@article{ZechSchuchPerezChaparroetal.2020,
  author    = {Zech, Philipp and Schuch, Felipe and P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Kangas, Maria and Rapp, Michael A. and Heissel, Andreas},
  title     = {Exercise, Comorbidities, and Health-Related Quality of Life in People Living with HIV},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {17},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {14},
  publisher = {MDPI AG},
  address   = {Basel},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph17145138},
  pages     = {15},
  year      = {2020},
  abstract  = {(1) Background: People with HIV (PWH) may perform more than one type of exercise cumulatively. The objective of this study is to investigate recreational exercise and its association with health-related quality of life (HRQOL) and comorbidities in relation to potential covariates. (2) Methods: The HIBES study (HIV-Begleiterkrankungen-Sport) is a cross-sectional study for people with HIV. The differences between non-exercisers versus exercisers (cumulated vs. single type of exercises) were investigated using regression models based on 454 participants. (3) Results: Exercisers showed a higher HRQOL score compared to non-exercisers (Wilcox r = 0.2 to 0.239). Psychological disorders were identified as the main covariate. Participants performing exercise cumulatively showed higher scores in duration, frequency, and intensity when compared to participants performing only one type of exercise. The mental health summary score was higher for the cumulated and single type of exercise if a psychological disorder existed. Duration and intensity were associated with an increase of HRQOL, whilst a stronger association between psychological disorders and exercise variables were evident. Exercise duration (minutes) showed a significant effect on QOL (standardized beta = 0.1) and for participants with psychological disorders (standardized beta = 0.3), respectively. (4) Conclusions: Psychological disorders and other covariates have a prominent effect on HRQOL and its association with exercise. For PWH with a psychological disorder, a stronger relationship between HRQOL with exercise duration and intensity emerged. However, differentiation of high-HRQOL individuals warrants further investigation by considering additional factors.},
  language  = {en}
}
@article{KlugeRappMehranetal.2019,
  author    = {Kluge, Ulrike and Rapp, Michael A. and Mehran, Nassim and Abi Jumaa, Jinan and Aichberger, Marion Christina},
  title     = {Poverty, migration and mental health},
  series = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie},
  volume    = {90},
  journal   = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie},
  number    = {11},
  publisher = {Springer},
  address   = {New York},
  issn      = {0028-2804},
  doi       = {10.1007/s00115-019-00790-2},
  pages     = {1103 -- 1108},
  year      = {2019},
  abstract  = {Poverty and social exclusion are closely related to an increased risk for the deterioration of mental health. In 2018 approximately 19\% of the German population were threatened by poverty and the associated social ostracization. Migrant groups in particular often show an increased risk for poverty and are often exposed to multiple socioeconomic stress factors depending on the context of migration, pre-migration and post-migration social factors. Numerous studies have shown that societal exclusion, precarious living conditions and the residential environment negatively affect mental health beyond the effects of pre-migration risk factors. This article provides a review and discussion on the relationship between mental health, poverty and related constructs, such as social cohesion, social capital and social exclusion in general as well as in specific risk groups, such as migrant and refugee populations.},
  language  = {en}
}
@article{Rapp2019,
  author    = {Rapp, Michael A.},
  title     = {Die Versorgung f{\"u}r die n{\"a}chste Dekade sichern: Gerontopsychiatrie in der Krise?},
  series = {Psychatrische Praxis},
  volume    = {46},
  journal   = {Psychatrische Praxis},
  number    = {6},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0303-4259},
  doi       = {10.1055/a-0971-5551},
  pages     = {305 -- 306},
  year      = {2019},
