[Pharmacological treatment of posttraumatic stress disorder].

In addition to trauma-focussed psychotherapy, pharmacological treatment is often unavoidable, especially in patients with severe posttraumatic stress disorder (PTSD). As long as comorbid disorders do not dictate the pharmacotherapy approach, sertraline and paroxetine, along with other off-label prescribable substances approved in Germany, can be used for the treatment of PTSD. Venlafaxine, in particular, has shown good effectiveness in studies, whereas risperidone has shown lower effectiveness in augmentation.

[Trauma and memory-A contribution to the current debate in law and psychotherapy].

The recall of memories of past events, experiences and emotions is a complex process. When experiencing traumatic events, as is the case with sexual violence, a host of additional complexities and difficulties arise. This becomes especially important in court cases which rely mostly or exclusively on the testimony of the victim, where the problem of the fallibility of memory takes center stage.

Drug-Induced Liver Injury (DILI) in Patients with Depression Treated with Antidepressants: A Retrospective Multicenter Study.

Introduction: Drug-induced liver injury (DILI) is the 4th most common cause of liver damage in Western countries and can be caused by antidepressants.

Methods: Against the background of increasing antidepressant prescriptions and increasing use of polypharmacy, we analyzed administered antidepressants and other pharmacological substances, liver toxicity, comorbid somatic secondary diseases together with the occurrence of DILI in a patient population of 6 centers throughout Germany.

Results: The majority of the enrolled 329 patients received polypharmacological treatment in an inpatient setting.

Do adjuvant interventions improve treatment outcome in adult patients with posttraumatic stress disorder receiving trauma-focused psychotherapy? A systematic review.

: According to clinical guidelines, trauma-focused psychotherapies (TF-PT) such as trauma-focused cognitive behavioural therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are recommended as first-line treatments for posttraumatic stress disorder (PTSD). TF-CBT and EMDR are equally effective and have large effect sizes. However, many patients fail to respond or have comorbid symptoms or disorders that only partially decline with TF-PT.

[Delayed Onset of PTSD - A Problem for Diagnosis and Litigation - with Special Reference to Political Imprisonment in the GDR].

More often than is generally assumed: according to 2 metaanalyses, an average of about 25% of all cases of PTSD are not definitively diagnosed with post-traumatic stress disorder (PTSD) until 6 months or more after their trauma. Its prevalence varies widely depending on the given population. Delayed onset PTSD is diagnosed in military personnel much more often than in the civilian population (38,2 vs.

[Resources, Childhood Trauma and Psychopathology in a Psychiatric Inpatient Sample].

Childhood trauma can have a negative impact on the development of personal and social resources in later adulthood. This is problematic, because resources can be a protective factor against the development of psychiatric disorders and are potentially beneficial for therapy outcomes. The current study considered the association between childhood trauma and resources as well as the impact of these 2 factors on psychopathology and symptom reduction in a psychiatric in-patient sample.

A feasibility study on violence prevention in outpatients with schizophrenia.

Patients with schizophrenia have an increased risk of violent behavior, and occupy a large percentage of forensic beds. Most patients in forensic psychiatry have already undergone general psychiatric therapy. This predestinates general psychiatrists to identify those patients presenting such a risk, and to try to intervene so that violence can be prevented.

Pharmacological treatment for schizoaffective disorder : A comparison with schizophrenia and bipolar disorder.

Background: Bipolar disorder and schizophrenia are severe mental illnesses, each with a prevalence of approximately 1-2% in the general population. There is considerable controversy about differentiating schizophrenia from schizoaffective or bipolar disorder owing to many similarities in psychopathology, progression, and biological factors. The aim of this study was to identify similarities and differences in the pharmacological treatment of these disorders by comparing the prescription patterns.

Reduced amygdala responsivity during conditioning to trauma-related stimuli in posttraumatic stress disorder.

Exaggerated conditioned fear responses and impaired extinction along with amygdala overactivation have been observed in posttraumatic stress disorder (PTSD). These fear responses might be triggered by cues related to the trauma through higher-order conditioning, where reminders of the trauma may serve as unconditioned stimuli (US) and could maintain the fear response. We compared arousal, valence, and US expectancy ratings and BOLD brain responses using fMRI in 14 traumatized persons with PTSD and 14 without PTSD (NPTSD) and 13 matched healthy controls (HC) in a differential aversive conditioning paradigm.

Mobility behaviour and driving status of patients with mental disorders - an exploratory study.

Background: Driving is an important activity of daily life and an integral part of mobility. However, impact of mental illness on road mobility is widely unexplored.

Method: Driving status in 1497 psychiatric inpatients (PPs) and a clinical control group of 313 neurological inpatients (NPs) was investigated using a brief questionnaire.

[Expert testimony in post-traumatic stress disorder with pain as the main symptom].

Post-traumatic stress disorder (PTSD) is one of the most relevant disorders of patients with chronic pain, but is often underdiagnosed. This also applies to expert testimony. Further complicating the assessment are the different definitions of PTSD in ICD-10 and DSM-IV; the new DSM-5 has added a further definition.

