Clinical decision-making style preferences of European psychiatrists: Results from the Ambassadors survey in 38 countries.

Background: While shared clinical decision-making (SDM) is the preferred approach to decision-making in mental health care, its implementation in everyday clinical practice is still insufficient. The European Psychiatric Association undertook a study aiming to gather data on the clinical decision-making style preferences of psychiatrists working in Europe.

Methods: We conducted a cross-sectional online survey involving a sample of 751 psychiatrists and psychiatry specialist trainees from 38 European countries in 2021, using the Clinical Decision-Making Style - Staff questionnaire and a set of questions regarding clinicians' expertise, training, and practice.

Understanding Barriers to the Realization of Human Rights Among Older Women With Mental Health Conditions.

There is increasing emphasis in research and at the level of international human rights bodies such as the United Nations on the gendered contours of age-based disadvantage and discrimination, and the cumulative effects of gender inequalities over the life-course on outcomes in later life. However, to date, the role of mental health in shaping the age/gender nexus in the realization of human rights has received little attention. In response, this paper aims to 1) elucidate the economic, social and cultural disadvantages and discrimination faced by older women living with mental health conditions; and 2) identify opportunities to protect their human rights.

COVID-19 and dementia: experience from six European countries.

The effects of coronavirus disease 2019 (COVID-19) have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer-term effects such as neurological damage. The International Dementia Alliance is a group of dementia specialists from six European countries and this paper is a summary of our experience of the effects of COVID-19 on our populations.

Development of an international schedule for the assessment and staging of care for dementia.

Background: A reliable and valid global staging scale has been lacking within dementia care.

Objective: To develop an easy-to-use multi-dimensional clinical staging schedule for dementia.

Methods: The schedule was developed through: i) Two series of focus groups (40 and 48 participants, respectively) in Denmark, France, Germany, Netherlands, Spain, Switzerland, and UK with a multi-disciplinary group of professionals working within dementia care, to assess the need for a dementia-staging tool and to obtain suggestions on its design and characteristics; ii) A pilot-study over three rounds to test inter-rater reliability of the newly developed schedule using written case histories, with five members of the project's steering committee and 27 of their colleagues from Netherlands, France, and Spain as participants; and iii) A field-study to test the schedule's inter-rater reliability in clinical practice in France, Germany, Netherlands, Spain, Italy, Turkey, South Korea, Romania, and Serbia, which included 209 dementia patients and 217 of their caregivers as participants.

Working memory training in patients with chronic schizophrenia: a pilot study.

Background. There is evidence that patients with schizophrenia suffer from decline in working memory performance with consequences for psychosocial outcome. Objective.

[Changes of the psychogeriatric inpatient care at the University Psychiatric Hospitals in Basel following the constitution of an outpatient care service for the elderly].

Objective: 10-year follow-up of the psychogeriatric inpatient care at the University Psychiatric Hospitals Basel following the establishment of an outpatient care service for the elderly (ADA).

Method: Standardized chart review of a random sample of psychogeriatric cases (≥ 65 y) of the years 1997 and 2007 (n = 100 each) in terms of socio-demographic, diagnostic, therapeutic und administrative data.

Results: The number of patients with contact to both inpatient and outpatient services prior to admission increased.

Validity, reliability, and feasibility of clinical staging scales in dementia: a systematic review.

New staging systems of dementia require adaptation of disease management programs and adequate staging instruments. Therefore, we systematically reviewed the literature on validity and reliability of clinically applicable, multidomain, and dementia staging instruments. A total of 23 articles describing 12 staging instruments were identified (N = 6109 participants, age 65-87).

Selective optimization with compensation (SOC) competencies in depression.

Background: The metamodel of selective optimization with compensation (SOC) aims to integrate scientific knowledge about the nature of development and aging with a focus on successful adaptation. For the first time the present study examines how SOC competencies and depressive symptoms are associated. In particular, potential state or trait effects of SOC competencies are considered.

Sleep-wake cycles and cognitive functioning in schizophrenia.

Background: Irregular sleep-wake cycles and cognitive impairment are frequently observed in schizophrenia, however, how they interact remains unclear.

Aims: To investigate the repercussions of circadian rhythm characteristics on cognitive performance and psychopathology in individuals with schizophrenia.

Method: Fourteen middle-aged individuals diagnosed with schizophrenia underwent continuous wrist actimetry monitoring in real-life settings for 3 weeks, and collected saliva samples to determine the onset of endogenous melatonin secretion as a circadian phase marker.

Consensus statement on genetic research in dementia.

