TY - JOUR
A1 - Kaminski, Jakob A.
A1 - Schlagenhauf, Florian
A1 - Rapp, Michael Armin
A1 - Awasthi, Swapnil
A1 - Ruggeri, Barbara
A1 - Deserno, Lorenz
A1 - Banaschewski, Tobias
A1 - Bokde, Arun L. W.
A1 - Bromberg, Uli
A1 - Büchel, Christian
A1 - Quinlan, Erin Burke
A1 - Desrivieres, Sylvane
A1 - Flor, Herta
A1 - Frouin, Vincent
A1 - Garavan, Hugh
A1 - Gowland, Penny
A1 - Ittermann, Bernd
A1 - Martinot, Jean-Luc
A1 - Martinot, Marie-Laure Paillere
A1 - Nees, Frauke
A1 - Orfanos, Dimitri Papadopoulos
A1 - Paus, Tomas
A1 - Poustka, Luise
A1 - Smolka, Michael N.
A1 - Fröhner, Juliane H.
A1 - Walter, Henrik
A1 - Whelan, Robert
A1 - Ripke, Stephan
A1 - Schumann, Gunter
A1 - Heinz, Andreas
T1 - Epigenetic variance in dopamine D2 receptor
BT - a marker of IQ malleability?
JF - Translational Psychiatry
N2 - Genetic and environmental factors both contribute to cognitive test performance. A substantial increase in average intelligence test results in the second half of the previous century within one generation is unlikely to be explained by genetic changes. One possible explanation for the strong malleability of cognitive performance measure is that environmental factors modify gene expression via epigenetic mechanisms. Epigenetic factors may help to understand the recent observations of an association between dopamine-dependent encoding of reward prediction errors and cognitive capacity, which was modulated by adverse life events. The possible manifestation of malleable biomarkers contributing to variance in cognitive test performance, and thus possibly contributing to the "missing heritability" between estimates from twin studies and variance explained by genetic markers, is still unclear. Here we show in 1475 healthy adolescents from the IMaging and GENetics (IMAGEN) sample that general IQ (gIQ) is associated with (1) polygenic scores for intelligence, (2) epigenetic modification of DRD2 gene, (3) gray matter density in striatum, and (4) functional striatal activation elicited by temporarily surprising reward-predicting cues. Comparing the relative importance for the prediction of gIQ in an overlapping subsample, our results demonstrate neurobiological correlates of the malleability of gIQ and point to equal importance of genetic variance, epigenetic modification of DRD2 receptor gene, as well as functional striatal activation, known to influence dopamine neurotransmission. Peripheral epigenetic markers are in need of confirmation in the central nervous system and should be tested in longitudinal settings specifically assessing individual and environmental factors that modify epigenetic structure.
Y1 - 2018
U6 - https://doi.org/10.1038/s41398-018-0222-7
SN - 2158-3188
VL - 8
PB - Nature Publ. Group
CY - New York
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 -
TY - JOUR
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
JF - Addiction Biology
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.
KW - addiction
KW - alternative rewards
KW - animal and computational models
KW - cognitive-behavioral control
KW - craving and relapse
KW - habit formation
Y1 - 2019
VL - 25
IS - 2
PB - John Wiley & Sons, Inc.
CY - New Jersey
ER -
TY - GEN
A1 - Kaminski, Jakob
A1 - Schlagenhauf, Florian
A1 - Rapp, Michael Armin
A1 - Awasthi, Swapnil
A1 - Ruggeri, Barbara
A1 - Deserno, Lorenz
A1 - Laura, Daedelow
A1 - Banaschewski, Tobias
A1 - Bokde, Arun
A1 - Quinlan, Erin Burke
A1 - Buechel, Christian
A1 - Bromberg, Uli
A1 - Desrivieres, Sylvane
A1 - Flor, Herta
A1 - Frouin, Vincent
A1 - Garavan, Hugh
A1 - Gowland, Penny
A1 - Ittermann, Bernd
A1 - Martinot, Jean-Luc
A1 - Martinot, Marie-Laure Paillere
A1 - Nees, Frauke
A1 - Orfanos, Dimitri Papadopoulos
A1 - Paus, Tomas
A1 - Poustka, Luise
A1 - Smolka, Michael
A1 - Froehner, Juliane
A1 - Walter, Henrik
A1 - Whelan, Robert
A1 - Ripke, Stephan
A1 - Schumann, Gunter
A1 - Heinz, Andreas
T1 - Variance in Dopaminergic Markers
BT - a possible marker of individual differences in IQ?
T2 - Biological psychiatry : a journal of psychiatric neuroscience and therapeutics ; a publication of the Society of Biological Psychiatry
KW - Intelligence
KW - Dopamine
KW - Epigenetic Biomarkers
KW - Reward Anticipation
KW - Polygenic Risk Score
Y1 - 2018
U6 - https://doi.org/10.1016/j.biopsych.2018.02.311
SN - 0006-3223
SN - 1873-2402
VL - 83
IS - 9
SP - S118
EP - S118
PB - Elsevier
CY - New York
ER -
TY - GEN
A1 - Garbusow, Maria
A1 - Sommer, Christian
A1 - Nebe, Stephan
A1 - Sebold, Miriam Hannah
A1 - Kuitunen-Paul, Sören
A1 - Wittchen, Hans-Ulrich
A1 - Smolka, Michael N.
A1 - Zimmermann, Ulrich S.
A1 - Rapp, Michael Armin
A1 - Huys, Quentin J. M.
A1 - Schlagenhauf, Florian
A1 - Heinz, Andreas
T1 - Multi-level evidence of general pavlovian-to-instrumental transfer in alcohol use disorder
T2 - Alcoholism : clinical and experimental research ; the official journal of the American Medical Society on Alcoholism and the Research Society on Alcoholism
Y1 - 2018
SN - 0145-6008
SN - 1530-0277
VL - 42
SP - 128A
EP - 128A
PB - Wiley
CY - Hoboken
ER -
TY - GEN
A1 - Deeken, Friederike
A1 - Reichert, Markus
A1 - Zech, Hilmar
A1 - Wenzel, Julia
A1 - Wedemeyer, Friederike
A1 - Aguilera, Alvaro
A1 - Aslan, Acelya
A1 - Bach, Patrick
A1 - Bahr, Nadja Samia
A1 - Ebrahimi, Claudia
A1 - Fischbach, Pascale Christine
A1 - Ganz, Marvin
A1 - Garbusow, Maria
A1 - Großkopf, Charlotte M.
A1 - Heigert, Marie
A1 - Hentschel, Angela
A1 - Karl, Damian
A1 - Pelz, Patricia
A1 - Pinger, Mathieu
A1 - Riemerschmid, Carlotta
A1 - Rosenthal, Annika
A1 - Steffen, Johannes
A1 - Strehle, Jens
A1 - Weiss, Franziska
A1 - Wieder, Gesine
A1 - Wieland, Alfred
A1 - Zaiser, Judith
A1 - Zimmermann, Sina
A1 - Walter, Henrik
A1 - Lenz, Bernd
A1 - Deserno, Lorenz
A1 - Smolka, Michael N.
A1 - Liu, Shuyan
A1 - Ebner-Priemer, Ulrich Walter
A1 - Heinz, Andreas
A1 - Rapp, Michael Armin
T1 - Patterns of Alcohol Consumption Among Individuals With Alcohol Use Disorder During the COVID-19 Pandemic and Lockdowns in Germany
T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - 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.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 805
Y1 - 2022
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-571460
SN - 1866-8364
IS - 805
ER -
TY - JOUR
A1 - Deeken, Friederike
A1 - Reichert, Markus
A1 - Zech, Hilmar
A1 - Wenzel, Julia
A1 - Wedemeyer, Friederike
A1 - Aguilera, Alvaro
A1 - Aslan, Acelya
A1 - Bach, Patrick
A1 - Bahr, Nadja Samia
A1 - Ebrahimi, Claudia
A1 - Fischbach, Pascale Christine
A1 - Ganz, Marvin
A1 - Garbusow, Maria
A1 - Großkopf, Charlotte M.
A1 - Heigert, Marie
A1 - Hentschel, Angela
A1 - Karl, Damian
A1 - Pelz, Patricia
A1 - Pinger, Mathieu
A1 - Riemerschmid, Carlotta
A1 - Rosenthal, Annika
A1 - Steffen, Johannes
A1 - Strehle, Jens
A1 - Weiss,, Franziska
A1 - Wieder, Gesine
A1 - Wieland, Alfred
A1 - Zaiser, Judith
A1 - Zimmermann, Sina
A1 - Walter, Henrik
A1 - Lenz, Bernd
A1 - Deserno, Lorenz
A1 - Smolka, Michael N.
A1 - Liu, Shuyan
A1 - Ebner-Priemer, Ulrich Walter
A1 - Heinz, Andreas
A1 - Rapp, Michael Armin
T1 - Patterns of Alcohol Consumption Among Individuals With Alcohol Use Disorder During the COVID-19 Pandemic and Lockdowns in Germany
JF - JAMA Network Open
N2 - 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.
Y1 - 2022
U6 - https://doi.org/10.1001/jamanetworkopen.2022.24641
SN - 2574-3805
VL - 5
SP - 1
EP - 11
PB - JAMA Network / American Medical Association
CY - Chicago, Illinois, USA
ET - 8
ER -
TY - GEN
A1 - Kaminski, Jakob A.
A1 - Schlagenhauf, Florian
A1 - Rapp, Michael Armin
A1 - Awasthi, Swapnil
A1 - Ruggeri, Barbara
A1 - Deserno, Lorenz
A1 - Banaschewski, Tobias
A1 - Bokde, Arun L. W.
A1 - Bromberg, Uli
A1 - Büchel, Christian
A1 - Quinlan, Erin Burke
A1 - Desrivières, Sylvane
A1 - Flor, Herta
A1 - Frouin, Vincent
A1 - Garavan, Hugh
A1 - Gowland, Penny
A1 - Ittermann, Bernd
A1 - Martinot, Jean-Luc
A1 - Paillère Martinot, Marie-Laure
A1 - Nees, Frauke
A1 - Papadopoulos Orfanos, Dimitri
A1 - Paus, Tomáš
A1 - Poustka, Luise
A1 - Smolka, Michael N.
A1 - Fröhner, Juliane H.
A1 - Walter, Henrik
A1 - Whelan, Robert
A1 - Ripke, Stephan
A1 - Schumann, Gunter
A1 - Heinz, Andreas
T1 - Epigenetic variance in dopamine D2 receptor
BT - a marker of IQ malleability?
T2 - Postprints der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe
N2 - Genetic and environmental factors both contribute to cognitive test performance. A substantial increase in average intelligence test results in the second half of the previous century within one generation is unlikely to be explained by genetic changes. One possible explanation for the strong malleability of cognitive performance measure is that environmental factors modify gene expression via epigenetic mechanisms. Epigenetic factors may help to understand the recent observations of an association between dopamine-dependent encoding of reward prediction errors and cognitive capacity, which was modulated by adverse life events. The possible manifestation of malleable biomarkers contributing to variance in cognitive test performance, and thus possibly contributing to the "missing heritability" between estimates from twin studies and variance explained by genetic markers, is still unclear. Here we show in 1475 healthy adolescents from the IMaging and GENetics (IMAGEN) sample that general IQ (gIQ) is associated with (1) polygenic scores for intelligence, (2) epigenetic modification of DRD2 gene, (3) gray matter density in striatum, and (4) functional striatal activation elicited by temporarily surprising reward-predicting cues. Comparing the relative importance for the prediction of gIQ in an overlapping subsample, our results demonstrate neurobiological correlates of the malleability of gIQ and point to equal importance of genetic variance, epigenetic modification of DRD2 receptor gene, as well as functional striatal activation, known to influence dopamine neurotransmission. Peripheral epigenetic markers are in need of confirmation in the central nervous system and should be tested in longitudinal settings specifically assessing individual and environmental factors that modify epigenetic structure.
T3 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe - 950
KW - genome-wide association
KW - reward anticipation
KW - human intelligence
KW - human brain
KW - stress
KW - metaanalysis
KW - striatum
KW - psychopathology
KW - prediction
KW - volume
KW - epigenetics and behaviour
KW - human behaviour
KW - learning and memory
Y1 - 2020
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-425687
SN - 1866-8372
IS - 950
ER -
TY - JOUR
A1 - Friedel, Eva
A1 - Sebold, Miriam Hannah
A1 - Kuitunen-Paul, Sören
A1 - Nebe, Stephan
A1 - Veer, Ilya M.
A1 - Zimmermann, Ulrich S.
A1 - Schlagenhauf, Florian
A1 - Smolka, Michael N.
A1 - Rapp, Michael Armin
A1 - Walter, Henrik
A1 - Heinz, Andreas
T1 - How Accumulated Real Life Stress Experience and Cognitive Speed Interact on Decision-Making Processes
JF - Frontiers in human neuroscienc
N2 - Rationale: Advances in neurocomputational modeling suggest that valuation systems for goal-directed (deliberative) on one side, and habitual (automatic) decision-making on the other side may rely on distinct computational strategies for reinforcement learning, namely model-free vs. model-based learning. As a key theoretical difference, the model-based system strongly demands cognitive functions to plan actions prospectively based on an internal cognitive model of the environment, whereas valuation in the model-free system relies on rather simple learning rules from operant conditioning to retrospectively associate actions with their outcomes and is thus cognitively less demanding. Acute stress reactivity is known to impair model-based but not model-free choice behavior, with higher working memory capacity protecting the model-based system from acute stress. However, it is not clear which impact accumulated real life stress has on model-free and model-based decision systems and how this influence interacts with cognitive abilities. Methods: We used a sequential decision-making task distinguishing relative contributions of both learning strategies to choice behavior, the Social Readjustment Rating Scale questionnaire to assess accumulated real life stress, and the Digit Symbol Substitution Test to test cognitive speed in 95 healthy subjects. Results: Individuals reporting high stress exposure who had low cognitive speed showed reduced model-based but increased model-free behavioral control. In contrast, subjects exposed to accumulated real life stress with high cognitive speed displayed increased model-based performance but reduced model-free control. Conclusion: These findings suggest that accumulated real life stress exposure can enhance reliance on cognitive speed for model-based computations, which may ultimately protect the model-based system from the detrimental influences of accumulated real life stress. The combination of accumulated real life stress exposure and slower information processing capacities, however, might favor model-free strategies. Thus, the valence and preference of either system strongly depends on stressful experiences and individual cognitive capacities.
KW - chronic stress
KW - model-based learning
KW - model-free learning
KW - decision making
KW - cognitive speed
KW - real-life events
Y1 - 2017
U6 - https://doi.org/10.3389/fnhum.2017.00302
SN - 1662-5161
VL - 11
SP - 1
EP - 9
PB - Frontiers Research Foundation
CY - Lausanne
ER -
TY - JOUR
A1 - Sánchez, Alba
A1 - Thomas, Christine
A1 - Deeken, Friederike
A1 - Wagner, Sören
A1 - Klöppel, Stefan
A1 - Kentischer, Felix
A1 - von Arnim, Chrstine A. F.
A1 - Denkinger, Michael
A1 - Conzelmann, Lars O.
A1 - Biermann-Stallwitz, Janine
A1 - Joos, Stefanie
A1 - Sturm, Heidrun
A1 - Metz, Brigitte
A1 - Auer, Ramona
A1 - Skrobik, Yoanna
A1 - Eschweiler, Gerhard W.
A1 - Rapp, Michael Armin
T1 - Patient safety, cost-effectiveness, and quality of life
BT - reduction of delirium risk and postoperative cognitive dysfunction after elective procedures in older adults—study protocol for a stepped-wedge cluster randomized trial (PAWEL Study)
JF - Trials
N2 - Background
Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients’ age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective.
