@article{HeinzelLorenzPelzetal.2016, author = {Heinzel, Stephan and Lorenz, Robert C. and Pelz, Patricia and Heinz, Andreas and Walter, Henrik and Kathmann, Norbert and Rapp, Michael Armin and Stelzel, Christine}, title = {Neural correlates of training and transfer effects in working memory in older adults}, series = {NeuroImage : a journal of brain function}, volume = {134}, journal = {NeuroImage : a journal of brain function}, publisher = {Elsevier}, address = {San Diego}, issn = {1053-8119}, doi = {10.1016/j.neuroimage.2016.03.068}, pages = {236 -- 249}, year = {2016}, abstract = {As indicated by previous research, aging is associated with a decline in working memory (WM) functioning, related to alterations in fronto-parietal neural activations. At the same time, previous studies showed that WM training in older adults may improve the performance in the trained task (training effect), and more importantly, also in untrained WM tasks (transfer effects). However, neural correlates of these transfer effects that would improve understanding of its underlying mechanisms, have not been shown in older participants as yet. In this study, we investigated blood-oxygen-level-dependent (BOLD) signal changes during n-back performance and an untrained delayed recognition (Sternberg) task following 12 sessions (45 min each) of adaptive n-back training in older adults. The Sternberg task used in this study allowed to test for neural training effects independent of specific task affordances of the trained task and to separate maintenance from updating processes. Thirty-two healthy older participants (60-75 years) were assigned either to an n-back training or a no-contact control group. Before (t1) and after (t2) training/waiting period, both the n-back task and the Sternberg task were conducted while BOLD signal was measured using functional Magnetic Resonance Imaging (fMRI) in all participants. In addition, neuropsychological tests were performed outside the scanner. WM performance improved with training and behavioral transfer to tests measuring executive functions, processing speed, and fluid intelligence was found. In the training group, BOLD signal in the right lateral middle frontal gyrus/caudal superior frontal sulcus (Brodmann area, BA 6/8) decreased in both the trained n-back and the updating condition of the untrained Sternberg task at t2, compared to the control group. fMRI findings indicate a training-related increase in processing efficiency of WM networks, potentially related to the process of WM updating. Performance gains in untrained tasks suggest that transfer to other cognitive tasks remains possible in aging. (C) 2016 Elsevier Inc. All rights reserved.}, language = {en} } @misc{HeinzBeckRapp2016, author = {Heinz, Andreas and Beck, Anne and Rapp, Michael Armin}, title = {Alcohol as an Environmental Mortality Hazard}, series = {JAMA psychiatry}, volume = {73}, journal = {JAMA psychiatry}, publisher = {American Veterinary Medical Association}, address = {Chicago}, issn = {2168-622X}, doi = {10.1001/jamapsychiatry.2016.0399}, pages = {549 -- 550}, year = {2016}, language = {en} } @article{DrosselmeyerRappKostev2016, author = {Drosselmeyer, Julia and Rapp, Michael Armin and Kostev, Karel}, title = {Prevalence and type of antidepressant therapy used by German general practitioners to treat female patients with osteoporosis}, series = {International journal of clinical pharmacology and therapeutics}, volume = {54}, journal = {International journal of clinical pharmacology and therapeutics}, publisher = {Dustri-Verlag Dr. Karl Feistle}, address = {Deisenhofen-M{\~A}¼nchen}, issn = {0946-1965}, doi = {10.5414/CP202610}, pages = {743 -- 749}, year = {2016}, abstract = {Objective: To estimate the prevalence and type of antidepressant medication prescribed by German primary care physicians for patients with depression and osteoporosis. Methods: This study was a retrospective database analysis conducted in Germany utilizing the Disease Analyzer (R) Database (IMS Health, Germany). The study population included 3,488 female osteoporosis patients aged between 40 and 90 years recruited from 1,179 general practitioner practices and who were initially diagnosed with depression during the index period (January 2004 to December 2013). Follow-up lasted up to 12 months and was completed in August 2015. Also included in this study were 3,488 nonosteoporosis controls who were matched (1 : 1) to osteoporosis cases on the basis of age, health insurance coverage, severity of depression, and physician carrying out the diagnosis. Results: After 12 months of followup, 30.1\% of osteoporosis and 29.9\% of nonosteoporosis patients with mild depression (p = 0.783), 52.4\% of osteoporosis and 48.0\% of non-osteoporosis patients