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Abstract: The psychotherapeutic care of people with multiple sclerosis (MS) is highly relevant. In addition to the obvious motor and sensory dysfunctions, the quality of life of those affected is also limited by the so-called "invisible symptoms" of MS. These invisible symptoms include depressive symptoms, fatigue, anxiety, pain, and cognitive deficits. This review provides an overview of the psychotherapeutic treatment options for evidence-based interventions regarding each symptom as well as a recommendation for action for treating (neuro-)psychologists and therapists. We conducted a (nonsystematic) literature search via PubMed for this purpose. The review shows that cognitive behavioral therapy (CBT) and mindfulness-based interventions (AIs) are potentially effective methods for reducing the symptoms mentioned, but that high-quality studies with sufficient sample sizes are still lacking in this field of research. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Psychosomatische Medizin und Psychotherapie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Antidepressive pharmacotherapy has undergone various phases in its history. The euphoria of the early years on the relief of depressive symptoms was followed by a long period of clinical experience and intensive scientific work resulting in a more balanced perspective. Current debates circle around the actual effectiveness, especially with respect to long-term treatment, the prevention of suicide and the sequelae of discontinuation of an antidepressant. The evaluation of antidepressants as a group and often also the risk-benefit ratio of an individual treatment change over time. Antidepressants are typical for many forms of psychiatric treatment which, in a term from Hanfried Helmchen, are just as Janus-faced as psychiatry in a general sense is as a science and as a clinical discipline. [ABSTRACT FROM AUTHOR]

Whereof one cannot speak, thereof one can sing The article describes an in-depth psychoanalytic treatment of a man suffering from depression, inner emptiness and the consequences of earlier traumatic experiences. It begins with behavioral pre-treatment, which lays the foundation for later psychoanalytic psychotherapy. Over the course of the therapy, an intensive process unfolds in which the patient works through deep inner states and traumatic experiences. The article sheds light on the complexity of the treatment, which is characterized by the interweaving of structural, conflict-related and traumatic aspects, and shows how the therapeutic relationship and creative forms of expression contribute to healing. [ABSTRACT FROM AUTHOR]

Copyright of Ergoscience is the property of Schulz-Kirchner Verlag Gmbh and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Lithium is considered the gold standard for the treatment of bipolar affective disorder for the prevention of recurrence of manic and depressive episodes and for augmentation treatment in unipolar severe depressive episodes. The indications for treatment with lithium do not differ for older or younger patients. Nevertheless, there are a number of aspects to be considered with respect to drug safety in the group of old patients. Objective: The aim was to give an overview of the current literature on lithium treatment in old age and from this to derive recommendations for action. Material and methods: A selective literature review on lithium treatment in old age was conducted to answer questions on drug safety, monitoring (particularly with respect to comorbidities) and potential alternatives to lithium. Results and discussion: Lithium is an effective and, if used correctly, safe drug also in old people; however, with respect to somatic comorbidities that increase with age, special caution is required when using lithium in order to prevent nephropathy and intoxication. [ABSTRACT FROM AUTHOR]

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Background: Depressive disorders are a frequent reason for consultations in general practice. Evidence-based guidelines for diagnosis and treatment of unipolar depression support general practitioners (GPs) in the treatment of patients. Objectives: To present the up-dated version of the German National Guideline (NVL)--Unipolar Depression and its relevance for primary care providers. Materials and methods: Comparison of the 2022 and 2015 versions of the NVL--Unipolar Depression with a focus on GP practice. Results: The updated version of the NVL picks up on current scientific developments and advises on new drugs such as esketamine and increasingly relevant treatment strategies such as internet- and mobile-based interventions (IMI). In particular, the areas of functioning and participation are highlighted in their importance for diagnosis and treatment. In contrast to the previous version of the NVL on unipolar depression, no recommendation is made regarding "watchful waiting" as a therapy alternative. The new version of the NVL emphasizes "shared decision making" and the involvement of relatives. Conclusion: The updated version of the NVL emphasises the importance of GP care for unipolar depression. However, it does not go into detail onwhether and howguidelines should be implemented in clinical practice. Close cooperation between users and the guideline group seems to be particularly important when it comes to implementing evidence-based recommendations in practice. [ABSTRACT FROM AUTHOR]

