2.79, p = 0.025). Similar interaction effects were observed in 12 out of 34 cortical regions. Our results suggest that childhood abuse is associated with reduced cortical thickness in subjects with depressive symptoms. In abused subjects without depressive symptoms, larger cortical thickness might act compensatory and thus reflect resilience against depressive symptoms.
Stigma of Mental Illness in Germans and Turkish Immigrants in Germany: The Effect of Causal Beliefs
(2019)
Background: Stigma poses an additional burden for people suffering from mental illness, one that often impairs their social participation and can prevent them from seeking adequate help. It is therefore crucial to understand how stigma develops in order to counteract it by setting up effective evidence-based anti-stigma interventions. The present study examines the effect of causal beliefs on stigmatizing behavioral intentions, namely people's desire to distance themselves from persons with mental illness. In addition, we draw cross-cultural comparisons between native Germans and Turkish immigrants to investigate the influence of culture on stigma and causal beliefs and to broaden knowledge on the biggest immigrant group in Germany and on immigrants in Western countries in general.
Methods: n = 302 native Germans and n = 173 Turkish immigrants were presented either a depression or a schizophrenia vignette. Then, causal beliefs, emotional reaction and desire for social distance were assessed with questionnaires. Path analyses were carried out to investigate the influence of causal beliefs on the desire for social distance and their mediation by emotional reactions for Germans and Turkish immigrants, respectively.
Results: We found an influence of causal beliefs on the desire for social distance. Emotional reactions partly mediated this relationship. Causal attribution patterns as well as the relationship between causal attributions and stigma varied across both subsamples and mental illnesses. In the German subsample, the ascription of unfavorable personal traits resulted in more stigma. In the Turkish immigrant subsample, supernatural causal beliefs increased stigma while attribution to current stress reduced stigma.
Conclusion: Our study has implications for future anti-stigma interventions that intend to reduce stigmatization of mentally ill people. Targeting the ascription of unfavorable personal traits and supernatural causal attributions as well as promoting current stress as the cause for mental illness appears to be of particular importance. Also, the mediating influence of emotional responses to causal beliefs needs to be addressed. Furthermore, differential interventions across cultural groups and specific mental illnesses may be appropriate.
21 Patienten mit einer onkologischen Grunderkrankung und einer Major Depression wurden über einen Zeitraum von acht Wochen mit dem Selektiven Serotonin Reuptake Inhibitor Citalopram in einer Dosis zwischen 20 und 60 mg pro Tag behandelt. Eine Kontrollgruppe wurde anhand von Matching Kriterien ausgewählt. Als Erhebungsinstrumente wurde bezüglich der Ausprägung der depressiven Symptomatik der MADRS, für die Angstempfindung das BAI, für die Selbsteinschätzung der Lebensqualität der EORTC-QLQ-C30 sowie für die Erfassung körperlicher Beschwerden und Nebenwirkungen der FKB verwendet. Innerhalb des Beobachtungszeitraumes konnte ein signifikanter Rückgang depressiver Symptome sowie der Angstempfindung verzeichnet werden. Bezüglich der Lebensqualität ist eine positive Beeinflussung vorrangig auf das allgemeine Gesundheitsempfinden und das emotionale Befinden zu verzeichnen. Im Vergleich der Patientenkollektive konnte keine Zunahme von körperlichen Beschwerdesymptomen nach pharmakologischer Intervention mit Citalopram beobachtet werden. Das Ergebnis der Studie bestätigt die positive Therapieresponse und die gute Verträglichkeit sowie damit die Notwendigkeit einer psychiatrischen Intervention in diesem Fall durch eine pharmakologische, antidepressive Medikation im Kollektiv depressiver Patienten mit malignen Grunderkrankungen.
The hypothalamus–pituitary–adrenal axis is the main physiological stress response system and regulating the release of cortisol. The two corticoid receptors encoded by the genes NR3C1 and NR3C2 are the main players in regulating the physiological response to cortisol. This biological system has been linked to neurocognitive processes and memory, yet the mechanisms remain largely unclear. In two independent general population studies (SHIP, total sample size > 5500), we aim to diseantangle the effects of genetic variation, gene expression and cortisol on verbal memory and memory associated brain volume. Especially for NR3C1 results exhibited a consistent pattern of direct an interactive effects. All three biological layers, genetic variation (rs56149945), gene expression for NR3C1 and cortisol levels, were directly associated with verbal memory. Interactions between these components showed significant effects on verbal memory as well as hippocampal volume. For NR3C2 such a complex association pattern could not be observed. Our analyses revealed that different components of the stress response system are acting together on different aspects of cognition. Complex phenotypes, such as cognition and memory function are regulated by a complex interplay between different genetic and epigenetic features. We promote the glucocorticoid receptor NR3C1 as a main target to focus in the context of verbal memory and provided a mechanistic concept of the interaction between various biological layers spanning NR3C1 function and its effects on memory. Especially the NR3C1 transcript seemed to be a key element in this complex system.
