TY - JOUR A1 - Bauer, M. A1 - Banaschewski, Tobias A1 - Heinz, A. A1 - Kamp-Becker, I. A1 - Meyer-Lindenberg, A. A1 - Padberg, F. A1 - Rapp, Michael A. A1 - Rupprecht, R. A1 - Schneider, F. A1 - Schulze, T. G. A1 - Wittchen, Hans-Ulrich T1 - The German Research Network for mental Disorders JF - Der Nervenarzt : Organ der Deutschen Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft für Neurologie N2 - Mental disorders are among the greatest medical and social challenges facing us. They can occur at all stages of life and are among the most important commonly occurring diseases. In Germany 28 % of the population suffer from a mental disorder every year, while the lifetime risk of suffering from a mental disorder is almost 50 %. Mental disorders cause great suffering for those affected and their social network. Quantitatively speaking, they can be considered to be among those diseases creating the greatest burden for society due to reduced productivity, absence from work and premature retirement. The Federal Ministry of Education and Research is funding a new research network from 2015 to 2019 with up to 35 million euros to investigate mental disorders in order to devise and develop better therapeutic measures and strategies for this population by means of basic and translational clinical research. This is the result of a competitive call for research proposals entitled research network for mental diseases. It is a nationwide network of nine consortia with up to ten psychiatric and clinical psychology partner institutions from largely university-based research facilities for adults and/or children and adolescents. Furthermore, three cross-consortia platform projects will seek to identify shared causes of diseases and new diagnostic modalities for anxiety disorders, attention deficit hyperactivity disorders (ADHS), autism, bipolar disorders, depression, schizophrenia and psychotic disorders as well as substance-related and addictive disorders. The spectrum of therapeutic approaches to be examined ranges from innovative pharmacological and psychotherapeutic treatment to novel brain stimulation procedures. In light of the enormous burden such diseases represent for society as a whole, a sustainable improvement in the financial support for those researching mental disorders seems essential. This network aims to become a nucleus for long overdue and sustained support for a German center for mental disorders. Y1 - 2016 U6 - https://doi.org/10.1007/s00115-016-0169-y SN - 0028-2804 SN - 1433-0407 VL - 87 SP - 989 EP - 1010 PB - Springer CY - New York ER - TY - JOUR A1 - Reppert, Alexander von A1 - Sarhan, Radwan Mohamed A1 - Stete, Felix A1 - Pudell, Jan-Etienne A1 - Del Fatti, N. A1 - Crut, A. A1 - Koetz, Joachim A1 - Liebig, Ferenc A1 - Prietzel, Claudia Christina A1 - Bargheer, Matias T1 - Watching the Vibration and Cooling of Ultrathin Gold Nanotriangles by Ultrafast X-ray Diffraction JF - The journal of physical chemistry : C, Nanomaterials and interfaces N2 - We study the vibrations of ultrathin gold nanotriangles upon optical excitation of the electron gas by ultrafast X-ray diffraction. We quantitatively measure the strain evolution in these highly asymmetric nano-objects, providing a direct estimation of the amplitude and phase of the excited vibrational motion. The maximal strain value is well reproduced by calculations addressing pump absorption by the nanotriangles and their resulting