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Posttraumatic stress disorder and substance use disorder often co-occur within the health care system. Their comorbidity is associated with more serious acute clinical symptomatology, more frequent hospital admissions in state of emergency and significantly lower chances of improvement by psychological and pharmacological treatment. Their comorbidity contributes to dramatically unfavourable courses of illness as regards all biopsychosocial levels. The survey presented will discuss empirical findings from various perspectives: general epidemiology, substance use disorder as risk factor of trauma and PTSD, trauma and PTSD as risk factor of SUD, neurobiological effects of SUD converging towards neurobiology of PTSD, shared common factors of genetics/epigenetics, personality traits, and early developmental stress and trauma. The main focus of analysis will be put on processes that are intrinsically linked to the development and course of both disorders., (© 2021. The Author(s).)

This article is reporting about a spontaneous occurred catatonic syndrome in a 52 years old female patients with no prior psychiatric illness record. The catatonia followed a severe depressive episode with psychotic symptoms. At the beginning additionally to the catatonic-symptoms severe disorientation and memory disturbances were prominent in a way it can be seen in neurodegenerative diseases like Lewy-Body-Dementia and Creutzfeldt-Jacob-Disease. The patient didn't respond on any medication or showed severe side-effects which led to discontinue the medication. After applying widespread somatic diagnostics, which has excluded a neurodegenerative disease a electroconvulsive therapy was applied. During this treatment the patient showed a recurrence of her catatonic symptoms but they remitted if there was a too long period between the convulsive treatments. After establishing a sufficient period between the convulsive treatments the symptoms remitted totally.

Background: The somatoform disorders include a group of complex disorders consist of somatic symptoms for which there are no identifiable organic cause or pathogenetic mechanisms. Given the importance of these disorders and the need to clarify the diagnosis of somatoform disorder affecting the suicide risk, we took into consideration the scientific literature to investigate the correlation between the two conditions., Methods: We performed a bibliographic search through Medline, Embase, PsycINFO, Scopus, SciELO, ORCID, Google Scholar, DOAJ using the following terms: somatoform, somatization disorder, pain disorder AND psychological factor, suicide, parasuicide, suicidality., Results: In all studies reported in our review, the suicidal behavior risk is high. But in the majority, the data are relatively unreliable because it takes into account the category nosographic "Neurotic, stress-related and somatoform disorders", too wide to be able to identify the clinical characteristics of patients at risk of only somatoform disorder., Conclusions: Several studies conclude that psychiatric comorbidity increases the suicide risk: patients with two or more psychiatric disorders are more likely to commit a suicide attempt; in particular if there is a axis I diagnosis, the risk reduplicate. The somatization disorder seems to have a significant psychiatric comorbidity in particular with anxious and affective disorders spectrum.

From a perspective of conceptual evolution schizoidia was initially considered to describe features both of the premorbid personality of schizophrenic patients and of the personalities of non-psychotic family members (Bleuler, Kahlbaum, Kraepelin). On a psychopatholocial level a close link to the complex basic symptom of autism was stressed. From the very beginnings of modern psychiatry schizoidia was discussed within a conceptual frame of schizophrenia spectrum disorders (Kretschmer, Hoch, Polatin). Approaches to operationalize these conceptual works laid the basis for the cluster A personalities in DSM-III. Due to the prominent concept of schizotypy (Kety, Rado, Meehl) three split up diagnostic categories of schizotypal, schizoid and paranoid personality disorders resulted. Cluster A personality disorders are frequent in community-based epidemiological studies. Health-care seeking behaviour due to primary personality-related problems, however, seems to be less paramount compared to cluster B and C personality disorders. Many family- and twin-based genetic studies convincingly stress a close link between schizotypal personality disorder and schizophrenia. This link is less pronounced for paranoid personality disorder, and even vanishingly low for schizoid personality disorder. From a perspective of schizophrenia spectrum disorders a vast amount of data from molecular genetic, neurobiological, neuropsychological and psychosocial research has impressingly confirmed this link for schizotypal personality disorder. Major research deficits, however, have to be noticed for paranoid and schizoid personality disorder.

