TY - JOUR
A1 - Bangeow, Petjo
A1 - Rapp, Michael Armin
T1 - Beurteilung und Nutzung der 2016 reformierten Psychotherapierichtlinie
T1 - Assessment and use of 2016 reformed psychotherapeutic guideline
BT - Teil II : Ost-West- und Stadt-Land-Vergleich
BT - part II : comparing Eastern and Western Germany as well as urban and rural areas
JF - Psychiatrische Praxis : Sozialpsychiatrie, klinische Psychiatrie, public mental health, Versorgungsforschung
N2 - Ziel der Studie Dieser Artikel untersucht, inwiefern sich die 2016 reformierte Richtlinie im Stadt-Land- sowie im Ost-West-Vergleich auf die ambulante psychotherapeutische Arbeit und Versorgung auswirkt.
Methodik Eine Onlineumfrage unter vertragsärztlich tätigen TherapeutInnen wurde durchgeführt. Die Fragen bezogen sich auf verschiedene Neuerungen in der Richtlinie.
Ergebnisse Unabhängig von der Region schätzten die Befragten ein, dass die Reform zu keiner verbesserten Versorgung führte.
Im Westen und in der Stadt tätige TherapeutInnen verwiesen PatientInnen nach der Sprechstunde öfter an andere Psychotherapiepraxen, im Osten und auf dem Land tätige hingegen öfter auf andere Hilfeangebote.
Schlussfolgerung Stärkere Anreize für die psychotherapeutische Tätigkeit auf dem Land sind zu schaffen. Abbaumaßnahmen der Ost-West-Ungleichheiten in der Versorgungsdichte scheinen nötig.
N2 - Objective This article investigated whether or not the reformed psychotherapeutic guideline had different effects on outpatient psychotherapeutic work and services comparing urban and rural areas as well as eastern and western Germany.
Methods An online survey of psychotherapists was conducted. The survey included questions on various innovations within the reformed guideline.
Results Regardless of region, therapists stated overall that the reform has not led to improved psychotherapeutic care.
Therapists in the West and in urban areas referred more patients to other psychotherapeutic practices after their consultation. Therapists in the East and in rural areas referred more patients to other institutions and services.
Conclusions Psychotherapeutic work in rural areas should be better incentivized. Interventions to reduce east-west inequalities in the density of service provision seem to be necessary.
KW - Psychotherapierichtlinie
KW - Ostdeutschland
KW - Westdeutschland
KW - Stadt-Land-Vergleich
KW - psychotherapy guidelines
KW - Eastern-Western Germany
KW - urban-rural
KW - comparison
Y1 - 2020
U6 - https://doi.org/10.1055/a-1045-9820
SN - 0303-4259
SN - 1439-0876
VL - 47
IS - 07
SP - 383
EP - 387
PB - Thieme
CY - Stuttgart
ER -
TY - JOUR
A1 - Drosselmeyer, Julia
A1 - Jacob, Louis
A1 - Rathmann, Wolfgang
A1 - Rapp, Michael Armin
A1 - Kostev, Karel
T1 - Depression risk in patients with late-onset rheumatoid arthritis in Germany
JF - Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
N2 - The goal of this study was to determine the prevalence of depression and its risk factors in patients with late-onset rheumatoid arthritis (RA) treated in German primary care practices. Longitudinal data from general practices (n=1072) throughout Germany were analyzed. Individuals initially diagnosed with RA (2009-2013) were identified, and 7301 patients were included and matched (1:1) to 7301 controls. The primary outcome measure was the initial diagnosis of depression within 5 years after the index date in patients with and without RA. Cox proportional hazards models were used to adjust for confounders. The mean age was 72.2 years (SD: 7.6 years). A total of 34.9 % of patients were men. Depression diagnoses were present in 22.0 % of the RA group and 14.3 % of the control group after a 5-year follow-up period (p < 0.001). In the multivariate regression model, RA was a strong risk factor for the development of depression (HR: 1.55, p < 0.001). There was significant interaction of RA and diagnosed inflammatory polyarthropathies (IP) (RA*IP interaction: p < 0.001). Furthermore, dementia, cancer, osteoporosis, hypertension, and diabetes were associated with a higher risk of developing depression (p values < 0.001). The risk of depression is significantly higher in patients with late-onset RA than in patients without RA for subjects treated in primary care practices in Germany. RA patients should be screened routinely for depression in order to ensure improved treatment and management.
