@article{BangeowRapp2020, author = {Bangeow, Petjo and Rapp, Michael Armin}, title = {Beurteilung und Nutzung der 2016 reformierten Psychotherapierichtlinie}, series = {Psychiatrische Praxis : Sozialpsychiatrie, klinische Psychiatrie, public mental health, Versorgungsforschung}, volume = {47}, journal = {Psychiatrische Praxis : Sozialpsychiatrie, klinische Psychiatrie, public mental health, Versorgungsforschung}, number = {07}, publisher = {Thieme}, address = {Stuttgart}, issn = {0303-4259}, doi = {10.1055/a-1045-9820}, pages = {383 -- 387}, year = {2020}, abstract = {Ziel der Studie Dieser Artikel untersucht, inwiefern sich die 2016 reformierte Richtlinie im Stadt-Land- sowie im Ost-West-Vergleich auf die ambulante psychotherapeutische Arbeit und Versorgung auswirkt. Methodik Eine Onlineumfrage unter vertrags{\"a}rztlich t{\"a}tigen TherapeutInnen wurde durchgef{\"u}hrt. Die Fragen bezogen sich auf verschiedene Neuerungen in der Richtlinie. Ergebnisse Unabh{\"a}ngig von der Region sch{\"a}tzten die Befragten ein, dass die Reform zu keiner verbesserten Versorgung f{\"u}hrte. Im Westen und in der Stadt t{\"a}tige TherapeutInnen verwiesen PatientInnen nach der Sprechstunde {\"o}fter an andere Psychotherapiepraxen, im Osten und auf dem Land t{\"a}tige hingegen {\"o}fter auf andere Hilfeangebote. Schlussfolgerung St{\"a}rkere Anreize f{\"u}r die psychotherapeutische T{\"a}tigkeit auf dem Land sind zu schaffen. Abbaumaßnahmen der Ost-West-Ungleichheiten in der Versorgungsdichte scheinen n{\"o}tig.}, language = {de} } @article{DrosselmeyerJacobRathmannetal.2017, author = {Drosselmeyer, Julia and Jacob, Louis and Rathmann, Wolfgang and Rapp, Michael Armin and Kostev, Karel}, title = {Depression risk in patients with late-onset rheumatoid arthritis in Germany}, series = {Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation}, volume = {26}, journal = {Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation}, number = {2}, publisher = {Springer}, address = {Dordrecht}, issn = {0962-9343}, doi = {10.1007/s11136-016-1387-2}, pages = {437 -- 443}, year = {2017}, abstract = {The goal of this study was to determine the prevalence of depression and its risk factors in patients with late-onset rheumatoid arthritis (RA) treated in German primary care practices. Longitudinal data from general practices (n=1072) throughout Germany were analyzed. Individuals initially diagnosed with RA (2009-2013) were identified, and 7301 patients were included and matched (1:1) to 7301 controls. The primary outcome measure was the initial diagnosis of depression within 5 years after the index date in patients with and without RA. Cox proportional hazards models were used to adjust for confounders. The mean age was 72.2 years (SD: 7.6 years). A total of 34.9 \% of patients were men. Depression diagnoses were present in 22.0 \% of the RA group and 14.3 \% of the control group after a 5-year follow-up period (p < 0.001). In the multivariate regression model, RA was a strong risk factor for the development of depression (HR: 1.55, p < 0.001). There was significant interaction of RA and diagnosed inflammatory polyarthropathies (IP) (RA*IP interaction: p < 0.001). Furthermore, dementia, cancer, osteoporosis, hypertension, and diabetes were associated with a higher risk of developing depression (p values < 0.001). The risk of depression is significantly higher in patients with late-onset RA than in patients without RA for subjects treated in primary care practices in Germany. RA patients should be screened routinely for depression in order to ensure improved treatment and management.}, language = {en} } @article{HeinzelRappFydrichetal.2017, author = {Heinzel, Stephan and Rapp, Michael Armin and Fydrich, Thomas and Str{\"o}hle, Andreas and Teran, Christina and Kallies, Gunnar and Schwefel, Melanie and Heissel, Andreas}, title = {Neurobiological mechanisms of exercise and psychotherapy in depression}, series = {Clinical Trials}, volume = {15}, journal = {Clinical Trials}, number = {1}, publisher = {Sage Publ.}, address = {London}, issn = {1740-7745}, doi = {10.1177/1740774517729161}, pages = {53 -- 64}, year = {2017}, abstract = {Background/Aims: Even though cognitive behavioral therapy has become a relatively effective treatment for major depressive disorder and cognitive behavioral therapy-related changes of dysfunctional neural activations were shown in recent studies, remission rates still remain at an insufficient level. Therefore, the implementation of effective augmentation strategies is needed. In recent meta-analyses, exercise therapy (especially endurance exercise) was reported to be an effective intervention in major depressive disorder. Despite these findings, underlying mechanisms of the antidepressant effect of exercise especially in combination with cognitive behavioral therapy have rarely been studied to date and an investigation of its neural underpinnings is lacking. A better understanding of the psychological and neural mechanisms of exercise and cognitive behavioral therapy would be important for developing optimal treatment strategies in depression. The SPeED study (Sport/Exercise Therapy and Psychotherapyevaluating treatment Effects in Depressive patients) is a randomized controlled trial to investigate underlying physiological, neurobiological, and psychological mechanisms of the augmentation of cognitive behavioral therapy with endurance exercise. It is investigated if a preceding endurance exercise program will enhance the effect of a subsequent cognitive behavioral therapy. Methods: This study will include 105 patients diagnosed with a mild or moderate depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The participants are randomized into one of three groups: a high-intensive or a low-intensive endurance exercise group or a waiting list control group. After the exercise program/waiting period, all patients receive an outpatient cognitive behavioral therapy treatment according to a standardized therapy manual. At four measurement points, major depressive disorder symptoms (Beck Depression Inventory, Hamilton Rating Scale for Depression), (neuro)biological measures (neural activations during working memory, monetary incentive delay task, and emotion regulation, as well as cortisol levels and brain-derived neurotrophic factor), neuropsychological test performance, and questionnaires (psychological needs, self-efficacy, and quality of life) are assessed. Results: In this article, we report the design of the SPeED study and refer to important methodological issues such as including both high- and low-intensity endurance exercise groups to allow the investigation of dose-response effects and physiological components of the therapy effects. Conclusion: The main aims of this research project are to study effects of endurance exercise and cognitive behavioral therapy on depressive symptoms and to investigate underlying physiological and neurobiological mechanisms of these effects. Results may provide important implications for the development of effective treatment strategies in major depressive disorder, specifically concerning the augmentation of cognitive behavioral therapy by endurance exercise.}, language = {en} } @misc{PerezChaparroSchuchZechetal.2021, author = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Schuch, Felipe Barreto and Zech, Philipp and Kangas, Maria and Rapp, Michael Armin and Heißel, Andreas}, title = {Recreational Exercising and Self-Reported Cardiometabolic Diseases in German People Living with HIV: A Cross-Sectional Study}, series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, volume = {18}, journal = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, edition = {21}, publisher = {Universit{\"a}tsverlag Potsdam}, address = {Potsdam}, issn = {1866-8364}, doi = {10.25932/publishup-55204}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-552049}, pages = {1 -- 10}, year = {2021}, abstract = {Exercise is known for its beneficial effects on preventing cardiometabolic diseases (CMDs) in the general population. People living with the human immunodeficiency virus (PLWH) are prone to sedentarism, thus raising their already elevated risk of developing CMDs in comparison to individuals without HIV. The aim of this cross-sectional study was to determine if exercise is associated with reduced risk of self-reported CMDs in a German HIV-positive sample (n = 446). Participants completed a self-report survey to assess exercise levels, date of HIV diagnosis, CD4 cell count, antiretroviral therapy, and CMDs. Participants were classified into exercising or sedentary conditions. Generalized linear models with Poisson regression were conducted to assess the prevalence ratio (PR) of PLWH reporting a CMD. Exercising PLWH were less likely to report a heart arrhythmia for every increase in exercise duration (PR: 0.20: 95\% CI: 0.10-0.62, p < 0.01) and diabetes mellitus for every increase in exercise session per week (PR: 0.40: 95\% CI: 0.10-1, p < 0.01). Exercise frequency and duration are associated with a decreased risk of reporting arrhythmia and diabetes mellitus in PLWH. Further studies are needed to elucidate the mechanisms underlying exercise as a protective factor for CMDs in PLWH.}, language = {en} } @article{BaltaBeylergilBeckDesernoetal.2017, author = {Balta Beylergil, Sinem and Beck, Anne and Deserno, Lorenz and Lorenz, Robert C. and Rapp, Michael Armin and Schlagenhauf, Florian and Heinz, Andreas and Obermayer, Klaus}, title = {Dorsolateral prefrontal cortex contributes to the impaired behavioral adaptation in alcohol dependence}, series = {NeuroImage: Clinical : a journal of diseases affecting the nervous system}, volume = {15}, journal = {NeuroImage: Clinical : a journal of diseases affecting the nervous system}, publisher = {Elsevier}, address = {Oxford}, issn = {2213-1582}, doi = {10.1016/j.nicl.2017.04.010}, pages = {80 -- 94}, year = {2017}, abstract = {Substance-dependent individuals often lack the ability to adjust decisions flexibly in response to the changes in reward contingencies. Prediction errors (PEs) are thought to mediate flexible decision-making by updating the reward values associated with available actions. In this study, we explored whether the neurobiological correlates of PEs are altered in alcohol dependence. Behavioral, and functional magnetic resonance imaging (fMRI) data were simultaneously acquired from 34 abstinent alcohol-dependent patients (ADP) and 26 healthy controls (HC) during a probabilistic reward-guided decision-making task with dynamically changing reinforcement contingencies. A hierarchical Bayesian inference method was used to fit and compare learning models with different assumptions about the amount of task-related information subjects may have inferred during the experiment. Here, we observed that the best-fitting model was a modified Rescorla-Wagner type model, the "double-update" model, which assumes that subjects infer the knowledge that reward contingencies are anti-correlated, and integrate both actual and hypothetical outcomes into their decisions. Moreover, comparison of the best-fitting model's parameters showed that ADP were less sensitive to punishments compared to HC. Hence, decisions of ADP after punishments were loosely coupled with the expected reward values assigned to them. A correlation analysis between the model-generated PEs and the fMRI data revealed a reduced association between these PEs and the BOLD activity in the dorsolateral prefrontal cortex (DLPFC) of ADP. A hemispheric asymmetry was observed in the DLPFC when positive and negative PE signals were analyzed separately. The right DLPFC activity in ADP showed a reduced correlation with positive PEs. On the other hand, ADP, particularly the patients with high dependence severity, recruited the left DLPFC to a lesser extent than HC for processing negative PE signals. These results suggest that the DLPFC, which has been linked to adaptive control of action selection, may play an important role in cognitive inflexibility observed in alcohol dependence when reinforcement contingencies change. Particularly, the left DLPFC may contribute to this impaired behavioral adaptation, possibly by impeding the extinction of the actions that no longer lead to a reward.}, language = {en} } @article{BangeowRapp2020, author = {Bangeow, Petjo and Rapp, Michael Armin}, title = {Beurteilung und Nutzung der 2016 reformierten Psychotherapierichtlinie}, series = {Psychiatrische Praxis}, volume = {47}, journal = {Psychiatrische Praxis}, number = {3}, publisher = {Thieme}, address = {Stuttgart}, issn = {0303-4259}, doi = {10.1055/a-1045-9801}, pages = {135 -- 141}, year = {2020}, abstract = {Objective This article investigates how aspects of 2016 reform of the German psychotherapeutic guideline were evaluated and used differently by therapists from three different psychotherapeutic treatment methods.
Methods An online survey was conducted with 987 statutory health insurance approved therapists. The questionnaire focused on various innovations in the guideline.
Results There were significant differences in the use of the broadened authority and of specific treatment services. There were also differences in the application for short-term and long-term psychotherapies as well as in the application to extend short to long-term psychotherapy.
Conclusions Elements of the guideline should be evaluated in relation to the preferred treatment method. Aspects related to the psychotherapeutic work with patients seem to be especially significant.}, language = {de} } @article{JacobRappKostev2017, author = {Jacob, Louis and Rapp, Michael Armin and Kostev, Karel}, title = {Long-term use of benzodiazepines in older patients in Germany}, series = {Therapeutic Advances in Psychopharmacology}, volume = {7}, journal = {Therapeutic Advances in Psychopharmacology}, number = {6/7}, publisher = {Sage Publ.}, address = {London}, issn = {2045-1253}, doi = {10.1177/2045125317696454}, pages = {191 -- 200}, year = {2017}, abstract = {Background: The purpose of this study was to analyze the prevalence of long-term benzodiazepine use in older adults treated in general and neuropsychiatric practices in Germany. Methods: This study included 32,182 patients over the age of 65 years who received benzodiazepine prescriptions for the first time between January 2010 and December 2014 in general and neuropsychiatric practices in Germany. Follow up lasted until July 2016. The main outcome measure was the proportion of patients treated with benzodiazepines for >6 months. Results: The proportion of patients with benzodiazepine therapy for >6 months increased with age (65-70 years: 12.3\%; 71-80 years: 15.5\%; 81-90 years: 23.7\%; >90 years: 31.6\%) but did not differ significantly between men (15.5\%) and women (17.1\%). The proportion of patients who received benzodiazepines for >6 months was higher among those with sleep disorders (21.1\%), depression (20.8\%) and dementia (32.1\%) than among those with anxiety (15.5\%). By contrast, this proportion was lower among people diagnosed with adjustment disorders (7.7\%) and back pain (3.8\%). Conclusion: Overall, long-term use of benzodiazepines is common in older people, particularly in patients over the age of 80 and in those diagnosed with dementia, sleep disorders, or depression.}, language = {en} } @misc{WuertzKozakRoszkowskiCambriaetal.2020, author = {Wuertz-Kozak, Karin and Roszkowski, Martin and Cambria, Elena and Block, Andrea and Kuhn, Gisela A. and Abele, Thea and Hitzl, Wolfgang and Drießlein, David and M{\"u}ller, Ralph and Rapp, Michael Armin and Mansuy, Isabelle M. and Peters, Eva M. J. and Wippert, Pia-Maria}, title = {Effects of Early Life Stress on Bone Homeostasis in Mice and Humans}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {670}, issn = {1866-8364}, doi = {10.25932/publishup-48532}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-485324}, pages = {26}, year = {2020}, abstract = {Bone pathology is frequent in stressed individuals. A comprehensive examination of mechanisms linking life stress, depression and disturbed bone homeostasis is missing. In this translational study, mice exposed to early life stress (MSUS) were examined for bone microarchitecture (μCT), metabolism (qPCR/ELISA), and neuronal stress mediator expression (qPCR) and compared with a sample of depressive patients with or without early life stress by analyzing bone mineral density (BMD) (DXA) and metabolic changes in serum (osteocalcin, PINP, CTX-I). MSUS mice showed a significant decrease in NGF, NPYR1, VIPR1 and TACR1 expression, higher innervation density in bone, and increased serum levels of CTX-I, suggesting a milieu in favor of catabolic bone turnover. MSUS mice had a significantly lower body weight compared to control mice, and this caused minor effects on bone microarchitecture. Depressive patients with experiences of childhood neglect also showed a catabolic pattern. A significant reduction in BMD was observed in depressive patients with childhood abuse and stressful life events during childhood. Therefore, future studies on prevention and treatment strategies for both mental and bone disease should consider early life stress as a risk factor for bone pathologies.}, language = {en} } @article{WuertzKozakRoszkowskiCambriaetal.2020, author = {Wuertz-Kozak, Karin and Roszkowski, Martin and Cambria, Elena and Block, Andrea and Kuhn, Gisela A. and Abele, Thea and Hitzl, Wolfgang and Drießlein, David and M{\"u}ller, Ralph and Rapp, Michael Armin and Mansuy, Isabelle M. and Peters, Eva M. J. and Wippert, Pia-Maria}, title = {Effects of Early Life Stress on Bone Homeostasis in Mice and Humans}, series = {International Journal of Molecular Sciences}, volume = {21}, journal = {International Journal of Molecular Sciences}, number = {18}, publisher = {Molecular Diversity Preservation International}, address = {Basel}, issn = {1422-0067}, doi = {10.3390/ijms21186634}, pages = {24}, year = {2020}, abstract = {Bone pathology is frequent in stressed individuals. A comprehensive examination of mechanisms linking life stress, depression and disturbed bone homeostasis is missing. In this translational study, mice exposed to early life stress (MSUS) were examined for bone microarchitecture (μCT), metabolism (qPCR/ELISA), and neuronal stress mediator expression (qPCR) and compared with a sample of depressive patients with or without early life stress by analyzing bone mineral density (BMD) (DXA) and metabolic changes in serum (osteocalcin, PINP, CTX-I). MSUS mice showed a significant decrease in NGF, NPYR1, VIPR1 and TACR1 expression, higher innervation density in bone, and increased serum levels of CTX-I, suggesting a milieu in favor of catabolic bone turnover. MSUS mice had a significantly lower body weight compared to control mice, and this caused minor effects on bone microarchitecture. Depressive patients with experiences of childhood neglect also showed a catabolic pattern. A significant reduction in BMD was observed in depressive patients with childhood abuse and stressful life events during childhood. Therefore, future studies on prevention and treatment strategies for both mental and bone disease should consider early life stress as a risk factor for bone pathologies.}, language = {en} } @article{Rapp2019, author = {Rapp, Michael Armin}, title = {Alterspsychiatrie ist Teil ganzheitlicher Altersmedizin, kein Teilbereich der Psychiatrie - Kontra}, series = {Psychatrische Praxis}, volume = {46}, journal = {Psychatrische Praxis}, number = {6}, publisher = {Thieme}, address = {Stuttgart}, issn = {0303-4259}, doi = {10.1055/a-0958-8403}, pages = {308 -- 309}, year = {2019}, abstract = {Wenn in der Medizin vom demografischen Wandel gesprochen wird [1], wird zumeist von einer rasanten Zunahme der Hochaltrigen gesprochen, bei denen aufgrund der differenziellen altersassoziierten Inzidenzraten in erster Linie eine Zunahme an Demenzerkrankungen, kardiovaskul{\"a}ren Erkrankungen, Krebserkrankungen und allgemeiner Multimorbidit{\"a}t und Gebrechlichkeit zu erwarten ist [2]. Dies ist unstrittig richtig, aber nur ein Teil der Folgen des demografischen Wandels f{\"u}r die psychiatrische Versorgung. Diese muss weiterhin die gesamte adulte Lebensspanne im Blick haben, da sonst Versorgungsengp{\"a}sse bei ohnehin vulnerablen Patienten verst{\"a}rkt werden, mit Folgen f{\"u}r die Morbidit{\"a}t und Mortalit{\"a}t auf Bev{\"o}lkerungsebene [3].