Methods
The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures.
Discussion
Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances.
Trial registration
German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.
KW - Cross-sectoral care
KW - Delirium prevention
KW - Postoperative cognitive dysfunction
KW - Dementia
KW - Older patients
KW - Elective surgery
KW - Quality of life
KW - Cost-effectiveness
Y1 - 2019
U6 - https://doi.org/10.1186/s13063-018-3148-8
SN - 1468-6694
SN - 1745-6215
SN - 1468-6708
VL - 20
IS - 71
PB - BioMed Central
CY - London
ER -
TY - GEN
A1 - Sánchez, Alba
A1 - Thomas, Christine
A1 - Deeken, Friederike
A1 - Wagner, Sören
A1 - Klöppel, Stefan
A1 - Kentischer, Felix
A1 - von Arnim, Chrstine A. F.
A1 - Denkinger, Michael
A1 - Conzelmann, Lars O.
A1 - Biermann-Stallwitz, Janine
A1 - Joos, Stefanie
A1 - Sturm, Heidrun
A1 - Metz, Brigitte
A1 - Auer, Ramona
A1 - Skrobik, Yoanna
A1 - Eschweiler, Gerhard W.
A1 - Rapp, Michael Armin
T1 - Patient safety, cost-effectiveness, and quality of life
BT - reduction of delirium risk and postoperative cognitive dysfunction after elective procedures in older adults—study protocol for a stepped-wedge cluster randomized trial (PAWEL Study)
T2 - Postprints der Universität Potsdam Humanwissenschaftliche Reihe
N2 - Background
Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients’ age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective.
Methods
The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures.
Discussion
Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances.
Trial registration
German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 535
KW - Cross-sectoral care
KW - Delirium prevention
KW - Postoperative cognitive dysfunction
KW - Dementia
KW - Older patients
KW - Elective surgery
KW - Quality of life
KW - Cost-effectiveness
Y1 - 2019
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-424883
SN - 1866-8364
IS - 535
ER -
TY - CHAP
A1 - Schad, Daniel
A1 - Juenger, Elisabeth
A1 - Sebold, Miriam Hannah
A1 - Garbusow, Maria
A1 - Bernhart, Nadine
A1 - Javadi, Amir Homayoun
A1 - Zimmermann, Ulrich S.
A1 - Smolka, Michael N.
A1 - Heinz, Andreas
A1 - Rapp, Michael Armin
A1 - Huys, Quentin J. M.
T1 - Smart goals, slow habits? Individual differences in processing speed and working memory capacity moderate the balance between habitual and goal-directed choice behavior
T2 - Cognitive processing : international quarterly of cognitive science
Y1 - 2014
SN - 1612-4782
SN - 1612-4790
VL - 15
IS - 1
SP - S62
EP - S62
PB - Springer
CY - Heidelberg
ER -
TY - GEN
A1 - Garbusow, Maria
A1 - Nebe, Stephan
A1 - Sommer, Christian
A1 - Kuitunen-Paul, Sören
A1 - Sebold, Miriam Hannah
A1 - Schad, Daniel
A1 - Friedel, Eva
A1 - Veer, Ilya M.
A1 - Wittchen, Hans-Ulrich
A1 - Rapp, Michael Armin
A1 - Ripke, Stephan
A1 - Walter, Henrik
A1 - Huys, Quentin J. M.
A1 - Schlagenhauf, Florian
A1 - Smolka, Michael N.
A1 - Heinz, Andreas
T1 - Pavlovian-To-Instrumental Transfer and Alcohol Consumption in Young Male Social Drinkers
BT - Behavioral, Neural and Polygenic Correlates
T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - In animals and humans, behavior can be influenced by irrelevant stimuli, a phenomenon called Pavlovian-to-instrumental transfer (PIT). In subjects with substance use disorder, PIT is even enhanced with functional activation in the nucleus accumbens (NAcc) and amygdala. While we observed enhanced behavioral and neural PIT effects in alcohol-dependent subjects, we here aimed to determine whether behavioral PIT is enhanced in young men with high-risk compared to low-risk drinking and subsequently related functional activation in an a-priori region of interest encompassing the NAcc and amygdala and related to polygenic risk for alcohol consumption. A representative sample of 18-year old men (n = 1937) was contacted: 445 were screened, 209 assessed: resulting in 191 valid behavioral, 139 imaging and 157 genetic datasets. None of the subjects fulfilled criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-IV-TextRevision (DSM-IV-TR). We measured how instrumental responding for rewards was influenced by background Pavlovian conditioned stimuli predicting action-independent rewards and losses. Behavioral PIT was enhanced in high-compared to low-risk drinkers (b = 0.09, SE = 0.03, z = 2.7, p < 0.009). Across all subjects, we observed PIT-related neural blood oxygen level-dependent (BOLD) signal in the right amygdala (t = 3.25, p(SVC) = 0.04, x = 26, y = -6, z = -12), but not in NAcc. The strength of the behavioral PIT effect was positively correlated with polygenic risk for alcohol consumption (r(s) = 0.17, p = 0.032). We conclude that behavioral PIT and polygenic risk for alcohol consumption might be a biomarker for a subclinical phenotype of risky alcohol consumption, even if no drug-related stimulus is present. The association between behavioral PIT effects and the amygdala might point to habitual processes related to out PIT task. In non-dependent young social drinkers, the amygdala rather than the NAcc is activated during PIT; possible different involvement in association with disease trajectory should be investigated in future studies.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 841
KW - Pavlovian-to-instrumental transfer
KW - amygdala
KW - alcohol
KW - polygenic risk
KW - high risk drinkers
Y1 - 2019
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-473280
SN - 1866-8364
IS - 841
ER -
TY - JOUR
A1 - Chen, Hao
A1 - Nebe, Stephan
A1 - Mojtahedzadeh, Negin
A1 - Kuitunen-Paul, Soren
A1 - Garbusow, Maria
A1 - Schad, Daniel
A1 - Rapp, Michael Armin
A1 - Huys, Quentin J. M.
A1 - Heinz, Andreas
A1 - Smolka, Michael N.
T1 - Susceptibility to interference between Pavlovian and instrumental control is associated with early hazardous alcohol use
JF - Addiction biology
N2 - 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.
KW - high‐risk drinking
KW - interference control
KW - Pavlovian‐to‐instrumental transfer
Y1 - 2020
U6 - https://doi.org/10.1111/adb.12983
SN - 1355-6215
SN - 1369-1600
VL - 26
IS - 4
SP - 1
EP - 14
PB - Wiley
CY - Hoboken
ER -
TY - JOUR
A1 - Nebe, Stephan
A1 - Kroemer, Nils B.
A1 - Schad, Daniel
A1 - Bernhardt, Nadine
A1 - Sebold, Miriam Hannah
A1 - Mueller, Dirk K.
A1 - Scholl, Lucie
A1 - Kuitunen-Paul, Sören
A1 - Heinz, Andreas
A1 - Rapp, Michael Armin
A1 - Huys, Quentin J. M.
A1 - Smolka, Michael N.
T1 - No association of goal-directed and habitual control with alcohol consumption in young adults
JF - Addiction biology
N2 - Alcohol dependence is a mental disorder that has been associated with an imbalance in behavioral control favoring model-free habitual over model-based goal-directed strategies. It is as yet unknown, however, whether such an imbalance reflects a predisposing vulnerability or results as a consequence of repeated and/or excessive alcohol exposure. We, therefore, examined the association of alcohol consumption with model-based goal-directed and model-free habitual control in 188 18-year-old social drinkers in a two-step sequential decision-making task while undergoing functional magnetic resonance imaging before prolonged alcohol misuse could have led to severe neurobiological adaptations. Behaviorally, participants showed a mixture of model-free and model-based decision-making as observed previously. Measures of impulsivity were positively related to alcohol consumption. In contrast, neither model-free nor model-based decision weights nor the trade-off between them were associated with alcohol consumption. There were also no significant associations between alcohol consumption and neural correlates of model-free or model-based decision quantities in either ventral striatum or ventromedial prefrontal cortex. Exploratory whole-brain functional magnetic resonance imaging analyses with a lenient threshold revealed early onset of drinking to be associated with an enhanced representation of model-free reward prediction errors in the posterior putamen. These results suggest that an imbalance between model-based goal-directed and model-free habitual control might rather not be a trait marker of alcohol intake per se.
KW - alcohol
KW - goal-directed
KW - reinforcement learning
Y1 - 2017
U6 - https://doi.org/10.1111/adb.12490
SN - 1355-6215
SN - 1369-1600
VL - 23
IS - 1
SP - 379
EP - 393
PB - Wiley
CY - Hoboken
ER -
TY - GEN
A1 - Sebold, Miriam Hannah
A1 - Nebe, Stephan
A1 - Garbusow, Maria
A1 - Schad, Daniel
A1 - Sommer, Christian
A1 - Rapp, Michael Armin
A1 - Smolka, Michael N.
A1 - Huys, Quentin J. M.
A1 - Schlagenhauf, Florian
A1 - Heinz, Andreas
T1 - Neurobiological correlates of learning and decision-making in alcohol dependence
T2 - European psychiatry : the journal of the Association of European Psychiatrists
Y1 - 2017
U6 - https://doi.org/10.1016/j.eurpsy.2017.01.084
SN - 0924-9338
SN - 1778-3585
VL - 41
SP - S11
EP - S11
PB - Elsevier
CY - Paris
ER -
TY - JOUR
A1 - Schad, Daniel
A1 - Garbusow, Maria
A1 - Friedel, Eva
A1 - Sommer, Christian
A1 - Sebold, Miriam Hannah
A1 - Hägele, Claudia
A1 - Bernhardt, Nadine
A1 - Nebe, Stephan
A1 - Kuitunen-Paul, Sören
A1 - Liu, Shuyan
A1 - Eichmann, Uta
A1 - Beck, Anne
A1 - Wittchen, Hans-Ulrich
A1 - Walter, Henrik
A1 - Sterzer, Philipp
A1 - Zimmermann, Ulrich S.
A1 - Smolka, Michael N.
A1 - Schlagenhauf, Florian
A1 - Huys, Quentin J. M.
A1 - Heinz, Andreas
A1 - Rapp, Michael Armin
T1 - Neural correlates of instrumental responding in the context of alcohol-related cues index disorder severity and relapse risk
JF - European archives of psychiatry and clinical neuroscience : official organ of the German Society for Biological Psychiatry
N2 - The influence of Pavlovian conditioned stimuli on ongoing behavior may contribute to explaining how alcohol cues stimulate drug seeking and intake. Using a Pavlovian-instrumental transfer task, we investigated the effects of alcohol-related cues on approach behavior (i.e., instrumental response behavior) and its neural correlates, and related both to the relapse after detoxification in alcohol-dependent patients. Thirty-one recently detoxified alcohol-dependent patients and 24 healthy controls underwent instrumental training, where approach or non-approach towards initially neutral stimuli was reinforced by monetary incentives. Approach behavior was tested during extinction with either alcohol-related or neutral stimuli (as Pavlovian cues) presented in the background during functional magnetic resonance imaging (fMRI). Patients were subsequently followed up for 6 months. We observed that alcohol-related background stimuli inhibited the approach behavior in detoxified alcohol-dependent patients (t = -3.86, p < .001), but not in healthy controls (t = -0.92, p = .36). This behavioral inhibition was associated with neural activation in the nucleus accumbens (NAcc) (t((30)) = 2.06, p < .05). Interestingly, both the effects were only present in subsequent abstainers, but not relapsers and in those with mild but not severe dependence. Our data show that alcohol-related cues can acquire inhibitory behavioral features typical of aversive stimuli despite being accompanied by a stronger NAcc activation, suggesting salience attribution. The fact that these findings are restricted to abstinence and milder illness suggests that they may be potential resilience factors.
KW - Alcohol dependence
KW - Human neuroimaging
KW - Nucleus accumbens
KW - Pavlovian-instrumental transfer
KW - Relapse
Y1 - 2018
U6 - https://doi.org/10.1007/s00406-017-0860-4
SN - 0940-1334
SN - 1433-8491
VL - 269
IS - 3
SP - 295
EP - 308
PB - Springer
CY - Heidelberg
ER -
TY - JOUR
A1 - Schad, Daniel
A1 - Juenger, Elisabeth
A1 - Sebold, Miriam Hannah
A1 - Garbusow, Maria
A1 - Bernhardt, Nadine
A1 - Javadi, Amir-Homayoun
A1 - Zimmermann, Ulrich S.
A1 - Smolka, Michael N.
A1 - Heinz, Andreas
A1 - Rapp, Michael Armin
A1 - Huys, Quentin J. M.
T1 - Processing speed enhances model-based over model-free reinforcement learning in the presence of high working memory functioning
JF - Frontiers in psychology
N2 - Theories of decision-making and its neural substrates have long assumed the existence of two distinct and competing valuation systems, variously described as goal-directed vs. habitual, or, more recently and based on statistical arguments, as model-free vs. model-based reinforcement-learning. Though both have been shown to control choices, the cognitive abilities associated with these systems are under ongoing investigation. Here we examine the link to cognitive abilities, and find that individual differences in processing speed covary with a shift from model-free to model-based choice control in the presence of above-average working memory function. This suggests shared cognitive and neural processes; provides a bridge between literatures on intelligence and valuation; and may guide the development of process models of different valuation components. Furthermore, it provides a rationale for individual differences in the tendency to deploy valuation systems, which may be important for understanding the manifold neuropsychiatric diseases associated with malfunctions of valuation.
KW - decision-making
KW - reward
KW - cognitive abilities
KW - model-based and model-free learning
KW - fluid intelligence
KW - habitual and goal-directed system
Y1 - 2014
U6 - https://doi.org/10.3389/fpsyg.2014.01450
SN - 1664-1078
VL - 5
PB - Frontiers Research Foundation
CY - Lausanne
ER -
TY - JOUR
A1 - Garbusow, Maria
A1 - Nebe, Stephan
A1 - Sommer, Christian
A1 - Kuitunen-Paul, Sören
A1 - Sebold, Miriam Hannah
A1 - Schad, Daniel
A1 - Friedel, Eva
A1 - Veer, Ilya M.
A1 - Wittchen, Hans-Ulrich
A1 - Rapp, Michael Armin
A1 - Ripke, Stephan
A1 - Walter, Henrik
A1 - Huys, Quentin J. M.
A1 - Schlagenhauf, Florian
A1 - Smolka, Michael N.
A1 - Heinz, Andreas
T1 - Pavlovian-To-Instrumental Transfer and Alcohol Consumption in Young Male Social Drinkers
BT - Behavioral, Neural and Polygenic Correlates
JF - Journal of Clinical Medicine
N2 - In animals and humans, behavior can be influenced by irrelevant stimuli, a phenomenon called Pavlovian-to-instrumental transfer (PIT). In subjects with substance use disorder, PIT is even enhanced with functional activation in the nucleus accumbens (NAcc) and amygdala. While we observed enhanced behavioral and neural PIT effects in alcohol-dependent subjects, we here aimed to determine whether behavioral PIT is enhanced in young men with high-risk compared to low-risk drinking and subsequently related functional activation in an a-priori region of interest encompassing the NAcc and amygdala and related to polygenic risk for alcohol consumption. A representative sample of 18-year old men (n = 1937) was contacted: 445 were screened, 209 assessed: resulting in 191 valid behavioral, 139 imaging and 157 genetic datasets. None of the subjects fulfilled criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-IV-TextRevision (DSM-IV-TR). We measured how instrumental responding for rewards was influenced by background Pavlovian conditioned stimuli predicting action-independent rewards and losses. Behavioral PIT was enhanced in high-compared to low-risk drinkers (b = 0.09, SE = 0.03, z = 2.7, p < 0.009). Across all subjects, we observed PIT-related neural blood oxygen level-dependent (BOLD) signal in the right amygdala (t = 3.25, p(SVC) = 0.04, x = 26, y = -6, z = -12), but not in NAcc. The strength of the behavioral PIT effect was positively correlated with polygenic risk for alcohol consumption (r(s) = 0.17, p = 0.032). We conclude that behavioral PIT and polygenic risk for alcohol consumption might be a biomarker for a subclinical phenotype of risky alcohol consumption, even if no drug-related stimulus is present. The association between behavioral PIT effects and the amygdala might point to habitual processes related to out PIT task. In non-dependent young social drinkers, the amygdala rather than the NAcc is activated during PIT; possible different involvement in association with disease trajectory should be investigated in future studies.