KW - Late-onset rheumatoid arthritis
KW - Depression
KW - Primary care
KW - Risk factors
KW - Germany
Y1 - 2016
U6 - https://doi.org/10.1007/s11136-016-1387-2
SN - 0962-9343
SN - 1573-2649
VL - 26
IS - 2
SP - 437
EP - 443
PB - Springer
CY - Dordrecht
ER -
TY - GEN
A1 - Pérez Chaparro, Camilo Germán Alberto
A1 - Schuch, Felipe Barreto
A1 - Zech, Philipp
A1 - Kangas, Maria
A1 - Rapp, Michael Armin
A1 - Heißel, Andreas
T1 - Recreational Exercising and Self-Reported Cardiometabolic Diseases in German People Living with HIV: A Cross-Sectional Study
T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - 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.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 768
KW - HIV
KW - exercise
KW - cardiovascular diseases
KW - metabolic disease
KW - sedentary
Y1 - 2022
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-552049
SN - 1866-8364
VL - 18
SP - 1
EP - 10
PB - Universitätsverlag Potsdam
CY - Potsdam
ET - 21
ER -
TY - JOUR
A1 - Balta Beylergil, Sinem
A1 - Beck, Anne
A1 - Deserno, Lorenz
A1 - Lorenz, Robert C.
A1 - Rapp, Michael Armin
A1 - Schlagenhauf, Florian
A1 - Heinz, Andreas
A1 - Obermayer, Klaus
T1 - Dorsolateral prefrontal cortex contributes to the impaired behavioral adaptation in alcohol dependence
JF - NeuroImage: Clinical : a journal of diseases affecting the nervous system
N2 - Substance-dependent individuals often lack the ability to adjust decisions flexibly in response to the changes in reward contingencies. Prediction errors (PEs) are thought to mediate flexible decision-making by updating the reward values associated with available actions. In this study, we explored whether the neurobiological correlates of PEs are altered in alcohol dependence. Behavioral, and functional magnetic resonance imaging (fMRI) data were simultaneously acquired from 34 abstinent alcohol-dependent patients (ADP) and 26 healthy controls (HC) during a probabilistic reward-guided decision-making task with dynamically changing reinforcement contingencies. A hierarchical Bayesian inference method was used to fit and compare learning models with different assumptions about the amount of task-related information subjects may have inferred during the experiment. Here, we observed that the best-fitting model was a modified Rescorla-Wagner type model, the “double-update” model, which assumes that subjects infer the knowledge that reward contingencies are anti-correlated, and integrate both actual and hypothetical outcomes into their decisions. Moreover, comparison of the best-fitting model's parameters showed that ADP were less sensitive to punishments compared to HC. Hence, decisions of ADP after punishments were loosely coupled with the expected reward values assigned to them. A correlation analysis between the model-generated PEs and the fMRI data revealed a reduced association between these PEs and the BOLD activity in the dorsolateral prefrontal cortex (DLPFC) of ADP. A hemispheric asymmetry was observed in the DLPFC when positive and negative PE signals were analyzed separately. The right DLPFC activity in ADP showed a reduced correlation with positive PEs. On the other hand, ADP, particularly the patients with high dependence severity, recruited the left DLPFC to a lesser extent than HC for processing negative PE signals. These results suggest that the DLPFC, which has been linked to adaptive control of action selection, may play an important role in cognitive inflexibility observed in alcohol dependence when reinforcement contingencies change. Particularly, the left DLPFC may contribute to this impaired behavioral adaptation, possibly by impeding the extinction of the actions that no longer lead to a reward.
KW - Alcohol dependence
KW - Prediction error
KW - Reinforcement learning
KW - Reversal learning
KW - Dorsolateral prefrontal cortex
KW - Decision-making
Y1 - 2017
U6 - https://doi.org/10.1016/j.nicl.2017.04.010
SN - 2213-1582
VL - 15
SP - 80
EP - 94
PB - Elsevier
CY - Oxford
ER -
TY - JOUR
A1 - Bangeow, Petjo
A1 - Rapp, Michael Armin
T1 - Beurteilung und Nutzung der 2016 reformierten Psychotherapierichtlinie
BT - Teil I: Vergleich unter den psychotherapeutischen Richtlinienverfahren
BT - Part I: A Comparison of the Psychotherapeutic Methods
JF - Psychiatrische Praxis
N2 - Objective This article investigates how aspects of 2016 reform of the German psychotherapeutic guideline were evaluated and used differently by therapists from three different psychotherapeutic treatment methods.
Methods An online survey was conducted with 987 statutory health insurance approved therapists. The questionnaire focused on various innovations in the guideline.
Results There were significant differences in the use of the broadened authority and of specific treatment services. There were also differences in the application for short-term and long-term psychotherapies as well as in the application to extend short to long-term psychotherapy.
