The predictive validity and temporal characteristics of the HCR-20v3 for inpatient violence in forensic inpatient settings. An international study.

Aggression and violence are common day to day problems in psychiatric settings. However, the optimal means of assessing that risk remains unclear. In the context of that uncertainty many tools have evolved, among which the HCR-20 is one of the most globally accepted, though many questions remain about its performance, how and when it should be deployed and how it can be most effectively used.

Neonatal outcome and adaption after in utero exposure to antidepressants: A systematic review and meta-analysis.

Objective: Major depressive disorder (MDD) and anxiety disorders are both common and especially challenging during pregnancy. Considering possible risks of intrauterine drug exposure of the child, the role of psychopharmacological treatment is ambiguous and various negative obstetric outcomes were inconsistently associated with medication. Consequently, a critical examination of peri- and postnatal phenomena associated with intrauterine exposure to antidepressants based on serotonin reuptake inhibition (SRI) and subsumed under the term "poor neonatal adaptation syndrome" (PNAS) is urgently called for.

["Psychiatry Takes its Time … " Why Does One Become a Psychiatrist? - A Qualitative Study].

Objective: Identification of intrinsic motivators involved in choosing psychiatry as a career path.

Methods: 14 qualitative in-depth interviews were analysed systematically using coding frames.

Results: Positive findings were the interpersonal focus and the holistic approach of psychiatry.

A relationship of sorts: gender and auditory hallucinations in schizophrenia spectrum disorders.

Voice hearing has been conceptualized as an interrelational framework, where the interaction between voice and voice hearer is reciprocal and resembles "real-life interpersonal interactions." Although gender influences social functioning in "real-life situations," little is known about respective effects of gender in the voice hearing experience. One hundred seventeen participants with a schizophrenia spectrum disorder took part in a semi-structured interview about the phenomenology of their voices and completed standardized self-rating questionnaires on their beliefs about their most dominant male and female voices and the power differentials in their respective voice-voice hearer interactions.

Attention-Deficit Hyperactivity Disorder Symptom Status in a Mixed Gender Population of Opioid-Maintained Prison Inmates.

Objective: Attention-deficit hyperactivity disorder (ADHD) often coincides with substance abuse and delinquency. A sample of opioid-maintained inmates was assessed for symptoms of ADHD, substance abuse history, types of offense, psychiatric comorbidities, and psychopharmacological treatment using a standardized battery of instruments.

Method: Adult inmates (n = 133, mean age 35.

Development of a clinical version of the Carers' Needs Assessment for Schizophrenia.

Objective: Based on the research version of the Carers' Needs Assessment for Schizophrenia (CNA-S) a shortened clinical version was developed for routine assessment of interventions needed by the caregivers of schizophrenia patients in everyday clinical work.

Methods: The development of this questionnaire (including a manual explaining its use) was based on results from earlier studies and suggestions from Austrian researchers involved in previous studies using the research version. Based on discussions with researchers the questionnaire and the manual were improved step by step.

Monitoring neonatal abstinence syndrome in buprenorphine-exposed in vitro fertilization twins: A case study.

Background: Prior studies have reported on the pregnancies and outcomes of in vitro fertilization (IVF) in special subpopulations; however, there is a lack of studies on opioid-exposed IVF-conceived neonates.

Case Presentation: A young adult IVF-pregnant woman was maintained on buprenorphine throughout pregnancy and received follow-up from the addiction clinic from estimated gestational week 32. She delivered healthy dichorionic twins via cesarean section at 38 weeks gestational age (buprenorphine dose at time of delivery: 16 mg).

[Projections about the future number of dementia sufferers: increasing life expectancy not sufficiently considered?].

Background: Several authors pointed out that in the next decades dementia will affect a considerably increasing number of the elderly. The question was raised if life-expectancy was projected to conservative, resulting in revisions with higher life-expectancy and larger numbers of the oldest population. The present paper analyses the influence of such revisions on the future numbers of dementia sufferers in Austria.

Opioid Maintenance Treatment--A Call for a Joint European Quality Care Approach.

Aims: The aim of this exploratory analysis of European Quality Audit of Opioid Treatment data was to identify areas of improvement for current opioid maintenance treatment (OMT) approaches.

Methods: Factors facilitating treatment entry, retention and refusal were compared between 8 European countries and between OMT patient (OMT-P) and active opioid user (AOU) sample groups. Both groups were divided into those who had never had OMT before (un-experienced OMT-P (n = 573) and AOU (n = 360)) and those who had been maintained at least once prior to this investigation (experienced OMT-P (n = 746) and AOU (n = 377)).

[Depression Symptoms of Mothers and Fathers of Persons with Schizophrenia].

Objective: The purpose of the present study was to investigate if depression symptomatology of patients' parents is predicted by the symptoms of schizophrenia.

Methods: 101 mothers and 101 fathers of the same patients suffering from schizophrenia were included into this study. Parents filled in the "Beck Depression Inventory".

[Burden of mothers and fathers of persons with schizophrenia].