Background: In recent years positive effects of Yoga (as a kind of spiritual exercise) in regards to subjective well-being and physical health can be found as well documented in the literature., Method: Based on a construct-psychological approach a newly developed scale for the assessment of Yoga involvement (immersion) was validated on a sample of 233 non-clinical subjects (210 females) by means of socio-demographic and well established psychometric parameters of psychological well-being and psychiatric symptoms. Furthermore, the group of yoga practitioners was compared with a control group consisting of 93 gymnastics practitioners (83 women) with respect to these parameters., Results: The amount of Yoga Immersion (YI) can be reliably assessed by means of the one-dimensional YI-scale (10 items) and shows to be strongly correlated with Mindfulness (r = .56; p < .01), Inner Correspondence (r = .61; p < .01) and Religious/Spiritual Well-being (r = .68; p < .01). Furthermore highly yoga-immersive practitioners exhibited a significant higher amount of psychological well-being (p < .01) compared to marginally/moderately yoga-immersive and gymnastics practitioners. The Yoga-group also showed a lower amount of psychiatric symptoms (e.g. depression; p < .01)., Conclusions: The globally postulated positive relationship between Yoga-practicing and mental health could be confirmed; thereby the impact of YI can be assumed as central. Further randomized controlled trial research focusing on the health/disease-related aspects of YI might be conducted especially in clinical groups.

Psychotic symptoms are common in Parkinson's disease (PD) and are associated with increased disability, worsened quality of life, and poor long-term prognosis. In this article, clinical features, hypotheses on pathogenesis, and current treatment strategies for Parkinson's disease psychosis (PDP) are reviewed. According to epidemiological studies, the prevalence of PDP is between 20 to 40 %. Complex visual hallucinations are the most common psychotic symptoms and are present in 17-72 % of the patients. Other sensory disturbances encompass tactile hallucinations and minor hallucinatory phenomena, such as sense of presence and visual illusions. Hallucinations are often accompanied by delusions, whose most frequent themes are persecution and jealousy. The pathophysiology of PDP remains unclear. Different factors have been implicated, including Levo-dopa and dopaminergic medications, neurotransmitter imbalances, neuroanatomic alterations, abnormal visuospatial processes, and genetic predisposition. The first-line strategy in the treatment of persistent and problematic PDP is represented by reduction in anti-PD medications. Second-generation antipsychotics are the treatment of choice, with clozapine being demonstrated as the most effective and tolerable drug for PD patients.

Sexuality has been defined a central feature of personal identity since the epoch of enlightenment and has gradually become a decisive issue also in societal and political terms. A major transfer from religion and religious institutions to medicine and medical experts and later on to neuropsychiatrists has to be underlined in the primary position to assess "normal" and "deviant" manifestations of sexuality. Richard Freiherr von Krafft-Ebing and Sigmund Freund play an eminent role in this "discourse on sexuality" (M. Foucault) during the nineteenth and beginning twentieth century on the way to modern sexology. Within this overarching context Krafft-Ebing's and Freud's theoretical conceptualizations of sexuality and perversion will be sketched and basic clinical and societal implications there out will be discussed.

Objective: In recent years, positive effects of religiosity and spirituality on mental health can be found as well documented in the literature. However, very few studies have examined the effects of a spiritually based therapeutic intervention among psychiatric patients., Method: For this reason, in this pilot study we examined the effectiveness of a morning body-centered meditation in comparison to a conventional morning walk in regards to subjective well-being and stress coping styles in 44 (26 females) randomly assigned psychiatric in-patients (according to ICD 10). The patients' amount of subjective well-being as well as their coping ability was assessed at the beginning and at the end of a 6 weeks therapy., Results: Thereby we found a significant increase in Religious/Spiritual Well-Being, Awareness and more adequate Coping strategies. This was paralleled by a decrease of psychiatric symptoms. Overall the general assumption of a positive association between spirituality and mental health was affirmed. However, we did not find any differences between the two treatment methods (meditation vs. morning walk)., Conclusions: Both interventions showed the same positive efficacy. Based on these initial results, possibilities and boundaries for the integration of religious/spiritual issues into the treatment of psychiatric patients are discussed.