In this article, the authors describe how the European Dementia Consensus Network developed a consensus on research ethics in dementia, taking into account the questions posed by the era of genetic research and its new research methods. The consensus process started with a Delphi procedure to analyze relevant stakeholders' positions by describing their statements on the possibilities and limitations of research into genetic determinants of Alzheimer disease and to describe and analyze the moral desirability of genetic research on Alzheimer disease. The conclusions drawn from the Delphi procedure fuelled the development of the consensus statement, which is presented in this paper.

[Depression in old age].

Depression is the most frequent psychiatric disorder in old age. Some patients have had depressive episodes or other psychological disorder in an earlier part of their life span. Older people show more somatic or cognitive complaints compared to younger depressives.

Dementia diagnostics in primary care: a representative 8-year follow-up study in Lower Saxony, Germany.

Aim: To investigate whether primary-care physicians' competency regarding dementia diagnostics improved from 1993 to 2001.

Methods: In a representative follow-up survey 122 out of 170 (71.8%) family physicians (FPs) were randomly assigned to 2 written case samples presenting patients with slight memory impairment (case 1a: female vs.

Primary care physicians' attitudes related to cognition enhancers in early dementia: a representative eight-year follow-up study in Lower Saxony, Germany.

Objective: By means of a representative follow-up survey, we investigated changes in family physicians' (FPs) attitudes towards cognition enhancers in early dementia during 1993 and 2001.

Methods: One hundred and twenty-two FPs (response rate 71.8%) in Lower Saxony, Germany, were randomly assigned to one of two written case samples presenting a patient with cognitive decline suggestive of early Alzheimer's disease (DAT; case A: female patient vs case B: male patient).

[Physicians' competence regarding the early diagnosis of dementia: differences between family physicians and primary care neuropsychiatrists in Germany].

Objective: Are there any differences between family physicians (FP) and primary care neuropsychiatrists (NP) with regard to their diagnostic competence of early dementia?

Methods: Trained interviewers presented written case vignettes to 68 NP and 122 FP during a structured interview. The case history described an otherwise healthy 70 years old patient complaining about cognitive disturbances suggesting incipient dementia.

Results: The survey is representative with a high response rate (71.

Diagnosis of dementia in primary care: a representative survey of family physicians and neuropsychiatrists in Germany.

Aim: To measure the diagnostic competence of family physicians (FP) and neuropsychiatrists (NP) for moderate dementia.

Methods: Written case vignettes describing moderate dementia either of Alzheimer type or vascular type were randomized to a representative sample of 122 FP and 68 NP, corresponding to response rates of 71.8 and 67.

Access to diagnostic evaluation and treatment for dementia in Europe.

This paper reviews and discusses existing barriers to diagnosis and treatment for patients with dementia in Europe as well as approaches to overcome these barriers. The barriers to care are manifold, being present at all levels in each society and between countries in Europe. Multilevel and multifaceted strategies are needed to improve diagnosis and treatments for all patients with cognitive complaints.

Early diagnosis of dementia in primary care: a representative eight-year follow-up study in Lower Saxony, Germany.

Objective: To investigate whether primary care competency in early diagnosis of dementia might have changed during 1993 and 2001.

Method: By means of a representative follow-up survey 122 out of 170 (71.8%) family physicians (FPs) in Lower Saxony, Germany, were randomly assigned to two written case samples presenting a patient with mild cognitive impairment (case 1a vs.

[7-year-follow-up investigations and comparison of the geriatric psychiatric inpatient service in a separated care at a state hospital (obligatory service) and an integrated care at a university hospital in Goettingen, Germany -- II. Diagnosis and treatment].

Objective: By use of a 7-y-follow-up investigation of differences between geriatric psychiatric patients and their management in an integrated (with other adult age groups) care in the University Psychiatric Hospital (PUK) compared to those in a separated (only according to age) care in the Psychiatric State Hospital (LKH), which together treat all psychiatric inpatients in Goettingen, Germany, we wanted to show, whether progress can be made visible.

Method: We performed standardized chart reviews of randomly selected groups of patients, who had been treated in the PUK (n = 104) and the LKH (n = 100) in the years 1998 and 1999.

Results: Again, organic brain diseases/dementia was the most frequent diagnosis in the LKH and depression that of the PUK.

[7-year-follow-up investigations of the geriatric psychiatric inpatient service in a separated care at a state hospital (obligatory service) and an integrated care at a university hospital in Goettingen, Germany -- I. Type of patients].

Objective: 7 years after our first investigation we were interested in the stability versus (trends of) change in geriatric psychiatric inpatients while the structure of services was mainly unchanged.

Method: We performed standardised chart reviews of randomly selected groups of geriatric psychiatric inpatients who had been treated in 1998 and 1999 in the Psychiatric University Hospital (PUK; n = 104) or the Psychiatric State Hospital (LKH; n = 100), which together treat all psychiatric inpatients in the region. With regard to age, the PUK provides integrated and the LKH separated care.