Zusammenfassung Extended-Reality-Technologien (XR; Virtual, Augmented und Mixed Reality) eröffnen neue Möglichkeiten für Psychotherapie und psychosomatische Versorgung. Ziel dieser Arbeit ist es, aktuelle Anwendungen und die Evidenzlage zu XR in der Psychotherapie und Psychosomatik in einer Übersicht darzustellen. Es wurde ein narrativer Review konzeptueller Arbeiten sowie Studien zu konkreten Anwendungsbereichen und Akzeptanz von XR in der klinischen Versorgung durchgeführt. Betrachtet werden psychosomatisch relevante Anwendungsfelder im Rahmen der psychotherapeutischen Richtlinienverfahren, bei der Entwicklung innovativer störungsspezifischer Interventionen sowie in ergänzenden Verfahren wie Achtsamkeit, Entspannung oder künstlerischen Therapien. Konzeptuell können der stark kontrollierte Charakter von XR, die intensive Darbietung und die Möglichkeit von Perspektivwechseln auch in andere Personen für den Einsatz von XR sprechen. Für viele Interventionen aus Richtlinienverfahren existieren bereits XR-Varianten, wobei die virtuelle Exposition bisher am besten untersucht ist. Innovative Entwicklungen zielen vor allem auf Perspektivwechsel und Embodiment anderer Personen oder Varianten des Selbst ab. Darüber hinaus finden sich vielfältige Einsatzmöglichkeiten in Entspannungsverfahren, Achtsamkeit, Aufmerksamkeitslenkung und künstlerischen Therapien. Bei grundsätzlich offener Haltung der Therapeut*innen wurden jedoch einige praktische Hürden einer breiten Implementierung in die Versorgung identifiziert. XR ist ein ergänzendes Medium, das neue Erfahrungsräume eröffnet. Für die psychosomatische Versorgung bietet es Potenzial, erfordert jedoch eine enge Einbettung in therapeutische Gesamtkonzepte. Hürden bestehen in technischem und personellem Aufwand, Datenschutz sowie fehlender Kostenerstattung. XR bietet ein breites Anwendungspotenzial in der psychosomatischen Medizin, doch bedarf es weiterer klinischer Studien, standardisierter Konzepte und tragfähiger Versorgungsstrukturen, um dieses Potenzial in der Praxis nutzbar zu machen.

Objective:Extended reality (XR; virtual, augmented, and mixed reality) opens up new opportunities for psychotherapy and psychosomatic care. The aim of this review is to summarize current applications and the state of evidence regarding XR in psychotherapy and psychosomatic medicine. Methods:A narrative review of conceptual papers as well as clinical and feasibility studies on the use of XR was conducted, focusing on psychosomatically relevant fields of application. These include evidence-based psychotherapy approaches, the development of innovative disorder-specific interventions, and complementary approaches such as mindfulness, relaxation, or arts-based therapies. Results:Conceptually, the highly controlled nature of XR, its immersive presentation, and the possibility of perspective-taking (including embodiment of other persons or self-representations) support its potential use. XR variants already exist for many established therapeutic techniques, with virtual exposure therapy being the most extensively studied. Recent innovations emphasize perspective-taking and embodiment, while additional applications are found in relaxation, mindfulness, attention training, and arts-based therapies. While therapists generally express openness toward XR, several practical barriers to broad implementation have been identified. Discussion:XR constitutes a complementary medium that enables novel experiential dimensions. It holds significant potential for psychosomatic care but requires careful integration into therapeutic frameworks. Key challenges include technical and personnel demands, data protection, and the current lack of reimbursement structures. Conclusion:XR offers broad potential for psychosomatic medicine. To translate this promise into routine practice, further clinical studies, standardized implementation concepts, and sustainable service structures are needed.