  abstract  = {Der demografische Wandel wird nicht nur mit einer rasanten Zunahme der Hochaltrigen einhergehen [1], was f{\"u}r die gerontopsychiatrische Versorgung aufgrund der altersassoziierten Inzidenzraten in erster Linie eine Zunahme an Demenzerkrankungen und Patienten mit Multimorbidit{\"a}t und Gebrechlichkeit bedeutet [2], sondern auch mit einer Zunahme j{\"u}ngerer alter Menschen vom 65. bis 75. Lebensjahr, was f{\"u}r die Gerontopsychiatrie eine Zunahme der Patienten mit Abh{\"a}ngigkeitserkrankungen, Erkrankungen aus dem schizophrenen Formenkreis und affektiven Erkrankungen bedeutet. Soziale Faktoren werden hier mehr und mehr eine zentrale Rolle spielen, da neben der Qualit{\"a}t der medizinischen Versorgung insbesondere die individuelle soziale Situation der Patienten mit einer erh{\"o}hten Morbidit{\"a}t und Mortalit{\"a}t einhergehen wird [3].},
  language  = {de}
}
@article{Rapp2019,
  author    = {Rapp, Michael A.},
  title     = {Alterspsychiatrie ist Teil ganzheitlicher Altersmedizin, kein Teilbereich der Psychiatrie - Kontra},
  series = {Psychatrische Praxis},
  volume    = {46},
  journal   = {Psychatrische Praxis},
  number    = {6},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0303-4259},
  doi       = {10.1055/a-0958-8403},
  pages     = {308 -- 309},
  year      = {2019},
  abstract  = {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, kardiovaskul{\"a}ren Erkrankungen, Krebserkrankungen und allgemeiner Multimorbidit{\"a}t und Gebrechlichkeit zu erwarten ist [2]. Dies ist unstrittig richtig, aber nur ein Teil der Folgen des demografischen Wandels f{\"u}r die psychiatrische Versorgung. Diese muss weiterhin die gesamte adulte Lebensspanne im Blick haben, da sonst Versorgungsengp{\"a}sse bei ohnehin vulnerablen Patienten verst{\"a}rkt werden, mit Folgen f{\"u}r die Morbidit{\"a}t und Mortalit{\"a}t auf Bev{\"o}lkerungsebene [3].},
  language  = {de}
}
@article{DeekenReichertZechetal.2022,
  author    = {Deeken, Friederike and Reichert, Markus and Zech, Hilmar and Wenzel, Julia and Wedemeyer, Friederike and Aguilera, Alvaro and Aslan, Acelya and Bach, Patrick and Bahr, Nadja Samia and Ebrahimi, Claudia and Fischbach, Pascale Christine and Ganz, Marvin and Garbusow, Maria and Großkopf, Charlotte M. and Heigert, Marie and Hentschel, Angela and Karl, Damian and Pelz, Patricia and Pinger, Mathieu and Riemerschmid, Carlotta and Rosenthal, Annika and Steffen, Johannes and Strehle, Jens and Weiss,, Franziska and Wieder, Gesine and Wieland, Alfred and Zaiser, Judith and Zimmermann, Sina and Walter, Henrik and Lenz, Bernd and Deserno, Lorenz and Smolka, Michael N. and Liu, Shuyan and Ebner-Priemer, Ulrich Walter and Heinz, Andreas and Rapp, Michael A.},
  title     = {Patterns of Alcohol Consumption Among Individuals With Alcohol Use Disorder During the COVID-19 Pandemic and Lockdowns in Germany},
  series = {JAMA Network Open},
  volume    = {5},
  journal   = {JAMA Network Open},
  edition   = {8},
  publisher = {JAMA Network / American Medical Association},
  address   = {Chicago, Illinois, USA},
  issn      = {2574-3805},
  doi       = {10.1001/jamanetworkopen.2022.24641},
  pages     = {1 -- 11},
  year      = {2022},
  abstract  = {Importance Alcohol consumption (AC) leads to death and disability worldwide. Ongoing discussions on potential negative effects of the COVID-19 pandemic on AC need to be informed by real-world evidence. Objective To examine whether lockdown measures are associated with AC and consumption-related temporal and psychological within-person mechanisms. Design, Setting, and Participants This quantitative, intensive, longitudinal cohort study recruited 1743 participants from 3 sites from February 20, 2020, to February 28, 2021. Data were provided before and within the second lockdown of the COVID-19 pandemic in Germany: before lockdown (October 2 to November 1, 2020); light lockdown (November 2 to December 15, 2020); and hard lockdown (December 16, 2020, to February 28, 2021). Main Outcomes and Measures Daily ratings of AC (main outcome) captured during 3 lockdown phases (main variable) and temporal (weekends and holidays) and psychological (social isolation and drinking intention) correlates. Results Of the 1743 screened participants, 189 (119 [63.0\%] male; median [IQR] age, 37 [27.5-52.0] years) with at least 2 alcohol use disorder (AUD) criteria according to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) yet without the need for medically supervised alcohol withdrawal were included. These individuals provided 14 694 smartphone ratings from October 2020 through February 2021. Multilevel modeling revealed significantly higher AC (grams of alcohol per day) on weekend days vs weekdays (β = 11.39; 95\% CI, 10.00-12.77; P < .001). Alcohol consumption was above the overall average on Christmas (β = 26.82; 95\% CI, 21.87-31.77; P < .001) and