@article{NienaberHeinzRappetal.2018, author = {Nienaber, Andr{\´e} and Heinz, Andreas and Rapp, Michael A. 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} } @misc{HeisselZechRappetal.2019, author = {Heissel, Andreas and Zech, Philipp and Rapp, Michael A. 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{GleichSpittaButleretal.2020, author = {Gleich, Tobias and Spitta, Gianna and Butler, Oisin and Zacharias, Kristin and Aydin, Semiha and Sebold, Miriam and Garbusow, Maria and Rapp, Michael A. and Schubert, Florian and Buchert, Ralph and Heinz, Andreas and Gallinat, J{\"u}rgen}, title = {Dopamine D2/3 receptor availability in alcohol use disorder and individuals at high risk}, series = {Addiction Biology}, volume = {26}, journal = {Addiction Biology}, number = {2}, publisher = {Wiley-Blackwell}, address = {Hoboken}, issn = {1369-1600}, doi = {10.1111/adb.12915}, pages = {1 -- 10}, year = {2020}, abstract = {Alcohol use disorder (AUD) is the most common substance use disorder worldwide. Although dopamine-related findings were often observed in AUD, associated neurobiological mechanisms are still poorly understood. Therefore, in the present study, we investigate D2/3 receptor availability in healthy participants, participants at high risk (HR) to develop addiction (not diagnosed with AUD), and AUD patients in a detoxified stage, applying F-18-fallypride positron emission tomography (F-18-PET). Specifically, D2/3 receptor availability was investigated in (1) 19 low-risk (LR) controls, (2) 19 HR participants, and (3) 20 AUD patients after alcohol detoxification. Quality and severity of addiction were assessed with clinical questionnaires and (neuro)psychological tests. PET data were corrected for age of participants and smoking status. In the dorsal striatum, we observed significant reductions of D2/3 receptor availability in AUD patients compared with LR participants. Further, receptor availability in HR participants was observed to be intermediate between LR and AUD groups (linearly decreasing). Still, in direct comparison, no group difference was observed between LR and HR groups or between HR and AUD groups. Further, the score of the Alcohol Dependence Scale (ADS) was inversely correlated with D2/3 receptor availability in the combined sample. Thus, in line with a dimensional approach, striatal D2/3 receptor availability showed a linear decrease from LR participants to HR participants to AUD patients, which was paralleled by clinical measures. Our study shows that a core neurobiological feature in AUD seems to be detectable in an early, subclinical state, allowing more individualized alcohol prevention programs in the future.}, language = {en} } @article{Rapp2019, author = {Rapp, Michael A.}, 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} } @article{DrosselmeyerJacobRathmannetal.2017, author = {Drosselmeyer, Julia and Jacob, Louis and Rathmann, Wolfgang and Rapp, Michael A. 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{HeinzelRiemerSchulteetal.2014, author = {Heinzel, Stephan and Riemer, Thomas G. and Schulte, Stefanie and Onken, Johanna and Heinz, Andreas and Rapp, Michael A.}, 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} } @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 A. 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{StelzelSchauenburgRappetal.2017, author = {Stelzel, Christine and Schauenburg, Gesche and Rapp, Michael A. and Heinzel, Stephan and Granacher, Urs}, title = {Age-Related Interference between the Selection of Input-Output Modality Mappings and Postural Control-a Pilot Study}, series = {Frontiers in psychology}, volume = {8}, journal = {Frontiers in psychology}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-1078}, doi = {10.3389/fpsyg.2017.00613}, pages = {15}, year = {2017}, abstract = {Age-related decline in executive functions and postural control due to degenerative processes in the central nervous system have been related to increased fall-risk in old age. Many studies have shown cognitive-postural dual-task interference in old adults, but research on the role of specific executive functions in this context has just begun. In this study, we addressed the question whether postural control is impaired depending on the coordination of concurrent response-selection processes related to the compatibility of input and output modality mappings as compared to impairments related to working-memory load in the comparison of cognitive dual and single tasks. Specifically, we measured total center of pressure (CoP) displacements in healthy female participants aged 19-30 and 66-84 years while they performed different versions of a spatial one-back working memory task during semi-tandem stance on an unstable surface (i.e., balance pad) while standing on a force plate. The specific working-memory tasks comprised: (i) modality compatible single tasks (i.e., visual-manual or auditory-vocal tasks), (ii) modality compatible dual tasks (i.e., visual-manual and auditory-vocal tasks), (iii) modality incompatible single tasks (i.e., visual-vocal or auditory-manual tasks), and (iv) modality incompatible dual tasks (i.e., visual-vocal and auditory-manual tasks). In addition, participants performed the same tasks while sitting. As expected from previous research, old adults showed generally impaired performance under high working-memory load (i.e., dual vs. single one-back task). In addition, modality compatibility affected one-back performance in dual-task but not in single-task conditions with strikingly pronounced impairments in old adults. Notably, the modality incompatible dual task also resulted in a selective increase in total CoP displacements compared to the modality compatible dual task in the old but not in the young participants. These results suggest that in addition to effects of working-memory load, processes related to simultaneously overcoming special linkages between input-and output modalities interfere with postural control in old but not in young female adults. Our preliminary data provide further evidence for the involvement of cognitive control processes in postural tasks.}, language = {en} }