@article{AichbergerMontesinosBromandetal.2015,
author = {Aichberger, Marion Christina and Montesinos, Amanda Heredia and Bromand, Zohra and Yesil, Rahsan and Temur-Erman, Selver and Rapp, Michael Armin 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{BakanidzeBrandlHutzleretal.2016,
author = {Bakanidze, George and Brandl, Eva J. and Hutzler, Christine and Aurass, Friederike and Onken, Silke and Rapp, Michael Armin 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{BaltaBeylergilBeckDesernoetal.2017,
author = {Balta Beylergil, Sinem and Beck, Anne and Deserno, Lorenz and Lorenz, Robert C. and Rapp, Michael Armin 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{BangeowRapp2020,
author = {Bangeow, Petjo and Rapp, Michael Armin},
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.
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.},
language = {de}
}
@article{BangeowRapp2020,
author = {Bangeow, Petjo and Rapp, Michael Armin},
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{BauerBanaschewskiHeinzetal.2016,
author = {Bauer, M. and Banaschewski, Tobias and Heinz, A. and Kamp-Becker, I. and Meyer-Lindenberg, A. and Padberg, F. and Rapp, Michael Armin and Rupprecht, R. and Schneider, F. and Schulze, T. G. and Wittchen, Hans-Ulrich},
title = {The German Research Network for mental Disorders},
series = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\~A}¼r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\~A}¼r Neurologie},
volume = {87},
journal = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\~A}¼r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\~A}¼r Neurologie},
publisher = {Springer},
address = {New York},
issn = {0028-2804},
doi = {10.1007/s00115-016-0169-y},
pages = {989 -- 1010},
year = {2016},
abstract = {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.},
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 Armin 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{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 Armin and Granacher, Urs},
title = {Behavioral and Neural Correlates of Cognitive-Motor Interference during Multitasking in Young and Old Adults},
series = {Neural Plasticity},
journal = {Neural Plasticity},
publisher = {Hindawi},
address = {New York},
issn = {2090-5904},
doi = {10.1155/2019/9478656},
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}
}
@article{BohlkenJacobSchaumetal.2017,
author = {Bohlken, Jens and Jacob, Louis and Schaum, Peter and Rapp, Michael Armin and Kostev, Karel},
title = {Hip fracture risk in patients with dementia in German primary care practices},
series = {Dementia},
volume = {16},
journal = {Dementia},
publisher = {Sage Publ.},
address = {London},
issn = {1471-3012},
doi = {10.1177/1471301215621854},
pages = {853 -- 864},
year = {2017},
abstract = {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.},
language = {en}
}
@article{BohlkenSchulzRappetal.2015,
author = {Bohlken, Jens and Schulz, Mandy and Rapp, Michael Armin and Baetzing-Feigenbaum, Joerg},
title = {Pharmacotherapy of dementia in Germany: Results from a nationwide claims database},
series = {European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology},
volume = {25},
journal = {European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology},
number = {12},
publisher = {Elsevier},
address = {Amsterdam},
issn = {0924-977X},
doi = {10.1016/j.euroneuro.2015.09.014},
pages = {2333 -- 2338},
year = {2015},
abstract = {In 2011, about 1.1-1.4 million patients with dementia were living in Germany, a number expected to rise to three million by 2050. Dementia poses a major challenge to the healthcare system and neuropharmacological service provision. The aim of this study was to determine prescription rates for anti-dementia drugs as well as for neuroleptics, sedative-hypnotics and antidepressants in dementia using the complete nationwide outpatient claims data pertaining to the services of statutory health insurance. We controlled for gender, age, dementia diagnosis, physician specialty (general practitioner GP versus neuropsychiatry specialist physician NPSP), and rural and urban living area. In about one million prevalent dementia patients (N=1,014,710) in 2011, the prescription prevalence rate of anti-dementia drugs was 24.6\%; it varied with gender, age, and diagnosis (highest in Alzheimer's disease; 42\%), and was higher in patients treated by NPSPs (48\% vs. 25\% in GPs). At the same time, we found an alarmingly high rate of treatment with neuroleptics in dementia patients (35\%), with an only slightly decreased risk in patients treated exclusively by NPSPs (OR=0.86). We found marginal differences between rural and urban areas. Our results show that the majority of anti-dementia drug prescriptions appear guideline-oriented, yet prescription rates are overall comparatively low. On the other hand, neuroleptic drugs, which are associated with excess morbidity and mortality in dementia, were prescribed very frequently, suggesting excess use given current guidelines. We therefore suggest that guideline implementation measures and increasing quality control procedures are needed with respect to the pharmacotherapy of this vulnerable population. (C) 2015 Elsevier B.V. and ECNR All rights reserved.},