KW - Pavlovian-to-instrumental transfer
KW - amygdala
KW - alcohol
KW - polygenic risk
KW - high risk drinkers
Y1 - 2019
U6 - https://doi.org/10.3390/jcm8081188
SN - 2077-0383
VL - 8
IS - 8
PB - MDPI
CY - Basel
ER -
TY - JOUR
A1 - Sebold, Miriam Hannah
A1 - Deserno, Lorenz
A1 - Nebe, Stefan
A1 - Schad, Daniel
A1 - Garbusow, Maria
A1 - Haegele, Claudia
A1 - Keller, Juergen
A1 - Juenger, Elisabeth
A1 - Kathmann, Norbert
A1 - Smolka, Michael N.
A1 - Rapp, Michael Armin
A1 - Schlagenhauf, Florian
A1 - Heinz, Andreas
A1 - Huys, Quentin J. M.
T1 - Model-based and model-free decisions in alcohol dependence
JF - Neuropsychobiology : international journal of experimental and clinical research in biological psychiatry, pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography
N2 - Background: Human and animal work suggests a shift from goal-directed to habitual decision-making in addiction. However, the evidence for this in human alcohol dependence is as yet inconclusive. Methods: Twenty-six healthy controls and 26 recently detoxified alcohol-dependent patients underwent behavioral testing with a 2-step task designed to disentangle goal-directed and habitual response patterns. Results: Alcohol-dependent patients showed less evidence of goal-directed choices than healthy controls, particularly after losses. There was no difference in the strength of the habitual component. The group differences did not survive controlling for performance on the Digit Symbol Substitution Task. Conclusion: Chronic alcohol use appears to selectively impair goal-directed function, rather than promoting habitual responding. It appears to do so particularly after nonrewards, and this may be mediated by the effects of alcohol on more general cognitive functions subserved by the prefrontal cortex.
KW - Alcohol dependence
KW - Decision-making
KW - Reinforcement learning
KW - Dopamine
KW - Computational psychiatry
Y1 - 2014
U6 - https://doi.org/10.1159/000362840
SN - 0302-282X
SN - 1423-0224
VL - 70
IS - 2
SP - 122
EP - 131
PB - Karger
CY - Basel
ER -
TY - JOUR
A1 - Garbusow, Maria
A1 - Schad, Daniel
A1 - Sebold, Miriam Hannah
A1 - Friedel, Eva
A1 - Bernhardt, Nadine
A1 - Koch, Stefan P.
A1 - Steinacher, Bruno
A1 - Kathmann, Norbert
A1 - Geurts, Dirk E. M.
A1 - Sommer, Christian
A1 - Mueller, Dirk K.
A1 - Nebe, Stephan
A1 - Paul, Soeren
A1 - Wittchen, Hans-Ulrich
A1 - Zimmermann, Ulrich S.
A1 - Walter, Henrik
A1 - Smolka, Michael N.
A1 - Sterzer, Philipp
A1 - Rapp, Michael Armin
A1 - Huys, Quentin J. M.
A1 - Schlagenhauf, Florian
A1 - Heinz, Andreas
T1 - Pavlovian-to-instrumental transfer effects in the nucleus accumbens relate to relapse in alcohol dependence
JF - Addiction biology
N2 - In detoxified alcohol-dependent patients, alcohol-related stimuli can promote relapse. However, to date, the mechanisms by which contextual stimuli promote relapse have not been elucidated in detail. One hypothesis is that such contextual stimuli directly stimulate the motivation to drink via associated brain regions like the ventral striatum and thus promote alcohol seeking, intake and relapse. Pavlovian-to-Instrumental-Transfer (PIT) may be one of those behavioral phenomena contributing to relapse, capturing how Pavlovian conditioned (contextual) cues determine instrumental behavior (e.g. alcohol seeking and intake). We used a PIT paradigm during functional magnetic resonance imaging to examine the effects of classically conditioned Pavlovian stimuli on instrumental choices in n=31 detoxified patients diagnosed with alcohol dependence and n=24 healthy controls matched for age and gender. Patients were followed up over a period of 3 months. We observed that (1) there was a significant behavioral PIT effect for all participants, which was significantly more pronounced in alcohol-dependent patients; (2) PIT was significantly associated with blood oxygen level-dependent (BOLD) signals in the nucleus accumbens (NAcc) in subsequent relapsers only; and (3) PIT-related NAcc activation was associated with, and predictive of, critical outcomes (amount of alcohol intake and relapse during a 3 months follow-up period) in alcohol-dependent patients. These observations show for the first time that PIT-related BOLD signals, as a measure of the influence of Pavlovian cues on instrumental behavior, predict alcohol intake and relapse in alcohol dependence.
KW - human Pavlovian-to-instrumental transfer
KW - nucleus accumbens
KW - relapse in alcohol use disorder
Y1 - 2016
U6 - https://doi.org/10.1111/adb.12243
SN - 1355-6215
SN - 1369-1600
VL - 21
SP - 719
EP - 731
PB - Wiley-Blackwell
CY - Hoboken
ER -
TY - JOUR
A1 - Sebold, Miriam Hannah
A1 - Nebe, Stephan
A1 - Garbusow, Maria
A1 - Guggenmos, Matthias
A1 - Schad, Daniel
A1 - Beck, Anne
A1 - Kuitunen-Paul, Sören
A1 - Sommer, Christian
A1 - Frank, Robin
A1 - Neu, Peter
A1 - Zimmermann, Ulrich S.
A1 - Rapp, Michael Armin
A1 - Smolka, Michael N.
A1 - Huys, Quentin J. M.
A1 - Schlagenhauf, Florian
A1 - Heinz, Andreas
T1 - When Habits Are Dangerous: Alcohol Expectancies and Habitual Decision Making Predict Relapse in Alcohol Dependence
JF - Biological psychiatry : a journal of psychiatric neuroscience and therapeutics ; a publication of the Society of Biological Psychiatry
N2 - BACKGROUND: Addiction is supposedly characterized by a shift from goal-directed to habitual decision making, thus facilitating automatic drug intake. The two-step task allows distinguishing between these mechanisms by computationally modeling goal-directed and habitual behavior as model-based and model-free control. In addicted patients, decision making may also strongly depend upon drug-associated expectations. Therefore, we investigated model-based versus model-free decision making and its neural correlates as well as alcohol expectancies in alcohol-dependent patients and healthy controls and assessed treatment outcome in patients. METHODS: Ninety detoxified, medication-free, alcohol-dependent patients and 96 age-and gender-matched control subjects underwent functional magnetic resonance imaging during the two-step task. Alcohol expectancies were measured with the Alcohol Expectancy Questionnaire. Over a follow-up period of 48 weeks, 37 patients remained abstinent and 53 patients relapsed as indicated by the Alcohol Timeline Followback method. RESULTS: Patients who relapsed displayed reduced medial prefrontal cortex activation during model-based decision making. Furthermore, high alcohol expectancies were associated with low model-based control in relapsers, while the opposite was observed in abstainers and healthy control subjects. However, reduced model-based control per se was not associated with subsequent relapse. CONCLUSIONS: These findings suggest that poor treatment outcome in alcohol dependence does not simply result from a shift from model-based to model-free control but is instead dependent on the interaction between high drug expectancies and low model-based decision making. Reduced model-based medial prefrontal cortex signatures in those who relapse point to a neural correlate of relapse risk. These observations suggest that therapeutic interventions should target subjective alcohol expectancies.
KW - Alcohol dependence
KW - Alcohol expectancy
KW - Goal-directed control
KW - Medial prefrontal cortex
KW - Reinforcement learning
KW - Treatment outcome
Y1 - 2017
U6 - https://doi.org/10.1016/j.biopsych.2017.04.019
SN - 0006-3223
SN - 1873-2402
VL - 82
SP - 847
EP - 856
PB - Elsevier
CY - New York
ER -
TY - JOUR
A1 - Sebold, Miriam Hannah
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 Armin
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 - 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 - JOUR
A1 - Heinzel, Stephan
A1 - Rapp, Michael Armin
A1 - Fydrich, Thomas
A1 - Ströhle, Andreas
A1 - Teran, Christina
A1 - Kallies, Gunnar
A1 - Schwefel, Melanie
A1 - Heissel, Andreas
T1 - Neurobiological mechanisms of exercise and psychotherapy in depression
BT - the SPeED studyRationale, design, and methodological issues
JF - Clinical Trials
N2 - Background/Aims: Even though cognitive behavioral therapy has become a relatively effective treatment for major depressive disorder and cognitive behavioral therapy-related changes of dysfunctional neural activations were shown in recent studies, remission rates still remain at an insufficient level. Therefore, the implementation of effective augmentation strategies is needed. In recent meta-analyses, exercise therapy (especially endurance exercise) was reported to be an effective intervention in major depressive disorder. Despite these findings, underlying mechanisms of the antidepressant effect of exercise especially in combination with cognitive behavioral therapy have rarely been studied to date and an investigation of its neural underpinnings is lacking. A better understanding of the psychological and neural mechanisms of exercise and cognitive behavioral therapy would be important for developing optimal treatment strategies in depression. The SPeED study (Sport/Exercise Therapy and Psychotherapyevaluating treatment Effects in Depressive patients) is a randomized controlled trial to investigate underlying physiological, neurobiological, and psychological mechanisms of the augmentation of cognitive behavioral therapy with endurance exercise. It is investigated if a preceding endurance exercise program will enhance the effect of a subsequent cognitive behavioral therapy. Methods: This study will include 105 patients diagnosed with a mild or moderate depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The participants are randomized into one of three groups: a high-intensive or a low-intensive endurance exercise group or a waiting list control group. After the exercise program/waiting period, all patients receive an outpatient cognitive behavioral therapy treatment according to a standardized therapy manual. At four measurement points, major depressive disorder symptoms (Beck Depression Inventory, Hamilton Rating Scale for Depression), (neuro)biological measures (neural activations during working memory, monetary incentive delay task, and emotion regulation, as well as cortisol levels and brain-derived neurotrophic factor), neuropsychological test performance, and questionnaires (psychological needs, self-efficacy, and quality of life) are assessed. Results: In this article, we report the design of the SPeED study and refer to important methodological issues such as including both high- and low-intensity endurance exercise groups to allow the investigation of dose-response effects and physiological components of the therapy effects. Conclusion: The main aims of this research project are to study effects of endurance exercise and cognitive behavioral therapy on depressive symptoms and to investigate underlying physiological and neurobiological mechanisms of these effects. Results may provide important implications for the development of effective treatment strategies in major depressive disorder, specifically concerning the augmentation of cognitive behavioral therapy by endurance exercise.
KW - Major depressive disorder
KW - depression
KW - psychotherapy
KW - cognitive behavioral therapy
KW - endurance exercise
KW - training
KW - functional magnetic resonance imaging
KW - brain-derived neurotrophic factor
KW - basic psychological needs
KW - cortisol
Y1 - 2017
U6 - https://doi.org/10.1177/1740774517729161
SN - 1740-7745
SN - 1740-7753
VL - 15
IS - 1
SP - 53
EP - 64
PB - Sage Publ.
CY - London
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 - Awasthi, Swapnil
A1 - Kaminski, Jakob
A1 - Rapp, Michael Armin
A1 - Schlagenhauf, Florian
A1 - Walter, Henrik
A1 - Ruggeri, Barbara
A1 - Ripke, Stephan
A1 - Schumann, Gunter
A1 - Heinz, Andreas
T1 - A neural signature of malleability
BT - general intelligence correlates with ventral striatal activation and epigenetic makers of dopamine neurotransmission
T2 - European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
N2 - General intelligence has a substantial genetic background in children, adolescents, and adults, but environmental factors also strongly correlate with cognitive performance as evidenced by a strong (up to one SD) increase in average intelligence test results in the second half of the previous century. This change occurred in a period apparently too short to accommodate radical genetic changes. It is highly suggestive that environmental factors interact with genotype by possible modification of epigenetic factors that regulate gene expression and thus contribute to individual malleability. This modification might as well be reflected in recent observations of an association between dopamine-dependent encoding of reward prediction errors and cognitive capacity, which was modulated by adverse life events.
Y1 - 2019
U6 - https://doi.org/10.1016/j.euroneuro.2017.08.139
SN - 0924-977X
SN - 1873-7862
VL - 29
SP - S858
EP - S859
PB - Elsevier
CY - Amsterdam
ER -
TY - JOUR
A1 - Gruebner, Oliver
A1 - Rapp, Michael Armin
A1 - Adli, Mazda
A1 - Kluge, Ulrike
A1 - Galea, Sandro
A1 - Heinz, Andreas
T1 - Cities and Mental Health
JF - Deutsches Ärzteblatt international : a weekly online journal of clinical medicine and public health
N2 - Background: More than half of the global population currently lives in cities, with an increasing trend for further urbanization. Living in cities is associated with increased population density, traffic noise and pollution, but also with better access to health care and other commodities. Methods: This review is based on a selective literature search, providing an overview of the risk factors for mental illness in urban centers. Results: Studies have shown that the risk for serious mental illness is generally higher in cities compared to rural areas. Epidemiological studies have associated growing up and living in cities with a considerably higher risk for schizophrenia. However, correlation is not causation and living in poverty can both contribute to and result from impairments associated with poor mental health. Social isolation and discrimination as well as poverty in the neighborhood contribute to the mental health burden while little is known about specific inter actions between such factors and the built environment. Conclusion: Further insights on the interaction between spatial heterogeneity of neighborhood resources and socio-ecological factors is warranted and requires interdisciplinary research.
Y1 - 2017
U6 - https://doi.org/10.3238/arztebl.2017.0121
SN - 1866-0452
VL - 114
IS - 8
SP - 121
EP - 127
PB - Dt. Ärzte-Verl.
CY - Cologne
ER -
TY - JOUR
A1 - Rapp, Michael Armin
A1 - Mell, Thomas
A1 - Majic, Tomislav
A1 - Treusch, Yvonne
A1 - Nordheim, Johanna
A1 - Niemann-Mirmehdi, Mechthild
A1 - Gutzmann, Hans
A1 - Heinz, Andreas
T1 - Agitation in Nursing Home Residents With Dementia (VIDEANT Trial) - Effects of a Cluster-Randomized, Controlled, Guideline Implementation Trial
JF - Journal of the American Medical Directors Association
N2 - Objective: To test the effect of a complex guideline-based intervention on agitation and psychotropic prescriptions.
Design, Setting, Participants: Cluster randomized controlled trial (VIDEANT) with blinded assessment of outcome in 18 nursing homes in Berlin, Germany, comprising 304 dementia patients.
Intervention: Training, support, and activity therapy intervention, delivered at the level of each nursing home, focusing on the management of agitation in dementia. Control group nursing homes received treatment as usual.