with moderate depression (p = 0.003), and 39.4\% of osteoporosis and 35.1\% of nonosteoporosis patients with severe depression (p = 0.147) were being treated with antidepressants. Osteoporosis patients with moderate depression had a higher chance of being prescribed antidepressant therapy at the initial diagnosis (hazard ratio (HR): 1.12, p = 0.014). No differences were found between osteoporosis and nonosteoporosis patients regarding the proportion of patients receiving selective serotonin reuptake inhibitors (SSRI)/serotonin-noradrenaline reuptake inhibitors (SNRI), tricyclic antidepressant (TCA), or other antidepressants. Osteoporosis patients were more often referred to hospitals or psychiatrists for consultation. Conclusion: Osteoporosis patients are more often treated initially with antidepressants than non-osteoporosis patients, especially within the groups of patients with moderate or severe depression. TCA was the most frequently used antidepressant therapy class on initial diagnosis in both patient groups. Osteo-porosis patients receive referrals to hospitals or psychiatrists more often than patients without osteoporosis.}, language = {en} } @article{KonradBohlkenRappetal.2016, author = {Konrad, Marcel and Bohlken, Jens and Rapp, Michael Armin and Kostev, Karel}, title = {Depression risk in patients with heart failure in primary care practices in Germany}, series = {International psychogeriatrics}, volume = {28}, journal = {International psychogeriatrics}, publisher = {Cambridge Univ. Press}, address = {New York}, issn = {1041-6102}, doi = {10.1017/S1041610216000867}, pages = {1889 -- 1894}, year = {2016}, abstract = {Background: The goal of this study was to estimate the prevalence of and risk factors for diagnosed depression in heart failure (HF) patients in German primary care practices. Methods: This study was a retrospective database analysis in Germany utilizing the Disease Analyzer (R) Database (IMS Health, Germany). The study population included 132,994 patients between 40 and 90 years of age from 1,072 primary care practices. The observation period was between 2004 and 2013. Follow-up lasted up to five years and ended in April 2015. A total of 66,497 HF patients were selected after applying exclusion criteria. The same number of 66,497 controls were chosen and were matched (1:1) to HF patients on the basis of age, sex, health insurance, depression diagnosis in the past, and follow-up duration after index date. Results: HF was a strong risk factor for diagnosed depression (p < 0.0001). A total of 10.5\% of HF patients and 6.3\% of matched controls developed depression after one year of follow-up (p < 0.001). Depression was documented in 28.9\% of the HF group and 18.2\% of the control group after the five-year follow-up (p < 0.001). Cancer, dementia, osteoporosis, stroke, and osteoarthritis were associated with a higher risk of developing depression. Male gender and private health insurance were associated with lower risk of depression. Conclusions: The risk of diagnosed depression is significantly increased in patients with HF compared to patients without HF in primary care practices in Germany.}, language = {en} } @article{HaeuslerSanchezGellertetal.2016, author = {H{\"a}usler, Andreas and S{\´a}nchez, Alba and Gellert, Paul and Deeken, Friederike and Rapp, Michael Armin and Nordheim, Johanna}, title = {Perceived stress and quality of life in dementia patients and their caregiving spouses: does dyadic coping matter?}, series = {International psychogeriatrics}, volume = {28}, journal = {International psychogeriatrics}, publisher = {Cambridge Univ. Press}, address = {New York}, issn = {1041-6102}, doi = {10.1017/S1041610216001046}, pages = {1857 -- 1866}, year = {2016}, abstract = {Background: Given the well-established association between perceived stress and quality of life (QoL) in dementia patients and their partners, our goal was to identify whether relationship quality and dyadic coping would operate as mediators between perceived stress and QoL. Results: We found negative correlations between stress and QoL in both partners (QoL-AD: r = -0.62; p < 0.001; WHO-QOL Overall: r = -0.27; p = 0.02). Spousal caregivers had a significantly lower DCI total score than dementia patients (p < 0.001). Dyadic coping was a significant mediator of the relationship between stress and QoL in spousal caregivers (z = 0.28; p = 0.02), but not in dementia patients. Likewise, relationship quality significantly mediated the relationship between stress and QoL in caregivers only (z = -2.41; p = 0.02). Conclusions: This study identified dyadic coping as a mediator on the relationship between stress and QoL in (caregiving) partners of dementia patients. In patients, however, we found a direct negative effect of stress on QoL. The findings suggest the importance of stress reducing and dyadic interventions for dementia patients and their partners, respectively.