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OBJECTIVE: Chronic obstructive pulmonary disease is currently the fourth leading cause of death in the world. Pulmonary rehabilitation is recommended for chronic obstructive pulmonary disease. MATERIAL AND METHODS: This study aimed to evaluate the effects of non-invasive ventilation, supplemental oxygen, and exercise training and supplemental oxygen during exercise training during pulmonary rehabilitation practice in comparison with only exercise training on lung functions, blood gases, lactate levels, respiratory muscle pressures, dyspnea, walking distances, quality of life, and depression in patients with severe chronic obstructive pulmonary disease. The main outcome measure is exercise capacity (6-minute walk test), and the secondary end-point included quality of life. RESULTS: Thirty-five patients (mean ± SD age, 65.4 ± 6.5 years) with a mean bronchodilator forced expiratory volume in the first second of expiration of 39.4 ± 7%, undergoing an 8-week outpatient pulmonary rehabilitation, were randomized to either non-invasive ventilation, supplemental oxygen, and exercise training, supplemental oxygen during exercise training, or exercise training groups. The improvements in respiratory muscle strength were higher in non-invasive ventilation, supplemental oxygen, and exercise training patients than the moderate improvements in the exercise training group. Both non-invasive ventilation, supplemental oxygen, and exercise training and supplemental oxygen during exercise training groups showed significant increases in the 6-minute walk test and incremental shuttle walk test. However, the increase in walking distance was better in non-invasive ventilation, supplemental oxygen, and exercise training group (69.8 ± 53.2 m in 6-minute walk test and 66.6 ± 65.2 m in incremental shuttle walk test, P = .001 and P = .005, respectively) compared to supplemental oxygen during exercise training group (42.5 + 55.5 m in 6-minute walk test and 53.5 + 70.2 m in incremental shuttle walk test, P = .01 each, respectively). The total St. George's Respiratory Questionnaire score was similar in all study groups after the intervention. Symptoms of depression significantly improved only in non-invasive ventilation, supplemental oxygen, and exercise training group (-2.8 + 2.8, P = .006). CONCLUSION: Non-invasive positive-pressure ventilation (NIPPV) added to supplemental oxygen during exercise training was associated with better physiological adaptations than other modalities. [ABSTRACT FROM AUTHOR]

Fathers also play an important role during pregnancy and the postpartum period, both for the partner and for the child. With changes in society and increasing early involvement in the care of infants, the father-child relationship has become increasingly more important in recent years. There is growing evidence that fathers can also suffer from mental illnesses during their partner's pregnancy and especially after the birth of a child. As the transition to the role of a father is a major change in a man's life, the birth of a child can be a life event that contributes to a first time mental illness or triggers a new episode of an already existing illness. For example, birth complications can also traumatize the attendant fathers and result in trauma sequelae. Peripartum anxiety disorders and depression probably affect approximately 5% of all men and can among other things have a negative impact on the development of exposed children. Specific screening or even treatment services for affected men are still very rare and little research has been performed. Much less is known about the prevalence, risk factors, and treatment of other mental illnesses in fathers, and there is still a great need for research in this respect. [ABSTRACT FROM AUTHOR]

The present review article describes the basic principles of psychiatry and psychiatric disorders. Mental illnesses are common and debilitating worldwide. The most important psychiatric disorders, their origins, prevalence, and treatment options are described. The diagnostic manuals DSM-5 or ICD are used for classification and diagnosis. Treatment options in psychiatry are adapted to individual needs and include psychopharmacological therapy combined with psychotherapy and biological approaches. Psychiatry also deals with ethical and legal issues in the treatment of mental illnesses. [Extracted from the article]

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Treatment bottlenecks in outpatient psychotherapy have led to various legislative initiatives in recent years. One of these ideas was the implementation of diagnosis-specific treatment quotas. Based on this healthcare policy proposal, the question arose to what extent empirical data support or refute such a practice, i.e., how "homogeneous" are patients with the same ICD-10 diagnosis from a psychodynamic perspective. Using qualitative content analysis 13 reports on patients with an initial diagnosis of major depressive disorder, recurrent, moderate (F33.1) were evaluated, who were then examined within the German assessment procedure for outpatient treatment. In addition, the general level of functioning was assessed and the maturity of defence mechanisms was compared with the presence of comorbid mental diagnoses. A total of 56 pages of text material were analyzed. Based on this, 4 different types of conflict (self-esteem, closeness-distance, submission, guilt) were identified as well as structural impairments in 4 areas (self-perception and object perception, self-regulation, attachment, and identity), in the presence of diverse treatment goals and forms of interaction. The defence mechanisms ranged from immature to neurotic levels, which were not related to the presence of other comorbid diagnoses. The level of functioning suggested a broad spectrum of general impairment. The results indicate that unipolar depression has multiple manifestations and psychodynamic backgrounds. This is in contradiction to the idea of an assignment of ICD-10 diagnosis and treatment quotas. [ABSTRACT FROM AUTHOR]

Abstract: Deep Brain Stimulation ("DBS") is a minimally invasive, neurosurgical and hypothesis-driven therapeutic procedure for permanent local regulation of pathological circuits. While depression represents a heterogeneous syndrome with multifactorial etiopathogenesis, neuroscience research is advancing evidence to identify network-level mechanisms that play an important role in the pathophysiology of depression. In the following article, we will review the role of DBS in treatment-resistant or difficult-to-treat depression. The aim is to increase the awareness of DBS and to discuss the challenges of its therapy and implementation. [ABSTRACT FROM AUTHOR]