thermal expansion. The amplitude and phase of the out-of-plane vibration mode with 3.6 ps period dominating the observed oscillations are related to two distinct excitation mechanisms. Electronic and phonon pressures impose stresses with different time dependences. The nanosecond relaxation of the expansion yields a direct temperature sensing of the nano-object. The presence of a thin organic molecular layer at the nanotriangle/substrate interfaces drastically reduces the thermal conductance to the substrate. Y1 - 2016 U6 - https://doi.org/10.1021/acs.jpcc.6b11651 SN - 1932-7447 VL - 120 SP - 28894 EP - 28899 PB - American Chemical Society CY - Washington ER - TY - JOUR A1 - Heinzel, Stephan A1 - Lorenz, Robert C. A1 - Pelz, Patricia A1 - Heinz, Andreas A1 - Walter, Henrik A1 - Kathmann, Norbert A1 - Rapp, Michael A. A1 - Stelzel, Christine T1 - Neural correlates of training and transfer effects in working memory in older adults JF - NeuroImage : a journal of brain function N2 - 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. KW - Aging KW - Working memory KW - Training KW - Transfer KW - Neuroimaging KW - fMRI KW - Updating KW - Executive functions KW - Fluid intelligence Y1 - 2016 U6 - https://doi.org/10.1016/j.neuroimage.2016.03.068 SN - 1053-8119 SN - 1095-9572 VL - 134 SP - 236 EP - 249 PB - Elsevier CY - San Diego ER - TY - JOUR A1 - Drosselmeyer, Julia A1 - Rapp, Michael A. A1 - Kostev, Karel T1 - Prevalence and type of antidepressant therapy used by German general practitioners to treat female patients with osteoporosis JF - International journal of clinical pharmacology and therapeutics N2 - 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. KW - depression therapy KW - osteoporosis KW - hospital referral KW - primary care practices Y1 - 2016 U6 - https://doi.org/10.5414/CP202610 SN - 0946-1965 VL - 54 SP - 743 EP - 749 PB - Dustri-Verlag Dr. Karl Feistle CY - Deisenhofen-München ER - TY - JOUR A1 - Bakanidze, George A1 - Brandl, Eva J. A1 - Hutzler, Christine A1 - Aurass, Friederike A1 - Onken, Silke A1 - Rapp, Michael A. A1 - Puls, Imke T1 - Association of Dystrobrevin-Binding Protein 1 Polymorphisms with Sustained Attention and Set-Shifting in Schizophrenia Patients JF - Neuropsychobiology : international journal of experimental and clinical research in biological psychiatry, pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography N2 - 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 KW - DTNBP1 KW - Genetics KW - Cognitive dysfunction KW - Factor analysis Y1 - 2016 U6 - https://doi.org/10.1159/000450550 SN - 0302-282X SN - 1423-0224 VL - 74 SP - 41 EP - 47 PB - Karger CY - Basel ER - TY - JOUR A1 - Drosselmeyer, J. A1 - Rapp, Michael A. A1 - Hadji, P. A1 - Kostev, K. T1 - Depression risk in female patients with osteoporosis in primary care practices in Germany JF - Osteoporosis international N2 - 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. KW - Comorbidity KW - Depression risk KW - Osteoporosis KW - Primary care practice Y1 - 2016 U6 - https://doi.org/10.1007/s00198-016-3584-9 SN - 0937-941X SN - 1433-2965 VL - 27 SP - 2739 EP - 2744 PB - Springer CY - London ER - TY - JOUR A1 - Konrad, Marcel A1 - Jacob, Louis A1 - Rapp, Michael A. A1 - Kostev, Karel T1 - Depression risk in patients with coronary heart disease in Germany JF - World Journal of Cardiology N2 - 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. KW - Coronary heart disease KW - Depression KW - Primary care KW - Risk factors KW - Quality of life Y1 - 2016 U6 - https://doi.org/10.4330/wjc.v8.i9.547 SN - 1949-8462 VL - 8 SP - 547 EP - 552 PB - Baishideng Publishing Group CY - Pleasanton ER - TY - JOUR A1 - Booker, Anke A1 - Bohlken, Jens A1 - Rapp, Michael A. A1 - Kostev, Karel T1 - Persistence with antidepressant drugs in patients with dementia: a retrospective database analysis JF - International journal of clinical pharmacology and therapeutics N2 - 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. KW - depression Y1 - 2016 U6 - https://doi.org/10.5414/CP202572 SN - 0946-1965 VL - 54 SP - 323 EP - 329 PB - Dustri-Verlag Dr. Karl Feistle CY - Deisenhofen-München ER - TY - JOUR A1 - Booker, Anke A1 - Jacob, Louis E. C. A1 - Rapp, Michael A. A1 - Bohlken, Jens A1 - Kostev, Karel T1 - Risk factors for dementia diagnosis in German primary care practices JF - International psychogeriatrics N2 - 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. KW - dementia KW - Alzheimer KW - risk factors KW - statins Y1 - 2016 U6 - https://doi.org/10.1017/S1041610215002082 SN - 1041-6102 SN - 1741-203X VL - 28 SP - 1059 EP - 1065 PB - Cambridge Univ. Press CY - New York ER - TY - JOUR A1 - Reppert, Alexander von A1 - Pudell, Jan-Etienne A1 - Koc, A. A1 - Reinhardt, M. A1 - Leitenberger, Wolfram A1 - Dumesnil, K. A1 - Zamponi, Flavio A1 - Bargheer, Matias T1 - Persistent nonequilibrium dynamics of the thermal energies in the spin and phonon systems of an antiferromagnet JF - Structural dynamics N2 - We present a temperature and fluence dependent Ultrafast X-Ray Diffraction study of a laser-heated antiferromagnetic dysprosium thin film. The loss of antiferromagnetic order is evidenced by a pronounced lattice contraction. We devise a method to determine the energy flow between the phonon and spin system from calibrated Bragg peak positions in thermal equilibrium. Reestablishing the magnetic order is much slower than the cooling of the lattice, especially around the Neel temperature. Despite the pronounced magnetostriction, the transfer of energy from the spin system to the phonons in Dy is slow after the spin-order is lost. (C) 2016 Author(s). Y1 - 2016 U6 - https://doi.org/10.1063/1.4961253 SN - 2329-7778 VL - 3 PB - American Institute of Physics CY - Melville ER - TY - GEN A1 - Stroehle, Andreas A1 - Rapp, Michael A. T1 - Prevention of Cognitive Decline: A Physical Exercise Perspective on Brain Health in the Long Run T2 - Journal of the American Medical Directors Association Y1 - 2016 U6 - https://doi.org/10.1016/j.jamda.2016.02.030 SN - 1525-8610 SN - 1538-9375 VL - 17 SP - 461 EP - 462 PB - Elsevier CY - New York ER - TY - JOUR A1 - Sebold, Miriam A1 - Schad, Daniel A1 - Nebe, Stephan A1 - Garbusow, Maria A1 - Juenger, Elisabeth A1 - Kroemer, Nils B. A1 - Kathmann, Norbert A1 - Zimmermann, Ulrich S. A1 - Smolka, Michael N. A1 - Rapp, Michael A. A1 - Heinz, Andreas A1 - Huys, Quentin J. M. T1 - Pavlovian-to-Instrumental Transfer Effects Rely Less on Model-based Reinforcement Learning JF - Journal of cognitive neuroscience N2 - Behavioral choice can be characterized along two axes. One axis distinguishes reflexive, model-free systems that slowly accumulate values through experience and a model-based system that uses knowledge to reason prospectively. The second axis distinguishes Pavlovian valuation of stimuli from instrumental valuation of actions or stimulus–action pairs. This