Measurements: Levels of agitated and disruptive behavior (Cohen-Mansfield agitation inventory [CMAI]) as the primary outcome. Number of neuroleptics, antidepressants, and cholinesterase inhibitors (ChEIs) prescribed in defined daily dosages (DDDs).
Results: Of 326 patients screened, 304 (93.3%) were eligible and cluster-randomized to 9 intervention (n = 163) and 9 control (n = 141) nursing homes. Data were collected from 287 (94.4%) patients at 10 months. At 10 months, compared with controls, nursing home residents with dementia in the intervention group exhibited significantly less agitation as measured with the CMAI (adjusted mean difference, 6.24; 95% CI 2.03-14.14; P = .009; Cohen's d = 0.43), received fewer neuroleptics (P < .05), more ChEIs (P < .05), and more antidepressants (P < .05).
Conclusion: Complex guideline-based interventions are effective in reducing agitated and disruptive behavior in nursing home residents with dementia. At the same time, increased prescription of ChEIs and antidepressants together with decreased neuroleptic prescription suggests an effect toward guideline-based pharmacotherapy.
KW - Dementia
KW - agitation
KW - nursing home
KW - guideline
KW - trial
Y1 - 2013
U6 - https://doi.org/10.1016/j.jamda.2013.05.017
SN - 1525-8610
VL - 14
IS - 9
SP - 690
EP - 695
PB - Elsevier
CY - New York
ER -
TY - JOUR
A1 - Majic, Tomislav
A1 - Gutzmann, Hans
A1 - Heinz, Andreas
A1 - Lang, Undine E.
A1 - Rapp, Michael Armin
T1 - Animal-assisted therapy and agitation and depression in nursing home residents with dementia - a matched case-control trial
JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
N2 - Objectives: To investigate the efficacy of animal-assisted therapy (AAT) on symptoms of agitation/aggression and depression in nursing home residents with dementia in a randomized controlled trial. Previous studies have indicated that AAT has beneficial effects on neuropsychiatric symptoms in various psychiatric disorders but few studies have investigated the efficacy of AAT in patients suffering from dementia. Methods: Of 65 nursing home residents with dementia (mean [standard deviation] age: 81.8 [9.2] years; mean Mini-Mental State Examination score: 7.1 [0.7]), 27 matched pairs (N = 54) were randomly assigned to either treatment as usual or treatment as usual combined with AAT, administered over 10 weekly sessions. Blinded raters assessed cognitive impairment with the Mini-Mental State Examination, presence of agitation/aggression with the Cohen-Mansfield Agitation Inventory, and depression with the Dementia Mood Assessment Scale at baseline and during a period of 4 weeks after AAT intervention. Results: In the control group, symptoms of agitation/aggression and depression significantly increased over 10 weeks; in the intervention group, patients receiving combined treatment displayed constant frequency and severity of symptoms of agitation/aggression (F-1,F-48 = 6.43; p <0.05) and depression (F-1,F-48 = 26.54; p <0.001). Symptom amelioration did not occur in either group. Conclusions: AAT is a promising option for the treatment of agitation/aggression and depression in patients with dementia. Our results suggest that AAT may delay progression of neuropsychiatric symptoms in demented nursing home residents. Further research is needed to determine its long-time effects.
KW - AAT
KW - Alzheimer disease
KW - agitation
KW - animal-assisted therapy
KW - BPSD
KW - depression
KW - dog-assisted therapy
KW - nursing home
Y1 - 2013
U6 - https://doi.org/10.1016/j.jagp.2013.03.004
SN - 1064-7481
SN - 1545-7214
VL - 21
IS - 11
SP - 1052
EP - 1059
PB - Lippincott Williams & Wilkins
CY - Philadelphia
ER -
TY - JOUR
A1 - Deserno, Lorenz
A1 - Beck, Anne
A1 - Huys, Quentin J. M.
A1 - Lorenz, Robert C.
A1 - Buchert, Ralph
A1 - Buchholz, Hans-Georg
A1 - Plotkin, Michail
A1 - Kumakara, Yoshitaka
A1 - Cumming, Paul
A1 - Heinze, Hans-Jochen
A1 - Grace, Anthony A.
A1 - Rapp, Michael Armin
A1 - Schlagenhauf, Florian
A1 - Heinz, Andreas
T1 - Chronic alcohol intake abolishes the relationship between dopamine synthesis capacity and learning signals in the ventral striatum
JF - European journal of neuroscience
N2 - Drugs of abuse elicit dopamine release in the ventral striatum, possibly biasing dopamine-driven reinforcement learning towards drug-related reward at the expense of non-drug-related reward. Indeed, in alcohol-dependent patients, reactivity in dopaminergic target areas is shifted from non-drug-related stimuli towards drug-related stimuli. Such hijacked' dopamine signals may impair flexible learning from non-drug-related rewards, and thus promote craving for the drug of abuse. Here, we used functional magnetic resonance imaging to measure ventral striatal activation by reward prediction errors (RPEs) during a probabilistic reversal learning task in recently detoxified alcohol-dependent patients and healthy controls (N=27). All participants also underwent 6-[F-18]fluoro-DOPA positron emission tomography to assess ventral striatal dopamine synthesis capacity. Neither ventral striatal activation by RPEs nor striatal dopamine synthesis capacity differed between groups. However, ventral striatal coding of RPEs correlated inversely with craving in patients. Furthermore, we found a negative correlation between ventral striatal coding of RPEs and dopamine synthesis capacity in healthy controls, but not in alcohol-dependent patients. Moderator analyses showed that the magnitude of the association between dopamine synthesis capacity and RPE coding depended on the amount of chronic, habitual alcohol intake. Despite the relatively small sample size, a power analysis supports the reported results. Using a multimodal imaging approach, this study suggests that dopaminergic modulation of neural learning signals is disrupted in alcohol dependence in proportion to long-term alcohol intake of patients. Alcohol intake may perpetuate itself by interfering with dopaminergic modulation of neural learning signals in the ventral striatum, thus increasing craving for habitual drug intake.
KW - alcohol addiction
KW - dopamine
KW - fMRI
KW - PET
KW - prediction error
Y1 - 2015
U6 - https://doi.org/10.1111/ejn.12802
SN - 0953-816X
SN - 1460-9568
VL - 41
IS - 4
SP - 477
EP - 486
PB - Wiley-Blackwell
CY - Hoboken
ER -
TY - JOUR
A1 - Haegele, Claudia
A1 - Schlagenhauf, Florian
A1 - Rapp, Michael Armin
A1 - Sterzer, Philipp
A1 - Beck, Anne
A1 - Bermpohl, Felix
A1 - Stoy, Meline
A1 - Stroehle, Andreas
A1 - Wittchen, Hans-Ulrich
A1 - Dolan, Raymond J.
A1 - Heinz, Andreas
T1 - Dimensional psychiatry: reward dysfunction and depressive mood across psychiatric disorders
JF - Psychopharmacology
N2 - A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries.
We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative mood) of such an impairment.
During reward anticipation, we observed significant group differences in ventral striatal (VS) activation: patients with schizophrenia, alcohol dependence, and major depression showed significantly less ventral striatal activation compared to healthy controls. Depressive symptoms correlated with dysfunction in reward anticipation regardless of diagnostic entity. There was no significant correlation between anxiety symptoms and VS functional activation.
Our findings demonstrate a neurobiological dysfunction related to reward prediction that transcended disorder categories and was related to measures of depressed mood. The findings underline the potential of a dimensional approach in psychiatry and strengthen the hypothesis that neurobiological research in psychiatric disorders can be targeted at core mechanisms that are likely to be implicated in a range of clinical entities.
KW - Dimensional
KW - fMRI
KW - Reward system
KW - Ventral striatum
KW - Monetary incentive delay task
KW - Depressive symptoms
Y1 - 2015
U6 - https://doi.org/10.1007/s00213-014-3662-7
SN - 0033-3158
SN - 1432-2072
VL - 232
IS - 2
SP - 331
EP - 341
PB - Springer
CY - New York
ER -
TY - JOUR
A1 - Aichberger, Marion Christina
A1 - Montesinos, Amanda Heredia
A1 - Bromand, Zohra
A1 - Yesil, Rahsan
A1 - Temur-Erman, Selver
A1 - Rapp, Michael Armin
A1 - Heinz, Andreas
A1 - Schouler-Ocak, Meryam
T1 - Suicide attempt rates and intervention effects in women of Turkish origin in Berlin
JF - European psychiatry : the journal of the Association of European Psychiatrists
N2 - 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.
KW - Suicide attempt
KW - Incidence rates
KW - Turkish migrants
KW - Intervention study
Y1 - 2015
U6 - https://doi.org/10.1016/j.eurpsy.2014.12.003
SN - 0924-9338
SN - 1778-3585
VL - 30
IS - 4
SP - 480
EP - 485
PB - Elsevier
CY - Paris
ER -
TY - JOUR
A1 - Treusch, Yvonne
A1 - Majic, Tomislav
A1 - Page, Julie
A1 - Gutzmann, Hans
A1 - Heinz, Andreas
A1 - Rapp, Michael Armin
T1 - Apathy in nursing home residents with dementia: Results from a cluster-randomized controlled trial
JF - European psychiatry : the journal of the Association of European Psychiatrists
N2 - Purpose: Here we evaluate an interdisciplinary occupational and sport therapy intervention for dementia patients suffering from apathy.
Subjects and methods: A prospective, controlled, rater-blinded, clinical trial with two follow-ups was conducted as part of a larger cluster-randomized trial in 18 nursing homes in Berlin. n = 117 dementia patients with apathy, defined as a score of 40 or more on the apathy evaluation scale (AES) or presence of apathy on the Neuropsychiatric Inventory (NPI), were randomly assigned to intervention or control group. The intervention included 10 months of brief activities, provided once a week. The primary outcome measure was the total score on the AES scale measured directly after the intervention period and again after 12 months.
Results: We found significant group differences with respect to apathy during the 10 month intervention period (F-2,F-82 = 7.79, P < 0.01), which reflected an increase in apathy in the control group, but not in the intervention group. Within one year after the intervention was ceased, the treatment group worsened and no longer differed significantly from the control group (P = 0.55).
Conclusions: Our intervention was effective for the therapy of apathy in dementia, when applied, but not one year after cessation of therapy. (C) 2014 Elsevier Masson SAS. All rights reserved.
KW - Dementia
KW - Apathy
KW - Non-pharmacological intervention
KW - Occupational therapy
KW - Sport therapy
Y1 - 2015
U6 - https://doi.org/10.1016/j.eurpsy.2014.02.004
SN - 0924-9338
SN - 1778-3585
VL - 30
IS - 2
PB - Elsevier
CY - Paris
ER -
TY - GEN
A1 - Rapp, Michael Armin
A1 - Kluge, Ulrike
A1 - Penka, Simone
A1 - Vardar, Azra
A1 - Aichberger, Marion Christina
A1 - Mundt, Adrian P.
A1 - Schouler-Ocak, Meryam
A1 - Mösko, Mike
A1 - Butler, Jeffrey
A1 - Meyer-Lindenberg, Andreas
A1 - Heinz, Andreas
T1 - When local poverty is more important than your income: Mental health in minorities in inner cities
T2 - World psychiatry
Y1 - 2015
U6 - https://doi.org/10.1002/wps.20221
SN - 1723-8617
SN - 2051-5545
VL - 14
IS - 2
SP - 249
EP - 250
PB - Wiley-Blackwell
CY - Hoboken
ER -
TY - INPR
A1 - Heinz, Andreas
A1 - Charlet, Katrin
A1 - Rapp, Michael Armin
T1 - Public mental health: a call to action
T2 - World psychiatry
Y1 - 2015
U6 - https://doi.org/10.1002/wps.20182
SN - 1723-8617
SN - 2051-5545
VL - 14
IS - 1
SP - 49
EP - 50
PB - Wiley-Blackwell
CY - Hoboken
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 Armin
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 - GEN
A1 - Heinz, Andreas
A1 - Beck, Anne
A1 - Rapp, Michael Armin
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 - GEN
A1 - Hägele, Claudia
A1 - Schlagenhauf, Florian
A1 - Rapp, Michael Armin
A1 - Sterzer, Philipp
A1 - Beck, Anne
A1 - Bermpohl, Felix
A1 - Stoy, Meline
A1 - Ströhle, Andreas
A1 - Wittchen, Hans-Ulrich
A1 - Dolan, Raymond J.
A1 - Heinz, Andreas
T1 - Dimensional psychiatry
BT - reward dysfunction and depressive mood across psychiatric disorders
T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries.
We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative mood) of such an impairment.
We used functional magnetic resonance imaging (fMRI) and a monetary incentive delay (MID) task to study the functional correlates of reward anticipation across major psychiatric disorders in 184 subjects, with the diagnoses of alcohol dependence (n = 26), schizophrenia (n = 44), major depressive disorder (MDD, n = 24), bipolar disorder (acute manic episode, n = 13), attention deficit/hyperactivity disorder (ADHD, n = 23), and healthy controls (n = 54). Subjects' individual Beck Depression Inventory-and State-Trait Anxiety Inventory-scores were correlated with clusters showing significant activation during reward anticipation.
During reward anticipation, we observed significant group differences in ventral striatal (VS) activation: patients with schizophrenia, alcohol dependence, and major depression showed significantly less ventral striatal activation compared to healthy controls. Depressive symptoms correlated with dysfunction in reward anticipation regardless of diagnostic entity. There was no significant correlation between anxiety symptoms and VS functional activation.
Our findings demonstrate a neurobiological dysfunction related to reward prediction that transcended disorder categories and was related to measures of depressed mood. The findings underline the potential of a dimensional approach in psychiatry and strengthen the hypothesis that neurobiological research in psychiatric disorders can be targeted at core mechanisms that are likely to be implicated in a range of clinical entities.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 653
KW - dimensional
KW - fMRI
KW - reward system
KW - ventral striatum
KW - monetary incentive delay task
KW - depressive symptoms
Y1 - 2020
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-431064
SN - 1866-8364
IS - 653
SP - 331
EP - 341
ER -
TY - GEN
A1 - Friedel, Eva
A1 - Schlagenhauf, Florian
A1 - Beck, Anne
A1 - Dolan, Raymond J.
A1 - Huys, Quentin J. M.
A1 - Rapp, Michael Armin
A1 - Heinz, Andreas
T1 - The effects of life stress and neural learning signals on fluid intelligence
T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - Fluid intelligence (fluid IQ), defined as the capacity for rapid problem solving and behavioral adaptation, is known to be modulated by learning and experience. Both stressful life events (SLES) and neural correlates of learning [specifically, a key mediator of adaptive learning in the brain, namely the ventral striatal representation of prediction errors (PE)] have been shown to be associated with individual differences in fluid IQ. Here, we examine the interaction between adaptive learning signals (using a well-characterized probabilistic reversal learning task in combination with fMRI) and SLES on fluid IQ measures. We find that the correlation between ventral striatal BOLD PE and fluid IQ, which we have previously reported, is quantitatively modulated by the amount of reported SLES. Thus, after experiencing adversity, basic neuronal learning signatures appear to align more closely with a general measure of flexible learning (fluid IQ), a finding complementing studies on the effects of acute stress on learning. The results suggest that an understanding of the neurobiological correlates of trait variables like fluid IQ needs to take socioemotional influences such as chronic stress into account.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 621
KW - reinforcement learning
KW - prediction error signal
KW - ventral striatum
KW - stress
KW - intelligence
Y1 - 2020
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-435140
SN - 1866-8372
IS - 621
SP - 35
EP - 43
ER -
TY - GEN
A1 - Herold, Fabian
A1 - Theobald, Paula
A1 - Gronwald, Thomas
A1 - Rapp, Michael Armin
A1 - Müller, Notger Germar
T1 - Going digital – a commentary on the terminology used at the intersection of physical activity and digital health
T2 - Zweitveröffentlichungen der Universität Potsdam : Gesundheitswissenschaftliche Reihe
N2 - In recent years digital technologies have become a major means for providing health-related services and this trend was strongly reinforced by the current Coronavirus disease 2019 (COVID-19) pandemic. As it is well-known that regular physical activity has positive effects on individual physical and mental health and thus is an important prerequisite for healthy aging, digital technologies are also increasingly used to promote unstructured and structured forms of physical activity. However, in the course of this development, several terms (e.g., Digital Health, Electronic Health, Mobile Health, Telehealth, Telemedicine, and Telerehabilitation) have been introduced to refer to the application of digital technologies to provide health-related services such as physical interventions. Unfortunately, the above-mentioned terms are often used in several different ways, but also relatively interchangeably. Given that ambiguous terminology is a major source of difficulty in scientific communication which can impede the progress of theoretical and empirical research, this article aims to make the reader aware of the subtle differences between the relevant terms which are applied at the intersection of physical activity and Digital Health and to provide state-of-art definitions for them.