Objective: Most studies about the burden of schizophrenia carers included only one care-giving relative, usually the patients' mothers. The present study intended to analyse differences of the level of burden between mothers and fathers of the same patients.

Methods: 101 mothers and 101 fathers of the same patients suffering from schizophrenia were included into this study.

Substance abuse/dependence treatment: a European perspective.

During the past decade, substantial progress has been made in the field of addiction medicine in Europe, particularly regarding the development of new treatment interventions, resulting in a wide range of therapeutic options for patients with substance use disorders. However, not all interventions are evidence based. Patients with cannabis and cocaine/amphetamine use disorders and special patient populations especially lack evidence-based treatment recommendations.

[First contact with psychiatric services: what do relatives caring for schizophrenia patients need?].

Objective: The purpose of the present study was to investigate the problems and needs for interventions among caregivers of patients with schizophrenia who were the first time in contact with psychiatric services.

Methods: 93 family caregivers of schizophrenia patients during the first contact with services were investigated by means of the the "Carer's Needs Assessment for Schizophrenia" (CNA-S).

Results: The most frequent problems of caregivers of first contact patients with schizophrenia were insufficient information on mental illness and concerns about the patient's future.

Discontinuous patterns of brain activation in the psychotherapy process of obsessive-compulsive disorder: converging results from repeated FMRI and daily self-reports.

This study investigates neuronal activation patterns during the psychotherapeutic process, assuming that change dynamics undergo critical instabilities and discontinuous transitions. An internet-based system was used to collect daily self-assessments during inpatient therapies. A dynamic complexity measure was applied to the resulting time series.

[Internalized Stigma of Schizophrenia: Validation of the German Version of the Internalized Stigma of Mental Illness-Scale (ISMI)].

Objectives: Schizophrenia is particularly associated with stigma. Especially internalized stigma, the inner subjective experience of stigma and its psychological effects resulting from applying negative stereotypes and stigmatising attitudes to oneself, is a barrier to recovery. The Internalized Stigma of Mental Illness-scale (ISMI) developed by Jennifer Boyd Ritsher and colleagues is a valid instrument for self-rated assessment of the subjective experience of stigma.

Lessons learned from a comparison of evidence-based research in pregnant opioid-dependent women.

Objectives: Lessons learned in research and treatment of opioid dependence demonstrate the need to include pregnant women in clinical trials.

Methods: Two double-blind, double-dummy, randomized controlled trials (Pilot study, European sample(†) of MOTHER-trial) comparing buprenorphine and methadone in opioid-dependent pregnant women were conducted. In both studies, participants received voucher-based incentives for attendance and completion of study assessments.

[Risks for Burden among Relatives Caring for Schizophrenia Patients].

Objective: Relatives of persons with schizophrenia have an essential role in informal caregiving. This may result in a high level of burden. Aim of the study was to investigate, if the frequency of unmet needs among relatives caring for schizophrenia patients increases the risk for burden among these relatives.

Age-related aspects of addiction.

Research has shown that substance use, abuse and addiction are not limited to a specific age group. Problems related to substance addiction are an important cause of morbidity in the population aged 65 years and above, especially the abuse of prescription drugs and legal substances. A lack of evidence-based studies and tailored treatment options for the aging population is evident.

Opioid dependent and pregnant: what are the best options for mothers and neonates?

Pregnancy in opioid-dependent women is a major public health issue. Women who are afflicted by opioid addiction are a highly vulnerable group of patients frequently becoming pregnant unplanned and at risk of adverse pregnancy outcomes and peri-natal complications. Opioid agonist maintenance treatment is the best option for the majority of women.

Influence of site differences between urban and rural American and Central European opioid-dependent pregnant women and neonatal outcome characteristics.

Background: Multi-center trials enable the recruitment of larger study samples, although results might be influenced by site-specific factors.

Methods: Site differences of a multi-center prospective double-blind, double-dummy randomized controlled trial (7 centers: Central Europe (Vienna)/USA (3 urban/3 rural centers)) comparing safety and efficacy of methadone and buprenorphine in pregnant opioid-dependent women and their neonates.

Results: Urban US women had the highest rate of concomitant opioid (p = 0.

Are male neonates more vulnerable to neonatal abstinence syndrome than female neonates?

Background: Prior studies have shown an increased vulnerability among males to adverse outcomes during the postnatal period. Most children exposed to opioids and other medications in utero develop neonatal abstinence syndrome (NAS), yet individual predisposition for NAS is poorly understood.

Objective: This investigation examined the role of neonatal sex in the postnatal period for neonates exposed to standardized opioid maintenance treatment in utero with a focus on NAS regarding severity, medication requirements, and duration.

Randomized controlled trials in pregnancy: scientific and ethical aspects. Exposure to different opioid medications during pregnancy in an intra-individual comparison.

Background: Chronic medical conditions such as opioid dependence require evidence-based treatment recommendations. However, pregnant women are under-represented in clinical trials. We describe the first within-subject comparison of maternal and neonatal outcomes for methadone- versus buprenorphine-exposed pregnancies.