}, language = {de} } @article{KaminskiSchlagenhaufRappetal.2018, author = {Kaminski, Jakob A. and Schlagenhauf, Florian and Rapp, Michael Armin and Awasthi, Swapnil and Ruggeri, Barbara and Deserno, Lorenz and Banaschewski, Tobias and Bokde, Arun L. W. and Bromberg, Uli and B{\"u}chel, Christian and Quinlan, Erin Burke and Desrivieres, Sylvane and Flor, Herta and Frouin, Vincent and Garavan, Hugh and Gowland, Penny and Ittermann, Bernd and Martinot, Jean-Luc and Martinot, Marie-Laure Paillere and Nees, Frauke and Orfanos, Dimitri Papadopoulos and Paus, Tomas and Poustka, Luise and Smolka, Michael N. and Fr{\"o}hner, Juliane H. and Walter, Henrik and Whelan, Robert and Ripke, Stephan and Schumann, Gunter and Heinz, Andreas}, title = {Epigenetic variance in dopamine D2 receptor}, series = {Translational Psychiatry}, volume = {8}, journal = {Translational Psychiatry}, publisher = {Nature Publ. Group}, address = {New York}, organization = {IMAGEN Consortium}, issn = {2158-3188}, doi = {10.1038/s41398-018-0222-7}, pages = {11}, year = {2018}, abstract = {Genetic and environmental factors both contribute to cognitive test performance. A substantial increase in average intelligence test results in the second half of the previous century within one generation is unlikely to be explained by genetic changes. One possible explanation for the strong malleability of cognitive performance measure is that environmental factors modify gene expression via epigenetic mechanisms. Epigenetic factors may help to understand the recent observations of an association between dopamine-dependent encoding of reward prediction errors and cognitive capacity, which was modulated by adverse life events. The possible manifestation of malleable biomarkers contributing to variance in cognitive test performance, and thus possibly contributing to the "missing heritability" between estimates from twin studies and variance explained by genetic markers, is still unclear. Here we show in 1475 healthy adolescents from the IMaging and GENetics (IMAGEN) sample that general IQ (gIQ) is associated with (1) polygenic scores for intelligence, (2) epigenetic modification of DRD2 gene, (3) gray matter density in striatum, and (4) functional striatal activation elicited by temporarily surprising reward-predicting cues. Comparing the relative importance for the prediction of gIQ in an overlapping subsample, our results demonstrate neurobiological correlates of the malleability of gIQ and point to equal importance of genetic variance, epigenetic modification of DRD2 receptor gene, as well as functional striatal activation, known to influence dopamine neurotransmission. Peripheral epigenetic markers are in need of confirmation in the central nervous system and should be tested in longitudinal settings specifically assessing individual and environmental factors that modify epigenetic structure.}, language = {en} } @misc{AwasthiKaminskiRappetal.2019, author = {Awasthi, Swapnil and Kaminski, Jakob and Rapp, Michael Armin and Schlagenhauf, Florian and Walter, Henrik and Ruggeri, Barbara and Ripke, Stephan and Schumann, Gunter and Heinz, Andreas}, title = {A neural signature of malleability}, series = {European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology}, volume = {29}, journal = {European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0924-977X}, doi = {10.1016/j.euroneuro.2017.08.139}, pages = {S858 -- S859}, year = {2019}, abstract = {General intelligence has a substantial genetic background in children, adolescents, and adults, but environmental factors also strongly correlate with cognitive performance as evidenced by a strong (up to one SD) increase in average intelligence test results in the second half of the previous century. This change occurred in a period apparently too short to accommodate radical genetic changes. It is highly suggestive that environmental factors interact with genotype by possible modification of epigenetic factors that regulate gene expression and thus contribute to individual malleability. This modification might as well be reflected in recent observations of an association between dopamine-dependent encoding of reward prediction errors and cognitive capacity, which was modulated by adverse life events.}, language = {en} } @misc{HeinzKieferSmolkaetal.2020, author = {Heinz, Andreas and Kiefer, Falk and Smolka, Michael N. and Endrass, Tanja and Beste, Christian and Beck, Anne and Liu, Shuyan and Genauck, Alexander and Romund, Lydia and Rapp, Michael Armin and Tost, Heike and Spanagel, Rainer}, title = {Addiction research consortium: losing and regaining control over drug intake (ReCoDe) - from trajectories to mechanisms and interventions}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {2}, issn = {1866-8364}, doi = {10.25932/publishup-52597}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-525972}, pages = {8}, year = {2020}, abstract = {One of the major risk factors for global death and disability is alcohol, tobacco, and illicit drug use. While there is increasing knowledge with respect to individual factors promoting the initiation and maintenance of substance use disorders (SUDs), disease trajectories involved in losing and regaining control over drug intake (ReCoDe) are still not well described. Our newly formed German Collaborative Research Centre (CRC) on ReCoDe has an interdisciplinary approach funded by the German Research Foundation (DFG) with a 12-year perspective. The main goals of our research consortium are (i) to identify triggers and modifying factors that longitudinally modulate the trajectories of losing and regaining control over drug consumption in real life, (ii) to study underlying behavioral, cognitive, and neurobiological mechanisms, and (iii) to implicate mechanism-based interventions. These goals will be achieved by: (i) using mobile health (m-health) tools to longitudinally monitor the effects of triggers (drug cues, stressors, and priming doses) and modify factors (eg, age, gender, physical activity, and cognitive control) on drug consumption patterns in real-life conditions and in animal models of addiction; (ii) the identification and computational modeling of key mechanisms mediating the effects of such triggers and modifying factors on goal-directed, habitual, and compulsive aspects of behavior from human studies and animal models; and (iii) developing and testing interventions that specifically target the underlying mechanisms for regaining control over drug intake.}, language = {en} } @article{HeinzKieferSmolkaetal.2020, author = {Heinz, Andreas and Kiefer, Falk and Smolka, Michael N. and Endrass, Tanja and Beste, Christian and Beck, Anne and Liu, Shuyan and Genauck, Alexander and Romund, Lydia and Rapp, Michael Armin and Tost, Heike and Spanagel, Rainer}, title = {Addiction research consortium: losing and regaining control over drug intake (ReCoDe) - from trajectories to mechanisms and interventions}, series = {Addiction Biology}, volume = {25}, journal = {Addiction Biology}, number = {2}, publisher = {John Wiley \& Sons, Inc.}, address = {New Jersey}, pages = {6}, year = {2020}, abstract = {One of the major risk factors for global death and disability is alcohol, tobacco, and illicit drug use. While there is increasing knowledge with respect to individual factors promoting the initiation and maintenance of substance use disorders (SUDs), disease trajectories involved in losing and regaining control over drug intake (ReCoDe) are still not well described. Our newly formed German Collaborative Research Centre (CRC) on ReCoDe has an interdisciplinary approach funded by the German Research Foundation (DFG) with a 12-year perspective. The main goals of our research consortium are (i) to identify triggers and modifying factors that longitudinally modulate the trajectories of losing and regaining control over drug consumption in real life, (ii) to study underlying behavioral, cognitive, and neurobiological mechanisms, and (iii) to implicate mechanism-based interventions. These goals will be achieved by: (i) using mobile health (m-health) tools to longitudinally monitor the effects of triggers (drug cues, stressors, and priming doses) and modify factors (eg, age, gender, physical activity, and cognitive control) on drug consumption patterns in real-life conditions and in animal models of addiction; (ii) the identification and computational modeling of key mechanisms mediating the effects of such triggers and modifying factors on goal-directed, habitual, and compulsive aspects of behavior from human studies and animal models; and (iii) developing and testing interventions that specifically target the underlying mechanisms for regaining control over drug intake.}, language = {en} } @misc{KaminskiSchlagenhaufRappetal.2018, author = {Kaminski, Jakob and Schlagenhauf, Florian and Rapp, Michael Armin and Awasthi, Swapnil and Ruggeri, Barbara and Deserno, Lorenz and Laura, Daedelow and Banaschewski, Tobias and Bokde, Arun and Quinlan, Erin Burke and Buechel, Christian and Bromberg, Uli and Desrivieres, Sylvane and Flor, Herta and Frouin, Vincent and Garavan, Hugh and Gowland, Penny and Ittermann, Bernd and Martinot, Jean-Luc and Martinot, Marie-Laure Paillere and Nees, Frauke and Orfanos, Dimitri Papadopoulos and Paus, Tomas and Poustka, Luise and Smolka, Michael and Froehner, Juliane and Walter, Henrik and Whelan, Robert and Ripke, Stephan and Schumann, Gunter and Heinz, Andreas}, title = {Variance in Dopaminergic Markers}, series = {Biological psychiatry : a journal of psychiatric neuroscience and therapeutics ; a publication of the Society of Biological Psychiatry}, volume = {83}, journal = {Biological psychiatry : a journal of psychiatric neuroscience and therapeutics ; a publication of the Society of Biological Psychiatry}, number = {9}, publisher = {Elsevier}, address = {New York}, organization = {IMAGEN Consortium}, issn = {0006-3223}, doi = {10.1016/j.biopsych.2018.02.311}, pages = {S118 -- S118}, year = {2018}, language = {en} } @misc{GarbusowSommerNebeetal.2018, author = {Garbusow, Maria and Sommer, Christian and Nebe, Stephan and Sebold, Miriam Hannah and Kuitunen-Paul, S{\"o}ren and Wittchen, Hans-Ulrich and Smolka, Michael N. and Zimmermann, Ulrich S. and Rapp, Michael Armin and Huys, Quentin J. M. and Schlagenhauf, Florian and Heinz, Andreas}, title = {Multi-level evidence of general pavlovian-to-instrumental transfer in alcohol use disorder}, series = {Alcoholism : clinical and experimental research ; the official journal of the American Medical Society on Alcoholism and the Research Society on Alcoholism}, volume = {42}, journal = {Alcoholism : clinical and experimental research ; the official journal of the American Medical Society on Alcoholism and the Research Society on Alcoholism}, publisher = {Wiley}, address = {Hoboken}, issn = {0145-6008}, pages = {128A -- 128A}, year = {2018}, language = {en} } @misc{GruebnerRappAdlietal.2017, author = {Gruebner, Oliver and Rapp, Michael Armin and Adli, Mazda and Kluge, Ulrike and Galea, Sandro and Heinz, Andreas}, title = {Cities and Mental Health}, series = {Deutsches {\"A}rzteblatt international : a weekly online journal of clinical medicine and public health}, volume = {114}, journal = {Deutsches {\"A}rzteblatt international : a weekly online journal of clinical medicine and public health}, number = {8}, publisher = {Dt. {\"A}rzte-Verl.}, address = {Cologne}, issn = {1866-0452}, doi = {10.3238/arztebl.2017.0121}, pages = {121 -- 127}, year = {2017}, abstract = {Background: More than half of the global population currently lives in cities, with an increasing trend for further urbanization. Living in cities is associated with increased population density, traffic noise and pollution, but also with better access to health care and other commodities. Methods: This review is based on a selective literature search, providing an overview of the risk factors for mental illness in urban centers. Results: Studies have shown that the risk for serious mental illness is generally higher in cities compared to rural areas. Epidemiological studies have associated growing up and living in cities with a considerably higher risk for schizophrenia. However, correlation is not causation and living in poverty can both contribute to and result from impairments associated with poor mental health. Social isolation and discrimination as well as poverty in the neighborhood contribute to the mental health burden while little is known about specific inter actions between such factors and the built environment. Conclusion: Further insights on the interaction between spatial heterogeneity of neighborhood resources and socio-ecological factors is warranted and requires interdisciplinary research.}, language = {en} } @article{RappMellMajicetal.2013, author = {Rapp, Michael Armin and Mell, Thomas and Majic, Tomislav and Treusch, Yvonne and Nordheim, Johanna and Niemann-Mirmehdi, Mechthild and Gutzmann, Hans and Heinz, Andreas}, title = {Agitation in Nursing Home Residents With Dementia (VIDEANT Trial) - Effects of a Cluster-Randomized, Controlled, Guideline Implementation Trial}, series = {Journal of the American Medical Directors Association}, volume = {14}, journal = {Journal of the American Medical Directors Association}, number = {9}, publisher = {Elsevier}, address = {New York}, issn = {1525-8610}, doi = {10.1016/j.jamda.2013.05.017}, pages = {690 -- 695}, year = {2013}, abstract = {Objective: To test the effect of a complex guideline-based intervention on agitation and psychotropic prescriptions. Design, Setting, Participants: Cluster randomized controlled trial (VIDEANT) with blinded assessment of outcome in 18 nursing homes in Berlin, Germany, comprising 304 dementia patients. Intervention: Training, support, and activity therapy intervention, delivered at the level of each nursing home, focusing on the management of agitation in dementia. Control group nursing homes received treatment as usual. Measurements: Levels of agitated and disruptive behavior (Cohen-Mansfield agitation inventory [CMAI]) as the primary outcome. Number of neuroleptics, antidepressants, and cholinesterase inhibitors (ChEIs) prescribed in defined daily dosages (DDDs). Results: Of 326 patients screened, 304 (93.3\%) were eligible and cluster-randomized to 9 intervention (n = 163) and 9 control (n = 141) nursing homes. Data were collected from 287 (94.4\%) patients at 10 months. At 10 months, compared with controls, nursing home residents with dementia in the intervention group exhibited significantly less agitation as measured with the CMAI (adjusted mean difference, 6.24; 95\% CI 2.03-14.14; P = .009; Cohen's d = 0.43), received fewer neuroleptics (P < .05), more ChEIs (P < .05), and more antidepressants (P < .05). Conclusion: Complex guideline-based interventions are effective in reducing agitated and disruptive behavior in nursing home residents with dementia. At the same time, increased prescription of ChEIs and antidepressants together with decreased neuroleptic prescription suggests an effect toward guideline-based pharmacotherapy.}, language = {en} } @article{MajicGutzmannHeinzetal.2013, author = {Majic, Tomislav and Gutzmann, Hans and Heinz, Andreas and Lang, Undine E. and Rapp, Michael Armin}, title = {Animal-assisted therapy and agitation and depression in nursing home residents with dementia - a matched case-control trial}, series = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry}, volume = {21}, journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry}, number = {11}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {1064-7481}, doi = {10.1016/j.jagp.2013.03.004}, pages = {1052 -- 1059}, year = {2013}, abstract = {Objectives: To investigate the efficacy of animal-assisted therapy (AAT) on symptoms of agitation/aggression and depression in nursing home residents with dementia in a randomized controlled trial. Previous studies have indicated that AAT has beneficial effects on neuropsychiatric symptoms in various psychiatric disorders but few studies have investigated the efficacy of AAT in patients suffering from dementia. Methods: Of 65 nursing home residents with dementia (mean [standard deviation] age: 81.8 [9.2] years; mean Mini-Mental State Examination score: 7.1 [0.7]), 27 matched pairs (N = 54) were randomly assigned to either treatment as usual or treatment as usual combined with AAT, administered over 10 weekly sessions. Blinded raters assessed cognitive impairment with the Mini-Mental State Examination, presence of agitation/aggression with the Cohen-Mansfield Agitation Inventory, and depression with the Dementia Mood Assessment Scale at baseline and during a period of 4 weeks after AAT intervention. Results: In the control group, symptoms of agitation/aggression and depression significantly increased over 10 weeks; in the intervention group, patients receiving combined treatment displayed constant frequency and severity of symptoms of agitation/aggression (F-1,F-48 = 6.43; p <0.05) and depression (F-1,F-48 = 26.54; p <0.001). Symptom amelioration did not occur in either group. Conclusions: AAT is a promising option for the treatment of agitation/aggression and depression in patients with dementia. Our results suggest that AAT may delay progression of neuropsychiatric symptoms in demented nursing home residents. Further research is needed to determine its long-time effects.}, language = {en} } @article{DesernoBeckHuysetal.2015, author = {Deserno, Lorenz and Beck, Anne and Huys, Quentin J. M. and Lorenz, Robert C. and Buchert, Ralph and Buchholz, Hans-Georg and Plotkin, Michail and Kumakara, Yoshitaka and Cumming, Paul and Heinze, Hans-Jochen and Grace, Anthony A. and Rapp, Michael Armin and Schlagenhauf, Florian and Heinz, Andreas}, title = {Chronic alcohol intake abolishes the relationship between dopamine synthesis capacity and learning signals in the ventral striatum}, series = {European journal of neuroscience}, volume = {41}, journal = {European journal of neuroscience}, number = {4}, publisher = {Wiley-Blackwell}, address = {Hoboken}, issn = {0953-816X}, doi = {10.1111/ejn.12802}, pages = {477 -- 486}, year = {2015}, abstract = {Drugs of abuse elicit dopamine release in the ventral striatum, possibly biasing dopamine-driven reinforcement learning towards drug-related reward at the expense of non-drug-related reward. Indeed, in alcohol-dependent patients, reactivity in dopaminergic target areas is shifted from non-drug-related stimuli towards drug-related stimuli. Such hijacked' dopamine signals may impair flexible learning from non-drug-related rewards, and thus promote craving for the drug of abuse. Here, we used functional magnetic resonance imaging to measure ventral striatal activation by reward prediction errors (RPEs) during a probabilistic reversal learning task in recently detoxified alcohol-dependent patients and healthy controls (N=27). All participants also underwent 6-[F-18]fluoro-DOPA positron emission tomography to assess ventral striatal dopamine synthesis capacity. Neither ventral striatal activation by RPEs nor striatal dopamine synthesis capacity differed between groups. However, ventral striatal coding of RPEs correlated inversely with craving in patients. Furthermore, we found a negative correlation between ventral striatal coding of RPEs and dopamine synthesis capacity in healthy controls, but not in alcohol-dependent patients. Moderator analyses showed that the magnitude of the association between dopamine synthesis capacity and RPE coding depended on the amount of chronic, habitual alcohol intake. Despite the relatively small sample size, a power analysis supports the reported results. Using a multimodal imaging approach, this study suggests that dopaminergic modulation of neural learning signals is disrupted in alcohol dependence in proportion to long-term alcohol intake of patients. Alcohol intake may perpetuate itself by interfering with dopaminergic modulation of neural learning signals in the ventral striatum, thus increasing craving for habitual drug intake.