After gambling disorder (GD) was included as the first behavioral addiction in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), many studies focused on epidemiology and the impact of different risk factors. In this context, online gambling seems to show especially high addictive potential and, additionally, lacks government control and restrictions. In this study, we aimed to evaluate the prevalence of GD, as well as various aspects of gambling behavior in a representative Austrian sample (N = 3658). An adapted version of a standardized questionnaire was applied, which covered all nine DSM-5 criteria for GD. Results indicate a lifetime prevalence for gambling of 34.9
Psychoses are among the most debilitating mental disorders, making early detection a major public health priority. In extension of the ultra-high-risk (UHR) approach, which was developed to identify an imminent risk of psychosis, the basic symptom (BS) approach aims for the earliest possible detection of the developing disorder; it is increasingly used worldwide. Basic symptoms are subtle, self-perceived disturbances affecting various domains, such as cognition, perception, affect, and drive, that precede and scaffold the development of attenuated and frank psychotic symptoms. This narrative review outlines historical foundations, phenomenology, and assessment instruments for BSs. It summarizes empirical findings on their predictive value for subsequent psychosis and their specificity for psychotic disorders across all age groups. Furthermore, developmental aspects and neurobiological findings are highlighted that support one of the core assumptions of the BS concept, namely, that BSs represent the most immediate phenomenological manifestation of the cerebral alterations underlying the development of psychosis. Finally, evidence for the broader clinical significance of BSs beyond psychosis prediction is discussed, indicating that BSs as a whole are useful for both multi- and differential-diagnostic purposes. Overall, the reviewed findings underline the value of BSs for advancing neurobiological research on the etiopathology of psychoses and for developing individualized prediction models and targeted early interventions.
Major depressive disorder (MDD) is a heterogeneous, debilitating disorder. A distinct subgroup within the MDD spectrum is identified to have treatment-resistant depression (TRD). There is an impetus to find alternative treatments for TRD to reduce disease burden and improve quality of life. Psychedelics have been used in the treatment of various psychiatric disorders since the 1950s, with potential benefits in TRD. Aiming to summarize the evidence of using psychedelics for TRD by exploring mechanisms and potential benefits, we conducted a literature search on different psychedelics with their mechanisms from clinical and preclinical evidence. Psychedelics have been examined in many preclinical studies for efficacy and mechanisms with fewer clinical studies on patients with TRD. Besides serotonergic agonism, glutamate surge and monoamine release, psychedelics promote neuroplasticity, corticolimbic function, and epigenetic changes. Psilocybin, ketamine, and esketamine are the most researched agents of psychedelics in the context of TRD. Psilocybin-assisted therapy has been shown to induce short-term improvement in symptoms that can persist for weeks and months, with some meta-analyses consolidating such findings. Ketamine, as an atypical psychedelic, in many clinical trials of intravenous, subcutaneous, and oral forms, had rapid and robust effects in reducing depressive symptoms and relapses without decreasing cognitive function. Similarly, esketamine induced early and clinically meaningful improvements in function and productivity. Ayahuasca also showed fast and sustained effects with higher remission rates and good safety. Psychedelics have significant potential in TRD with superior mechanisms over traditional antidepressants. Despite the encouraging findings of the existing studies, large, well-designed studies are needed to extend their use as part of standard recommendations.
Burnout among medical students is a well-known problem, but only few data from Austria are available. This study’s goal was to examine the prevalence of burnout symptoms in two private universities in Austria and to identify the stressors contributing to it. Medical students in their second year or at later stages of their studies were asked to complete an online questionnaire. Using the Maslach Burnout Inventory—Student Survey (MBI-SS), the three subscales emotional exhaustion, cynicism, and reduced academic efficacy were measured. The six potentially burnout-related stressors identified were workload, exam pressure, financial stress, work–life balance, time management, and lack of support for mental health. Additionally, psychological well-being measured via the World Health Organization-Five Well-Being Index (WHO-5) and subjective stress assessed via the visual analog scale (VAS) were examined. A total of 168 students were included in the final analysis (average age 23.9 years; 69.0
Ziel dieser Studie war es, ärztliche Perspektiven auf das Reduzieren und Absetzen (R A) von Antidepressiva (AD) und Antipsychotika (AP) zu untersuchen. In zehn systematischen Interviews und einer Fokusgruppe mit ambulant tätigen Psychiater*innen aus Berlin und Brandenburg wurden Unterschiede in Einschätzungen, Beratungspraktiken und Entscheidungsmuster erfasst und anschließend mittels MAXQDA induktiv ausgewertet. R A wird bei AD häufiger initiiert, da depressive Patient*innen als einsichtiger und therapietreuer gelten. Im Gegensatz dazu schätzen Psychiater*innen das Rückfallrisiko und die Folgen des Absetzens von AP höher ein, was zu einer Zurückhaltung beim R A führt. Strukturelle Hürden, unklare Leitlinien und fehlende nicht-medikamentöse Alternativen erschweren das R A insbesondere im Fall von Psychosen. Für das gemeinschaftliche R A von AP und AD braucht es klare Leitlinien, Wissenstransfer und bessere psychosoziale Versorgungsangebote – vor allem für Patient*innen mit Psychosen.