New Year's Eve (β = 66.88; 95\% CI, 59.22-74.54; P < .001). During the hard lockdown, perceived social isolation was significantly higher (β = 0.12; 95\% CI, 0.06-0.15; P < .001), but AC was significantly lower (β = -5.45; 95\% CI, -8.00 to -2.90; P = .001). Independent of lockdown, intention to drink less alcohol was associated with lower AC (β = -11.10; 95\% CI, -13.63 to -8.58; P < .001). Notably, differences in AC between weekend and weekdays decreased both during the hard lockdown (β = -6.14; 95\% CI, -9.96 to -2.31; P = .002) and in participants with severe AUD (β = -6.26; 95\% CI, -10.18 to -2.34; P = .002). Conclusions and Relevance This 5-month cohort study found no immediate negative associations of lockdown measures with overall AC. Rather, weekend-weekday and holiday AC patterns exceeded lockdown effects. Differences in AC between weekend days and weekdays evinced that weekend drinking cycles decreased as a function of AUD severity and lockdown measures, indicating a potential mechanism of losing and regaining control. This finding suggests that temporal patterns and drinking intention constitute promising targets for prevention and intervention, even in high-risk individuals.},
  language  = {en}
}
@article{BaltaBeylergilBeckDesernoetal.2017,
  author    = {Balta Beylergil, Sinem and Beck, Anne and Deserno, Lorenz and Lorenz, Robert C. and Rapp, Michael A. and Schlagenhauf, Florian and Heinz, Andreas and Obermayer, Klaus},
  title     = {Dorsolateral prefrontal cortex contributes to the impaired behavioral adaptation in alcohol dependence},
  series = {NeuroImage: Clinical : a journal of diseases affecting the nervous system},
  volume    = {15},
  journal   = {NeuroImage: Clinical : a journal of diseases affecting the nervous system},
  publisher = {Elsevier},
  address   = {Oxford},
  issn      = {2213-1582},
  doi       = {10.1016/j.nicl.2017.04.010},
  pages     = {80 -- 94},
  year      = {2017},
  abstract  = {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.},
  language  = {en}
}
@article{ChenNebeMojtahedzadehetal.2020,
  author    = {Chen, Hao and Nebe, Stephan and Mojtahedzadeh, Negin and Kuitunen-Paul, Soren and Garbusow, Maria and Schad, Daniel and Rapp, Michael A. and Huys, Quentin J. M. and Heinz, Andreas and Smolka, Michael N.},
  title     = {Susceptibility to interference between Pavlovian and instrumental control is associated with early hazardous alcohol use},
  series = {Addiction biology},
  volume    = {26},
  journal   = {Addiction biology},
  number    = {4},
  publisher = {Wiley},
  address   = {Hoboken},
  issn      = {1355-6215},
  doi       = {10.1111/adb.12983},
  pages     = {1 -- 14},
  year      = {2020},
  abstract  = {Pavlovian-to-instrumental transfer (PIT) tasks examine the influence of Pavlovian stimuli on ongoing instrumental behaviour. Previous studies reported associations between a strong PIT effect, high-risk drinking and alcohol use disorder. This study investigated whether susceptibility to interference between Pavlovian and instrumental control is linked to risky alcohol use in a community sample of 18-year-old male adults. Participants (N = 191) were instructed to 'collect good shells' and 'leave bad shells' during the presentation of appetitive (monetary reward), aversive (monetary loss) or neutral Pavlovian stimuli. We compared instrumental error rates (ER) and functional magnetic resonance imaging (fMRI) brain responses between the congruent and incongruent conditions, as well as among high-risk and low-risk drinking groups. On average, individuals showed a substantial PIT effect, that is, increased ER when Pavlovian cues and instrumental stimuli were in conflict compared with congruent trials. Neural PIT correlates were found in the ventral striatum and the dorsomedial and lateral prefrontal cortices (lPFC). Importantly, high-risk drinking was associated with a stronger behavioural PIT effect, a decreased lPFC response and an increased neural response in the ventral striatum on the trend level. Moreover, high-risk drinkers showed weaker connectivity from the ventral striatum to the lPFC during incongruent trials. Our study links interference during PIT to drinking behaviour in healthy, young adults. High-risk drinkers showed higher susceptibility to Pavlovian cues, especially when they conflicted with instrumental behaviour, indicating lower interference control abilities. Increased activity in the ventral striatum (bottom-up), decreased lPFC response (top-down), and their altered interplay may contribute to poor interference control in the high-risk drinkers.},