Objective: The Multidimensional Inventory for Religious/Spiritual Well-Being (MI-RSWB) was successfully applied in several clinical as well as non-clinical studies. However, the original version of the scale often showed to be as too comprehensive especially for clinical surroundings. There for the aim of this study is to develop a short version of the scale comprising 12 items., Method: Based on a sample representative of the Austrian general population (N = 1,500), a first MI-RSWB short version is developed by means of factor- and reliability analysis. Furthermore the new short version of the scale is initially validated through several indicators of mental illness., Results: The MI-RSWB short version shows convincing psychometric properties. The total scale as well as the sub scales exhibit at least a sufficient internal consistency. A significant negative association with several indicators of psychiatric illness is also confirmed for the short version of the scale., Conclusions: The MI-RWSB 12 scale is especially recommended for further research focusing on the clinical relevance of religiosity and spirituality.

The high rate of co-existent emotional disorders in major neurological disorders, such as epilepsy and multiple sclerosis is challenging. As a rule, this co-existence comprises a more dramatic subjective suffering, a reduced psychological coping, possible negative interferences with somatic treatments and rehabilitations, an impaired quality of life and higher grades of psychosocial disability. It may also lead to an overall increased risk of somatic morbidity and even mortality in the further course of illness. These complex interrelations may be favourably integrated within a biopsychosocial model. Psychological and psychosocial stressors can be appreciated on their own discrete levels, have to be reflected, however, in their neurobiological correlates. Both neurological and emotional disorders frequently share decisive pathogenetic mechanisms, i.e. the underlying process of neurological disease may contribute to major affective problems also in a somato-psychic direction. In addition, mutual interactions of both neurological and psychiatric treatments in their impact on the emotional and neurological risks have to be appreciated.

Any association of early childhood maltreatment and later risk of psychosis may be favourably investigated by epidemiological studies in the general population. Primary outcome variable in these studies is the prevalence of subclinical psychotic symptoms (hallucinations, delusions) in early trauma-exposed groups compared to control groups without any significant trauma in childhood. A systematic literature search underlines a significant association of early childhood trauma and later non-clinical psychotic symptoms in representative samples of the general population both during childhood, adolescence and adulthood. Important questions deal with the issues, which psychological, psychosocial and neurobiological mechanisms may mediate the risk of early trauma in respect of later psychotic symptoms on the one side, and which factors may determine the transition from non-clinical psychotic symptoms to major psychotic disorders cared for within mental health services. Both theoretical models and first data derived from empirical studies will be presented.

Objective: The aim of this study is to investigate different dimensions of religiosity and spirituality among psychiatric in-patients. The study examines differences between addictive (ICD 10: F1x) and anxious/depressive (ICD 10: F3x/F4x) patients and considers the main implications for treatment., Method: Differences in dimensions of religious/spiritual well-being (RSWB) between addictive (n = 389) and anxious/depressive patients (n = 200) are investigated, also by comparison to a control group (n = 1,500). Furthermore dimensions of RSWB are related to personality factors and different psychiatric parameters within the psychiatric groups., Results: The psychiatric groups show a lower amount of overall RSWB (p < 0.001) than the healthy controls. Furthermore, dimensions of RSWB turned out to be negatively correlated with several psychiatric symptoms., Conclusions: Based on these results we emphasize religious/spiritual issues within psychiatric treatment. Moreover, there may be a strong potential of the RSWB dimensions such as "Hope" or "Forgiveness" as positive therapeutic factors in psychiatric treatment.