T3 - Zweitveröffentlichungen der Universität Potsdam : Gesundheitswissenschaftliche Reihe - 5
KW - Digital Health
KW - Electronic Health
KW - Mobile Health
KW - Telehealth
KW - Telemedicine
KW - Physical activity
KW - Physical training
KW - Aging
Y1 - 2023
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-581301
IS - 5
ER -
TY - JOUR
A1 - Herold, Fabian
A1 - Theobald, Paula
A1 - Gronwald, Thomas
A1 - Rapp, Michael Armin
A1 - Müller, Notger Germar
T1 - Going digital – a commentary on the terminology used at the intersection of physical activity and digital health
JF - European review of aging and physical activity
N2 - In recent years digital technologies have become a major means for providing health-related services and this trend was strongly reinforced by the current Coronavirus disease 2019 (COVID-19) pandemic. As it is well-known that regular physical activity has positive effects on individual physical and mental health and thus is an important prerequisite for healthy aging, digital technologies are also increasingly used to promote unstructured and structured forms of physical activity. However, in the course of this development, several terms (e.g., Digital Health, Electronic Health, Mobile Health, Telehealth, Telemedicine, and Telerehabilitation) have been introduced to refer to the application of digital technologies to provide health-related services such as physical interventions. Unfortunately, the above-mentioned terms are often used in several different ways, but also relatively interchangeably. Given that ambiguous terminology is a major source of difficulty in scientific communication which can impede the progress of theoretical and empirical research, this article aims to make the reader aware of the subtle differences between the relevant terms which are applied at the intersection of physical activity and Digital Health and to provide state-of-art definitions for them.
KW - Digital Health
KW - Electronic Health
KW - Mobile Health
KW - Telehealth
KW - Telemedicine
KW - Physical activity
KW - Physical training
KW - Aging
Y1 - 2022
U6 - https://doi.org/10.1186/s11556-022-00296-y
SN - 1861-6909
VL - 19
PB - Springer
CY - Berlin ; Heidelberg
ER -
TY - CHAP
A1 - Dahling, Volker
A1 - May, Susann
A1 - Greiner, Timo
A1 - Thoma, Samuel
A1 - Peter, Sebastian von
A1 - Schwantes, Ulrich
A1 - Rapp, Michael Armin
A1 - Heinze, Martin
T1 - Verschreibungspraxis von Psychopharmaka in brandenburgischen Pflegeheimen
T2 - Zeitschrift für Gerontologie und Geriatrie : Organ der Deutschen Gesellschaft für Gerontologie und Geriatrie
T2 - Prescribing practice of psychotropic drugs in Brandenburg nursing homes
Y1 - 2021
SN - 0948-6704
SN - 1435-1269
VL - 54
IS - SUPPL 1
SP - S26
EP - S26
PB - Springer Medizin
CY - Heidelberg
ER -
TY - GEN
A1 - Gellert, Paul
A1 - Häusler, Andreas
A1 - Suhr, Ralf
A1 - Gholami, Maryam
A1 - Rapp, Michael Armin
A1 - Kuhlmey, Adelheid
A1 - Nordheim, Johanna
T1 - Testing the stress-buffering hypothesis of social support in couples coping with early-stage dementia
T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - Purpose
To test whether the negative relationship between perceived stress and quality of life (Hypothesis 1) can be buffered by perceived social support in patients with dementia as well as in caregivers individually (Hypothesis 2: actor effects) and across partners (Hypothesis 3: partner effects and actor-partner effects).
Method
A total of 108 couples (N = 216 individuals) comprised of one individual with early-stage dementia and one caregiving partner were assessed at baseline and one month apart. Moderation effects were investigated by applying linear mixed models and actor-partner interdependence models.
Results
Although the stress-quality of life association was more pronounced in caregivers (beta = -.63, p<.001) compared to patients (beta= -.31, p<.001), this association was equally moderated by social support in patients (beta = .14, p<.05) and in the caregivers (beta =.13, p<.05). From one partner to his or her counterpart, the partner buffering and actor-partner-buffering effect were not present.
Conclusion
The stress-buffering effect has been replicated in individuals with dementia and caregivers but not across partners. Interventions to improve quality of life through perceived social support should not only focus on caregivers, but should incorporate both partners.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 657
KW - partner interdependence model
KW - Quality-of-life
KW - Alzheimers disease
KW - depressive symptomatology
KW - longitudinal cohort
KW - caregivers
KW - health
KW - communication
KW - metaanalysis
KW - association
Y1 - 2020
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-446270
SN - 1866-8364
IS - 657
ER -
TY - JOUR
A1 - Drosselmeyer, Julia
A1 - Rapp, Michael Armin
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 - Konrad, Marcel
A1 - Bohlken, Jens
A1 - Rapp, Michael Armin
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 Armin
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 Armin
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 Armin
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 - Mell, Thomas
A1 - Jacob, Louis
A1 - Fuhr, Ida
A1 - Dick, Sandra
A1 - Rapp, Michael Armin
A1 - Kostev, Karel
T1 - Patterns of benzodiazepine prescribing by neuropsychiatrists and general practitioners for elderly patients in Germany in 2014
JF - International journal of clinical pharmacology and therapeutics
N2 - Background: The patterns of benzodiazepine prescriptions in older adults are of general and scientific interest as they are not yet well understood. The aim of this study was to compare the prescription patterns of benzodiazepines in elderly people in Germany to determine the share or proportion treated by general practitioners (GP) and neuropsychiatrists (NP). Methods: This study included 31,268 and 6,603 patients between the ages of 65 and 100 with at least one benzodiazepine prescription in 2014 from GP and NP, respectively. Demographic data included age, gender, and type of health insurance coverage. The share of elderly people with benzodiazepine prescriptions was estimated in different age and disease groups for both GP and NP patients. The share of the six most commonly prescribed drugs was also calculated for each type of practice. Results: The share of people taking benzodiazepines prescribed by GP increased from 3.2% in patients aged between 65 and 69 years to 8.6% in patients aged between 90 and 100 years, whereas this share increased from 5.4% to 7.1% in those seen by NP. Benzodiazepines were frequently used by patients suffering from sleep disorders (GP: 33.9%; NP: 5.5%), depression (GP: 17.9%; NP: 29.8%), and anxiety disorders (GP: 14.5%; NP: 22.8%). Lorazepam (30.3%), oxazepam (24.7%), and bromazepam (24.3%) were the three most commonly prescribed drugs for GP patients. In contrast, lorazepam (60.4%), diazepam (14.8%), and oxazepam (11.2%) were those more frequently prescribed to NP patients. Conclusion: Prescription patterns of benzodiazepine in the elderly varied widely between GP and NP.
KW - benzodiazepines
KW - prescription patterns
KW - elderly people
KW - Germany
Y1 - 2017
U6 - https://doi.org/10.5414/CP202904
SN - 0946-1965
VL - 55
SP - 466
EP - 471
PB - Dustri-Verlag Dr. Karl Feistle
CY - Deisenhofen-München
ER -
TY - GEN
A1 - Chaparro, Camilo G. A. Perez
A1 - Zech, Philipp A.
A1 - Heinzel, Stephan
A1 - Mayer, Frank
A1 - Wolfarth, Bernd
A1 - Rapp, Michael Armin
A1 - Heissel, Andreas
T1 - Effects Of Aerobic & Resistance Training On Cardiorespiratory Fitness In People Living with HIV. A Meta-analysis
T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine
Y1 - 2017
U6 - https://doi.org/10.1249/01.mss.0000519265.28705.86
SN - 0195-9131
SN - 1530-0315
VL - 49
SP - 842
EP - 842
PB - Lippincott Williams & Wilkins
CY - Philadelphia
ER -
TY - GEN
A1 - Zech, Philipp A.
A1 - Rapp, Michael Armin
A1 - Heinzel, Stephan
A1 - Wolfarth, Bernd
A1 - Lawrence, Jimmy B.
A1 - Heissel, Andreas
T1 - Does Exercise Help People Living with HIV Improve Their Quality of Life? A meta-analysis.
T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine
Y1 - 2017
U6 - https://doi.org/10.1249/01.mss.0000518177.22369.2f
SN - 0195-9131
SN - 1530-0315
VL - 49
SP - 470
EP - 470
PB - Lippincott Williams & Wilkins
CY - Philadelphia
ER -
TY - JOUR
A1 - Bohlken, Jens
A1 - Jacob, Louis
A1 - Schaum, Peter
A1 - Rapp, Michael Armin
A1 - Kostev, Karel
T1 - Hip fracture risk in patients with dementia in German primary care practices
JF - Dementia
N2 - The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65-90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance. The primary outcome was the diagnosis of hip fracture during the three-year follow-up period. A total of 53,156 dementia patients and 53,156 controls were included. A total of 5.3% of patients and 0.7% of controls displayed hip fracture after three years. Hip fracture occurred more frequently in dementia subjects living in nursing homes than in those living at home (9.2% versus 4.3%). Dementia, residence in nursing homes, and osteoporosis were risk factors for fracture development. Antidementia, antipsychotic, and antidepressant drugs generally had no significant impact on hip fracture risk when prescribed for less than six months. Dementia increased hip fracture risk in German primary care practices.
KW - hip fracture
KW - dementia
KW - nursing homes
KW - osteoporosis
KW - risk factors
Y1 - 2015
U6 - https://doi.org/10.1177/1471301215621854
SN - 1471-3012
SN - 1741-2684
VL - 16
SP - 853
EP - 864
PB - Sage Publ.
CY - London
ER -
TY - GEN
A1 - Schraplau, Anne
A1 - Block, Andrea
A1 - Häusler, Andreas
A1 - Wippert, Pia-Maria
A1 - Rapp, Michael Armin
A1 - Völler, Heinz
A1 - Bonaventura, Klaus
A1 - Mayer, Frank
T1 - Mobile diagnostics and consultation for the prevention of the metabolic syndrome and its secondary diseases in Brandenburg—study protocol of a regional prospective cohort study: the Mobile Brandenburg Cohort
T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - Background
The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. The implementation of prevention programs requires early detection of individuals at risk. However, access to health care providers is limited in structurally weak regions. Brandenburg, a rural federal state in Germany, has an especially high MetS prevalence and disease burden. This study aims to validate and test the feasibility of a setup for mobile diagnostics of MetS and its secondary diseases, to evaluate the MetS prevalence and its association with moderating factors in Brandenburg and to identify new ways of early prevention, while establishing a “Mobile Brandenburg Cohort” to reveal new causes and risk factors for MetS.
Methods
In a pilot study, setups for mobile diagnostics of MetS and secondary diseases will be developed and validated. A van will be equipped as an examination room using point-of-care blood analyzers and by mobilizing standard methods. In study part A, these mobile diagnostic units will be placed at different locations in Brandenburg to locally recruit 5000 participants aged 40-70 years. They will be examined for MetS and advice on nutrition and physical activity will be provided. Questionnaires will be used to evaluate sociodemographics, stress perception, and physical activity. In study part B, participants with MetS, but without known secondary diseases, will receive a detailed mobile medical examination, including MetS diagnostics, medical history, clinical examinations, and instrumental diagnostics for internal, cardiovascular, musculoskeletal, and cognitive disorders. Participants will receive advice on nutrition and an exercise program will be demonstrated on site. People unable to participate in these mobile examinations will be interviewed by telephone. If necessary, participants will be referred to general practitioners for further diagnosis.
Discussion
The mobile diagnostics approach enables early detection of individuals at risk, and their targeted referral to local health care providers. Evaluation of the MetS prevalence, its relation to risk-increasing factors, and the “Mobile Brandenburg Cohort” create a unique database for further longitudinal studies on the implementation of home-based prevention programs to reduce mortality, especially in rural regions.
Trial registration
German Clinical Trials Register, DRKS00022764; registered 07 October 2020—retrospectively registered.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 759
KW - Metabolic syndrome
KW - Mobile diagnostics
KW - Prevention
KW - Nutrition
KW - Physical activity
KW - Rural health
Y1 - 2022
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-549506
SN - 1866-8364
SP - 1
EP - 11
PB - Universitätsverlag Potsdam
CY - Potsdam
ER -
TY - GEN
A1 - Heißel, Andreas
A1 - Bollmann, J
A1 - Kangas, Maria
A1 - Rapp, Michael Armin
A1 - Sánchez, Alba Cristina
A1 - Abdulla, K
T1 - Validation of the German version of the work and social adjustment scale in a sample of depressed patients
T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - Background
Depression is one of the key factors contributing to difficulties in one’s ability to work, and serves as one of the major reasons why employees apply for psychotherapy and receive insurance subsidization of treatments. Hence, an increasing and growing number of studies rely on workability assessment scales as their primary outcome measure. The Work and Social Assessment Scale (WSAS) has been documented as one of the most psychometrically reliable and valid tools especially developed to assess workability and social functioning in patients with mental health problems. Yet, the application of the WSAS in Germany has been limited due to the paucity of a valid questionnaire in the German language. The objective of the present study was to translate the WSAS, as a brief and easy administrable tool into German and test its psychometric properties in a sample of adults with depression.
Methods
Two hundred seventy-seven patients (M = 48.3 years, SD = 11.1) with mild to moderately severe depression were recruited. A multistep translation from English into the German language was performed and the factorial validity, criterion validity, convergent validity, discriminant validity, internal consistency, and floor and ceiling effects were examined.
Results
The confirmatory factor analysis results confirmed the one-factor structure of the WSAS. Significant correlations with the WHODAS 2–0 questionnaire, a measure of functionality, demonstrated good convergent validity. Significant correlations with depression and quality of life demonstrated good criterion validity. The WSAS also demonstrated strong internal consistency (α = .89), and the absence of floor and ceiling effects indicated good sensitivity of the instrument.