}, language = {en} } @article{HaegeleSchlagenhaufRappetal.2015, author = {Haegele, Claudia and Schlagenhauf, Florian and Rapp, Michael Armin and Sterzer, Philipp and Beck, Anne and Bermpohl, Felix and Stoy, Meline and Stroehle, Andreas and Wittchen, Hans-Ulrich and Dolan, Raymond J. and Heinz, Andreas}, title = {Dimensional psychiatry: reward dysfunction and depressive mood across psychiatric disorders}, series = {Psychopharmacology}, volume = {232}, journal = {Psychopharmacology}, number = {2}, publisher = {Springer}, address = {New York}, issn = {0033-3158}, doi = {10.1007/s00213-014-3662-7}, pages = {331 -- 341}, year = {2015}, abstract = {A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries. We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative mood) of such an impairment. During reward anticipation, we observed significant group differences in ventral striatal (VS) activation: patients with schizophrenia, alcohol dependence, and major depression showed significantly less ventral striatal activation compared to healthy controls. Depressive symptoms correlated with dysfunction in reward anticipation regardless of diagnostic entity. There was no significant correlation between anxiety symptoms and VS functional activation. Our findings demonstrate a neurobiological dysfunction related to reward prediction that transcended disorder categories and was related to measures of depressed mood. The findings underline the potential of a dimensional approach in psychiatry and strengthen the hypothesis that neurobiological research in psychiatric disorders can be targeted at core mechanisms that are likely to be implicated in a range of clinical entities.}, language = {en} } @article{AichbergerMontesinosBromandetal.2015, author = {Aichberger, Marion Christina and Montesinos, Amanda Heredia and Bromand, Zohra and Yesil, Rahsan and Temur-Erman, Selver and Rapp, Michael Armin and Heinz, Andreas and Schouler-Ocak, Meryam}, title = {Suicide attempt rates and intervention effects in women of Turkish origin in Berlin}, series = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {30}, journal = {European psychiatry : the journal of the Association of European Psychiatrists}, number = {4}, publisher = {Elsevier}, address = {Paris}, issn = {0924-9338}, doi = {10.1016/j.eurpsy.2014.12.003}, pages = {480 -- 485}, year = {2015}, abstract = {Purpose: Ethnic minority groups show elevated suicide attempt rates across Europe. Evidence suggests a similar trend for women of Turkish origin in Germany, yet data on suicidal behaviour in minorities in Germany is scarce. The objective was to examine rates of suicidal behaviour, underlying motives, and to explore the effectiveness of an intervention program. Methods: From 05/2009-09/2011, data on all suicide attempts among women of Turkish origin who presented at a hospital-based emergency unit in Berlin, Germany, were collected. A multi-modal intervention was conducted in 2010 and the effects of age, generation and the intervention on suicide attempt rates were examined. Results: At the start, the highest rate was found in women aged 18-24 years with 225.4 (95\% CI = 208.8-242.0)/100,000. Adjustment disorder was the most prevalent diagnosis with 49.7\% (n = 79), being more common in second-generation women (P = .004). Further analyses suggested an effect of the intervention in the youngest age group (trend change of beta = -1.25; P = .017). Conclusion: Our findings suggest a particularly high rate of suicide attempts by 18-24-year-old, second-generation women of Turkish origin in Berlin. Furthermore, our results suggest a trend change in suicide attempts in women aged 18-24 years related to a population-based intervention program. (C) 2015 Elsevier Masson SAS. All rights reserved.}, language = {en} } @article{TreuschMajicPageetal.2015, author = {Treusch, Yvonne and Majic, Tomislav and Page, Julie and Gutzmann, Hans and Heinz, Andreas and Rapp, Michael Armin}, title = {Apathy in nursing home residents with dementia: Results from a cluster-randomized controlled trial}, series = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {30}, journal = {European psychiatry : the journal of the Association of European Psychiatrists}, number = {2}, publisher = {Elsevier}, address = {Paris}, issn = {0924-9338}, doi = {10.1016/j.eurpsy.2014.02.004}, pages = {7}, year = {2015}, abstract = {Purpose: Here we evaluate an interdisciplinary occupational and sport therapy intervention for dementia patients suffering from apathy. Subjects and methods: A prospective, controlled, rater-blinded, clinical trial with two follow-ups was conducted as part of a larger cluster-randomized trial in 18 nursing homes in Berlin. n = 117 dementia patients with apathy, defined as a score of 40 or more on the apathy evaluation scale (AES) or presence of apathy on the Neuropsychiatric Inventory (NPI), were randomly assigned to intervention or control group. The intervention included 10 months of brief activities, provided once a week. The primary outcome measure was the total score on the AES scale measured directly after the intervention period and again after 12 months. Results: We found significant group differences with respect to apathy during the 10 month intervention period (F-2,F-82 = 7.79, P < 0.01), which reflected an increase in apathy in the control group, but not in the intervention group. Within one year after the intervention was ceased, the treatment group worsened and no longer differed significantly from the control group (P = 0.55). Conclusions: Our intervention was effective for the therapy of apathy in dementia, when applied, but not one year after cessation of therapy. (C) 2014 Elsevier Masson SAS. All rights reserved.}, language = {en} } @misc{RappKlugePenkaetal.2015, author = {Rapp, Michael Armin and Kluge, Ulrike and Penka, Simone and Vardar, Azra and Aichberger, Marion Christina and Mundt, Adrian P. and Schouler-Ocak, Meryam and M{\"o}sko, Mike and Butler, Jeffrey and Meyer-Lindenberg, Andreas and Heinz, Andreas}, title = {When local poverty is more important than your income: Mental health in minorities in inner cities}, series = {World psychiatry}, volume = {14}, journal = {World psychiatry}, number = {2}, publisher = {Wiley-Blackwell}, address = {Hoboken}, issn = {1723-8617}, doi = {10.1002/wps.20221}, pages = {249 -- 250}, year = {2015}, language = {en} } @unpublished{HeinzCharletRapp2015, author = {Heinz, Andreas and Charlet, Katrin and Rapp, Michael Armin}, title = {Public mental health: a call to action}, series = {World psychiatry}, volume = {14}, journal = {World psychiatry}, number = {1}, publisher = {Wiley-Blackwell}, address = {Hoboken}, issn = {1723-8617}, doi = {10.1002/wps.20182}, pages = {49 -- 50}, year = {2015}, language = {en} } @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} } @misc{HaegeleSchlagenhaufRappetal.2014, author = {H{\"a}gele, Claudia and Schlagenhauf, Florian and Rapp, Michael Armin and Sterzer, Philipp and Beck, Anne and Bermpohl, Felix and Stoy, Meline and Str{\"o}hle, Andreas and Wittchen, Hans-Ulrich and Dolan, Raymond J. and Heinz, Andreas}, title = {Dimensional psychiatry}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {653}, issn = {1866-8364}, doi = {10.25932/publishup-43106}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-431064}, pages = {331 -- 341}, year = {2014}, abstract = {A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries. We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative mood) of such an impairment. We used functional magnetic resonance imaging (fMRI) and a monetary incentive delay (MID) task to study the functional correlates of reward anticipation across major psychiatric disorders in 184 subjects, with the diagnoses of alcohol dependence (n = 26), schizophrenia (n = 44), major depressive disorder (MDD, n = 24), bipolar disorder (acute manic episode, n = 13), attention deficit/hyperactivity disorder (ADHD, n = 23), and healthy controls (n = 54). Subjects' individual Beck Depression Inventory-and State-Trait Anxiety Inventory-scores were correlated with clusters showing significant activation during reward anticipation. During reward anticipation, we observed significant group differences in ventral striatal (VS) activation: patients with schizophrenia, alcohol dependence, and major depression showed significantly less ventral striatal activation compared to healthy controls. Depressive symptoms correlated with dysfunction in reward anticipation regardless of diagnostic entity. There was no significant correlation between anxiety symptoms and VS functional activation. Our findings demonstrate a neurobiological dysfunction related to reward prediction that transcended disorder categories and was related to measures of depressed mood. The findings underline the potential of a dimensional approach in psychiatry and strengthen the hypothesis that neurobiological research in psychiatric disorders can be targeted at core mechanisms that are likely to be implicated in a range of clinical entities.}, language = {en} } @misc{FriedelSchlagenhaufBecketal.2014, author = {Friedel, Eva and Schlagenhauf, Florian and Beck, Anne and Dolan, Raymond J. and Huys, Quentin J. M. and Rapp, Michael Armin and Heinz, Andreas}, title = {The effects of life stress and neural learning signals on fluid intelligence}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {621}, issn = {1866-8372}, doi = {10.25932/publishup-43514}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-435140}, pages = {35 -- 43}, year = {2014}, abstract = {Fluid intelligence (fluid IQ), defined as the capacity for rapid problem solving and behavioral adaptation, is known to be modulated by learning and experience. Both stressful life events (SLES) and neural correlates of learning [specifically, a key mediator of adaptive learning in the brain, namely the ventral striatal representation of prediction errors (PE)] have been shown to be associated with individual differences in fluid IQ. Here, we examine the interaction between adaptive learning signals (using a well-characterized probabilistic reversal learning task in combination with fMRI) and SLES on fluid IQ measures. We find that the correlation between ventral striatal BOLD PE and fluid IQ, which we have previously reported, is quantitatively modulated by the amount of reported SLES. Thus, after experiencing adversity, basic neuronal learning signatures appear to align more closely with a general measure of flexible learning (fluid IQ), a finding complementing studies on the effects of acute stress on learning. The results suggest that an understanding of the neurobiological correlates of trait variables like fluid IQ needs to take socioemotional influences such as chronic stress into account.}, language = {en} } @misc{HeroldTheobaldGronwaldetal.2022, author = {Herold, Fabian and Theobald, Paula and Gronwald, Thomas and Rapp, Michael Armin and M{\"u}ller, Notger Germar}, title = {Going digital - a commentary on the terminology used at the intersection of physical activity and digital health}, series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Gesundheitswissenschaftliche Reihe}, journal = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Gesundheitswissenschaftliche Reihe}, number = {5}, doi = {10.25932/publishup-58130}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-581301}, pages = {7}, year = {2022}, abstract = {In recent years digital technologies have become a major means for providing health-related services and this trend was strongly reinforced by the current Coronavirus disease 2019 (COVID-19) pandemic. As it is well-known that regular physical activity has positive effects on individual physical and mental health and thus is an important prerequisite for healthy aging, digital technologies are also increasingly used to promote unstructured and structured forms of physical activity. However, in the course of this development, several terms (e.g., Digital Health, Electronic Health, Mobile Health, Telehealth, Telemedicine, and Telerehabilitation) have been introduced to refer to the application of digital technologies to provide health-related services such as physical interventions. Unfortunately, the above-mentioned terms are often used in several different ways, but also relatively interchangeably. Given that ambiguous terminology is a major source of difficulty in scientific communication which can impede the progress of theoretical and empirical research, this article aims to make the reader aware of the subtle differences between the relevant terms which are applied at the intersection of physical activity and Digital Health and to provide state-of-art definitions for them.}, language = {en} } @article{HeroldTheobaldGronwaldetal.2022, author = {Herold, Fabian and Theobald, Paula and Gronwald, Thomas and Rapp, Michael Armin and M{\"u}ller, Notger Germar}, title = {Going digital - a commentary on the terminology used at the intersection of physical activity and digital health}, series = {European review of aging and physical activity}, volume = {19}, journal = {European review of aging and physical activity}, publisher = {Springer}, address = {Berlin ; Heidelberg}, issn = {1861-6909}, doi = {10.1186/s11556-022-00296-y}, pages = {7}, year = {2022}, abstract = {In recent years digital technologies have become a major means for providing health-related services and this trend was strongly reinforced by the current Coronavirus disease 2019 (COVID-19) pandemic. As it is well-known that regular physical activity has positive effects on individual physical and mental health and thus is an important prerequisite for healthy aging, digital technologies are also increasingly used to promote unstructured and structured forms of physical activity. However, in the course of this development, several terms (e.g., Digital Health, Electronic Health, Mobile Health, Telehealth, Telemedicine, and Telerehabilitation) have been introduced to refer to the application of digital technologies to provide health-related services such as physical interventions. Unfortunately, the above-mentioned terms are often used in several different ways, but also relatively interchangeably. Given that ambiguous terminology is a major source of difficulty in scientific communication which can impede the progress of theoretical and empirical research, this article aims to make the reader aware of the subtle differences between the relevant terms which are applied at the intersection of physical activity and Digital Health and to provide state-of-art definitions for them.}, language = {en} } @inproceedings{DahlingMayGreineretal.2021, author = {Dahling, Volker and May, Susann and Greiner, Timo and Thoma, Samuel and Peter, Sebastian von and Schwantes, Ulrich and Rapp, Michael Armin and Heinze, Martin}, title = {Verschreibungspraxis von Psychopharmaka in brandenburgischen Pflegeheimen}, series = {Zeitschrift f{\"u}r Gerontologie und Geriatrie : Organ der Deutschen Gesellschaft f{\"u}r Gerontologie und Geriatrie}, volume = {54}, booktitle = {Zeitschrift f{\"u}r Gerontologie und Geriatrie : Organ der Deutschen Gesellschaft f{\"u}r Gerontologie und Geriatrie}, number = {SUPPL 1}, publisher = {Springer Medizin}, address = {Heidelberg}, issn = {0948-6704}, pages = {S26 -- S26}, year = {2021}, language = {de} } @misc{GellertHaeuslerSuhretal.2018, author = {Gellert, Paul and H{\"a}usler, Andreas and Suhr, Ralf and Gholami, Maryam and Rapp, Michael Armin and Kuhlmey, Adelheid and Nordheim, Johanna}, title = {Testing the stress-buffering hypothesis of social support in couples coping with early-stage dementia}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {657}, issn = {1866-8364}, doi = {10.25932/publishup-44627}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-446270}, pages = {16}, year = {2018}, abstract = {Purpose To test whether the negative relationship between perceived stress and quality of life (Hypothesis 1) can be buffered by perceived social support in patients with dementia as well as in caregivers individually (Hypothesis 2: actor effects) and across partners (Hypothesis 3: partner effects and actor-partner effects). Method A total of 108 couples (N = 216 individuals) comprised of one individual with early-stage dementia and one caregiving partner were assessed at baseline and one month apart. Moderation effects were investigated by applying linear mixed models and actor-partner interdependence models. Results Although the stress-quality of life association was more pronounced in caregivers (beta = -.63, p<.001) compared to patients (beta= -.31, p<.001), this association was equally moderated by social support in patients (beta = .14, p<.05) and in the caregivers (beta =.13, p<.05). From one partner to his or her counterpart, the partner buffering and actor-partner-buffering effect were not present. Conclusion The stress-buffering effect has been replicated in individuals with dementia and caregivers but not across partners. Interventions to improve quality of life through perceived social support should not only focus on caregivers, but should incorporate both partners.}, 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{MellJacobFuhretal.2017, author = {Mell, Thomas and Jacob, Louis and Fuhr, Ida and Dick, Sandra and Rapp, Michael Armin and Kostev, Karel}, title = {Patterns of benzodiazepine prescribing by neuropsychiatrists and general practitioners for elderly patients in Germany in 2014}, series = {International journal of clinical pharmacology and therapeutics}, volume = {55}, journal = {International journal of clinical pharmacology and therapeutics}, publisher = {Dustri-Verlag Dr. Karl Feistle}, address = {Deisenhofen-M{\"u}nchen}, issn = {0946-1965}, doi = {10.5414/CP202904}, pages = {466 -- 471}, year = {2017}, abstract = {Background: The patterns of benzodiazepine prescriptions in older adults are of general and scientific interest as they are not yet well understood. The aim of this study was to compare the prescription patterns of benzodiazepines in elderly people in Germany to determine the share or proportion treated by general practitioners (GP) and neuropsychiatrists (NP). Methods: This study included 31,268 and 6,603 patients between the ages of 65 and 100 with at least one benzodiazepine prescription in 2014 from GP and NP, respectively. Demographic data included age, gender, and type of health insurance coverage. The share of elderly people with benzodiazepine prescriptions was estimated in different age and disease groups for both GP and NP patients. The share of the six most commonly prescribed drugs was also calculated for each type of practice. Results: The share of people taking benzodiazepines prescribed by GP increased from 3.2\% in patients aged between 65 and 69 years to 8.6\% in patients aged between 90 and 100 years, whereas this share increased from 5.4\% to 7.1\% in those seen by NP. Benzodiazepines were frequently used by patients suffering from sleep disorders (GP: 33.9\%; NP: 5.5\%), depression (GP: 17.9\%; NP: 29.8\%), and anxiety disorders (GP: 14.5\%; NP: 22.8\%). Lorazepam (30.3\%), oxazepam (24.7\%), and bromazepam (24.3\%) were the three most commonly prescribed drugs for GP patients. In contrast, lorazepam (60.4\%), diazepam (14.8\%), and oxazepam (11.2\%) were those more frequently prescribed to NP patients. Conclusion: Prescription patterns of benzodiazepine in the elderly varied widely between GP and NP.}, language = {en} } @misc{ChaparroZechHeinzeletal.2017, author = {Chaparro, Camilo G. A. Perez and Zech, Philipp A. and Heinzel, Stephan and Mayer, Frank and Wolfarth, Bernd and Rapp, Michael Armin and Heissel, Andreas}, title = {Effects Of Aerobic \& Resistance Training On Cardiorespiratory Fitness In People Living with HIV. A Meta-analysis}, series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine}, volume = {49}, journal = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {0195-9131}, doi = {10.1249/01.mss.0000519265.28705.86}, pages = {842 -- 842}, year = {2017}, language = {en} } @misc{ZechRappHeinzeletal.2017, author = {Zech, Philipp A. and Rapp, Michael Armin and Heinzel, Stephan and Wolfarth, Bernd and Lawrence, Jimmy B. and Heissel, Andreas}, title = {Does Exercise Help People Living with HIV Improve Their Quality of Life? A meta-analysis.