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Journal: Psychiatrische Praxis


Objective: In many countries diphenhydramine (DPH) is commonly available over the counter, frequently used, and generally regarded as a harmless drug. It is used as a sedative, antiallergic or antiemetic substance.Methods: We present a systematic review of literature search in Pubmed from 1972 to 2012 describing DPH addiction. The literature search in reveals that the addictive potential of DPH can be regarded as proved, based on cases series, eight case reports, a pharmacological overview, one uncontrolled, and one randomized, placebo controlled study. In addition we report a case of an abstinent alcoholic patient treated in our department for DPH-dependency.Conclusion: Especially when treating patients with a history of addiction, physicians should consider and check the possibility of a DPH dependency.

Concepts: Anxiolytic, Substance abuse, Morphine, Alcoholism, Physical dependence, Diphenhydramine, Addiction, Drug addiction


Objective: Multiple models of Integrated Care (IC) have been implemented in German mental health services in the last decade in order to improve cross-sectoral, interdisciplinary cooperation. This study investigates an IC network model providing home treatment, case management and a 24/7 hotline. The aim of the study was to explore how health professionals working in this service model perceive both cooperation within their facilities and with external stakeholders. Methods: 5 focus groups with 39 health professionals working in an IC mental health network were conducted and analyzed with qualitative content analysis. Results: Focus groups participants reported on excellent cooperation within their facilities. The cooperation with external stakeholders, i. e. physicians, psychotherapists and psychiatric clinics, leaves room for improvement. Conclusions: Until now little consideration has been given to the perspectives of health professionals. Cooperation within IC mental health networks seems to be effective. Cooperation with stakeholders outside the networks needs to be enhanced.

Concepts: Qualitative research, Content analysis, Medicine, Health care, Focus group, Psychiatry, Mental health, Psychology


Objective: Participation of mental health services users in research is increasingly acknowledged in Germany. Principles for successful involvement include research training for service users. The aims of the project were (1) to develop and (2) to evaluate a research training. Methods: The research training was developed in five participatory meetings and piloted with 28 participants. They answered questions on the research training and about their interest in research, research-related empowerment and research participation. Results: Interest in research did not change. But there is a difference between research-related empowerment before (t1) and after (t2) the research training (z = - 2.237; p = 0.025). The number of participants registered in scientific studies increased from 4 (t1) to 8 three months later (t3) whereas the number of participants reporting own research ideas decreased from 7 (t1) to 5 (t3). Conclusion: Although interest has not been affected, the evaluation shows significant effects on research-related empowerment in participants. Results concerning transfer are divergent. However, feedback was positive. We are planning to disseminate and refine the training.

Concepts: Participatory democracy, Effect, Participation, Science, Scientific method, Mental health, Mental disorder


Objective: The present study was designed to investigate the frequency of media stigmatization of mentally ill persons after the crash of the “Germanwings”-aircraft on March 2015. Method: Evaluation of 251 texts, which were published in 12 national German newspapers. Categorical distinction between risky coverage and explicit characteristics of stigmatization. Results: In 64.1 % of the evaluated texts, a psychiatric disease of the co-pilot was discussed as the possible cause of the crash, making this the most widely-used explanation in the media that we view “risky coverage”. Characteristics of explicit stigmatization were found in 31.5 % of the texts. Most prominent category of explicit stigmatization was the rubric “Metaphorical language/dramatizations”. It was found in 23.5 % of the articles. Conclusion: Predominantly risky coverage of mentally ill persons has occured in the wake of a spectacular crime. By obtaining professional expertise of psychiatrists and consistent interpretation of journalistic guidelines, unintended effects of stigmatization could be avoided in the future.

Concepts: Mental disorder, Present, Newspaper, Future, Mental health, Psychiatric medication, Mass media, Psychiatry


A better understanding of specific sociodemographic and clinical factors in patients with migration background may help to significantly improve psychiatric treatment outcome of these patients. Therefore, we investigated these factors in a large sample of psychiatric outpatients.