}, language = {en} } @article{BookersJacobBohlkenetal.2016, author = {Bookers, Anke and Jacob, Louis and Bohlken, Jens and Rapp, Michael Armin and Kostev, Karel}, title = {Persistence with antipsychotics in dementia patients in Germany}, series = {International journal of clinical pharmacology and therapeutics}, volume = {54}, journal = {International journal of clinical pharmacology and therapeutics}, publisher = {Dustri-Verlag Dr. Karl Feistle}, address = {Deisenhofen-M{\~A}¼nchen}, issn = {0946-1965}, doi = {10.5414/CP202631}, pages = {835 -- 840}, year = {2016}, abstract = {Background/Aims: To analyze the duration of treatment with antipsychotics in German dementia patients. Methods: This study included patients aged 60 years and over with dementia who received a first-time antipsychotic prescription by psychiatrists between 2009 and 2013. The main outcome measure was the treatment rate for more than 6 months following the index date. Results: A total of 12,979 patients with dementia (mean age 82 years, 52.1\% living in nursing homes) were included. After 2 years of follow-up, 54.8\%, 57.2\%, 61.1\%, and 65.4\% of patients aged 60 - 69, 70 - 79, 80 - 89, and 90 - 99 years, respectively, received antipsychotic prescriptions. 63.9\% of subjects living in nursing homes and 55.0\% of subjects living at home also continued their treatment (p-value < 0.001). Conclusion: The percentage of dementia patients treated with anti psychotics is very high.}, language = {en} } @misc{HeinzKlugeRapp2016, author = {Heinz, A. and Kluge, U. and Rapp, Michael Armin}, title = {Heritability of living in deprived neighbourhoods}, series = {Translational Psychiatry}, volume = {6}, journal = {Translational Psychiatry}, publisher = {Nature Publ. Group}, address = {New York}, issn = {2158-3188}, doi = {10.1038/tp.2016.215}, pages = {1}, year = {2016}, language = {en} } @article{BauerBanaschewskiHeinzetal.2016, author = {Bauer, M. and Banaschewski, Tobias and Heinz, A. and Kamp-Becker, I. and Meyer-Lindenberg, A. and Padberg, F. and Rapp, Michael Armin and Rupprecht, R. and Schneider, F. and Schulze, T. G. and Wittchen, Hans-Ulrich}, title = {The German Research Network for mental Disorders}, series = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\~A}¼r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\~A}¼r Neurologie}, volume = {87}, journal = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\~A}¼r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\~A}¼r Neurologie}, publisher = {Springer}, address = {New York}, issn = {0028-2804}, doi = {10.1007/s00115-016-0169-y}, pages = {989 -- 1010}, year = {2016}, abstract = {Mental disorders are among the greatest medical and social challenges facing us. They can occur at all stages of life and are among the most important commonly occurring diseases. In Germany 28 \% of the population suffer from a mental disorder every year, while the lifetime risk of suffering from a mental disorder is almost 50 \%. Mental disorders cause great suffering for those affected and their social network. Quantitatively speaking, they can be considered to be among those diseases creating the greatest burden for society due to reduced productivity, absence from work and premature retirement. The Federal Ministry of Education and Research is funding a new research network from 2015 to 2019 with up to 35 million euros to investigate mental disorders in order to devise and develop better therapeutic measures and strategies for this population by means of basic and translational clinical research. This is the result of a competitive call for research proposals entitled research network for mental diseases. It is a nationwide network of nine consortia with up to ten psychiatric and clinical psychology partner institutions from largely university-based research facilities for adults and/or children and adolescents. Furthermore, three cross-consortia platform projects will seek to identify shared causes of diseases and new diagnostic modalities for anxiety disorders, attention deficit hyperactivity disorders (ADHS), autism, bipolar disorders, depression, schizophrenia and psychotic disorders as well as substance-related and addictive disorders. The spectrum of therapeutic approaches to be examined ranges from innovative pharmacological and psychotherapeutic treatment to novel brain stimulation procedures. In light of the enormous burden such diseases represent for society as a whole, a sustainable improvement in the financial support for those researching mental disorders seems essential. This network aims to become a nucleus for long overdue and sustained support for a German center for mental disorders.