Objective To examine the prescribing sequence of anti-dementia drugs and antipsychotics after initial dementia diagnosis in general and specialist practices in Germany. Methods Retrospective cohort study using the IQVIA Disease Analyzer database (1,179 general, 214 specialist practices; 2005-2024). Patients aged >= 65 years with an initial dementia diagnosis,>= 1 year of observation and no prior prescription were included (general: n=94,036; specialist: n=55,341). Results In general practices, 54.2% received neither drug class, 27.3% antipsychotics only, 8.7% anti-dementia drugs only. In specialist practices, the untreated proportion was lower (22.2%); anti-dementia treatment was initiated first more often (16.0% vs. 5.6%). Conclusion Specialist practices more often initiate guideline-concordant anti-dementia treatment first; general practices show more exclusive antipsychotic prescribing and treatment forgoing.
Objective Chronically multiply dependent individuals (CMD) have increased morbidity and mortality. Data on the use of preventive services are lacking. This pilot study assesses health perception, health behaviour, risk perception, motivation for preventive care, and social support. Methods Standardized questionnaire-based interviews were conducted with 78 CMD in a long-term sociotherapeutic facility. In addition to the above parameters, also sociodemographic variables were analysed descriptively. Results Despite positive attitudes, participation rates in preventive examinations were low. Participants often rated their own health too positively and underestimated their risks. Health care utilization was predominantly reactive. Conclusion There is a discrepancy between attitudes, perceived need, and behaviour. Structural support, repeated communication about prevention services, and low-threshold assistance appear necessary to reduce health inequalities.
Zusammenfassung Untersucht wurden Unterschiede zwischen Patienten mit und ohne vorbeschriebene psychotische Symptomatik (vpS) in der Unterbringung gemäß § 64 StGB hinsichtlich klinischer, funktioneller, kognitiver und suchtbezogener Merkmale sowie Veränderungen ihres Anteils zwischen 2021 und 2025. Analysiert wurden Daten von 292 Patienten (259 ohne vpS, 33 mit vpS). Der Anteil von Patienten mit vpS nahm signifikant zu (OR=1,65; p<0,001). Sie wiesen ein niedrigeres Funktionsniveau (35,24 vs. 44,37; p<0,001) und weniger Haftmonate auf (29,8 vs. 49,4; p=0,003). Zudem bestanden Unterschiede hinsichtlich Substanzkonsumstörung und Schuldfähigkeit, nicht jedoch bei kognitiver Leistungsfähigkeit und sozialen Kompetenzen. Die Ergebnisse deuten darauf hin, dass Patienten mit vpS im Maßregelvollzug gemäß § 64 StGB besondere funktionelle Beeinträchtigungen aufweisen, aus denen spezifische diagnostische und therapeutische Anforderungen resultieren.
Objective:Given the societal importance of education (in the sense of the German term 'Bildung') this paper explores how education is associated with mental disorders. Methods:Conceptual literature review. Results:Three aspects were identified: Mental disorders can predict poorer education levels. At the lower end of education levels relatively better education is linked with fewer mental disorders, whilst the opposite might possibly apply in people with high education levels. Attempts to support the rehabilitation of people with mental illnesses through more education have so far been without clear evidence for effectiveness. Conclusion:Prevention policies should be targeted on improving education for disadvantaged groups. In research and practice, aspects of education should be considered more specifically to foster the acquisition of specific skills that may facilitate establishing self-confidence and helpful social relationships.
Background:In Germany, people with dementia are mainly treated as outpatients by general practitioners and neuropsychiatric specialists; besides antidementia drugs, antipsychotics, antidepressants and benzodiazepines/Z-drugs are mainly used for behavioural and psychological symptoms of dementia (BPSD). Methods:In a retrospective trend analysis of the IQVIA Disease Analyzer database, dementia patients from 389 general and 77 specialist practices (2016-2025) were included. The annual proportion with≥1 prescription per drug class was determined. Results:Antidementia prescribing rose from 14.7% to 17.3% among GPs and fell from 49.6% to 40.9% among specialists. Antipsychotics increased in both sectors, antidepressants remained stable, and benzodiazepines/Z-drugs declined. Conclusions:Persistent sector-specific differences were observed. The rising use of antipsychotics despite known risks highlights the importance of BPSD and regular benefit-risk assessment.
