@misc{BohleRimpelSchauenburgetal.2019, author = {Bohle, Hannah and Rimpel, J{\´e}r{\^o}me and Schauenburg, Gesche and Gebel, Arnd and Stelzel, Christine and Heinzel, Stephan and Rapp, Michael A. and Granacher, Urs}, title = {Behavioral and Neural Correlates of Cognitive-Motor Interference during Multitasking in Young and Old Adults}, series = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe}, number = {563}, issn = {1866-8364}, doi = {10.25932/publishup-43597}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-435972}, pages = {20}, year = {2019}, abstract = {The concurrent performance of cognitive and postural tasks is particularly impaired in old adults and associated with an increased risk of falls. Biological aging of the cognitive and postural control system appears to be responsible for increased cognitive-motor interference effects. We examined neural and behavioral markers of motor-cognitive dual-task performance in young and old adults performing spatial one-back working memory single and dual tasks during semitandem stance. On the neural level, we used EEG to test for age-related modulations in the frequency domain related to cognitive-postural task load. Twenty-eight healthy young and 30 old adults participated in this study. The tasks included a postural single task, a cognitive-postural dual task, and a cognitive-postural triple task (cognitive dual-task with postural demands). Postural sway (i.e., total center of pressure displacements) was recorded in semistance position on an unstable surface that was placed on top of a force plate while performing cognitive tasks. Neural activation was recorded using a 64-channel mobile EEG system. EEG frequencies were attenuated by the baseline postural single-task condition and demarcated in nine Regions-of-Interest (ROIs), i.e., anterior, central, posterior, over the cortical midline, and both hemispheres. Our findings revealed impaired cognitive dual-task performance in old compared to young participants in the form of significantly lower cognitive performance in the triple-task condition. Furthermore, old adults compared with young adults showed significantly larger postural sway, especially in cognitive-postural task conditions. With respect to EEG frequencies, young compared to old participants showed significantly lower alpha-band activity in cognitive-cognitive-postural triple-task conditions compared with cognitive-postural dual tasks. In addition, with increasing task difficulty, we observed synchronized theta and delta frequencies, irrespective of age. Taskdependent alterations of the alpha frequency band were most pronounced over frontal and central ROIs, while alterations of the theta and delta frequency bands were found in frontal, central, and posterior ROIs. Theta and delta synchronization exhibited a decrease from anterior to posterior regions. For old adults, task difficulty was reflected by theta synchronization in the posterior ROI. For young adults, it was reflected by alpha desynchronization in bilateral anterior ROIs. In addition, we could not identify any effects of task difficulty and age on the beta frequency band. Our results shed light on age-related cognitive and postural declines and how they interact. Modulated alpha frequencies during high cognitive-postural task demands in young but not old adults might be reflective of a constrained neural adaptive potential in old adults. Future studies are needed to elucidate associations between the identified age-related performance decrements with task difficulty and changes in brain activity.}, language = {en} } @misc{HaegeleSchlagenhaufRappetal.2014, author = {H{\"a}gele, Claudia and Schlagenhauf, Florian and Rapp, Michael A. 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{GellertHaeuslerSuhretal.2018, author = {Gellert, Paul and H{\"a}usler, Andreas and Suhr, Ralf and Gholami, Maryam and Rapp, Michael A. 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} } @misc{FriedelSchlagenhaufBecketal.2014, author = {Friedel, Eva and Schlagenhauf, Florian and Beck, Anne and Dolan, Raymond J. and Huys, Quentin J. M. and Rapp, Michael A. 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} } @article{GarbusowSchadSommeretal.2014, author = {Garbusow, Maria and Schad, Daniel and Sommer, Christian and Juenger, Elisabeth and Sebold, Miriam and Friedel, Eva and Wendt, Jean and Kathmann, Norbert and Schlagenhauf, Florian and Zimmermann, Ulrich S. and Heinz, Andreas and Huys, Quentin J. M. and Rapp, Michael A.