results in four values and many possible interactions between them, with important consequences for accounts of individual variation. We here explored whether individual variation along one axis was related to individual variation along the other. Specifically, we asked whether individuals' balance between model-based and model-free learning was related to their tendency to show Pavlovian interferences with instrumental decisions. In two independent samples with a total of 243 participants, Pavlovian–instrumental transfer effects were negatively correlated with the strength of model-based reasoning in a two-step task. This suggests a potential common underlying substrate predisposing individuals to both have strong Pavlovian interference and be less model-based and provides a framework within which to interpret the observation of both effects in addiction. Y1 - 2016 U6 - https://doi.org/10.1162/jocn_a_00945 SN - 0898-929X SN - 1530-8898 VL - 28 SP - 985 EP - 995 PB - MIT Press CY - Cambridge ER - TY - THES A1 - Booker, Anke T1 - Datenbankbasierte epidemiologische Untersuchung über die Versorgung demenzerkrankter Patienten N2 - Hintergrund: Demenz wird von der Weltgesundheitsorganisation als ein in der Regel chronisch oder progressiv verlaufendes Syndrom definiert, das von einer Vielzahl von Hirnerkrankungen verursacht wird, welche das Gedächtnis, das Denkvermögen, das Verhalten und die Fähigkeit, alltägliche Tätigkeiten auszuführen, beeinflussen. Weltweit leiden 47,5 Millionen Menschen unter Demenz und diese Zahl wird sich voraussichtlich bis zum Jahr 2050 verdreifachen. In den vorliegenden Studien wurden zum Einem die Faktoren, welche mit dem Risiko einhergehen eine Demenz zu entwickeln, analysiert. Zum Anderen wurde die Persistenz der medikamentösen Behandlung von depressiven Zuständen mit Antidepressiva sowie die Persistenz der medikamentösen Behandlung von Verhaltensstörungen, therapiert mit Antipsychotika, bei Demenzpatienten untersucht. Durchführung: Alle drei Studien basieren auf den Daten der IMS Disease Analyzer-Datenbank. Die Daten der Disease Analyzer-Datenbank werden über standardisierte Schnittstellen direkt monatlich aus dem Praxiscomputer generiert. Die Daten werden vor der Übertragung verschlüsselt und entsprechen in Umfang und Detaillierungsgrad der Patientenakte. Risikofaktoren für eine Demenzdiagnose Methode: Insgesamt wurden in die Studie 11.956 Patienten mit einer Erstdiagnose (Indexdatum) einer Demenz (ICD 10: F01, F03, G30) zwischen Januar 2010 und Dezember 2014 eingeschlossen. 11.956 Kontrollpatienten (ohne Demenz) wurden den Patienten nach Alter, Geschlecht, Art der Krankenversicherung und Arzt zugeordnet. In beiden Fällen wurden die Praxisaufzeichnungen dazu verwendet, sicherzustellen, dass die Patienten vor dem Indexdatum jeweils 10 Jahre kontinuierlich beobachtet worden waren. Insgesamt wurden 23.912 Personen betrachtet. Mehrere Erkrankungen, die möglicherweise mit Demenz assoziiert sind, wurden anhand von allgemeinärztlichen Diagnosen bestimmt (ICD-10-Codes): Diabetes (E10-E14), Hypertonie (I10), Adipositas (E66), Hyperlipidämie (E78), Schlaganfall (einschließlich transitorische ischämische Attacke, TIA) (I63, I64, G45), Parkinson-Krankheit (G20, G21), intrakranielle Verletzung (S06), koronare Herzkrankheit (I20-I25), leichte kognitive Beeinträchtigung (F06) und psychische und Verhaltensstörungen durch Alkohol (F10). Das Vorhandensein mehrerer Medikamente, wie z. B. Statine, Protonenpumpenhemmer und Antihypertensiva (einschließlich Diuretika, Beta-Blocker, Calciumkanalblocker, ACE-Hemmer und Angiotensin-II), wurde ebenfalls bemessen. Ergebnisse: Das Durchschnittsalter für die 11.956 Demenzpatienten und die 11.956 der Kontrollkohorte war 80,4 (SD 5,3) Jahre. 