Post-traumatic stress disorder--a diagnostic and therapeutic challenge.

Background: In Germany, the one-month prevalence of post-traumatic stress disorder (PTSD) is in the range of 1% to 3%. Soldiers, persons injured in accidents, and victims of domestic violence increasingly seek medical help for symptoms of emotional stress. Days lost from work and monetary compensation for emotional disturbances are markedly on the rise.

Protecting self-esteem from stigma: a test of different strategies for coping with the stigma of mental illness.

Background: To date, there has been little research into effective strategies for preventing the detrimental effects of stigma on the well-being of people with mental illness.

Aim: The present research set out to identify adaptive strategies for dealing with the stigma of mental illness.

Methods: On the basis of the responses of 355 people with mental illness (PWMI) a standardized questionnaire assessing 10 identity management strategies was developed.

Trauma exposure and post-traumatic stress disorder in bipolar disorder.

Introduction: There is a lack of data about post-traumatic stress disorder (PTSD) in European bipolar patients compared to the US-population. This study was conducted to ascertain the rates and types of traumatic events and PTSD in bipolar-I disorder.

Methods: Euthymic bipolar patients were screened for lifetime diagnosis of PTSD using the Post-Traumatic Stress Diagnostic Scale and the Clinician Administered Post-traumatic Stress Disorder Scale.

Adherence to guidelines for treatment of depression in in-patients.

Background: Adherence to treatment guidelines enhances treatment outcome. However, in clinical practice many patients with depression do not receive appropriate treatment.

Aims: To evaluate the treatment of depression in in-patients of German psychiatric hospitals with respect to treatment outcome and adherence to guidelines.

Posttraumatic stress disorders and extent of psychosocial impairments five years after a traffic accident.

This five year long-term follow-up study estimated the prevalence of Posttraumatic Stress Disorder (PTSD) and other mental health problems in traffic accident victims. 70 patients were invited for a personal interview to assess mental disorders (DIA-X), depression (BDI), mental distress (SCL-90-R), and psychosocial (SDS) and physical impairments at least five years after their first admission to a university hospital (Department of Traumatology). Prevalence of PTSD was 10%, and another 14.

Comparison between paroxetine and behaviour therapy in patients with posttraumatic stress disorder (PTSD): A pilot study.

Antidepressants and cognitive-behavioural therapy (CBT) have been reported to decrease severity of psychopathology in PTSD-patients. To date, no study has been carried out which compares psychopharmacolo-gical and psychotherapeutic treatments. In a randomized pilot study, PTSD-patients were treated either with paroxetine or CBT.

[Psychological disorders after severe occupational accidents].

After severe accidents, a significant number of victims develop post-traumatic stress disorder (PTSD) and other psychiatric disorders, which lead to considerable impairment in work and daily life. Few studies exist which deal with the psychological consequences of industrial accidents. The Department of Psychiatry and Psychotherapy (University of Freiburg) in cooperation with the Department of Trauma Surgery (University of Freiburg) have therefore carried out a prospective study on the subject.

Evaluation of the German version of the PTSD Symptom Scale (PSS).

The psychometric properties of the PTSD Symptom Scale (PSS) were evaluated in a clinical sample of severely injured in-patients after a traffic accident (n = 123). The PSS contains 17 items which were derived from the DSM-III-R criteria of posttraumatic stress disorder (PTSD). The results indicate that the PSS has satisfactory reliability and validity (internal and external).

The concept of "sense of coherence" and the development of posttraumatic stress disorder in traffic accident victims.

According to the "sense of coherence" concept, those subjects who can give meaning to a traumatic event can comprehend what has happened and have a sense of manageability of the sequelae, are able to cope better with the traumatic event itself. In the present study, this concept was applied to traffic accident victims. Severely injured traffic accident victims were assessed a few days after the accident and at 6-month follow-up.

Prediction of posttraumatic stress disorder by immediate reactions to trauma: a prospective study in road traffic accident victims.

Road traffic accidents often cause serious physical and psychological sequelae. Specialists of various medical faculties are involved in the treatment of accident victims. Little is known about the factors which might predict psychiatric disorders, e.

Interleukin-6-(IL-6) plasma levels in depression and schizophrenia: comparison between the acute state and after remission.

The concentration of cytokines such as Interleukin-6 (IL-6) has been reported to be elevated in depressed and schizophrenic patients and, in healthy persons, upon stress. Interleukin-6 plasma levels were determined in depressed (n = 12) and schizophrenic (n = 32) patients during the acute state of illness and after remission at approximately 8 weeks after admission and were compared with healthy controls (n = 12). Patients were diagnosed according to DSM-III-R by the Structured Clinical Interview (SCID).

[Treatment of panic disorders and agoraphobia. Psychotherapy, psychopharmacotherapy and their combination].

During the last two decades substantial progress has been achieved in the development and evaluation of effective treatment approaches to panic disorder and agoraphobia. Many clinical research studies in this area were begun after the definition of operationalized diagnostic criteria for panic disorder and agoraphobia in the DSM-III in 1980. Different concepts concerning the etiology, pathogenesis and maintaining factors of these disorders are still controversial.