e24069 Background: Current guidelines on palliative care in oncological patients recommend assessing physical, psychological, social, and spiritual needs as well as distress and information needs of patients and relatives. A validated tool frequently used for this purpose is the Edmonton Symptom Assessment Scale (ESAS). The MIDOS2 questionnaire is the validated German version of the ESAS. Though validated in cancer patients (pts) in general, the MIDOS2 has not yet been validated specifically in uro-oncological patients. Methods: Uro-oncological pts receiving systemic cancer therapy at a single academic center were enrolled in this prospective cross-sectional study. After consent, patients were screened with MIDOS2 as well as the Distress Thermometer (DT), G8 Questionnaire (G8), 6-Item Screener (SIS) and Mini Nutritional Assessment (MNA). Repeated screening was performed after 3 months (T3). Epidemiological and clinical data collected as well. Using the MIDOS2 cut-off of ≥8 points indicating need for palliative support, patients were grouped and DT, G8, 6IS and MNA results compared. MIDOS2 sum scores were additionally analyzed across tumor entities. Descriptive statistics, ANOVA, Mann–Whitney U, and Pearson/Spearman correlations were applied. Results: From 04/2025-01/2026, 133 patients were included (median age: 65 y, 119 male, 43 prostate cancer, 37 urothelial carcinoma, 24 renal cell carcinoma, 29 other). Comparing pts with low (0-7 points, n = 86) and high (³8 points n = 47) symptom burden values, DT (p = 0,002) MNA (p < 0,001) and G8 (p < 0,001) results were more frequently pathological in the high burden group. No significant correlation was found for the SIS. Symptom burden as assessed by MIDOS 2 was highest in weakness (mean 1,23) and lowest in vomit (mean 0,17). At data cut-off, 86/133 pts had assessments at T0 and T3 months (43/53 pts with T0 at any time of treatment, 43/80 pts with T0 before start of treatment). Comparing assessment at T3 to T0, 12 pts improved from the high to low symptom burden group, and 12 pts impaired regarding symptom burden, while 62 pts had no change. Comparing reassessment between pts tested at any time of treatment and tested before and after initiation of treatment, differences in improving and impairing rates were not observed. When analysing DT, MNA and G8 scores, improvement was more frequently observed. SIS remained unchanged. Conclusions: Uro-oncological pts often experience symptom burden detectable by MIDOS2, influenced by cancer type, treatment and patient-related factors. MIDOS2 total scores of 8 points or higher indicate further stress for the patient and should lead to the initiation of specialized palliative care. As symptom burden may vary during patient history, even within a limited time frame, repeat testing is reasonable.

Risk-adapted prostate cancer screening is urgently needed to reduce overdiagnosis and overtreatment in the general population while allowing intensified risk adapted early detection in high-risk individuals. Clear eligibility criteria for genetic testing, professional education, and structured early detection programs must be established.

Abstract Background As improvements in anti-cancer treatments have extended survival, patients with advanced cancer and their family caregivers face existential tension between engaging in life and coping with uncertainty about illness trajectory and the course of treatment. For a subgroup, this tension is associated with overwhelming fear and existential distress. Such adjustment difficulties may increase the risk of mental disorders, poor quality of life, and suicidality, and impair prognostic awareness and patient-clinician communication. Despite growing interest in open conversations about end-of-life issues, systematic evidence on effective psychotherapies to best support psychological adaptation in patients with high levels of existential distress is still scarce. We aim to evaluate the effectiveness of a short-term psychodynamic therapy (ORPHYS) to mitigate existential distress compared to usual psycho-oncological treatment (TAU). Methods We conduct a two-arm parallel randomized controlled trial with an active control group. ORPHYS is a manualized individual face-to-face psychotherapy focusing on emotional and relational conflicts specific to cancer patients’ illness situation. Treatment lasts between 5 and 11 months with 15 to 31 weekly sessions (50 min). TAU includes at least one individual session provided by physicians or psychologists with experience in psycho-oncological care. Patients will be assessed pre-intervention and 3, 6, 9, and 12 months after baseline. Target sample size is 160 randomized participants. We recruit patients with stage III/IV solid tumors or advanced hematological cancer and clinically significant existential distress from psycho-oncology clinics and referring oncologists at Hamburg, Düsseldorf, and Würzburg Comprehensive Cancer Centers, Germany. The primary outcome is demoralization (Demoralization Scale-II). Secondary outcomes include diagnoses of affective, anxiety and stress-related disorders, death anxiety, dignity-related distress, and quality of life. Outcome assessments are conducted via self-report questionnaires and diagnostic interviews. Linear mixed models examine outcome differences between trial arms. A confirmatory test of the group contrast at 6-month follow-up after baseline is conducted. Discussion Due to an aging population and prolonged survival, there is a growing demand to help patients deal with existential challenges undergoing palliative cancer care. The study will contribute to knowledge about how clinicians can best help patients with advanced cancer who substantially struggle with uncertainty at the end of life. Trial registration German Clinical Trials Registry, DRKS00038173. Registered October 20th, 2025, https://drks.de/search/en/trial/DRKS00038173 . ClinicalTrials.gov, NCT07312760. Registered December 30, 2025, https://clinicaltrials.gov/study/NCT07312760 .

