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.
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.
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.
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.
Objective To identify and prioritize research questions about treatment and care of depression which are relevant to patients, carers and clinicians. The importance of involvement of those stakeholder groups in health services research is increasingly recognized internationally. Methods Research topics were collected in an online survey using unipark software. Patients, carers and clinicians wrote down research topics, i. e. uncertainties they experienced when dealing with depression. The stated research topics were summarized by the authors to generate research questions. Patients, carers and clinicians rated the importance of the identified research questions using a 7 point likert-scale in a further online-survey. Results Respondents rated research questions with regard to accessibility and organization of care as especially relevant. A research question regarding the effectiveness of self-help and coping-strategies was rated as most important. Further relevant research questions refer to decide on and find effective therapy. Conclusion According to patients, carers and clinicians more research about self-help and access to treatment should be conducted.
Objective The study aims to assess the acceptance, chances and barriers of an online self-management program (moodgym) for depression from the perspective of experts and patients in inpatient psychiatric settings. Methods Paper-pencil interviews were conducted with n = 181 depressed inpatients (n = 181, pre-post-assessment after 8 weeks) and n = 31 medical experts. Two regression models were carried out to investigate factors associated with the uptake and the user acceptance of moodgym. Chances and barriers were analysed qualitatively. Results Experts and patients reported moderate to high user acceptance. 59 % (n = 107) of the patients logged in to moodgym. Factors associated with the uptake were the educational level and treatment preferences. The user acceptance was influenced by the patients' self-rated health and the frequency of using moodgym. Relevant barriers anticipated by experts were limited computer skills, difficulties in concentration and a severe course of depression. Patients highlighted the ease of use, the moodgym characters and the flexible availability. Conclusions moodgym may represent a complementary treatment option for depressive disorders in an inpatient setting.
Objective This study investigates the promotion of adherence of patients to a psychodynamic treatment program by means of a psycho educational program in the context of randomized field study. Method A sample of a whole year of admittances of patients convicted for forensic treatment due to § 64 of the german penal code were randomized assigned in two groups. An early intervention group received after a 6-week introduction period a specially designed modular psycho educational treatment program parallel to an psychodynamic treatment program. The late intervention group underwent the same psychodynamic treatment program but received psychoeducation 3 month later. The study investigated the drop-out rate and the differences of the two groups in relevant areas. Results After 7 month significantly more patients of the early intervention group are still in psychodynamic treatment Conclusions The study shows positive effects concerning the adherence of forensic inpatients for a psychodynamic orientated therapy.
Objective The aim of the study was to investigate the current state of research concerning internationally developed Online Coaches for treatment support and prevention of mental disorders. Evidence and effectiveness of the Online Coaches ought to be explored. Methods A systematic literature search was performed in international databases in order to provide a meta-review of existing Online Coaches for mental disorders. The assessment of the methodological quality and evidence of the studies was based on the established guidelines of the Scottish Intercollegiate Guideline Network. Results 52 studies (24 meta-analyses, 16 systematic reviews, 2 health-technology assessment reports, and 10 RCT studies) were identified. The efficacy was demonstrated for a variety of Online Coaches for mental disorders, especially for anxiety and depressive disorders, insomnia, and post-traumatic stress disorders, with predominantly acceptable and high quality. Conclusion The present work provides an overview of internationally developed Online Coaches in the field of mental health care. Online Coaches can serve as a useful supplement to the treatment and prevention of mental disorders.
A young male with schizophrenia, dependence syndrome (multiple drug use) and a severe depressive episode develops a serotonin syndrome with Sertraline and Ziprasidone. Making the correct diagnosis, although potentially challenging, remains vital.
Objective A subproject of the study “Sexual abuse of minors by Catholic priests and deacons in the authority of the German Bishops' conference” deals with aspects of prevention. Method Structured questions were used to record objective data on preventive work. The questionnaire was completed in all 27 dioceses of Germany. Results The average hourly rate available for the work of the prevention officers is about 30 hours per week. At the end of 2014, 59 % of clerics were involved in preventive training. The temporal extent of prevention training differs greatly between individual dioceses. Discussion The Catholic Church of Germany has undertaken extensive efforts to implement a comprehensive prevention work to avoid sexual abuse of minors within catholic institutions. However, there are considerable differences between the individual dioceses.