Conclusions
The results of the present study demonstrated that the German version of the WSAS has good psychometric properties comparable to other international versions of this scale. The findings recommend a global assessment of psychosocial functioning with the sum score of the WSAS.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 756
KW - Workability
KW - Social functioning
KW - Depression
KW - Psychometric evaluation
KW - Translation
Y1 - 2022
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-547810
SN - 1866-8364
SP - 1
EP - 11
PB - Universitätsverlag Potsdam
CY - Potsdam
ER -
TY - JOUR
A1 - Heißel, Andreas
A1 - Bollmann, Julian
A1 - Kangas, Maria
A1 - Abdulla, K
A1 - Rapp, Michael Armin
A1 - Sánchez Fernàndez, Alba Cristina
T1 - Validation of the German version of the work and social adjustment scale in a sample of depressed patients
JF - BMC health services research
N2 - Background
Depression is one of the key factors contributing to difficulties in one’s ability to work, and serves as one of the major reasons why employees apply for psychotherapy and receive insurance subsidization of treatments. Hence, an increasing and growing number of studies rely on workability assessment scales as their primary outcome measure. The Work and Social Assessment Scale (WSAS) has been documented as one of the most psychometrically reliable and valid tools especially developed to assess workability and social functioning in patients with mental health problems. Yet, the application of the WSAS in Germany has been limited due to the paucity of a valid questionnaire in the German language. The objective of the present study was to translate the WSAS, as a brief and easy administrable tool into German and test its psychometric properties in a sample of adults with depression.
Methods
Two hundred seventy-seven patients (M = 48.3 years, SD = 11.1) with mild to moderately severe depression were recruited. A multistep translation from English into the German language was performed and the factorial validity, criterion validity, convergent validity, discriminant validity, internal consistency, and floor and ceiling effects were examined.
Results
The confirmatory factor analysis results confirmed the one-factor structure of the WSAS. Significant correlations with the WHODAS 2–0 questionnaire, a measure of functionality, demonstrated good convergent validity. Significant correlations with depression and quality of life demonstrated good criterion validity. The WSAS also demonstrated strong internal consistency (α = .89), and the absence of floor and ceiling effects indicated good sensitivity of the instrument.
Conclusions
The results of the present study demonstrated that the German version of the WSAS has good psychometric properties comparable to other international versions of this scale. The findings recommend a global assessment of psychosocial functioning with the sum score of the WSAS.
KW - Workability
KW - Social functioning
KW - Depression
KW - Psychometric evaluation
KW - Translation
Y1 - 2021
U6 - https://doi.org/10.1186/s12913-021-06622-x
SN - 1472-6963
VL - 21
SP - 1
EP - 11
PB - BioMed Central
CY - London
ER -
TY - JOUR
A1 - Heinzel, Stephan
A1 - Lorenz, Robert C.
A1 - Quynh-Lam Duong,
A1 - Rapp, Michael Armin
A1 - Deserno, Lorenz
T1 - Prefrontal-parietal effective connectivity during working memory in older adults
JF - Neurobiology of Aging
N2 - Theoretical models and preceding studies have described age-related alterations in neuronal activation of frontoparietal regions in a working memory (WM)load-dependent manner. However, to date, underlying neuronal mechanisms of these WM load-dependent activation changes in aging remain poorly understood. The aim of this study was to investigate these mechanisms in terms of effective connectivity by application of dynamic causal modeling with Bayesian Model Selection. Eighteen healthy younger (age: 20-32 years) and 32 older (60-75 years) participants performed an n-back task with 3 WM load levels during functional magnetic resonance imaging (fMRI). Behavioral and conventional fMRI results replicated age group by WM load interactions. Importantly, the analysis of effective connectivity derived from dynamic causal modeling, indicated an age-and performance-related reduction in WM load-dependent modulation of connectivity from dorsolateral prefrontal cortex to inferior parietal lobule. This finding provides evidence for the proposal that age-related WM decline manifests as deficient WM load-dependent modulation of neuronal top-down control and can integrate implications from theoretical models and previous studies of functional changes in the aging brain.
KW - Aging
KW - Dynamic causal modeling (DCM)
KW - Effective connectivity
KW - Functional magnetic resonance imaging (fMRI)
KW - Working memory
Y1 - 2017
U6 - https://doi.org/10.1016/j.neurobiolaging.2017.05.005
SN - 0197-4580
SN - 1558-1497
VL - 57
SP - 18
EP - 27
PB - Elsevier
CY - New York
ER -
TY - JOUR
A1 - Deeken, Friederike
A1 - Häusler, Andreas
A1 - Nordheim, Johanna
A1 - Rapp, Michael Armin
A1 - Knoll, Nina
A1 - Rieckmann, Nina
T1 - Psychometric properties of the Perceived Stress Scale in a sample of German dementia patients and their caregivers
JF - International psychogeriatrics
N2 - 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.
KW - Perceived Stress Scale
KW - psychometric properties
KW - dementia
KW - caregiver
Y1 - 2017
U6 - https://doi.org/10.1017/S1041610217001387
SN - 1041-6102
SN - 1741-203X
VL - 30
IS - 1
SP - 39
EP - 47
PB - Cambridge Univ. Press
CY - New York
ER -
TY - JOUR
A1 - Gellert, Paul
A1 - Häusler, Andreas
A1 - Gholami, Maryam
A1 - Rapp, Michael Armin
A1 - Kuhlmey, Adelheid
A1 - Nordheim, Johanna
T1 - Own and partners’ dyadic coping and depressive symptoms in individuals with early-stage dementia and their caregiving partners
JF - Aging & Mental Health
N2 - Objectives: In patients with early-stage dementia and their caregiving partners, reciprocal dyadic coping (DC) is crucial for preventing or reducing depressive symptoms in both partners. This study examines the relationships between ‘own DC’ and ‘perceived partner DC’ with depressive symptoms in couples coping with dementia on individual (actor effects) and cross-person (partner effects) levels.
Method: 164 individuals (82 patients with early-stage dementia and their 82 caregiving partners; ND = 82 dyads) participated in this prospective study with measures (DC, depressive symptoms, and dementia severity) taken at baseline and at six months. Each partner evaluated their own and the perceived partner DC. Actor–partner interdependence models were applied to the resulting four independent evaluations.
Results: Results differed substantially between patients and caregivers. DC was significantly related to patients’ but not to caregivers’ depressive symptoms, when adjustments were made for individual coping. Perceived partner DC showed a negative association with depressive symptoms in patients, whereas own DC was adversely related for actor as well as for partner effects across individuals.
Conclusion: The adverse association between the own DC of the caregiver and the patient on depressive symptoms of the patient might be due to inappropriate efforts or to the loss of autonomy as a care-receiver. DC is important in both patients and caregivers, as shown by the negative association between perceived partner DC and depressive symptoms in the patients, which might inform interventions that target the couple as a whole.
KW - Dyadic coping
KW - dementia
KW - actor-partner interdependence model
KW - caregiver
KW - quality of life
KW - depression
Y1 - 2017
U6 - https://doi.org/10.1080/13607863.2017.1334759
SN - 1360-7863
SN - 1364-6915
VL - 22
IS - 8
SP - 1008
EP - 1016
PB - Routledge, Taylor & Francis Group
CY - Abingdon
ER -
TY - JOUR
A1 - Meiberth, Dix Urs
A1 - Rapp, Michael Armin
A1 - Jessen, Frank
T1 - Gedächtnisambulanzstrukturen in Deutschland – Ergebnisse einer Klinikbefragung
JF - Psychiatrische Praxis
N2 - Ziel der Studie Erfassung der Strukturen zur Frühdiagnostik von Demenzen an Krankenhäusern in Deutschland.
Methodik Fragebogenerhebung.
Ergebnisse 14 % von 1758 kontaktierten Einrichtungen antworteten. 52 % berichteten über ein entsprechendes Angebot, zum großen Teil mit leitlinienorientierten Verfahren, wie Liquordiagnostik. Das Diagnosespektrum umfasste zu 46 % Demenzen und zu 41 % Diagnosen der leichten oder subjektiven kognitiven Störung.
Schlussfolgerung Leitlinienbasierte Diagnostik und Früherkennungskonzepte sind in Gedächtnisambulanzen weitgehend etabliert.
N2 - Objective To assess the structures for early and differential diagnosis of dementia in hospitals in Germany.
Methods Written questionnaire to all German hospitals.
Results 14 % of 1.758 hospitals responded. Of those, 52 % reported to offer a special service for early dementia diagnosis, mostly on an outpatient basis. The applied methods were in agreement with the national guideline for diagnosis and treatment of dementias, including technical diagnostics, such as neuroimaging and cerebrospinal fluid examinations. 46 % of the diagnostic spectrum were dementia. 41 % were either diagnosed as mild cognitive impairment (MCI) or as subjective cognitive decline (SCD).
Conclusion Despite mostly insufficient reimbursement, a large proportion of the responding hospitals offer a specialized service, which largely adheres to guideline-based diagnostic procedures. The concepts of at-risk and prodromal stages of dementia seem to be largely established.
T2 - Memory Clinics in Germany - Results of a Hospital Survey
KW - dementia
KW - Alzheimer
KW - memory clinic
KW - early diagnosis
KW - Demenz
KW - Alzheimer
KW - Gedächtnisambulanz
KW - Frühdiagnose
Y1 - 2019
U6 - https://doi.org/10.1055/a-0825-9049
SN - 0303-4259
SN - 1439-0876
VL - 46
IS - 4
SP - 213
EP - 216
PB - Thieme
CY - Stuttgart
ER -
TY - JOUR
A1 - Deeken, Friederike
A1 - Rezo, Anna
A1 - Hinz, Matthias
A1 - Discher, Robert
A1 - Rapp, Michael Armin
T1 - Evaluation of technology-based interventions for informal caregivers of patients with dementia
BT - a Meta-Analysis of Randomized Controlled Trials
JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
N2 - Objective: The aim of this study was to estimate the efficacy of technology-based interventions for informal caregivers of people with dementia (PWD). Methods: PubMed, PsycINFO, and Cochrane Library databases were searched in August 2018, with no restrictions in language or publication date. Two independent reviewers identified 33 eligible randomized controlled trials (RCTs) conducting a technology-based intervention for informal carers of PWD. Meta-analyses for the outcome measures caregiver depression and caregiver burden were conducted with subgroup analyses according to mode of delivery (telephone, computer/web-based, combined interventions). To assess methodologic quality, the Cochrane risk-of-bias assessment was rated. Results: Meta-analyses revealed a small but significant postintervention effect of technology-based interventions for caregiver depression and caregiver burden. Combined interventions showed the strongest effects. Conclusion: Technology-based interventions have the potential to support informal caregivers of PWD. Because of advantages such as high flexibility and availability, technology-based interventions provide a promising alternative compared with "traditional services," e.g., those for people living in rural areas. More high-quality RCTs for specific caregiver groups are needed.
KW - Caregiver
KW - dementia
KW - technology
KW - meta-analysis
Y1 - 2019
U6 - https://doi.org/10.1016/j.jagp.2018.12.003
SN - 1064-7481
SN - 1545-7214
VL - 27
IS - 4
SP - 426
EP - 445
PB - Elsevier
CY - New York
ER -
TY - JOUR
A1 - Bohlken, Jens
A1 - Weber, Simon A.
A1 - Siebert, Anke
A1 - Forstmeier, Simon
A1 - Kohlmann, Thomas
A1 - Rapp, Michael Armin
T1 - Reminiscence therapy for depression in dementia
BT - An observational study with matched pairs
JF - GeroPsych - The Journal of gerontopsychology and geriatric psychiatry
N2 - 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.
KW - reminiscence
KW - life story book
Y1 - 2017
U6 - https://doi.org/10.1024/1662-9647/a000175
SN - 1662-9647
SN - 1662-971X
VL - 30
SP - 145
EP - 151
PB - Hogrefe
CY - Göttingen
ER -
TY - GEN
A1 - Thomas, Christine
A1 - Sabbah, Patricia
A1 - Rapp, Michael Armin
A1 - Eschweiler, Gerhard
T1 - The Perioperative Care of Older Patients
T2 - Deutsches Ärzteblatt international : a weekly online journal of clinical medicine and public health
T2 - Bedarf für eine perioperative Altersmedizin
Y1 - 2019
U6 - https://doi.org/10.3238/arztebl.2019.0373a
SN - 1866-0452
VL - 116
IS - 21
SP - 373
EP - 373
PB - Dt. Ärzte-Verl.
CY - Cologne
ER -
TY - JOUR
A1 - Sturm, Heidrun
A1 - Wildermuth, Ronja
A1 - Stolz, Regina
A1 - Bertram, L.
A1 - Eschweiler, G. W.
A1 - Thomas, C.
A1 - Rapp, Michael Armin
A1 - Joos, S.
T1 - Diverging awareness of postoperative delirium and cognitive dysfunction in German Health Care Providers
JF - Clinical interventions in agins
N2 - Purpose: Postoperative cognitive dysfunction (POCD) appears in up to 30% of patients suffering from postoperative delirium (POD). Both are associated with higher mortality and postoperative complications, prolonged hospital stays, and increased costs. Multi-modal models with pre-admission risk reduction counselling, perioperative monitoring, and training of multidisciplinary patient care providers have been shown to decrease the prevalence of both. The aim of our study is to understand how far those measures are known and implemented in routine care and to detect potential gaps in the current practice regarding risk communication and information flow between involved caregivers for patients at risk for POD/POCD. Patients and Methods: As part of a multicenter study, seven semi-structured focus group (FG) discussions with nurses and physicians from tertiary care hospitals (surgery, anesthesiology, and orthopedics, n=31) and general practitioners (GPs) in private practice (n=7) were performed. Transcribed discussions were analyzed using qualitative content analysis. Results: POD is present above all in the daily work of nurses, whereas physicians do not perceive it as a relevant problem. Physicians report that no regular risk assessment or risk communication was performed prior to elective surgery. Information about POD often gets lost during hand-offs and is not regularly reported in discharge letters. Thus, persisting cognitive dysfunction is often missed. The importance of standardized documentation and continuous education concerning risks, screening, and treatment was emphasized. The often-suggested pre-OP medication adjustment was seen as less important; in contrast, avoiding withdrawal was regarded as far more important. Conclusion: Altogether, it seems that standards and available best practice concepts are rarely implemented. In contrast to physicians, nurses are highly aware of delirium and ask for standardized procedures and more responsibility. Therefore, raising awareness regarding risks, screening tools, and effective preventive measures for POD/POCD seems an urgent goal. Nurses should have a central role in coordination and care of POD to prevent the risk for POCD.
KW - cross-sectoral care
KW - delirium prevention
KW - postoperative cognitive dysfunction
KW - POCD
KW - dementia
KW - clinical pathways
KW - risk screening
Y1 - 2019
U6 - https://doi.org/10.2147/CIA.S230800
SN - 1178-1998
VL - 14
SP - 2125
EP - 2135
PB - DOVE Medical Press
CY - Albany
ER -
TY - JOUR
A1 - Gellert, Paul
A1 - Häusler, Andreas
A1 - Suhr, Ralf
A1 - Gholami, Maryam
A1 - Rapp, Michael Armin
A1 - Kuhlmey, Adelheid
A1 - Nordheim, Johanna
T1 - Testing the stress-buffering hypothesis of social support in couples coping with early-stage dementia
JF - PLoS one
N2 - Purpose:
To test whether the negative relationship between perceived stress and quality of life (Hypothesis 1) can be buffered by perceived social support in patients with dementia as well as in caregivers individually (Hypothesis 2: actor effects) and across partners (Hypothesis 3: partner effects and actor-partner effects).
Method:
A total of 108 couples (N = 216 individuals) comprised of one individual with early-stage dementia and one caregiving partner were assessed at baseline and one month apart. Moderation effects were investigated by applying linear mixed models and actor-partner interdependence models.
Results:
Although the stress-quality of life association was more pronounced in caregivers (beta = -.63, p<.001) compared to patients (beta= -.31, p<.001), this association was equally moderated by social support in patients (beta = .14, p<.05) and in the caregivers (beta =.13, p<.05). From one partner to his or her counterpart, the partner buffering and actor-partner-buffering effect were not present.
Conclusion:
The stress-buffering effect has been replicated in individuals with dementia and caregivers but not across partners. Interventions to improve quality of life through perceived social support should not only focus on caregivers, but should incorporate both partners.