}, series = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine}, volume = {49}, journal = {Medicine and science in sports and exercise : official journal of the American College of Sports Medicine}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {0195-9131}, doi = {10.1249/01.mss.0000518177.22369.2f}, pages = {470 -- 470}, year = {2017}, language = {en} } @article{BohlkenJacobSchaumetal.2017, author = {Bohlken, Jens and Jacob, Louis and Schaum, Peter and Rapp, Michael Armin and Kostev, Karel}, title = {Hip fracture risk in patients with dementia in German primary care practices}, series = {Dementia}, volume = {16}, journal = {Dementia}, publisher = {Sage Publ.}, address = {London}, issn = {1471-3012}, doi = {10.1177/1471301215621854}, pages = {853 -- 864}, year = {2017}, abstract = {The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65-90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance. The primary outcome was the diagnosis of hip fracture during the three-year follow-up period. A total of 53,156 dementia patients and 53,156 controls were included. A total of 5.3\% of patients and 0.7\% of controls displayed hip fracture after three years. Hip fracture occurred more frequently in dementia subjects living in nursing homes than in those living at home (9.2\% versus 4.3\%). Dementia, residence in nursing homes, and osteoporosis were risk factors for fracture development. Antidementia, antipsychotic, and antidepressant drugs generally had no significant impact on hip fracture risk when prescribed for less than six months. Dementia increased hip fracture risk in German primary care practices.}, language = {en} } @misc{SchraplauBlockHaeusleretal.2021, author = {Schraplau, Anne and Block, Andrea and H{\"a}usler, Andreas and Wippert, Pia-Maria and Rapp, Michael Armin and V{\"o}ller, Heinz and Bonaventura, Klaus and Mayer, Frank}, title = {Mobile diagnostics and consultation for the prevention of the metabolic syndrome and its secondary diseases in Brandenburg—study protocol of a regional prospective cohort study: the Mobile Brandenburg Cohort}, series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, publisher = {Universit{\"a}tsverlag Potsdam}, address = {Potsdam}, issn = {1866-8364}, doi = {10.25932/publishup-54950}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-549506}, pages = {1 -- 11}, year = {2021}, abstract = {Background The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. The implementation of prevention programs requires early detection of individuals at risk. However, access to health care providers is limited in structurally weak regions. Brandenburg, a rural federal state in Germany, has an especially high MetS prevalence and disease burden. This study aims to validate and test the feasibility of a setup for mobile diagnostics of MetS and its secondary diseases, to evaluate the MetS prevalence and its association with moderating factors in Brandenburg and to identify new ways of early prevention, while establishing a "Mobile Brandenburg Cohort" to reveal new causes and risk factors for MetS. Methods In a pilot study, setups for mobile diagnostics of MetS and secondary diseases will be developed and validated. A van will be equipped as an examination room using point-of-care blood analyzers and by mobilizing standard methods. In study part A, these mobile diagnostic units will be placed at different locations in Brandenburg to locally recruit 5000 participants aged 40-70 years. They will be examined for MetS and advice on nutrition and physical activity will be provided. Questionnaires will be used to evaluate sociodemographics, stress perception, and physical activity. In study part B, participants with MetS, but without known secondary diseases, will receive a detailed mobile medical examination, including MetS diagnostics, medical history, clinical examinations, and instrumental diagnostics for internal, cardiovascular, musculoskeletal, and cognitive disorders. Participants will receive advice on nutrition and an exercise program will be demonstrated on site. People unable to participate in these mobile examinations will be interviewed by telephone. If necessary, participants will be referred to general practitioners for further diagnosis. Discussion The mobile diagnostics approach enables early detection of individuals at risk, and their targeted referral to local health care providers. Evaluation of the MetS prevalence, its relation to risk-increasing factors, and the "Mobile Brandenburg Cohort" create a unique database for further longitudinal studies on the implementation of home-based prevention programs to reduce mortality, especially in rural regions. Trial registration German Clinical Trials Register, DRKS00022764; registered 07 October 2020—retrospectively registered.}, language = {en} } @misc{HeisselBollmannKangasetal.2021, author = {Heißel, Andreas and Bollmann, J and Kangas, Maria and Rapp, Michael Armin and S{\´a}nchez, Alba Cristina and Abdulla, K}, title = {Validation of the German version of the work and social adjustment scale in a sample of depressed patients}, series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, publisher = {Universit{\"a}tsverlag Potsdam}, address = {Potsdam}, issn = {1866-8364}, doi = {10.25932/publishup-54781}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-547810}, pages = {1 -- 11}, year = {2021}, abstract = {Background Depression is one of the key factors contributing to difficulties in one's ability to work, and serves as one of the major reasons why employees apply for psychotherapy and receive insurance subsidization of treatments. Hence, an increasing and growing number of studies rely on workability assessment scales as their primary outcome measure. The Work and Social Assessment Scale (WSAS) has been documented as one of the most psychometrically reliable and valid tools especially developed to assess workability and social functioning in patients with mental health problems. Yet, the application of the WSAS in Germany has been limited due to the paucity of a valid questionnaire in the German language. The objective of the present study was to translate the WSAS, as a brief and easy administrable tool into German and test its psychometric properties in a sample of adults with depression. Methods Two hundred seventy-seven patients (M = 48.3 years, SD = 11.1) with mild to moderately severe depression were recruited. A multistep translation from English into the German language was performed and the factorial validity, criterion validity, convergent validity, discriminant validity, internal consistency, and floor and ceiling effects were examined. Results The confirmatory factor analysis results confirmed the one-factor structure of the WSAS. Significant correlations with the WHODAS 2-0 questionnaire, a measure of functionality, demonstrated good convergent validity. Significant correlations with depression and quality of life demonstrated good criterion validity. The WSAS also demonstrated strong internal consistency (α = .89), and the absence of floor and ceiling effects indicated good sensitivity of the instrument. Conclusions The results of the present study demonstrated that the German version of the WSAS has good psychometric properties comparable to other international versions of this scale. The findings recommend a global assessment of psychosocial functioning with the sum score of the WSAS.}, language = {en} } @article{HeisselBollmannKangasetal.2021, author = {Heißel, Andreas and Bollmann, Julian and Kangas, Maria and Abdulla, K and Rapp, Michael Armin and S{\´a}nchez Fern{\`a}ndez, Alba Cristina}, title = {Validation of the German version of the work and social adjustment scale in a sample of depressed patients}, series = {BMC health services research}, volume = {21}, journal = {BMC health services research}, publisher = {BioMed Central}, address = {London}, issn = {1472-6963}, doi = {10.1186/s12913-021-06622-x}, pages = {1 -- 11}, year = {2021}, abstract = {Background Depression is one of the key factors contributing to difficulties in one's ability to work, and serves as one of the major reasons why employees apply for psychotherapy and receive insurance subsidization of treatments. Hence, an increasing and growing number of studies rely on workability assessment scales as their primary outcome measure. The Work and Social Assessment Scale (WSAS) has been documented as one of the most psychometrically reliable and valid tools especially developed to assess workability and social functioning in patients with mental health problems. Yet, the application of the WSAS in Germany has been limited due to the paucity of a valid questionnaire in the German language. The objective of the present study was to translate the WSAS, as a brief and easy administrable tool into German and test its psychometric properties in a sample of adults with depression. Methods Two hundred seventy-seven patients (M = 48.3 years, SD = 11.1) with mild to moderately severe depression were recruited. A multistep translation from English into the German language was performed and the factorial validity, criterion validity, convergent validity, discriminant validity, internal consistency, and floor and ceiling effects were examined. Results The confirmatory factor analysis results confirmed the one-factor structure of the WSAS. Significant correlations with the WHODAS 2-0 questionnaire, a measure of functionality, demonstrated good convergent validity. Significant correlations with depression and quality of life demonstrated good criterion validity. The WSAS also demonstrated strong internal consistency (α = .89), and the absence of floor and ceiling effects indicated good sensitivity of the instrument. Conclusions The results of the present study demonstrated that the German version of the WSAS has good psychometric properties comparable to other international versions of this scale. The findings recommend a global assessment of psychosocial functioning with the sum score of the WSAS.}, language = {en} } @article{HeinzelLorenzQuynhLamDuongetal.2017, author = {Heinzel, Stephan and Lorenz, Robert C. and Quynh-Lam Duong, and Rapp, Michael Armin and Deserno, Lorenz}, title = {Prefrontal-parietal effective connectivity during working memory in older adults}, series = {Neurobiology of Aging}, volume = {57}, journal = {Neurobiology of Aging}, publisher = {Elsevier}, address = {New York}, issn = {0197-4580}, doi = {10.1016/j.neurobiolaging.2017.05.005}, pages = {18 -- 27}, year = {2017}, abstract = {Theoretical models and preceding studies have described age-related alterations in neuronal activation of frontoparietal regions in a working memory (WM)load-dependent manner. However, to date, underlying neuronal mechanisms of these WM load-dependent activation changes in aging remain poorly understood. The aim of this study was to investigate these mechanisms in terms of effective connectivity by application of dynamic causal modeling with Bayesian Model Selection. Eighteen healthy younger (age: 20-32 years) and 32 older (60-75 years) participants performed an n-back task with 3 WM load levels during functional magnetic resonance imaging (fMRI). Behavioral and conventional fMRI results replicated age group by WM load interactions. Importantly, the analysis of effective connectivity derived from dynamic causal modeling, indicated an age-and performance-related reduction in WM load-dependent modulation of connectivity from dorsolateral prefrontal cortex to inferior parietal lobule. This finding provides evidence for the proposal that age-related WM decline manifests as deficient WM load-dependent modulation of neuronal top-down control and can integrate implications from theoretical models and previous studies of functional changes in the aging brain.}, language = {en} } @article{DeekenHaeuslerNordheimetal.2017, author = {Deeken, Friederike and H{\"a}usler, Andreas and Nordheim, Johanna and Rapp, Michael Armin and Knoll, Nina and Rieckmann, Nina}, title = {Psychometric properties of the Perceived Stress Scale in a sample of German dementia patients and their caregivers}, series = {International psychogeriatrics}, volume = {30}, journal = {International psychogeriatrics}, number = {1}, publisher = {Cambridge Univ. Press}, address = {New York}, issn = {1041-6102}, doi = {10.1017/S1041610217001387}, pages = {39 -- 47}, year = {2017}, abstract = {Background: The aim of the present study was to investigate the psychometric characteristics of the Perceived Stress Scale (PSS) in a sample of dementia patients and their spousal caregivers. Methods: We investigated the reliability and validity of the 14-item PSS in a sample of 80 couples, each including one spouse who had been diagnosed with mild to moderate dementia (mean age 75.55, SD = 5.85, 38.7\% female) and one spousal caregiver (mean age 73.06, SD = 6.75, 61.3\% female). We also examined the factor structure and sensitivity of the scale with regard to gender differences. Results: Exploratory factor analysis of the PSS revealed a two-factor solution for the scale; the first factor reflected general stress while the second factor consisted of items reflecting the perceived ability to cope with stressors. A confirmatory factor analysis verified that the data were a better fit for the two-factor model than a one-factor model. The two factors of the PSS showed good reliability for patients as well as for caregivers ranging between alpha = 0.73 and alpha = 0.82. Perceived stress was significantly positively correlated with depressive symptomatology in both caregivers and patients. Mean PSS scores did not significantly differ between male and female patients nor did they differ between male and female caregivers. Conclusion: The present data indicate that the PSS provides a reliable and valid measure of perceived stress in dementia patients and their caregivers.}, language = {en} } @article{GellertHaeuslerGholamietal.2017, author = {Gellert, Paul and H{\"a}usler, Andreas and Gholami, Maryam and Rapp, Michael Armin and Kuhlmey, Adelheid and Nordheim, Johanna}, title = {Own and partners' dyadic coping and depressive symptoms in individuals with early-stage dementia and their caregiving partners}, series = {Aging \& Mental Health}, volume = {22}, journal = {Aging \& Mental Health}, number = {8}, publisher = {Routledge, Taylor \& Francis Group}, address = {Abingdon}, issn = {1360-7863}, doi = {10.1080/13607863.2017.1334759}, pages = {1008 -- 1016}, year = {2017}, abstract = {Objectives: In patients with early-stage dementia and their caregiving partners, reciprocal dyadic coping (DC) is crucial for preventing or reducing depressive symptoms in both partners. This study examines the relationships between 'own DC' and 'perceived partner DC' with depressive symptoms in couples coping with dementia on individual (actor effects) and cross-person (partner effects) levels. Method: 164 individuals (82 patients with early-stage dementia and their 82 caregiving partners; ND = 82 dyads) participated in this prospective study with measures (DC, depressive symptoms, and dementia severity) taken at baseline and at six months. Each partner evaluated their own and the perceived partner DC. Actor-partner interdependence models were applied to the resulting four independent evaluations. Results: Results differed substantially between patients and caregivers. DC was significantly related to patients' but not to caregivers' depressive symptoms, when adjustments were made for individual coping. Perceived partner DC showed a negative association with depressive symptoms in patients, whereas own DC was adversely related for actor as well as for partner effects across individuals. Conclusion: The adverse association between the own DC of the caregiver and the patient on depressive symptoms of the patient might be due to inappropriate efforts or to the loss of autonomy as a care-receiver. DC is important in both patients and caregivers, as shown by the negative association between perceived partner DC and depressive symptoms in the patients, which might inform interventions that target the couple as a whole.}, language = {en} } @article{MeiberthRappJessen2019, author = {Meiberth, Dix Urs and Rapp, Michael Armin and Jessen, Frank}, title = {Ged{\"a}chtnisambulanzstrukturen in Deutschland - Ergebnisse einer Klinikbefragung}, series = {Psychiatrische Praxis}, volume = {46}, journal = {Psychiatrische Praxis}, number = {4}, publisher = {Thieme}, address = {Stuttgart}, issn = {0303-4259}, doi = {10.1055/a-0825-9049}, pages = {213 -- 216}, year = {2019}, abstract = {Ziel der Studie Erfassung der Strukturen zur Fr{\"u}hdiagnostik von Demenzen an Krankenh{\"a}usern in Deutschland. Methodik Fragebogenerhebung. Ergebnisse 14 \% von 1758 kontaktierten Einrichtungen antworteten. 52 \% berichteten {\"u}ber ein entsprechendes Angebot, zum großen Teil mit leitlinienorientierten Verfahren, wie Liquordiagnostik. Das Diagnosespektrum umfasste zu 46 \% Demenzen und zu 41 \% Diagnosen der leichten oder subjektiven kognitiven St{\"o}rung. Schlussfolgerung Leitlinienbasierte Diagnostik und Fr{\"u}herkennungskonzepte sind in Ged{\"a}chtnisambulanzen weitgehend etabliert.}, language = {de} } @article{DeekenRezoHinzetal.2019, author = {Deeken, Friederike and Rezo, Anna and Hinz, Matthias and Discher, Robert and Rapp, Michael Armin}, title = {Evaluation of technology-based interventions for informal caregivers of patients with dementia}, series = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry}, volume = {27}, journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry}, number = {4}, publisher = {Elsevier}, address = {New York}, issn = {1064-7481}, doi = {10.1016/j.jagp.2018.12.003}, pages = {426 -- 445}, year = {2019}, abstract = {Objective: The aim of this study was to estimate the efficacy of technology-based interventions for informal caregivers of people with dementia (PWD). Methods: PubMed, PsycINFO, and Cochrane Library databases were searched in August 2018, with no restrictions in language or publication date. Two independent reviewers identified 33 eligible randomized controlled trials (RCTs) conducting a technology-based intervention for informal carers of PWD. Meta-analyses for the outcome measures caregiver depression and caregiver burden were conducted with subgroup analyses according to mode of delivery (telephone, computer/web-based, combined interventions). To assess methodologic quality, the Cochrane risk-of-bias assessment was rated. Results: Meta-analyses revealed a small but significant postintervention effect of technology-based interventions for caregiver depression and caregiver burden. Combined interventions showed the strongest effects. Conclusion: Technology-based interventions have the potential to support informal caregivers of PWD. Because of advantages such as high flexibility and availability, technology-based interventions provide a promising alternative compared with "traditional services," e.g., those for people living in rural areas. More high-quality RCTs for specific caregiver groups are needed.}, language = {en} } @article{BohlkenWeberSiebertetal.2017, author = {Bohlken, Jens and Weber, Simon A. and Siebert, Anke and Forstmeier, Simon and Kohlmann, Thomas and Rapp, Michael Armin}, title = {Reminiscence therapy for depression in dementia}, series = {GeroPsych - The Journal of gerontopsychology and geriatric psychiatry}, volume = {30}, journal = {GeroPsych - The Journal of gerontopsychology and geriatric psychiatry}, publisher = {Hogrefe}, address = {G{\"o}ttingen}, issn = {1662-9647}, doi = {10.1024/1662-9647/a000175}, pages = {145 -- 151}, year = {2017}, abstract = {We investigated the efficacy of reminiscence therapy (RT) on symptoms of depression in patients with mild to moderate dementia. Out of 227 patients with mild to moderate dementia from a specialized physician's office, 27 pairs (N = 54; mean age 79.04 ± 6.16 years) who had either received treatment as usual (TAU) or TAU combined with RT, were matched retrospectively according to age as well as cognitive and depressive symptom scores. After controlling for age and sex, symptoms of depression significantly decreased over time in the RT group compared to TAU (F1,52 = 4.36; p < .05). RT is a promising option for the treatment of depression in mild to moderate dementia. Larger randomized-controlled trials are needed.