OBJECTIVE:The aim of this study was to investigate physicians' perspectives on the tapering and discontinuation (R&D) of antidepressants (AD) and antipsychotics (AP). METHODS:In ten systematic interviews and a focus group with outpatient psychiatrists from Berlin and Brandenburg, differences in assessments, counseling practices, and decision-making patterns were recorded and subsequently with MAXQDA inductively evaluated. RESULTS:R&D is initiated more frequently in AD because depressed patients are considered more insightful and adherent to treatment. In contrast, psychiatrists perceive the risk of relapse and the consequences of discontinuing AP to be higher, leading to more reluctance to initiate R&A. Structural barriers, unclear guidelines, and a lack of non-pharmacological alternatives make R&A difficult, particularly in cases of psychosis. CONCLUSION:More participatory R&D practices require clear guidelines, knowledge transfer, and improved psychosocial care services-especially for patients with psychosis.
BACKGROUND:Burnout among medical students is a well-known problem, but only few data from Austria are available. This study's goal was to examine the prevalence of burnout symptoms in two private universities in Austria and to identify the stressors contributing to it. METHODS:Medical students in their second year or at later stages of their studies were asked to complete an online questionnaire. Using the Maslach Burnout Inventory-Student Survey (MBI-SS), the three subscales emotional exhaustion, cynicism, and reduced academic efficacy were measured. The six potentially burnout-related stressors identified were workload, exam pressure, financial stress, work-life balance, time management, and lack of support for mental health. Additionally, psychological well-being measured via the World Health Organization-Five Well-Being Index (WHO-5) and subjective stress assessed via the visual analog scale (VAS) were examined. RESULTS:A total of 168 students were included in the final analysis (average age 23.9 years; 69.0% female). Overall, 33.9% of students met the cut-off criteria for burnout on all three subscales and 78% on at least two. Scores for emotional exhaustion (86.3%) and reduced academic efficacy (82.1%) were most frequently elevated. Work-life balance and a perceived lack of mental health support were most consistently linked to higher burnout subscale and lower WHO‑5 scores. CONCLUSION:Around one third of students met the cut-off criteria on all three MBI-SS subscales. Not one single stressor was observed to be causing burnout symptoms, but rather a lack of work-life balance and mental health support seem to play a major role.
Due to an ageing population and increased life expectancy, Alzheimer’s dementia (AD) is becoming increasingly important. Since AD is characteristically preceded by subjective cognitive decline (SCD) and mild cognitive impairment (MCI), innovative diagnostic tools and therapeutics are essential for diagnosis at an early stage. Olfactory dysfunction is commonly associated with cognitive decline, indicating its potential as a diagnostic marker. This study examined the association between olfactory function, evaluated with the Sniffin’ Sticks Odor Identification Test (SS-OIT), and Assessment of Self-Reported Olfactory Functioning (ASOF) inventory across five cognitive subgroups (healthy controls [HC], SCD, non-amnestic MCI, amnestic MCI, and AD). Furthermore, this study investigated the utility of olfactory testing in screening for AD. This retrospective, single-center cross-sectional study was conducted at the Neurology Department of the Medical University of Vienna. The study included 958 participants during the period 2000–2023. Cognitive and olfactory functions were assessed using standardized neuropsychological and olfactory tools. Statistical analyses included descriptive measures, analysis of variance (ANOVA), model testing, and the receiver operating characteristic (ROC) methodology. Olfactory performance declined with increasing cognitive impairment, with the strongest contrast showing an effect size of r = 0.51 between HC and AD. The SS-OIT (area under the ROC curve [AUC]: 75.3
Reforms of psychiatric care systems in Western countries have been guided by several principles such as de-institutionalization, mental healthcare close to the community, and integration into general healthcare. This paper reflects the achievements, shortfalls, and problems of selected aspects of mental health reforms. Despite major improvements, there have also been some setbacks. We consider such analyses to be essential for future care planning.