Psychiatric disorders are highly heritable. But the underlying molecular mechanisms are largely unknown or not understood. For many disorders, candidate genes have been proposed which are biologically driven or based on large GWAS studies. In this work different approaches were shown to investigate the impact of genetic risk factors for major psychiatric disorders in the general population. These genetic risk variants include single nucleotide polymorphisms associated with schizophrenia or major depression and were analyzed using the whole-genome information in polygenic scores or candidate marker analysis in GxE studies. Genetic data from SHIP-0 and SHIP-TREND have been used to calculate a polygenic risk score for schizophrenia. Here, the association between this genetic score and brain alterations is shown in three independent samples (SHIP-2, SHIP-TREND and BIG) which revealed no hint of a common genetic basis for schizophrenia and brain structure. These results are in line with other studies that also failed to find a genetic overlap. The same polygenic scores had been used in a PHEWAS analysis in SHIP-0 where an inverse association to migraine was found. This association could be attributed to the NMDA receptor activation via D-serine at the glutamatergic synapse. To assess the impact of environmental factors on the path from genes to phenotype, gene-environment interactions were applied. A significant interaction could be observed between rs7305115 (TPH2) and rs25531 (5-HTTLPR) and childhood abuse on current depression score in SHIP-LEGEND and SHIP-TREND. In summary, genetic variants associated with major psychiatric disorders can exhibit pleiotropic effects on common phenotypes in the general population.
Background: A telemedicine care concept based on telephone contacts and individualized text messages was developed for patients with mental disorders to continue treatment after therapy in a psychiatric day hospital. The primary objective of this study was to evaluate the effectiveness of the telemedicine interventions. Methods: The study had a 3-armed, randomized design with 2 intervention arms (intervention 1: telephone contacts; intervention 2: telephone contacts and short text messages; both took place over a period of 6 months and in addition to usual care), and a control group with usual care. Primary outcomes were 18-item Brief Symptom Inventory (BSI-18) scores for anxiety, depression and somatization. All participants were recruited from psychiatric day hospitals. The study was registered in the German Clinical Trials Register (DRKS00000662). Results: 113 participants were analyzed 6 months after starting the intervention. The average BSI-18 anxiety score after 6 months was -2.04 points lower in intervention group 2 than in the control group (p value: 0.042). The difference in BSI depression score between these two groups was marginally significant (p value: 0.1), with an average treatment effect of -1.73. In an exploratory sensitivity analysis restricted to the 75% of patients with the highest symptom scores at baseline, intervention group 1 yielded a significant effect for anxiety and depression compared to the control group (p = 0.036 and 0.046, respectively). Conclusions: Telemedicine provides a novel option in psychiatric ambulatory care with statistically significant effects on anxiety. A positive tendency was observed for depression, especially in cases with higher symptom load at baseline.
Da die Prävalenz von Übergewicht und Adipositas weiterhin ansteigt, wird die Prävention sowie die Behandlung von Adipositas und ihren Folgeerkrankungen in Zukunft eine entscheidende Rolle in der Medizin spielen.
Um jedoch passende Präventionsstrategien und Behandlungsmöglichkeiten zu entwickeln, ist es von großer Bedeutung, die pathophysiologischen Grundlagen dieser Volkskrankheit zu erforschen.
Da die Prävalenz erst in den letzten Jahren deutlich angestiegen ist, gibt es bislang nur wenige Langzeitstudien zu Adipositas und ihrem Effekt auf Hirnparameter.
Die vorliegende Studie verwendet jedoch einen Versuchsaufbau, der es ermöglicht strukturelle Adipositaseffekte des Gehirns über einen Zeitraum von durchschnittlich 4,9 Jahren zu dokumentieren. Gleichzeitig ermöglicht diese Arbeit die Beobachtung langfristiger Auswirkungen polygener Adipositas auf die graue Substanz.
Nach standardisierter Erhebung somatometrischer Daten von 502 Probanden, erfolgte die Durchführung von ebenfalls standardisierten MRT-Untersuchungen des Hirns an zwei Messzeitpunkten, jeweils unter den gleichen Bedingungen. Daraufhin erfolgte die statistische Auswertung dieser Daten unter Verwendung einer Zielregion- sowie Globalanalyse. Eine mögliche altersbedingte Verzerrung wurde durch die Adjustierung an das Alter verhindert. Es konnten strukturelle Unterschiede der grauen Substanz des Gehirns dokumentiert und bestätigt sowie eine mögliche Verbindung zwischen hohen BMI-Werten und einer konsekutiven Hirnatrophie formuliert werden.
Die Ergebnisse liefern erste Hinweise auf einen möglichen kausalen Zusammenhang struktureller Adipositas-Effekte auf das Gehirn.
Im Zuge dieser Arbeit wurde herausgefunden, dass hauptsächlich die kortikale Dicke sowie das Volumen des OFC und des AC-MPFC durch einen höheren Ausgangs-BMI-Wert negativ beeinflusst werden. Allerdings ergibt sich aus den vorliegenden Daten kein Hinweis auf einen Zusammenhang zwischen genetisch bedingter BMI-Erhöhung und Hirnatrophie.
Eine Vielzahl von unterschiedlichen Mechanismen könnten dabei eine mögliche Rolle bei der Entstehung einer Hirnatrophie bei adipösen Personen spielen. Um diese besser zu verstehen, sind weitere Studien notwendig und aufgrund der hohen Prävalenzen sicher auch von medizinischem, aber auch wirtschaftlichem Interesse.