39,0% der waren männlich. In dem multivariaten Regressionsmodell, wurden folgende Variablen mit einem erhöhten Risiko von Demenz in einem signifikanten Einfluß assoziiert: milde kognitive Beeinträchtigung (MCI) (OR: 2,12), psychische und Verhaltensstörungen durch Alkohol (1,96), Parkinson-Krankheit (PD) (1,89), Schlaganfall (1,68), intrakranielle Verletzung (1,30), Diabetes (1,17), Fettstoffwechselstörung (1,07), koronare Herzkrankheit (1,06). Der Einsatz von Antihypertensiva (0,96), Statinen (OR: 0,94) und Protonen-Pumpen-Inhibitoren (PPI) (0,93) wurden mit einem verringerten Risiko der Entwicklung von Demenz. Schlussfolgerung: Die gefundenen Risikofaktoren für Demenz stehen in Einklang mit der Literatur. Nichtsdestotrotz bedürfen die Zusammenhänge zwischen der Verwendung von Statinen, PPI und Antihypertensiva und einem verringerten Demenzrisiko weiterer Untersuchungen. Persistenz der Behandlung mit Antidepressiva bei Patienten mit Demenz Methode: Patienten wurden ausgewählt, wenn bei ihnen im Zeitraum zwischen Januar 2004 und Dezember 2013 eine Demenzdiagnose (ICD 10: F01, F03, G30) und eine erste Verordnung eines trizyklischen Antidepressivums oder selektiven Serotonin- Wiederaufnahmehemmers (SSRI) oder Serotonin-Noradrenalin-Wiederaufnahmehemmers (SSNRI) vorlagen. Ausgewählte Patienten wurden über einen Zeitraum von bis zu zwei Jahre nach dem Indexdatum beobachtet. Das letzte Nachbeobachtungsdatum eines Patienten war der 31. Dezember 2014. Insgesamt standen 12.281 Patienten für die Persistenzanalyse zur Verfügung. Der Hauptzielparameter war die Abbruchrate der Antidepressivabehandlung innerhalb von sechs Monaten nach dem Indexdatum. Behandlungsabbruch wurde definiert als ein Zeitraum von 90 Tagen ohne diese Therapie. Als demographische Daten wurden Alter, Art der Krankenversicherung (privat oder gesetzlich), Art der Praxis (Neurologe oder Allgemeinmediziner) und Praxisregion (Ost- oder Westdeutschland) erhoben. Die folgenden Demenzdiagnosen wurden berücksichtigt: Alzheimer-Krankheit (G30), vaskuläre Demenz (F01) und nicht näher bezeichnete Demenz (F03). Darüber hinaus wurde der Charlson-Komorbiditäts-Index als allgemeiner Marker für Komorbidität verwendet. Darüber hinaus wurden die folgenden Diagnosen als Komorbiditäten in die Studie aufgenommen: Depression (ICD 10: F32-33), Delir (F05), Typ-2-Diabetes mellitus (E11, E14), Hypertonie (I10), koronare Herzkrankheit (I24, I25), Schlaganfall (I63, I64), Myokardinfarkt (I21-23) und Herzinsuffizienz (I50). Ergebnisse: Nach sechs Monaten Nachbeobachtung hatten 52,7 % (von 12,281 Demenzpatienten) der mit Antidepressiva behandelten Demenzpatienten die Medikamenteneinnahme abgebrochen. Die multivariaten Regressionsanalysen zeigten ein signifikant geringeres Risiko für einen Behandlungsabbruch bei mit SSRRI oder SSNRI behandelten Patienten verglichen mit Patienten, die trizyklische Antidepressiva einnahmen. Es zeigte sich ein signifikant geringeres Risiko eines Behandlungsabbruchs bei jüngeren Patienten. Schlussfolgerung: Die Ergebnisse zeigen eine unzureichende Persistenz mit Antipsychotika bei Demenzpatienten unter Alltagsbedingungen. Es muss eine Verbesserung