Hikikomori, described as “prolonged social withdrawal,” is a condition characterized by an individual’s severe social isolation in their home for at least 6 months with consequent functional impairment or distress. It is mainly observed in adolescents and young adults. It was initially described in Japanese cultures, but has since been reported in other countries. This report is the first to describe a case of hikikomori in a male patient in Malta, an island nation in the central Mediterranean and one of Europeʼs smallest countries. He presented to psychiatric services incidentally after over 20 years of being voluntarily housebound. The social isolation occurred in the context of social anxiety with agoraphobia and an overreliance on the online world. We discuss the multidisciplinary team approach applied throughout the inpatient hospitalization period, with a focus on rehabilitation and functional improvement, while prioritizing the patient’s wishes and preferences. This case reinforces the view of hikikomori as a culturally influenced syndrome, rather than a culturally bound one.
Im Zuge aktueller Ereignisse erhebt sich die Frage, welche möglichen psychologischen und biologischen Folgen das Spielen gewalttätiger Videospiele haben kann. In den letzten Jahrzehnten ist dieser Forschungsbereich zu dieser Frage enorm gewachsen, mit mehreren Hundert Publikationen, die insgesamt über 100.000 Studienteilnehmer untersuchten. Verschiedene Meta-Analysen der letzten Jahre wiesen wiederholt eine statistisch signifikante aggressionsfördernde Wirkung des Spielens gewalttätiger Videospiele nach. Trotzdem kommt es immer wieder zu Kontroversen in diesem Feld. Studien zu möglichen biologisch messbaren Veränderungen im Gehirn ergaben gemischte Resultate. Der folgende Übersichtsartikel soll einen kurzen Überblick über den aktuellen Stand dieses Forschungsbereiches geben. In der Diskussion wird auf methodische Schwierigkeiten, weitere offene Fragen, Hypothesen zur Art des aggressionsfördernden Effekts, gesellschaftspolitische Aspekte und mögliche Schlussfolgerungen eingegangen.
In the wake of current events, the question arises as to the possible psychological and biological consequences of playing violent video games. This area of research has grown enormously in recent decades, with several hundred publications examining a total of over 100,000 study participants. Various meta-analyses in recent years have repeatedly demonstrated a statistically significant aggression-promoting effect of playing violent video games. Nevertheless, controversies continue to arise in this field. Studies on possible biologically measurable changes in the brain have produced mixed results. The following review article provides a brief overview of the current state of this research area. The discussion addresses methodological difficulties, further open questions, hypotheses regarding the nature of the aggression-promoting effect, sociopolitical aspects, and possible conclusions.
Among mentally ill young people, the rate of nicotine consumptionremains high despite an overall decline in numbers. Within the group ofyoung people with mental illness the proportion is 38% and in a population receiving child and adolescent psychiatric care the proportion of consumers is as high as 63%. Thelegal ban on tobacco products for young people therefore presents staff in child andadolescent psychiatric institutions with the ongoing challenge ofenforcing rules and prohibitions, while at the same time perceivingperceive consumption as an addiction. In this paper we will discussthe specifics of the substance nicotine, current forms of consumption and epidemiology, but above all we will consider how to deal withnicotine consumption by underage patients in the often highly complex situations ofpsychiatric and acute psychiatric settings.
Unter psychisch kranken Jugendlichen ist die Rate nikotinkonsumierender Jugendlicher trotz insgesamt rückläufiger Zahlen nach wie hoch. So finden sich unter Jugendlichen mit einer psychischen Krankheit Anteile von 38
Treating delirium in adolescents with congenital long QT syndrome (LQTS) demands agents that do not aggravate ventricular repolarisation. A 15-year-old girl with genetically confirmed LQT1 and newly diagnosed acute lymphoblastic leukaemia developed hyperactive delirium in the paediatric intensive care unit after sepsis, abdominal surgery and prolonged sedation. Baseline manually calculated QTc in lead II was 533 ms (Bazett), 500 ms (Framingham), and 489 ms (Fridericia). Standard antipsychotics were avoided owing to torsadogenic risk. Low-dose aripiprazole (2 mg p.o. initially, up to 2 mg every 2 h as needed) was introduced, with twice-daily 12-lead ECGs. Agitation resolved within 48 h; QTc fluctuated between 460 and 490 ms (all three formulas) without ventricular arrhythmia. Serial serum aripiprazole levels were monitored for toxicity during intermittent dosing (cumulative dose 42 mg over 6 days). No extrapyramidal or haemodynamic adverse effects occurred, and aripiprazole was discontinued after a further 8 days. This case illustrates a structured approach to delirium in adolescent LQTS and supports aripiprazole as a pragmatic option when QT-prolonging antipsychotics are contraindicated.