}, language = {en} } @misc{ThomasSabbahRappetal.2019, author = {Thomas, Christine and Sabbah, Patricia and Rapp, Michael Armin and Eschweiler, Gerhard}, title = {The Perioperative Care of Older Patients}, series = {Deutsches {\"A}rzteblatt international : a weekly online journal of clinical medicine and public health}, volume = {116}, journal = {Deutsches {\"A}rzteblatt international : a weekly online journal of clinical medicine and public health}, number = {21}, publisher = {Dt. {\"A}rzte-Verl.}, address = {Cologne}, issn = {1866-0452}, doi = {10.3238/arztebl.2019.0373a}, pages = {373 -- 373}, year = {2019}, language = {en} } @article{SturmWildermuthStolzetal.2019, author = {Sturm, Heidrun and Wildermuth, Ronja and Stolz, Regina and Bertram, L. and Eschweiler, G. W. and Thomas, C. and Rapp, Michael Armin and Joos, S.}, title = {Diverging awareness of postoperative delirium and cognitive dysfunction in German Health Care Providers}, series = {Clinical interventions in agins}, volume = {14}, journal = {Clinical interventions in agins}, publisher = {DOVE Medical Press}, address = {Albany}, issn = {1178-1998}, doi = {10.2147/CIA.S230800}, pages = {2125 -- 2135}, year = {2019}, abstract = {Purpose: Postoperative cognitive dysfunction (POCD) appears in up to 30\% of patients suffering from postoperative delirium (POD). Both are associated with higher mortality and postoperative complications, prolonged hospital stays, and increased costs. Multi-modal models with pre-admission risk reduction counselling, perioperative monitoring, and training of multidisciplinary patient care providers have been shown to decrease the prevalence of both. The aim of our study is to understand how far those measures are known and implemented in routine care and to detect potential gaps in the current practice regarding risk communication and information flow between involved caregivers for patients at risk for POD/POCD. Patients and Methods: As part of a multicenter study, seven semi-structured focus group (FG) discussions with nurses and physicians from tertiary care hospitals (surgery, anesthesiology, and orthopedics, n=31) and general practitioners (GPs) in private practice (n=7) were performed. Transcribed discussions were analyzed using qualitative content analysis. Results: POD is present above all in the daily work of nurses, whereas physicians do not perceive it as a relevant problem. Physicians report that no regular risk assessment or risk communication was performed prior to elective surgery. Information about POD often gets lost during hand-offs and is not regularly reported in discharge letters. Thus, persisting cognitive dysfunction is often missed. The importance of standardized documentation and continuous education concerning risks, screening, and treatment was emphasized. The often-suggested pre-OP medication adjustment was seen as less important; in contrast, avoiding withdrawal was regarded as far more important. Conclusion: Altogether, it seems that standards and available best practice concepts are rarely implemented. In contrast to physicians, nurses are highly aware of delirium and ask for standardized procedures and more responsibility. Therefore, raising awareness regarding risks, screening tools, and effective preventive measures for POD/POCD seems an urgent goal. Nurses should have a central role in coordination and care of POD to prevent the risk for POCD.}, language = {en} } @article{GellertHaeuslerSuhretal.2018, author = {Gellert, Paul and H{\"a}usler, Andreas and Suhr, Ralf and Gholami, Maryam and Rapp, Michael Armin and Kuhlmey, Adelheid and Nordheim, Johanna}, title = {Testing the stress-buffering hypothesis of social support in couples coping with early-stage dementia}, series = {PLoS one}, volume = {13}, journal = {PLoS one}, number = {1}, publisher = {PLoS}, address = {San Fransisco}, issn = {1932-6203}, doi = {10.1371/journal.pone.0189849}, pages = {14}, year = {2018}, abstract = {Purpose: To test whether the negative relationship between perceived stress and quality of life (Hypothesis 1) can be buffered by perceived social support in patients with dementia as well as in caregivers individually (Hypothesis 2: actor effects) and across partners (Hypothesis 3: partner effects and actor-partner effects). Method: A total of 108 couples (N = 216 individuals) comprised of one individual with early-stage dementia and one caregiving partner were assessed at baseline and one month apart. Moderation effects were investigated by applying linear mixed models and actor-partner interdependence models. Results: Although the stress-quality of life association was more pronounced in caregivers (beta = -.63, p<.001) compared to patients (beta= -.31, p<.001), this association was equally moderated by social support in patients (beta = .14, p<.05) and in the caregivers (beta =.13, p<.05). From one partner to his or her counterpart, the partner buffering and actor-partner-buffering effect were not present. Conclusion: The stress-buffering effect has been replicated in individuals with dementia and caregivers but not across partners. Interventions to improve quality of life through perceived social support should not only focus on caregivers, but should incorporate both partners.}, 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} } @article{KonradJacobRappetal.2016, author = {Konrad, Marcel and Jacob, Louis and Rapp, Michael Armin and Kostev, Karel}, title = {Depression risk in patients with coronary heart disease in Germany}, series = {World Journal of Cardiology}, volume = {8}, journal = {World Journal of Cardiology}, publisher = {Baishideng Publishing Group}, address = {Pleasanton}, issn = {1949-8462}, doi = {10.4330/wjc.v8.i9.547}, pages = {547 -- 552}, year = {2016}, abstract = {AIM To determine the prevalence of depression and its risk factors among patients with coronary heart disease (CHD) treated in German primary care practices. METHODS Longitudinal data from nationwide general practices in Germany (n = 1072) were analyzed. Individuals initially diagnosed with CHD (2009-2013) were identified, and 59992 patients were included and matched (1: 1) to 59992 controls. The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD. Cox proportional hazards models were used to adjust for confounders. RESULTS Mean age was equal to 68.0 years (SD = 11.3). A total of 55.9\% of patients were men. After a five-year follow-up, 21.8\% of the CHD group and 14.2\% of the control group were diagnosed with depression (P < 0.001). In the multivariate regression model, CHD was a strong risk factor for developing depression (HR = 1.54, 95\% CI: 1.49-1.59, P < 0.001). Prior depressive episodes, dementia, and eight other chronic conditions were associated with a higher risk of developing depression. Interestingly, older patients and women were also more likely to be diagnosed with depression compared with younger patients and men, respectively. CONCLUSION The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany. CHD patients should be routinely screened for depression to ensure improved treatment and management.}, language = {en} } @article{BookerJacobRappetal.2016, author = {Booker, Anke and Jacob, Louis E. C. and Rapp, Michael Armin and Bohlken, Jens and Kostev, Karel}, title = {Risk factors for dementia diagnosis in German primary care practices}, series = {International psychogeriatrics}, volume = {28}, journal = {International psychogeriatrics}, publisher = {Cambridge Univ. Press}, address = {New York}, issn = {1041-6102}, doi = {10.1017/S1041610215002082}, pages = {1059 -- 1065}, year = {2016}, abstract = {Background: Dementia is a psychiatric condition the development of which is associated with numerous aspects of life. Our aim was to estimate dementia risk factors in German primary care patients. Methods: The case-control study included primary care patients (70-90 years) with first diagnosis of dementia (all-cause) during the index period (01/2010-12/2014) (Disease Analyzer, Germany), and controls without dementia matched (1:1) to cases on the basis of age, sex, type of health insurance, and physician. Practice visit records were used to verify that there had been 10 years of continuous follow-up prior to the index date. Multivariate logistic regression models were fitted with dementia as a dependent variable and the potential predictors. Conclusions: Risk factors for dementia found in this study are consistent with the literature. Nevertheless, the associations between statin, PPI and antihypertensive drug use, and decreased risk of dementia need further investigations.}, language = {en} } @misc{HeinzVossLawrieetal.2016, author = {Heinz, A. and Voss, M. and Lawrie, S. M. and Mishara, A. and Bauer, M. and Gallinat, J. and Juckel, G. and Lang, U. and Rapp, Michael Armin and Falkai, P. and Strik, W. and Krystal, J. and Abi-Dargham, A. and Galderisi, S.}, title = {Shall we really say goodbye to first rank symptoms?}, series = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {37}, journal = {European psychiatry : the journal of the Association of European Psychiatrists}, publisher = {Elsevier}, address = {Paris}, issn = {0924-9338}, doi = {10.1016/j.eurpsy.2016.04.010}, pages = {8 -- 13}, year = {2016}, abstract = {Background: First rank symptoms (FRS) of schizophrenia have been used for decades for diagnostic purposes. In the new version of the DSM-5, the American Psychiatric Association (APA) has abolished any further reference to FRS of schizophrenia and treats them like any other "criterion A' symptom (e.g. any kind of hallucination or delusion) with regard to their diagnostic implication. The ICD-10 is currently under revision and may follow suit. In this review, we discuss central points of criticism that are directed against the continuous use of first rank symptoms (FRS) to diagnose schizophrenia.}, language = {en} } @article{BakanidzeBrandlHutzleretal.2016, author = {Bakanidze, George and Brandl, Eva J. and Hutzler, Christine and Aurass, Friederike and Onken, Silke and Rapp, Michael Armin and Puls, Imke}, title = {Association of Dystrobrevin-Binding Protein 1 Polymorphisms with Sustained Attention and Set-Shifting in Schizophrenia Patients}, series = {Neuropsychobiology : international journal of experimental and clinical research in biological psychiatry, pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography}, volume = {74}, journal = {Neuropsychobiology : international journal of experimental and clinical research in biological psychiatry, pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography}, publisher = {Karger}, address = {Basel}, issn = {0302-282X}, doi = {10.1159/000450550}, pages = {41 -- 47}, year = {2016}, abstract = {Background: Despite extensive research in the past decades, the influence of genetics on cognitive functions in schizophrenia remains unclear. Dystrobrevin-binding protein 1 (DTNBP1) is one of the most promising candidate genes in schizophrenia. An association of DTNBP1 with cognitive dysfunction, particularly memory impairment, has been reported in a number of studies. However, the results remain inconsistent. The aim of this study was to measure the association between DTNBP1 polymorphisms and cognitive domains in a well-characterized sample. Methods: Ninety-one clinically stable schizophrenia outpatients underwent a battery of cognitive tests. Six single nucleotide polymorphisms (SNPs) of DTNBP1 were genotyped in all participants. Statistical and multivariate analyses were performed. Results: Factor analysis revealed 4 factors corresponding to distinct cognitive domains, namely sustained attention, set-shifting, executive functioning, and memory. We found a significant association of the rs909706 polymorphism with attention (p = 0.030) and a nonsignificant trend for set-shifting (p = 0.060). The other SNPs and haplotypes were not associated with cognitive function. Discussion: Replication of this finding in a larger sample is needed in order to confirm the importance of this particular polymorphism in the genetics of schizophrenia, particularly the distinct cognitive domains. In conclusion, the present study supports the involvement of DTNBP1 in the regulation of cognitive processes and demonstrates association in particular with sustained attention and set-shifting in schizophrenia patients. (C) 2016 S. Karger AG, Basel}, language = {en} } @article{BookerBohlkenRappetal.2016, author = {Booker, Anke and Bohlken, Jens and Rapp, Michael Armin and Kostev, Karel}, title = {Persistence with antidepressant drugs in patients with dementia: a retrospective database analysis}, 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/CP202572}, pages = {323 -- 329}, year = {2016}, abstract = {Background: The aims of the present study are to determine what proportion of patients with dementia receives antidepressants, how long the treatment is administered, and what factors increase the risk of discontinuation. Methods: The study was based on Disease Analyzer database and included 1,203 general practitioners (GP) and 209 neurologists/psychiatrists (NP). 12,281 patients with a diagnosis of dementia and an initial prescription of an antidepressant drug between January 2004 and December 2013 were included. The main outcome measure was antidepressant discontinuation rates within 6 months of the index date. Results: After 6 months of follow-up, 52.7\% of dementia patients treated with antidepressants had stopped medication intake. There was a significantly decreased risk for treatment discontinuation for patients using selective serotonin reuptake inhibitors (SSRRIs) or serotonin and norepinephrine reuptake inhibitors (SSNRIs) compared to tricyclic antidepressants. There was a significantly increased risk of treatment discontinuation for older patients and patients treated in NP practice. Comorbidity of diabetes or history of stroke was associated with a decreased risk of treatment discontinuation. Conclusion: The study results show insufficient persistence in antidepressant treatment in dementia patients in a real world setting. The improvement must be achieved to ensure the treatment recommended in the guidelines.}, language = {en} } @misc{StroehleRapp2016, author = {Stroehle, Andreas and Rapp, Michael Armin}, title = {Prevention of Cognitive Decline: A Physical Exercise Perspective on Brain Health in the Long Run}, series = {Journal of the American Medical Directors Association}, volume = {17}, journal = {Journal of the American Medical Directors Association}, publisher = {Elsevier}, address = {New York}, issn = {1525-8610}, doi = {10.1016/j.jamda.2016.02.030}, pages = {461 -- 462}, year = {2016}, language = {en} } @misc{HeisselZechRappetal.2019, author = {Heissel, Andreas and Zech, Philipp and Rapp, Michael Armin and Schuch, Felipe B. and Lawrence, Jimmy B. and Kangas, Maria and Heinzel, Stephan}, title = {Effects of exercise on depression and anxiety in persons living with HIV: A meta-analysis}, series = {Journal of psychosomatic research}, volume = {126}, journal = {Journal of psychosomatic research}, publisher = {Elsevier}, address = {Oxford}, issn = {0022-3999}, doi = {10.1016/j.jpsychores.2019.109823}, pages = {12}, year = {2019}, abstract = {Objective: The purpose of this systematic review and meta-analysis was to examine the effects of exercise on depression and anxiety in people living with HIV (PLWH), and to evaluate, through subgroup analysis, the effects of exercise type, frequency, supervision by exercise professionals, study quality, and control group conditions on these outcomes. Method: A literature search was conducted through four electronic databases from inception to February 2019. Considered for inclusion were randomized controlled trials (RCTs) investigating exercise interventions and depression or anxiety as outcomes in people living with HIV (>= 18 years of age). Ten studies were included (n = 479 participants, 49.67\% females at baseline), and the standardized mean difference (SMD) and heterogeneity were calculated using random-effect models. An additional pre-post meta-analysis was also conducted. Results: A large effect in favor of exercise when compared to controls was found for depression (SMD = -0.84, 95\%CI = [-1.57, -0.11], p = 0.02) and anxiety (SMD = -1.23, 95\%CI = [-2.42, 0.04], p = -0.04). Subgroup analyses for depression revealed large effects on depression for aerobic exercise only (SMD = -0.96, 95\%CI = [-1.63, -0.30], p = 0.004), a frequency of >= 3 exercise sessions per week (SMD = -1.39, 95\%CI = [-2.24, -0.54], p < 0.001), professionally supervised exercise (SMD = -1.40, 95\%CI = [-2.46, -0.17], p = 0.03]), and high-quality studies (SMD = -1.31, 95\%CI = [-2.46, -0.17], p = 0.02). Conclusion: Exercise seems to decrease depressive symptoms and anxiety in PLWH, but other larger and high-quality studies are needed to verify these effects.}, language = {en} } @article{KlugeRappMehranetal.2019, author = {Kluge, Ulrike and Rapp, Michael Armin and Mehran, Nassim and Abi Jumaa, Jinan and Aichberger, Marion Christina}, title = {Poverty, migration and mental health}, series = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie}, volume = {90}, journal = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie}, number = {11}, publisher = {Springer}, address = {New York}, issn = {0028-2804}, doi = {10.1007/s00115-019-00790-2}, pages = {1103 -- 1108}, year = {2019}, abstract = {Poverty and social exclusion are closely related to an increased risk for the deterioration of mental health. In 2018 approximately 19\% of the German population were threatened by poverty and the associated social ostracization. Migrant groups in particular often show an increased risk for poverty and are often exposed to multiple socioeconomic stress factors depending on the context of migration, pre-migration and post-migration social factors. Numerous studies have shown that societal exclusion, precarious living conditions and the residential environment negatively affect mental health beyond the effects of pre-migration risk factors. This article provides a review and discussion on the relationship between mental health, poverty and related constructs, such as social cohesion, social capital and social exclusion in general as well as in specific risk groups, such as migrant and refugee populations.}, language = {en} } @article{Rapp2019, author = {Rapp, Michael Armin}, title = {Die Versorgung f{\"u}r die n{\"a}chste Dekade sichern: Gerontopsychiatrie in der Krise?}, series = {Psychatrische Praxis}, volume = {46}, journal = {Psychatrische Praxis}, number = {6}, publisher = {Thieme}, address = {Stuttgart}, issn = {0303-4259}, doi = {10.1055/a-0971-5551}, pages = {305 -- 306}, year = {2019}, abstract = {Der demografische Wandel wird nicht nur mit einer rasanten Zunahme der Hochaltrigen einhergehen [1], was f{\"u}r die gerontopsychiatrische Versorgung aufgrund der altersassoziierten Inzidenzraten in erster Linie eine Zunahme an Demenzerkrankungen und Patienten mit Multimorbidit{\"a}t und Gebrechlichkeit bedeutet [2], sondern auch mit einer Zunahme j{\"u}ngerer alter Menschen vom 65. bis 75. Lebensjahr, was f{\"u}r die Gerontopsychiatrie eine Zunahme der Patienten mit Abh{\"a}ngigkeitserkrankungen, Erkrankungen aus dem schizophrenen Formenkreis und affektiven Erkrankungen bedeutet. Soziale Faktoren werden hier mehr und mehr eine zentrale Rolle spielen, da neben der Qualit{\"a}t der medizinischen Versorgung insbesondere die individuelle soziale Situation der Patienten mit einer erh{\"o}hten Morbidit{\"a}t und Mortalit{\"a}t einhergehen wird [3].