[Current aspects on the antipsychotic treatment of older people with schizophrenia spectrum disorders].

Background: From a geriatric perspective, the use of antipsychotic drugs (AP) is associated with significant risks in addition to their known effects. These include unfavorable interactions with geriatric syndromes, such as immobility and risk of falling, and potentially increased mortality, at least in certain patient groups. With reference to this the current state of knowledge on treatment with AP in older people with schizophrenia spectrum disorders is summarized with a focus on the typical multimorbidity of geriatric patients.

Interventions to Promote the Utilization of Physical Health Care for People with Severe Mental Illness: A Scoping Review.

Background: The main contributor to excess mortality in severe mental illness (SMI) is poor physical health. Causes include unfavorable health behaviors among people with SMI, stigmatization phenomena, as well as limited access to and utilization of physical health care. Patient centered interventions to promote the utilization of and access to existing physical health care facilities may be a pragmatic and cost-effective approach to improve health equity in this vulnerable and often neglected patient population.

[Palliative care of persons with dementia and delirium].

The number of people with dementia and delirium not induced by alcohol and other psychoactive substances has significantly increased during the last decades and will rise further in the future, particularly in the oldest old. In the vast majority of cases dementia is characterized by a progressive course with shortened life expectancy and a lack of curative treatment options. Delirium will remit in many cases; however, in a substantial proportion of patients the further course is unfavorable.

Mortality and Medical Comorbidity in the Severely Mentally Ill.

Background: Mentally ill patients die on average 10 years earlier than the general population, largely due to general medical disorders. This study is the first to explore in a large German sample the prevalence, mortality, and medical comorbidity in pa- tients with severe mental illness (SMI). The patients were affected by borderline personality disorder (BPD), psychotic disorders, bipolar disorder, or severe unipolar depression.

[Somatic risks in elderly people with severe psychiatric illnesses].

Background: Aged patients with severe mental illness (SMI) suffer from a high risk for functional impairment and a high load of somatic comorbidities. Until now, there has been a lack of systematic studies on this patient population in later life. This review summarizes the most significant somatic comorbidities and discusses the consequences for the medical care of this elderly group of patients.

[Treatment with psychotropic agents in patients with dementia and delirium : Gap between guideline recommendations and treatment practice].

Background And Objectives: Psychiatric symptoms in dementia and delirium are associated with a substantially reduced quality of life of patients and their families and often challenging for professionals. Pharmacoepidemiological surveys have shown that, in particular, patients living in nursing homes receive prescriptions of psychotropic agents in significant higher frequency than recommended by current guidelines. This article focuses on a critical appraisal of this gap from the point of view of German healthcare services.

Influence of anesthetic drugs and concurrent psychiatric medication on seizure adequacy during electroconvulsive therapy.

Objective: Electroconvulsive therapy (ECT) is performed under anesthesia and muscle relaxation. Only well-generalized seizures seem to have the high "adequacy" or "quality" that have been claimed to reflect positive predictive power for the outcome of an ECT course. The induction of well-generalized seizures can be potentially influenced by several variables.

Testing the association between thyroid dysfunction and psychiatric diagnostic group in an iodine-deficient area.

Objective: To test the association between thyroid dysfunction and psychiatric diagnostic group in a large sample of consecutive patients, while controlling for the effects of age, sex, medication and concomitant medical conditions.

Methods: We compared the distribution of psychiatric diagnostic groups according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), and of selected psychopathological symptoms in 100 newly admitted psychiatric patients who had genuine thyroid disease and 92 psychiatric patients who had nonspecific alterations of thyroid function with the corresponding items for the whole group of admitted patients (n = 1134) during the observation period. This analysis was then repeated using an age-matched and sex-matched comparison group selected from all admitted patients in a random order.

[Quality of care in internal medicine in German psychiatric hospitals].

Objective: Study on selected aspects of structural quality of care in internal medicine in German psychiatric hospitals.

Method: Investigation by questionnaire completed by medical directors of German psychiatric hospitals (response quote 48.8 %).

[Münchhausen syndrome: diagnosis and management].

The authors review the literature on Münchhausen syndrome, and ilustrate the clinical features of the disorder with the description of a characteristic case. Diagnosis and differential diagnosis are discussed with regard to other somatoform disorders such as conversion disorder and somatization disorder as well as to malingering and schizophrenia. The awareness of general practitioners and surgeons regarding this syndrome may avoid the exposure of these patients to serious complications of unnecessary medical and surgical procedures.