@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{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} } @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} } @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{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{FriedelSchlagenhaufBecketal.2015, 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 = {European archives of psychiatry and clinical neuroscience : official organ of the German Society for Biological Psychiatry}, volume = {265}, journal = {European archives of psychiatry and clinical neuroscience : official organ of the German Society for Biological Psychiatry}, number = {1}, publisher = {Springer}, address = {Heidelberg}, issn = {0940-1334}, doi = {10.1007/s00406-014-0519-3}, pages = {35 -- 43}, year = {2015}, 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} } @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} } @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} } @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{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} }