OBJECTIVE:Men with a family history of prostate cancer (PCa) or a pathogenic germline variant (PGV) face increased PCa risk. However, structured PCa early detection and insights into the experiences of affected men remain limited. This qualitative analysis explored (i) why men with familial or genetic PCa risk attended a risk-adapted prevention clinic, (ii) which elements they found helpful, and (iii) how early detection services could be tailored to their needs. METHODS:This study was part of the psychosocial mixed-methods study ProFam-Psych, run alongside the ProFam-Risk prevention clinic. Semi-structured interviews were conducted in a subgroup (13/86 study participants). The clinic offered PSA testing, mpMRI, genetic counselling and panel testing followed by risk-adapted recommendations. Participants were men without PCa who had a family history or previously detected PGV, and men with PCa who had a family history. Participants were selected using maximum variation sampling. Data were analysed by two researchers using Kuckartz's qualitative content analysis. RESULTS:Seven motivators were identified: (1) clarify risk/PGV status, (2) information needs, (3) benefits for the family, (4) support others, (5) external recommendation, (6) access to structured screening, and (7) preventive recommendations. Participants with a family history were primarily motivated by (1) and (3), men with PGVs by (5) and (6), with (6) and (7) unique to this group. Perceptions of elements most helpful to participants varied, but the integrated setting with time for questions, clear guidance, and a reliable point of contact was valued. Suggested improvements were mostly organisational, including reminder systems to support long-term adherence. CONCLUSION:Interdisciplinary early detection for PCa was accepted by participants, with motivators such as screening access and information needs highlighting the need for the implementation of structured screening programs for high-risk men. PRACTICE IMPLICATIONS:Results may inform future outreach efforts and design of screening strategies for familial and genetic PCa risk. TRIAL AND PROTOCOL REGISTRATION:DRKS.de, DRKS00032350. Prospectively registered with the German Clinical Trials Register (DRKS) on 14 September, 2023 SELECTED HEADING: Patient and User Perspectives and Characteristics.

Introduction Fear of Cancer Recurrence (FCR) is a prevalent and distressing issue for a significant proportion of cancer patients across various disciplines, yet it remains one of the most frequently unaddressed psychosocial needs. A key barrier to identifying affected individuals is the lack of brief screening tools suitable for clinical settings. The objective of this research is to validate the one-item FCR screening tool (FCR-1r) in a German cohort of urologic cancer patients. Validating such an ultra-brief measure may help address this clinically relevant gap and serve as a viable, clinically applicable alternative to lengthy questionnaires. Methods Statistical analyses were conducted using R software. Criterion validity was assessed against the CARQ-4. Convergent validity was tested against the FoP-Q-SF and GAD-7. Discriminant validity was tested against the HLS-EU-Q16. Validity was assessed using chi-square tests with phi coefficients, accuracy measures, negative and positive predictive values, sensitivity, specificity and odds ratios. Results The final analysis sample consisted of 236 participants with complete data on all study measures. The FCR-1r demonstrated excellent criterion validity with respect to the CARQ-4 (χ²(1) = 101.97, p < 0.001, φ = 0.66), with an overall accuracy of 84% (95% CI: 79-89%). Sensitivity was 84%, and specificity was 85%. The analysis of convergent validity revealed a moderate association with both the FoP-Q-SF (χ²(1) = 20.25, p < 0.001, φ = 0.29; accuracy 62% (95% CI: 56-68%)) and the Generalised Anxiety Disorder-7 (GAD-7) (χ²(1) = 11.82, p < 0.001, φ = 0.22; accuracy 64% (95% CI: 58-70%)). The analysis of discriminant validity showed no significant association between the FCR-1r and health literacy (HLS-EU-Q16): χ²(1) = 3.44, p = 0.064, φ = 0.12. Conclusion The German version of the FCR-1r demonstrates good psychometric properties, confirming its validity as a tool for assessing fear of cancer recurrence in clinical practice.