}, language = {de} } @article{DrosselmeyerRappHadjietal.2016, author = {Drosselmeyer, J. and Rapp, Michael Armin and Hadji, P. and Kostev, K.}, title = {Depression risk in female patients with osteoporosis in primary care practices in Germany}, series = {Osteoporosis international}, volume = {27}, journal = {Osteoporosis international}, publisher = {Springer}, address = {London}, issn = {0937-941X}, doi = {10.1007/s00198-016-3584-9}, pages = {2739 -- 2744}, year = {2016}, abstract = {The Summary Thirty-five thousand four hundred eighty-three female osteoporosis patients were compared with 35,483 patients without osteoporosis regarding the incidence of depression. The risk of depression is significantly increased for patients with osteoporosis compared with patients without osteoporosis in primary care practices within Germany. Introduction The objectives of the present study were to analyze the incidence of depression in German female patients with osteoporosis and to evaluate the risk factors for depression diagnosis within this patient population. Methods This study was a retrospective database analysis conducted in Germany utilizing the Disease Analyzer (R) Database (IMS Health, Germany). The study population included 70,966 patients between 40 and 80 years of age from 1072 primary care practices. The observation period was between 2004 and 2013. Follow-up duration was 5 years and was completed in April 2015. A total of 35,483 osteoporosis patients were selected after applying exclusion criteria, and 35,483 controls were chosen and then matched (1:1) to osteoporosis patients based on age, sex, health insurance coverage, depression diagnosis in the past, and follow-up duration after index date. The analyses of depression-free survival were carried out using Kaplan-Meier curves and log-rank tests. Cox proportional hazards models (dependent variable: depression) were used to adjust for confounders. Results Depression diagnoses were presented in 33.0\% of the osteoporosis group and 22.7\% of the control group after the 5-year follow-up (p < 0.001). Dementia, cancer, heart failure, coronary heart disease, and diabetes were associated with a higher risk of developing depression (p < 0.001). Private health insurance was associated with a lower risk of depression. There was no significant effect of fractures on depression risk. Conclusion The risk of depression is significantly increased for patients with osteoporosis in primary care practices within Germany.}, language = {en} } @article{KonradJacobRappetal.2016, author = {Konrad, Marcel and Jacob, Louis and Rapp, Michael Armin and Kostev, Karel}, title = {Treatment of depression in patients with cardiovascular diseases by German psychiatrists}, series = {International journal of clinical pharmacology and therapeutics}, volume = {54}, journal = {International journal of clinical pharmacology and therapeutics}, publisher = {Dustri-Verlag Dr. Karl Feistle}, address = {Deisenhofen-M{\~A}¼nchen}, issn = {0946-1965}, doi = {10.5414/CP202591}, pages = {557 -- 563}, year = {2016}, abstract = {Objective: To estimate the prevalence and the type of antidepressant medication prescribed by German psychiatrists to patients with depression and cardiovascular diseases (CVD). Methods: This study was a retrospective database analysis in Germany using the Disease Analyzer Database (IMS Health, Germany). The study population included 2,288 CVD patients between 40 and 90 years of age from 175 psychiatric practices. The observation period was between 2004 and 2013. Follow-up lasted up to 12 months and ended in April 2015. Also included were 2,288 non-CVD controls matched (1 : 1) to CVD cases on the basis of age, gender, health insurance coverage, depression severity, and diagnosing physician. Results: Mean age was 68.6 years. 46.2\% of patients were men, and 5.9\% had private health insurance coverage. Mild, moderate, or severe depression was present in 18.7\%, 60.7\%, and 20.6\% of patients, respectively. Most patients had treatment within a year, many of them immediately after depression diagnosis. Patients with moderate and severe depression were more likely to receive treatment than patients with mild depression. There was no difference between CVD and non-CVD in the proportion of patients treated. Nonetheless, CVD patients received selective serotonin reuptake inhibitors / serotonin-noradrenaline reuptake inhibitors (SSRIs/SNRIs) significantly more frequently. Conversely, patients without CVD were more often treated with TCA. Conclusion: There was no association between CVD and the initiation of depression treatment. Furthermore, CVD patients received SSRIs/SNRIs more frequently.}, language = {en} }