}, title = {Pavlovian-to-instrumental transfer in alcohol dependence: a pilot study}, series = {Neuropsychobiology : international journal of experimental and clinical research in biological psychiatry, pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography}, volume = {70}, journal = {Neuropsychobiology : international journal of experimental and clinical research in biological psychiatry, pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography}, number = {2}, publisher = {Karger}, address = {Basel}, issn = {0302-282X}, doi = {10.1159/000363507}, pages = {111 -- 121}, year = {2014}, 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 ongoing thought and behavior. The influence of pavlovian stimuli on ongoing 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 PIT. Methods: Thirty-two recently detoxified alcohol-dependent patients and 32 age- and gender-matched healthy controls performed a PIT task with instrumental go/no-go approach behaviors. 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{RappMellMajicetal.2013, author = {Rapp, Michael A. 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{TreuschMajicPageetal.2015, author = {Treusch, Yvonne and Majic, Tomislav and Page, Julie and Gutzmann, Hans and Heinz, Andreas and Rapp, Michael A.}, 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} } @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}, 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}, 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} } @article{StelzelBohleSchauenburgetal.2018, author = {Stelzel, Christine and Bohle, Hannah and Schauenburg, Gesche and Walter, Henrik and Granacher, Urs and Rapp, Michael A. and Heinzel, Stephan}, title = {Contribution of the Lateral Prefrontal Cortex to Cognitive-Postural Multitasking}, series = {Frontiers in psychologie}, volume = {9}, journal = {Frontiers in psychologie}, publisher = {Frontiers}, address = {Lausanne}, issn = {1664-1078}, doi = {10.3389/fpsyg.2018.01075}, pages = {12}, year = {2018}, abstract = {There is evidence for cortical contribution to the regulation of human postural control. Interference from concurrently performed cognitive tasks supports this notion, and the lateral prefrontal cortex (lPFC) has been suggested to play a prominent role in the processing of purely cognitive as well as cognitive-postural dual tasks. The degree of cognitive-motor interference varies greatly between individuals, but it is unresolved whether individual differences in the recruitment of specific lPFC regions during cognitive dual tasking are associated with individual differences in cognitive-motor interference. Here, we investigated inter-individual variability in a cognitive-postural multitasking situation in healthy young adults (n = 29) in order to relate these to inter-individual variability in lPFC recruitment during cognitive multitasking. For this purpose, a oneback working memory task was performed either as single task or as dual task in order to vary cognitive load. Participants performed these cognitive single and dual tasks either during upright stance on a balance pad that was placed on top of a force plate or during fMRI measurement with little to no postural demands. We hypothesized dual one-back task performance to be associated with lPFC recruitment when compared to single one-back task performance. In addition, we expected individual variability in lPFC recruitment to be associated with postural performance costs during concurrent dual one-back performance. As expected, behavioral performance costs in postural sway during dual-one back performance largely varied between individuals and so did lPFC recruitment during dual one-back performance. Most importantly, individuals who recruited the right mid-lPFC to a larger degree during dual one-back performance also showed greater postural sway as measured by larger performance costs in total center of pressure displacements. This effect was selective to the high-load dual one-back task and suggests a crucial role of the right lPFC in allocating resources during cognitivemotor interference. Our study provides further insight into the mechanisms underlying cognitive-motor multitasking and its impairments.}, language = {en} } @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 A.}, 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} } @article{HeisselSanchezPietreketal.2023, author = {Heissel, Andreas and Sanchez, Alba and Pietrek, Anou F. and Bergau, Theresa and Stielow, Christiane and Rapp, Michael A. 