Conclusions Elements of the guideline should be evaluated in relation to the preferred treatment method. Aspects related to the psychotherapeutic work with patients seem to be especially significant.
N2 - Ziel der Studie Dieser Artikel untersucht, inwiefern Aspekte der 2016 reformierten Psychotherapierichtlinie aus Sicht der drei Richtlinienverfahren für die praktische Arbeit unterschiedlich bewertet und genutzt werden.
Methodik Eine Onlineumfrage wurde unter vertragsärztlich tätigen PsychotherapeutInnen (n = 987) durchgeführt. Die Fragen bezogen sich auf die unterschiedlichen Neuerungen in der Psychotherapierichtlinie.
Ergebnisse Signifikante Unterschiede wurden u. a. in der Nutzung der erweiterten Befugnisse sowie in der Abrechnung bestimmter Leistungen deutlich. Die Gruppen unterschieden sich auch in der Beantragung von Behandlungskontingenten.
Schlussfolgerung Es scheint sinnvoll, Elemente der Richtlinienreform aus der Sicht des bevorzugten Behandlungsverfahrens zu evaluieren. Jene Aspekte scheinen bedeutsam, die sich auf die unmittelbare Arbeit mit den PatientInnen beziehen.
T2 - Assessment and Use of 2016 Reformed Psychotherapeutic Guideline
KW - Psychotherapierichtlinie
KW - Richtlinienverfahren
KW - Unterschiede
KW - psychotherapy guideline
KW - psychotherapy methods
KW - differences
Y1 - 2020
U6 - https://doi.org/10.1055/a-1045-9801
SN - 0303-4259
SN - 1439-0876
VL - 47
IS - 3
SP - 135
EP - 141
PB - Thieme
CY - Stuttgart
ER -
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 - GEN
A1 - Wuertz-Kozak, Karin
A1 - Roszkowski, Martin
A1 - Cambria, Elena
A1 - Block, Andrea
A1 - Kuhn, Gisela A.
A1 - Abele, Thea
A1 - Hitzl, Wolfgang
A1 - Drießlein, David
A1 - Müller, Ralph
A1 - Rapp, Michael Armin
A1 - Mansuy, Isabelle M.
A1 - Peters, Eva M. J.
A1 - Wippert, Pia-Maria
T1 - Effects of Early Life Stress on Bone Homeostasis in Mice and Humans
T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - Bone pathology is frequent in stressed individuals. A comprehensive examination of mechanisms linking life stress, depression and disturbed bone homeostasis is missing. In this translational study, mice exposed to early life stress (MSUS) were examined for bone microarchitecture (μCT), metabolism (qPCR/ELISA), and neuronal stress mediator expression (qPCR) and compared with a sample of depressive patients with or without early life stress by analyzing bone mineral density (BMD) (DXA) and metabolic changes in serum (osteocalcin, PINP, CTX-I). MSUS mice showed a significant decrease in NGF, NPYR1, VIPR1 and TACR1 expression, higher innervation density in bone, and increased serum levels of CTX-I, suggesting a milieu in favor of catabolic bone turnover. MSUS mice had a significantly lower body weight compared to control mice, and this caused minor effects on bone microarchitecture. Depressive patients with experiences of childhood neglect also showed a catabolic pattern. A significant reduction in BMD was observed in depressive patients with childhood abuse and stressful life events during childhood. Therefore, future studies on prevention and treatment strategies for both mental and bone disease should consider early life stress as a risk factor for bone pathologies.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 670
KW - psychosocial stress
KW - bone pathologies
KW - osteoporosis
KW - bone mineral density
KW - childhood
KW - neuroendocrine
Y1 - 2020
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-485324
SN - 1866-8364
IS - 670
ER -
TY - JOUR
A1 - Wuertz-Kozak, Karin
A1 - Roszkowski, Martin
A1 - Cambria, Elena
A1 - Block, Andrea
A1 - Kuhn, Gisela A.
A1 - Abele, Thea
A1 - Hitzl, Wolfgang
A1 - Drießlein, David
A1 - Müller, Ralph
A1 - Rapp, Michael Armin
A1 - Mansuy, Isabelle M.
A1 - Peters, Eva M. J.