Migration remains a risk factor for unequal treatment in the healthcare system. Communication plays a key role in bridging linguistic and sociocultural differences, particularly in medically complex and ethically demanding fields such as paediatric oncology. We aim to improve the quality of intercultural conversations between paediatric patients with life-threatening diseases, their parents, and physicians. This is a monocentric, single-blind, cluster randomised interventional feasibility trial which analysed intercultural conversations to develop a skills training programme in migrant-sensitive communication for paediatric oncologists using an interventional approach. Initially, 16 conversations were observed in a non-participatory, open external observation in order to develop an observation-and interview catalogue. 10 additional observations followed by 20 interviews (10 patient families and 10 paediatric oncologists) were conducted. Based on the findings of this qualitative analysis, a literature review, and an advisory board workshop, a multimodal skills training programme in migrant-sensitive communication was developed and conducted. The observations and interview analysis identified the need for training in communication, cultural competence, and interpreter-assisted conversations. The subsequently developed skills training consisted of three modules on cultural competence, ethical issues, and interpreter-assisted conversations. The practical training included conversation simulations using three scripted patient scenarios. Conclusion: Even experienced paediatric oncologists identified a need to establish ongoing training in communication in an intercultural, family-centered setting and benefited from the multimodal training.

Introduction: Parental cancer affects the whole family and can have negative impact on family as a system as well as on single family members. This multicentre, prospective, interventional and non‐randomized family‐SCOUT study aimed to implement a comprehensive psychosocial intervention to provide support for the family during and after the disease. The purpose of this study is to analyse the contextual factors that impact the subjective perceived effectiveness of family‐scout support for families affected by parental cancer from the healthy parents’ perspective. Methods: Semi‐structured interviews with the healthy parent as a surrogate of family‐SCOUT families from the intervention group were conducted. All interviews were audio‐recorded, transcribed and analysed using template analysis. Results: Within two years, 23 interviews were conducted. Four themes were identified, highlighting contextual factors that indicate successful support for families: Ability to meet the support needs of families; cancer as a family disease—burdens in the context of the family system; coping strategies—how the individual family members deal with the situation and communication within the family. Conclusion: Family‐scouts can provide beneficial support to families affected by parental cancer, but individual time of the families, communication and stress factors need to be taken into consideration. Trial Registration: ​ Familien‐SCOUT: NCT04186923

Psychologische Interventionen während einer Chemotherapie können Patient*innen mit einer Krebserkrankung unterstützen und dazu beitragen, das subjektive Belastungserleben zu reduzieren. Die Nutzung von Virtueller Realität (VR) kann deren Wirksamkeit steigern. Ziel der vorliegenden Studie war die Evaluation von Machbarkeit und Akzeptanz einer VR-basierten Achtsamkeitsintervention während ambulanter Chemotherapie. In einer monozentrischen, dreiarmig randomisiert-kontrollierten Studie wurden in der ambulanten Chemotherapie-Einheit eines Onkologischen Zentrums Patient*innen mit Krebserkrankungen in eine von drei Gruppen randomisiert: (a) VR-Achtsamkeitsintervention, (b) rezeptive Musikintervention, (c) Kontrollgruppe. Die Interventionen wurden während zweier konsekutiver Chemotherapie-Applikationen durchgeführt. Zur Machbarkeit wurden Informationen zum Screening vor der Rekrutierung und während der Intervention durch eine teilnehmende Beobachtung standardisiert erhoben; die Akzeptanz wurde mittels eines Fragebogens nach der Intervention erfasst. Die Daten wurden deskriptiv analysiert. Von 3.072 angesprochenen Patient*innen erfüllten 1.590 formal die Einschlusskriterien. Es wurden N=85 Personen eingeschlossen (Teilnahmequote 5,4%). Häufige Gründe für Nichtteilnahme waren das Tragen einer Kühlkappe, Sprachbarrieren, fehlendes Interesse und das Vorhandensein eigener Bewältigungsstrategien. Die Durchführung beider Interventionen war grundsätzlich machbar; Störungen während der Interventionen waren häufig. Die VR-Achtsamkeit war mit hohem personellem Aufwand verbunden. Bei insgesamt positiver Bewertung durch die Teilnehmenden zeigte sich keine höhere Akzeptanz für die VR-Achtsamkeitsintervention im Vergleich zur Musikintervention. Der hohe Anteil nicht teilnehmender Patient*innen kann ein Hinweis sein, dass eine aktive VR-Achtsamkeitsintervention während der Infusion einer Chemotherapie für Patient*innen nicht bedarfsgerecht ist und als potenziell überfordernd erlebt wird. Der antizipierte Nutzen der VR-Achtsamkeitsintervention könnte zu einem anderen Zeitpunkt während der aktiven Therapie (zu Hause, zwischen den Sitzungen) oder zu einem späteren Zeitpunkt nach Ende der Therapie (Survivorship) möglicherweise besser zur Entfaltung kommen. Für unmittelbare Entlastung während einer Chemotherapie erscheint die Musikintervention als eine niederschwellig umsetzbare Möglichkeit. Die Integration digitaler psychologischer Interventionen in onkologische Routineversorgungspfade bedarf der stärkeren Beachtung der spezifischen Bedürfnisse der Patient*innen sowie der situativen und organisationsbezogenen Kontexte.