Y1 - 2018
U6 - https://doi.org/10.1371/journal.pone.0189849
SN - 1932-6203
VL - 13
IS - 1
PB - PLoS
CY - San Fransisco
ER -
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 Armin
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 - Drosselmeyer, J.
A1 - Rapp, Michael Armin
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 Armin
A1 - Kostev, Karel
T1 - Treatment of depression in patients with cardiovascular diseases by German psychiatrists
JF - International journal of clinical pharmacology and therapeutics
N2 - Objective: To estimate the prevalence and the type of antidepressant medication prescribed by German psychiatrists to patients with depression and cardiovascular diseases (CVD). Methods: This study was a retrospective database analysis in Germany using the Disease Analyzer Database (IMS Health, Germany). The study population included 2,288 CVD patients between 40 and 90 years of age from 175 psychiatric practices. The observation period was between 2004 and 2013. Follow-up lasted up to 12 months and ended in April 2015. Also included were 2,288 non-CVD controls matched (1 : 1) to CVD cases on the basis of age, gender, health insurance coverage, depression severity, and diagnosing physician. Results: Mean age was 68.6 years. 46.2% of patients were men, and 5.9% had private health insurance coverage. Mild, moderate, or severe depression was present in 18.7%, 60.7%, and 20.6% of patients, respectively. Most patients had treatment within a year, many of them immediately after depression diagnosis. Patients with moderate and severe depression were more likely to receive treatment than patients with mild depression. There was no difference between CVD and non-CVD in the proportion of patients treated. Nonetheless, CVD patients received selective serotonin reuptake inhibitors / serotonin-noradrenaline reuptake inhibitors (SSRIs/SNRIs) significantly more frequently. Conversely, patients without CVD were more often treated with TCA. Conclusion: There was no association between CVD and the initiation of depression treatment. Furthermore, CVD patients received SSRIs/SNRIs more frequently.
KW - depression
KW - cardiovascular diseases
KW - antidepressant therapy
KW - psychiatric practices
Y1 - 2016
U6 - https://doi.org/10.5414/CP202591
SN - 0946-1965
VL - 54
SP - 557
EP - 563
PB - Dustri-Verlag Dr. Karl Feistle
CY - Deisenhofen-München
ER -
TY - JOUR
A1 - Konrad, Marcel
A1 - Jacob, Louis
A1 - Rapp, Michael Armin
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 - Jacob, Louis E. C.
A1 - Rapp, Michael Armin
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 - Heinz, A.
A1 - Voss, M.
A1 - Lawrie, S. M.
A1 - Mishara, A.
A1 - Bauer, M.
A1 - Gallinat, J.
A1 - Juckel, G.
A1 - Lang, U.
A1 - Rapp, Michael Armin
A1 - Falkai, P.
A1 - Strik, W.
A1 - Krystal, J.
A1 - Abi-Dargham, A.
A1 - Galderisi, S.
T1 - Shall we really say goodbye to first rank symptoms?
JF - European psychiatry : the journal of the Association of European Psychiatrists
N2 - Background: First rank symptoms (FRS) of schizophrenia have been used for decades for diagnostic purposes. In the new version of the DSM-5, the American Psychiatric Association (APA) has abolished any further reference to FRS of schizophrenia and treats them like any other "criterion A' symptom (e.g. any kind of hallucination or delusion) with regard to their diagnostic implication. The ICD-10 is currently under revision and may follow suit. In this review, we discuss central points of criticism that are directed against the continuous use of first rank symptoms (FRS) to diagnose schizophrenia.
KW - First rank symptoms
KW - Schizophrenia
KW - ICD
KW - DSM
KW - Self-disorder
Y1 - 2016
U6 - https://doi.org/10.1016/j.eurpsy.2016.04.010
SN - 0924-9338
SN - 1778-3585
VL - 37
SP - 8
EP - 13
PB - Elsevier
CY - Paris
ER -
TY - JOUR
A1 - Bakanidze, George
A1 - Brandl, Eva J.
A1 - Hutzler, Christine
A1 - Aurass, Friederike
A1 - Onken, Silke
A1 - Rapp, Michael Armin
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 - Booker, Anke
A1 - Bohlken, Jens
A1 - Rapp, Michael Armin
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 - GEN
A1 - Stroehle, Andreas
A1 - Rapp, Michael Armin
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 - Heissel, Andreas
A1 - Zech, Philipp
A1 - Rapp, Michael Armin
A1 - Schuch, Felipe B.
A1 - Lawrence, Jimmy B.
A1 - Kangas, Maria
A1 - Heinzel, Stephan
T1 - Effects of exercise on depression and anxiety in persons living with HIV: A meta-analysis
JF - Journal of psychosomatic research
N2 - Objective: The purpose of this systematic review and meta-analysis was to examine the effects of exercise on depression and anxiety in people living with HIV (PLWH), and to evaluate, through subgroup analysis, the effects of exercise type, frequency, supervision by exercise professionals, study quality, and control group conditions on these outcomes. Method: A literature search was conducted through four electronic databases from inception to February 2019. Considered for inclusion were randomized controlled trials (RCTs) investigating exercise interventions and depression or anxiety as outcomes in people living with HIV (>= 18 years of age). Ten studies were included (n = 479 participants, 49.67% females at baseline), and the standardized mean difference (SMD) and heterogeneity were calculated using random-effect models. An additional pre-post meta-analysis was also conducted. Results: A large effect in favor of exercise when compared to controls was found for depression (SMD = -0.84, 95%CI = [-1.57, -0.11], p = 0.02) and anxiety (SMD = -1.23, 95%CI = [-2.42, 0.04], p = -0.04). Subgroup analyses for depression revealed large effects on depression for aerobic exercise only (SMD = -0.96, 95%CI = [-1.63, -0.30], p = 0.004), a frequency of >= 3 exercise sessions per week (SMD = -1.39, 95%CI = [-2.24, -0.54], p < 0.001), professionally supervised exercise (SMD = -1.40, 95%CI = [-2.46, -0.17], p = 0.03]), and high-quality studies (SMD = -1.31, 95%CI = [-2.46, -0.17], p = 0.02). Conclusion: Exercise seems to decrease depressive symptoms and anxiety in PLWH, but other larger and high-quality studies are needed to verify these effects.
KW - HIV
KW - Exercise
KW - Depression
KW - Anxiety
KW - Meta-analysis
KW - Supervision
Y1 - 2019
U6 - https://doi.org/10.1016/j.jpsychores.2019.109823
SN - 0022-3999
SN - 1879-1360
VL - 126
PB - Elsevier
CY - Oxford
ER -
TY - JOUR
A1 - Kluge, Ulrike
A1 - Rapp, Michael Armin
A1 - Mehran, Nassim
A1 - Abi Jumaa, Jinan
A1 - Aichberger, Marion Christina
T1 - Poverty, migration and mental health
JF - Der Nervenarzt : Organ der Deutschen Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft für Neurologie
N2 - 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.
KW - Social capital
KW - Social cohesion
KW - Migration
KW - Exclusion
KW - Residential environment
Y1 - 2019
U6 - https://doi.org/10.1007/s00115-019-00790-2
SN - 0028-2804
SN - 1433-0407
VL - 90
IS - 11
SP - 1103
EP - 1108
PB - Springer
CY - New York
ER -
TY - JOUR
A1 - Rapp, Michael Armin
T1 - Die Versorgung für die nächste Dekade sichern: Gerontopsychiatrie in der Krise?
T1 - Covering Care for the Next Decade: A Crisis in Geriatric Psychiatry?
JF - Psychatrische Praxis
N2 - Der demografische Wandel wird nicht nur mit einer rasanten Zunahme der Hochaltrigen einhergehen [1], was für die gerontopsychiatrische Versorgung aufgrund der altersassoziierten Inzidenzraten in erster Linie eine Zunahme an Demenzerkrankungen und Patienten mit Multimorbidität und Gebrechlichkeit bedeutet [2], sondern auch mit einer Zunahme jüngerer alter Menschen vom 65. bis 75. Lebensjahr, was für die Gerontopsychiatrie eine Zunahme der Patienten mit Abhängigkeitserkrankungen, Erkrankungen aus dem schizophrenen Formenkreis und affektiven Erkrankungen bedeutet. Soziale Faktoren werden hier mehr und mehr eine zentrale Rolle spielen, da neben der Qualität der medizinischen Versorgung insbesondere die individuelle soziale Situation der Patienten mit einer erhöhten Morbidität und Mortalität einhergehen wird [3].
Y1 - 2019
U6 - https://doi.org/10.1055/a-0971-5551
SN - 0303-4259
SN - 1439-0876
VL - 46
IS - 6
SP - 305
EP - 306
PB - Thieme
CY - Stuttgart
ER -
TY - GEN
A1 - Wippert, Pia-Maria
A1 - Block, Andrea
A1 - Mansuy, Isabelle M.
A1 - Peters, Eva M. J.
A1 - Rose, Matthias
A1 - Rapp, Michael Armin
A1 - Huppertz, Alexander
A1 - Würtz-Kozak, Karin
T1 - Alterations in Bone Homeostasis and Microstructure Related to Depression and Allostatic Load
T2 - Psychotherapy and Psychosomatics
Y1 - 2019
U6 - https://doi.org/10.1159/000503640
SN - 0033-3190
SN - 1423-0348
VL - 88
IS - 6
SP - 383
EP - 385
PB - Karger
CY - Basel
ER -
TY - JOUR
A1 - Block, Andrea
A1 - Schulze, Susanne
A1 - Deeken, Friederike
A1 - Häusler, Andreas
A1 - Rezo, Anna
A1 - Rapp, Michael Armin
A1 - Wippert, Pia-Maria
T1 - Effects of inflammatory markers and biographical stress on treatment response in depression
JF - Psychoneuroendocrinology : an international journal ; the official journal of the International Society of Psychoneuroendocrinology
N2 - 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.
Y1 - 2021
U6 - https://doi.org/10.1016/j.psyneuen.2021.105535
SN - 0306-4530
SN - 1873-3360
VL - 131
IS - Supplement
SP - S24
EP - S24
PB - Elsevier
CY - Oxford
ER -
TY - GEN
A1 - Garbusow, Maria
A1 - Sommer, C.
A1 - Nebe, S.
A1 - Sebold, Miriam Hannah
A1 - Kuitunen-Paul, Sören
A1 - Wittchen, H. U.
A1 - Smolka, M.
A1 - Zimmermann, U.
A1 - Rapp, Michael Armin
A1 - Huys, Q.
A1 - Schlagenhauf, Florian
A1 - Heinz, A.
T1 - Pavlovian-instrumental transfer in the course of alcohol use disorder
T2 - European psychiatry : the journal of the Association of European Psychiatrists
N2 - Background: Pavlovian processes are thought to play an important role in the development, maintenance and relapse of alcohol dependence, possibly by influencing and usurping on- going thought and behavior. The influence of Pavlovian stimuli on on-going behavior is paradigmatically measured by Pavlovian-to-instrumental-transfer (PIT) tasks. These involve multiple stages and are complex. Whether increased PIT is involved in human alcohol
dependence is uncertain. We therefore aimed to establish and validate a modified PIT paradigm that would be robust, consistent, and tolerated by healthy controls as well as by patients suffering from alcohol dependence, and to explore whether alcohol dependence is associated with enhanced Pavlovian-Instrumental transfer.
Methods: 32 recently detoxified alcohol-dependent patients and 32 age and gender matched healthy controls performed a PIT task with instrumental go/no-go approach behaviours. The task involved both Pavlovian stimuli associated with monetary rewards and losses, and images of drinks.
Results: Both patients and healthy controls showed a robust and temporally stable PIT effect. Strengths of PIT effects to drug-related and monetary conditioned stimuli were highly correlated. Patients more frequently showed a PIT effect and the effect was stronger in response to aversively conditioned CSs (conditioned suppression), but there was no group difference in response to appetitive CSs.
Conclusion: The implementation of PIT has favorably robust properties in chronic alcohol- dependent patients and in healthy controls. It shows internal consistency between monetary and drug-related cues. The findings support an association of alcohol dependence with an increased propensity towards PIT.
Y1 - 2018
SN - 0924-9338
SN - 1778-3585
VL - 48
SP - S546
EP - S546
PB - Elsevier
CY - ISSY-LES-MOULINEAUX
ER -
TY - JOUR
A1 - Sebold, Miriam Hannah
A1 - Spitta, G.
A1 - Gleich, T.
A1 - Dembler-Stamm, T.
A1 - Butler, O.
A1 - Zacharias, K.
A1 - Aydin, S.
A1 - Garbusow, Maria
A1 - Rapp, Michael Armin
A1 - Schubert, F.
A1 - Buchert, R.
A1 - Gallinat, J.
A1 - Heinz, A.
T1 - Stressful life events are associated with striatal dopamine receptor availability in alcohol dependence
JF - Journal of neural transmission
N2 - Stress plays a key role in modulating addictive behavior and can cause relapse following periods of abstinence. Common effects of stress and alcohol on the dopaminergic system have been suggested, although the precise mechanisms are unclear. Here, we investigated 20 detoxified alcohol-dependent patients and 19 matched healthy controls and assessed striatal D2/D3 availability using [F-18]-fallypride positron emission tomography and stressful life events. We found a strong association between striatal D2/D3 availability and stress in patients, but not in healthy controls. Interestingly, we found increased D2/D3 receptor availability in patients with higher stress levels. This mirrors complex interactions between stress and alcohol intake in animal studies and emphasizes the importance to investigate stress exposure in neurobiological studies of addiction.
KW - Stressful life events
KW - Dopamine D2
KW - D3 receptor
KW - Positron emission tomography
KW - Striatum
KW - Alcohol dependence
Y1 - 2019
U6 - https://doi.org/10.1007/s00702-019-01985-2
SN - 0300-9564
SN - 1435-1463
VL - 126
IS - 9
SP - 1127
EP - 1134
PB - Springer
CY - Wien
ER -
TY - JOUR
A1 - Heinzel, Stephan
A1 - Riemer, Thomas G.
A1 - Schulte, Stefanie
A1 - Onken, Johanna
A1 - Heinz, Andreas
A1 - Rapp, Michael Armin
T1 - Catechol-O-methyltransferase (COMT) genotype affects age-related changes in plasticity in working memory: a pilot study
JF - BioMed research international
N2 - Objectives. Recent work suggests that a genetic variation associated with increased dopamine metabolism in the prefrontal cortex (catechol-O-methyltransferase Val158Met; COMT) amplifies age-related changes in working memory performance. Research on younger adults indicates that the influence of dopamine-related genetic polymorphisms on working memory performance increases when testing the cognitive limits through training. To date, this has not been studied in older adults. Method. Here we investigate the effect of COMT genotype on plasticity in working memory in a sample of 14 younger (aged 24-30 years) and 25 older (aged 60-75 years) healthy adults. Participants underwent adaptive training in the n-back working memory task over 12 sessions under increasing difficulty conditions. Results. Both younger and older adults exhibited sizeable behavioral plasticity through training (P < .001), which was larger in younger as compared to older adults (P < .001). Age-related differences were qualified by an interaction with COMT genotype (P < .001), and this interaction was due to decreased behavioral plasticity in older adults carrying the Val/Val genotype, while there was no effect of genotype in younger adults. Discussion. Our findings indicate that age-related changes in plasticity in working memory are critically affected by genetic variation in prefrontal dopamine metabolism.
Y1 - 2014
U6 - https://doi.org/10.1155/2014/414351
SN - 2314-6133
SN - 2314-6141
PB - Hindawi Publishing Corp.