Objective: A sample of patients with a puerperal psychosis of an early manifestation is investigated in respect of special risks of suicide and infanticide., Methods: During a 20-year period 96 patients who had been fallen ill with a puerperal psychosis within four weeks after delivery were admitted to a psychiatric university hospital. Patients with an acute exacerbation of a known schizophrenic disorder were excluded. In a subgroup of 37 patients states of a previous (affective, bipolar affective) psychotic illness were recorded already before the puerperal index episode, in a subgroup of 59 patients puerperal psychosis was the first manifestation of a psychotic illness. Suicide- and infanticide-relevant psychopathological symptoms were analysed (suicidal ideas/behaviour before/during inpatient treatment, general disorganized aggression, psychotic anxieties related to baby, infanticidal obsessions, aggressive ideas/behaviour towards baby, neglect, infanticidal impulses)., Results: Puerperal psychoses were distributed to the diagnostic categories of psychotic depressive disorder, bipolar affective disorder, and schizoaffective disorder. Six patients died due to suicide, tragically already some few days till weeks after discharge from psychiatric hospital, despite a pronounced or even complete remission of puerperal psychotic symptoms at the time of discharge. Three patients committed an extended suicide attempt that resulted in two infanticides. All isolated and extended suicides were committed in a state of depressive mood and presumably synthymic delusion., Conclusions: Suicidal ideas and behaviour play a major role in patients with puerperal psychosis before and during inpatient treatment. An increased risk for mothers and babies may persist, however, even after a seemingly good symptomatic remission. Besides the clinical challenge of general prevention of puerperal psychosis the request of adequate models of inpatient treatment, carefully prepared discharge, close afterdischarge follow up, and continuous outpatient care have to be stressed.

A comprehensive literature stresses a high percentage of severe childhood maltreatment in the history of many psychotically ill patients treated in mental health services. Early childhood abuse seems to be associated among other things with a more severe clinical state, a more chronic course of illness and a more unfavourable psychosocial adaptation. In order not to jump to unwarranted causal conclusions, several conceptual und methodological problems have to be clarified before. From a conceptual perspective psychotic disorders diagnosed according to conventional criteria define only a minor subgroup within a much broader psychosis continuum in general population. Early childhood abuse has to be differentiated according to type, severity, timing, and context. The rates of early childhood abuse are high in general population. The methods of measurement of psychotic symptoms on the one side, of early trauma on the other side have to be critically evaluated. There is an empirically well founded association of childhood maltreatment and psychological and psychosomatic morbidity during adult years in general. In order to establish a potential conditional link also to psychotic disorders, clinical populations have to be compared to adequate control groups at least. A systematic literature search shows a very small number of studies including control groups at all. These studies underline that early childhood abuse may be significantly associated to the risk of psychosis indeed. The conditional role of early childhood abuse, however, has to be investigated only within a multifactorial biopsychosocial model of psychotic illness.

Case report on a 31-year old woman with chronic schizophrenia turning to a gynaecological university outpatient clinic with her husband and asking for an in vitro fertilization. After referral to the psychiatric consultation service the patient's psychiatric and psychosocial history was taken. The issue of indication was settled by considering medicoethical aspects, general risks in respect of the course of illness in pregnancy, postpartum period, and parenthood, and the special psychological burden due to in vitro fertilization with the issues of multiple pregnancy and the dilemma of fetal reduction. The patient's course during a triple pregnancy, postpartum period and early parenthood is described.

Recently Deep brain stimulation (DBS) has found continuous use in treatment of neurological movement disorders. However DBS in psychiatric illnesses is less investigated. Its application in depression, obsessive-compulsive disorder, and therapy-resistant Tourette- Syndrome shows positive effects and offers an advanced alternative to neurosurgical therapies of the past. There are also case reports suggesting therapeutic benefits in schizophrenia and addiction. To a large extent, the mechanisms of action appear to be still unknown; the side effects seem partially modulated through the stimulation parameters. Furthermore, some ethics committees argue that DBS exhibits a relevant impact on the personality. The novel approach as well as the unknown long term effects of DBS implicate that the technique can be performed only under strict individual diagnosis and rigorous consideration of all ethical concerns.

Anxiety disorders are highly prevalent in the general population, their course of illness is often chronic with many relapses, and is associated with a pronounced psychiatric comorbidity and psychosocial disability. Therefore, anxiety disorders are a major challenge to any mental health delivery system. From a perspective of treatment both differential psychopharmacological and psychotherapeutic interventions can be outlined which are well based in empirical terms. In psychiatric care biological and psychological approaches are often combined although the empirical basement of combined treatments still requires further validation.