[RCT on discharge planning for high utilisers of mental health care: conduct and quality of the intervention].

Objective: To evaluate feasibility of a structured discharge planning intervention for high utilisers of mental health care developed in a multicentre RCT.

Methods: Data of N = 241 participants (discharge and 3-month follow-up) allocated to the intervention group are analysed with regard to the intervention's quality of implementation, acceptance, and changes in needs.

Results: The intervention was well accepted among patients and staff.

Needs-oriented discharge planning and monitoring for high utilisers of psychiatric services (NODPAM): design and methods.

Background: Attempts to reduce high utilisation of psychiatric inpatient care by targeting the critical time of hospital discharge have been rare.

Methods: This paper presents design and methods of the study "Effectiveness and Cost-Effectiveness of Needs-Oriented Discharge Planning and Monitoring for High Utilisers of Psychiatric Services" (NODPAM), a multicentre RCT conducted in five psychiatric hospitals in Germany. Inclusion criteria are receipt of inpatient psychiatric care, adult age, diagnosis of schizophrenia or affective disorder, defined high utilisation of psychiatric care during two years prior to the current admission, and given informed consent.

Typical and atypical antipsychotics--the misleading dichotomy. Results from the Working Group 'Drugs in Psychiatry' (AGATE).

Objectives: (1) To investigate the risk of extrapyramidal motor side effects (EPS) associated with the prescription of different antipsychotics under naturalistic treatment conditions; (2) to test the rationale of the terms 'typical' and 'atypical' based on EPS rates.

Design: Cross-sectional study in the federal state of Bavaria.

Setting: 20 psychiatric hospitals in Bavaria.

[Via internet to the psychiatrist. The internet as a first step to seek psychiatric advice].

Objective: Consultation via Internet is becoming increasingly common for patients with psychiatric illnesses.

Methods: We report on the e-mail-correspondence with a young woman (according to her own statement), taking medical advice for depressive symptoms via Internet.

Results: The correspondence focuses on the difficulties of the consulter to find and accept adequate (professional) support in the "real world".

[Patients with mental retardation in a psychiatric hospital].

Objective: Because only few data are available, inpatient care of patients with mental retardation was evaluated to get a valid data base concerning quality and quantity of care and to reveal their deficits.

Methods: All patients with first admission to a psychiatric hospital between 1996 and 2002 were included in te cohort study (n=9727). The analyses were based on the psychiatric basis documentation system (DGPPN-BADO).

Quantitative analysis of motor disturbances in schizophrenic patients.

The presence of neurological signs and disturbed psychomotor performance have been consistently confirmed by clinical studies in schizophrenic patients. These parameters are mainly assessed by using clinical rating scales. In recent years, new approaches such as ultrasonic movement analysis systems have been introduced in order to objectively evaluate motor disturbances in schizophrenic patients.

Clustering and switching on verbal and figural fluency functions in adults with attention deficit hyperactivity disorder.

Introduction: Neuropsychological studies of adult patients with ADHD have revealed marked disturbances of executive functions including impairments of attention, working memory, impulsivity, shifting, and divergent thinking. Phonemic fluency tasks, in particular, have been shown to be sensitive measures for the assessment of executive functions of adults with ADHD.

Methods: The present study has examined figural fluency and both phonemic and semantic verbal fluency in 34 adult patients with ADHD and 34 healthy participants.

Novel PS1 mutation in a Bavarian kindred with familial Alzheimer disease.

We describe a novel Leu174Arg PS1 mutation in two members of a Bavarian family which were initially diagnosed with frontotemporal dementia. Intriguingly, there is the possibility that there is an 18th century founder effect and that this family is related to original kindreds with familial Alzheimer disease described in the early 20th century.

[Psychotherapy units in Bavarian state mental hospitals].

Objective And Method: In this paper we report about the situation of psychotherapeutic inpatient treatment in Bavarian state mental hospitals, based on data coming from surveys in those hospitals.

Results And Conclusion: 22 State mental hospitals in Bavaria have 1217 beds for acute psychotherapy, proofed on the basis of quality criteria. More than 50 per cent of all psychotherapy beds are located in those hospitals.

[Changes in the emotional processing in depressive patients: a study with functional magnetoresonance tomography under the employment of pictures with affective contents].

Objective: The influence of emotional contents on brain activation was examined using functional magnetic resonance tomography (fMRT).

Method: Aquiring 100 EPI-measurements of the whole brain, series of positive and negative pictures from the International Affective Picture System (IAPS) were shown to eight depressed males and to healthy controls.