CY - New York
ER -
TY - CHAP
A1 - Haegele, Claudia
A1 - Friedel, Eva
A1 - Schlagenhauf, Florian
A1 - Sterzer, Philipp
A1 - Beck, Anne
A1 - Bermpohl, Felix
A1 - Rapp, Michael Armin
A1 - Stoy, Meline
A1 - Stroehle, Andreas
A1 - Dolan, Raymond J.
A1 - Heinz, Andreas
T1 - Reward expectation and affective responses across psychiatric disorders - A dimensional approach
T2 - Biological psychiatry : a journal of psychiatric neuroscience and therapeutics ; a publication of the Society of Biological Psychiatry
KW - dimensional
KW - transdiagnostic
KW - reward system
KW - ventral striatum
KW - fMRI
Y1 - 2014
SN - 0006-3223
SN - 1873-2402
VL - 75
IS - 9
SP - 91S
EP - 92S
PB - Elsevier
CY - New York
ER -
TY - JOUR
A1 - Zaytseva, Yuliya
A1 - Korsakova, Natalya
A1 - Gurovich, Isaac Ya
A1 - Heinz, Andreas
A1 - Rapp, Michael Armin
T1 - Luria revisited: Complex motor phenomena in first episode schizophrenia and schizophrenia spectrum disorders
JF - Psychiatry research : the official publication of the International Society for Neuroimaging in Psychiatry
KW - Luria
KW - Fist-Edge-Palm test
KW - Bimanual probe
KW - Error monitoring
KW - First psychotic episode
KW - Schizophrenia
KW - Schizophrenia spectrum disorders
Y1 - 2014
U6 - https://doi.org/10.1016/j.psychres.2014.08.009
SN - 0165-1781
VL - 220
IS - 1-2
SP - 145
EP - 151
PB - Elsevier
CY - Clare
ER -
TY - JOUR
A1 - Schraplau, Anne
A1 - Block, Andrea
A1 - Häusler, Andreas
A1 - Wippert, Pia-Maria
A1 - Rapp, Michael A.
A1 - Völler, Heinz
A1 - Bonaventura, Klaus
A1 - Mayer, Frank
T1 - Mobile diagnostics and consultation for the prevention of the metabolic syndrome and its secondary diseases in Brandenburg—study protocol of a regional prospective cohort study
BT - the Mobile Brandenburg Cohort
JF - Pilot and Feasibility Studies
N2 - Background
The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. The implementation of prevention programs requires early detection of individuals at risk. However, access to health care providers is limited in structurally weak regions. Brandenburg, a rural federal state in Germany, has an especially high MetS prevalence and disease burden. This study aims to validate and test the feasibility of a setup for mobile diagnostics of MetS and its secondary diseases, to evaluate the MetS prevalence and its association with moderating factors in Brandenburg and to identify new ways of early prevention, while establishing a “Mobile Brandenburg Cohort” to reveal new causes and risk factors for MetS.
Methods
In a pilot study, setups for mobile diagnostics of MetS and secondary diseases will be developed and validated. A van will be equipped as an examination room using point-of-care blood analyzers and by mobilizing standard methods. In study part A, these mobile diagnostic units will be placed at different locations in Brandenburg to locally recruit 5000 participants aged 40-70 years. They will be examined for MetS and advice on nutrition and physical activity will be provided. Questionnaires will be used to evaluate sociodemographics, stress perception, and physical activity. In study part B, participants with MetS, but without known secondary diseases, will receive a detailed mobile medical examination, including MetS diagnostics, medical history, clinical examinations, and instrumental diagnostics for internal, cardiovascular, musculoskeletal, and cognitive disorders. Participants will receive advice on nutrition and an exercise program will be demonstrated on site. People unable to participate in these mobile examinations will be interviewed by telephone. If necessary, participants will be referred to general practitioners for further diagnosis.
Discussion
The mobile diagnostics approach enables early detection of individuals at risk, and their targeted referral to local health care providers. Evaluation of the MetS prevalence, its relation to risk-increasing factors, and the “Mobile Brandenburg Cohort” create a unique database for further longitudinal studies on the implementation of home-based prevention programs to reduce mortality, especially in rural regions.
Trial registration
German Clinical Trials Register, DRKS00022764; registered 07 October 2020—retrospectively registered.
KW - Metabolic syndrome
KW - Mobile diagnostics
KW - Prevention
KW - Nutrition
KW - Physical activity
KW - Rural health
Y1 - 2021
U6 - https://doi.org/10.1186/s40814-021-00898-w
SN - 2055-5784
VL - 7
SP - 1
EP - 11
PB - BioMed Central (Springer Nature)
CY - London
ER -
TY - GEN
A1 - Heissel, Andreas
A1 - Sanchez, Alba
A1 - Pietrek, Anou F.
A1 - Bergau, Theresa
A1 - Stielow, Christiane
A1 - Rapp, Michael Armin
A1 - Van der Kaap-Deeder, Jolene
T1 - Validating the German Short Basic Psychological Need Satisfaction and Frustration Scale in Individuals with Depression
T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
N2 - Satisfaction and frustration of the needs for autonomy, competence, and relatedness, as assessed with the 24-item Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), have been found to be crucial indicators of individuals’ psychological health. To increase the usability of this scale within a clinical and health services research context, we aimed to validate a German short version (12 items) of this scale in individuals with depression including the examination of the relations from need frustration and need satisfaction to ill-being and quality of life (QOL). This cross-sectional study involved 344 adults diagnosed with depression (Mage (SD) = 47.5 years (11.1); 71.8% females). Confirmatory factor analyses indicated that the short version of the BPNSFS was not only reliable, but also fitted a six-factor structure (i.e., satisfaction/frustration X type of need). Subsequent structural equation modeling showed that need frustration related positively to indicators of ill-being and negatively to QOL. Surprisingly, need satisfaction did not predict differences in ill-being or QOL. The short form of the BPNSFS represents a practical instrument to measure need satisfaction and frustration in people with depression. Further, the results support recent evidence on the importance of especially need frustration in the prediction of psychopathology.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 837
KW - basic psychological need frustration
KW - need satisfaction
KW - mental health
KW - ill-being
KW - depression
Y1 - 2023
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-589060
SN - 1866-8364
IS - 837
ER -
TY - JOUR
A1 - Heissel, Andreas
A1 - Pietrek, Anou F.
A1 - Rapp, Michael Armin
A1 - Heinzel, Stephan
A1 - Williams, Geoffrey
T1 - Perceived health care climate of older people attending an exercise program
BT - validation of the german short version of the health care climate questionnaire
JF - Journal of aging and physical activity : JAPA ; the official journal of the International Society for Aging and Physical Activity
N2 - The role of perceived need support from exercise professionals in improving mental health was examined in a sample of older adults, thereby validating the short Health Care Climate Questionnaire. A total of 491 older people (M = 72.68 years; SD = 5.47) attending a health exercise program participated in this study. Cronbach's alpha was found to be high (alpha = .90). Satisfaction with the exercise professional correlated moderately with the short Health Care Climate Questionnaire mean value (r = .38; p < .01). The mediator analyses yielded support for the self-determination theory process model in older adults by showing both basic need satisfaction and frustration as mediating variables between perceived autonomy support and depressive symptoms. The short Health Care Climate Questionnaire is an economical instrument for assessing basic need satisfaction provided by the exercise therapist from the participant's perspective. Furthermore, this cross-sectional study supported the link from coaching style to the satisfaction/frustration of basic psychological needs, which in turn, predicted mental health. Analyses of criterion validity suggest a revision of the construct by integrating need frustration.
KW - autonomy support
KW - basic psychological need satisfaction and frustration
KW - depression
KW - need support
KW - physical activity
Y1 - 2019
U6 - https://doi.org/10.1123/japa.2018-0350
SN - 1063-8652
SN - 1543-267X
VL - 28
IS - 2
SP - 276
EP - 286
PB - Human Kinetics Publ.
CY - Champaign
ER -
TY - JOUR
A1 - Heissel, Andreas
A1 - Sanchez, Alba
A1 - Pietrek, Anou F.
A1 - Bergau, Theresa
A1 - Stielow, Christiane
A1 - Rapp, Michael Armin
A1 - Van der Kaap-Deeder, Jolene
T1 - Validating the German Short Basic Psychological Need Satisfaction and Frustration Scale in Individuals with Depression
JF - Healthcare
N2 - Satisfaction and frustration of the needs for autonomy, competence, and relatedness, as assessed with the 24-item Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), have been found to be crucial indicators of individuals’ psychological health. To increase the usability of this scale within a clinical and health services research context, we aimed to validate a German short version (12 items) of this scale in individuals with depression including the examination of the relations from need frustration and need satisfaction to ill-being and quality of life (QOL). This cross-sectional study involved 344 adults diagnosed with depression (Mage (SD) = 47.5 years (11.1); 71.8% females). Confirmatory factor analyses indicated that the short version of the BPNSFS was not only reliable, but also fitted a six-factor structure (i.e., satisfaction/frustration X type of need). Subsequent structural equation modeling showed that need frustration related positively to indicators of ill-being and negatively to QOL. Surprisingly, need satisfaction did not predict differences in ill-being or QOL. The short form of the BPNSFS represents a practical instrument to measure need satisfaction and frustration in people with depression. Further, the results support recent evidence on the importance of especially need frustration in the prediction of psychopathology.
KW - basic psychological need frustration
KW - need satisfaction
KW - mental health
KW - ill-being
KW - depression
Y1 - 2023
U6 - https://doi.org/10.3390/healthcare11030412
SN - 2227-9032
VL - 11
IS - 3
PB - MDPI
CY - Basel
ER -
TY - JOUR
A1 - Kallies, Gunnar
A1 - Rapp, Michael Armin
A1 - Fydrich, Thomas
A1 - Fehm, Lydia
A1 - Tschorn, Mira
A1 - Teran, Christina
A1 - Schwefel, Melanie
A1 - Pietrek, Anou F.
A1 - Henze, Romy
A1 - Hellweg, Rainer
A1 - Ströhle, Andreas
A1 - Heinzel, Stephan
A1 - Heissel, Andreas
T1 - Serum brain-derived neurotrophic factor (BDNF) at rest and after acute aerobic exercise in major depressive disorder
JF - Psychoneuroendocrinology
N2 - Physiological mechanisms of an anti-depressive effect of physical exercise in major depressive disorder (MDD) seem to involve alterations in brain-derived neurotrophic factor (BDNF) level. However, previous studies which investigated this effect in a single bout of exercise, did not control for confounding peripheral factors that contribute to BDNF-alterations. Therefore, the underlying cause of exercise-induced BDNF-changes remains unclear. The current study aims to investigate serum BDNF (sBDNF)-changes due to a single-bout of graded aerobic exercise in a group of 30 outpatients with MDD, suggesting a more precise analysis method by taking plasma volume shift and number of platelets into account. Results show that exercise-induced increases in sBDNF remain significant (p<.001) when adjusting for plasma volume shift and controlling for number of platelets. The interaction of sBDNF change and number of platelets was also significant (p=.001) indicating larger sBDNF-increase in participants with smaller number of platelets. Thus, findings of this study suggest an involvement of peripheral as well as additional possibly brain-derived mechanisms explaining exercise-related BDNF release in MDD. For future studies in the field of exercise-related BDNF research, the importance of controlling for peripheral parameters is emphasized.
KW - Brain-derived neurotrophic factor (BDNF)
KW - Platelets
KW - Major depressive disorder
KW - Physical exercise
Y1 - 2018
U6 - https://doi.org/10.1016/j.psyneuen.2018.12.015
SN - 0306-4530
VL - 102
SP - 212
EP - 215
PB - Elsevier
CY - Oxford
ER -
TY - GEN
A1 - Booker, Anke
A1 - Jacob, Louis E. C.
A1 - Rapp, Michael Armin
A1 - Bohlken, Jens
A1 - Kostev, Karel
T1 - Risk factors for dementia diagnosis in German primary care practices
T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe
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.
Results: The mean age for the 11,956 cases and the 11,956 controls was 80.4 (SD: 5.3) years. 39.0% of them were male and 1.9% had private health insurance. In the multivariate regression model, the following variables were linked to a significant extent with an increased risk of dementia: diabetes (OR: 1.17; 95% CI: 1.10-1.24), lipid metabolism (1.07; 1.00-1.14), stroke incl. TIA (1.68; 1.57-1.80), Parkinson's disease (PD) (1.89; 1.64-2.19), intracranial injury (1.30; 1.00-1.70), coronary heart disease (1.06; 1.00-1.13), mild cognitive impairment (MCI) (2.12; 1.82-2.48), mental and behavioral disorders due to alcohol use (1.96; 1.50-2.57). The use of statins (OR: 0.94; 0.90-0.99), proton-pump inhibitors (PPI) (0.93; 0.90-0.97), and antihypertensive drugs (0.96, 0.94-0.99) were associated with a decreased risk of developing dementia.
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.
T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 449
KW - dementia
KW - Alzheimer
KW - risk factors
KW - statins
Y1 - 2018
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-413441
IS - 449
ER -
TY - JOUR
A1 - Heinzel, Stephan
A1 - Lawrence, Jimmy B.
A1 - Kallies, Gunnar
A1 - Rapp, Michael Armin
A1 - Heissel, Andreas
T1 - Using Exercise to Fight Depression in Older Adults
BT - A Systematic Review and Meta-Analysis
JF - GeroPsych : the journal of gerontopsychology and geriatric psychiatry
N2 - Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of –0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = –0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully.
KW - depression
KW - exercise
KW - older adults
KW - meta-analysis
KW - review
Y1 - 2015
U6 - https://doi.org/10.1024/1662-9647/a000133
SN - 1662-9647
SN - 1662-971X
VL - 28
SP - 149
EP - 162
PB - Hogrefe
CY - Cambridge, Mass. ; Göttingen [u.a.]
ER -
TY - CHAP
A1 - Nordheim, J.
A1 - Rapp, Michael Armin
A1 - Krause-Koehler, Kathleen
A1 - Niemann-Mirmehdi, M.
A1 - Haeusler, Andreas
T1 - Support for dementia affected Couples. Results of the DYADEM- study
T2 - Zeitschrift für Gerontologie und Geriatrie
Y1 - 2014
SN - 0948-6704
SN - 1435-1269
VL - 47
SP - 136
EP - 136
PB - Springer
CY - Heidelberg
ER -
TY - CHAP
A1 - Heinz, A.
A1 - Kluge, U.
A1 - Schouler-Ocak, M.
A1 - Rapp, Michael Armin
T1 - Biological Effects of Social Exclusion
T2 - European psychiatry : the journal of the Association of European Psychiatrists
N2 - Timing and magnitude of surface uplift are key to understanding the impact of crustal deformation and topographic growth on atmospheric circulation, environmental conditions, and surface processes. Uplift of the East African Plateau is linked to mantle processes, but paleoaltimetry data are too scarce to constrain plateau evolution and subsequent vertical motions associated with rifting. Here, we assess the paleotopographic implications of a beaked whale fossil (Ziphiidae) from the Turkana region of Kenya found 740 km inland from the present-day coastline of the Indian Ocean at an elevation of 620 m. The specimen is similar to 17 My old and represents the oldest derived beaked whale known, consistent with molecular estimates of the emergence of modern straptoothed whales (Mesoplodon). The whale traveled from the Indian Ocean inland along an eastward-directed drainage system controlled by the Cretaceous Anza Graben and was stranded slightly above sea level. Surface uplift from near sea level coincides with paleoclimatic change from a humid environment to highly variable and much drier conditions, which altered biotic communities and drove evolution in east Africa, including that of primates.
Y1 - 2015
SN - 0924-9338
SN - 1778-3585
VL - 30
PB - Elsevier
CY - Paris
ER -