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{HeisselPietrekFlungeretal.2018, author = {Heissel, Andreas and Pietrek, Anou F. and Flunger, Barbara and Fydrich, Thomas and Rapp, Michael A. and Heinzel, Stephan and Vansteenkiste, Maarten}, title = {The Validation of the German Basic Psychological Need Satisfaction and Frustration Scale in the Context of Mental Health}, series = {European Journal of Health Psychology}, volume = {25}, journal = {European Journal of Health Psychology}, number = {4}, publisher = {Hogrefe}, address = {G{\"o}ttingen}, issn = {2512-8442}, doi = {10.1027/2512-8442/a000017}, pages = {119 -- 132}, year = {2018}, abstract = {The primary aim of the current study was to examine the unique contribution of psychological need frustration and need satisfaction in the prediction of adults' mental well-being and ill-being in a heterogeneous sample of adults (N = 334; Mage = 43.33, SD = 32.26; 53\% females). Prior to this, validity evidence was provided for the German version of the Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS) based on Self-Determination Theory (SDT). The results of the validation analyses found the German BPNSFS to be a valid and reliable measurement. Further, structural equation modeling (SEM) showed that both need satisfaction and frustration yielded unique and opposing associations with well-being. Specifically, the dimension of psychological need frustration predicted adults' ill-being. Future research should examine whether frustration of psychological needs is involved in the onset and maintenance of psychopathology (e.g., major depressive disorder).}, language = {en} } @misc{RappKlugePenkaetal.2015, author = {Rapp, Michael A. 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} } @misc{ThomasSabbahRappetal.2019, author = {Thomas, Christine and Sabbah, Patricia and Rapp, Michael A. 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{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{HaegeleSchlagenhaufRappetal.2015, author = {Haegele, Claudia and Schlagenhauf, Florian and Rapp, Michael A. 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{MajicGutzmannHeinzetal.2013, author = {Majic, Tomislav and Gutzmann, Hans and Heinz, Andreas and Lang, Undine E. and Rapp, Michael A.}, 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{HeinzelLawrenceKalliesetal.2015, author = {Heinzel, Stephan and Lawrence, Jimmy B. and Kallies, Gunnar and Rapp, Michael A. 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{DahlingMayGreineretal.2021, author = {Dahling, Volker and May, Susann and Greiner, Timo and Thoma, Samuel and Peter, Sebastian von and Schwantes, Ulrich and Rapp, Michael A. 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} } @article{DeekenHaeuslerNordheimetal.2017, author = {Deeken, Friederike and H{\"a}usler, Andreas and Nordheim, Johanna and Rapp, Michael A. 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{HeroldTheobaldGronwaldetal.2022, author = {Herold, Fabian and Theobald, Paula and Gronwald, Thomas and Rapp, Michael A. 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} } @article{PerezChaparroKangasZechetal.2022, author = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Kangas, Maria and Zech, Philipp and Schuch, Felipe B. and Rapp, Michael A. and Heißel, Andreas}, title = {Recreational exercise is associated with lower prevalence of depression and anxiety and better quality of life in German people living with HIV}, series = {AIDS care : psychological and socio-medical aspects of AIDS/HIV}, volume = {34}, journal = {AIDS care : psychological and socio-medical aspects of AIDS/HIV}, number = {2}, publisher = {Taylor \& Francis Group}, address = {London [u.a.]}, issn = {1360-0451}, doi = {10.1080/09540121.2021.1889951}, pages = {182 -- 187}, year = {2022}, abstract = {Sedentarism is a risk factor for depression and anxiety. People living with the human immunodeficiency virus (PLWH) have a higher prevalence of anxiety and depression compared to HIV-negative individuals. This cross-sectional study (n = 450, median age 44 (19-75), 7.3\% females) evaluates the prevalence rates and prevalence ratio (PR) of anxiety and/or depression in PLWH associated with recreational exercise. A decreased likelihood of having anxiety (PR=0.57; 0.36-0.91; p = 0.01), depression (PR=0.41; 0.36-0.94; p=0.01), and comorbid anxiety and depression (PR = 0,43; 0.24-0.75; p=0.002) was found in exercising compared to non-exercising PLWH. Recreational exercise is associated with a lower risk for anxiety and/or depression. Further prospective studies are needed to provide insights on the direction of this association.}, language = {en} } @article{DeekenRezoHinzetal.2019, author = {Deeken, Friederike and Rezo, Anna and Hinz, Matthias and Discher, Robert and Rapp, Michael A.