A randomized clinical study in the USA examined the effects of pharmacogenetic testing on medication selection and symptom remission in severe depressive disorders. The results showed that the use of these tests reduced the prescription of antidepressants with known gene-drug interactions. However, the effects on symptom remission did not persist over time. The study had advantages and disadvantages, and it was found that pharmacogenetic testing is only beneficial for about 20% of those affected overall. A study from Sweden and Norway examined the effects of early introduction of potentially allergenic foods on the development of food allergies in infants. The risk of food allergies was significantly reduced in the group with early introduction of complementary foods compared to the group without intervention. Another study examined the effects of ezetimibe and PCSK9 inhibitors on cardiovascular risk. The study shows that adding ezetimibe to the maximum tolerated statin dose reduces the risk of myocardial infarction and stroke. [Extracted from the article]

Background: Since 2020, family physicians have been able to prescribe digital health interventions to people with statutory health insurance. Especially for people with depressive disorders, these digital interventions offer a perspective during waiting times for specialist or therapeutic care. Currently, it is not known how family physicians integrate digital health interventions into treatment for people with depressive disorders. Therefore, this article focuses on the reasons for and against the prescription of these interventions froma family physician perspective. Methods: A qualitative interview study was conducted with family physicians (n= 17) from January--April 2022. The data were analyzed according to the qualitative content analysis. Results: Treatment of patients with mild and moderate depression is challenging for family physicians. Meanwhile digital health interventions for depression are rarely used in family medicine. Physicians describe a lack of knowledge concerning the tools. Digital health interventions are discussed controversially by physicians: advantages from a family physician's perspective are, for example, the chance to offer patients a low-threshold, readily available treatment option with diverse language options. Supporting patient's self-management and extended treatment options for family physicians are further positive aspects. Criticized are costs and evidence basis of the interventions. Their patients are not seen as the right target group. Overall, there is a consensus that the prescription of digital interventions needs to be embedded in a personal provision of medical care. Conclusion: Overall, the evaluation of digital interventions by family physicians is quite ambivalent: though depressive disorders represent a burden in family medicine, they are not or with limited extent perceived as support or relief for physicians. [ABSTRACT FROM AUTHOR]

Copyright of Praxis der Kinderpsychologie und Kinderpsychiatrie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A randomized controlled study examined the effectiveness of digital cognitive behavioral therapy for insomnia (dCBT-I) in the German standard care. The study included 238 participants aged ≥ 18 years who were assigned to either the dCBT-I group or the waitlist control group. After 8 weeks, the dCBT-I group showed a significant reduction in the severity of insomnia compared to the control group. dCBT-I also led to long-term improvements in daytime functioning, quality of life, and symptoms of depression and anxiety. The authors interpreted the study as evidence of the effectiveness of dCBT-I in standard care, although some methodological limitations were discussed. [Extracted from the article]

The study examines the influence of the COVID-19 pandemic on mental health. The results show that there were no overall negative changes in mental health or anxiety symptoms, but there was a minimal worsening of depression symptoms. In women, all three factors were slightly worsened, possible reasons for this include the situation of single mothers and domestic violence. A slight increase in depression symptoms was observed in older individuals, students, and members of sexual minorities. The study is continuously updated. [Extracted from the article]

The present study examines the effects of the COVID pandemic on mental health. It has been found that the pandemic had a negative impact on mental health. However, it is pointed out that the use of easily applicable scales to assess mental health can lead to an overestimation of the prevalence of problems. In a study, over 90,000 publications on the topic of mental health during the pandemic were evaluated. The summarized evidence from 137 studies did not show negative changes in overall mental health or anxiety symptoms, but a minimal worsening of depression symptoms. In women, all three factors worsened to a small extent. In older individuals, students, and members of a sexual minority, a slight increase in depression symptoms was observed. The study is continuously updated. In another study, a smartphone intervention to reduce alcohol consumption among students was examined. After one year, the students in the app group drank 10% less alcohol per week. [Extracted from the article]

Relatives of patients with depression represent a care group that have been largely neglected. Evidence has shown that they experience high levels of stress, whilst being at an increased risk of developing depression themselves. Psychoeducational support services for relatives can reduce stress. This article highlights the current situation that relatives experience, and provides opportunities to convey quick help to target persons. [ABSTRACT FROM AUTHOR]