Introduction Patients undergoing chemotherapy often experience side effects during treatment, including psychological distress and symptoms of anxiety and depression. Interventions during chemotherapy that divert attention from potentially aversive environmental factors have been demonstrated to have a beneficial impact on these symptoms. Virtual reality (VR) offers the potential to visually and audibly disengage from the surrounding environment and can create an alternative sense of presence. This could facilitate the implementation of active guided interventions that may prove more effective than receptive interventions, such as listening to music. The present study examines the feasibility, acceptance and effectiveness of a VR intervention and a music intervention during chemotherapy.Methods The single-centre three-arm, randomised-controlled trial investigates the efficacy of a VR mindfulness intervention and a music intervention in patients with cancer undergoing chemotherapy at the University Hospital Düsseldorf, Germany. Patients were randomly assigned to receive either (a) the VR mindfulness intervention, (b) the receptive music intervention or (c) the standard care (control group) in two consecutive chemotherapy sessions. A comprehensive psychological assessment and self-ratings using visual analogue scales will be conducted with situational anxiety as the primary outcome measure. Additionally, secondary measures will be employed to assess cancer-related anxiety, self-efficacy and chemotherapy-related side effects. Furthermore, salivary cortisol, heart rate and blood pressure will be recorded. At the end of the study, an evaluation questionnaire will be completed. It is planned to enrol 82 patients.Ethics and dissemination The study has been approved by the ethics committee of the medical faculty of the Heinrich-Heine-University Düsseldorf (2022-1880). Written informed consent is obtained from the patients prior to participation. The results will be published in international scientific, peer-reviewed journals. Conference presentations are also planned.Trial registration number German Clinical Trials Register (DRKS00029738).

Extended Reality (XR) umfasst verschiedene immersive Technologien, die die Wahrnehmung mit virtuellen Elementen erweitern. Die bisherige Forschung hat sich insbesondere auf die mit Virtual Reality unterstützte Expositionstherapie fokussiert, aktuell gibt es jedoch dynamische Entwicklungen sowohl inhaltlicher als auch struktureller Art. Diese narrative Übersichtsarbeit beschreibt von Mitgliedern des Netzwerks „Extended Reality für die Psychotherapie“ genannte inhaltliche und technische sowie strukturelle Entwicklungen in der Erforschung von XR-Anwendungen für die Psychotherapie. Genannt wurden der Einsatz von Mixed-Reality-Technologien und künstlicher Intelligenz und die Entwicklung und Erprobung kreativer therapeutischer Konzepte jenseits des klassischen Expositionsparadigmas. Außerdem werden als strukturelle Entwicklungen die Etablierung standardisierter Prozesse, die Professionalisierung der Entwicklung, Barrieren bei der Implementierung in die Versorgungspraxis und regulatorische Aspekte skizziert. Die befragten Expert:innen weisen auf technische Weiterentwicklungen und innovative Konzepte hin, die in der aktuellen Psychotherapie so nicht umsetzbar wären. Angesichts der komplexen Technologie, die gleichzeitig multiplen regulatorischen Anforderungen entsprechen muss, bedarf es breit angelegter interdisziplinärer Forschung.

Single motherhood is associated with increased psychosocial risks, affecting both mothers and their minor children. However, little is known about the specific psychosocial impact of maternal cancer in single mothers (SMs). This study compared psychological burden, quality of life, specific problems, and parental concerns between SMs and partnered mothers (PMs) affected by cancer and caring for minor children. Cross-sectional analysis of baseline data from a multicenter, non-randomized, controlled trial in Germany (Family-SCOUT). SMs and PMs affected by cancer were assessed for psychological burden (anxiety, depression, distress), quality of life, practical, family, emotional, spiritual/religious, and physical problems and parental concerns. A total of 54 SMs and 245 PMs were included. SMs reported more practical problems (p = 0.008, d = 0.44) and parental concerns than PMs (p = 0.011, d = 0.40). After controlling for demographic and clinical group differences, practical problems (p = 0.009, OR = 1.53) and parental concerns (p = 0.015, OR = 1.73) remained significantly associated with single motherhood. SMs and PMs did not differ in anxiety, depression, distress or quality of life. Overall, a large proportion of mothers reported clinically relevant elevated levels of anxiety (71.9