BACKGROUND:The care and support of people with dementia (PwD) is predominantly provided by informal carers and support workers (iPuB). A high degree of preparedness for caregiving improves the care of PwD and reduces the burden of care. The development of support and information services to increase preparedness is one of the goals of the FFG-funded TeleCareHub project. METHODS:In this multicentre cross-sectional study, iPuB were examined using the following questionnaires: General Self-Efficacy Short Scale (ASKU-3), Affinity for Technology Interaction Scale (ATI-8), Zarit Burden Interview (ZBI-7), Loneliness Scale (UCLA-3), Patient Health Questionnaire (PHQ-9), Scale for the Quality of the Current Relationship in Caregiving (SQCRC-14) and the Preparedness for Caregiving Scale (PCS-8). Data analysis was performed using correlation, variance and linear regression analyses (including mediation and moderation models). RESULTS:This study analysed data from 308 iPuBs (76% female, PCS-8: 20.8 ± 6.4). Self-efficacy (ASKU-3) and relationship quality (SQCRC-14) correlated significantly positively with preparedness (PCS-8), whereas caregiver burden (ZBI-7), loneliness (UCLA-3) and depression (PHQ-9) correlated negatively with PCS‑8. In non-burdened iPuB (ZBI-7 < 11), but not in burdened iPuB, a low ZBI‑7 score and a short duration of care were predictive of high preparedness (β = -0.318; SE = 0.077; p < 0.001). Results from SQCRC-14, ASKU‑3 and PHQ‑9 showed significant modulating effects on the PCS‑8. CONCLUSION:The results highlight the influence of multiple personal factors of iPuB on the feeling of preparedness for caregiving. Interventions to strengthen self-efficacy and reduce depression in iPuB, who are not yet under significant stress, could improve preparedness.
Die Pflege und Betreuung von Menschen mit Demenz (MmD) wird überwiegend von informell Pflegenden und Betreuenden (iPuB) übernommen. Ein hohes Maß an Vorbereitet-sein („preparedness“) auf die Pflegetätigkeiten verbessert die Versorgung von MmD und vermindert die Pflegebelastung. Die Entwicklung von Unterstützungs- und Informationsangeboten, um die „preparedness“ zu steigern, ist ein wesentliches Ziel des vom FFG-geförderten Projekts TeleCareHub. In dieser multizentrischen Querschnittsuntersuchung wurden Daten von iPuB mit folgenden Fragebögen erhoben: Allgemeine Selbstwirksamkeits-Kurzskala (ASKU-3), Affinity for Technology Interaction Scale (ATI-8), Zarit Burden Interview (ZBI-7), Loneliness Scale (UCLA-3), Patient Health Questionnaire (PHQ-9), Scale for the Quality of the Current Relationship in Caregiving (SQCRC-14) und die Preparedness for Caregiving Scale (PCS-8). Die Datenanalyse erfolgte mittels Korrelationsanalysen, linearen Regressionsanalysen (einschließlich Mediations- und Moderationsmodellen) sowie Varianzanalysen. Es wurden Daten von 308 iPuB (76
Armed conflicts can engender substantial detrimental effects for mental health, both within immediate settings and for faraway populations. Guided by frameworks from geopsychiatry, this narrative review underlines the local- and macro-level psychiatric consequences of conflicts, informed by illustrative findings from academic sources and gray literature focusing on contemporary global disputes. Specifically, the review demonstrates that exposure to conflict is consistently associated with elevated rates of mental illnesses, which are worsened by devastated healthcare systems and related phenomena. Subsequently, it highlights how vulnerable populations often experience disproportionate mental health burdens in conflict, before exploring how secondary, distal psychiatric effects can arise from vicarious media exposure, forced displacement, and associated environmental degradation. With the most armed hostilities occurring since the end of World War Two, the paper concludes by considering how the psychiatric discipline can adapt to confront the modern challenges of diversifying patient populations in an increasingly turbulent geopolitical landscape.
Im Jahr 2017 wird im Schloss Pöllau eine außerordentliche Jahrestagung der ÖGKJP – die „Jubiläumstagung 10 Jahre Sonderfach Kinderund Jugendpsychiatrie (und Psychotherapeutische Medizin)“ stattfinden. Frau Primaria Purtscher-Penz, die vom 11. bis 13. Mai 2017 in Schloss Pöllau das nun schon „18. Kinderund Jugendpsychiatrische Symposium Pöllau“ veranstaltet, wird die Jubiläumstagung der ÖGKJP freundlicherweise beherbergen. Am 10. Mai 2017 wird in Pöllauberg ein AssistentInnentag stattfinden.