}, language = {de} } @misc{WippertBlockMansuyetal.2019, author = {Wippert, Pia-Maria and Block, Andrea and Mansuy, Isabelle M. and Peters, Eva M. J. and Rose, Matthias and Rapp, Michael Armin and Huppertz, Alexander and W{\"u}rtz-Kozak, Karin}, title = {Alterations in Bone Homeostasis and Microstructure Related to Depression and Allostatic Load}, series = {Psychotherapy and Psychosomatics}, volume = {88}, journal = {Psychotherapy and Psychosomatics}, number = {6}, publisher = {Karger}, address = {Basel}, issn = {0033-3190}, doi = {10.1159/000503640}, pages = {383 -- 385}, year = {2019}, language = {en} } @article{BlockSchulzeDeekenetal.2021, author = {Block, Andrea and Schulze, Susanne and Deeken, Friederike and H{\"a}usler, Andreas and Rezo, Anna and Rapp, Michael Armin and Wippert, Pia-Maria}, title = {Effects of inflammatory markers and biographical stress on treatment response in depression}, series = {Psychoneuroendocrinology : an international journal ; the official journal of the International Society of Psychoneuroendocrinology}, volume = {131}, journal = {Psychoneuroendocrinology : an international journal ; the official journal of the International Society of Psychoneuroendocrinology}, number = {Supplement}, publisher = {Elsevier}, address = {Oxford}, issn = {0306-4530}, doi = {10.1016/j.psyneuen.2021.105535}, pages = {S24 -- S24}, year = {2021}, abstract = {Background Recent research emphasized the role of inflammatory processes in the pathophysiology of depression. Theories hypothesizes that life events (LE) can affect the immune system and trigger depressive symptoms. LE are also considered as one of the best predictors for the onset and course of depressive disorders. Methods Observational study across three treatment settings: n=208 depressive patients (75.5\%f, M 46.6 y) were examined on depression (BDI-II), life events (ILE) and inflammatory markers (IL-6, CRP, fibrinogen, ICAM-1, TNF-alpha, E-selectin) at baseline (t0), 5-week(t1) and 5-month(t2) follow-up. Effects and interactions were analyzed with regression models. Results LE were associated with depressive symptoms at t0 (beta=.209; p=.002) and both follow-ups. Except for CRP, which was linked to depression symptoms at t2 (betai=-.190; p=.032), there were no effects of inflammatory markers on depressive symptoms. At t1, an interaction between CRP and LE in total (beta=-.249; p=.041) was found as well as for LE in the past five years (beta=-.122; p=.027). Similar interactions were found between cumulative LE and ICAM-1 (beta=-.197; p=.003) and IL-6 (beta=-.425; p=.001). Conclusion The cumulative burden of LE effects symptoms and treatment outcome in depressive patients. There is some evidence that inflammatory marker may have long-term effects on treatment outcome as they seem to weaken the determining relation between LE and depression.}, language = {en} } @misc{DeekenReichertZechetal., author = {Deeken, Friederike and Reichert, Markus and Zech, Hilmar and Wenzel, Julia and Wedemeyer, Friederike and Aguilera, Alvaro and Aslan, Acelya and Bach, Patrick and Bahr, Nadja Samia and Ebrahimi, Claudia and Fischbach, Pascale Christine and Ganz, Marvin and Garbusow, Maria and Großkopf, Charlotte M. and Heigert, Marie and Hentschel, Angela and Karl, Damian and Pelz, Patricia and Pinger, Mathieu and Riemerschmid, Carlotta and Rosenthal, Annika and Steffen, Johannes and Strehle, Jens and Weiss, Franziska and Wieder, Gesine and Wieland, Alfred and Zaiser, Judith and Zimmermann, Sina and Walter, Henrik and Lenz, Bernd and Deserno, Lorenz and Smolka, Michael N. and Liu, Shuyan and Ebner-Priemer, Ulrich Walter and Heinz, Andreas and Rapp, Michael Armin}, title = {Patterns of Alcohol Consumption Among Individuals With Alcohol Use Disorder During the COVID-19 Pandemic and Lockdowns in Germany}, series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {805}, issn = {1866-8364}, doi = {10.25932/publishup-57146}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-571460}, pages = {11}, abstract = {Importance Alcohol consumption (AC) leads to death and disability worldwide. Ongoing discussions on potential negative effects of the COVID-19 pandemic on AC need to be informed by real-world evidence. Objective To examine whether lockdown measures are associated with AC and consumption-related temporal and psychological within-person mechanisms. Design, Setting, and Participants This quantitative, intensive, longitudinal cohort study recruited 1743 participants from 3 sites from February 20, 2020, to February 28, 2021. Data were provided before and within the second lockdown of the COVID-19 pandemic in Germany: before lockdown (October 2 to November 1, 2020); light lockdown (November 2 to December 15, 2020); and hard lockdown (December 16, 2020, to February 28, 2021). Main Outcomes and Measures Daily ratings of AC (main outcome) captured during 3 lockdown phases (main variable) and temporal (weekends and holidays) and psychological (social isolation and drinking intention) correlates. Results Of the 1743 screened participants, 189 (119 [63.0\%] male; median [IQR] age, 37 [27.5-52.0] years) with at least 2 alcohol use disorder (AUD) criteria according to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) yet without the need for medically supervised alcohol withdrawal were included. These individuals provided 14 694 smartphone ratings from October 2020 through February 2021. Multilevel modeling revealed significantly higher AC (grams of alcohol per day) on weekend days vs weekdays (β = 11.39; 95\% CI, 10.00-12.77; P < .001). Alcohol consumption was above the overall average on Christmas (β = 26.82; 95\% CI, 21.87-31.77; P < .001) and New Year's Eve (β = 66.88; 95\% CI, 59.22-74.54; P < .001). During the hard lockdown, perceived social isolation was significantly higher (β = 0.12; 95\% CI, 0.06-0.15; P < .001), but AC was significantly lower (β = -5.45; 95\% CI, -8.00 to -2.90; P = .001). Independent of lockdown, intention to drink less alcohol was associated with lower AC (β = -11.10; 95\% CI, -13.63 to -8.58; P < .001). Notably, differences in AC between weekend and weekdays decreased both during the hard lockdown (β = -6.14; 95\% CI, -9.96 to -2.31; P = .002) and in participants with severe AUD (β = -6.26; 95\% CI, -10.18 to -2.34; P = .002). Conclusions and Relevance This 5-month cohort study found no immediate negative associations of lockdown measures with overall AC. Rather, weekend-weekday and holiday AC patterns exceeded lockdown effects. Differences in AC between weekend days and weekdays evinced that weekend drinking cycles decreased as a function of AUD severity and lockdown measures, indicating a potential mechanism of losing and regaining control. This finding suggests that temporal patterns and drinking intention constitute promising targets for prevention and intervention, even in high-risk individuals.}, language = {en} } @misc{GarbusowSommerNebeetal.2018, author = {Garbusow, Maria and Sommer, C. and Nebe, S. and Sebold, Miriam Hannah and Kuitunen-Paul, S{\"o}ren and Wittchen, H. U. and Smolka, M. and Zimmermann, U. and Rapp, Michael Armin and Huys, Q. and Schlagenhauf, Florian and Heinz, A.}, title = {Pavlovian-instrumental transfer in the course of alcohol use disorder}, series = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {48}, journal = {European psychiatry : the journal of the Association of European Psychiatrists}, publisher = {Elsevier}, address = {ISSY-LES-MOULINEAUX}, issn = {0924-9338}, pages = {S546 -- S546}, year = {2018}, abstract = {Background: Pavlovian processes are thought to play an important role in the development, maintenance and relapse of alcohol dependence, possibly by influencing and usurping on- going thought and behavior. The influence of Pavlovian stimuli on on-going behavior is paradigmatically measured by Pavlovian-to-instrumental-transfer (PIT) tasks. These involve multiple stages and are complex. Whether increased PIT is involved in human alcohol dependence is uncertain. We therefore aimed to establish and validate a modified PIT paradigm that would be robust, consistent, and tolerated by healthy controls as well as by patients suffering from alcohol dependence, and to explore whether alcohol dependence is associated with enhanced Pavlovian-Instrumental transfer. Methods: 32 recently detoxified alcohol-dependent patients and 32 age and gender matched healthy controls performed a PIT task with instrumental go/no-go approach behaviours. The task involved both Pavlovian stimuli associated with monetary rewards and losses, and images of drinks. Results: Both patients and healthy controls showed a robust and temporally stable PIT effect. Strengths of PIT effects to drug-related and monetary conditioned stimuli were highly correlated. Patients more frequently showed a PIT effect and the effect was stronger in response to aversively conditioned CSs (conditioned suppression), but there was no group difference in response to appetitive CSs. Conclusion: The implementation of PIT has favorably robust properties in chronic alcohol- dependent patients and in healthy controls. It shows internal consistency between monetary and drug-related cues. The findings support an association of alcohol dependence with an increased propensity towards PIT.}, language = {en} } @article{SeboldSpittaGleichetal.2019, author = {Sebold, Miriam Hannah and Spitta, G. and Gleich, T. and Dembler-Stamm, T. and Butler, O. and Zacharias, K. and Aydin, S. and Garbusow, Maria and Rapp, Michael Armin and Schubert, F. and Buchert, R. and Gallinat, J. and Heinz, A.}, title = {Stressful life events are associated with striatal dopamine receptor availability in alcohol dependence}, series = {Journal of neural transmission}, volume = {126}, journal = {Journal of neural transmission}, number = {9}, publisher = {Springer}, address = {Wien}, issn = {0300-9564}, doi = {10.1007/s00702-019-01985-2}, pages = {1127 -- 1134}, year = {2019}, abstract = {Stress plays a key role in modulating addictive behavior and can cause relapse following periods of abstinence. Common effects of stress and alcohol on the dopaminergic system have been suggested, although the precise mechanisms are unclear. Here, we investigated 20 detoxified alcohol-dependent patients and 19 matched healthy controls and assessed striatal D2/D3 availability using [F-18]-fallypride positron emission tomography and stressful life events. We found a strong association between striatal D2/D3 availability and stress in patients, but not in healthy controls. Interestingly, we found increased D2/D3 receptor availability in patients with higher stress levels. This mirrors complex interactions between stress and alcohol intake in animal studies and emphasizes the importance to investigate stress exposure in neurobiological studies of addiction.}, language = {en} } @article{DeekenReichertZechetal.2022, author = {Deeken, Friederike and Reichert, Markus and Zech, Hilmar and Wenzel, Julia and Wedemeyer, Friederike and Aguilera, Alvaro and Aslan, Acelya and Bach, Patrick and Bahr, Nadja Samia and Ebrahimi, Claudia and Fischbach, Pascale Christine and Ganz, Marvin and Garbusow, Maria and Großkopf, Charlotte M. and Heigert, Marie and Hentschel, Angela and Karl, Damian and Pelz, Patricia and Pinger, Mathieu and Riemerschmid, Carlotta and Rosenthal, Annika and Steffen, Johannes and Strehle, Jens and Weiss,, Franziska and Wieder, Gesine and Wieland, Alfred and Zaiser, Judith and Zimmermann, Sina and Walter, Henrik and Lenz, Bernd and Deserno, Lorenz and Smolka, Michael N. and Liu, Shuyan and Ebner-Priemer, Ulrich Walter and Heinz, Andreas and Rapp, Michael Armin}, title = {Patterns of Alcohol Consumption Among Individuals With Alcohol Use Disorder During the COVID-19 Pandemic and Lockdowns in Germany}, series = {JAMA Network Open}, volume = {5}, journal = {JAMA Network Open}, edition = {8}, publisher = {JAMA Network / American Medical Association}, address = {Chicago, Illinois, USA}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2022.24641}, pages = {1 -- 11}, year = {2022}, abstract = {Importance Alcohol consumption (AC) leads to death and disability worldwide. Ongoing discussions on potential negative effects of the COVID-19 pandemic on AC need to be informed by real-world evidence. Objective To examine whether lockdown measures are associated with AC and consumption-related temporal and psychological within-person mechanisms. Design, Setting, and Participants This quantitative, intensive, longitudinal cohort study recruited 1743 participants from 3 sites from February 20, 2020, to February 28, 2021. Data were provided before and within the second lockdown of the COVID-19 pandemic in Germany: before lockdown (October 2 to November 1, 2020); light lockdown (November 2 to December 15, 2020); and hard lockdown (December 16, 2020, to February 28, 2021). Main Outcomes and Measures Daily ratings of AC (main outcome) captured during 3 lockdown phases (main variable) and temporal (weekends and holidays) and psychological (social isolation and drinking intention) correlates. Results Of the 1743 screened participants, 189 (119 [63.0\%] male; median [IQR] age, 37 [27.5-52.0] years) with at least 2 alcohol use disorder (AUD) criteria according to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) yet without the need for medically supervised alcohol withdrawal were included. These individuals provided 14 694 smartphone ratings from October 2020 through February 2021. Multilevel modeling revealed significantly higher AC (grams of alcohol per day) on weekend days vs weekdays (β = 11.39; 95\% CI, 10.00-12.77; P < .001). Alcohol consumption was above the overall average on Christmas (β = 26.82; 95\% CI, 21.87-31.77; P < .001) and New Year's Eve (β = 66.88; 95\% CI, 59.22-74.54; P < .001). During the hard lockdown, perceived social isolation was significantly higher (β = 0.12; 95\% CI, 0.06-0.15; P < .001), but AC was significantly lower (β = -5.45; 95\% CI, -8.00 to -2.90; P = .001). Independent of lockdown, intention to drink less alcohol was associated with lower AC (β = -11.10; 95\% CI, -13.63 to -8.58; P < .001). Notably, differences in AC between weekend and weekdays decreased both during the hard lockdown (β = -6.14; 95\% CI, -9.96 to -2.31; P = .002) and in participants with severe AUD (β = -6.26; 95\% CI, -10.18 to -2.34; P = .002). Conclusions and Relevance This 5-month cohort study found no immediate negative associations of lockdown measures with overall AC. Rather, weekend-weekday and holiday AC patterns exceeded lockdown effects. Differences in AC between weekend days and weekdays evinced that weekend drinking cycles decreased as a function of AUD severity and lockdown measures, indicating a potential mechanism of losing and regaining control. This finding suggests that temporal patterns and drinking intention constitute promising targets for prevention and intervention, even in high-risk individuals.}, language = {en} } @article{HeinzelRiemerSchulteetal.2014, author = {Heinzel, Stephan and Riemer, Thomas G. and Schulte, Stefanie and Onken, Johanna and Heinz, Andreas and Rapp, Michael Armin}, title = {Catechol-O-methyltransferase (COMT) genotype affects age-related changes in plasticity in working memory: a pilot study}, series = {BioMed research international}, journal = {BioMed research international}, publisher = {Hindawi Publishing Corp.}, address = {New York}, issn = {2314-6133}, doi = {10.1155/2014/414351}, pages = {7}, year = {2014}, abstract = {Objectives. Recent work suggests that a genetic variation associated with increased dopamine metabolism in the prefrontal cortex (catechol-O-methyltransferase Val158Met; COMT) amplifies age-related changes in working memory performance. Research on younger adults indicates that the influence of dopamine-related genetic polymorphisms on working memory performance increases when testing the cognitive limits through training. To date, this has not been studied in older adults. Method. Here we investigate the effect of COMT genotype on plasticity in working memory in a sample of 14 younger (aged 24-30 years) and 25 older (aged 60-75 years) healthy adults. Participants underwent adaptive training in the n-back working memory task over 12 sessions under increasing difficulty conditions. Results. Both younger and older adults exhibited sizeable behavioral plasticity through training (P < .001), which was larger in younger as compared to older adults (P < .001). Age-related differences were qualified by an interaction with COMT genotype (P < .001), and this interaction was due to decreased behavioral plasticity in older adults carrying the Val/Val genotype, while there was no effect of genotype in younger adults. Discussion. Our findings indicate that age-related changes in plasticity in working memory are critically affected by genetic variation in prefrontal dopamine metabolism.}, language = {en} } @inproceedings{HaegeleFriedelSchlagenhaufetal.2014, author = {Haegele, Claudia and Friedel, Eva and Schlagenhauf, Florian and Sterzer, Philipp and Beck, Anne and Bermpohl, Felix and Rapp, Michael Armin and Stoy, Meline and Stroehle, Andreas and Dolan, Raymond J. and Heinz, Andreas}, title = {Reward expectation and affective responses across psychiatric disorders - A dimensional approach}, series = {Biological psychiatry : a journal of psychiatric neuroscience and therapeutics ; a publication of the Society of Biological Psychiatry}, volume = {75}, booktitle = {Biological psychiatry : a journal of psychiatric neuroscience and therapeutics ; a publication of the Society of Biological Psychiatry}, number = {9}, publisher = {Elsevier}, address = {New York}, issn = {0006-3223}, pages = {91S -- 92S}, year = {2014}, language = {en} } @article{ZaytsevaKorsakovaGurovichetal.2014, author = {Zaytseva, Yuliya and Korsakova, Natalya and Gurovich, Isaac Ya and Heinz, Andreas and Rapp, Michael Armin}, title = {Luria revisited: Complex motor phenomena in first episode schizophrenia and schizophrenia spectrum disorders}, series = {Psychiatry research : the official publication of the International Society for Neuroimaging in Psychiatry}, volume = {220}, journal = {Psychiatry research : the official publication of the International Society for Neuroimaging in Psychiatry}, number = {1-2}, publisher = {Elsevier}, address = {Clare}, issn = {0165-1781}, doi = {10.1016/j.psychres.2014.08.009}, pages = {145 -- 151}, year = {2014}, language = {en} } @misc{KaminskiSchlagenhaufRappetal.2018, author = {Kaminski, Jakob A. and Schlagenhauf, Florian and Rapp, Michael Armin and Awasthi, Swapnil and Ruggeri, Barbara and Deserno, Lorenz and Banaschewski, Tobias and Bokde, Arun L. W. and Bromberg, Uli and B{\"u}chel, Christian and Quinlan, Erin Burke and Desrivi{\`e}res, Sylvane and Flor, Herta and Frouin, Vincent and Garavan, Hugh and Gowland, Penny and Ittermann, Bernd and Martinot, Jean-Luc and Paill{\`e}re Martinot, Marie-Laure and Nees, Frauke and Papadopoulos Orfanos, Dimitri and Paus, Tom{\´a}š and Poustka, Luise and Smolka, Michael N. and Fr{\"o}hner, Juliane H. and Walter, Henrik and Whelan, Robert and Ripke, Stephan and Schumann, Gunter and Heinz, Andreas}, title = {Epigenetic variance in dopamine D2 receptor}, series = {Postprints der Universit{\"a}t Potsdam : Mathematisch-Naturwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Mathematisch-Naturwissenschaftliche Reihe}, number = {950}, issn = {1866-8372}, doi = {10.25932/publishup-42568}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-425687}, pages = {13}, year = {2018}, abstract = {Genetic and environmental factors both contribute to cognitive test performance. A substantial increase in average intelligence test results in the second half of the previous century within one generation is unlikely to be explained by genetic changes. One possible explanation for the strong malleability of cognitive performance measure is that environmental factors modify gene expression via epigenetic mechanisms. Epigenetic factors may help to understand the recent observations of an association between dopamine-dependent encoding of reward prediction errors and cognitive capacity, which was modulated by adverse life events. The possible manifestation of malleable biomarkers contributing to variance in cognitive test performance, and thus possibly contributing to the "missing heritability" between estimates from twin studies and variance explained by genetic markers, is still unclear. Here we show in 1475 healthy adolescents from the IMaging and GENetics (IMAGEN) sample that general IQ (gIQ) is associated with (1) polygenic scores for intelligence, (2) epigenetic modification of DRD2 gene, (3) gray matter density in striatum, and (4) functional striatal activation elicited by temporarily surprising reward-predicting cues. Comparing the relative importance for the prediction of gIQ in an overlapping subsample, our results demonstrate neurobiological correlates of the malleability of gIQ and point to equal importance of genetic variance, epigenetic modification of DRD2 receptor gene, as well as functional striatal activation, known to influence dopamine neurotransmission. Peripheral epigenetic markers are in need of confirmation in the central nervous system and should be tested in longitudinal settings specifically assessing individual and environmental factors that modify epigenetic structure.