}, 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{ZechPerezChaparroSchuchetal.2019, author = {Zech, Philipp and Perez Chaparro, Camilo Germ{\´a}n Alberto and Schuch, Felipe and Wolfarth, Bernd and Rapp, Michael A. and Heissel, Andreas}, title = {Effects of Aerobic and Resistance Exercise on Cardiovascular Parameters for People Living With HIV}, series = {JANAC-Journal of the Association of Nurses in AIDS Care}, volume = {30}, journal = {JANAC-Journal of the Association of Nurses in AIDS Care}, number = {2}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {1055-3290}, doi = {10.1097/JNC.0000000000000006}, pages = {186 -- 205}, year = {2019}, abstract = {People living with HIV (PLWH) have limited exercise capacity because of anemia, neuromuscular disorders, and pulmonary limitations. We used a meta-analysis to examine the effect of aerobic and resistance exercise alone and in combination on cardiovascular parameters. Subgroup meta-analyses were conducted and long-term effects of exercise were investigated. A systematic literature search was conducted up to July/August 2017. The Physiotherapy Evidence Database-scale was used to rate quality and assess the risk of bias on the papers. Standardized mean differences (SMDs) were calculated to assess the effect of exercise. Posttreatment comparison between the exercise and control groups revealed moderate and large effect sizes in favor of the intervention group for VO2max (SMD50.66, p < .0001) and the 6-minute walk test (SMD = 1.11, p = .0001). Exercise had a positive effect on cardiovascular parameters in PLWH. Exercise can be a prevention factor for PLWH dealing with multiple comorbidities.}, 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 A. 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} } @article{DrosselmeyerRappKostev2016, author = {Drosselmeyer, Julia and Rapp, Michael A. 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{BakanidzeBrandlHutzleretal.2016, author = {Bakanidze, George and Brandl, Eva J. and Hutzler, Christine and Aurass, Friederike and Onken, Silke and Rapp, Michael A. 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{DrosselmeyerRappHadjietal.2016, author = {Drosselmeyer, J. and Rapp, Michael A. 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 A. 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{BookerBohlkenRappetal.2016, author = {Booker, Anke and Bohlken, Jens and Rapp, Michael A. 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} } @article{BookerJacobRappetal.2016, author = {Booker, Anke and Jacob, Louis E. C. and Rapp, Michael A. 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{StroehleRapp2016, author = {Stroehle, Andreas and Rapp, Michael A.}, 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} } @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} } @article{HeisselBollmannKangasetal.2021, author = {Heißel, Andreas and Bollmann, Julian and Kangas, Maria and Abdulla, K and Rapp, Michael A. 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{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 A. and Heißel, Andreas}, title = {Recreational exercising and self-reported cardiometabolic diseases in German people living with HIV}, series = {International journal of environmental research and public health : IJERPH / Molecular Diversity Preservation International}, volume = {18}, journal = {International journal of environmental research and public health : IJERPH / Molecular Diversity Preservation International}, number = {21}, publisher = {MDPI}, address = {Basel, Schweiz}, issn = {1660-4601}, doi = {10.3390/ijerph182111579}, 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{GellertHaeuslerSuhretal.2018, author = {Gellert, Paul and H{\"a}usler, Andreas and Suhr, Ralf and Gholami, Maryam and Rapp, Michael A. 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{GellertHaeuslerGholamietal.2017, author = {Gellert, Paul and H{\"a}usler, Andreas and Gholami, Maryam and Rapp, Michael A. 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{HeinzelRappFydrichetal.2017, author = {Heinzel, Stephan and Rapp, Michael A. 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} } @article{SchraplauBlockHaeusleretal.2021, author = {Schraplau, Anne and Block, Andrea and H{\"a}usler, Andreas and Wippert, Pia-Maria and Rapp, Michael A. 