Copyright of Public Health Forum is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Psychosomatische Medizin und Psychotherapie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Background: This study investigated the extent to which the cognitive impairment of alcohol-dependent patients improves relative to abstinence and depression. Methods: We examined alcohol-dependent patients with (n = 22) and without depression (n = 58) neuropsychologically and regarding depressivity three times (after withdrawal, 6 weeks later, and 6 months later). Additionally, we examined 33 healthy control subjects. Results: Alcohol-dependent patients showed decreased reasoning compared to healthy control subjects. In the further course, abstinent patients tended to perform better than relapsed patients, and depressivity was associated with weaker performance. Discussion: Alcohol-dependent patients suffer from cognitive deficits, some of which seem to improve in the further course of treatment, especially with abstinence. [ABSTRACT FROM AUTHOR]

Copyright of Lernen und Lernstörungen is the property of Hogrefe AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Psychosomatische Medizin und Psychotherapie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Psychosomatische Medizin und Psychotherapie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sports and exercise therapy is an effective complemant in the treatment of major depression. The recommendations of at least 150 minutes of moderate or 75 minutes of intensive physical activity per week should be met to achieve positive effects of physical activity. In addition, individual needs and the physical health conditions must be considered in the planning and implementation, so that exercise will be enjoyed in the long term. [ABSTRACT FROM AUTHOR]

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Copyright of Praxis der Kinderpsychologie und Kinderpsychiatrie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Problem cases in gynecological practice include patients with complaints in the vulva area – especially if the diagnosis has shown that there is no clear organic cause. These patients offer a physical sympton on which they are fixated on. The mostly chronic existing complaints lead to psychological, sexual, social and almost always to partnership problems. Comprehensive psychosomatic anamnesis includes a wide variety of controversial affects, such as deeply repressed anger, identity and role conflicts, repression and denial of pleasurable sexuality. One finds anxiety disorders, depression and post-traumatic stress disorder. In the sense of a somatization disorder, the patients show a physical symptom and are convinced that an organic cause is the basis. The way of dealing with these patients is to „decipher“ this symptom of vulvodynia and to put it into the context of the patient‘s personality and her bio-psycho-social situation. Only gynecological, psychosomatic and sexual medicine diagnostics, beginning as early as possible, ideally with the initial gynecological examination, enables an immediate holistic view of the patient and her suffering. Already during the first gynecological examination, the doctor should make clear to the patient during careful rectovaginal palpation that the significantly increased muscle tone of the pelvic floor muscles is most probably the main cause of the chronic pain. After the gynecological examination, this finding is visually enhanced with image material from the anatomy atlas. In this way, a common disease model, the so-called “Passung” can be established. This is important for the development of the doctor-patient relationship, during which the manifold possible causes for the patient‘s vulvodynia can be derived from her biography, “deciphered” as a somatization disorder and gradually resolved. A high-dose magnesium therapy and a pharmacotherapy with selective serotonin reuptake inhibitors (SSRI) that changes the “pain memory” leads to a significant reduction in pain and changes the frequently encountered – often compulsive – search for a somatic cause of the patient’s pain. A therapeutic manner radiating patience, calmness and optimism can promote this process. In addition, targeted physiotherapy in the pelvic floor-vulva perineal area by specially trained therapists is supportive and helpful. A too rapid psychologization or even referral to the psychotherapist is to be avoided, as this can lead to the termination of the doctor-patient relationship. In the field of sexuality, the involvement of the partner in a couple‘s therapeutic setting with instructions for body exercises – as they are known from vaginismus therapy – allows pain to gradually become pleasure. Surgical intervention should be avoided because it irreversibly destroys anatomical structures that are important for the sexual experience of the woman. [ABSTRACT FROM AUTHOR]

Stopping antidepressants can cause withdrawal (discontinuation) symptoms, the return of the original illness, and rebound. The latter means that the disease will return stronger, faster, or with greater likelihood than if it had not been treated with medication. The Psychiatry Working Group of the Drug Commission of the German Medical Association (AkdÄ) presents the scientific findings and provides practical recommendations for action. Withdrawal symptoms are multiform; unspecific physical symptoms are predominant. Distinguishing them from the recurrence of depressive symptoms can be difficult. Most of them are mild and self-limiting. There is insufficient evidence on the extent and frequency of rebound depression. The rebound risk implies that when establishing the medication, the short-term benefit must be weighed against the possible long-term risk of chronic depression or the possible need for long-term medication. Patients should be informed about the risk of withdrawal both as early as the joint decision-making process about treatment initiation and regularly during the course of treatment. Withdrawal should take place gradually, except in emergency situations, whereby small steps should be taken, especially in the low-dose range. [ABSTRACT FROM AUTHOR]

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Copyright of Praxis der Kinderpsychologie und Kinderpsychiatrie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Praxis der Kinderpsychologie und Kinderpsychiatrie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Praxis der Kinderpsychologie und Kinderpsychiatrie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)