}, language = {en} } @article{FriedelSeboldKuitunenPauletal.2017, author = {Friedel, Eva and Sebold, Miriam Hannah and Kuitunen-Paul, S{\"o}ren and Nebe, Stephan and Veer, Ilya M. and Zimmermann, Ulrich S. and Schlagenhauf, Florian and Smolka, Michael N. and Rapp, Michael Armin and Walter, Henrik and Heinz, Andreas}, title = {How Accumulated Real Life Stress Experience and Cognitive Speed Interact on Decision-Making Processes}, series = {Frontiers in human neuroscienc}, volume = {11}, journal = {Frontiers in human neuroscienc}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1662-5161}, doi = {10.3389/fnhum.2017.00302}, pages = {1 -- 9}, year = {2017}, abstract = {Rationale: Advances in neurocomputational modeling suggest that valuation systems for goal-directed (deliberative) on one side, and habitual (automatic) decision-making on the other side may rely on distinct computational strategies for reinforcement learning, namely model-free vs. model-based learning. As a key theoretical difference, the model-based system strongly demands cognitive functions to plan actions prospectively based on an internal cognitive model of the environment, whereas valuation in the model-free system relies on rather simple learning rules from operant conditioning to retrospectively associate actions with their outcomes and is thus cognitively less demanding. Acute stress reactivity is known to impair model-based but not model-free choice behavior, with higher working memory capacity protecting the model-based system from acute stress. However, it is not clear which impact accumulated real life stress has on model-free and model-based decision systems and how this influence interacts with cognitive abilities. Methods: We used a sequential decision-making task distinguishing relative contributions of both learning strategies to choice behavior, the Social Readjustment Rating Scale questionnaire to assess accumulated real life stress, and the Digit Symbol Substitution Test to test cognitive speed in 95 healthy subjects. Results: Individuals reporting high stress exposure who had low cognitive speed showed reduced model-based but increased model-free behavioral control. In contrast, subjects exposed to accumulated real life stress with high cognitive speed displayed increased model-based performance but reduced model-free control. Conclusion: These findings suggest that accumulated real life stress exposure can enhance reliance on cognitive speed for model-based computations, which may ultimately protect the model-based system from the detrimental influences of accumulated real life stress. The combination of accumulated real life stress exposure and slower information processing capacities, however, might favor model-free strategies. Thus, the valence and preference of either system strongly depends on stressful experiences and individual cognitive capacities.}, language = {en} } @misc{HeisselSanchezPietreketal.2023, author = {Heissel, Andreas and Sanchez, Alba and Pietrek, Anou F. and Bergau, Theresa and Stielow, Christiane and Rapp, Michael Armin and Van der Kaap-Deeder, Jolene}, title = {Validating the German Short Basic Psychological Need Satisfaction and Frustration Scale in Individuals with Depression}, series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {837}, issn = {1866-8364}, doi = {10.25932/publishup-58906}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-589060}, pages = {18}, year = {2023}, abstract = {Satisfaction and frustration of the needs for autonomy, competence, and relatedness, as assessed with the 24-item Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), have been found to be crucial indicators of individuals' psychological health. To increase the usability of this scale within a clinical and health services research context, we aimed to validate a German short version (12 items) of this scale in individuals with depression including the examination of the relations from need frustration and need satisfaction to ill-being and quality of life (QOL). This cross-sectional study involved 344 adults diagnosed with depression (Mage (SD) = 47.5 years (11.1); 71.8\% females). Confirmatory factor analyses indicated that the short version of the BPNSFS was not only reliable, but also fitted a six-factor structure (i.e., satisfaction/frustration X type of need). Subsequent structural equation modeling showed that need frustration related positively to indicators of ill-being and negatively to QOL. Surprisingly, need satisfaction did not predict differences in ill-being or QOL. The short form of the BPNSFS represents a practical instrument to measure need satisfaction and frustration in people with depression. Further, the results support recent evidence on the importance of especially need frustration in the prediction of psychopathology.}, language = {en} } @article{HeisselPietrekRappetal.2019, author = {Heissel, Andreas and Pietrek, Anou F. and Rapp, Michael Armin and Heinzel, Stephan and Williams, Geoffrey}, title = {Perceived health care climate of older people attending an exercise program}, series = {Journal of aging and physical activity : JAPA ; the official journal of the International Society for Aging and Physical Activity}, volume = {28}, journal = {Journal of aging and physical activity : JAPA ; the official journal of the International Society for Aging and Physical Activity}, number = {2}, publisher = {Human Kinetics Publ.}, address = {Champaign}, issn = {1063-8652}, doi = {10.1123/japa.2018-0350}, pages = {276 -- 286}, year = {2019}, abstract = {The role of perceived need support from exercise professionals in improving mental health was examined in a sample of older adults, thereby validating the short Health Care Climate Questionnaire. A total of 491 older people (M = 72.68 years; SD = 5.47) attending a health exercise program participated in this study. Cronbach's alpha was found to be high (alpha = .90). Satisfaction with the exercise professional correlated moderately with the short Health Care Climate Questionnaire mean value (r = .38; p < .01). The mediator analyses yielded support for the self-determination theory process model in older adults by showing both basic need satisfaction and frustration as mediating variables between perceived autonomy support and depressive symptoms. The short Health Care Climate Questionnaire is an economical instrument for assessing basic need satisfaction provided by the exercise therapist from the participant's perspective. Furthermore, this cross-sectional study supported the link from coaching style to the satisfaction/frustration of basic psychological needs, which in turn, predicted mental health. Analyses of criterion validity suggest a revision of the construct by integrating need frustration.}, language = {en} } @article{HeisselSanchezPietreketal.2023, author = {Heissel, Andreas and Sanchez, Alba and Pietrek, Anou F. and Bergau, Theresa and Stielow, Christiane and Rapp, Michael Armin and Van der Kaap-Deeder, Jolene}, title = {Validating the German Short Basic Psychological Need Satisfaction and Frustration Scale in Individuals with Depression}, series = {Healthcare}, volume = {11}, journal = {Healthcare}, number = {3}, publisher = {MDPI}, address = {Basel}, issn = {2227-9032}, doi = {10.3390/healthcare11030412}, pages = {18}, year = {2023}, abstract = {Satisfaction and frustration of the needs for autonomy, competence, and relatedness, as assessed with the 24-item Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), have been found to be crucial indicators of individuals' psychological health. To increase the usability of this scale within a clinical and health services research context, we aimed to validate a German short version (12 items) of this scale in individuals with depression including the examination of the relations from need frustration and need satisfaction to ill-being and quality of life (QOL). This cross-sectional study involved 344 adults diagnosed with depression (Mage (SD) = 47.5 years (11.1); 71.8\% females). Confirmatory factor analyses indicated that the short version of the BPNSFS was not only reliable, but also fitted a six-factor structure (i.e., satisfaction/frustration X type of need). Subsequent structural equation modeling showed that need frustration related positively to indicators of ill-being and negatively to QOL. Surprisingly, need satisfaction did not predict differences in ill-being or QOL. The short form of the BPNSFS represents a practical instrument to measure need satisfaction and frustration in people with depression. Further, the results support recent evidence on the importance of especially need frustration in the prediction of psychopathology.}, language = {en} } @article{KalliesRappFydrichetal.2018, author = {Kallies, Gunnar and Rapp, Michael Armin and Fydrich, Thomas and Fehm, Lydia and Tschorn, Mira and Teran, Christina and Schwefel, Melanie and Pietrek, Anou F. and Henze, Romy and Hellweg, Rainer and Str{\"o}hle, Andreas and Heinzel, Stephan and Heissel, Andreas}, title = {Serum brain-derived neurotrophic factor (BDNF) at rest and after acute aerobic exercise in major depressive disorder}, series = {Psychoneuroendocrinology}, volume = {102}, journal = {Psychoneuroendocrinology}, publisher = {Elsevier}, address = {Oxford}, issn = {0306-4530}, doi = {10.1016/j.psyneuen.2018.12.015}, pages = {212 -- 215}, year = {2018}, abstract = {Physiological mechanisms of an anti-depressive effect of physical exercise in major depressive disorder (MDD) seem to involve alterations in brain-derived neurotrophic factor (BDNF) level. However, previous studies which investigated this effect in a single bout of exercise, did not control for confounding peripheral factors that contribute to BDNF-alterations. Therefore, the underlying cause of exercise-induced BDNF-changes remains unclear. The current study aims to investigate serum BDNF (sBDNF)-changes due to a single-bout of graded aerobic exercise in a group of 30 outpatients with MDD, suggesting a more precise analysis method by taking plasma volume shift and number of platelets into account. Results show that exercise-induced increases in sBDNF remain significant (p<.001) when adjusting for plasma volume shift and controlling for number of platelets. The interaction of sBDNF change and number of platelets was also significant (p=.001) indicating larger sBDNF-increase in participants with smaller number of platelets. Thus, findings of this study suggest an involvement of peripheral as well as additional possibly brain-derived mechanisms explaining exercise-related BDNF release in MDD. For future studies in the field of exercise-related BDNF research, the importance of controlling for peripheral parameters is emphasized.}, language = {en} } @misc{BookerJacobRappetal.2016, author = {Booker, Anke and Jacob, Louis E. C. and Rapp, Michael Armin and Bohlken, Jens and Kostev, Karel}, title = {Risk factors for dementia diagnosis in German primary care practices}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {449}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-413441}, pages = {7}, year = {2016}, abstract = {Background: Dementia is a psychiatric condition the development of which is associated with numerous aspects of life. Our aim was to estimate dementia risk factors in German primary care patients. Methods: The case-control study included primary care patients (70-90 years) with first diagnosis of dementia (all-cause) during the index period (01/2010-12/2014) (Disease Analyzer, Germany), and controls without dementia matched (1:1) to cases on the basis of age, sex, type of health insurance, and physician. Practice visit records were used to verify that there had been 10 years of continuous follow-up prior to the index date. Multivariate logistic regression models were fitted with dementia as a dependent variable and the potential predictors. Results: The mean age for the 11,956 cases and the 11,956 controls was 80.4 (SD: 5.3) years. 39.0\% of them were male and 1.9\% had private health insurance. In the multivariate regression model, the following variables were linked to a significant extent with an increased risk of dementia: diabetes (OR: 1.17; 95\% CI: 1.10-1.24), lipid metabolism (1.07; 1.00-1.14), stroke incl. TIA (1.68; 1.57-1.80), Parkinson's disease (PD) (1.89; 1.64-2.19), intracranial injury (1.30; 1.00-1.70), coronary heart disease (1.06; 1.00-1.13), mild cognitive impairment (MCI) (2.12; 1.82-2.48), mental and behavioral disorders due to alcohol use (1.96; 1.50-2.57). The use of statins (OR: 0.94; 0.90-0.99), proton-pump inhibitors (PPI) (0.93; 0.90-0.97), and antihypertensive drugs (0.96, 0.94-0.99) were associated with a decreased risk of developing dementia. Conclusions: Risk factors for dementia found in this study are consistent with the literature. Nevertheless, the associations between statin, PPI and antihypertensive drug use, and decreased risk of dementia need further investigations.}, language = {en} } @article{HeinzelLawrenceKalliesetal.2015, author = {Heinzel, Stephan and Lawrence, Jimmy B. and Kallies, Gunnar and Rapp, Michael Armin and Heissel, Andreas}, title = {Using Exercise to Fight Depression in Older Adults}, series = {GeroPsych : the journal of gerontopsychology and geriatric psychiatry}, volume = {28}, journal = {GeroPsych : the journal of gerontopsychology and geriatric psychiatry}, publisher = {Hogrefe}, address = {Cambridge, Mass. ; G{\"o}ttingen [u.a.]}, issn = {1662-9647}, doi = {10.1024/1662-9647/a000133}, pages = {149 -- 162}, year = {2015}, abstract = {Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of -0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = -0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully.}, language = {en} } @inproceedings{NordheimRappKrauseKoehleretal.2014, author = {Nordheim, J. and Rapp, Michael Armin and Krause-Koehler, Kathleen and Niemann-Mirmehdi, M. and Haeusler, Andreas}, title = {Support for dementia affected Couples. Results of the DYADEM- study}, series = {Zeitschrift f{\"u}r Gerontologie und Geriatrie}, volume = {47}, booktitle = {Zeitschrift f{\"u}r Gerontologie und Geriatrie}, publisher = {Springer}, address = {Heidelberg}, issn = {0948-6704}, pages = {136 -- 136}, year = {2014}, language = {de} } @inproceedings{HeinzKlugeSchoulerOcaketal.2015, author = {Heinz, A. and Kluge, U. and Schouler-Ocak, M. and Rapp, Michael Armin}, title = {Biological Effects of Social Exclusion}, series = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {30}, booktitle = {European psychiatry : the journal of the Association of European Psychiatrists}, publisher = {Elsevier}, address = {Paris}, issn = {0924-9338}, pages = {1}, year = {2015}, abstract = {Timing and magnitude of surface uplift are key to understanding the impact of crustal deformation and topographic growth on atmospheric circulation, environmental conditions, and surface processes. Uplift of the East African Plateau is linked to mantle processes, but paleoaltimetry data are too scarce to constrain plateau evolution and subsequent vertical motions associated with rifting. Here, we assess the paleotopographic implications of a beaked whale fossil (Ziphiidae) from the Turkana region of Kenya found 740 km inland from the present-day coastline of the Indian Ocean at an elevation of 620 m. The specimen is similar to 17 My old and represents the oldest derived beaked whale known, consistent with molecular estimates of the emergence of modern straptoothed whales (Mesoplodon). The whale traveled from the Indian Ocean inland along an eastward-directed drainage system controlled by the Cretaceous Anza Graben and was stranded slightly above sea level. Surface uplift from near sea level coincides with paleoclimatic change from a humid environment to highly variable and much drier conditions, which altered biotic communities and drove evolution in east Africa, including that of primates.}, language = {en} } @inproceedings{Rapp2015, author = {Rapp, Michael Armin}, title = {When Local Poverty is More Important Than Your Income: Migrant Mental Health in Inner Cities}, series = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {30}, booktitle = {European psychiatry : the journal of the Association of European Psychiatrists}, publisher = {Elsevier}, address = {Paris}, issn = {0924-9338}, pages = {1}, year = {2015}, language = {en} } @misc{HeinzelRimpelStelzeletal.2017, author = {Heinzel, Stephan and Rimpel, J{\´e}r{\^o}me and Stelzel, Christine and Rapp, Michael Armin}, title = {Transfer Effects to a Multimodal Dual-Task after Working Memory Training and Associated Neural Correlates in Older Adults}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-401921}, pages = {15}, year = {2017}, abstract = {Working memory (WM) performance declines with age. However, several studies have shown that WM training may lead to performance increases not only in the trained task, but also in untrained cognitive transfer tasks. It has been suggested that transfer effects occur if training task and transfer task share specific processing components that are supposedly processed in the same brain areas. In the current study, we investigated whether single-task WM training and training-related alterations in neural activity might support performance in a dual-task setting, thus assessing transfer effects to higher-order control processes in the context of dual-task coordination. A sample of older adults (age 60-72) was assigned to either a training or control group. The training group participated in 12 sessions of an adaptive n-back training. At pre and post-measurement, a multimodal dual-task was performed in all participants to assess transfer effects. This task consisted of two simultaneous delayed match to sample WM tasks using two different stimulus modalities (visual and auditory) that were performed either in isolation (single-task) or in conjunction (dual-task). A subgroup also participated in functional magnetic resonance imaging (fMRI) during the performance of the n-back task before and after training. While no transfer to single-task performance was found, dual-task costs in both the visual modality (p < 0.05) and the auditory modality (p < 0.05) decreased at post-measurement in the training but not in the control group. In the fMRI subgroup of the training participants, neural activity changes in left dorsolateral prefrontal cortex (DLPFC) during one-back predicted post-training auditory dual-task costs, while neural activity changes in right DLPFC during three-back predicted visual dual-task costs. Results might indicate an improvement in central executive processing that could facilitate both WM and dual-task coordination.}, language = {en} } @misc{BohlkenJacobSchaumetal.2017, author = {Bohlken, Jens and Jacob, Louis and Schaum, Peter and Rapp, Michael Armin and Kostev, Karel}, title = {Hip fracture risk in patients with dementia in German primary care practices}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {395}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-404526}, pages = {12}, year = {2017}, abstract = {The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65-90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance. The primary outcome was the diagnosis of hip fracture during the three-year follow-up period. A total of 53,156 dementia patients and 53,156 controls were included. A total of 5.3\% of patients and 0.7\% of controls displayed hip fracture after three years. Hip fracture occurred more frequently in dementia subjects living in nursing homes than in those living at home (9.2\% versus 4.3\%). Dementia, residence in nursing homes, and osteoporosis were risk factors for fracture development. Antidementia, antipsychotic, and antidepressant drugs generally had no significant impact on hip fracture risk when prescribed for less than six months. Dementia increased hip fracture risk in German primary care practices.