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}, series = {Pilot and Feasibility Studies}, volume = {7}, journal = {Pilot and Feasibility Studies}, publisher = {BioMed Central (Springer Nature)}, address = {London}, issn = {2055-5784}, doi = {10.1186/s40814-021-00898-w}, 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} } @article{HeisselPietrekSchwefeletal.2020, author = {Heissel, Andreas and Pietrek, Anou F. and Schwefel, Melanie and Abula, Kahar and Wilbertz, Gregor and Heinzel, Stephan and Rapp, Michael A.}, title = {STEP.De study}, series = {BMJ open}, volume = {10}, journal = {BMJ open}, number = {4}, publisher = {BMJ Publishing Group}, address = {London}, issn = {2044-6055}, doi = {10.1136/bmjopen-2019-036287}, pages = {10}, year = {2020}, abstract = {Introduction Although exercise therapy has widely been shown to be an efficacious treatment modality for depression, evidence for its effectiveness and cost efficiency is lacking. The Sport/Exercise Therapy for Depression study is a multicentre cluster-randomised effectiveness trial that aims to compare the effectiveness and cost efficiency of exercise therapy and psychotherapy as antidepressant treatment.
Methods and analysis 480 patients (aged 18-65) with an International Classification of Diseases diagnosis associated with depressive symptoms are recruited. Up to 30 clusters (psychotherapists) are randomly assigned to allocate patients to either an exercise or a psychotherapy treatment as usual in a 2: 1 ratio. The primary outcome (depressive symptoms) and the secondary outcomes (work and social adjustment, quality of life) will be assessed at six measurement time points (t0: baseline, t1: 8 weeks after treatment initiation, t2: 16 weeks after treatment initiation, t3/ 4/5: 2, 6, 12 months after treatment). Linear regression analyses will be used for the primary endpoint data analysis. For the secondary endpoints, mixed linear and logistic regression models with fixed and random factors will be added. For the cost efficiency analysis, expenditures in the 12 months before and after the intervention and the outcome difference will be compared between groups in a multilevel model. Recruitment start date was 1 July 2018 and the planned recruitment end date is 31 December 2020.
Ethics and dissemination The study protocol was approved by the ethics committee of the University of Potsdam (No. 17/2018) and the Freie Universitat Berlin (No. 206/2018) and registered in the ISRCTN registry. Informed written consent will be obtained from all participants. The study will be reported in accordance with the Consolidated Standards of Reporting Trials and the Recommendations for Interventional Trials statements. The results will be published in peer-reviewed academic journals and disseminated to the public.}, language = {en} } @article{LorenzGleichBecketal.2014, author = {Lorenz, Robert C. and Gleich, Tobias and Beck, Anne and Poehland, Lydia and Raufelder, Diana and Sommer, Werner and Rapp, Michael A. and Kuehn, Simone and Gallinat, J{\"u}rgen}, title = {Reward anticipation in the adolescent and aging brain}, series = {Human brain mapping : a journal devoted to functional neuroanatomy and neuroimaging}, volume = {35}, journal = {Human brain mapping : a journal devoted to functional neuroanatomy and neuroimaging}, number = {10}, publisher = {Wiley-Blackwell}, address = {Hoboken}, issn = {1065-9471}, doi = {10.1002/hbm.22540}, pages = {5153 -- 5165}, year = {2014}, abstract = {Processing of reward is the basis of adaptive behavior of the human being. Neural correlates of reward processing seem to be influenced by developmental changes from adolescence to late adulthood. The aim of this study is to uncover these neural correlates during a slot machine gambling task across the lifespan. Therefore, we used functional magnetic resonance imaging to investigate 102 volunteers in three different age groups: 34 adolescents, 34 younger adults, and 34 older adults. We focused on the core reward areas ventral striatum (VS) and ventromedial prefrontal cortex (VMPFC), the valence processing associated areas, anterior cingulate cortex (ACC) and insula, as well as information integration associated areas, dorsolateral prefrontal cortex (DLPFC), and inferior parietal lobule (IPL). Results showed that VS and VMPFC were characterized by a hyperactivation in adolescents compared with younger adults. Furthermore, the ACC and insula were characterized by a U-shape pattern (hypoactivation in younger adults compared with adolescents and older adults), whereas the DLPFC and IPL were characterized by a J-shaped form (hyperactivation in older adults compared with younger groups). Furthermore, a functional connectivity analysis revealed an elevated negative functional coupling between the inhibition-related area rIFG and VS in younger adults compared with adolescents. Results indicate that lifespan-related changes during reward anticipation are characterized by different trajectories in different reward network modules and support the hypothesis of an imbalance in maturation of striatal and prefrontal cortex in adolescents. Furthermore, these results suggest compensatory age-specific effects in fronto-parietal regions. Hum Brain Mapp 35:5153-5165, 2014. (c) 2014 Wiley Periodicals, Inc.