A1 - Wippert, Pia-Maria
T1 - Effects of Early Life Stress on Bone Homeostasis in Mice and Humans
JF - International Journal of Molecular Sciences
N2 - Bone pathology is frequent in stressed individuals. A comprehensive examination of mechanisms linking life stress, depression and disturbed bone homeostasis is missing. In this translational study, mice exposed to early life stress (MSUS) were examined for bone microarchitecture (μCT), metabolism (qPCR/ELISA), and neuronal stress mediator expression (qPCR) and compared with a sample of depressive patients with or without early life stress by analyzing bone mineral density (BMD) (DXA) and metabolic changes in serum (osteocalcin, PINP, CTX-I). MSUS mice showed a significant decrease in NGF, NPYR1, VIPR1 and TACR1 expression, higher innervation density in bone, and increased serum levels of CTX-I, suggesting a milieu in favor of catabolic bone turnover. MSUS mice had a significantly lower body weight compared to control mice, and this caused minor effects on bone microarchitecture. Depressive patients with experiences of childhood neglect also showed a catabolic pattern. A significant reduction in BMD was observed in depressive patients with childhood abuse and stressful life events during childhood. Therefore, future studies on prevention and treatment strategies for both mental and bone disease should consider early life stress as a risk factor for bone pathologies.
KW - psychosocial stress
KW - bone pathologies
KW - osteoporosis
KW - bone mineral density
KW - childhood
KW - neuroendocrine
Y1 - 2020
U6 - https://doi.org/10.3390/ijms21186634
SN - 1422-0067
VL - 21
IS - 18
PB - Molecular Diversity Preservation International
CY - Basel
ER -
TY - JOUR
A1 - Rapp, Michael Armin
T1 - Alterspsychiatrie ist Teil ganzheitlicher Altersmedizin, kein Teilbereich der Psychiatrie – Kontra
T1 - Not a Sub-Speciality of Psychiatry - Contra
JF - Psychatrische Praxis
N2 - Wenn in der Medizin vom demografischen Wandel gesprochen wird [1], wird zumeist von einer rasanten Zunahme der Hochaltrigen gesprochen, bei denen aufgrund der differenziellen altersassoziierten Inzidenzraten in erster Linie eine Zunahme an Demenzerkrankungen, kardiovaskulären Erkrankungen, Krebserkrankungen und allgemeiner Multimorbidität und Gebrechlichkeit zu erwarten ist [2]. Dies ist unstrittig richtig, aber nur ein Teil der Folgen des demografischen Wandels für die psychiatrische Versorgung. Diese muss weiterhin die gesamte adulte Lebensspanne im Blick haben, da sonst Versorgungsengpässe bei ohnehin vulnerablen Patienten verstärkt werden, mit Folgen für die Morbidität und Mortalität auf Bevölkerungsebene [3].
Y1 - 2019
U6 - https://doi.org/10.1055/a-0958-8403
SN - 0303-4259
SN - 1439-0876
VL - 46
IS - 6
SP - 308
EP - 309
PB - Thieme
CY - Stuttgart
ER -
TY - GEN
A1 - Heinz, Andreas
A1 - Kiefer, Falk
A1 - Smolka, Michael N.
A1 - Endrass, Tanja
A1 - Beste, Christian
A1 - Beck, Anne
A1 - Liu, Shuyan
A1 - Genauck, Alexander
A1 - Romund, Lydia
A1 - Rapp, Michael Armin
A1 - Tost, Heike
A1 - Spanagel, Rainer
T1 - Addiction research consortium: losing and regaining control over drug intake (ReCoDe) - from trajectories to mechanisms and interventions
T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - One of the major risk factors for global death and disability is alcohol, tobacco, and illicit drug use. While there is increasing knowledge with respect to individual factors promoting the initiation and maintenance of substance use disorders (SUDs), disease trajectories involved in losing and regaining control over drug intake (ReCoDe) are still not well described. Our newly formed German Collaborative Research Centre (CRC) on ReCoDe has an interdisciplinary approach funded by the German Research Foundation (DFG) with a 12-year perspective. The main goals of our research consortium are (i) to identify triggers and modifying factors that longitudinally modulate the trajectories of losing and regaining control over drug consumption in real life, (ii) to study underlying behavioral, cognitive, and neurobiological mechanisms, and (iii) to implicate mechanism-based interventions. These goals will be achieved by: (i) using mobile health (m-health) tools to longitudinally monitor the effects of triggers (drug cues, stressors, and priming doses) and modify factors (eg, age, gender, physical activity, and cognitive control) on drug consumption patterns in real-life conditions and in animal models of addiction; (ii) the identification and computational modeling of key mechanisms mediating the effects of such triggers and modifying factors on goal-directed, habitual, and compulsive aspects of behavior from human studies and animal models; and (iii) developing and testing interventions that specifically target the underlying mechanisms for regaining control over drug intake.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 727
KW - addiction
KW - alternative rewards
KW - animal and computational models
KW - cognitive-behavioral control
KW - craving and relapse
KW - habit formation
Y1 - 2019
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-525972
SN - 1866-8364
IS - 2
ER -