Concepts: Mental health professional, Clinical psychology, Psychotherapy, Psychiatry


The role of the relatives in the context of the “euthanasia” “Aktion T4” (“T4” campaign) has been controversially discussed in recent years. Based on documents of the National Socialist bureaucracy, statements of asylum psychiatrists in the year 1945 to the French occupation force as well as letters from relatives to Weissenau asylum in Wuerttemberg, these sources are analysed here in the light of the reactions of family members in respect to “Aktion T4”. The results testify to a broad spectrum of responses of relatives, which are mainly characterised by fear, helplessness and protest.

Concepts: The Victim, Socialism, French language, French people, Victim, Asylum, Marriage


Objective Examination of the attendance for using internet-based measures after inpatient treatment. Methods Cross-sectional-survey in former inpatients (N = 247). Results 44.9 % are willing to use measures via videoconference, 34.7 % via Chat, 50.0 % via E-Mail and 38.0 % as onlinetherapy. Attendance is lower in older age groups. Benefits regarding the introduced measures are seen mainly in the flexibility and disadvantages in the impersonal character. Conclusions A relevant share of especially younger patients is willing to use internet-based measures.

Concepts: Cross-sectional analysis, Cross-sectional study, Internet


Objective Translation and psychometric testing of a German adaptation of the Australian Depression Literacy Scale. Methods Translation of the Depression Literacy Scale by Griffith et al. (2004) into German and testing for depression literacy in a sample of 229 people with depressive syndrome. Results The investigated sample had a mean age of 49.4 years (18 - 80 years). On average, 51 % of the 22 questions were correctly answered. The scale showed a satisfactory internal consistency with α = .74. The first-time application of the translated D-Lit German scale showed significant differences in subgroup analyzes of sex, age, and education. Hence, women, younger persons and persons with a higher school education reported higher values on the Depression Literacy Scale. Conclusion The translation of the Depression Literacy Scale (D-Lit German) resulted in an easy-to-understand and applicable questionnaire. Items relating to therapeutic and drug-related treatments of depressen were more difficult to answer. The D-Lit scale proved to be a reliable and economic instrument for the investigation of depression literacy. Future studies should include depression literacy in investigations on the demands and help-seeking behaviour of people with depression.

Concepts: Cronbach's alpha, Translation, Leonard Cohen, Weimar Republic, Educational psychology, Reliability, Great Depression, Psychometrics


Objective The investigation of clinical characteristics of patients in adolescence psychiatry relevant for transition medicine. Methodology Sociodemographic and clinical data (SCID I/II, SIPS/SOPS, SPI-A, GAF, CGI) were consecutively taken from the interdisciplinary inpatient treatment centre for adolescents and young adults with mental disorders (N = 229, aged 16 - 25). Results Average age was 19 years (38 % male, 23 % migration background). A high proportion of early mental illnesses and comorbidities (66 %), psychosis risk syndromes (20 %) and suicidality (54 %), treatment discontinuation (33 %) with daily-life, social and family stress factors (52 % positive family history, 34 % trauma) were observed and a persistently high level of support and treatment was needed despite a significant clinical improvement (p < 0.001). Conclusion The results support the need for an interdisciplinary collaboration for the joint development of care structures in transition medicine.

Concepts: Psychology, Cross-cultural psychiatry, Medicine, Psychiatric medication, Mental health, Schizophrenia, Mental disorder, Psychiatry


Objective Students with specialization preferences in psychiatry, neurology, or psychosomatic medicine were retrospectively compared with regard to aspects of motivation to choose medicine as their field of study. Methods To identify early predictors of specialization preferences, a nationwide online survey was conducted with 9079 medical students. The statements of those with a preference for neurology, psychiatry, or psychosomatic medicine were evaluated using analysis of variance (ANOVA). Results Prospective neurologists were motivated by scientific interest variables and less by the aspects of life management. On the other hand, students with preferences for one of the psychological disciplines reported comparatively higher degrees of desire to actively provide help and of the importance of their own medical history. There were no significant differences between future psychiatrists and psychosomatic professionals. Conclusion The reported motives point to thematic orientations that might be useful in the subject-specific acquisition of young academics.

Concepts: Avicenna, Psychology, Analysis of variance, Medical school, Motivation, Neurology, Psychiatry, Medicine