}, language = {en} } @article{KuschpelLiuSchadetal.2015, author = {Kuschpel, Maxim S. and Liu, Shuyan and Schad, Daniel and Heinzel, Stephan and Heinz, Andreas and Rapp, Michael A.}, title = {Differential effects of wakeful rest, music and video game playing on working memory performance in the n-back task}, series = {Frontiers in psychology}, journal = {Frontiers in psychology}, number = {6}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-1078}, doi = {10.3389/fpsyg.2015.01683}, year = {2015}, abstract = {The interruption of learning processes by breaks filled with diverse activities is common in everyday life. We investigated the effects of active computer gaming and passive relaxation (rest and music) breaks on working memory performance. Young adults were exposed to breaks involving (i) eyes-open resting, (ii) listening to music and (iii) playing the video game "Angry Birds" before performing the n-back working memory task. Based on linear mixed-effects modeling, we found that playing the "Angry Birds" video game during a short learning break led to a decline in task performance over the course of the task as compared to eyes-open resting and listening to music, although overall task performance was not impaired. This effect was associated with high levels of daily mind wandering and low self-reported ability to concentrate. These findings indicate that video games can negatively affect working memory performance over time when played in between learning tasks. We suggest further investigation of these effects because of their relevance to everyday activity.}, language = {en} } @article{PerezChaparroZechSchuchetal.2018, author = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Zech, Philipp and Schuch, Felipe and Wolfarth, Bernd and Rapp, Michael A. and Heiβel, Andreas}, title = {Effects of aerobic and resistance exercise alone or combined on strength and hormone outcomes for people living with HIV}, series = {PLOS One}, volume = {13}, journal = {PLOS One}, number = {9}, publisher = {PLOS}, address = {San Francisco}, issn = {1932-6203}, doi = {10.1371/journal.pone.0203384}, pages = {1 -- 12}, year = {2018}, abstract = {Background: Infection with human immunodeficiency virus (HIV) affects muscle mass, altering independent activities of people living with HIV (PLWH). Resistance training alone (RT) or combined with aerobic exercise (AE) is linked to improved muscle mass and strength maintenance in PLWH. These exercise benefits have been the focus of different meta-analyses, although only a limited number of studies have been identified up to the year 2013/4. An up-to-date systematic review and meta-analysis concerning the effect of RT alone or combined with AE on strength parameters and hormones is of high value, since more and recent studies dealing with these types of exercise in PLWH have been published. Methods: Randomized controlled trials evaluating the effects of RT alone, AE alone or the combination of both (AERT) on PLWH was performed through five web-databases up to December 2017. Risk of bias and study quality was attained using the PEDro scale. Weighted mean difference (WMD) from baseline to post-intervention changes was calculated. The I2 statistics for heterogeneity was calculated. Results: Thirteen studies reported strength outcomes. Eight studies presented a low risk of bias. The overall change in upper body strength was 19.3 Kg (95\% CI: 9.8±28.8, p< 0.001) after AERT and 17.5 Kg (95\% CI: 16±19.1, p< 0.001) for RT. Lower body change was 29.4 Kg (95\% CI: 18.1±40.8, p< 0.001) after RT and 10.2 Kg (95\% CI: 6.7±13.8, p< 0.001) for AERT. Changes were higher after controlling for the risk of bias in upper and lower body strength and for supervised exercise in lower body strength. A significant change towards lower levels of IL-6 was found (-2.4 ng/dl (95\% CI: -2.6, -2.1, p< 0.001). Conclusion: Both resistance training alone and combined with aerobic exercise showed a positive change when studies with low risk of bias and professional supervision were analyzed, improving upper and, more critically, lower body muscle strength. Also, this study found that exercise had a lowering effect on IL-6 levels in PLWH.