Results: In depression, there was an overactivation in hippocampal area during positive stimulation, whereas an overactivation of amygdala, orbital and prefrontal regions was seen during negative stimulation.

[Familial plaque-only Alzheimer's disease in the Rottal-Inn and Passau counties].

We describe the kindred of Alois Alzheimer's second patient, who died from plaque-only Alzheimer's disease (AD) in 1910. There is a neuropathologically defined subtype of AD without or only few tangles. This plaque-only form is found in about 6 % of autopsied cases of AD.

[Evidence-based hospital management considering data from the psychiatric basic documentation system].

Objective: The study aimed to demonstrate how data from the psychiatric basic documentation system (DGPPN-BADO) are able to support the hospital management in making evidence-based decisions.

Methods: Data from 14 327 psychiatric in-patients in the years 1997, 1999 and 2001 were analysed.

Results: About 40 % of patients were admitted without any medical sending, 20 % were referred by a general practitioner and 10 % by a psychiatrist in private practice.

["Acquired psychopathy" and the neurobiology of emotion and violence].

"Psychopathy" describes a type of personality disorder characterized by a dysregulation of emotion processing. Social behaviour, emotion regulation and competency are of particular relevance in forensic psychiatry. Structural-morphological and functional imaging studies prove that emotion regulation, aggressive-impulsive behaviour and learning from negative experiences are greatly influenced by frontal brain regions.

[No association of 141C-ins/del polymorphism in the D2 dopamine receptor gene in schizophrenia].

Recently, a putative functional polymorphism (-141C Ins/Del) in the 5'-flanking region of the dopamine D2 receptor was found. An association of the Ins allele with schizophrenia has been described in a Japanese sample. In the present study this association was examined in a German schizophrenia patient population.

[Segregated or mixed sex treatment in the psychiatric clinic--what do patients prefer?].

Objective: Preference on separate or mixed sex treatment should be evaluated from the viewpoint of patients of a psychiatric hospital.

Methods: The preference of patients were surveyed by questionnaire before and after mixing four single sex wards. The adjusted response rate was 74.

["Acquired Psychopathy" and the Neurobiology of Emotion and Violence].

"Psychopathy" describes a type of personality disorder characterized by a dysregulation of emotion processing. Social behaviour, emotion regulation and competency are of particular relevance in forensic psychiatry. Structural-morphological and functional imaging studies prove that emotion regulation, aggressive-impulsive behaviour and learning from negative experiences are greatly influenced by frontal brain regions.

[No Association of the - 141C Ins/Del Polymorphism of the Dopamine D2 Receptor with Schizophrenia].

Recently, a putative functional polymorphism (- 141C Ins/Del) in the 5'-flanking region of the dopamine D (2) receptor was found. An association of the Ins allele with schizophrenia has been described in a Japanese sample. In the present study this association was examined in a German schizophrenia patient population.

[Single or Mixed Sex Wards in Psychiatric Hospital from the Patients' Viewpoint].

OBJECTIVE: Preference on separate or mixed sex treatment should be evaluated from the viewpoint of patients of a psychiatric hospital. METHODS: The preference of patients were surveyed by questionnaire before and after mixing four single sex wards. The adjusted response rate was 74.

Abnormalities in emotion processing within cortical and subcortical regions in criminal psychopaths: evidence from a functional magnetic resonance imaging study using pictures with emotional content.

Background: Neurobiology of psychopathy is important for our understanding of current neuropsychiatric questions. Despite a growing interest in biological research in psychopathy, its neural underpinning remains obscure.

Methods: We used functional magnetic resonance imaging to study the influence of affective contents on brain activation in psychopaths.

Frontal lobe atrophy due to a mutation in the cholesterol binding protein HE1/NPC2.

This is the first description of slowly progressive Niemann-Pick disease type C (NPC) without the typical lysosomal storage in bone marrow and viscera in two descendants of a group of 17th century French-Canadians. The index patient was a married 43-year-old woman with onset of dementia in her thirties, later followed by the development of ataxia and athetoid movements. Her autopsy disclosed frontal lobe atrophy, neurolysosomal storage with oligolamellar inclusion and tau-positive neurofibrillary tangles.

Alzheimer's second patient: Johann F. and his family.

Alois Alzheimer evaluated five cases of Alzheimer's disease in the early 20th century. We focused on the family of "Johann F.," Alzheimer's second patient, who died in October 1910 at age 57 years, and whose brain pathology is typical of a subgroup of Alzheimer's disease, the so-called "plaque-only type.