Characteristics of clinical-pharmacological recommendations in psychiatry in Germany.

Objective: Psychiatric patients in general, and elderly psychiatric patients in particular, are at risk of adverse drug reactions due to comorbidities and inappropriate polypharmacy. Interdisciplinary and clinical-pharmacologist-led medication reviews may contribute to medication safety in the field of psychiatry. In this study, we reported the frequency and characteristics of clinical-pharmacological recommendations in psychiatry, with a particular focus on geriatric psychiatry.

Shrink that frown! Botulinum toxin therapy is lifting the face of psychiatry.

Treating glabellar frown lines with injections of botulinum toxin is the most frequently applied procedure in aesthetic medicine. In addition to its cosmetic effect, botulinum toxin may also positively modulate mood and affect, which may contribute to its popularity. A series of clinical studies has shown that this modulation can be used in the treatment of major depression.

Reduced muscle mass in middle-aged depressed patients is associated with male gender and chronicity.

Objective: Reduced muscle mass is a characteristic finding in sarcopenia, the central element of physical frailty syndrome, and a major cause of physical function decay, morbidity and mortality in the elderly. Studies so far demonstrated reduced muscle mass in depressed patients with an average age over 60years. An open question is whether muscle mass reduction is already observed earlier.

The New Hamburg-Hannover Agitation Scale in Clinical Samples: Manifestation and Differences of Agitation in Depression, Anxiety, and Borderline Personality Disorder.

Background/aims: Agitation is a burdening phenomenon that occurs in a variety of psychiatric disorders. The aim of this study was to give a first direction for agitation occurrence in depression, anxiety disorder, and borderline personality disorder (BPD) as well as in healthy controls with and without psychiatric record.

Methods: Using the Hamburg-Hannover Agitation Scale (H2A), an instrument that allows for the measurement of agitation independently of the presence of a specific disorder, a patient sample (n = 158) and a healthy control group (n = 685) with (n = 94) and without (n = 591) psychiatric record were examined.

Placebo and Nocebo Effects in Sexual Medicine: An Experimental Approach.

Few studies have investigated placebo and nocebo effects in a human sexuality context. Studying placebo and nocebo responses in this context may provide insight into their potential to modulate sexual drive and function. To examine such effects in sexual medicine, 48 healthy, male heterosexual participants were divided into four groups.

Depression--An emerging indication for botulinum toxin treatment.

The treatment of glabellar frown lines with botulinum toxin injection is one of the most prevalent procedures in esthetic medicine. It is possible that the popularity of this intervention is not only owing to its cosmetic effect but also to modulatory effects on mood and affectivity. Recently, a series of studies including three randomized controlled trials have consistently shown that such effects can be used in the treatment of depression.

The Hamburg-Hannover Agitation Scale (H2A): Development and validation of a self-assessment tool for symptoms of agitation.

Background: Agitation has long been underestimated as a symptom occurring across psychiatric disorders. While several instruments exist for highly specific clinical target groups (e.g.

The Neurobiology and Psychology of Pedophilia: Recent Advances and Challenges.

A pedophilic disorder is recognized for its impairment to the individual and for the harm it may cause to others. Pedophilia is often considered a side issue and research into the nature of pedophilia is delayed in comparison to research into other psychiatric disorders. However, with the increasing use of neuroimaging techniques, such as functional and structural magnetic resonance imaging (sMRI, fMRI), together with neuropsychological studies, we are increasing our knowledge of predisposing and accompanying factors contributing to pedophilia development.

Diminished functional connectivity on the road to child sexual abuse in pedophilia.

Background: Pedophilia is a disorder recognized for its impairment to the individual and for the harm it may cause to others. However, the neurobiology of pedophilia and a possible propensity to sexually abuse children are not well understood. In this study, we thus aimed at providing new insights in how functional integration of brain regions may relate to pedophilia or child sexual abuse (CSA).

Brain alterations in paedophilia: a critical review.

Psychosocial and biological factors have been implicated in paedophilia, such as alterations in brain structure and function. The purpose of this paper is to review the expanding body of literature on this topic including brain abnormality case reports, as well as structural and functional neuroimaging studies. Case studies of men who have committed sexual offences against children implicate frontal and temporal abnormalities that may be associated with impaired impulse inhibition.