erreicht werden, um die in den Richtlinien empfohlene Behandlung sicherzustellen. Persistenz der Behandlung mit Antipsychotika bei Patienten mit Demenz Methode: Diese Studie umfasste Patienten im Alter ab 60 Jahren mit Demenz beliebigen Ursprungs, die zwischen Januar 2009 und Dezember 2013 (Indexdatum) zum ersten Mal Antipsychotikaverordnungen (ATC: N05A) von deutschen Psychiatern erhielten. Der Nachbeobachtungszeitraum endete im Oktober 2015. Die Demenz wurde auf Grundlage der ICD-10-Codes für vaskuläre Demenz (F01), nicht näher bezeichnete Demenz (F03) und Alzheimer-Krankheit (G30) bewertet. Der Hauptzielparameter war die Behandlungspersistenzrate über einen Zeitraum von mehr als 6 Monaten nach dem Indexdatum. Die Persistenz wurde als Therapiezeit ohne Absetzen der Behandlung, definiert als mindestens 180 Tage ohne Antipsychotikatherapie, geschätzt. Alle Patienten wurden für eine Dauer von bis zu zwei Jahren ab ihrem Indexdatum beobachtet. Gleichzeitig auftretende Erkrankungen wurden anhand von Diagnosen (ICD-10-Codes) von Depression (F32, F33), Parkinson-Krankheit (G20), psychischer Störungen aufgrund bekannter physiologischer Erkrankungen (F06) und Persönlichkeits- und Verhaltensstörungen aufgrund physiologischer Erkrankungen (F07) bestimmt. Als demographische Daten wurden Alter, Geschlecht und Art der Krankenversicherung (privat/gesetzlich) erhoben. Ergebnisse: 12,979 Demenzpatienten mit einem Durchschnittsalter von 82 Jahre (52.1% leben in Pflegeheimen) wurden in diese Studie analysiert. Nach zwei Jahren Nachbeobachtung hatten 54,8 %, 57,2 %, 61,1 % bzw. 65,4 % der Patienten zwischen 60-69, 70-79, 80-89 bzw. 90-99 Jahren Antipsychotikaverordnungen erhalten (p<0,001). 82,6 % der in Pflegeheimen lebenden Patienten und 76,2 % der Patienten in häuslicher Pflege setzten ihre Behandlung ebenfalls länger als 6 Monate fort; nach zwei Jahren lag der Anteil bei 63,9 % (in Pflegeheimen) bzw. 55,0 % (in häuslicher Pflege) (p<0,001). Schlussfolgerung: Die Studie zeigt, dass der Anteil der mit Antipsychotika behandelten Demenzpatienten sehr hoch ist. Weitere Studien, einschließlich qualitativer Untersuchungen, sind nötig, um die Gründe für dieses Verschreibungsverhalten zu verstehen und zu erklären. KW - Demenz KW - Antidepressiva KW - Antipsychotika KW - Risikofaktoren KW - Deutschland Y1 - 2016 ER - TY - JOUR A1 - Konrad, Marcel A1 - Bohlken, Jens A1 - Rapp, Michael A. A1 - Kostev, Karel T1 - Depression risk in patients with heart failure in primary care practices in Germany JF - International psychogeriatrics N2 - 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. KW - depression KW - primary care KW - risk factors KW - antidepressants Y1 - 2016 U6 - https://doi.org/10.1017/S1041610216000867 SN - 1041-6102 SN - 1741-203X VL - 28 SP - 1889 EP - 1894 PB - Cambridge Univ. Press CY - New York ER - TY - JOUR A1 - Häusler, Andreas A1 - Sánchez, Alba A1 - Gellert, Paul A1 - Deeken, Friederike A1 - Rapp, Michael A. A1 - Nordheim, Johanna T1 - Perceived stress and quality of life in dementia patients and their caregiving spouses: does dyadic coping matter? JF - International psychogeriatrics N2 - 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. KW - dementia KW - dyadic coping KW - perceived stress KW - quality of life Y1 - 2016 U6 - https://doi.org/10.1017/S1041610216001046 SN - 1041-6102 SN - 1741-203X VL - 28 SP - 1857 EP - 1866 PB - Cambridge Univ. Press CY - New York ER - TY - JOUR A1 - Bookers, Anke A1 - Jacob, Louis A1 - Bohlken, Jens A1 - Rapp, Michael A. A1 - Kostev, Karel T1 - Persistence with antipsychotics in dementia patients in Germany JF - International journal of clinical pharmacology and therapeutics N2 - 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. KW - persistence KW - antipsychotics KW - dementia Y1 - 2016 U6 - https://doi.org/10.5414/CP202631 SN - 0946-1965 VL - 54 SP - 835 EP - 840 PB - Dustri-Verlag Dr. Karl Feistle CY - Deisenhofen-München ER - TY - GEN A1 - Heinz, A. A1 - Kluge, U. A1 - Rapp, Michael A. T1 - Heritability of living in deprived neighbourhoods T2 - Translational Psychiatry Y1 - 2016 U6 - https://doi.org/10.1038/tp.2016.215 SN - 2158-3188 VL - 6 PB - Nature Publ. Group CY - New York ER - TY - JOUR A1 - Reppert, Alexander von A1 - Puddell, J. A1 - Koc, A. A1 - Reinhardt, M. A1 - Leitenberger, Wolfram A1 - Dumesnil, K. A1 - Zamponi, Flavio A1 - Bargheer, Matias T1 - Persistent nonequilibrium dynamics of the thermal energies in the spin and phonon systems of an antiferromagnet JF - Structural dynamics N2 - We present a temperature and fluence dependent Ultrafast X-Ray Diffraction study of a laser-heated antiferromagnetic dysprosium thin film. The loss of antiferromagnetic order is evidenced by a pronounced lattice contraction. We devise a method to determine the energy flow between the phonon and spin system from calibrated Bragg peak positions in thermal equilibrium. Reestablishing the magnetic order is much slower than the cooling of the lattice, especially around the Néel temperature. Despite the pronounced magnetostriction, the transfer of energy from the spin system to the phonons in Dy is slow after the spin-order is lost. Y1 - 2016 U6 - https://doi.org/10.1063/1.4961253 SN - 2329-7778 VL - 3 PB - AIP Publishing LLC CY - Melville, NY ER - TY - GEN A1 - Heinz, Andreas A1 - Beck, Anne A1 - Rapp, Michael A. T1 - Alcohol as an Environmental Mortality Hazard T2 - JAMA psychiatry Y1 - 2016 U6 - https://doi.org/10.1001/jamapsychiatry.2016.0399 SN - 2168-622X SN - 2168-6238 VL - 73 SP - 549 EP - 550 PB - American Veterinary Medical Association CY - Chicago ER - TY - JOUR A1 - Sander, Mathias A1 - Koc, A. A1 - Kwamen, C. T. A1 - Michaels, H. A1 - Reppert, Alexander von A1 - Pudell, Jan-Etienne A1 - Zamponi, Flavio A1 - Bargheer, Matias A1 - Sellmann, J. A1 - Schwarzkopf, J. A1 - Gaal, P. T1 - Characterization of an ultrafast Bragg-Switch for shortening hard x-ray pulses JF - Journal of applied physics N2 - We present a nanostructured device that functions as photoacoustic hard x-ray switch. The device is triggered by femtosecond laser pulses and allows for temporal gating of hard x-rays on picosecond (ps) timescales. It may be used for pulse picking or even pulse shortening in 3rd generation synchrotron sources. Previous approaches mainly suffered from insufficient switching contrasts due to excitation-induced thermal distortions. We present a new approach where thermal distortions are spatially separated from the functional switching layers in the structure. Our measurements yield a switching contrast of 14, which is sufficient for efficient hard x-ray pulse shortening. The optimized structure also allows for utilizing the switch at high repetition rates of up to 208 kHz. Published by AIP Publishing. Y1 - 2016 U6 - https://doi.org/10.1063/1.4967835 SN - 0021-8979 SN - 1089-7550 VL - 120 PB - American Institute of Physics CY - Melville ER -