language = {en}
}
@article{BohlkenWeberSiebertetal.2017,
author = {Bohlken, Jens and Weber, Simon A. and Siebert, Anke and Forstmeier, Simon and Kohlmann, Thomas and Rapp, Michael Armin},
title = {Reminiscence therapy for depression in dementia},
series = {GeroPsych - The Journal of gerontopsychology and geriatric psychiatry},
volume = {30},
journal = {GeroPsych - The Journal of gerontopsychology and geriatric psychiatry},
publisher = {Hogrefe},
address = {G{\"o}ttingen},
issn = {1662-9647},
doi = {10.1024/1662-9647/a000175},
pages = {145 -- 151},
year = {2017},
abstract = {We investigated the efficacy of reminiscence therapy (RT) on symptoms of depression in patients with mild to moderate dementia. Out of 227 patients with mild to moderate dementia from a specialized physician's office, 27 pairs (N = 54; mean age 79.04 ± 6.16 years) who had either received treatment as usual (TAU) or TAU combined with RT, were matched retrospectively according to age as well as cognitive and depressive symptom scores. After controlling for age and sex, symptoms of depression significantly decreased over time in the RT group compared to TAU (F1,52 = 4.36; p < .05). RT is a promising option for the treatment of depression in mild to moderate dementia. Larger randomized-controlled trials are needed.},
language = {en}
}
@article{BohlkenWeberRappetal.2015,
author = {Bohlken, Jens and Weber, Simon and Rapp, Michael Armin and Kostev, Karel},
title = {Continuous treatment with antidementia drugs in Germany 2003-2013: a retrospective database analysis},
series = {International psychogeriatrics},
volume = {27},
journal = {International psychogeriatrics},
number = {8},
publisher = {Cambridge Univ. Press},
address = {New York},
issn = {1041-6102},
doi = {10.1017/S1041610215000654},
pages = {1335 -- 1342},
year = {2015},
abstract = {Background: Continuous treatment is an important indicator of medication adherence in dementia. However, long-term studies in larger clinical settings are lacking, and little is known about moderating effects of patient and service characteristics. Methods: Data from 12,910 outpatients with dementia (mean age 79.2 years; SD = 7.6 years) treated between January 2003 and December 2013 in Germany were included. Continuous treatment was analysed using Kaplan-Meier curves and log-rank tests. In addition, multivariate Cox regression models were fitted with continuous treatment as dependent variable and the predictors antidementia agent, age, gender, medical comorbidities, physician specialty, and health insurance status. Results: After one year of follow-up, nearly 60\% of patients continued drug treatment. Donezepil (HR: 0.88; 95\% CI: 0.82-0.95) and memantine (HR: 0.85; 0.79-0.91) patients were less likely to be discontinued treatment as compared to rivastigmine users. Patients were less likely to be discontinued if they were treated by specialist physicians as compared to general practitioners (HR: 0.44; 0.41-0.48). Younger male patients and patients who had private health insurance had a lower discontinuation risk. Regarding comorbidity, patients were more likely to be continuously treated with the index substance if a diagnosis of heart failure or hypertension had been diagnosed at baseline. Conclusions: Our results imply that besides type of antidementia agent, involvement of a specialist in the complex process of prescribing antidementia drugs can provide meaningful benefits to patients, in terms of more disease-specific and continuous treatment.},
language = {en}
}
@article{BookerBohlkenRappetal.2016,
author = {Booker, Anke and Bohlken, Jens and Rapp, Michael Armin 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 Armin 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}
}
@article{BookersJacobBohlkenetal.2016,
author = {Bookers, Anke and Jacob, Louis and Bohlken, Jens and Rapp, Michael Armin 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}
}
@article{BrahmsHeinzelRappetal.2022,
author = {Brahms, Markus and Heinzel, Stephan and Rapp, Michael Armin and M{\"u}ckstein, Marie and Hortob{\´a}gyi, Tibor and Stelzel, Christine and Granacher, Urs},
title = {The acute effects of mental fatigue on balance performance in healthy young and older adults - A systematic review and meta-analysis},
series = {Acta Psychologica},
volume = {225},