Treatment of major depressive disorder using botulinum toxin A: a 24-week randomized, double-blind, placebo-controlled study.

Objective: To determine whether a single treatment of botulinum toxin A in the forehead (glabellar) region can improve symptoms of depression in patients with major depressive disorder (MDD), as defined by DSM-IV criteria.

Method: Thirty participants were randomly assigned to receive either placebo or botulinum toxin A (BTA; onabotulinumtoxinA) injections in the forehead. Female participants received 29 units; male participants received 39 units.

Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial.

In a randomized, controlled trial (n = 30), we showed that botulinum toxin injection to the glabellar region produces a marked improvement in the symptoms of major depression. We hypothesized that the mood-lifting effect was mediated by facial feedback mechanisms. Here we assessed if agitation, which may be associated with increased dynamic psychomotor activity of the facial musculature, can predict response to the treatment.

Cox's Chair Revisited: Can Spinning Alter Mood States?

Although there is clinical and historical evidence for a vivid relation between the vestibular and emotional systems, the neuroscientific underpinnings are poorly understood. The "spin doctors" of the nineteenth century used spinning chairs (e.g.

Hypersexual behavior in an online sample of males: associations with personal distress and functional impairment.

Introduction: The population of individuals reporting hypersexual behavior is heterogeneous. Prior research has implicated the importance of personal distress and functional impairment, as both may serve as indicators of problem severity and relevance. Still, little is known about associations with distress and impairment following hypersexuality.

Vestibular stimulation on a motion-simulator impacts on mood States.

We are familiar with both pleasant and unpleasant psychotropic effects of movements associated with vestibular stimulation. However, there has been no attempt to scientifically explore the impact of different kinds of vestibular stimulation on mood states and biomarkers. A sample of 23 healthy volunteers were subjected to a random sequence of three different passive rotational (yaw, pitch, roll) and translational (heave, sway, surge) vestibular stimulation paradigms using a motion-simulator (hexapod).

Individual and dyadic barriers to a pharmacotherapeutic treatment of hypoactive sexual desire disorders: results and implications from a small-scale study with bupropion.

This article describes the results of an independent small-scale trial with the centrally acting agent bupropion for female hypoactive sexual desire disorder. The main goals were to gain insight into the intrapsychic and interpersonal barriers to improvement associated with the pharmacological treatment of this common disorder. Eligible subjects entered a 2-week run-in period and a 4-week placebo phase, followed by a 20-week treatment phase.

Endoscopy for repeatedly ingested sharp foreign bodies in patients with borderline personality disorder: an international survey.

Background: The general guidelines on the management of ingested foreign bodies (FBs) do not address specific aspects raised by psychiatric patients, particularly in patients with borderline personality disorders (BPD) who repeatedly ingest FBs. The aim of this survey was to collect data on experience and opinions on the management of FBs in psychiatric patients with BPD and to review the relevant literature.

Methods: A survey focusing on the indication and the timing of endoscopy for sharp FB removal in patients with BPD was e-mailed to 215 gastroenterologists, psychiatrists, and surgeons in Switzerland, Germany and Austria, discussing this clinical problem using a specific case vignette.

Facing depression with botulinum toxin: a randomized controlled trial.

Positive effects on mood have been observed in subjects who underwent treatment of glabellar frown lines with botulinum toxin and, in an open case series, depression remitted or improved after such treatment. Using a randomized double-blind placebo-controlled trial design we assessed botulinum toxin injection to the glabellar region as an adjunctive treatment of major depression. Thirty patients were randomly assigned to a verum (onabotulinumtoxinA, n = 15) or placebo (saline, n = 15) group.

Prolactin secretory rhythm in women: immediate and long-term alterations after sexual contact.

Background: Prolactin (PRL) is one of the most versatile hormones in the mammalian body, affecting reproductive, sexual and other functions. In rats, mating or vaginocervical stimulation activates a characteristic PRL secretory pattern for several days, which is essential for successful reproduction. Although the underlying mechanisms appear to be different, PRL is also crucial for human fertility.