}, language = {en} } @article{HeinzelRimpelStelzeletal.2017, author = {Heinzel, Stephan and Rimpel, J{\´e}r{\^o}me and Stelzel, Christine and Rapp, Michael Armin}, title = {Transfer Effects to a Multimodal Dual-Task after Working Memory Training and Associated Neural Correlates in Older Adults}, series = {Frontiers in human neuroscience}, volume = {11}, journal = {Frontiers in human neuroscience}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, doi = {10.3389/fnhum.2017.00085}, year = {2017}, abstract = {Working memory (WM) performance declines with age. However, several studies have shown that WM training may lead to performance increases not only in the trained task, but also in untrained cognitive transfer tasks. It has been suggested that transfer effects occur if training task and transfer task share specific processing components that are supposedly processed in the same brain areas. In the current study, we investigated whether single-task WM training and training-related alterations in neural activity might support performance in a dual-task setting, thus assessing transfer effects to higher-order control processes in the context of dual-task coordination. A sample of older adults (age 60-72) was assigned to either a training or control group. The training group participated in 12 sessions of an adaptive n-back training. At pre and post-measurement, a multimodal dual-task was performed in all participants to assess transfer effects. This task consisted of two simultaneous delayed match to sample WM tasks using two different stimulus modalities (visual and auditory) that were performed either in isolation (single-task) or in conjunction (dual-task). A subgroup also participated in functional magnetic resonance imaging (fMRI) during the performance of the n-back task before and after training. While no transfer to single-task performance was found, dual-task costs in both the visual modality (p < 0.05) and the auditory modality (p < 0.05) decreased at post-measurement in the training but not in the control group. In the fMRI subgroup of the training participants, neural activity changes in left dorsolateral prefrontal cortex (DLPFC) during one-back predicted post-training auditory dual-task costs, while neural activity changes in right DLPFC during three-back predicted visual dual-task costs. Results might indicate an improvement in central executive processing that could facilitate both WM and dual-task coordination.}, language = {en} } @misc{HaeuslerSanchezGellertetal.2016, author = {H{\"a}usler, Andreas and S{\´a}nchez, Alba and Gellert, Paul and Deeken, Friederike and Nordheim, Johanna and Rapp, Michael Armin}, title = {Perceived stress and quality of life in dementia patients and their caregiving spouses}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {448}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-413464}, pages = {10}, 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. Methods: 82 dyads of dementia patients and their spousal caregivers were included in a cross-sectional assessment from a prospective study. QoL was assessed with the Quality of Life in Alzheimer's Disease scale (QoL-AD) for dementia patients and the WHO Quality of Life-BREF for spousal caregivers. Perceived stress was measured with the Perceived Stress Scale (PSS-14). Both partners were assessed with the Dyadic Coping Inventory (DCI). Analyses of correlation as well as regression models including mediator analyses were performed. 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} } @misc{BohlkenWeberRappetal.2015, author = {Bohlken, Jens and Weber, Simon and Rapp, Michael Armin and Kostev, Karel}, title = {Continuous treatment with antidementia drugs in Germany 2003-2013}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {522}, issn = {1866-8364}, doi = {10.25932/publishup-41471}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-414718}, pages = {8}, year = {2015}, abstract = {Background: Continuous treatment is an important indicator of medication adherence in dementia. However, long-term studies in larger clinical settings are lacking, and little is known about moderating effects of patient and service characteristics. Methods: Data from 12,910 outpatients with dementia (mean age 79.2 years; SD = 7.6 years) treated between January 2003 and December 2013 in Germany were included. Continuous treatment was analysed using Kaplan-Meier curves and log-rank tests. In addition, multivariate Cox regression models were fitted with continuous treatment as dependent variable and the predictors antidementia agent, age, gender, medical comorbidities, physician specialty, and health insurance status. Results: After one year of follow-up, nearly 60\% of patients continued drug treatment. Donezepil (HR: 0.88; 95\% CI: 0.82-0.95) and memantine (HR: 0.85; 0.79-0.91) patients were less likely to be discontinued treatment as compared to rivastigmine users. Patients were less likely to be discontinued if they were treated by specialist physicians as compared to general practitioners (HR: 0.44; 0.41-0.48). Younger male patients and patients who had private health insurance had a lower discontinuation risk. Regarding comorbidity, patients were more likely to be continuously treated with the index substance if a diagnosis of heart failure or hypertension had been diagnosed at baseline. Conclusions: Our results imply that besides type of antidementia agent, involvement of a specialist in the complex process of prescribing antidementia drugs can provide meaningful benefits to patients, in terms of more disease-specific and continuous treatment.}, language = {en} } @misc{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 = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {458}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-414159}, pages = {6}, 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} } @misc{HeinzKlugeRapp2016, author = {Heinz, A. and Kluge, U. and Rapp, Michael Armin}, title = {Heritability of living in deprived neighbourhoods}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-103770}, pages = {1}, year = {2016}, language = {en} } @article{StroehleSchmidtSchultzetal.2015, author = {Stroehle, Andreas and Schmidt, Dietlinde K. and Schultz, Florian and Fricke, Nina and Staden, Theresa and Hellweg, Rainer and Priller, Josef and Rapp, Michael Armin and Rieckmann, Nina}, title = {Drug and Exercise Treatment of Alzheimer Disease and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Effects on Cognition in Randomized Controlled Trials}, series = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry}, volume = {23}, journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry}, number = {12}, publisher = {Elsevier}, address = {New York}, issn = {1064-7481}, doi = {10.1016/j.jagp.2015.07.007}, pages = {1234 -- 1249}, year = {2015}, abstract = {Objective: Demographic changes are increasing the pressure to improve therapeutic strategies against cognitive decline in Alzheimer disease (AD) and mild cognitive impairment (MCI). Besides drug treatment, physical activity seems to be a promising intervention target as epidemiological and clinical studies suggest beneficial effects of exercise training on cognition. Using comparable inclusion and exclusion criteria, we analyzed the efficacy of drug therapy (cholinesterase inhibitors, memantine, and Ginkgo biloba) and exercise interventions for improving cognition in AD and MCI populations. Methods: We searched The Cochrane Library, EBSCO, OVID, Web of Science, and U.S Food and Drug Administration data from inception through October 30, 2013. Randomized controlled trials in which at least one treatment arm consisted of an exercise or a pharmacological intervention for AD or MCI patients, and which had either a non-exposed control condition or a control condition that received another intervention. Treatment discontinuation rates and Standardized Mean Change score using Raw score standardization (SMCR) of cognitive performance were calculated. Results: Discontinuation rates varied substantially and ranged between 0\% and 49\% with a median of 18\%. Significantly increased discontinuation rates were found for galantamine and rivastigmine as compared to placebo in AD studies. Drug treatments resulted in a small pooled effect on cognition (SMCR: 0.23, 95\% CI: 0.20 to 0.25) in AD studies (N = 45, 18,434 patients) and no effect in any of the MCI studies (N = 5, 3,693 patients; SMCR: 0.03, 95\% CI: 0.00 to 0.005). Exercise interventions had a moderate to strong pooled effect size (SMCR: 0.83, 95\% CI: 0.59 to 1.07) in AD studies (N = 4, 119 patients), and a small effect size (SMCR: 0.20, 95\% CI: 0.11 to 0.28) in MCI (N = 6, 443 patients). Conclusions: Drug treatments have a small but significant impact on cognitive functioning in AD and exercise has the potential to improve cognition in AD and MCI. Head-to-head trials with sufficient statistical power are necessary to directly compare efficacy, safety, and acceptability. Combining these two approaches might further increase the efficacy of each individual intervention. Identifier: PROSPERO (2013:CRD42013003910).}, language = {en} } @article{BohlkenSchulzRappetal.2015, author = {Bohlken, Jens and Schulz, Mandy and Rapp, Michael Armin and Baetzing-Feigenbaum, Joerg}, title = {Pharmacotherapy of dementia in Germany: Results from a nationwide claims database}, series = {European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology}, volume = {25}, journal = {European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology}, number = {12}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0924-977X}, doi = {10.1016/j.euroneuro.2015.09.014}, pages = {2333 -- 2338}, year = {2015}, abstract = {In 2011, about 1.1-1.4 million patients with dementia were living in Germany, a number expected to rise to three million by 2050. Dementia poses a major challenge to the healthcare system and neuropharmacological service provision. The aim of this study was to determine prescription rates for anti-dementia drugs as well as for neuroleptics, sedative-hypnotics and antidepressants in dementia using the complete nationwide outpatient claims data pertaining to the services of statutory health insurance. We controlled for gender, age, dementia diagnosis, physician specialty (general practitioner GP versus neuropsychiatry specialist physician NPSP), and rural and urban living area. In about one million prevalent dementia patients (N=1,014,710) in 2011, the prescription prevalence rate of anti-dementia drugs was 24.6\%; it varied with gender, age, and diagnosis (highest in Alzheimer's disease; 42\%), and was higher in patients treated by NPSPs (48\% vs. 25\% in GPs). At the same time, we found an alarmingly high rate of treatment with neuroleptics in dementia patients (35\%), with an only slightly decreased risk in patients treated exclusively by NPSPs (OR=0.86). We found marginal differences between rural and urban areas. Our results show that the majority of anti-dementia drug prescriptions appear guideline-oriented, yet prescription rates are overall comparatively low. On the other hand, neuroleptic drugs, which are associated with excess morbidity and mortality in dementia, were prescribed very frequently, suggesting excess use given current guidelines. We therefore suggest that guideline implementation measures and increasing quality control procedures are needed with respect to the pharmacotherapy of this vulnerable population. (C) 2015 Elsevier B.V. and ECNR All rights reserved.}, language = {en} } @article{BohlkenWeberRappetal.2015, author = {Bohlken, Jens and Weber, Simon and Rapp, Michael Armin and Kostev, Karel}, title = {Continuous treatment with antidementia drugs in Germany 2003-2013: a retrospective database analysis}, series = {International psychogeriatrics}, volume = {27}, journal = {International psychogeriatrics}, number = {8}, publisher = {Cambridge Univ. Press}, address = {New York}, issn = {1041-6102}, doi = {10.1017/S1041610215000654}, pages = {1335 -- 1342}, year = {2015}, abstract = {Background: Continuous treatment is an important indicator of medication adherence in dementia. However, long-term studies in larger clinical settings are lacking, and little is known about moderating effects of patient and service characteristics. Methods: Data from 12,910 outpatients with dementia (mean age 79.2 years; SD = 7.6 years) treated between January 2003 and December 2013 in Germany were included. Continuous treatment was analysed using Kaplan-Meier curves and log-rank tests. In addition, multivariate Cox regression models were fitted with continuous treatment as dependent variable and the predictors antidementia agent, age, gender, medical comorbidities, physician specialty, and health insurance status. Results: After one year of follow-up, nearly 60\% of patients continued drug treatment. Donezepil (HR: 0.88; 95\% CI: 0.82-0.95) and memantine (HR: 0.85; 0.79-0.91) patients were less likely to be discontinued treatment as compared to rivastigmine users. Patients were less likely to be discontinued if they were treated by specialist physicians as compared to general practitioners (HR: 0.44; 0.41-0.48). Younger male patients and patients who had private health insurance had a lower discontinuation risk. Regarding comorbidity, patients were more likely to be continuously treated with the index substance if a diagnosis of heart failure or hypertension had been diagnosed at baseline. Conclusions: Our results imply that besides type of antidementia agent, involvement of a specialist in the complex process of prescribing antidementia drugs can provide meaningful benefits to patients, in terms of more disease-specific and continuous treatment.}, language = {en} } @article{SanchezThomasDeekenetal.2019, author = {S{\´a}nchez, Alba and Thomas, Christine and Deeken, Friederike and Wagner, S{\"o}ren and Kl{\"o}ppel, Stefan and Kentischer, Felix and von Arnim, Chrstine A. F. and Denkinger, Michael and Conzelmann, Lars O. and Biermann-Stallwitz, Janine and Joos, Stefanie and Sturm, Heidrun and Metz, Brigitte and Auer, Ramona and Skrobik, Yoanna and Eschweiler, Gerhard W. and Rapp, Michael Armin}, title = {Patient safety, cost-effectiveness, and quality of life}, series = {Trials}, volume = {20}, journal = {Trials}, number = {71}, publisher = {BioMed Central}, address = {London}, issn = {1468-6694}, doi = {10.1186/s13063-018-3148-8}, pages = {15}, year = {2019}, abstract = {Background Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients' age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective. Methods The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures. Discussion Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances. Trial registration German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.}, language = {en} } @misc{SanchezThomasDeekenetal.2019, author = {S{\´a}nchez, Alba and Thomas, Christine and Deeken, Friederike and Wagner, S{\"o}ren and Kl{\"o}ppel, Stefan and Kentischer, Felix and von Arnim, Chrstine A. F. and Denkinger, Michael and Conzelmann, Lars O. and Biermann-Stallwitz, Janine and Joos, Stefanie and Sturm, Heidrun and Metz, Brigitte and Auer, Ramona and Skrobik, Yoanna and Eschweiler, Gerhard W. and Rapp, Michael Armin}, title = {Patient safety, cost-effectiveness, and quality of life}, series = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe}, number = {535}, issn = {1866-8364}, doi = {10.25932/publishup-42488}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-424883}, pages = {15}, year = {2019}, abstract = {Background Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients' age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective. Methods The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures. Discussion Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances. Trial registration German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.}, language = {en} } @article{NienaberHeinzRappetal.2018, author = {Nienaber, Andr{\´e} and Heinz, Andreas and Rapp, Michael Armin and Bermpohl, F. and Schulz, M. and Behrens, J. and L{\"o}hr, M.}, title = {Einfluss der Personalbesetzung auf Konflikte auf psychiatrischen Stationen}, series = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie}, volume = {89}, journal = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie}, number = {7}, publisher = {Springer}, address = {New York}, issn = {0028-2804}, doi = {10.1007/s00115-018-0521-5}, pages = {821 -- 827}, year = {2018}, abstract = {Psychiatrische Stationen sind ein wichtiges Element in der psychiatrischen Versorgung von Menschen mit akuter Eigen- oder Fremdgef{\"a}hrdung. Leider kommt es in diesem Rahmen immer wieder auch zu Aggression, Gewalt (Konflikten) sowie zur Anwendung von Zwang (Eind{\"a}mmung). Als entscheidender Faktor f{\"u}r den sachgem{\"a}ßen Umgang mit diesen Situationen wird sowohl die Quantit{\"a}t als auch die Qualit{\"a}t der Mitarbeitenden angesehen. Vor diesem Hintergrund besch{\"a}ftigt sich die vorliegende Untersuchung mit der Versorgungssituation auf akutpsychiatrischen Stationen. Die Hypothese lautet, dass sowohl die Gr{\"o}ße der akutpsychiatrischen Station als auch die Anzahl der Pflegenden einen Einfluss auf das Vorkommen konflikthafter Situationen haben. Hierf{\"u}r sind Daten in 6 Kliniken auf insgesamt 12 psychiatrischen Stationen erfasst worden. Als Erfassungsinstrument diente die Patient Staff Conflict Checklist - Shift Report (PCC-SR). Insgesamt konnten 2026 Schichten (Fr{\"u}h‑, Sp{\"a}t- und Nachtschicht) erfasst und ausgewertet werden. Die personelle Besetzung der Stationen mit Pflegepersonal variierte erheblich. Die Ergebnisse zeigen, dass sowohl die Stationsgr{\"o}ße als auch die Anzahl der Pflegepersonen auf akutpsychiatrischen Stationen einen signifikanten Einfluss auf das Vorkommen von Konflikten haben. In den Ergebnissen zeigt sich weiterhin, dass sich die Inzidenz des konflikthaften Verhaltens von Patienten sowohl im Hinblick auf die untersuchten Stationen der beteiligten Krankenh{\"a}user als auch im Hinblick auf die betrachteten Dienstzeittypen unterscheiden. Dar{\"u}ber hinaus zeigt sich, dass das Ausmaß der Schließung einer Akutstation und die Gr{\"o}ße einer Station einen negativen Einfluss auf die Inzidenz von Konflikten im station{\"a}r akutpsychiatrischen Kontext haben. Das Auftreten konflikthaften Verhaltens kann zur Fremd- oder Selbstgef{\"a}hrdung und zu einer Vielzahl deeskalierender und eind{\"a}mmender Maßnahmen f{\"u}hren. Hierf{\"u}r sind entsprechende personelle Ressourcen erforderlich.}, language = {de} } @article{HeinzelLorenzBrockhausetal.2014, author = {Heinzel, Stephan and Lorenz, Robert C. and Brockhaus, Wolf-Ruediger and Wuestenberg, Torsten and Kathmann, Norbert and Heinz, Andreas and Rapp, Michael Armin}, title = {Working memory load-dependent brain response predicts behavioral training gains in older adults}, series = {The journal of neuroscience}, volume = {34}, journal = {The journal of neuroscience}, number = {4}, publisher = {Society for Neuroscience}, address = {Washington}, issn = {0270-6474}, doi = {10.1523/JNEUROSCI.2463-13.2014}, pages = {1224 -- 1233}, year = {2014}, abstract = {In the domain of working memory (WM), a sigmoid-shaped relationship between WM load and brain activation patterns has been demonstrated in younger adults. It has been suggested that age-related alterations of this pattern are associated with changes in neural efficiency and capacity. At the same time, WM training studies have shown that some older adults are able to increase their WM performance through training. In this study, functional magnetic resonance imaging during an n-back WM task at different WM load levels was applied to compare blood oxygen level-dependent (BOLD) responses between younger and older participants and to predict gains in WM performance after a subsequent 12-session WM training procedure in older adults. We show that increased neural efficiency and capacity, as reflected by more "youth-like" brain response patterns in regions of interest of the frontoparietal WM network, were associated with better behavioral training outcome beyond the effects of age, sex, education, gray matter volume, and baseline WM performance. Furthermore, at low difficulty levels, decreases in BOLD response were found after WM training. Results indicate that both neural efficiency (i. e., decreased activation at comparable performance levels) and capacity (i. e., increasing activation with increasing WM load) of a WM-related network predict plasticity of the WM system, whereas WM training may specifically increase neural efficiency in older adults.}, language = {en} }