}, 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 A. 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{KonradBohlkenRappetal.2016, author = {Konrad, Marcel and Bohlken, Jens and Rapp, Michael A. 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 A. 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 A. 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} } @unpublished{HeinzCharletRapp2015, author = {Heinz, Andreas and Charlet, Katrin and Rapp, Michael A.}, 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{SchulzeMerzThieretal.2022, author = {Schulze, Susanne and Merz, Sibille and Thier, Anne and Tallarek, Marie and K{\"o}nig, Franziska and Uhlenbrock, Greta and N{\"u}bling, Matthias and Lincke, Hans-Joachim and Rapp, Michael A. and Spallek, Jacob and Holmberg, Christine}, title = {Psychosocial burden in nurses working in nursing homes during the Covid-19 pandemic}, series = {BMC health services research}, volume = {22}, journal = {BMC health services research}, number = {1}, publisher = {BMC}, address = {London}, issn = {1472-6963}, doi = {10.1186/s12913-022-08333-3}, pages = {13}, year = {2022}, abstract = {Background The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. Methods We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales 'quantitative demands', 'hiding emotions', 'work-privacy conflicts', 'role conflicts', 'quality of leadership', 'support at work', 'recognition', 'physical demands', 'intention to leave profession', 'burnout', 'presenteeism' and 'inability to relax'. The interviews (n = 15) revealed six main themes related to nurses' psychosocial stress: 'overall working conditions', 'concern for residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' (interviews), 'meaning of work' and 'quantity of social relations' (COPSOQ III) were identified as positive effects of the pandemic. Conclusions Results clearly illustrate an aggravation of geriatric nurses' situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses' strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.}, language = {en} } @article{HoffmannTschornMichalskietal.2022, author = {Hoffmann, Stephanie and Tschorn, Mira and Michalski, Niels and Hoebel, Jens and F{\"o}rstner, Bernd Rainer and Rapp, Michael A. and Spallek, Jacob}, title = {Association of regional socioeconomic deprivation and rurality with global developmental delay in early childhood}, series = {Health \& place : an international journal ; a social science \& medicine publication ; incorporating Geographia medica}, volume = {75}, journal = {Health \& place : an international journal ; a social science \& medicine publication ; incorporating Geographia medica}, publisher = {Elsevier Science}, address = {Amsterdam [u.a.]}, issn = {1353-8292}, doi = {10.1016/j.healthplace.2022.102794}, pages = {8}, year = {2022}, abstract = {Background: From birth to young adulthood, health and development of young people are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living environment. The impact of regional characteristics on development in early childhood beyond family SEP has been rarely investigated. This study aimed to identify regional predictors of global developmental delay at school entry taking family SEP into consideration. Method: We used representative, population-based data from mandatory school entry examinations of the German federal state of Brandenburg in 2018/2019 with n=22,801 preschool children. By applying binary multilevel models, we hierarchically analyzed the effect of regional deprivation defined by the German Index of Socioeconomic Deprivation (GISD) and rurality operationalized as inverted population density of the children's school district on global developmental delay (GDD) while adjusting for family SEP (low, medium and high) Results: Family SEP was significantly and strongly linked to GDD. Children with the highest family SEP showed a lower odds for GDD compared to a medium SEP (female: OR=4.26, male: OR=3.46) and low SEP (female: OR=16.58, male: OR=12.79). Furthermore, we discovered a smaller, but additional and independent effect of regional socioeconomic deprivation on GDD, with a higher odds for children from a more deprived school district (female: OR=1.35, male: OR=1.20). However, rurality did not show a significant link to GDD in preschool children beyond family SEP and regional deprivation. Conclusion: Family SEP and regional deprivation are risk factors for child development and of particular interest to promote health of children in early childhood and over the life course.}, language = {en} }