journal = {Acta Psychologica},
publisher = {Elsevier},
address = {Amsterdam},
issn = {1873-6297},
doi = {10.1016/j.actpsy.2022.103540},
pages = {1 -- 13},
year = {2022},
abstract = {Cognitive resources contribute to balance control. There is evidence that mental fatigue reduces cognitive resources and impairs balance performance, particularly in older adults and when balance tasks are complex, for example when trying to walk or stand while concurrently performing a secondary cognitive task. We conducted a systematic literature search in PubMed (MEDLINE), Web of Science and Google Scholar to identify eligible studies and performed a random effects meta-analysis to quantify the effects of experimentally induced mental fatigue on balance performance in healthy adults. Subgroup analyses were computed for age (healthy young vs. healthy older adults) and balance task complexity (balance tasks with high complexity vs. balance tasks with low complexity) to examine the moderating effects of these factors on fatigue-mediated balance performance. We identified 7 eligible studies with 9 study groups and 206 participants. Analysis revealed that performing a prolonged cognitive task had a small but significant effect (SMDwm = -0.38) on subsequent balance performance in healthy young and older adults. However, age- and task-related differences in balance responses to fatigue could not be confirmed statistically. Overall, aggregation of the available literature indicates that mental fatigue generally reduces balance in healthy adults. However, interactions between cognitive resource reduction, aging and balance task complexity remain elusive.},
language = {en}
}
@article{ChenBelangerGarbusowetal.2023,
author = {Chen, Hao and Belanger, Matthew J. and Garbusow, Maria and Kuitunen-Paul, Soeren and Huys, Quentin J. M. and Heinz, Andreas and Rapp, Michael Armin and Smolka, Michael N.},
title = {Susceptibility to interference between Pavlovian and instrumental control predisposes risky alcohol use developmental trajectory from ages 18 to 24},
series = {Addiction biology},
volume = {28},
journal = {Addiction biology},
number = {2},
publisher = {Wiley},
address = {Hoboken},
issn = {1355-6215},
doi = {10.1111/adb.13263},
pages = {18},
year = {2023},
abstract = {Pavlovian cues can influence ongoing instrumental behaviour via Pavlovian-to-instrumental transfer (PIT) processes. While appetitive Pavlovian cues tend to promote instrumental approach, they are detrimental when avoidance behaviour is required, and vice versa for aversive cues. We recently reported that susceptibility to interference between Pavlovian and instrumental control assessed via a PIT task was associated with risky alcohol use at age 18. We now investigated whether such susceptibility also predicts drinking trajectories until age 24, based on AUDIT (Alcohol Use Disorders Identification Test) consumption and binge drinking (gramme alcohol/drinking occasion) scores. The interference PIT effect, assessed at ages 18 and 21 during fMRI, was characterized by increased error rates (ER) and enhanced neural responses in the ventral striatum (VS), the lateral and dorsomedial prefrontal cortices (dmPFC) during conflict, that is, when an instrumental approach was required in the presence of an aversive Pavlovian cue or vice versa. We found that a stronger VS response during conflict at age 18 was associated with a higher starting point of both drinking trajectories but predicted a decrease in binge drinking. At age 21, high ER and enhanced neural responses in the dmPFC were associated with increasing AUDIT-C scores over the next 3 years until age 24. Overall, susceptibility to interference between Pavlovian and instrumental control might be viewed as a predisposing mechanism towards hazardous alcohol use during young adulthood, and the identified high-risk group may profit from targeted interventions.},
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 Armin 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{DeekenHaeuslerNordheimetal.2017,
author = {Deeken, Friederike and H{\"a}usler, Andreas and Nordheim, Johanna and Rapp, Michael Armin 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{DeekenRapp2022,
author = {Deeken, Friederike and Rapp, Michael Armin},
title = {Technology-based interventions as an approach to treating apathy in people with dementia},
series = {International psychogeriatrics : the official journal of the International Psychogeriatric Association},
volume = {34},
journal = {International psychogeriatrics : the official journal of the International Psychogeriatric Association},
number = {2},
publisher = {Cambridge Univ. Press},
address = {Cambridge},
issn = {1741-203X},
doi = {10.1017/S1041610222000035},
pages = {95 -- 96},
year = {2022},
language = {en}
}