  language  = {en}
}
@article{BangeowRapp2020,
  author    = {Bangeow, Petjo and Rapp, Michael A.},
  title     = {Beurteilung und Nutzung der 2016 reformierten Psychotherapierichtlinie},
  series = {Psychiatrische Praxis : Sozialpsychiatrie, klinische Psychiatrie, public mental health, Versorgungsforschung},
  volume    = {47},
  journal   = {Psychiatrische Praxis : Sozialpsychiatrie, klinische Psychiatrie, public mental health, Versorgungsforschung},
  number    = {07},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0303-4259},
  doi       = {10.1055/a-1045-9820},
  pages     = {383 -- 387},
  year      = {2020},
  abstract  = {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 vertrags{\"a}rztlich t{\"a}tigen TherapeutInnen wurde durchgef{\"u}hrt. Die Fragen bezogen sich auf verschiedene Neuerungen in der Richtlinie. Ergebnisse Unabh{\"a}ngig von der Region sch{\"a}tzten die Befragten ein, dass die Reform zu keiner verbesserten Versorgung f{\"u}hrte. Im Westen und in der Stadt t{\"a}tige TherapeutInnen verwiesen PatientInnen nach der Sprechstunde {\"o}fter an andere Psychotherapiepraxen, im Osten und auf dem Land t{\"a}tige hingegen {\"o}fter auf andere Hilfeangebote. Schlussfolgerung St{\"a}rkere Anreize f{\"u}r die psychotherapeutische T{\"a}tigkeit auf dem Land sind zu schaffen. Abbaumaßnahmen der Ost-West-Ungleichheiten in der Versorgungsdichte scheinen n{\"o}tig.},
  language  = {de}
}
@article{BlockSchulzeDeekenetal.2021,
  author    = {Block, Andrea and Schulze, Susanne and Deeken, Friederike and H{\"a}usler, Andreas and Rezo, Anna and Rapp, Michael A. and Wippert, Pia-Maria},
  title     = {Effects of inflammatory markers and biographical stress on treatment response in depression},
  series = {Psychoneuroendocrinology : an international journal ; the official journal of the International Society of Psychoneuroendocrinology},
  volume    = {131},
  journal   = {Psychoneuroendocrinology : an international journal ; the official journal of the International Society of Psychoneuroendocrinology},
  number    = {Supplement},
  publisher = {Elsevier},
  address   = {Oxford},
  issn      = {0306-4530},
  doi       = {10.1016/j.psyneuen.2021.105535},
  pages     = {S24 -- S24},
  year      = {2021},
  abstract  = {Background Recent research emphasized the role of inflammatory processes in the pathophysiology of depression. Theories hypothesizes that life events (LE) can affect the immune system and trigger depressive symptoms. LE are also considered as one of the best predictors for the onset and course of depressive disorders. Methods Observational study across three treatment settings: n=208 depressive patients (75.5\%f, M 46.6 y) were examined on depression (BDI-II), life events (ILE) and inflammatory markers (IL-6, CRP, fibrinogen, ICAM-1, TNF-alpha, E-selectin) at baseline (t0), 5-week(t1) and 5-month(t2) follow-up. Effects and interactions were analyzed with regression models. Results LE were associated with depressive symptoms at t0 (beta=.209; p=.002) and both follow-ups. Except for CRP, which was linked to depression symptoms at t2 (betai=-.190; p=.032), there were no effects of inflammatory markers on depressive symptoms. At t1, an interaction between CRP and LE in total (beta=-.249; p=.041) was found as well as for LE in the past five years (beta=-.122; p=.027). Similar interactions were found between cumulative LE and ICAM-1 (beta=-.197; p=.003) and IL-6 (beta=-.425; p=.001). Conclusion The cumulative burden of LE effects symptoms and treatment outcome in depressive patients. There is some evidence that inflammatory marker may have long-term effects on treatment outcome as they seem to weaken the determining relation between LE and depression.},
  language  = {en}
}
@article{BangeowRapp2020,
  author    = {Bangeow, Petjo and Rapp, Michael A.},
  title     = {Beurteilung und Nutzung der 2016 reformierten Psychotherapierichtlinie},
  series = {Psychiatrische Praxis},
  volume    = {47},
  journal   = {Psychiatrische Praxis},
  number    = {3},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0303-4259},
  doi       = {10.1055/a-1045-9801},
  pages     = {135 -- 141},
  year      = {2020},
  abstract  = {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. <br /> Methods An online survey was conducted with 987 statutory health insurance approved therapists. The questionnaire focused on various innovations in the guideline. <br /> 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. <br /> 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.},
  language  = {de}
}