TY - JOUR A1 - Jacob, Louis A1 - Rapp, Michael Armin A1 - Kostev, Karel T1 - Long-term use of benzodiazepines in older patients in Germany BT - a retrospective analysis JF - Therapeutic Advances in Psychopharmacology N2 - Background: The purpose of this study was to analyze the prevalence of long-term benzodiazepine use in older adults treated in general and neuropsychiatric practices in Germany. Methods: This study included 32,182 patients over the age of 65 years who received benzodiazepine prescriptions for the first time between January 2010 and December 2014 in general and neuropsychiatric practices in Germany. Follow up lasted until July 2016. The main outcome measure was the proportion of patients treated with benzodiazepines for >6 months. Results: The proportion of patients with benzodiazepine therapy for >6 months increased with age (65-70 years: 12.3%; 71-80 years: 15.5%; 81-90 years: 23.7%; >90 years: 31.6%) but did not differ significantly between men (15.5%) and women (17.1%). The proportion of patients who received benzodiazepines for >6 months was higher among those with sleep disorders (21.1%), depression (20.8%) and dementia (32.1%) than among those with anxiety (15.5%). By contrast, this proportion was lower among people diagnosed with adjustment disorders (7.7%) and back pain (3.8%). Conclusion: Overall, long-term use of benzodiazepines is common in older people, particularly in patients over the age of 80 and in those diagnosed with dementia, sleep disorders, or depression. KW - benzodiazepines KW - Germany KW - long-term use KW - older people KW - risk factors Y1 - 2017 U6 - https://doi.org/10.1177/2045125317696454 SN - 2045-1253 SN - 2045-1261 VL - 7 IS - 6/7 SP - 191 EP - 200 PB - Sage Publ. CY - London ER - TY - JOUR A1 - Hohm, Erika A1 - Laucht, Manfred A1 - Zohsel, Katrin A1 - Schmidt, Martin H. A1 - Esser, Günter A1 - Brandeis, Daniel A1 - Banaschewski, Tobias T1 - Resilienz und Ressourcen im Verlauf der Entwicklung T1 - Resilience and Resources During Development BT - Von der frühen Kindheit bis zum Erwachsenenalter BT - From Early Childhood to Adulthood JF - Kindheit und Entwicklung N2 - Anhand von Daten der Mannheimer Risikokinderstudie, die sich mit der langfristigen Entwicklung von Kindern mit unterschiedlichen Risikobelastungen beschäftigt, wird gezeigt, wie Schutzfaktoren aufseiten des Kindes und seines familiären Umfelds im Verlauf der Entwicklung wirksam werden und zur Entstehung von Resilienz beitragen können. Eine besondere Rolle kommt dabei positiven frühen Eltern-Kind-Beziehungen zu (sowohl Mutter- als auch Vater-Kind-Interaktionen). Daneben spielen auch Interaktionserfahrungen im Alter von zwei Jahren des Kindes eine bedeutsame Rolle; diese schützen Risikokinder davor, eine ungünstige Entwicklung zu nehmen und tragen dazu bei, dass sich Kinder, die in psychosozialen Hochrisikofamilien aufwachsen, trotz ungünstiger „Startbedingungen“ positiv entwickeln. Neben Merkmalen der sozialen Umwelt nehmen auch sprachliche, sozial-emotionale und internale Kompetenzen des Kindes im Entwicklungsverlauf eine wichtige Rolle ein. Diese Kompetenzen ermöglichen es Risikokindern auch unter widrigen Lebensumständen (psychosoziale Hochrisikofamilien, Aufwachsen in Armutsverhältnissen) erfolgreich zu bestehen. Darüber hinaus zeigt die Arbeit, dass Resilienz ein Persönlichkeitsmerkmal ist, das ab dem frühen Erwachsenenalter eine hohe Stabilität besitzt. Mit diesen Befunden verweist die Arbeit auf die große Bedeutung der Resilienz bei der Vorhersage der langfristigen Entwicklung von Risikokindern. N2 - Resilience refers to the ability to successfully deal with stressful life circumstances and experiences and to cope with them. Based on data from the Mannheim Study of Children at Risk, which follows a sample of children at risk from birth to adulthood, the present paper provides convincing evidence demonstrating how protective factors in the child and his/her family environment operate during the course of development to contribute to the development of resilience. As shown, a major role is assigned to positive early parent–child relationships (both mother– and father–child interactions). Moreover, positive interactive experiences at the child’s age of 2 years play a significant role. These experiences consistently contribute to a positive child development in the face of adversity. In addition to characteristics of the social environment of the child, cognitive, social–emotional, and internal competencies during childhood, youth, and young adulthood play a major role in the development of resilience. These competencies enable children at risk who are growing up in psychosocial high-risk families or in poverty to successfully cope with conditions of high adversity. Moreover, the findings presented here demonstrate that resilience may be conceived as a personal characteristic that exhibits high stability since young adulthood. With these findings, the present study points to the significance of resilience in predicting the long-term outcome of children at risk. KW - protective factors KW - risk factors KW - longitudinal study KW - Mannheim Study of Children at Risk KW - early parent-child relationship KW - Schutzfaktoren KW - Risikofaktoren KW - Längsschnittstudie KW - Mannheimer Risikokinderstudie KW - frühe Eltern-Kind-Beziehung Y1 - 2018 U6 - https://doi.org/10.1026/0942-5403/a000236 SN - 0942-5403 SN - 2190-6246 VL - 26 SP - 230 EP - 239 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Bohlken, Jens A1 - Jacob, Louis A1 - Schaum, Peter A1 - Rapp, Michael Armin A1 - Kostev, Karel T1 - Hip fracture risk in patients with dementia in German primary care practices JF - Dementia N2 - The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65-90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance. The primary outcome was the diagnosis of hip fracture during the three-year follow-up period. A total of 53,156 dementia patients and 53,156 controls were included. A total of 5.3% of patients and 0.7% of controls displayed hip fracture after three years. Hip fracture occurred more frequently in dementia subjects living in nursing homes than in those living at home (9.2% versus 4.3%). Dementia, residence in nursing homes, and osteoporosis were risk factors for fracture development. Antidementia, antipsychotic, and antidepressant drugs generally had no significant impact on hip fracture risk when prescribed for less than six months. Dementia increased hip fracture risk in German primary care practices. KW - hip fracture KW - dementia KW - nursing homes KW - osteoporosis KW - risk factors Y1 - 2015 U6 - https://doi.org/10.1177/1471301215621854 SN - 1471-3012 SN - 1741-2684 VL - 16 SP - 853 EP - 864 PB - Sage Publ. CY - London ER -